Effects of extracts of Salvadora persica on proliferation and viability of human dental pulp stem cells

Zinc oxide nanoparticles functionalized with cinnamic acid for targeting dental pathogens receptor and modulating apoptotic genes in human oral epidermal carcinoma KB cells

BACKGROUND

Oral diseases are often attributed to dental pathogens such as S. aureus, S. mutans, E. faecalis, and C. albicans. In this research work, a novel approach was employed to combat these pathogens by preparing zinc oxide nanoparticles (ZnO NPs) capped with cinnamic acid (CA) plant compounds.

METHODS

The synthesized ZnO-CA NPs were characterized using SEM, FTIR, and XRD to validate their composition and structural features. The antioxidant activity of ZnO-CA NPs was confirmed using DPPH and ABTS free radical scavenging assays. The antimicrobial effects of ZnO-CA NPs were validated using a zone of inhibition assay against dental pathogens. Autodock tool was used to identify the interaction of cinnamic acid with dental pathogen receptors.

RESULTS

ZnO-CA NPs exhibited potent antioxidant activity in both DPPH and ABTS assays, suggesting their potential as powerful antioxidants. The minimal inhibitory concentration of ZnO-CA NPs against dental pathogens was found 25 µg/mL, indicating their effective antimicrobial properties. Further, ZnO-CA NPs showed better binding affinity and amino acid interaction with dental pathogen receptors. Also, the ZnO-CA NPs exhibited dose-dependent (5 µg/mL, 15 µg/mL, 25 µg/mL, and 50 µg/mL) anticancer activity against Human Oral Epidermal Carcinoma KB cells. The mechanism of action of apoptotic activity of ZnO-CA NPs on the KB cells was identified through the upregulation of BCL-2, BAX, and P53 genes.

CONCLUSIONS

This research establishes the potential utility of ZnO-CA NPs as a promising candidate for dental applications. The potent antioxidant, anticancer, and effective antimicrobial properties of ZnO-CA NPs make them a valuable option for combating dental pathogens.

Effect of Motiflor AS probiotic for oral health on cell viability in human gingival fibroblasts and human dental pulp stem cells

Objectives

In this study, it was aimed to investigate the possible effects of oral chewable probiotic tablets (PTs) produced to directly support the oral flora on the proliferation of human dental pulp stem cells (DPSCs) and human gingival fibroblast cells (HGFCs).

Materials and Methods

For analysis in this study, "Motiflor AS," a PT that dissolves in the mouth, containing 13.5mg Lactobacillus helveticus Rosell-52, L. rhamnosus Rosell-11, L. halivarus HA-118, and Bifidobacterium longum Rosell-175 was used. Cell survival and proliferation were analyzed by methyl-thiazole-diphenyl-tetrazolium (MTT) test and real-time cell analysis method (xCELLigence RTCA-DP) after 24-, 48-, and 72-h incubation periods.

Results

According to the data obtained with RTCA-DP software, there was a significant increase in the proliferation of human dental pulp stem cells (HDPSCs) and HGFCs in the 72-h incubation after PT application compared to the 24-h and 48-h incubations (P < 0.0001). After the MTT test, for HDPSCs, the cell proliferation rate was 62.8% and 85.6% in 24- and 48-h incubation, respectively, while HDPSCs cell proliferation rate in 72-h incubation was 135.2% (P < 0.0001). For HGFCs, the cell proliferation rate was 73% and 120.4% in 24- and 48-h incubation, respectively, while HDPSCs cell proliferation rate in 72-h incubation was 139.8% (P < 0.0001). When the results of the two tests applied were evaluated together, the results showed compatibility.

Conclusions

Based on the results, it has been concluded that PT will be useful for maintaining oral health and for dental and gingival patients who will/have undergone dental treatment. It should be keep in mind that protecting our oral and dental health is very important in terms of protecting our general health.

Effects of MRI on stemness properties of Wharton's jelly-derived mesenchymal stem cells

Mesenchymal stem cells (MSCs), derived from various tissues, are served as a promising source of cells in clinic and regenerative medicine. Umbilical cord-Wharton's jelly (WJ-MSCs)-derived MSCs exhibit advantages over those from adult tissues, such as no ethical concerns, shorter population doubling time, broad differentiation potential, readily available non-invasive source, prolonged maintenance of stemness properties. The aim of this study was to evaluate the effect of MRI (1.5 T, 10 min) on stemness gene expression patterns (OCT-4, SOX-2, NANOG) of WJ-MSCs. Additionally, we assessed cell viability, growth kinetics and apoptosis of WJ-MSCs after MRI treatment. The quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) data showed that transcript levels of SOX-2, NANOG in MRI-treated WJ-MSCs were increased 32- and 213-fold, respectively. MTT assay was performed at 24, 48, and 72 h post-treatment and the viability was not significantly different between the two groups. The doubling time of the MRI group was markedly higher than the control group. In addition, the colony formation ability of WJ-MSCs after MRI treatment significantly increased. Furthermore, no change in apoptosis was seen before or after MRI treatment. Our results suggest that the use of MRI can improve the quality of MSCs and enhance the efficacy of mesenchymal stem cell-based therapies.

Green Alternatives as Antimicrobial Agents in Mitigating Periodontal Diseases: A Narrative Review

Periodontal diseases and dental caries are the most common infectious oral diseases impacting oral health globally. Oral cavity health is crucial for enhancing life quality since it serves as the entranceway to general health. The oral microbiome and oral infectious diseases are strongly correlated. Gram-negative anaerobic bacteria have been associated with periodontal diseases. Due to the shortcomings of several antimicrobial medications frequently applied in dentistry, the lack of resources in developing countries, the prevalence of oral inflammatory conditions, and the rise in bacterial antibiotic resistance, there is a need for reliable, efficient, and affordable alternative solutions for the prevention and treatment of periodontal diseases. Several accessible chemical agents can alter the oral microbiota, although these substances also have unfavorable symptoms such as vomiting, diarrhea, and tooth discoloration. Natural phytochemicals generated from plants that have historically been used as medicines are categorized as prospective alternatives due to the ongoing quest for substitute products. This review concentrated on phytochemicals or herbal extracts that impact periodontal diseases by decreasing the formation of dental biofilms and plaques, preventing the proliferation of oral pathogens, and inhibiting bacterial adhesion to surfaces. Investigations examining the effectiveness and safety of plant-based medicines have also been presented, including those conducted over the past decade.

Salvadora persica’s Biological Properties and Applications in Different Dental Specialties: A Narrative Review

Salvadora persica is a tree that belongs to the salvadorecea family. It is also known as Miswak, which is a popular natural toothbrush that was used centuries ago in oral hygiene by Muslims in all parts of the world, especially in the Middle East. Numerous researchers highlighted the biological activity of this plant in medicine, dentistry, and pharmacology. The purpose of this article is to narratively review the biological properties of Salvadora persica. In addition, it expresses variant applications of this herb in different dental specialties. Materials and Methods. The search of the literature was based on PubMed, MEDLINE, and Google Scholar using keywords: Salvadora persica, S. persica, Miswak, Dentistry, and Dental. All relevant articles were reviewed to check if they would fit within the scope of this review, and then, the information was extracted. Results. Multiple biological effects of S. persica have been reported including antibacterial, antiviral, antifungal, antibiofilm, antioxidant, and even antiulcer effects. Dental effects were discussed and presented. Conclusion. The wide biological range of Salvadora persica's effects is promising for dental and nondental fields and allows for an expanded clinical application that has otherwise not been discussed in the literature.

Biocompatibility and Antibacterial Action of Salvadora persica Extract as Intracanal Medication (In Vitro and Ex Vivo Experiment)

This study aimed to test the biocompatibility and antibacterial properties of Salvadora persica (S. persica) extract, a natural product, as an intracanal medication in comparison with calcium hydroxide (Metapaste, META BIOMED, Cheongju, Korea). The pH values of both materials were tested. The biocompatibility of S. persica extract and Metapaste was determined using light microscopy and MTT assays. The antibacterial action was tested using the zone of bacterial inhibition on four common bacterial species. In addition, intracanal medication was administered using 68 extracted single-rooted teeth contaminated with Enterococcus faecalis (E. faecalis), and the percentage reduction in colony count (% RCC) at 1, 3, and 7 days was measured. The extension of activity for both materials was assessed using histological sections and scanning electron microscopy. S. persica was found to be acidic in nature. Both materials showed significantly lower cell viability than the positive control cells on days 1 and 3 but not on day 7. S. persica showed better antibacterial effects against E. faecalis and S. mutans. S. persica extract showed 97.6%, 98.9%, and 99.3% RCC values at 1, 3, and 7 days, respectively, which are comparable to those of Metapaste. S. persica herbal extract is a promising material that can be utilized as an intracanal medication, but its use requires further research.

Salvadora persica: Nature's Gift for Periodontal Health

Salvadora persica (SP) extract, displays very valuable biotherapeutic capacities such as antimicrobial, antioxidant, antiparasitic and anti-inflammatory effects. Numerous investigations have studied the pharmacologic actions of SP in oral disease therapies but its promising outcomes in periodontal health and treatment are not yet entirely described. The current study has been planned to analyze the reported effects of SP as a support to periodontal therapy to indorse regeneration and healing. In consort with clinical trials, in vitro investigations show the advantageous outcomes of SP adjunctive to periodontal treatment. Yet, comprehensive supplementary preclinical and clinical investigations at molecular and cellular levels are indispensable to reveal the exact therapeutic mechanisms of SP and its elements for periodontal health and therapy.

The Hydroalcoholic Extract of Uncaria tomentosa (Cat's Claw) Inhibits the Infection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) In Vitro

The coronavirus disease 2019 (COVID-19) has become a serious problem for public health since it was identified in the province of Wuhan (China) and spread around the world producing high mortality rates and economic losses. Nowadays, the WHO recognizes traditional, complementary, and alternative medicine for treating COVID-19 symptoms. Therefore, we investigated the antiviral potential of the hydroalcoholic extract of Uncaria tomentosa stem bark from Peru against SARS-CoV-2 in vitro. The antiviral activity of U. tomentosa against SARS-CoV-2 in vitro was assessed in Vero E6 cells using cytopathic effect (CPE) and plaque reduction assay. After 48 h of treatment, U. tomentosa showed an inhibition of 92.7% of SARS-CoV-2 at 25.0 μg/mL (p < 0.0001) by plaque reduction assay on Vero E6 cells. In addition, U. tomentosa induced a reduction of 98.6% (p=0.02) and 92.7% (p=0.03) in the CPE caused by SARS-CoV-2 on Vero E6 cells at 25 μg/mL and 12.5 μg/mL, respectively. The EC50 calculated for the U. tomentosa extract by plaque reduction assay was 6.6 μg/mL (4.89–8.85 μg/mL) for a selectivity index of 4.1. The EC50 calculated for the U. tomentosa extract by TCID50 assay was 2.57 μg/mL (1.05–3.75 μg/mL) for a selectivity index of 10.54. These results showed that U. tomentosa, known as cat's claw, has an antiviral effect against SARS-CoV-2, which was observed as a reduction in the viral titer and CPE after 48 h of treatment on Vero E6 cells. Therefore, we hypothesized that U. tomentosa stem bark could be promising in the development of new therapeutic strategies against SARS-CoV-2.

Enhancement of aqueous solubility and antibiofilm activity of 4-allylpyrocatechol by polymeric micelles

4-Allylpyrocatechol (APC), a major active compound of Piper betle, possesses strong antimicrobial activity. However, the water-insoluble property of APC limits its clinical and pharmaceutical use. To solve this problem, APC loaded polymeric micelles (PMAC) was fabricated using the thin-film hydration method. Nanoparticles of PMAC were characterized using a photon correlation spectrophotometer and transmission electron microscope (TEM). Antibiofilm activity of PMAC was investigated using crystal violet assay and confocal laser scanning microscopy (CLSM). Cytotoxic effects of PMAC on normal cells were investigated using MTT assay. The results demonstrate that a ratio of APC to the polymer plays an important role in the physicochemical characteristics of PMAC. The most suitable PMAC formulation having a small particle size (38.8 ± 1.4 nm), narrow size distribution (0.28 ± 0.10), a high negative zeta potential (- 16.43 ± 0.55 mV), and high entrapment efficiency (86.33 ± 14.27%) can be obtained from the ratio 1:4. The water solubility of this PMAC is significantly improved, approximately 1,000-fold higher than the unentrapped APC. TEM images demonstrate that PMAC is spherical in shape. The inhibitory effects of PMAC (1.5 mg APC/mL) against Streptococcus intermedius and Streptococcus mutans biofilms are significantly stronger than chlorhexidine (0.06 mg/mL). Images from CLSM demonstrate the destruction and thickness reduction of the pathogenic biofilms after contacting with PMAC. The MTT assay confirms that PMAC at this concentration is non-toxic to normal cells. These results obviously indicate that PMAC is a promising natural and harmless antimicrobial agent suitable for use in the oral cavity for inhibition of pathogenic bacterial biofilms.

Development of Self-Nanoemulsifying Drug Delivery Systems Containing 4-Allylpyrocatechol for Treatment of Oral Infections Caused by Candida albicans

Clinical use of 4-Allylpyrocatechol (APC), a potential antifungal agent from Piper betle, is limited because of its low water solubility. The current study explores the development of the self-nanoemulsifying drug delivery system (SNEDDS) containing APC (APC-SNEDDS) to enhance APC solubility. Results demonstrated that excipient type and concentration played an important role in the solubility of APC in the obtained SNEEDS. SNEDDS, comprising 20% Miglyol 812N, 30% Maisine 35-1, 40% Kolliphor RH40, and 10% absolute ethanol, provided the highest loading capacity and significantly increased water solubility of APC. Oil-in-water nanoemulsions (NE) with droplet sizes of less than 40 nm and a narrow size distribution were obtained after dispersing this APC-SNEDDS in water. The droplets had a negative zeta potential between -10 and -20 mV. The release kinetics of APC from APC-SNEDDS followed the Higuchi model. The NE containing 1.6 mg APC/mL had effective activity against Candida albicans with dose-dependent killing kinetics and was nontoxic to normal cells. The antifungal potential was similar to that of 1 mg nystatin/mL. These findings suggest that APC-SNEDDS are a useful system to enhance the apparent water solubility of APC and are a promising system for clinical treatment of oral infection caused by C. albicans.

2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside-stimulated dental pulp stem cells-derived conditioned medium enhances cell activity and anti-inflammation

Background/purpose

Dental pulp stem cells (DPSCs) contribute to the regeneration of various tissues and have superior proliferation, immune privilege, and anti-inflammation properties to other mesenchymal stem cells. 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside (THSG) not only enhances the aforementioned properties of DPSCs but also promotes self-renewal and reprogramming-like ability. However, whether THSG enhances the aforementioned properties and abilities through direct or indirect interaction mechanisms remains unclear. To address this knowledge gap, we examined the effects of THSG-stimulated DPSC-derived conditioned medium (THSG-CM) on the activity and anti-inflammation properties of cells.

Materials and methods

DPSCs were treated with various concentrations of THSG to produce THSG-CM, which was then collected, analyzed, and lyophilized. A cytokine profiling antibody assay was used to compare protein components between THSG-treated and nontreated CM. Human skin fibroblasts (HSFs) and human gingival fibroblasts (HGFs) were used to investigate the effect of THSG-CM on cell proliferation, anti-inflammation, and wound healing abilities; for this investigation, MTS assay, quantitative real-time PCR analysis, and 2-well silicone inserts wound model were conducted.

Results

We observed that THSG enhanced the secretion of growth- and immune-associated proteins in THSG-CM and increased the proliferation of HSFs and HGFs. Furthermore, THSG-CM significantly attenuated lipopolysaccharide-stimulated mRNA levels of cytokines in both cells and improved wound healing abilities.

Conclusion

We conclude that THSG-CM had more beneficial effects on cell activity and anti-inflammation in the HSFs and HGFs than DPSC-derived CM. DPSC-derived CM can be developed into a cell-free regenerative strategy in the future, and its therapeutic efficacy may be improved by THSG-CM.

Antifungal activity of Punicalagin-nystatin combinations against Candida albicans

OBJECTIVES

Oral candidiasis is the most common opportunistic fungal infection of oral mucosa and results from an overgrowth of Candida, especially Candida albicans. The potential anti-C. albicans and cytotoxicity of punicalagin (PCG), isolated from Punica granatum, alone or with nystatin (NYS) were evaluated.

METHODS

Activity of compounds alone or in combinations was determined against two C. albicans strains (ATCC 90028 and SC5314). Minimal inhibitory concentration (MIC)-50 and Minimum Fungicidal Concentration (MFC) were assessed by XTT assay and CFU counts, respectively. For combinations, determination of fractional inhibitory concentration index was performed. Ergosterol pathway was investigated as a possible PCG antifungal mechanism. Cytotoxicity assays were undertaken on human primary oral keratinocytes and gingival fibroblasts incubated with antifungal concentrations of PCG and/or NYS for 24 hr.

RESULTS

Combination of NYS and PCG increased antifungal efficacy, compared with compounds tested alone. Combinations 4 (PCG-6.25 μg/ml; NYS-3.9 μg/ml) and 5 (PCG-12.5 μg/ml; NYS-1.95 μg/ml) were more effective since they reduced the MIC-50 of PCG (50 μg/ml) by 8 and 4 times, respectively, increased the candidal inhibition and nullified the PCG cytotoxicity for keratinocytes. PCG antifungal mechanism did not involve ergosterol biosynthesis pathway.

CONCLUSIONS

The favorable outcomes for combination of PCG and NYS encourage further testing this therapeutic strategy against C. albicans.

Miswak and oral health: An evidence-based review

Poor oral health has been associated with several chronic and systemic disease. Currently, the most common method of teeth cleaning is the use of a toothbrush together with dentifrices. However, natural chewing stick such as S. persica miswak is still used in many developing countries due to their low cost and availability. The present review aims to summarize the evidences on effectiveness of miswak in promoting oral health. The search was performed using Medline via Ebscohost, Scopus and Google Scholar database to obtain relevant articles published between 2010 to May 2020 using the following set of keywords 1) Miswak OR Salvadora OR persica AND 2) dental OR caries OR plaque OR oral OR orthodontics. Isolated microbial inhibition studies were excluded from the review due to its well-established wealth of literature. Miswak was administered as ten different forms, namely mouthwash, toothpaste, chewing stick, essential oil, aqueous extract, ethanol extract, probiotic spray, dental varnish, dental cement or chewing gum. All studies reported a positive effect of miswak as an anti-plaque, anti-gingivitis, anti-cariogenic, promotion of gingival wound healing, whitening properties, orthodontic chain preservation, and biocompatibility with oral cells. Miswak in its different forms demonstrated positive effect towards oral health maintenance and management.

Angiogenic properties of dental pulp stem cells conditioned medium on endothelial cells in vitro and in rodent orthotopic dental pulp regeneration

Objectives

To evaluate the effect of SHED-CM on the proliferation, differentiation, migration ability, cell death, gene expression and production of VEGF of HUVEC in vitro and in a rodent orthotopic dental pulp regeneration.

Methods

Three culture media [M199, DMEM/Ham's F12 and DMEM/Ham's F12 conditioned by SHEDs] were used as experimental groups. SHED-CM was prepared maintaining confluent cells in culture without serum for 3 days. The proliferation and cell death marker of HUVECs were assessed using flow cytometry. The capacity of formation of vascular-like structures was analyzed in cells grown over Matrigel^® in hypoxic condition. HUVECs migration was followed using the scratch test. VEGF-A expression in HUVECs was assessed using real time RT-qPCR; and VEGF synthesis with ELISA test. SHED-CM was also applied in rodent ortotopic model of dental pulp regeneration in rats. The formed tissue was submitted to histological and immunohistochemical analyses.

Results

SHED-CM promoted significantly lower expression of 7AAD in HUVECs; whereas the expression of the Ki67 was similar in all groups. The vascular-like structures were observed in all groups. Migration of SHED-CM group was faster than DMEM/Ham's F12. SHED-CM induced similar expression of VEGF-A than M199, and higher than DMEM/Ham's F12. SHED-CM induced significantly higher VEGF synthesis than other media. SHED-CM induced formation of a vascularized connective tissue inside the root canal.

Conclusion

The study showed that SHEDs release angiogenic and cytoprotective factors, which are of great importance for tissue engineering.

Clinical significance

SHED-CM could be an option to the use of stem cells in tissue engineering.

Effect of sodium chloride on gene expression of Streptococcus mutans and zeta potential of demineralized dentin

Purpose

In this work, the effects of sodium chloride (NaCl) on gene expression of planktonic Streptococcus mutans cells are investigated. Also assessed are the effects of NaCl on zeta potential of sound and demineralized dentin.

Methods

The relative level of glucosyltransferase B (gtfB), gtfC and gtfD transcription of S. mutans in the presence of NaCl was evaluated by quantitative polymerase chain reaction (qPCR). The osmolality of varying salt (NaCl) concentrations and their influence on the zeta potential of sound and demineralized dentin was investigated as well.

Results

NaCl significantly reduced the expression of gtfB and C genes in planktonic S. mutans; whereas, gtf D gene expression significantly increased in the presence of NaCl (P < 0.05). NaCl at concentrations of 37.5 mg/ml reduced zeta potential of demineralized dentin, while no significant decrease of zeta potential was found when sound dentin was exposed to this concentration.

Conclusion

NaCl reduces the expression of some gtfs in S. mutans and increases negative potential charge of demineralized dentin.

A review of the traditional and modern uses of Salvadora persica L. (Miswak): Toothbrush tree of Prophet Muhammad

ETHNOPHARMACOLOGICAL RELEVANCE

Salvadora persica L., also known as Arak (in Arabic) and Peelu (in Urdu), is the most common traditional source of tooth or chewing stick (miswak) highly recommended by Prophet Muhammad. To date, extensive studies have probed primarily into the validation of its traditional uses in oral care. Nonetheless, there is still a dearth of updated compilation and critical analysis of other potential ethnopharmacological properties of S. persica. This review therefore aims to provide an up-to-date detailed structured description of the traditional uses of S. persica and a critical analysis of its modern uses, highlighting its phytochemistry, pharmacological properties, and bioapplications.

MATERIALS AND METHODS

Various databases (Science Direct, PubMed, Wiley Online Library, and Google Scholar), books, and relevant primary sources were probed, surveyed, analysed, and included in this review. The literature cited in this review dated from 1979 to 2017.

RESULTS

S. persica was found to possess a plethora of bioactive compounds and broad pharmacological properties, including antimicrobial, antioxidant, enzyme inhibitory activity, antiulcer, anticonvulsant, sedative, analgesic, anti-inflammatory, hypoglycemic, hypolipidemic, antiosteoporosis, and antitumor activities. Studies also revealed the potential use of S. persica as a natural food preservative and a novel functional food ingredient. In addition, improvement in growth and reproductive performances have been observed by the introduction of S. persica in animal feed. Lastly, S. persica has also been used in the green synthesis of nanoparticles showing potential biotechnological applications.

CONCLUSION

S. persica showed a wide scope of application and its uses have been extended far beyond the initial traditional uses of its roots, stems, and twigs in oral care. We found a number of other ethnopharmacological uses and potential bioapplications of different parts of S. persica that warrants further investigations. Though widely studied using several in vitro and in vivo models, and tested clinically for oral hygiene mainly, several gaps and research priorities have been identified which needs to be addressed in future.

Antiosteoporotic activity of Salvadora persica sticks extract in an estrogen deficient model of osteoporosis

Objectives

The effect of Salvadora persica sticks on prevention of tooth decay is well established, but the effect of S. persica stick extract (SPE) on the prevention/treatment of osteoporosis has not been studied. The purpose of this study is to provide baseline information of the effectiveness of SPE on ovariectomized (OVX) rat model of osteoporosis.

Methods

SPE was administered at 50, 150, and 300 mg/d orally to OVX rats for 16 weeks. Serum osteocalcin, alkaline phosphatase, calcium, and phosphorus, and urinary deoxypyridinoline, calcium, and phosphorus were measured. Bone mineral density (BMD), 3-point bending test, and histomorphometric characteristics of the femoral bone were also examined.

Results

SPE at doses of 150 and 300 mg/d, but not 50 mg/d, significantly prevented bone loss in OVX rats as proved by decreased biochemical markers of bone resorption and increased BMD and biomechanical indices of the femoral bone.

Conclusions

This study confirms a dose-dependent protective action of SPE on rat OVX model of osteoporosis. This effect needs further investigation at the molecular and clinical levels to provide a natural and cost-effective alternative for the management of postmenopausal osteoporosis.