Oral streptococci: modulators of health and disease

Streptococci are primary colonizers of the oral cavity where they are ubiquitously present and an integral part of the commensal oral biofilm microflora. The role oral streptococci play in the interaction with the host is ambivalent. On the one hand, they function as gatekeepers of homeostasis and are a prerequisite for the maintenance of oral health - they shape the oral microbiota, modulate the immune system to enable bacterial survival, and antagonize pathogenic species. On the other hand, also recognized pathogens, such as oral Streptococcus mutans and Streptococcus sobrinus, which trigger the onset of dental caries belong to the genus Streptococcus. In the context of periodontitis, oral streptococci as excellent initial biofilm formers have an accessory function, enabling late biofilm colonizers to inhabit gingival pockets and cause disease. The pathogenic potential of oral streptococci fully unfolds when their dissemination into the bloodstream occurs; streptococcal infection can cause extra-oral diseases, such as infective endocarditis and hemorrhagic stroke. In this review, the taxonomic diversity of oral streptococci, their role and prevalence in the oral cavity and their contribution to oral health and disease will be discussed, focusing on the virulence factors these species employ for interactions at the host interface.

Tracing of Microbes in Prepared Cavity Following Different Minimally Invasive Caries Removal Protocols

AIMS

The conventional caries removal technique has been replaced with minimally invasive (MI) techniques to preserve healthy natural teeth and to provide durable dental restorations. Each of these MI caries removal protocols is reported to be favorable in dealing with different caries conditions. The current study aimed to trace the residual bacteria that may remain in a prepared cavity following a visual-tactile (VT), caries detection dye (CDD), and chemo-mechanical caries removal (CMCR) protocol.

MATERIALS AND METHODS

A total of 29 extracted human molar teeth with visible caries lesions were randomly divided into three groups. The cavity preparation and caries removal of each group was accomplished following one of the MI caries removal protocols. Swab samples (one from each specimen) were taken and inoculated onto a blood agar plate and incubated for 48 hours. The growth of the bacterial colony was observed under a microscope and the specific genome of the bacteria was identified by polymerase chain reaction (PCR) test.

RESULTS

The maximum number of traceable bacteria was observed following the chemo-mechanical caries removal group followed by the caries detection dye group and the least in the visual-tactile group. The PCR test revealed the presence of Streptococcus mutans in all the observed colonies; however, Streptococcus sobrinus was absent completely. The Chi-square test reveals a statistically insignificant (p = 0.646) difference among the tested groups.

CONCLUSION

All of the MI caries removal protocols used in this study showed a trace of microbes in certain teeth. The cavity prepared following a visual tactile protocol showed the least amount of traceable bacteria in the prepared cavity.

CLINICAL SIGNIFICANCE

Cavity that is prepared following individual MI protocol has a risk of leaving microbes in it.

Saliva sampling methods. Cariogenic streptococci count using two different methods of saliva collection in children

The aim of this study is to compare the efficacy of two methods for collecting saliva samples from infants under 2 years of age for cariogenic streptococci (CS) count. Two collection methods were applied in 11 infants. In Method (A), saliva samples were collected by swabbing the inner cheek mucosa and floor of the mouth in figure of eight motions with a sterile cotton swab until it was soaked. In method (B), saliva samples were collected by aspiration of 1 ml of saliva with a sterile plastic syringe on the floor of the mouth, after stimulation with glove. The samples were cultured in modified Gold's broth (MSMG), and on trypticase, yeast extract, sucrose, cystine and bacitracin culture medium (TYSCB). In method (A), the swab with the sample was unloaded in situ on TYSCB and placed in PBS medium for transport. Then, 100 μl of the eluate was seeded in MSMG. In method (B) 100 μl were seeded in TYSCB and 100 μl in MSMG. Both culture media were incubatedundercapnophilicconditions for 48 hours at 37 °C. Colony forming units (CFU/ml) were counted by calibrated operators (kappa = 0.75). The presence of cariogenic streptococci (CS) (Streptococcus mutans-Streptococcus sobrinus) was determined by qPCR in the samples collected by both methods. The CFU/ml counts in MSMG differed significantly between methods (p = 0.021). In TYSCB, the recovery of CFU/ml was higher in method (A), without significant difference (p = 0.705). The molecular technique detected presence of CS, with no difference between collection methods. Collecting saliva samples by swabbing proved more effective in terms of recovery of microorganisms, and did not affect the detection of presence of CS by molecular techniques.

Antimicrobial activity of ginger on cariogenic bacteria: molecular networking and molecular docking analyses

Streptococcus mutans and Streptococcus sobrinus have been implicated as the primary causative agents of dental caries in humans. This study aimed to screen the antibacterial activity of the n-hexane, ethyl acetate, methanol, and aqueous extracts of Ginger against mentioned bacteria and investigate chemical constituents of the extracts, and their activity against some drug targets in S. mutans. Antimicrobial tests including biofilm inhibition, time-kill kinetics, and adherence inhibition alongside cytotoxicity of extracts, were assessed. A molecular networking technique was used to find chemical constituents of the extracts. Molecular docking analysis on the Schrodinger package was applied to identify the binding interactions of the compounds to targeted enzymes. Methanol and ethyl acetate extracts showed the highest antibacterial activity against S. mutans and S. sobrinus. Different compounds including polyphenols, alkaloids, anthraquinones, flavonoids, terpenoids, glycosides, steroids, and reducing sugars dereplicated from Ginger extracts. The binding affinity of ligands with free hydroxyl groups was better than other ligands against all tested enzymes. This study introduces a wide range of Z. officinal extracts compounds to be used in different drug discovery studies. Some Ginger compounds with high affinity to investigated enzymes can be considered as candidate compounds for anti-caries drug development studies.Communicated by Ramaswamy H. Sarma.

Effect of Full-Mouth Rehabilitation on Streptococcus mutans and Streptococcus sobrinus Levels in Children with Severe Early Childhood Caries

Purpose: To investigate the effect of full-mouth rehabilitation on the levels of Streptococcus mutans and Streptococcus sobrinus in plaque samples of children suffering from severe early childhood caries using the quantitative reverse transcription polymerase chain reaction method.<br/> Methods: A dental examination was performed to determine the decayed, missing, and filled primary teeth and surfaces (dmft and dmfs, respectively) in three- to five-year-old children using the World Health Organization's caries diagnostic criteria. Supragingival plaque samples were collected from all tooth surfaces with a sterile universal scaler at baseline and six months after full-mouth rehabilitation. The Wilcoxon signed-rank test was used to compare the mean values of dmft and dmfs scores and the mean values of S. mutans and S. sobrinus levels between the pre- and post-treatment period.<br/> Results: At six months, the mean relative quantification values of S. mutans and S. sobrinus showed significant reductions (P > 0.05) in the post-treatment samples but the mean dmft scores remained the same.<br/> Conclusion: Full-mouth rehabilitation is effective in reducing levels of S. mutans and S. sobrinus, thus diminishing the cariogenic challenge in the oral cavity.

Influence of Resin Monomers on Growth of Oral Streptococci

Ethyleneglycol dimethacrylate monomers have been previously reported to stimulate the growth of certain caries-associated bacteria on the basis of turbidity measurements. To elucidate the detail of this effect, we examined the influence of resin monomers on the growth of Streptococcus sobrinus and Streptococcus sanguis by determination of bacterial numbers (colony-forming units), morphological observation, and chemical analysis. Although the absorbance values in the stationary phase of bacterial suspension were increased in the presence of ethyleneglycol monomers, no significant differences were observed for bacterial numbers throughout the incubation period. Scanning electron microscopy observation revealed the formation of sparse vesicular material surrounding bacterial cells when incubated with ethyleneglycol monomers, and these products were proved to be resin polymers. The results demonstrate that the apparent biomass increase during incubation with ethyleneglycol monomers is due not to promotion of bacterial multiplication, but to the polymerization of resin monomers to form vesicular structures attached to cells.

Protection Offered by Root-surface Restorative Materials against Biofilm Challenge

The prevalence of root-surface caries is increasing. We hypothesized that some restorative materials are protective against cariogenic challenge on root surfaces. Our goal was to study the effects of different restorative materials on root surfaces incubated with an oral biofilm generated in an artificial mouth. A biofilm of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus rhamnosus, and Actinomyces naeslundii was co-cultured for 21 days on 24 glass-ionomer cement, resin-modified glass-ionomer cement, or resin-composite-restored root surfaces. These surfaces were then examined with Fourier transform infrared spectroscopy and scanning electron energy-dispersive spectroscopy. Only glass-ionomer restorations showed a significant increase in log calcium-to-phosphorus ratio (P < 0.01), and a significantly lower log amide I-to-hydrogen phosphate ratio on the root surface after incubation in the artificial mouth. Glass-ionomer restoratives conferred a preventive effect on the root surfaces against initial cariogenic challenge with a mixed-species oral biofilm without therapeutic intervention.

[Influence of surface roughness on oral streptococcal adhesion forces to dental filling materials]

OBJECTIVE

This study is to determine the common oral streptococcal adhesion forces by using composite resin and glass ionomer cement (GIC) with different degrees of surface roughness via atomic force microscopy (AFM) analysis. The influence of surface roughness on bacterial adhesion force is also discussed.

METHODS

Polishing and grinding were applied to obtain 300, 200, 100, and 10 nm surfaces of light-cured composite resin and GIC samples. Surface topography was assessed by AFM analysis. Initial colonizers (Streptococcus sanguinis and Streptococcus mitis) and cariogenic bacterial strains (Streptococcus mutans and Streptococcus sobrinus) were used to obtain bacteria-modified AFM probes. The force-distance curves were also measured by AFM analysis to determine the adhesion forces of bacteria on the surfaces of the composite resin and GIC. Material surface roughness was analyzed using ANOVA, and adhesion forces were subjected to nonparametric analysis (Kruskal-Wallis test). Comparison among groups was performed by Dunn's test. Material surface roughness and bacterial adhesion forces were subjected to correlation analysis.

RESULTS

Bacterial adhesion forces increased with increasing material roughness. The adhesion forces of the four bacterial species reached the maximum on the material surface of 300 nm. The adhesion force of Streptococcus mutans increased from 0.578 nN to 2.876 nN on GIC surfaces with 10 and 300 nm roughness. The adhesion forces of the four species on the surface of the composite resin were stronger than that of GIC. The initial colonizers exhibited stronger adhesion forces to different materials than the cariogenic strains. Intergroup differences were evident on the 200 and 300 nm material surfaces.

CONCLUSIONS

The surface roughness of the material significantly affected the bacterial adhesion forces, and a significant linear correlation existed between both factors. The bacterial adhesion forces of the GIC were lower than that of the composite resin. Furthermore, surface roughness exhibited less influence on the cariogenic strains than that on the initial colonizers.

[Effects of Yili dark bee propolis on oral cariogenic biofilm in vitro]

OBJECTIVE

To evaluate the effects of Yili dark bee propolis on the main cariogenic biofilm and mechanisms.

METHODS

Susceptibilities to the ethanolic extract of propolis against Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Streptococcus sanguis (S. sanguis), Actinomyces viscosus (A. viscosus), and Actinomyces naeslundii (A. naeslundii) were analyzed by crystal violet stain method to determine the minimum biofilm eradication concentration (MBEC). The biofilm was initially cultivated for 24 h. Subsequently, the propolis groups with different concentration MBEC and initial pH 7.0 were cultured for 24 h. Moreover, the pH value was measured to evaluate the acid-producing ability of the tested plaque biofilm. The effects of propolis on the insoluble extracellular polysaccharide synthesis of S. mutans biofilm were evaluated by anthrone method.

RESULTS

The MBEC of Yili propolis on S. mutans, S. sobrinus, S. sanguis, A. viscosus, and A. naeslundii were 6.25, 1.56, 3.13, 0.78, and 0.78 mg.mL-1, respectively. Propolis could decrease the ΔpH of the tested plaque biofilm, and the differences between the control and propolis groups were statistically significant (P<0.05). At MBEC, propolis could reduce the ability of S. mutans in synthesizing insoluble extracellular polysaccharides.

CONCLUSION

Yili propolis demonstrate remarkable eradicative effects on the cariogenic plaque biofilm, showing inhibition of the synthesis of biofilm-produced acids and insoluble extracellular polysaccharides.

[Effects of Yili dark bee propolis on oral cariogenic biofilm in vitro]

OBJECTIVE

To evaluate the effects of Yili dark bee propolis on the main cariogenic biofilm and mechanisms.

METHODS

Susceptibilities to the ethanolic extract of propolis against Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Streptococcus sanguis (S. sanguis), Actinomyces viscosus (A. viscosus), and Actinomyces naeslundii (A. naeslundii) were analyzed by crystal violet stain method to determine the minimum biofilm eradication concentration (MBEC). The biofilm was initially cultivated for 24 h. Subsequently, the propolis groups with different concentration MBEC and initial pH 7.0 were cultured for 24 h. Moreover, the pH value was measured to evaluate the acid-producing ability of the tested plaque biofilm. The effects of propolis on the insoluble extracellular polysaccharide synthesis of S. mutans biofilm were evaluated by anthrone method.

RESULTS

The MBEC of Yili propolis on S. mutans, S. sobrinus, S. sanguis, A. viscosus, and A. naeslundii were 6.25, 1.56, 3.13, 0.78, and 0.78 mg.mL-1, respectively. Propolis could decrease the ΔpH of the tested plaque biofilm, and the differences between the control and propolis groups were statistically significant (P<0.05). At MBEC, propolis could reduce the ability of S. mutans in synthesizing insoluble extracellular polysaccharides.

CONCLUSION

Yili propolis demonstrate remarkable eradicative effects on the cariogenic plaque biofilm, showing inhibition of the synthesis of biofilm-produced acids and insoluble extracellular polysaccharides.

[The relationship between Streptococcus sobrinus and rampant caries in children]

PURPOSE

To explore the relations between Streptococcus sobrinus (S. Sobrinus) and rampant caries in children.

METHODS

Based on previous investigation result for rampant caries in Zhengzhou city, 66 children aged 3-5 years were selected by random sampling, and divided into 3 groups of rampant caries, high dental caries and no caries, 22 cases in each group. The final identification of S. mutans and S. sobrinus were performed after using culture medium TYCSB to operate preliminary screening of Streptococcus mutans (S. Mutans) and S. Sobrinus with polymerase chain reaction(PCR) combined with physiological and biochemical identification. SPSS10.0 software package was used to compare the detection rate and mean values of S.mutans and S.sobrinus in the experimental group and the control group.

RESULTS

It was found that single S. sobrinus without S. mutans was not detected from dental plaque in each group. The detection rate of S. mutans in group of rampant caries was higher than in group of high dental caries, but there was no significant difference (P>0.05). The difference of detection rate of S. sobrinus between the two groups and the detection rate of S. mutans between group of rampant caries and group without caries was significant(P<0.05). The difference of the detection rate of S. sobrinus between group of rampant caries and group without caries was also significant(P<0.01). The incidence of rampant caries, DMFT, DMFS, smooth-surface caries among the sample with both of S. sobrinus and S. mutans detected and the sample only with S. mutans and the sample without S. sobrinus and S. mutans were significantly different (P<0.01).

CONCLUSIONS

The main pathogenic bacteria of rampant caries in children are S. mutans and S. sobrinus. The incidence of rampant caries was related to S. sobrinus, which had synergic effect on the occurrence and development of rampant caries in children.

[Study on exopolysaccharides produced by planktonic and attached Streptococcus sobrinus]

PURPOSE

To elucidate the amount of exopolysaccharides produced by Streptococcus sobrinus when cultivated at different conditions.

METHODS

S. sobrinus was grown in TS broth and was allowed to attach to the cover glass surface to form bioflims. The anthrone method was applied to measure the amounts of soluble and insoluble exopolysaccharides produced by attached S. sobrinus and planktonic ones when cultivated at different time and in different concentrations of sucrose. The data were analyzed using SPSS 10.0 software package, Dunnett's t test was used to compare the difference between the two groups.

RESULTS

Attached bacteria synthesized more insoluble polysaccharide than planktonic ones at every sucrose concentration (P<0.05), but almost the same production of soluble polysaccharide (P>0.05).

CONCLUSION

The ability of S. sobrinus to synthesize insoluble polysaccharide was enhanced in the adherent phase, which may clarify why bacteria in biofilms are highly cariogenic.

The in vitro effect of fluoridated milk in a bacterial biofilm--enamel model

OBJECTIVES

The purpose of this study was to investigate the effect of milk and fluoridated milk on bacterially induced caries-like lesions.

SAMPLE AND METHODS

Extracted impacted human molars were cut in half and covered with a varnish leaving a 4*4 mm window. The samples were coated with biofilm of S. sobrinus and were further divided into three experimental groups of S. sobrinus, S. sobrinus and milk and S. sobrinus and fluoridated milk. As negative controls served teeth incubated in saline. Of twenty tooth halves serial ground sections were cut through the lesions and investigated with polarization light microscopy (PLM) and scanning electron microscopy (SEM) and EDX element analysis. The PLM photographs were used for 3D reconstruction, volumetric assessment and determination of the extension of the lesion zones. Of eight tooth halves the biofilm on the enamel surface was studied with SEM and EDX element analysis.

RESULTS

Volumetric assessment showed a statistically significant difference in the volume of the body of the lesion and the translucent zone between the milk group and fluoridated milk group. Quantitative element analysis demonstrated significant differences between sound enamel and the superficial layer in the fluoridated milk group. The biofilm on the enamel surface showed an increased Ca content in the milk group and fluoridated milk group.

CONCLUSIONS

Milk as a common nutrient seems to play a complex role in in-vitro biofilm--enamel interactions stimulating bacterial demineralization on one hand, and, as effective fluoride carrier, inhibits caries-like demineralization.

[MGB probes detect Streptococcus mutans and Streptococcus sobrinus in real time]

OBJECTIVE

To detect and distinguish Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) quickly in epidemiology and investigate the distribution of S. mutans in the oral of children with rampant caries.

METHODS

Designed minor groove binder (MGB) probes according to the gtf gene of S. mutans and S. sobrinus. Detected 9 reference strains of Streptococcus mutans group by MGB probes in real time and after cultivation. Evaluated the results of these two methods. 92 dental plaques from pre-school children with rampant caries were detected in real time with MGB probes.

RESULTS

The primers could amplify the target sequences specificity and distinguished S. mutans and S. sobrinus from each other using MGB probes. Though the fluorescence occurred earlier in S. mutans than in S. sobrinus, they had the same results in nature. In 92 children with rampant caries, the detective ratio of S. mutans was 96.7% and that of S. sobrinus was 32.6%. All the samples which could detect S. sobrinus were positive for S. mutans.

CONCLUSION

The primers and probe designed from gtf genes of S. mutans and S. sobrinus can amplify the target sequence and distinguish them from each other in real time.

A novel approach for purification of recombinant proteins using the dextran-binding domain

Using the dextran-binding domain (DBD) of a type of glucosyltransferase (GTF) from Streptococcus sobrinus, we have developed a novel method for purifying recombinant proteins. DBD-tagged green and red fluorescent proteins as well as the parent GTF and DBD moiety were adsorbed well to commercially available cross-linked dextran (such as Sephadex beads and Sephacryl beads), and eluted efficiently with water-soluble dextran. The purity of the eluted proteins after this one-step affinity purification was approximately 90% or better. The results suggest that DBD can be used as a powerful carrier for purification of various recombinant proteins.

Adherence of plaque components to different restorative materials

This study compared the amount of artificial plaque synthesized in vitro by Streptococcus sobrinus on various dental materials using radioisotopes. In particular, plaque-retaining capacities of new types of ceramics were the focus of this study. Specimens were fabricated from the following materials (one amalgam alloy [Spherical-D], one casting gold alloy [Casting Gold TYPE I], one resin composite [Herculite XR] and three ceramics [Vita Celay Blanks, IPS Empress and Dicor MGC]). The amount of bacteria and glucans adhered on the specimens was measured after incubation for 24 hours at 37 degrees C with radio-labeled cariogenic bacteria and sucrose. This adhesion test was performed using two different surfaces with 600-grit roughness and clinical smoothness. Irrespective of the surface roughness, the least amount of plaque adhered to the ceramics. However, in the case of the resin composite and amalgam, the amount of bacteria and glucan adhesion decreased dramatically by polishing, though there were no statistically different changes in the amount of bacteria and glucans that adhered to the ceramics even after polishing. In general, the amount of adhered bacteria showed almost the same tendency as that of glucans. Although no statistical differences in the amount of bacteria and glucan adhesion were detected among the three ceramics investigated in this study, a lesser amount of bacteria and glucans adhered to them compared to the other materials.

Analysis of bacterial detachment from substratum surfaces by the passage of air-liquid interfaces

A theoretical analysis of the detachment of bacteria adhering to substratum surfaces upon the passage of an air-liquid interface is given, together with experimental results for bacterial detachment in the absence and presence of a conditioning film on different substratum surfaces. Bacteria (Streptococcus sobrinus HG1025, Streptococcus oralis J22, Actinomyces naeslundii T14V-J1, Bacteroides fragilis 793E, and Pseudomonas aeruginosa 974K) were first allowed to adhere to hydrophilic glass and hydrophobic dimethyldichlorosilane (DDS)-coated glass in a parallel-plate flow chamber until a density of 4 x 10(6) cells cm(-2) was reached. For S. sobrinus HG1025, S. oralis J22, and A. naeslundii T14V-J1, the conditioning film consisted of adsorbed salivary components, while for B. fragilis 793E and P. aeruginosa 974K, the film consisted of adsorbed human plasma components. Subsequently, air bubbles were passed through the flow chamber and the bacterial detachment percentages were measured. For some experimental conditions, like with P. aeruginosa 974K adhering to DDS-coated glass and an air bubble moving at high velocity (i.e., 13.6 mm s(-1)), no bacteria detached upon passage of an air-liquid interface, while for others, detachment percentages between 80 and 90% were observed. The detachment percentage increased when the velocity of the passing air bubble decreased, regardless of the bacterial strain and substratum surface hydrophobicity involved. However, the variation in percentages of detachment by a passing air bubble depended greatly upon the strain and substratum surface involved. At low air bubble velocities the hydrophobicity of the substratum had no influence on the detachment, but at high air bubble velocities all bacterial strains were more efficiently detached from hydrophilic glass substrata. Furthermore, the presence of a conditioning film could either inhibit or stimulate detachment. The shape of the bacterial cell played a major role in detachment at high air bubble velocities, and spherical strains (i.e., streptococci) detached more efficiently than rod-shaped organisms. The present results demonstrate that methodologies to study bacterial adhesion which include contact with a moving air-liquid interface (i.e., rinsing and dipping) yield detachment of an unpredictable number of adhering microorganisms. Hence, results of studies based on such methodologies should be referred as "bacterial retention" rather than "bacterial adhesion".

Aspiration pneumonia: dental and oral risk factors in an older veteran population

OBJECTIVES

To investigate the importance of medical and dental factors in aspiration pneumonia in an older veteran population.

DESIGN

Prospective enrollment of subjects with retrospective analysis of data.

SETTING

Department of Veterans Affairs outpatient clinic, inpatient ward, and nursing home.

PARTICIPANTS

358 veterans age 55 and older; 50 subjects with aspiration pneumonia.

MEASUREMENTS

Demographic and medical data; functional status; health-related behaviors; dental care utilization; personal oral hygiene; comprehensive dental examination; salivary assays including IgA antibodies; and cultures of saliva, throat, and dental plaques.

RESULTS

Two logistic regression models produced estimates of significant risk factors. One model using dentate patients included: requiring help with feeding (odds ratio (OR) = 13.9), chronic obstructive pulmonary disease (COPD) (OR = 4.7), diabetes mellitus (OR = 3.5), number of decayed teeth (OR = 1.2), number of functional dental units (OR = 1.2), presence of important organisms for decay, Streptococcus sobrinus in saliva (OR = 6.2), and periodontal disease, Porphyromonous gingivalis in dental plaque (OR = 4.2), and Staphylococcus aureus presence in saliva (OR = 7.4). The second model, containing both dentate and edentulous patients included: requiring help with feeding (OR = 4.7), COPD (OR = 2.5), diabetes mellitus (OR = 1.7), and presence of S. aureus in saliva (OR = 8.3).

CONCLUSION

This study supports the significance of oral and dental factors while controlling for established medical risk factors in aspiration pneumonia incidence.

High-sucrose diet reduces defensive reactions of the pulpo-dentinal complex to dentinal caries in young rats

The significance of systemic dietary effects on the response of the pulpo-dentinal complex to dentinal caries was examined. Weanling rats were divided into high sucrose or control diet groups both with and without cariogenic bacterial inoculation. At the onset, tetracycline was injected to mark the dentin formation during the experiment. After 5-6 week, mandibular molars were sectioned sagittally. The areas of dentin formed during the experiment and those of dentinal caries were quantified separately in the first and second molars. In the control diet groups the area of dentin was significantly greater under carious fissures, whereas in the high sucrose diet groups the area of dentin formed did not differ between intact and carious fissures. The high sucrose diet resulted in a significantly smaller area of dentin formation than did the control diet. The high sucrose diet with cariogenic bacterial inoculation resulted in the greatest area of dentinal caries. With the control diet a positive response against dentinal caries occurs, but the high dietary sucrose content impairs the defensive reactions of pulpo-dentinal complex against dentinal caries. These findings add further evidence of the importance of the local endogenous factors of caries progression.

Effect of matrix placement on furcation perforation repair

Furcation perforations are a serious complication during endodontic treatment, and a matrix to aid placement of repair material has been recommended. This study tested the sealing ability of amalgam and Ketac silver placed with and without plaster of Paris as a matrix. A bacterial penetration technique was used to test the seal. Perforations created in the pulpal floor of extracted human mandibular molars were repaired as follows: group 1, amalgam; group 2, amalgam plus plaster as a matrix; group 3, Ketac silver; and group 4, Ketac silver plus plaster (17 teeth/group). Leakage was measured by placing bacteria (Streptococcus sobrinus) in the pulp chamber, and recording the time taken for bacterial growth in a medium bathing the root surface. A plaster of Paris matrix improved the seal with amalgam, but not with Ketac silver. Ketac silver provided the best seal, but all materials showed complete leakage within 22 days.

Cariogenic [correction of Carcinogenic] potential of a typical cassava flour from the Amazonian region of Brazil

The purpose of this study was to compare the cariogenic potential of a typical cassava flour (CF) with sucrose and starch, using a severe cariogenic challenge model in rats. Thirty Wistar female pups with their dams (mutans streptococci free) were infected by Streptococcus sobrinus 6715, desalivated when aged 25 days, and placed in a Konig-Hofer programmed feeder at age 26 days. They received 17 meals daily at hourly intervals for 21 days as follows: group (1) powdered plain sucrose and sterile distilled water ad libitum (sdwal); (2) Lf and Sdwal (3) powdered starch and sdwal. Essential nutrition was administered by gavage. Data were analyzed by ANOVA. The percentage of S. Sobrinus related to the total flora and the number of this microorganism were higher in the sucrose and CF groups than starch group. Smooth-surface and [sulcal] caries scores for the groups were: (1) 105.5 [48.0]; (2) 34.1 [39.2]; (3) 10.2 [18.1]. All the groups were statistically significantly different from each other (p < 0.01), although the result for sulcal score for CF was very close to the sucrose group. It is concluded that cassava flour, the main source of carbohydrate for the Amazonian population of Brazil, has moderate cariogenic potential.

Anticariogenicity of calcium phosphate complexes of tryptic casein phosphopeptides in the rat

Casein phosphopeptides (CPP) stabilize calcium phosphate through the formation of casein-phosphopeptide amorphous calcium-phosphate complexes (CPP-CP). The ability of CPP-CP to reduce caries activity was investigated by use of specific-pathogen-free rats inoculated with Streptococcus sobrinus. The animals consumed a defined cariogenic diet free of dairy products. Solutions (100 microL) of the CPP-CP (0.1, 0.2, 0.5, 1.0% w/v) were applied to the animals' molar teeth twice daily. Other groups of animals received solutions containing 500 ppm F, the non-phosphorylated peptides of a casein tryptic digest (0.5% w/v), or the calcium-phosphate complex of a synthetic octapeptide, Ac-Glu-Ser(P)-Ile-Ser(P)-Ser(P)-Ser(P)-Glu-Glu-NHMe, corresponding to the common sequence in the CPP. The CPP-CP significantly reduced caries activity in a dose-response fashion, with 1.0% CPP-CP producing 55% and 46% reductions in smooth surface and fissure caries activity, respectively, being similar to that of 500 ppm F. The anticariogenic effects of CPP-CP and fluoride were additive, since animals receiving 0.5% CPP-CP plus 500 ppm F had significantly lower caries activity than those animals receiving either CPP-CP or fluoride alone. The tryptic digest of casein with the phosphopeptides selectively removed showed no anticariogenic activity. The synthetic octapeptide-calcium phosphate complex significantly reduced caries activity, confirming that this calcium-phosphate-stabilizing portion of the casein phospho-peptides is associated with anticariogenicity. The CPP-CP did not significantly affect the level of S. sobrinus in fissure plaque.(ABSTRACT TRUNCATED AT 250 WORDS)

Reduction of caries and of demineralization around orthodontic brackets: effect of a fluoride-releasing resin in the rat model

The effectiveness of fluoride in reduction of caries is well known. This study examined the ability of a fluoride-releasing resin to reduce caries, as well as demineralization around orthodontic brackets, by using the Sprague-Dawley rat as a model. Eighteen-day-old rats were infected with cariogenic Streptococcus sobrinus 6715. After infection was confirmed, standard orthodontic techniques were used to bond miniature orthodontic brackets to the lingual surfaces of maxillary first molars, with either a fluoride-releasing resin (group I) or a conventional resin (group II). A control group was infected but not bonded (group III). Bonding was done at age 34 days. Rats were fed a cariogenic diet and were killed at age 72 days. Lingual surfaces of maxillary first molars were evaluated for area of demineralization, and mandibular molars were scored for caries. Mean percent area of demineralization for group I was 4.7%, for group II 35.7%, and for group III 0%. The difference between groups I and II was statistically significant (p < 0.01). Mean mandibular molar enamel carious lesion unit count for group I was 9.8, for group II 16.3, and for group III 13.7. Group I had significantly fewer lesions than groups II and III (p < 0.01), and group II had significantly more lesions than group III (p < 0.01). These results indicate that a fluoride-releasing resin reduces demineralization at the site of application and reduces caries at distant sites in the experimental rat model.

The effect of ovariectomy and high-sucrose diet on dentine formation and caries in growing rats

Ovariectomized (Ovx) or sham-operated (Cnt) and tetracycline-labelled growing rats were fed either a commercial powdered standard rat diet (Ovx and Cnt) or a high-sucrose diet (Ovxsuc and Cntsuc). All animals were inoculated in the mouth with Streptococcus sobrinus. At 11 weeks of age the areas of caries lesions and dentinal apposition of the first and second molars and the areas of the pulpal cross-section of the incisors were determined. The area of dentinal apposition was largest in Cnt animals, the difference being statistically significant only in comparison with the Cntsuc animals. No such difference between the diets was found among the Ovx animals. The cross-section of the pulpal chamber was smallest in the Ovxsuc rats and largest in the Cnt animals, but no statistically significant differences were found between the groups. The caries lesions were significantly larger in Ovx, Ovxsuc and Cntsuc animals than in Cnt ones. Ovariectomy thus increased caries progression in growing rats, but the effect on dentine formation remained negligible. In this respect there is a difference between primary and secondary dentinogenesis.

Pilocarpine alters caries development in partially-desalivated rats

This study examined the effect of pilocarpine on caries and saliva composition in rats with compromised salivary gland function. Eight litters of specific-pathogen-free female Sprague-Dawley rats were divided into five groups for surgery. Partial desalivation was performed in either of three ways: (1) Both parotid ducts were ligated; (2) both submandibular/sublingual (SM/SL) glands were excised, or (3) one parotid duct was ligated, and submandibular/sublingual glands were removed unilaterally. Completely desalivated animals and unoperated animals served as positive and negative controls, respectively. One week following surgery, groups were subdivided so that half of each group had osmotic pumps implanted which delivered pilocarpine HCl (24 mg/kg/day). All animals were infected with Streptococcus sobrinus 6715 and fed cariogenic diet ad libitum for 28 days. Caries scores, microbiological data, and saliva flow rate and composition were determined for all animals. Animals which had both SM/SL glands removed and received pilocarpine developed significantly lower sulcal caries (p < or = 0.05) compared with the animals that had both SM/SL removed but did not receive pilocarpine. The concentration of protein in parotid saliva in these pilocarpine-treated animals was unaffected, and no differences were observed in the electrophoretic profiles on SDS-PAGE. Pilocarpine appears to exert its greatest caries-protective effect when the parotid glands remain intact.

Effect of milk on cariogenesis

Sprague-Dawley rats fed diet 2000, infected by Streptococcus sobrinus, and offered milk or lactose-reduced milk as drinking fluids developed essentially similar caries scores as controls given distilled water. In contrast, animals given fructose or sucrose solutions developed enhanced levels of caries. Significant differences were not detected in the S. sobrinus populations among the groups. In further experiments, the addition of sucrose to milk enhanced the severity of caries scores. However, sucrose-milk solutions were significantly less cariogenic than sucrose-water solutions. Animals fed sucrose (2-5%) milk solutions harbored enhanced populations of S. sobrinus. The results, overall, suggest that milk may have modest cariostatic properties when ingested at the same time as a cariogenic challenge.