Cocktail Approach with Polyserotonin Nanoparticles and Peptides for Treatment of Streptococcus mutans.

Dental plaque, formed by a Streptococcus mutans biofilm, is a major contributor to cavity formation. While antimicrobial strategies exist, the growing risk of antibiotic resistance necessitates alternative therapeutic solutions. Polyserotonin nanoparticles (PSeNPs), recently recognized for their photothermal property and promising biomedical applications, open up a new avenue for antimicrobial use. Here, we introduced a UV-initiated synthetic route for PSeNPs with improved yield. Using these PSeNPs, a cocktail treatment to reduce the viability of this cavity-causing bacteria was developed. This cocktail comprises an S. mutans-targeting antimicrobial peptide (GH12), an intraspecies competence-stimulating peptide that triggers altruistic cell death in S. mutans, and laser-activated heating of PSeNPs. The "peptide + PSeNP + laser" combination effectively inhibits S. mutans growth in both planktonic and biofilm states. Moreover, the cocktail approach remains effective in reducing the viability of S. mutans in a more virulent dual-species biofilm with Candida albicans. Overall, our results reinforce the utility of a multipronged therapeutic strategy to reduce cariogenic bacteria in the complex model oral biofilm.

Purification of proanthocyanidins from nut seeds and study on its bactericidal mechanism against Streptococcus mutans.

AIM: The aim of this study was to purify proanthocyanidins from areca nut seeds (P-AN) and to investigate the bactericidal activity and mechanism of the purified products against S. mutans. METHODS AND RESULTS: UPLC-Q-TOF-MS, FT-IR, MADLI-TOF-MS and thiolysis experiment were used for P-AN chemical analysis. Time-kill analysis and glycolytic pH drop were used to evaluate the activity of S. mutans in vitro. Meanwhile, the investigation of the bacteriostatic mechanism included membrane protein, fluidity, permeability and integrity tests. The results showed that P-AN was a kind of proanthocyanidins mainly composed of B-type proanthocyanidin and their polymers. Moreover, MADLI-TOF-MS and thiolysis experiments demonstrated that the degree of polymerization (DP) of P-AN was 13. The time-kill analysis showed that P-AN had strong bactericidal activity against S. mutans. P-AN at MIC concentrations was able to induce S. mutans death, while complete lethality occurred at 2 MIC. Glycolysis test showed that P-AN significantly inhibited S. mutans acid production (p < 0.01). The morphological changes of S. mutans were observed by SEM and TEM experiments, which indicated that P-AN destroyed the cellular structure of S. mutans. At the same time, significant changes were observed in membrane proteins, fluidity, permeability and integrity. CONCLUSION: P-AN can effectively inhibit the activity of S. mutans. P-AN can reduce the erosion of the tooth surface by the acid of S. mutans. P-AN could break the structure of cell membrane protein of S. mutans. P-AN could destroy the integrity of membrane, resulting in the death of S. mutans.

Evaluation of Caries Risk Using Cariogram Among Orthodontic Patients Before and During Treatment: A Comparative Study.

Objective The primary objective was to examine the Cariogram parameters among orthodontic patients with fixed appliances and evaluate the impact of preventive measures on mitigating the risk of dental caries during orthodontic therapy. Materials and methods Patients visiting the representative orthodontic clinics across 14 districts of Kerala participated in the comparative cross-sectional study from January 2023 to January 2024. The sampling method employed in this study was convenience quota sampling, where study subjects were allocated from each of the low, moderate, and high caries risk profiles until the sample size reached the minimal requirement within each group. The baseline Cariogram scores were used to divide the consented participants into two distinct groups. The intervention group was provided with preventive initiatives, including toothpaste comprising 1,450 ppm fluoride, 0.2% NaF mouthwash, pre-cut strands of SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, as well as videos, pamphlets, and brochures that promoted oral health habits. In contrast, the control group received normal oral health education solely through the use of pamphlets and brochures. After six months, the Cariogram elements were re-evaluated for individuals in both groups. The independent sample t-test and paired t-test were applied to evaluate statistically significant differences between and within the two groups, respectively, using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, US). The distribution of patients based on their caries risk profiles was compared between groups at the commencement of the study and six months later using the Chi-square test. Results While the intervention group had 20 males and 22 females, the control group consisted of 21 males and 21 females. The average age in the intervention and control groups was 20.7±3.56 years and 21.2±3.12 years, respectively. Between the two groups, age (t=-0.68; p=0.50) and gender differences (λ2=0.05; p=0.83) were statistically insignificant. The percentage mean of the "Chance to avoid caries" associated with the intervention group increased significantly from 46.15±0.96 to 57.88±1.91, (p<0.001). On the other hand, the chance to avoid caries in the control group at the commencement of the treatment and six months later was found to be statistically insignificant. A statistically highly significant differences for all the Cariogram parameters were found when contrasted between the groups after six months of orthodontic treatment. The distribution of caries risk categorization between the control and intervention groups after six months of orthodontic treatment was found to be statistically significant (λ2=20.16; p<0.0001). Further, a statistically significant difference was observed during the pre-treatment phase and six months later in the intervention group (λ2=13.02; p=0.001). Conclusion The study findings reveal that it would be prudent to utilize 0.2% sodium fluoride mouth rinse, SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, along with toothpaste containing 1450 ppm fluoride daily, to mitigate the risk of dental cavities during orthodontic treatment, in comparison to the control group.

Competitive dynamics and balance between Streptococcus mutans and commensal streptococci in oral microecology.

Dental caries, as a biofilm-related disease, is closely linked to dysbiosis in microbial ecology within dental biofilms. Beyond its impact on oral health, bacteria within the oral cavity pose systemic health risks by potentially entering the bloodstream, thereby increasing susceptibility to bacterial endocarditis, among other related diseases. Streptococcus mutans, a principal cariogenic bacterium, possesses virulence factors crucial to the pathogenesis of dental caries. Its ability to adhere to tooth surfaces, produce glucans for biofilm formation, and metabolize sugars into lactic acid contributes to enamel demineralization and the initiation of carious lesions. Its aciduricity and ability to produce bacteriocins enable a competitive advantage, allowing it to thrive in acidic environments and dominate in changing oral microenvironments. In contrast, commensal streptococci, such as Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus salivarius, act as primary colonizers and compete with S. mutans for adherence sites and nutrients during biofilm formation. This competition involves the production of alkali, peroxides, and antibacterial substances, thereby inhibiting S. mutans growth and maintaining microbial balance. This dynamic interaction influences the balance of oral microbiota, with disruptions leading to shifts in microbial composition that are marked by rapid increases in S. mutans abundance, contributing to the onset of dental caries. Thus, understanding the dynamic interactions between commensal and pathogenic bacteria in oral microecology is important for developing effective strategies to promote oral health and prevent dental caries. This review highlights the roles and competitive interactions of commensal bacteria and S. mutans in oral microecology, emphasizing the importance of maintaining oral microbial balance for health, and discusses the pathological implications of perturbations in this balance.

Assessing the physico-mechanical, anti-bacterial, and anti-demineralization properties of orthodontic resin composite containing different concentrations of photoactivated zinc oxide nanoparticles on Streptococcus mutans biofilm around ceramic and metal orthodontic brackets: An ex vivo study.

BACKGROUND AND PURPOSE: The aim of this study was to evaluate the physico-mechanical, anti-bacterial, and anti-demineralization properties of orthodontic resin composite containing photoactivated zinc oxide nanoparticles (ZnONPs) on Streptococcus mutans biofilm around ceramic and metal brackets. MATERIAL AND METHODS: Following the minimum inhibitory concentration (MIC) determination for ZnONPs, shear bond strength (SBS) was tested for composites containing different concentrations of ZnONPs. The chosen concentration was used to evaluate the microleakage, anti-bacterial, and anti-demineralization properties. RESULTS: Adding 50µg/mL of ZnONPs to the orthodontic composite did not negatively affect its physico-mechanical properties. ZnONPs (50µg/mL)-mediated aPDT and 0.2% chlorhexidine significantly (P=0.000) reduced S. mutans biofilms compared to the phosphate-buffered saline (PBS) groups (metal/PBS=7.47±0.7×106, and ceramic/PBS=7.47±0.7×106), with the lowest colony count observed in these groups (metal/chlorhexidine=1.06±0.4×105, ceramic/chlorhexidine=1±0.2×105, metal/ZnONPs-mediated aPDT=1.33±0.3×105, and ceramic/ZnONPs-mediated aPDT=1.2±0.3×105). Sodium fluoride varnish and ZnONPs-mediated aPDT showed the highest efficacy in anti-demineralization and significantly improving the enamel surface microhardness compared to the artificial saliva, especially in ceramic bracket groups (524.17±42.78N and 441.00±29.48N, 394.17±46.83N, P=0.000, and P=0.003, respectively). CONCLUSION: ZnONPs (50µg/mL)-mediated aPDT effectively inhibited S. mutans biofilm and promoted anti-demineralization without adverse effects on the physico-mechanical properties of the composite resin. These results suggest the potential of this method in preventing white spot lesions during orthodontic treatment.

Adding calcium phosphate agents alongside fluorides may enhance caries prevention and remineralization, although evidence is limited.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effectiveness of Calcium Phosphate derivative agents on the prevention and remineralization of caries among children- A systematic review & meta-analysis of randomized controlled trials. Singal K, Sharda S, Gupta A, Malik VS, Singh M, Chauhan A, Agarwal A, Pradhan P, Singh M. J Evid Based Dent Pract. 2022; 22(3):101746. SOURCE OF FUNDING: Indian Council of Medical Research. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.

Effect of adiposity status on salivary Streptococcus mutans and Streptococcus sobrinus.

OBJECTIVES: To investigate the effect of adiposity status, salivary physicochemical parameters, and inflammatory biomarkers on the salivary abundance of the two main cariogenic bacteria Streptococcus mutans and Streptococcus sobrinus among Hong Kong adolescents. SUBJECTS AND METHODS: This study included 180 adolescents aged 12-15 years from Hong Kong local secondary schools. Anthropometric measurements and oral health examinations were performed. Saliva samples were collected to measure salivary physicochemical parameters, protein biomarker levels, and salivary abundance of Streptococcus mutans, Streptococcus sobrinus, and total bacteria. RESULTS: Adolescents with general overweight/obesity or central obesity had significantly higher salivary Streptococcus mutans abundance and total bacterial load, lower stimulated salivary flow rate, and lower secretory phospholipase A2 group IIA levels than the lean controls. Adolescents with general overweight/obesity (OR = 3.33; 95% CI: 1.28-8.65) and those with central obesity (OR = 2.47; 95% CI: 1.02-6.00) had a significantly higher chance of having high salivary abundance of Streptococcus mutans than the lean controls after adjusting for confounders, with a similar detection rate of salivary Streptococcus sobrinus. CONCLUSION: General overweight or obesity and central obesity were associated with a high salivary abundance of Streptococcus mutans but had no significant effect on salivary Streptococcus sobrinus.

Antimicrobial Efficacy of Mangifera indica, Mentha arvensis, and Chlorhexidine Mouthwashes on Streptococcus mutans and Candida albicans in Children: A Comparative In Vivo Study.

Background: Herbal medicines are both promotive and preventive in inhibiting dental caries. Most commonly used natural plant extracts like mango (Mangifera indica) and pudina (Mentha arvensis) as an entire or together are scientifically well proven to be safe and effective against various oral health problems, especially in preventing dental caries and periodontal diseases. Aim: The present study aims to comparatively evaluate the effect of Mangifera indica, Mentha arvensis, and Chlorhexidine (CHX) (0.2%) mouthwashes on Streptococcus mutans (S. mutans) and Candida albicans (C. albicans) in children. Materials and methods: By random allocation, 45 healthy children were selected between the age-group of 7 and 10 years of both genders from a residential school. They were divided into three study groups of 15 in each; group I-CHX (control group), group II-Mangifera indica mouthwash, and group III-Mentha arvensis mouthwash. Stimulated whole saliva sample collected for the amount of colony forming units and cultured for S. mutans and C. albicans. The data was tabulated, and statistical analysis was done with one-way variance analysis of the variance (ANOVA), Tukey's post hoc honestly significant difference (HSD) test, and Bonferroni and Kruskal-Wallis test. Results: Mangifera indica (group II) and Mentha arvensis (group III) showed a significant reduction of salivary counts at baseline, 14th day, and 21st day period and minimal effect on C. albicans for Mangifera indica. Among the three types of mouthwash, the CHX was the most superior; it showed a statistically significant reduction overall. When compared to Mangifera indica with Mentha arvensis, Mentha arvensis showed a statistically significant reduction in S. mutans and C. albicans and had an almost equivocal effect like CHX. Conclusion: Both herbal mouthwashes had a significant reduction in the S. mutans and C. albicans in children. So, it can be considered an active ingredient in mouthwashes. It may serve as a natural antimicrobial mouthwash with no adverse effects. How to cite this article: Kajjari S, K VB, Janardhanan S, et al. Antimicrobial Efficacy of Mangifera indica, Mentha arvensis, and Chlorhexidine Mouthwashes on Streptococcus mutans and Candida albicans in Children: A Comparative In Vivo Study. Int J Clin Pediatr Dent 2024;17(S-1):S78-S83.

Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review.

The primary aim of this study was to evaluate the effectiveness of herbal mouthrinses (HMR) on caries prevention in children and adolescents. In addition, this systematic review assessed its effectiveness in remineralization of white spot lesions, reduction of halitosis, and improving gingival and periodontal health in orthodontic patients and patients with special healthcare needs (SHCN). A comprehensive bibliographic search was conducted in PubMed, Cochrane Central, EMBASE, AMED, ProQuest, CINAHL, AYUSH, Digital Helpline for Ayurveda Research Articles (DHARA), and Clinical Trial Gov databases. A total of 3,918 titles were identified during the initial search. Of these, 32 studies were selected for quality assessment. A total of 5,038 participants from 10 countries were thus included in this review, with 22 (66.7%) studies conducted in India. All included studies were published between 2004 and 2021. Included studies investigated the effect of HMR on caries increments, which record decayed, missing, filled (DMF) [International Caries Detection and Assessment System (ICDAS)], decayed, missing, filled teeth/surfaces (DMFT/S), and incipient caries. Changes in bacterial count (Streptococcus mutans and Lactobacillus) and alterations in levels of Candida albicans from saliva or plaque samples were also reported. The effect of HMR on gingival and plaque indices among adolescents undergoing orthodontic treatment and children with SHCN was reported in two studies. The variance in the HMR formula across studies, short follow-up period, and limiting grade of evidence do not allow for conclusive evidence of the efficacy of HMR. This warrants high-quality randomized controlled trials (RCTs) with longer intervention periods involving children under 6 years to yield more conclusive results. How to cite this article: Saikia AM, Sivasubramanian A, MS M, et al. Herbal Mouthrinses for Prevention of Dental Caries in Children and Adolescents: A Systematic Review. Int J Clin Pediatr Dent 2024;17(S-1):S100-S111.

Evaluation of the effects of Streptococcus salivarius M18 and K12 probiotic bacteria on the Streptococcus mutans in saliva: A randomized clinical trial.

Background: Various methods, including the use of probiotics, have been suggested to prevent caries. Caries, which is mainly caused by Streptococcus mutans, is one of the bacterial diseases that imposes a heavy cost on society. The present study was conducted to investigate the probiotic products available in Iranian pharmacies that are used for caries prevention. Materials and Methods: In this double-blind randomized clinical trial, 40 students of medicine and pharmacy were randomly allocated to two equal groups of intervention and control using random allocation software. The intervention group used a probiotic pill containing Streptococcus salivarius M18 and K12 bacteria every night before going to bed. The control group used a mouth freshener tablet with the same flavor as the probiotic tablet every night before going to bed. The data were analyzed by SPSS (version 24) software using descriptive statistics (central tendency and dispersion) and inferential statistics (paired t-test and independent t-test). Data were collected using Excel software, and statistical analyses were performed by SPSS software (version 24). Results: The mean number of S. mutans in the intervention group was 754.5 cfu/mm before the intervention and 1701.5 cfu/mm after the intervention, which showed a statistically significant difference (P < 0.05). In the control group, the mean S. mutans was 683 cfu/mm at the beginning of the intervention and 659 cfu/mm at the end of the intervention, which did not indicate a statistically significant difference (P > 0.05). Moreover, the normality of data was checked by the Kolmogorov-Smirnov test. Conclusion: The mean number of S. mutans bacteria in the group using probiotic tablets was significantly increased compared to those of the control group. However, further studies are suggested to evaluate these products.

Evaluation of the effects of probiotic pills on the oral plaque indices: A randomized clinical trial.

Background: Clinical trials investigating the efficacy of oral health prevention materials have conventionally used indices to evaluate the amount of plaque on tooth surfaces. Various methods, including the use of probiotics, have been suggested to prevent oral disease. The present study was conducted to investigate the probiotic products available in Iranian pharmacies that are used for the prevention of dental disease. Materials and Methods: In this double-blind randomized clinical trial, 40 students of medicine and pharmacy were randomly allocated into two equal groups of intervention and control using random allocation software. The intervention group used a probiotic pill containing Streptococcus salivarius M18 and K12 bacteria every night before going to bed. The control group used a mouth freshener tablet with the same flavor as the probiotic tablet every night before going to bed. The mean number of Streptococcus mutans bacteria in both the groups was calculated before and after using probiotic pills. The data were staticali analyzed by descriptive statistics (central tendency and dispersion) and inferential statistics (paired t-test and independent t-test) and Kolmogorov-Smironove tests (P<0.05). Results: The plaque index values at the beginning of the study showed no statistical differences between the intervention and control groups (P = 0.85). The plaque index values in the intervention group before and after the intervention were 0.41 and 0.75, respectively, which showed a statistically significant difference (P < 0.05). The plaque index values in the control group before and after the intervention were 0.42 and 0.42, respectively, which indicated no statistically significant difference (P > 0.05). Conclusion: The mean plaque index in the group using probiotic tablets was significantly increased compared to those of the control group. However, further studies are suggested to evaluate these products.

A Comparative Evaluation of Nanosilver Fluoride, Chlorhexidine, and Sodium Fluoride When Used as a Varnish on Streptococcus mutans Levels in Children with Caries.

Aim: The purpose of the present study is to evaluate the effect of nanosilver fluoride (NSF), chlorhexidine (CHX), and sodium fluoride (NaF) when used as a varnish on Streptococcus mutans levels in children with dental caries. Study design: A total of 120 children (age range 8-12 years) with incipient caries were randomly assigned to four groups (n = 30): group I-NSF varnish, group II-CHX varnish, group III-NaF varnish, and group IV-control. Varnish application at baseline was performed once. To assess the levels of S. mutans using the culture method [colony-forming units (CFUs)] and optical density (OD), plaque and samples were taken at baseline (T0), 1 month (T1), and 3 months (T3). Additionally, the oral hygiene index-simplified (OHI-S) was noted for clinical assessment. Results: By the end of 3 months, a statistically significant reduction in plaque CFU and salivary CFU was found in group II. At the conclusion of the 3 months, group I had the greatest decrease in OHI-S. After 3 months, the plaque CFU score did not differ significantly across groups I, II, and III. However, a statistically significant difference in OD values (p-value of 0.00) was discovered between group I and all other groups. Conclusion: Children with early caries can effectively lower their S. mutans count by using NSF varnish. How to cite this article: Raja T, Agarwal N, Jabin Z, et al. A Comparative Evaluation of Nanosilver Fluoride, Chlorhexidine, and Sodium Fluoride When Used as a Varnish on Streptococcus mutans Levels in Children with Caries. Int J Clin Pediatr Dent 2024;17(4):410-416.

Comparative Evaluation of the Antimicrobial Efficacy of Elettaria cardamomum (0.5%) Mouthwash, Camellia sinensis (0.5%) Mouthwash, and 0.12% Chlorhexidine Gluconate Mouthwash against Streptococcus mutans: An In Vitro Study.

Aim: The in vitro study aimed to evaluate and compare the antimicrobial efficacy of Elettaria cardamomum (0.5%) mouthwash, Camellia sinensis (0.5%) mouthwash, and 0.12% chlorhexidine gluconate mouthwash against Streptococcus mutans. Materials and methods: A total of 60 samples of the five mouthwash preparations were prepared to check for their antimicrobial efficacy. The zone of inhibition (ZOI) against S. mutans was measured as a diameter in mm, and the minimum inhibitory concentration (MIC) of mouthwash preparations was measured as µg/mL. All the groups were compared statistically using the Mann-Whitney U test and the Kruskal-Wallis test. Results: The highest ZOI was observed in group V chlorhexidine gluconate [mean: 20.8, standard deviation (SD): 0.58], followed by group III C. sinensis (alcohol-free) (mean: 15.5, SD: 0.67), group IV C. sinensis (alcohol-based) (mean: 14.08, SD: 0.66), and group II E. cardamomum (alcohol-based) (mean: 13.2, SD: 0.45). The least ZOI was observed in group I E. cardamomum (alcohol-free) (mean: 10.7, SD: 0.45). This difference was statistically significant (p < 0.01). The MIC was similar in all the groups (p = 0.13). Conclusion: Chlorhexidine gluconate 0.12% mouthwash showed the best antimicrobial action; however, C. sinensis mouthwash showed potential against S. mutans. E. cardamomum mouthwash exhibited limited antimicrobial activity. How to cite this article: Deolikar S, Jawdekar A, Saraf T, et al. Comparative Evaluation of the Antimicrobial Efficacy of Elettaria cardamomum (0.5%) Mouthwash, Camellia sinensis (0.5%) Mouthwash, and 0.12% Chlorhexidine Gluconate Mouthwash against Streptococcus mutans: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(4):461-466.

Targeting glucosyltransferases to combat dental caries: Current perspectives and future prospects.

The emergence of antimicrobial resistance within bacterial communities poses formidable challenges to existing therapeutic strategies aimed at mitigating biofilm-mediated infections. Recent advancements in this domain have spurred the development of targeted antimicrobial agents, designed to selectively eradicate the primary etiological agents while preserving the beneficial microbial diversity of the oral cavity. Targeting glucosyltransferases (GTFs), which play crucial roles in dental biofilm formation, offers a precise strategy to inhibit extracellular polysaccharide synthesis without compromising oral microbiota. This review article delves into the intricate mechanisms underlying dental caries, with a specific focus on the role of GTFs, enzymes produced by S. mutans. It further provides an overview of current research on GTF inhibitors, exploring their mechanisms of action, efficacy, and potential applications in clinical practice. Furthermore, it discusses the challenges and opportunities in the development of novel GTF inhibitors, emphasizing the need for innovative approaches to combat biofilm-mediated oral diseases effectively.

Real-time flow cytometry to assess qualitative and quantitative responses of oral pathobionts during exposure to antiseptics.

Antiseptics are widely used in oral healthcare to prevent or treat oral diseases, such as gingivitis and periodontitis. However, the incidence of bacteria being tolerant to standard antiseptics has sharply increased over the last few years. This stresses the urgency for surveillance against tolerant organisms, as well as the discovery of novel antimicrobials. Traditionally, susceptibility to antimicrobials is assessed by broth micro-dilution or disk diffusion assays, both of which are time-consuming, labor-intensive, and provide limited information on the mode of action of the antimicrobials. The abovementioned limitations highlight the need for the development of new methods to monitor and further understand antimicrobial susceptibility. In this study, we used real-time flow cytometry, combined with membrane permeability staining, as a quick and sensitive technology to study the quantitative and qualitative responses of two oral pathobionts to different concentrations of chlorhexidine (CHX), cetylpyridinium chloride (CPC), or triclosan. Apart from the real-time monitoring of cell damage, we further applied a phenotypic fingerprinting method to differentiate between the bacterial subpopulations that arose due to treatment. We quantified the pathobiont damage rate of different antiseptics at different concentrations within 15 minutes of exposure and identified the conditions under which the bacteria were most susceptible. Moreover, we detected species-specific and treatment-specific phenotypic subpopulations. This proves that real-time flow cytometry can provide information on the susceptibility of different microorganisms in a short time frame while differentiating between antiseptics and thus could be a valuable tool in the discovery of novel antimicrobial compound, while at the same time deciphering their mode of action. IMPORTANCE: With increasing evidence that microorganisms are becoming more tolerant to standard antimicrobials, faster and more accessible antimicrobial susceptibility testing methods are needed. However, traditional susceptibility assays are laborious and time-consuming. To overcome the abovementioned limitations, we introduce a novel approach to define antimicrobial susceptibility in a much shorter time frame with the use of real-time flow cytometry. Furthermore, phenotypic fingerprinting analysis can be applied on the data to study the way antiseptics affect the bacterial cell morphology over time and, thus, gain information on the mode of action of a certain compound.

Efficacy of Immunoglobulin Y Chewable Tablets on Streptococcus mutans Count in Patients Undergoing Orthodontic Treatment.

Aim: The aim of the study was to determine the efficacy of commercially available immunoglobulin Y (IgY) chewable tablets on Streptococcus mutans (S. mutans) count in patients undergoing orthodontic treatment. Materials and methods: Participants aged between 12 and 19 years who had fixed, nonextraction orthodontic treatment with no carious lesion were included in the study and advised to take IgY chewable tablet for 15 days (one course) and saliva samples were collected from the patients on day 61, 91, and 121 days from the placement of fixed appliance, to assess its ability in reduction of S. mutans count. The collected samples were processed, and S. mutans levels were estimated. The results were tabulated and subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) version 20, and the repeated measures test was used to compare different groups. Results: Immunoglobulin Y (IgY) chewable tablet was found to be significantly effective in decreasing S. mutans counts in patients undergoing orthodontic treatment during the study period. Conclusion: Oral passive immunotherapy via egg yolk antibody IgY effectively decreased the S. mutans level, which was found to increase during orthodontic fixed appliance treatment. Clinical significance: The IgY chewable tablets can be used as an adjuvant to reduce S. mutans counts and provide basic oral hygiene measures. How to cite this article: Muthukumaran M, Jayaprakash J, Arangannal P, et al. Efficacy of Immunoglobulin Y Chewable Tablets on Streptococcus mutans Count in Patients Undergoing Orthodontic Treatment. Int J Clin Pediatr Dent 2024;17(3):265-269.

In vitro assessment of NaF/Chit supramolecular complex: colloidal stability, antibacterial activity and enamel protection against S. mutans biofilm.

OBJECTIVES: This study assessed the effect of NaF/Chit suspensions on enamel and on S. mutans biofilm, simulating application of a mouthrinse. METHODS: The NaF/Chit particle suspensions were prepared at molar ratio [NaF]/Chitmon]≈0.68 at nominal concentrations of 0.2% and 0.05% NaF and characterized by Fourier transform infrared spectroscopy (FTIR), dynamic light scattering and zeta potential. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were measured. The S. mutans biofilm was formed for 7 days on eighty human enamel blocks that were divided into eight groups (n=10/group): i) 0.05% NaF solution; ii) 0.31% Chit solution; iii) NaF/Chit(R=0.68) suspension at 0.05% NaF; iv) 1.0% HAc solution (Control); v) 0.2% NaF solution; vi) 1.25% Chit solution; vii) NaF/Chit(R=0.68) suspension at 0.2% NaF; viii) 0.12% chlorhexidine digluconate. The substances were applied daily for 90s. S. mutans cell counts (CFU/mL) were performed, and the Knoop microhardness (KHN) of enamel samples were measured before and after biofilm formation. The KHN and CFU/mL data were analyzed by repeated measure ANOVA and Tukey's test (α = 0.05). RESULTS: Interactions between NaF and Chit were evidenced in solid state by FTIR spectra. The NaF/Chit complexes showed spontaneous microparticle formation and colloidal stability. The MIC and MBC ranged from 0.65-1.31 mg/mL. The NaF/Chit(R=0.68) suspension at 0.2%NaF Group showed lower CFU/mL values than other groups. The NaF/Chit(R=0.68) suspensions Groups had the highest KHN values after biofilm formation. CONCLUSIONS: The NaF/Chit(R=0.68) complexes exhibited an antibacterial effect against S. mutans biofilm and reduced the enamel hardness loss. CLINICAL SIGNIFICANCE: The NaF/Chit(R=0.68) suspensions showed potential to be used as a mouthrinse for caries prevention.

Evaluation of probiotics' efficiency on cariogenic bacteria: randomized controlled clinical study.

BACKGROUND: Probiotics are live beneficial bacteria to human health and their efficiency on oral health is still being investigated. The purpose of this study was to evaluate the level of Streptococcus mutans and Lactobacillus species with and without the use of probiotics for six-months after the treatment of all dental caries under general anesthesia. METHODS: Fifty-eight pediatric patients without any systemic diseases, whose dental treatments were completed under general anesthesia (GA), were included in the study. The patients were recruited in two-groups; Group A: Patients started using probiotics after GA and Group B: Patients did not use probiotics after GA. Saliva samples were taken from all patients on the day before GA (T0), at one-month (T1), three-month (T2) and six-month (T3) follow-up after GA. The counts of cariogenic bacteria were determined by the analysis of saliva samples using real-time polymerase chain reaction. Statistical significance level was accepted as p < 0.05. RESULTS: There was statistically significant difference between Group A and B for T0, T1, T2 and T3 regarding S. mutans (p = 0.001, p = 0.04, p = 0.04, p = 0.03; p < 0.05). However, there was no statistically significant difference between groups regarding Lactobacillus species (p ≥ 0.05). CONCLUSIONS: Probiotic use and treatment of all caries significantly reduced the level of S. mutans but not Lactobacillus species. Furthermore, S. mutans decreased after cessation of probiotics, but it was not statistically significant. TRIAL REGISTRATION: Study was registered as "Effects of Probiotics on Streptococcus mutans and Lactobacillus species" with the registration number of NCT05859646 (16/05/2023) at https://www. CLINICALTRIALS: gov Protocol Registration and Results System.

Development of antibacterial dual-cure dental resin composites via tetrapod-shaped zinc oxide incorporation.

OBJECTIVES: This study aimed to evaluate the effects of incorporating the 0-20 wt% tetrapod-shaped zinc oxide (tZnO) whiskers on the mechanical, antibacterial, and cytotoxic properties exhibited by experimental dual-cure resin composites. METHODS: Commercially obtained tZnO whiskers underwent surface modification using 3-methacryloxypropyltrimethoxysilane (γ-MPS). Subsequently, four groups of resin composites containing 0, 5, 10, and 20 wt% silanized tZnO along with barium borosilicate glass (BaBSG) fillers were fabricated while maintaining total filler loading at 60 wt%. Mechanical properties were examined utilizing specimens produced adhering to ISO 4049:2019 guidelines where applicable. Depth of cure was quantified immediately, while three-point flexural strength, flexural modulus, fracture toughness, Vickers hardness, compressive strength, and diametral tensile strength were assessed after 24 h of storage in 37 °C distilled water. Planktonic bacteria of Streptococcus mutans (S. mutans) were cultured and tested for antibacterial activity using disk diffusion and microbial anti-adhesion assays. Cytotoxicity was examined by preparing extracts from specimens in a cell culture medium and exposing stem cells from human exfoliated deciduous teeth (SHED) to serial dilutions of these extracts, then assessing cell viability and survival using CCK-8 assay and live/dead staining. RESULTS: Elevating tZnO loading yielded significant reductions in depth of cure, compressive (from 296.4 to 254.6 MPa), and diametral tensile strength (from 42.7 to 31.0 MPa), while flexural strength (91.3-94.1 MPa), flexural modulus (6.4-6.6 GPa), fracture toughness (0.96-1.04 MPa·m0.5), and Vickers hardness (36.5-37.4 kgf·mm-2) remained the same. Composites integrating tZnO displayed markedly enhanced antibacterial activity against S. mutans, based on anti-adhesion tests and live/dead staining. No cytotoxicity was observed for SHED treated with extracts from resin composites possessing up to 20 wt% tZnO whiskers. SIGNIFICANCE: This study demonstrates that incorporating up to 20 wt% silanized tZnO in place of traditional barium glass particles appreciably enhances dual-cure resin composite antibacterial function against S. mutans without compromising mechanical properties.

Bioactivity and antibacterial effect of star anise biosynthesized silver nanoparticles against Streptococcus mutans: an in vitro study.

BACKGROUND: Silver nanoparticles (AgNPs) are receiving a lot of attention as a prospective antibacterial agent for use in caries prevention. The objective of this study was to investigate the bioactivity and antibacterial effect of silver nanoparticles biosynthesized using Star Anise against Streptococcus mutans (S.mutans). METHODS: The bioactive components of the Star Anise were assessed by employing the gas chromatography-mass spectrometry technique. The antibacterial activities of Star Anise Biosynthesized Silver Nanoparticles against S.mutans bacteria were evaluated using Bauer and Kirby's disc diffusion mechanism and the minimum inhibitory concentration. RESULTS: Silver nanoparticles biosynthesized using Star Anise revealed high antioxidant activity. AgNPs inhibited S. mutans with a 16 mm inhibition zone diameter and demonstrated an 80 µg/ml minimum inhibitory concentration. CONCLUSIONS: Biologically synthesized AgNPs made from aqueous extract of Star anise appear to be a potential and effective bactericidal agent against S.mutans that can be used to prevent dental caries.