Comparison of modified bass, rolling, and current toothbrushing techniques for the efficacy of plaque control - A randomized trial.

OBJECTS: This study aimed to compare the effectiveness of the modified Bass technique (MBT), the Rolling technique and the current brushing technique(CBT) for plaque removal and to assess the acceptability of the first two brushing techniques. METHODS: 180 participants were randomly assigned to PowerPoint-based training with a demonstration of either the MBT plus basic toothbrushing, the Rolling technique plus basic toothbrushing, or the basics of tooth brushing alone (CBT group). The participants were asked to brush their teeth based on what they had learned. The Turesky modification of the plaque index of Quigley & Hein (TQHI) and marginal plaque index (MPI) were assessed at the baseline examination and after 1, 2, and 4 weeks. Brushing sequence, brushing technique, and brushing duration were measured immediately after training and at each subsequent interview. RESULTS: After instruction (0 weeks), all groups showed a significant decrease in TQHI and MPI (p<0.001), followed by a gradual increase. There was no difference in the overall effect of plaque removal between the groups(p>0.05). MBT had a better effect on cervical plaque removal than the Rolling technique after 4 weeks (p<0.05). More participants in the Rolling group were able to fully master the brushing technique during the whole four weeks. CONCLUSIONS: There was no difference in the overall plaque removal effect among the three groups. The MBT was most effective in removing plaque at the cervical margin but more difficult to master. CLINICAL SIGNIFICANCE STATEMENT: This study was conducted to compare the teaching and plaque removal effects of two brushing techniques and to understand which method is better for plaque removal as well as adoption. This study provides a reference and basis for future clinical work and oral hygiene education.

Exploration of the Main Antibiofilm Substance of Lactobacillus plantarum ATCC 14917 and Its Effect against Streptococcus mutans.

Dental plaque, a complex biofilm system established by cariogenic bacteria such as Streptococcus mutans (S. mutans), is the initiator of dental caries. Studies have found that the cell-free supernatant (CFS) of Lactobacilli could inhibit S. mutans biofilm formation. However, the main antibiofilm substance of the Lactobacilli CFS that acts against S. mutans is unclear. The present study found that the CFS of Lactobacillus plantarum (L. plantarum) ATCC 14917 had the strongest antibiofilm effect among the five tested oral Lactobacilli. Further bioassay-guided isolation was performed to identify the main antibiofilm substance. The antibiofilm effect of the end product, named 1-1-4-3, was observed and the structure of it was elucidated by using Q-TOF MS, 2D NMR and HPLC. The results showed that several components in the CFS had an antibiofilm effect; however, the effect of 1-1-4-3 was the strongest, as it could reduce the generation of exopolysaccharides and make the biofilm looser and thinner. After structure elucidation and validation, 1-1-4-3 was identified as a mixture of lactic acid (LA) and valine. Additionally, LA was shown to be the main antibiofilm substance in 1-1-4-3. In summary, this study found that the antibiofilm effect of the L. plantarum CFS against S. mutans was attributable to the comprehensive effect of multiple components, among which LA played a dominant role.

Effects of a derivative of reutericin 6 and gassericin A on the biofilm of Streptococcus mutans in vitro and caries prevention in vivo.

It is known that Streptococcus mutans (S. mutans) is the leading cariogenic pathogen. Recently, an increasing number of antimicrobial peptides (AMPs) have been brought into consideration as anti-caries agents. Here, we designed and synthesized an AMP derived from reutericin 6 and/or gassericin A, named LN-7, and explored its effect on biofilm of S. mutans UA159 in vitro and development of dental caries in vivo. Antibacterial assays showed that LN-7 was more active against S. mutans (3.2 µM) than many peptide-based agents, capable of killing other types of Streptococci in oral cavity. In addition, LN-7 presented fast killing kinetics, with more than 97% S. mutans killed within 5 min. The mechanism of the antimicrobial activity mainly lies on the disruption of bacterial membrane. Effects of LN-7 on the biofilm formation and the viability of preformed biofilm were quantified by crystal violet staining, which showed that LN-7 could effectively inhibit the biofilm accumulation of S. mutans. Moreover, the biofilm of S. mutans treated with LN-7 displayed notable changes in bacterial viability and morphology, observed by confocal laser scanning microscopy and scanning electron microscopy. In addition, topical oral treatment with LN-7 could suppress the development of dental caries in vivo, reducing the occurrence of severe dental lesion in a rodent model. These results reveal a new peptide-based agent as a topical treatment for dental caries, opening the door to clinical studies to explore its potential for caries prevention.

[Design, screening and antimicrobial activity of novel peptides against Streptococcus mutans].

OBJECTIVE: To construct antimicrobial peptides with potent antimicrobial activity, low cytotoxicity and efficient killing rate of Streptococcus mutans for prevention and treatment of dental caries. METHODS: We exploited the existing design strategies to modify reutericin 6 or gassericin A produced by Lactobacillus species in the oral cavity based on their cationicity, amphipathicity and α-helical structure. We examined their antimicrobial activities using bacterial susceptibility assay, their cytotoxicity through cytotoxicity assay and their killing rate of Streptococcus mutans with time-kill assay. We further evaluated the candidate derivatives for their killing rate against Streptococcus mutans, their antimicrobial activity against different oral pathogens and the development of drug resistance. RESULTS: We constructed 6 AT-1 derivatives, among which AT-7 showed an MIC of 3.3 µmol/L against Streptococcus mutans, Porphyromonas gingivalis and Actinomyces viscosus with a killing rate of 88.7% against Streptococcus mutans within 5 min. We did not obtain de novo strains of Streptococcus mutans resistant to AT- 7 after induction for 10 passages. CONCLUSIONS: Hydrophobicity and imperfect amphipathic structure are two key parameters that define the antimicrobial potency of the antimicrobial peptides. The imperfectly amphipathic peptide AT-7 shows the potential for clinical application in dental caries treatment.

Rational design of peptides with enhanced antimicrobial and anti-biofilm activities against cariogenic bacterium Streptococcus mutans.

Streptococcus mutans (S. mutans) is known to be a leading cariogenic pathogen in the oral cavity. Antimicrobial peptides possess excellent properties to combat such pathogens. In this study, we compared the antimicrobial activity of novel linear reutericin 6- and/or gassericin A-inspired peptides and identified LR-10 as the leading peptide. Antibacterial assays demonstrate that LR-10 is more active against S. mutans (3.3 µM) than many peptide-based agents without resistance selection, capable of killing many oral pathogens, and tolerant of physiological conditions. LR-10 also presented a faster killing rate than chlorhexidine and erythromycin, and appeared to display selective activity against S. mutans within 10 s. S. mutans is usually encased in plaque biofilms. Biofilm inhibitory assays indicated that LR-10 had excellent inhibitory effect on the biofilm formation of S. mutans and biofilm-encased cells in vitro at low concentrations (6.5 µM). Consistent with most peptides, LR-10 kills S. mutans mainly by disrupting the cell membranes. Notably, both hemolytic activity assays and cytotoxicity tests indicated that LR-10 could keep biocompatible at the effective concentrations. Hence, LR-10 could be a good candidate for clinical treatment of dental caries.