Evaluating biofilm growth of two oral pathogens

Preliminary study on the inhibitory effect of seaweed Gracilaria verrucosa extract on biofilm formation of Candida albicans cultured from the saliva of a smoker

Background:Candida albicans is an opportunistic fungus that might infect the oral cavity. Increased colony numbers of C. albicans in the mouth can be caused by multiple factors, such as smoking, weakened immune system, antibiotics use and immune-compromised condition. Smoking can increase expression of virulence factors of C. albicans and make it stronger. One virulence factor of C. albicans is biofilm formation. The ability of creating biofilm makes C. albicans more tolerant to commercial antifungal agents. The objective of this preliminary study was to examine the ability of the seaweed G.verrucosa extracts to inhibit the formation of biofilm by C. albicans isolated from the saliva of a smoker.

Methods: The extract of G. verrucosa was prepared by maceration using 96% methanol and subjected for phytochemical analysis. C. albicans was isolated from the saliva of a smoker who voluntarily participated in the study after providing informed consent. In triplicate, the fungus was cultured in the growth medium containing increased concentrations of G. verrucosa (6.25, 12.5, 25, 50, 75 and 100% ).The same reaction using fluconazole 0.31 µg/ml C. albicans was prepared as positive control. Biofilm formation was accessed based on optical density of cell mixtures using an ELISA reader. The data obtained were subjected to Kruskal-Wallis test at a significance limit of 0.05.

Results: Methanol extract of seaweed G. verrucosa contained three bio-active compounds namely steroids, terpenoid, and tannins. Inhibitory activity of seaweed extracts on C. albicans biofilm formation increased as their concentration increased. The highest inhibitory effect was recorded at fungus culture treated with seaweed concentration of 25% at 24 hours of time exposure.

Conclusions: Seaweed G. verrucosa extract contained steroids, terpenoids and tannins that were able to effectively inhibit the formation of biofilm by C. albicans at the concentration of 25% after 24 hours of time exposure.

Antimicrobial efficacy of an innovative emulsion of medium chain triglycerides against canine and feline periodontopathogens

OBJECTIVES

To test the in vitro antimicrobial efficacy of a non-toxic emulsion of free fatty acids against clinically relevant canine and feline periodontopathogens

METHODS

Antimicrobial kill kinetics were established utilising an alamarBlue(®) viability assay against 10 species of canine and feline periodontopathogens in the biofilm mode of growth at a concentration of 0·125% v/v medium chain triglyceride (ML:8) emulsion. The results were compared with 0·12% v/v chlorhexidine digluconate and a xylitol-containing dental formulation. Mammalian cellular cytotoxicity was also investigated for both the ML:8 emulsion and chlorhexidine digluconate (0·25 to 0·0625% v/v) using in vitro tissue culture techniques.

RESULTS

No statistically significant difference was observed in the antimicrobial activity of the ML:8 emulsion and chlorhexidine digluconate; a high percentage kill rate (>70%) was achieved within 5 minutes of exposure and was maintained at subsequent time points. A statistically significant improvement in antibiofilm activity was observed with the ML:8 emulsion compared with the xylitol-containing formulation. The ML:8 emulsion possessed a significantly lower (P < 0·001) toxicity profile compared with the chlorhexidine digluconate in mammalian cellular cytotoxicity assays.

CLINICAL SIGNIFICANCE

The ML:8 emulsion exhibited significant potential as a putative effective antimicrobial alternative to chlorhexidine- and xylitol- based products for the reduction of canine and feline periodontopathogens.

Capillary-tube-based micro-plasma system for disinfecting dental biofilm

PURPOSE

A low-temperature low-energy capillary-tube-based argon micro-plasma system was applied to disinfect Streptococcus mutans-containing biofilm.

MATERIALS AND METHODS

The micro-plasma system uses a hollow inner electrode that is ignited by a radio-frequency power supply with a matching network. The energy content was analyzed using optical emission spectroscopy. The micro-plasma-induced effect on a biofilm cultured for 24 or 48 h with a working distance of ≈3 mm at low temperature was evaluated. The morphologies of the treated live/dead bacteria and the produced polysaccharides after micro-plasma treatment were examined.

RESULTS

Scanning electron microscopy images and staining results show that most of the S. mutans on the treated biofilm were acutely damaged within a micro-plasma treatment time of 300 s.

CONCLUSIONS

The number of living bacteria underneath the treated biofilm greatly decreased with treatment time. The proposed micro-plasma system can thus disinfect S. mutans on/in biofilms.

MPC-polymer reduces adherence and biofilm formation by oral bacteria

Oral biofilms such as dental plaque cause dental caries and periodontitis, as well as aspiration pneumonia and infectious endocarditis by translocation. Hence, the suppression of oral biofilm formation is an issue of considerable importance. Mechanical removal, disinfectants, inhibition of polysaccharide formation, and artificial sugar have been used for the reduction of oral biofilm. From the viewpoint of the inhibition of bacterial adherence, we investigated whether aqueous biocompatible 2-methacryloyloxyethyl phosphorylcholine (MPC)-polymer can reduce streptococcal colonization and biofilm formation. We examined the effects of MPC-polymer on streptococcal adherence to saliva-coated hydroxyapatite and oral epithelial cells, and the adherence of Fusobacterium nucleatum to streptococcal biofilm. MPC-polymer application markedly inhibited both the adherence and biofilm formation of Streptococcus mutans on saliva-coated hydroxyapatite and streptococcal adherence to oral epithelial cells, and reduced the adherence of F. nucleatum to streptococcal biofilms. A small-scale clinical trial revealed that mouthrinsing with MPC-polymer inhibited the increase of oral bacterial numbers, especially of S. mutans. These findings suggest that MPC-polymer is a potent inhibitor of bacterial adherence and biofilm development, and may be useful to prevent dental-plaque-related diseases. (UMIN Clinical Trial Registry UMIN000003471).

In-vitro evidence for efficacy of antimicrobial mouthrinses

OBJECTIVE

The objective of this study was to compare the antimicrobial activity of commercially available antiseptic mouthrinses against saliva-derived plaque biofilms in static and flow-through biofilm systems in vitro.

METHODS

Nine mouthrinses were tested in a recirculating flow-through biofilm model (RFTB) with viability assessment by ATP bioluminescence. In addition, five mouthrinses were evaluated in a batch chamber slide biofilm (BCSB) model, using live/dead staining and confocal laser scanning microscopy.

RESULTS

In the RFTB model, essential oil (EO) and chlorhexidine (CHX)-containing rinses showed equivalent antimicrobial activity and were more effective than a range of cetyl pyridinium chloride (CPC1) formulations. In the BCSB model, twice-daily mouthrinse exposure demonstrated that the EO rinse was significantly more effective than rinses containing amine and stannous fluorides (AFSF), a combination of CPC/CHX, and another CPC formulation (CPC2). EO showed biofilm kill comparable to the CHX rinse.

CONCLUSIONS

The present studies have shown that mouthrinses vary significantly in their capability to kill plaque biofilm bacteria in BCSB and RFTB models. The EO mouthrinse demonstrated superior antiplaque biofilm activity to AFSF, CPC/CHX, and CPC rinses and comparable activity to CHX. The methods tested may be of value for the in-vitro screening of antiseptic rinses with different modes of antimicrobial action.

The effect of c-di-GMP (3'-5'-cyclic diguanylic acid) on the biofilm formation and adherence of Streptococcus mutans

Depending on a biofilm lifestyle, Streptococcus mutans (S. mutans) is thought to be one of the primary causative agents of dental caries. Biofilm formation and adhesion are crucial physiological functions and virulence factors for S. mutans. Thus, attempts to control the development of dental caries only by inhibiting one of the several virulence factors are not effective. Cyclic diguanylate (c-di-GMP) [bis(3',5')-cyclic diguanylic acid] is a prokaryotic cyclic dinucleotide second messenger that has been implicated in determining the timing and amplitude of complex biological processes from biofilm formation and virulence to photosynthesis. Here, we demonstrate that this signaling molecule also plays a role in the ability of S. mutans to initiate biofilm formation and adhere to tooth surfaces. To test this hypothesis, S. mutans UA159 and its gcp gene knockout mutant were assayed for their ability to initiate biofilm formation and adherence. The spatial distribution and architecture of the biofilms were examined by scanning electron microscopy. These results show that inactivation of the gcp gene resulted in the formation of an abnormal biofilm. We confirmed that c-di-GMP was effective in preventing biofilm formation of S. mutans UA159. We also found that extracellular c-di-GMP inhibited the adherence of S. mutans to tooth surfaces and reduced (>50%) biofilm formation compared to the untreated control. These results indicate that c-di-GMP attenuates the caries-inducing virulence factors of S. mutans. This suggests that c-di-GMP may be used alone or in combination with other antimicrobial agents, and that such a treatment could be developed into a novel method to prevent tooth decay.

Treatment of Streptococcus mutans biofilms with a nonthermal atmospheric plasma

AIMS

A nonthermal atmospheric plasma, designed for biomedical applications, was tested for its antimicrobial activity against biofilm cultures of a key cariogenic bacterium Streptococcus mutans.

METHODS AND RESULTS

The Strep. mutans biofilms were grown with and without 0.15% sucrose. A chlorhexidine digluconate rinse (0.2%) was used as a positive antimicrobial reference. The presence of sucrose and the frequency of plasma application during growth were shown to have a significant effect on the response to treatment and antibacterial activity.

CONCLUSIONS

A single plasma treatment for 1 min on biofilms cultured without sucrose caused no re-growth within the observation period. However, with either single or repeated plasma treatments of 1 min, on biofilms cultured with 0.15% sucrose, growth was only reduced.

SIGNIFICANCE AND IMPACT OF THE STUDY

In summary, there may be a role for nonthermal plasma therapies in dental procedures. Sucrose and associated growth conditions may be a factor in the survival of oral biofilms after treatment.

Real-time monitoring of the development and stability of biofilms of Streptococcus mutans using the quartz crystal microbalance with dissipation monitoring

Quartz crystal microbalance with dissipation monitoring (QCM-D) was used for continuous in-situ monitoring of cell attachment and growth of Streptococcus mutans as biofilms. Cell attachment and proliferation were monitored within an overnight period of 20 h. Biofilms generated using a 'continuous flow' method had a greater mass and were more dissipative (more viscoelastic) than those established using an 'attach and flow' strategy. Cell numbers (as colony forming units, c.f.u.) in biofilms formed inside the QCM-D device after a 2-h attachment phase and during a 20-h growth period could be related to frequency (f) changes. The percentage surface coverage on the QCM-D crystals by bacteria was estimated using the surface analysis features of the atomic force microscope and image analysis software. Both mean percentage coverage and c.f.u increased after growth of S. mutans. The energy losses displayed by the increases in the dissipative factor (D) indicated an increase in 'softness' of the attached cells. The ratio of D/f was used to provide information of the way in which viscoelasticity changed per unit mass. Flow conditions over the cells on the surface appeared to be important in creating biofilms of a greater complexity and stability and the QCM-D enabled properties of cells during attachment and binding, proliferation and removal to be monitored continuously.

Caries-related plaque microcosm biofilms developed in microplates

In vivo dental plaque biofilms consist of complex communities of oral bacteria that are a challenge to replicate in vitro. The aim of this investigation was to establish human dental plaque microcosms in microplates to reflect conditions that are relevant to dental caries. Microcosm plaque biofilms were initiated from the saliva of two different donors, grown for up to 10 days in 24-welled microplates on Thermanox coverslips in various types of artificial saliva with and without sucrose, which were replaced daily. Microbiota composition of 40 species associated with oral health and dental caries was monitored in the plaques using Checkerboard DNA-DNA hybridization analysis. pH was measured as an indicator of cariogenic potential. The composition of the saliva inocula was different, and yielded plaque microcosms with different composition and growth responses to sucrose. Artificial saliva type and presence of sucrose, and the resulting growth and pH conditions, modified the growth of individual species and hence the ecological profile of the microplate plaques during development. Complex population shifts were observed during development, and older plaques comprised predominantly facultative anaerobic species. Sucrose supplementation limited the decline of Streptococci over time but did not increase the abundance of mutans Streptococci. Sucrose at 0.15% increased levels of caries-associated species including Lactobacillus fermentum, Lactobacillus acidophilus and Actinomyces gerensceriae; these were further increased with sucrose at 0.5%, in addition to Actinomyces israelii, Rothia dentocariosa and Capnocytophaga gingivalis. The microplate plaques demonstrated complex community dynamics that appeared to reflect the maturation of natural plaques, and sucrose induced a cariogenic plaque composition and pH.

A simulated oral hygiene model to determine the efficacy of repeated exposure of amine oxide on the viability of Streptococcus mutans biofilms

The use of biocide in oral care products is important for controlling microbial pathogens. However, the use of biofilm tests that investigate repeated exposure to biocide, to mimic in situ treatment, has rarely been reported in the literature. The present study describes the application of a biofilm-based efficacy protocol, for testing the effect of repeated exposure to antimicrobials on biofilm, in an attempt to mimic oral care regimens. The activity of different treatment regimens, including repeated exposure to amine oxide (AO; C(10)-C(16)-alkyldimethyl N-oxides; 1.1% v/v), was conducted against 16-h Streptococcus mutans biofilms grown on hydroxyapatite disks. Single exposure to AO alone produced a 3 log(10) reduction in microbial count, but when combined with mechanical removal, a 5 log(10) reduction in microbial count was observed. Treatments incorporating repeated exposure to AO reduced the microbial count below the level of detection, even when exposure to AO was interspersed with recovery periods. The presence of organic load produced an additional 2 log(10) reduction in the microbial count. This study showed that the application of a biofilm-based efficacy protocol to mimic oral care regimens allowed the reproducible testing of repeated antimicrobial exposures against bacterial biofilm. In addition, AO was confirmed to be an excellent biocide for eliminating S. mutans biofilms and could therefore be beneficial in oral care formulations.

Activity of amine oxide against biofilms of Streptococcus mutans: a potential biocide for oral care formulations

AIMS

To assess the potential bactericidal activity of amine oxide (C10-C16-alkyldimethyl N-oxides) against Streptococcus mutans grown as planktonic suspension and as biofilm on hydroxyapatite discs, and its ability to control acidification of the media.

METHODS

Amine oxide bacteriostasis was investigated using the Bioscreen C Microbiological Growth Analyser, while a standard suspension test was used to determine its bactericidal efficacy. In addition, the lethal activity of amine oxide was studied against sedimentation biofilms of S. mutans on hydroxyapatite (HA) discs and resuspended biofilms. Several parameters were considered such as the surfactant concentration, pH, the starting inoculum and the maturity of the biofilm.

RESULTS

Amine oxide was bacteriostatic against planktonic S. mutans at a low concentration (0.006% v/v) and highly bactericidal against S. mutans in suspension or in a mature biofilm on hydroxyapatite, although the concentration required to achieve the latter effect was four times higher. The activity of amine oxide against biofilms depended upon its concentration and the age of the biofilm. In addition, amine oxide pre-treatment of the HA discs did not affect the growth of the biofilm. Finally, amine oxide did not prevent the acidification of the medium, although lower pHs had a potentiating effect on amine oxide activity.

CONCLUSION

Amine oxide showed high potential for controlling early biofilms caused by periodontal bacteria. Further investigations should be carried out, particularly on the potential toxicity of amine oxide and its efficacy in complex formulations for oral care products.

Antimicrobial effects of essential oils in combination with chlorhexidine digluconate

The aim of the present study was to compare antimicrobial effects of essential oils alone and in combination with chlorhexidine digluconate against planktonic and biofilm cultures of Streptococcus mutans and Lactobacillus plantarum. The essential oils included cinnamon, tea-tree (Melaleuca alternifola), manuka (Leptospermum scoparium), Leptospermum morrisonii, arnica, eucalyptus, grapefruit, the essential oil mouthrinse Cool Mint Listerine and two of its components, menthol and thymol. Cinnamon exhibited the greatest antimicrobial potency (1.25-2.5 mg/ml). Manuka, L. morrisonii, tea-tree oils, and thymol also showed antimicrobial potency but to a lesser extent. The combination effect of the essential oil-chlorhexidine was greater against biofilm cultures of both S. mutans and L. plantarum than against planktonic cultures. The amount of chlorhexidine required to achieve an equivalent growth inhibition against the biofilm cultures was reduced 4-10-fold in combination with cinnamon, manuka, L. morrisonii, thymol, and Listerine. We conclude that there may be a role for essential oils in the development of novel anticaries treatments.

An ex-vivo multiplexed antibacterial test on oral microflora

BACKGROUND/AIMS

Characterized clinical strains of oral bacteria are utilized to examine the antimicrobial efficacy of oral care formulations. A demonstration of antimicrobial effects of formulations on microbial samples obtained from the human mouth offers advantages, i.e. incorporates the considerable microbial diversity of this environment with bacteria harvested from naturally occurring biofilms to form the focus of this investigation.

MATERIALS AND METHODS

Samples of oral flora from each adult subject were briefly treated (2 min) with test and control formulations and plated on appropriate agar for multiplexed antimicrobial effects on functional groups of oral bacteria associated with specific conditions.

RESULTS

Ex-vivo treatments of oral samples with the triclosan/copolymer dentifrice demonstrated significant dose-dependent antimicrobial effects compared with a control formulation on anaerobic and facultative oral bacteria from a group of 16 volunteers (P < 0.05) with reproducible effects observed in three separate trials (P < 0.05). Similarly, significant dose-dependent effects were noted with chlorhexidine mouthrinses (P < 0.05). A simultaneous assessment of the effects of these formulations on several functional classes of oral bacteria associated with specific oral conditions such as dental caries and oral malodor demonstrated multiplexed antimicrobial activity (P < 0.05).

CONCLUSIONS

A rapid procedure using small volumes of human oral samples and well-known formulations demonstrates ex-vivo multiplexed antimicrobial effects on functional groups of bacteria with both dentifrices and mouthrinses. Modifications of this approach may include antibacterial effects over time with formulations at clinically relevant concentrations, effects of novel agents or samples from subjects stratified on the basis of their clinical status.

In vitro cytotoxic and anti-inflammatory effects of myrrh oil on human gingival fibroblasts and epithelial cells

Limited scientific studies suggest that myrrh (Commiphora molmol) has antibacterial and anti-inflammatory activities. This study determined myrrh oil (MO) cytotoxicity to human gingival fibroblasts and epithelial cells and its effect, measured by ELISA, on interleukin (IL)-1beta-stimulated IL-6 and IL-8 production. Cell viability and cytotoxicity were determined by metabolic reduction of a tetrazolium salt to a formazan dye (MTT assay) and by release of lactate dehydrogenase (LDH) from membrane damaged (LDH release assay) cells, respectively. Based on the MTT assay, 24- and 48-h exposures to </=0.001% MO had little effect on fibroblast and epithelial cell (24-h only) viability. At 48 h, 0.0005-0.001% MO decreased epithelial cell viability 30-50%. After 24 and 48 h, MO, at >/=0.005%, maximally decreased viability of all cell lines. In the LDH release assay, exposure to </=0.0001% MO caused <10% cytotoxicity to all cells. At 24 h, >/=0.0025% MO caused maximal cytotoxicity; </=0.001% MO caused 10-70% cytotoxicity. At longer exposure times, epithelial cells were more susceptible to cytotoxic effects of MO. There was little or no detectable IL-1beta-stimulated production of IL-6 or IL-8 by cells exposed to >/=0.0025% MO, probably reflective of loss of viability. At subtoxic MO levels (0.00001-0.001%), there was a significant reduction of IL-1beta-stimulated IL-6 and IL-8 production by fibroblasts, but not by epithelial cells.