Hemoglobin Protects Enamel against Intrinsic Enamel Erosive Demineralization

Impact of modifications on the characteristics of salivary pellicle on dental hard tissue: a scoping review

OBJECTIVES

The salivary pellicle regulates interfacial events on dental surfaces and is a promising target for modification to improve dental health. This scoping review systematically examines substances that modify the pellicle, evaluating their potential and identifying knowledge gaps.

DATA

This review followed the PRISMA-ScR guidelines. Studies investigating how substances applied during pellicle formation on enamel or dentin affect its structure, composition, or protective function were included.

SOURCES

A systematic search of Medline was conducted up to March 2024 using predefined terms. Only English-language research articles were included. No hand-searching was performed.

STUDY SELECTION

A total of 864 records were identified. After title and abstract screening, 110 articles were assessed in full, resulting in 85 eligible studies for data charting. These studies investigated human saliva-derived pellicles on enamel or dentin, comparing their composition, structure, or protective properties with and without modification. Most studies, conducted equally in vitro and in situ, focused on fluorides and metals (n = 28), peptides and proteins (n = 21), and polyphenols (n = 18), while other substances were less frequently examined (n = 17). Modifications affected the pellicle's ultrastructure, altered its proteome, or enhanced its protective role against erosion, abrasion, and bacterial adherence.

CONCLUSIONS

Despite numerous studies and distinct substance classes, findings remain inconclusive and must be interpreted within the context of individual study designs.

CLINICAL SIGNIFICANCE

Modifying the pellicle can improve its protective function, presenting a promising approach for preventive dentistry. However, the long-term effects of these substances within the dynamic oral environment remain unclear. This review underscores the need for further research to close existing knowledge gaps and confirm clinical relevance.

Acquired pellicle engineering: a fascinating approach to prevent demineralization

The acquired enamel pellicle (AEP) consists of an organic, acellular, and bacteria-free film, formed in vivo as a result of biomolecules adsorption onto the tooth surface. It is composed of proteins, glycoproteins, lipids, phospholipids, and other macromolecules, such as carbohydrates. The AEP formation process is complex and can be divided into three stages: initiation, development, and maturation. The pellicle has two main layers: the globular and basal layers. The basal layer offers the most protection against demineralization, as the subsequent globular layer is weaker and less tenacious. The formation of the AEP can be influenced by various factors, such as the physicochemical properties of the teeth, location in the oral cavity, pathologies, and even the oral microbiota. With the advancement of "omics" techniques, it has been possible to observe the presence of acid-resistant proteins in the AEP, which allowed the development of the "acquired pellicle engineering" strategy. This strategy involves enriching and modifying the basal layer with acid-resistant proteins. Among these proteins, hemoglobin, statherin-derived peptide, and a protein derived from sugarcane stand out. The objective of this literature review is to provide a comprehensive overview of the AEP, detailing its composition, formation process, and protective functions. Additionally, the review aims to explore recent advances in the field of "acquired pellicle engineering," highlighting the acid-resistant proteins of the AEP and their potential applications in dentistry. Finally, the review intends to highlight the clinical implications of these findings and how they may contribute to the development of new strategies for the prevention and treatment of dental pathologies according to published studies.

Resveratrol alters oral biofilm in vitro and in vivo

OBJECTIVE

To evaluate the ability of resveratrol to reduce dental caries in vitro and in vivo.

METHODS

In part 1, a microcosm biofilm protocol was employed. One hundred twenty-six bovine enamel specimens were treated with: Resveratrol (50, 100, 200, 400 µg/mL), Phosphate buffered saline (negative control), Dimethyl sulfoxide (negative control) and 0.12% Chlorhexidine (positive control). The biofilm was produced from the saliva of 10 volunteers, under 0.2% sucrose exposure for 5 days, and daily treated with the solutions (1 min). At the end of the experimental period, resazurin and viable plate count assays were performed. Enamel demineralization was evaluated by transverse microrradiography (TMR). In part 2, 12 volunteers participated in a triple-blind crossover protocol for 7 weeks, according to the following treatments: 1) 100 mg/L resveratrol; 2) 0.05% NaF (226 mg/L F); 3) 100 mg/L resveratrol + 0.05% NaF; 4) Deionized water (negative control). Biofilm samples were collected from both sides of the mouth 12 h after the use of the solutions.

RESULTS

Resveratrol at 50 and 200 µg/mL significantly reduced biofilm metabolic activity and mutans streptococci, respectively. Chlorhexidine was an effective treatment to significantly reduce all parameters, being an important antimicrobial and anticaries agent in vitro. Resveratrol alone or associated with NaF modulated several caries-associated bacteria in vivo.

CONCLUSION

The present study represents the first step regarding the use of resveratrol within the concept of acquired enamel pellicle and biofilm engineering to prevent dental caries.

Limitations, challenges and prospective solutions for bioactive glasses-based nanocomposites for dental applications: A critical review

Several nanomaterials have been recently used to overcome various challenges in the dental domain. Bioactive glasses, a class of bioceramics, with their outstanding properties including but not limited to their strong biocompatibility, antibacterial characteristics, and bioactivity inside the body's internal milieu have made them valuable biomaterials in a variety of dental domains. The utilization of nanomaterials has improved the performance of teeth, and the incorporation of bioactive glasses has the field of dentistry at an unsurpassed level in different categories such as esthetic and restorative dentistry, periodontics and dental implants, orthodontics, and endodontics. The current study discusses the most recent developments of the bioactive glasses' creation and implementation for dental applications, as well as the challenges and opportunities still facing the field. This work provides an overview of the current obstacles and potential future prospects for bioactive glasses-based nanocomposites to improve their dental uses. It also emphasizes the great potential synergistic effects of bioactive glasses used with other nanomaterials for dental applications.

In vivo modification of the enamel pellicle and saliva resveratrol levels after use of resveratrol-containing orodispersible capsules

OBJECTIVES

To evaluate in vivo 1) the bioavailability of trans-resveratrol when administered through sublingual capsules; 2) the effect of resveratrol on the protein composition of the acquired enamel pellicle (AEP).

DESIGN

Ten volunteers received a sublingual capsule containing 50 mg of trans-resveratrol. Unstimulated saliva was then collected after 0, 30, 60, and 120 min and AEP was collected after 120 min following administration of the capsule. In the next week, the volunteers received a placebo sublingual capsule, and saliva and AEP were collected again. Saliva samples were analyzed for free trans-resveratrol using high-performance liquid chromatopgraphy (HPLC), and AEP samples were subjected to proteomic analysis (nLC-ESI-MS/MS).

RESULTS

Trans-resveratrol was detected in saliva at all the time points evaluated, with the peak at 30 min. A total of 242 proteins were identified in both groups. Ninety-six proteins were increased and 23 proteins were decreased in the Resveratrol group. Among the up-regulated proteins, isoforms of cystatins, PRPs, Mucin-7, Histatin-1, Lactotrasnferrin and Lysozyme-C were increased and the isoforms of Protein S100, Neutrophil defensins, Albumin, PRPs, and, Statherin were decreased in Resveratrol group.

CONCLUSION

The sublingual capsule is effective at increasing the bioavailability of trans-resveratrol in saliva. Several proteins involved in important processes to maintain systemic and oral health homeostasis were identified. These proteins differently expressed due to the presence of trans-resveratrol deserve attention for future studies, since they have important functions, mainly related to antimicrobial action.

Acquired enamel pellicle and biofilm engineering with a combination of acid-resistant proteins (CaneCPI-5, StN15, and Hemoglobin) for enhanced protection against dental caries - in vivo and in vitro investigations

OBJECTIVE

This study was designed in two-legs. In the in vivo, we explored the potential of a rinse solution containing a combination (Comb) of 0.1 mg/mL CaneCPI-5 (sugarcane-derive cystatin), 1.88 × 10- 5M StN15 (statherin-derived peptide) and 1.0 mg/mL hemoglobin (Hb) to change the protein profile of the acquired enamel pellicle(AEP) and the microbiome of the enamel biofilm. The in vitro, was designed to reveal the effects of Comb on the viability and bacterial composition of the microcosm biofilm, as well as on enamel demineralization.

MATERIALS AND METHODS

In vivo study, 10 participants rinsed (10mL,1 min) with either deionized water (H2O-control) or Comb. AEP and biofilm were collected after 2 and 3 h, respectively, after rinsing. AEP samples underwent proteomics analysis, while biofilm microbiome was assessed via 16 S-rRNA Next Generation Sequencing(NGS). In vitro study, a microcosm biofilm protocol was employed. Ninety-six enamel specimens were treated with: 1)Phosphate-Buffered Solution-PBS(negative-control), 2)0.12%Chlorhexidine, 3)500ppmNaF and 4)Comb. Resazurin, colony-forming-units(CFU) and Transversal Microradiography(TMR) were performed.

RESULTS

The proteomic results revealed higher quantity of proteins in the Comb compared to control associated with immune system response and oral microbial adhesion. Microbiome showed a significant increase in bacteria linked to a healthy microbiota, in the Comb group. In the in vitro study, Comb group was only efficient in reducing mineral-loss and lesion-depth compared to the PBS.

CONCLUSIONS

The AEP modification altered the subsequent layers, affecting the initial process of bacterial adhesion of pathogenic and commensal bacteria, as well as enamel demineralization.

CLINICAL RELEVANCE

Comb group shows promise in shaping oral health by potentially introducing innovative approaches to prevent enamel demineralization and deter tooth decay.

Increase in plasma resveratrol levels and in acid-resistant proteins in the acquired enamel pellicle after use of resveratrol-containing orodispersible tablets

OBJECTIVE

This study evaluated the effect of administration of trans-resveratrol-containing orodispersible tablets on the protein composition of the AEP and on blood plasma trans-resveratrol concentrations.

METHODS

Ten volunteers participated in two crossover double-blind phases. In each phase, after dental prophylaxis, they received a trans-resveratrol (15 mg) orodispersible tablet, or a placebo tablet (without actives). The AEP formed after 120 min was collected with electrode filter papers soaked in 3 % citric acid. Blood samples were collected 30, 45, 60 and 120 min after the use of the tablet. After protein extraction, AEP samples were analyzed by shotgun labelfree quantitative proteomics and plasma samples were analyzed by high-performance liquid chromatography (HPLC).

RESULTS

Eight hundred and two proteins were identified in the AEP. Among them, 336 and 213 were unique to the trans-resveratrol and control groups, respectively, while 253 were common to both groups. Proteins with important functions in the AEP had increased expression in the trans-resveratroltreated group, such as neutrophil defensins, S100 protein isoforms, lysozyme C, cystatin-D, mucin-7, alphaamylase, albumin, haptoglobin and statherin. Trans-resveratrol was detected in the plasma at all the times evaluated, with the peak at 30 min.

CONCLUSIONS

The administration of trans-resveratrol in sublingual orodispersible tablets was effective both to increase the bioavailability of the polyphenol and the expression of antibacterial and acid-resistant proteins in the AEP, which might benefit oral and general health.