Após a exposição da raiz do dente na cavidade bucal, causada por recessão gengival, há uma mudança na microflora existente na região. Micro-organismos se depositam nessa região e formam um biofilme, que se exposto a carboidratos fermentáveis pode levar a uma queda de pH do meio, selecionando micro-organismos ácido-tolerantes e causando uma dissolução dos tecidos minerais e ativação de mecanismos de degradação da matriz orgânica da dentina. A presença de Candida albicans em lesões radiculares vem sendo relatada na literatura de forma controversa, alguns estudos sugerem que a cariogenicidade do biofilme aumenta na presença desse fungo, embora outros sugerem que o fungo levaria a uma neutralização do pH do biofilme por meio de secreção de metabólitos e consumo de ácido lático liberado na matriz do biofilme como resultado da metabolização de carboidratos. Frente ao exposto, o objetivo desse estudo foi avaliar o potencial cariogênico de biofilmes contendo Candida albicans em relação à dentina radicular. Discos de dentina radicular foram obtidos de raízes de dentes bovinos e tiveram sua microdureza de superfície inicial determinada. Foi realizado então um experimento in vitro nos quais os blocos de dentina foram aleatorizados em 3 grupos para cultivo de biofilme como se segue: Grupo 1 – biofilme monoespécie de S. mutans (SM); Grupo 2 – biofilme monoespécie de C. albicans (CA); e Grupo 3 – biofilme dualespécies de S. mutans + C. albicans (MIX). Os biofilmes foram cultivados na superfície dos blocos de dentina durante 24, 48 e 72 horas. pH do meio de cultura dos biofilmes foi aferido a cada 24 horas. Biofilmes foram coletados da superfície de seis blocos de dentina após cada um dos tempos acima descritos e a contagem de células viáveis foi determinada. Além disso, após cada período de formação de biofilme, os mesmos blocos de dentina tiveram sua microdureza de superfície medida novamente para determinação da porcentagem de perda de dureza de superfície (%PDS) e duas amostras de cada grupo/tempo foram submetidas a coloração histológica PicroSirius Red para determinação da porcentagem de colágeno estruturado na matriz orgânica da dentina desmineralizada. Os experimentos foram realizados em triplicata e os dados foram analisados por ANOVA de duas vias seguido de teste de Bonferroni ao nível de significância de 5%. Em relação aos resultados, independentemente da composição microbiana do biofilme, houve maior %PDS em biofilmes formados durante 48 e 72h em comparação aos biofilmes formados por 24 horas. Em relação à composição microbiana do biofilme, observou-se que a %PDS no biofilme de SM foi estatisticamente maior que na presença do biofilme MIX, que por sua vez foi maior que aquela encontrada na presença de biofilme CA. Os resultados mostraram ainda que os valores de pH do meio de cultivo dos biofilmes MIX foram estatisticamente maiores do que os valores encontrados na presença de biofilme SM nos tempos de 48 e 72 horas (p<0,05). Em relação à análise orgânica da dentina, os resultados sugerem que há uma maior tendência para manutenção de colágeno estruturado em biofilmes contendo CA do que em relação aos biofilmes de SM e de MIX. Nossos resultados sugerem que embora a C. albicans apresente potencial cariogênico para dentina radicular, o biofilme contendo C. albicans associada ao S. mutans parece apresentar um menor potencial cariogênico quando comparado aos biofilmes cultivados na ausência deste fungo. / After root exposure on the oral cavity, caused by gingival recession, a shift in the site microflora occurs. Deposits of microorganisms turn in to a biofilm in the root surface, which if exposed frequently to fermentable carbohydrates may lead to a pH drop on the biofilm matrix, selecting acid tolerant microorganisms causing solubilization of the mineralized tissues and the activation of dentin organic matrix degrading system. Candida albicans presence in root caries has been debated on the literature, some studies suggest that the cariogenicity of the biofilm increases on the fungus presence, although some others have said that the fungus would lead to a biofilm pH neutralization by releasing some metabolites and lactic acid consumption, the acid released on the biofilm matrix as a product of the carbohydrates metabolization. Therefore, the aim of this present study was to evaluate the cariogenic potential of biofilms containing C. albicans in relation to root dentin. Dentin root slabs were obtained from root of bovine teeth and its surface microhardness was accessed. An in vitro trial was performed, by randomizing the slabs in 3 groups: Group 1 – mono-species S. mutans biofilm (SM), Group 2 – monospecies C. albicans biofilm (CA) and Group 3 - dual-species S. mutans and C. albicans biofilm (MIX). The biofilms were grown at the dentin slab surface in 24, 48 and 72. The pH of the culture medium was checked every 24 hours. Biofilms were collected from the surface of six dentin slabs after each time as described above and the CFU/mL counts were determined. Additionally, after each time of biofilm growth, the surface microhardness of the samples was measured again to calculate the surface hardness loss percentage (%SHL) and, also, two samples of each group/time were sent to histological stain by PicroSirius Red to determine the percentage of structured collagen on the organic demineralized dentin. Each trial was performed three times and the data was analysed by Two-Way ANOVA, followed by Bonferroni test, with a significance level of 5%. As related to the results, irrespective from the microbial composition of the biofilm, a higher %SHL was observed in biofilms growth in 48 and 72 hours when compared to the biofilms growth in 24 hours. Regarding the microbial composition of the biofilm, it was observed that the %SHL at the SM biofilm was statistically higher than in the presence of the MIX biofilm, which was also higher than the one found at the CA biofilm. The results also show that the pH values of the culture medium in MIX biofilms were statistically higher than those found in the presence of SM biofilms at 48 and 72 hours (p<0,05). Related to the organic analysis of the dentin, the results suggest that there is a higher tendency to structured collagen maintenance in CA biofilms when compared to the SM and MIX biofilms. Our results suggest that, although C. albicans has a cariogenic potential related to root dentin, the biofilm containing C.albicans associated to S. mutans seems to present a lower cariogenic potential when compared to biofilms growth without this fungus.

Antimicrobial peptides are among the repertoire of host innate immune defenses. In mucosal immunity, the health-disease balance can be greatly modulated by the interplay between host immune factors and colonized microflora. Microbial ecology within dental plaque is constantly shaped by environmental factors present within the oral cavity. Several antimicrobial peptides are detected in saliva and their bactericidal activities against oral bacteria, including Streptococcus mutans, the primary etiologic agent of dental caries, have been clearly demonstrated. However, the role of these antimicrobial peptides in S .mutans ecology and host caries experience is not well-defined. We hypothesized that various strains of S. mutans possess different inherent susceptibility/resistance profiles to host salivary antimicrobial peptides and that host-specific quantities of these peptides may influence plaque colonization by particular S. mutans strains. S. mutans strains from subjects with variable caries experience were tested for susceptibility to a panel of antimicrobial peptides, including HNP-1-3, HBD-2-3 and LL-37, revealing that the susceptibilities of S. mutans to these peptides were strain-specific. S. mutans strains from high caries subjects showed greater resistance to these peptides at varying concentrations than those from caries-free subjects. In addition, when combinations of these peptides were tested, they showed either additive or synergistic interaction against S. mutans. Determinations of the salivary levels of these peptides showed that their concentrations were highly variable among subjects with no correlation to host caries experience. However, positive relationships between the salivary concentrations of HNP-1-3 and MS in dental plaque were found. Additionally, the levels of a number of these peptides in saliva appeared to be positively correlated within an individual. An analysis of the salivary peptide concentrations and the susceptibility profiles of S. mutans strains showed that S. mutans strains obtained from subjects with higher concentration of HNP-1-3 in saliva appeared to be more resistant to HNP-1. Collectively, our findings showed that salivary antimicrobial peptides affect S. mutans ecology by restricting the overall growth of this bacterium within the oral cavity and that their activity may help select resistant strains of S. mutans to colonize within dental plaque. The relative ability of S. mutans to resist host salivary antimicrobial peptides may be considered a potential virulence factor for this species.

ABSTRACT Background: The most common species associated with dental caries is Streptococcus mutans. Different Streptococcus mutans adhesion biotypes, SpaP A/B/C and Cnm/Cbm, with ability to predict individual caries development have recently been identified. Aim: The aim of the study was to investigate if there was a difference in growth ability of the Streptococcus mutans adhesion biotypes and their relative sensitivity to biocides such as fluoride and chlorhexidine in vitro. We also aim to compare the potency of biocides in vitro to those concentrations used in the clinic. Methods: Culturing of the Streptococcus mutans biotypes in a planktonic solution with and without fluoride and chlorhexidine. Used concentrations: 3.5-4500 parts per million fluoride and 15-500 parts per million chlorhexidine. Optical density was used to measure growth under the different conditions. Results: The tests with fluoride showed a similar dose dependent inhibition of growth for all 6 biotypes of Streptococcus mutans. The tests with chlorhexidine showed a major inhibition of growth for the concentration 62 parts per million which inhibited growth more than 500 parts per million. All biotypes had a similar proliferation pattern without any biocide present. Conclusion: All tested biotypes of Streptococcus mutans had a similar pattern of sensitivity to the different concentrations of biocides and cultivation conditions used.

The objective was to determine if a correlation exists between Streptococcus mutans and DMFT in the oral cavity. This study examined the feasibility of microbial screenings as an additional caries predictor tool. The sample included 108 participants (ages 18-25) in low, moderate, and high socioeconomic groups. Subjects were selected from one dental clinic and one college in Virginia. Subjects were assessed for DMFT, salivary and plaque bacterial load, and CRA. Salivary load positively correlated with the DMFT. Plaque bacterial load and CRA negatively correlated with DMFT. Comparison of salivary bacterial load among economic levels showed higher bacterial loads with lower economic level only. Twice the observed values were found in the low socioeconomic level with CRA. DMFT and economic level showed differences between economic levels. Microbial screenings may be a useful, additional tool in determining caries risk in oral hygiene programs for all income populations.

Documentation exists that mothers can pass the cariogenic bacteria Streptococcus mutans to their infants. The newest technology to identify Streptococcus mutans is a rapid detection saliva test. Two hundred patients above the age of 18 were targeted using random selection in a Louisville, Kentucky dental office. Patients signed an informed consent form and were given a qualifying questionnaire. Patients received 2 bitewing x-rays and a charted DMFT index and were administered the saliva test. While the null hypothesis was rejected using the chi square test, the results were inconclusive due to expected values. However, other chi square results revealed that the test worked or had the potential to work. Furthermore, it was concluded that the test had high specificity. Further research is warranted; however, the saliva test in combination with the DMFT and x-rays are instrumental tools for the dental professional in educating patients and prevention.

Bacteria in biofilms adhere well to surfaces and are quite difficult to remove. Oral plaque is one example of a biofilm. Many researchers have studied ways to remove plaque and bacteria from surfaces. It has been found that the passage of a bubble across a surface to which bacteria has adhered can remove the bacteria from the surface. Biofilms of Streptococcus mutans were grown on glass coverslips as a simple model for oral plaque. The coverslips were mounted in a Plexiglas chamber filled with artificial saliva. A bubble stream was directed at the mounted biofilm. The velocity, gas fraction, median bubble diameter, and impingement angle were all varied to determine the effect of each parameter on removal and which parameter was the most significant. To investigate the influence of sound on removal, a Ling oscillator was attached to the chamber, and was used simultaneously with and without a bubble stream. The acoustic intensity and the frequency were varied to determine if there was any effect on biofilm removal. Biofilm removal was also video taped. The results of these experiments confirmed that biofilms are removed by a stream of bubbles. Removal of biofilm is a function of stream velocity, gas fraction, and median bubble diameter, but not of impingement angle. The results of the acoustic experiments show that sound does not affect the removal of biofilm under the conditions used in these experiments. Mathematical models relating the removal of biofilm as a function of time were also developed from the data obtained from the video recording of the experiments. Additional tests using acoustic waves to remove biofilm should be performed to determine if more intense sound can remove biofilm. The intensity of the sound used in these experiments was low and the time of exposure was only 5 sec. Additional tests that more closely simulate the conditions of the mouth during brushing, like adding a surfactant, would also provide more insight as to whether bubbles in a clinical setting would remove biofilm.

No description available.

Streptococcus mutans is a facultative member of the oral plaque and is associated with dental caries. It is able to survive long periods of sugar starvation. The purpose of this project was to explore specific avenues that S. mutans may use in order to cope with carbohydrate deprivation. Intracellular polysaccharide (IPS) is accumulated by S. mutans when grown in excess sugar, and can contribute towards the cariogenicity of S. mutans. Inactivation of the glgA gene, encoding a putative glycogen synthase, prevented accumulation of IPS in batch cultures grown with excess glucose or sucrose. Inactivation of the pul gene, encoding a putative pullulanase which is thought to be involved in IPS catabolism, did not prevent IPS accumulation. IPS was found to be important for the persistence of S. mutans grown in batch culture with excess glucose, and then starved of glucose. In these conditions, the IPS was largely used up within one day of starvation, and yet survival of the parental strain was extended by at least 15 days beyond that of the glgA and pul mutants; potentially, some feature of IPS metabolism, distinct from providing nutrients, is important for persistence. IPS was not needed for persistence when sucrose was carbon source or when mucin was present in batch cultures. IPS accumulation was not clearly demonstrated in biofilm conditions. When grown in condition permissive for IPS accumulation, biofilms of the glgA and pul mutants did not show decreased survival, compared to the parental strain. It is plausible that, within a biofilm, S. mutans can use alternative sources of energy (like the extracellular matrix) to compensate for the lack of IPS. To look at specific genes upregulated by sugar starvation, microarrays analysis was performed on S. mutans batch cultures. Some of the genes upregulated by starved, stationary phase bacteria, appeared to be organized in an operon, thought to encode components of the pyruvate dehydrogenase (PDH) complex. Northern Blot analysis showed that pdhD and the downstream genes, pdhA, pdhB and pdhC, form an operon that is transcribed predominantly in stationary phase. Inactivation of pdhD impaired survival of both batch cultures and biofilms. Analysis with fluorescent reporters revealed a distinct expression pattern for the pdh promoter, with less than 1% of stationary phase bacteria displaying pdh expression. When first detected, after one day of sugar starvation, expression was in individual bacteria. At later times, expressing bacteria were often in chains. The lengths of chains increased with time suggesting growth and division. It is likely that the pdh-expressing sub-population is able to persist for extend times in stationary phase. / Microbiology and Immunology

A cárie dental é uma doença bacteriana infecciosa considerada como um dos principais problemas de saúde pública. O principal agente etiológico para o desenvolvimento da doença é o Streptococcus mutans. A proteína P1, também conhecida como antígeno I/II, do S. mutans é fundamental para a etapa inicial de adesão à superfície dental (sacarose-independente), sendo, portanto, considerada essencial para o processo de colonização deste patógeno. Algumas regiões dessa proteína vêm sendo empregadas como antígenos em estratégias vacinais contra a cárie, entre elas a região A, localizada na porção N-terminal, conhecida como região de ligação à saliva Saliva Binding Region (SBR). No entanto, apesar dos avanços, não existe vacina para a prevenção da cárie licenciada para uso em humanos. Diante disso, o presente trabalho tem como objetivo o desenvolvimento e caracterização de uma nova estratégia vacinal contra o S. mutans baseada em esquema de dose-reforço heterólogo, utilizando o fragmento P139-512, na forma de proteína purificada, expressa a partir de linhagens recombinantes de Bacillus subtilis. A proteína P139-512 compreende os aminoácidos 39-512 da proteína nativa, o que corresponde a toda região A e uma pequena porção da região variável da proteína P1. Utilizamos esporos de B. subtilis 1012, modificados para expressar o antígeno P139-512 (LDV702). A linhagem LDV704, além de expressar o antígeno, foi modificada para expressar uma invasina (InvA) com capacidade de se ligar a epitélios de mucosa. Camundongos da linhagem BALB/c foram imunizados por via sublingual com uma dose de esporos de B. subtilis (linhagens 1012, LDV702, LDV704 ou PBS) seguidos por dois reforços com a proteína P139-512, associada ou não com o adjuvante LTK63. Níveis significativos de anticorpos séricos foram induzidos pelas formulações em associação com o adjuvante após a terceira dose, e mostraram-se capazes de reconhecer os epítopos em diferentes linhagens de S. mutans. No entanto, nenhuma das formulações mostrou-se capaz de ativar respostas de mucosa (S-IgA). Porém, observamos que o adjuvante LTK63 empregado na estratégia dose-reforço heterólogo potencializou a resposta sérica de anticorpos IgG, sendo capaz de modular e melhorar qualitativamente as respostas induzidas. Assim, a administração das formulações na presença do adjuvante representa uma alternativa promissora para o controle do S. mutans. / Dental caries is an infectious bacterial disease considered as one of the main public health problems. The main etiological agent for the development of the disease is the Streptococcus mutans. The P1 protein, also known as S. mutans Ag I / II antigen, is essential for the initial stages of adhesion to the dental surface (sucrose-independent) and is, therefore, considered essential for the colonization process of this pathogen. Some regions of this protein have been used as antigens in vaccine strategies against caries, among them the A region, located at the amino terminal region also known as the Saliva Binding Region (SBR). However, despite the advances, there is no licensed anti-caries vaccine for human use. Therefore, the present work aims to develop and characterize a new vaccine strategy against S. mutans based on a heterologous priming/boost immunization regimen using the recombinant P139-512 fragment, expressed and purified from a Bacillus subtilis strain. The P139-512 protein comprises amino acids that encompasses the entire A region and a small portion of the variable region of the P1 protein. We used spores of B. subtilis 1012 (wild-strain) and recombinants that were modified to express the antigen P139-512 (LDV702). In addition to express the antigen, the LDV704 strain was modified to express a surface-exposed bacterial invasin (InvA) capable of binding to the mucosal epithelia. BALB/c mice were primed via the sublingual route with a dose of B. subtilis spores (1012, LDV702, or LDV704 strains) followed by two boosting doses with the purified protein P139-512, associated or not with the LTK63 adjuvant, by the same administration route. Significant serum antibody levels were induced by the formulations with the adjuvants after the third dose and the antibodies were shown to recognize epitopes exposed on the surface of different S. mutans strains. However, none of the formulations were capable to activate mucosal responses (S-IgA). Nevertheless, we observed that the LTK63 enhanced the serum IgG responses and qualitatively improved the induced antibody response. Thus, the administration of the formulations in the presence of the adjuvant represents a promising alternative for the control of S. mutans.

O objetivo do presente estudo clínico randomizado foi avaliar in vivo, por meio da técnica de biologia molecular Checkerboard DNA-DNA Hybridization: 1) A contaminação de bráquetes metálicos por 4 espécies bacterianas de microrganismos cariogênicos (Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei e Lactobacillus acidophilus); e 2) A eficácia da utilização do gluconato de clorexidina a 0,12% (Periogard&reg;) sob a forma de bochechos, sobre esses microrganismos. Participaram do estudo 39 pacientes de 11 a 33 anos de idade, em tratamento com aparelho ortodôntico fixo, nos quais foram colados 2 bráquetes metálicos novos, nos pré-molares. Os pacientes do Grupo Controle (n=20) foram orientados a fazer 2 bochechos semanais com solução placebo, durante 30 dias. Os pacientes do Grupo Experimental (n=19) foram orientados a fazer bochechos com solução à base de gluconato de clorexidina a 0,12% (Periogard&reg;), da mesma forma que o grupo Controle. Decorridos 30 dias, os 2 bráquetes foram removidos de cada paciente e processados para detecção das 4 cepas bacterianas, pela técnica Checkerboard DNADNA Hybridization. Os resultados obtidos foram analisados por meio do teste nãoparamétrico de Kruskal-Wallis, utilizando o software SAS (Statistical Analysis System). O nível de significância adotado foi de 5%. De acordo com os resultados obtidos, observou-se que S. mutans, S. sobrinus, L. casei e L. acidophilus foram detectados em 100% das amostras dos bráquetes de ambos os grupos. No entanto, os bráquetes do grupo Controle encontravam-se mais densamente contaminados por S. mutans e S. sobrinus (p<0,01). No grupo Experimental, embora as quantidades de S. mutans, S. sobrinus, L. casei e L. acidophilus tenham sofrido redução numérica após o uso dos bochechos com solução de gluconato de clorexidina a 0,12%, a comparação com os valores observados no grupo Controle evidenciou diferença estatisticamente significante apenas para S. mutans (p=0,03). Concluiu-se que os bochechos com solução de gluconato de clorexidina a 0,12% podem ser úteis, na prática clínica, com a finalidade de reduzir os níveis de microrganismos cariogênicos, em pacientes portadores de aparelhos ortodônticos fixos. / The purpose of this randomized clinical study was to evaluate in vivo, by the checkerboard DNA-DNA hybridization biomolecular technique: 1) The contamination of metallic brackets by four cariogenic bacterial strains (Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei and Lactobacillus acidophilus); and 2) The efficacy of 0.12% chlorhexidine gluconate mouthrinses (Periogard&reg;) against these microorganisms. Thirty-nine 11-33-year-old patients under treatment with fixed orthodontic appliances were enrolled in the study and had 2 new metallic brackets bonded to the premolars. For the patients of the control group (n=20), mouthrinses with a placebo solution were prescribed twice a week during 30 days. The patients randomized to the experimental group (n=19) were instructed to use a 0.12% chlorhexidine gluconate solution (Periogard&reg;) as an oral rinse twice a week during 30 days, in the same way as in control group. After this period, the 2 brackets were removed from each patient and processed for detection of the 4 bacterial strains by checkerboard DNA-DNA hybridization. The obtained data were analyzed statistically by the non-parametric Kruskal-Wallis test using the SAS (Statistical Analysis System) software. A level of significance of 5% was set for all analysis. S. mutans, S. sobrinus, L. casei and L. acidophilus were detected in 100% of the samples from brackets of both groups. However, the brackets of the control group were more heavily contaminated by S. mutans and S. sobrinus (p<0.01). In the experimental group, although S. mutans, S. sobrinus, L. casei and L. acidophilus counts decreased after rinsing with the 0.12% chlorhexidine gluconate solution, the comparison with the values obtained in the control group showed statistically significant difference only for S. mutans (p=0.03). In conclusion, the use of 0.12% chlorhexidine gluconate mouthrinses can be useful in clinical practice to reduce the levels of cariogenic microorganisms in patients under treatment with fixed orthodontic appliances.