Flavonoids effects against bacteria associated to periodontal disease and dental caries: a scoping review.

This scoping review focused on exploring the efficacy of flavonoids against bacteria associated with dental caries and periodontal diseases. Inclusion criteria comprise studies investigating the antibacterial effects of flavonoids against bacteria linked to caries or periodontal diseases, both pure or diluted in vehicle forms. The search, conducted in August 2023, in databases including PubMed/MEDLINE, Scopus, Web of Science, Embase, LILACS, and Gray Literature. Out of the initial 1125 studies, 79 met the inclusion criteria, majority in vitro studies. Prominent flavonoids tested included epigallocatechin-gallate, apigenin, quercetin, and myricetin. Predominant findings consistently pointed to bacteriostatic, bactericidal, and antibiofilm activities. The study primarily investigated bacteria associated with dental caries, followed by periodontopathogens. A higher number of publications presented positive antibacterial results against Streptococcus mutans in comparison to Porphyromonas gingivalis. These encouraging findings underline the potential applicability of commercially available flavonoids in materials or therapies, underscoring the need for further exploration in this field.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness.

This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Effect of whitening toothpastes and activated charcoal powder on enamel wear and surface roughness

Abstract This study aimed to evaluate surface roughness (Sa), roughness profile (Rv), and enamel wear after brushing with different whitening toothpastes and charcoal powders. Sixty (n = 10) bovine enamel blocks (6 × 6 × 3 mm) were randomly distributed into six groups according to toothpaste type: regular toothpaste (CONT), toothpaste containing 2% hydrogen peroxide (HP), toothpaste containing titanium dioxide (TiO2), toothpaste containing charcoal (COAL), toothpaste containing charcoal and TiO2 (COAL+TiO2), and activated charcoal powder (COAL_PWD). Each block was subjected to 30,000 reciprocal cycles at a 1:3 proportion slurry. After brushing, the blocks were analyzed using an optical profilometer to determine Sa, Rv, and enamel wear. In addition, representative 3D images of each group and wear profiles were obtained. Sa was analyzed using generalized linear models followed by Bonferroni correction, whereas Rv was analyzed using one-way analysis of variance. After brushing, COAL and COAL+TiO2 showed higher Sa values than COAL_PWD. However, no significant difference was observed in Sa between whitening toothpaste and COAL_PWD, and CONT (p > 0.05). In addition, no differences were observed among the groups in Rv (p > 0.05). Conversely, enamel wear was higher for TiO2, COAL, COAL+TiO2, and COAL_PWD than for CONT. CONT showed the least enamel wear, whereas HP showed intermediate values. Representative 3D images and line profiles showed lower step-height and lower mean surface losses for the CONT and HP groups than for the other groups. Whitening toothpastes and COAL_PWD did not increase Sa or Rv compared with CONT, while CONT demonstrated lower enamel wear.

Potencial antibacteriano dos flavonoides e desenvolvimento de uma resina composta experimental a base de flavonoide / Antibacterial potential of flavonoids and development of an experimental flavonoid-based resin composite

Os flavonoides podem ser considerados substâncias fitofarmacêuticas, ou seja, são obtidas na natureza e possuem benefícios à saúde humana. Alguns desses benefícios estão relacionados ao sistema cardiovascular, doenças crônicas como diabetes e em desordens bucais como periodontite e cárie. Assim, os objetivos do presente estudo foram: analisar efeitos antibacterianos de diferentes flavonoides contra bactérias relacionadas à doença periodontal e à cárie dentária por meio de uma revisão de escopo; avaliar as propriedades físico-químicas de uma resina composta experimental adicionada de naringina. Para a revisão de escopo, 19 artigos foram incluídos, todos estudos in vitro. Para bactérias relacionadas à doença periodontal, proantocianidinas, isoliquiritigenina, liquiritigenina, galangina, quercitrina, taxifolina, crisina, diosmetina, quercetina, miricetina, naringina, apigenina, catequinas, luteolina, morina e rutina foram investigadas. Para bactérias relacionadas à cárie dentária, baicaleína, naringenina, catequina, isoliquiritigenina, liquiritigenina, miricetina, quercetina e kaempferol já foram investigados. Atividade bacteriostática, bactericida e antibiofilme foram predominantemente relatadas. Para o desenvolvimento de uma resina experimental, naringina foi adicionada em concentrações de 5, 10 e 15mM. Testes laboratoriais foram conduzidos para avaliar a resistência flexural e modulo de elasticidade, alteração de cor, sorção e solubilidade e a citotoxicidade dessas resinas, comparado ao controle sem adição do flavonoide. Os dados foram analisados quanto à normalidade e homoscedasticidade. A resistência à flexão, o módulo de flexão, a sorção de água, a solubilidade em água, os parâmetros a* e C* e a citotoxicidade de 24 horas foram analisados por ANOVA de uma via seguida pelo teste de Tukey. L*, b* e WID foram analisados por Welch ANOVA seguido pelo teste T3 de Dunnett, pois os dados eram heteroscedásticos. A citotoxicidade após 48h e 72h foi analisada pelo teste de Kruskal Wallis e Dunn porque os dados não foram normalmente distribuídos e heteroscedásticos. A revisão de escopo demonstrou um potencial de ação dos flavonoides nas bactérias relacionadas à carie e doença periodontal, sendo promissor quanto ao desenvolvimento de novas terapias e novos materiais restauradores. As resinas compostas experimentais adicionadas de naringina não apresentaram citotoxicidade e não demonstraram efeitos deletérios quanto as propriedades físico-químicas, apesar de promover uma alteração na cor final da resina.

Flavonoids can be considered phytopharmaceutical substances, that is, they are obtained in nature and have benefits to human health. Some of these benefits are related to the cardiovascular system, chronic diseases such as diabetes, and oral disorders as periodontitis and dental caries. Thus, the objectives of the present study were: to analyze the antibacterial effects of different flavonoids against bacteria related to periodontal disease and dental caries through a scoping review; to evaluate the physicalchemical properties of an experimental resin composite with naringin addition. For the scoping review, nineteen articles were included, all in vitro studies. For bacteria related to periodontal disease, proanthocyanidins isoliquiritigenin, liquiritigenin, galangin, quercetrin, taxifolin, chrysin, diosmetin, quercetin, myricetin, naringin, apigenin, catechins, luteolin, morin and rutin were investigated. For bacteria related to dental caries, baicalein, naringenin, catechin, isoliquiritigenin, liquiritigenin, myricetin, quercetin and kaempferol have been investigated. Bacteriostatic, bactericidal and antibiofilm activity were predominantly reported. For the development of an experimental composite, naringin was added in concentrations of 5, 10 and 15mM. Laboratory tests were conducted to evaluate the flexural strength and flexural modulus, color change, sorption and solubility, and the cytotoxicity of these composites, compared to the control group without flavonoids addition. Data were analyzed for normality and homoscedasticity. Flexural strength, flexural modulus, water sorption, water solubility, a* and C* parameters, and 24-hour cytotoxicity were analyzed by one-way ANOVA followed by Tukey's test. L*, b* and WID were analyzed by Welch ANOVA followed by Dunnett's T3 test, as the data were heteroscedastic. While the 48h and 72h cytotoxicity was analyzed by the Kruskal Wallis and Dunn test, because the data were not normally distributed and heteroskedastic. The scope review demonstrated a potential action of flavonoids on bacteria related to caries and periodontal disease, with potential development of new therapies and new restorative materials. The experimental composites with naringin addition did not show cytotoxicity and did not demonstrate deleterious effects in terms of physicochemical properties, despite promoting a change in the final color of the resin.

Oral metastasis intraosseous mimicking periapical lesion: a case report / Metástase oral intraóssea mimetizando lesão periapical: um relato de caso

ABSTRACT Jaw metastasis can be mistaken for inflammatory or infectious diseases. Then, they should be considered in the differential diagnosis of unknown jaw lesions. Study reported here involved metastasis of breast cancer in the mandible of a 45-year-old woman. The most important differential diagnostic was a reactive lesion in an unusual periapical location associated with a nonvital tooth. However, given patient's medical history and because paresthesia and pain were observed a few days after pulpectomy, metastasis of breast cancer could not be ruled out. When bone scintigraphy suggested the metastasis of a malignant bone tumor, incisional biopsy was performed. Histopathologic examination and immunohistochemical reaction confirmed the diagnosis of metastasis of breastcancer, and chemotherapy was thus performed as well. Unfortunately, patient died 2 years after diagnosis. Dentists as well as general physicians should therefore consider presence of oral metastasis in cases involving atypical symptoms, especially in patients with known malignant disease.

RESUMO As metástases mandibulares podem ser confundidas com doenças inflamatórias ou infecciosas. Sendo assim, elas devem ser consideradas no diagnóstico diferencial de lesões desconhecidas na mandíbula. Esse relato de caso envolveu metástase de câncer de mama na mandíbula de uma mulher de 45 anos. O diagnóstico diferencial mais importante foi uma lesão reacional, em uma localização periapical incomum, associada a um dente não vital. No entanto, dado o histórico médico da paciente e uma vez que parestesia e dor foram observadas alguns dias após a realização da pulpectomia, a metástase de câncer de mama não foi descartada. Quando a cintilografia óssea sugeriu a metástase de um tumor ósseo maligno, uma biópsia incisional foi realizada. O exame histopatológico e a reação imunohistoquímica confirmaram o diagnóstico de metástase do câncer de mama, e a quimioterapia foi então realizada. Infelizmente, a paciente morreu 2 anos após o diagnóstico. Portanto, dentistas e médicos generalistas devem considerar a presença demetástases oral em casos que envolvam sintomas atípicos, principalmente em pacientes com doença maligna conhecida.