In vitro biofilm models to study dental caries: a systematic review

Abstract

The aim of this systematic review is to characterize and discuss key methodological aspects of in vitro biofilm models for caries-related research and to verify the reproducibility and dose-response of models considering the response to anti-caries and/or antimicrobial substances. Inclusion criteria were divided into Part I (PI): an in vitro biofilm model that produces a cariogenic biofilm and/or caries-like lesions and allows pH fluctuations; and Part II (PII): models showing an effect of anti-caries and/or antimicrobial substances. Within PI, 72.9% consisted of dynamic biofilm models, while 27.1% consisted of batch models. Within PII, 75.5% corresponded to dynamic models, whereas 24.5% corresponded to batch models. Respectively, 20.4 and 14.3% of the studies reported dose-response validations and reproducibility, and 32.7% were classified as having a high risk of bias. Several in vitro biofilm models are available for caries-related research; however, most models lack validation by dose-response and reproducibility experiments for each proposed protocol.

Keywords:

• Biofilm models
• caries-like lesion
• artificial caries
• in vitro studies

Acknowledgments

The first author thanks the National Council for Scientific and Technological Development (CNPq, Brazil, process no. 140237/2015-1) for the scholarship received during this study. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.