Effect of experimental and commercial artificial saliva formulations on the activity and viability of microcosm biofilm and on enamel demineralization for irradiated patients with head and neck cancer (HNC)

Abstract

The effect of different artificial saliva formulations on biofilm activity and viability, and on enamel demineralization for head and neck cancer (HNC) patients was evaluated. Irradiated enamel samples were treated (1 min) with BioXtra® or with experimental formulations containing carboxymethylcellulose plus inorganic constituents alone (AS) or containing 0.1 mg mL⁻¹ CaneCPI-5 (AS + Cane), 1.0 mg mL⁻¹ hemoglobin (AS + Hb) or combination of both (AS + Cane + Hb). Phosphate-buffered-saline and chlorhexidine (0.12%) were negative and positive control, respectively. Biofilm was produced from the saliva of five male HNC patients, under 0.2% sucrose exposure for 5 days, and daily treated with the formulations (1 min). No significant effects were observed for the different experimental treatments. BioXtra^® significantly reduced lactobacilli, demonstrating antibacterial potential for this group. Chlorhexidine was an effective treatment to significantly reduce all parameters, being an important antimicrobial and anticaries agent. Future in vitro studies must be performed using a new approach for the design of the experimental formulations.

Keywords:

• Dental caries
• enamel
• hyposalivation
• microcosm biofilm
• protein incorporation
• salivary substitute

Acknowledgements

The authors thank Coordination for the Improvement of Higher Education Personnel for the concession of a PhD scholarship for the first author (CAPES 88887.185799/2018-00) and National Council for Scientific and Technological Development for the undergraduate research scholarship provided to the second (CNPq 144283/2018-2) and third authors (CNPq 19641/2019-4 and 138387/2020-6). F.H.-S. and M.A.R.B. are recipients of a Research Productivity Scholarship from the National Council for Scientific and Technological Development (CNPq 311746/2017-9 and 302371/2018-4, respectively). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors gave final approval and agreed to be accountable for all aspects of the work. The authors are grateful especially to the trial participants, their families, and the staff of the Clinical Research Center at Bauru School of Dentistry. The authors are thankful to the Radiotherapy Center of Bauru, particularly to medical radio-oncologist Ana Tarsila Fonseca and medical physics Simone Zuquerato Sansavino.

CRediT authorship contribution statement

Natara Dias Gomes da Silva: Conceptualization, Methodology, Validation, Formal analysis, Investigation, Writing - original draft, Writing - review & editing. Pedro Renato Bodo de Paiva: Methodology, Investigation, Writing - review & editing. Talita Vaz Moreira Magalhães: Methodology, Investigation, Writing - review & editing. Paulo Sérgio da Silva Santos: Methodology, Investigation, Resources, Writing - review & editing. Flávio Henrique-Silva: Methodology, Resources, Writing - review & editing. Ana Carolina Magalhães: Conceptualization, Methodology, Resources, Writing - review & editing. Marília Afonso Rabelo Buzalaf: Conceptualization, Methodology, Resources, Validation, Supervision, Project administration, Funding acquisition, Writing - review & editing.

Disclosure statement

University of São Paulo and Federal University of São Carlos hold a patent request at INPI (Brazil) entitled ‘Sugarcane derived cystatin to protect against dental caries and dental erosion’.

Data availability statement

The data that support the findings of this study are available from the corresponding author, M.A.R.B., upon reasonable request.

Additional information

Funding

The authors thank Coordination for the Improvement of Higher Education Personnel for the concession of a PhD scholarship for the first author (CAPES 88887.185799/2018-00) and National Council for Scientific and Technological Development for the undergraduate research scholarship provided to the second (CNPq 144283/2018-2) and third authors (CNPq 19641/2019-4 and 138387/2020-6). F.H.-S. and M.A.R.B. are recipients of a Research Productivity Scholarship from the National Council for Scientific and Technological Development (CNPq 311746/2017-9 and 302371/2018-4, respectively). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. All authors gave final approval and agreed to be accountable for all aspects of the work. The authors are grateful especially to the trial participants, their families, and the staff of the Clinical Research Center at Bauru School of Dentistry. The authors are thankful to the Radiotherapy Center of Bauru, particularly to medical radio-oncologist Ana Tarsila Fonseca and medical physics Simone Zuquerato Sansavino.