Development of novel anti-plaque agents for the control of bracket induced plaque

Objectives: Orthodontic brackets alter tooth surface topology and hamper effective oral hygiene, which often cause heavy accumulation of dental plaques in the area, leading to the negative consequences such as decalcification of enamel surface (white spot lesions), caries, as well as gingival inflammation. So far, brushing alone is not an effective way to control bracket-induced plaque, making it a major problem in the orthodontic care. The aim of this study is to develop a novel effective formula consisting of chemicals with strong anti-microbial adherence and anti-microbial-biofilm formation abilities. It could be used, in conjunction with mechanical brushing, to effectively manage orthodontic bracket induced plaque formation and its associated oral diseases such as white spot lesions and gingivitis.
Methods: In vitro bracket biofilm model was established for screening chemical compounds. A panel of sugar and amino acids was tested for their anti-adherence/anti-biofilm formation as well as biofilm dispersion activities against oral pathogens associated with white spot lesions and gingivitis (such as Streptococcus mutans and Porphyromonas gingivitis). The effective chemicals were formulated into a new chemical mixture and further tested against biofilm formation by saliva-derived oral microflora using the same in vitro bracket-plaque formation model system.
Results: By screening the panel of sugar and amino acids using in vitro bracket-related biofilm model, we demonstrated that 4 amino acids displayed strong inhibitory effect against in vitro biofilm formation by saliva-derived oral microbiota. Furthermore, one of the amino acid was shown to be able to disperse existing oral biofilms with great efficacy.
Conclusions: Our study identified several chemicals compounds with high oral biofilm inhibition capability. This finding provided useful knowledge for developing new formula for controlling bracket-induced plaque formation as well as their associated diseases.