Background: Dental caries remains a prevalent oral health concern among children worldwide, necessitating effective preventive measures. This study evaluates the efficacy of cranberry extract mouthwash and fluoride mouthwashes in reducing Streptococcus mutans counts among children aged 6–12 years with moderate to severe dental caries. 

Materials and methods: A randomized controlled trial was conducted involving children with three or more carious lesions [Caries Assessment Spectrum and Treatment (CAST) types 3–9]. Participants were assigned to receive either cranberry extract mouthwash or fluoride mouthwash, administered weekly for 6 months. S. mutans colony-forming units (CFUs) were assessed at baseline, 3 months, and 6 months to measure bacterial load reduction. 

Results: Both cranberry extract mouthwash and fluoride mouthwashes demonstrated statistically significant reductions in S. mutans CFUs at 3 months (p < 0.01) and 6 months (p < 0.01) compared to baseline. No significant difference was observed between the two mouthwashes, suggesting comparable efficacy in bacterial count reduction. 

Conclusion: This study supports the use of cranberry extract mouthwash as a natural alternative to fluoride mouthwash in managing dental caries among children. Both interventions effectively reduced S. mutans counts, highlighting their potential as adjuncts to conventional caries management strategies.

The aim of the study was to compare the effect of salivary pellicle modification with polyphenol-rich solutions containing fluoride on enamel erosion and abrasion. Human enamel specimens (n = 14/group) were assigned to five pellicle-modifying groups: GSE+F (grape seed extract +500 ppm F-); CRA+F (cranberry extract +500 ppm F-); NaF (sodium fluoride solution -5 00ppm F-); Sn+F (commercial solution, SnCl2/NaF/AmF); and DW (deionized water, negative control). The specimens were submitted to 5 cycles, each one consisting of pellicle formation (120mcl, 30 min, 37degreeC, no agitation), followed by pellicle modification with the experimental solutions (5 ml, 2 min, 25C, 70 rpm), and subsequent salivary pellicle formation (120 mcl, 60 min, 37degreeC, no agitation). The specimens were then submitted to erosion (1% citric acid, 10 ml, 1 min, pH 3.6, 70 rpm, 25C). Subsequently, they were submitted to abrasion with a fluoride-based toothpaste slurry in a toothbrushing machine (50 strokes, 200 g load, 2 min exposed to slurry). The enamel surface was evaluated with an optical profilometer at baseline and after the 5 cycles to assess the surface loss. Data were submitted to Kruskal-Wallis followed by a multiple comparisons test (alpha = 0.05). Significant differences were found between the tested solutions (p <0.001). The highest surface loss was verified in the DW group (p < 0.001). The other tested solutions (GSE+F, CRA+F, Sn+F, NaF) promoted significant enamel protection against the erosive-abrasive challenges with no differences between them. In conclusion, the modification of salivary pellicle with both polyphenol-rich, commercial solution and fluoride solutions were able to protect the enamel surface from erosion and abrasion

Introduction: Cranberry (Vaccinium macrocarpon) and Vitamin D have both demonstrated significant potential in combating microbial infections, particularly in the oral environment. Cranberry is known for its bioactive compounds, such as proanthocyanidins, flavonoids and organic acids, which exhibit antibacterial properties, while Vitamin D plays a crucial role in bone metabolism and immune response. This study aims to evaluate the antimicrobial efficacy of dental implants coated with cranberry extract and Vitamin D to inhibit bacterial biofilm formation and improve osseointegration. 

Materials and Methods: Titanium dental implants were coated with a cranberry hydrogel solution containing Vitamin D. The process involved surface preparation, dip coating and curing of the implants. Sub-gingival plaque samples were collected from patients with peri-implantitis for microbial analysis. In vitro biofilm formation was assessed on both coated and uncoated implants, followed by a colony reduction ability assessment where biofilm from the implant surfaces was dislodged and cultured to quantify bacterial colony-forming units (CFUs). 

Results: The results indicated a significant reduction in bacterial colonies in the test group (coated implants) compared to the control group (uncoated implants). The cranberry/Vitamin D coating effectively inhibited the growth of black-pigmented microbes. The test group showed a notable decrease in CFU count, confirming the antimicrobial properties of the coating. 

Conclusion: Cranberry and Vitamin D-coated dental implants exhibit significant antimicrobial activity, reducing bacterial colonisation and promoting better clinical outcomes in terms of infection control and bone healing. The use of natural bioactive compounds on implant surfaces represents a viable option to enhance the success rate of dental implants. However, further clinical trials are needed to validate long-term efficacy.

The search has been ongoing for safe and effective antimicrobial agents for control and prevention of oral biofilm associated with disease. Clinical trials for oral specific anti-bacterials are costly and often provide inconclusive results. The simple approach of ex vivo testing of these agents has not demonstrated utility, likely due to variability of effects observed even with a single donor. We show how shed oral biofilms, easily obtained from donor saliva, and tested under optimized conditions, respond reproducibly to anti-bacterial challenges measured by reductions in rRNA accumulation in susceptible taxa. Responses are in part donor specific, but many bacteria taxa were shown to be reproducibly susceptible over a group of donors. For two antibiotics, vancomycin and penicillin G tested at pharmacologic levels, a subset of Gram-positive bacteria was inhibited. A natural product with antibacterial properties, diluted Vaccinium macrocarpon (cranberry) juice, was shown to inhibit a range of oral taxa, including Alloprevotella sp__HMT_473, Granulicatella adiacens, Lachnoanaerobaculum umeaense, Lepotrichia sp__HMT_215, Peptostreptococcus stomatis, Prevotella nanceiensis, Stomatobaculum sp__HMT_097, Veillonella parvula, and kill some targets. The model discussed in this study has promise as a rapid, precise, and reproducible ex vivo method to test and identify potential clinically useful antimicrobial agents active against the oral biofilm community.

Background: The aim of this double-blind randomized placebo-controlled clinical trial was to evaluate the efficacy of a multinutrient supplement as an add-on therapy to scaling and root planing for patients with periodontitis. 

Methods: Forty-two patients with stage III or IV periodontitis were randomly allocated to a 2-month treatment of either a multinutrient supplement containing vitamin C, vitamin E, zinc, selenium, alpha-lipoic-acid, cranberry extract, grapeseed extract, and coenzyme Q10 or placebo capsules as an adjunct to conservative periodontal therapy. Periodontal parameters, including probing pocket depth, gingival recession, bleeding on probing, approximal plaque index, and papillary bleeding index, were assessed. Clinical attachment loss, periodontal inflamed surface area, periodontal epithelial surface area, and percentages of pocket sites with <=3, <=4, >=5, >=6, >=7, and >=4 mm with bleeding on probing were calculated. 

Results: All clinical parameters significantly improved from baseline to reevaluation within each group (p < 0.05). Multinutrient intake resulted in a significantly higher reduction of probing-pocket-depth (-0.75 +or- 0.42 mm) and bleeding-on-probing (-21.9 +or- 16.1%) from baseline to reevaluation compared with placebo (-0.51 +or- 0.30 mm, p = 0.040 and -12.5 +or- 9.8%, p = 0.046, respectively). All periodontal parameters showed insignificantly higher improvements in patients receiving the supplement compared with those receiving the placebo (p > 0.05). 

Conclusion: Multinutrient supplementation as an adjunct to nonsurgical treatment of periodontitis showed some additional benefit regarding probing-pocket-depth and bleeding-on-probing. However, the clinical relevance needs to be further explored.

A promising approach for managing root caries is the use of cross-linking agents to stabilize collagen. However, despite testing various natural and synthetic agents in vitro, their efficacy remains uncertain. The aim of this review was to examine which cross-linking agent performs better in reducing root caries lesion depth and the release of hydroxyproline, which is a marker of collagen degradation. Studies evaluating the impact of cross-linking agents on dentin were included, while studies performed on enamel surface/cell cultures and studies evaluating collagenase inhibitors were excluded, among others. A comprehensive search covered eight databases, and study quality was assessed using the QUINN Tool for in vitro dental studies. Synthesis of the results was done using a Bayesian network meta-analysis to compare agents. Fifty studies involving 31 cross-linking agents were included for qualitative synthesis. The network meta-analysis for lesion depth involved 284 samples across 36 comparisons and ranked cross-linking agents in terms of their caries lesion depth-reducing effect (from best to worst): naringin > quercetin > riboflavin > proanthocyanidins > hesperidin > glutaraldehyde > cranberry > grape seed extract > untreated controls. Only naringin, quercetin, proanthocyanidins, and glutaraldehyde showed statistically significant efficacy over untreated controls. Cranberry extract excelled in reducing hydroxyproline release, followed by proanthocyanidins. In conclusion, proanthocyanidins positively affected both outcomes, suggesting they are prime candidates for translational research. Clinical studies are now essential to evaluate their real-world effectiveness against root caries. PROSPERO-CRD42023404911. Copyright © 2024 Scandinavian Division of the International Association for Dental Research. Published by John Wiley & Sons Ltd.

Natural products are well-known due to their antimicrobial properties. This study aimed to evaluate the antimicrobial effect of Desplac (R) product (composed of Aloe Vera, Propolis Extract, Green Tea, Cranberry, and Calendula) on the subgingival biofilm. Two different protocols were used to treat the 33-species biofilms: (A) 2x/day (12/12 h) for 1 min with Desplac (R) or Noplak Toothpaste (Chlorhexidine + Cetylpyridinium Chloride) or Oral B ProGengiva (stannous Fluoride) or a placebo gel; (B) a 12-h use of the Desplac (R) product or 0.12% chlorhexidine gel or a placebo gel. After 7 days of biofilm formation, the metabolic activity (MA) and biofilm profile were determined by 2,3,5-triphenyltetrazolium chloride and Checker-board DNA-DNA hybridization, respectively. Statistical analysis used the Kruskal-Wallis test followed by Dunn's post-hoc. In protocol A, all treatments presented reduced MA compared to the placebo (p <= 0.05). The Desplac (R)-treated biofilm showed a similar microbial profile to other antimicrobials, although with higher bacterial total counts. In protocol B, MA of Desplac (R)-treated biofilms was lower than the placebo's MA but higher than chlorhexidine-treated biofilms (p <= 0.05). Pathogen levels in Desplac (R)-treated biofilms were lower than in placebo-treated biofilms and elevated compared to the chlorhexidine-treated biofilms (p <= 0.05). Desplac (R) inhibited the biofilm development and disrupted the mature subgingival biofilm, highlighting its effect on Tannerella forsythia counts.

Background: The present study formulates and evaluates a polyberry gel comprising extracts of cranberry (Vaccinium macrocarpon) and brindle berry (Garcinia cambogia) in patients suffering from chronic periodontitis.

Materials and Methods: The polyberry gel was evaluated for various physicochemical parameters, in vitro permeability and stability, and the active phytoconstituents were quantified by High-performance thin layer chromatography (HPTLC). Total phenolic content, total antioxidants, and ascorbic acid were estimated in the two extracts by in vitro assays. Patients suffering from chronic periodontitis with probing pocket depth (PPD) up to 5 mm were divided into 3 groups of 21 patients each and treated with scaling and root planing (SRP) or SRP followed by subgingival placement of polyberry gel or tetracycline fibers (standard). Plaque Index (PI), Gingival Index (GI), PPD, Clinical Attachment Level (CAL), and the salivary aspartate aminotransferase (AST) and C-reactive protein (CRP) levels were recorded at baseline and after 1 month.

Results: A significant (P < 0.01) reduction in the periodontic disease parameters was observed in the standard and gel-treated groups between their baseline and 1-month time-interval readings. The polyberry gel treatment significantly (P < 0.05 for AST and P < 0.01 for the rest) attenuated the periodontitis-elevated PI, GI PPD, CAL, AST and CRP levels when compared with SRP at the end of the study and was comparable with tetracycline.

Conclusion: The amelioration of periodontitis and gingival inflammation may be attributed to the potent antioxidant activity of the polyphenolic phytoconstituents of the gel. The polyberry gel may thus be used as a safe adjunct to SRP/tetracycline in chronic periodontitis.

Background: Recently, research in the field of caries prevention is emphasizing upon identification of edible non-toxic compounds that can interfere with the formation of cariogenic biofilm. 

Aim: This trial aimed to assess the effectiveness of non-dialyzable material (NDM) containing cranberry mouth rinse (C-MR) on the Streptococcus mutans (S. mutans) counts and compare with that of a sodium fluoride (F-MR) mouth rinse. 

Methods: 280 children (8-12 years old) were enrolled in this double-blind single center, parallel, one-month, IRB/IEC approved non-inferiority trial. The participants fulfilling the inclusion criteria were randomly allocated into one of the two groups: C-MR and F-MR. All participants were given verbal and written instructions about at-home mouth-rinsing regimen under parental supervision for a month. Dental plaque samples were collected before and after a month of mouth-rinsing and subjected to culture techniques. S. mutans counts were assessed and compared in both groups. Primary outcome was the difference in the S. mutans counts between two interventions. Both intention-to-treat (ITT) and per-protocol analysis were carried out using two-sample t test with equal variance. 

Results: The mean S. mutans counts (after log transformation) in C-MR group were: 14.66 (90% CI 14.4,14.9) at baseline and 12.85 (90% CI 12.5, 13.2) colony-forming units/ml (CFU/ml) at one-month post intervention (p = 0.001); while these counts were 14.69 (90% CI 14.5, 14.9) at baseline and 12.71 (90% CI 12.3, 13.1) at one-month intervention in F-MR groups (p = 0.001). ITT analysis showed an inter- group difference of 0.14 CFU/ml (90% CI - 0.32,0.59) in post-SM counts between groups (p = 0.629). 

Conclusion: The study demonstrated that the cranberry mouth rinse was non-inferior to the fluoride mouth rinse in terms of S. mutans levels change. Cranberry-based mouth rinse can be used effectively to reduce the S. mutans counts in children. Trial registrationRegistration number in case of Clinical Trials-CTRI/2019/05/019395.

Background: Cariogenic bacteria has always been considered as the highest risk factor for dental caries. The eradication of microorganisms from the oral health environment is important and hence may remedies have been suggested for its removal for a better oral health. 

Objectives: To assess the minimal inhibitory concentration (MIC) of Cranberry extract and to determine the efficacy and compare the effect of the three products on salivary Streptococcus Mutans count and lactobacilli count. 

Materials and Methodology: A randomized control, double blind, parallel-group clinical trial was conducted on 75 subjects of age group of 15 years who were divided into three study groups, Cranberry, Ozonized water and Chlorhexidine mouthwash. Microbial analysis was done by colony counter unit at baseline, 8th day and 15th day of using the mouthwashes. The inter-group variations were analysed by using one way ANOVA followed by Tukey's post hoc and Repeated measures for intra-group variations at different time intervals. 

Results: Streptococcus mutans and Lactobacilli colony count showed a statistically highly significant difference in reduction of colony count between the three groups (p=0.001) at 8th and 15th day of using the mouthwashes. Ozonized water showed better reduction when compared with Cranberry mouth wash in reduction of Streptococcus mutans count. Cranberry mouth wash had shown a better reduction when compared with Ozonized water in reduction of Lactobacilli colony count. 

Conclusion: The test mouthwash was effective in reducing the microbial count, similar to Chlorhexidine mouth wash. Recent advances may allow the dental community to be exposed to much better oral health care.