Aim: To evaluate the effect of different bleaching methods 40% (hydrogen peroxide) HP and Zinc Phthalocyanine (ZP) activated by photodynamic therapy (PDT) with the utilization of diverse procedures of reversal (10% ascorbic acid and 6% cranberry solution) on bond values, surface microhardness and surface roughness of bleached enamel surface.

Material and Methods: An aggregate of 60 extracted human mandibular molars was gathered and the buccal surface of each specimen was exposed to 2 mm of enamel surface for bleaching with chemical and photoactivated agents with the use of reversal solutions. Specimens were divided into six groups (n = 10) at random-Group 1: samples bleached with 40% HP with 10% ascorbic acid (reversal agent), group 2: ZP activated by PDT with 10% ascorbic acid (reversal agent), group 3: 40% HP with 6% cranberry solution as a reversal agent, group 4: ZP activated by PDT with 6% cranberry solution, group 5: 40% HP and group 6: ZP activated by PDT with no reversal agents. Resin cement restoration was performed via etch and rinse technique and SBS was estimated by using the universal testing machine, SMH by using Vickers hardness tester, and Ra by stylus profilometer. Statistical analysis was executed using the ANOVA test and the Tukey multiple tests (p<0.05). 

Results: Enamel surface bleached with 40% HP reversed with 10% ascorbic acid displayed the highest SBS while 40% HP with no reversal agent use showed the least SBS. For SMH, ZP activated by PDT when applied on the enamel surface and reversed with 10% ascorbic acid showed the highest SMH while when bleached with 40% HP and reversed with 6% cranberry solution showed the least SMH value. For Ra, Group 3: samples bleached with 40% HP with 6% cranberry solution as reversal agent showed the highest Ra value while bleaching of enamel surface with ZP activated by PDT with 6% cranberry displayed the least Ra value. 

Conclusion: Bleached enamel surface with Zinc Phthalocyanine activated by PDT with the application of 10% ascorbic acid as reversal solution has demonstrated the highest SBS and SMH with acceptable surface roughness for bonding adhesive resin to the enamel surface.

Objective: The aim of this work was to explore the potential of polyphenol supplement consumption in enhancing the treatment of periodontitis and diabetes mellitus in both diabetic animals and humans. 

Materials and methods: A comprehensive search across eight databases (MEDLINE, EBSCO, Taylor & Francis, PRIMO, Web of Science, Wiley Online Library, ScienceDirect, and SAGE Journals) and two registers (ClinicalTrials.gov and Cochrane Library Trials) was conducted. Methodological quality assessment employed the Cochrane Collaboration Risk of Bias Assessment Tool for randomised controlled trials and the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias Tool for experimental animal studies. 

Results: Ten articles meeting inclusion criteria were identified. Three clinical studies demonstrated significant reductions in probing depth (PD) and clinical attachment loss (CAL). Ginger supplementation showed a decrease in CAL (-0.57 +/- 0.50 vs. -0.14 +/- 0.35, p = 0.003) and PD (-0.52 +/- 0.51 vs. -0.19 +/- 0.51, p = 0.04), while resveratrol supplementation exhibited a reduction in PD (-1.1 +/- 0.58 vs. -0.6 +/- 0.47, p < 0.001). Additionally, cranberry juice supplementation led to a decrease in PD (-0.56 +/- 0.03, p < 0.001). However, there was no significant improvement in inflammation status. Although polyphenol supplementation did not impact fasting blood glucose levels, it did result in improved insulin resistance (3.66 +/- 0.97 vs. 4.49 +/- 1.56, p = 0.045). In diabetic animals, six studies reported a significant reduction (p < 0.05) in bone loss along with marked improvements in inflammation status. 

Conclusions: Despite the promising results observed in the included studies, the overall evidence supporting the positive effects of polyphenols on periodontal and diabetes mellitus status, along with their anti-inflammatory properties, remains inadequate.

Background: Among the several types of periodontitis, chronic periodontitis is the utmost common form of periodontal disease which can progress with a slow rate but may have a sudden rapid rate of progression along with a remarkable bone loss. In terms of adequacy in sufficient periodontal regeneration, periodontal flap surgeries lack the potential and takes often a back seat. Several other regenerative methods have been promoted among which platelet rich fibrin (PRF) is seen to be most extensively used. It is an old and successful trend to either add PRF or to infuse it along with other drugs at the wound site to enhance periodontal regeneration. Several herbal products were used as an infusion with PRF in the past for the antimicrobial effect but no herbal products were used in the form of a synergetic agent with PRF for enhancing periodontal regeneration. Cranberry fruit, its origin is from North America has been much popular because of its essential ingredients for a good health. It has got a significant therapeutic potential as an antimicrobial agent and as an antioxidant agent but been never used for enhancing periodontal regeneration. Hence, the current study's goal is to assess and compare the synergetic effect of Cranberry extract with PRF versus the use of PRF alone in the treatment of chronic periodontitis. 

Materials and Method: A double blinded randomized clinical trial (RCT) was done with twenty subjects which included patients based on the selection criteria in the age group of 35 to 55 years having periodontal intrabony defects. The Control Group A received PRF alone and the Test Group B received PRF+CRN at the site of intrabony defects. Subjects in each group were assessed for their clinical parameters such as probing pocket depth (PPD), relative attachment level (RAL), gingival index (GI), plaque index (PI) and radiographical parameters such as defect depth (DD), defect area (DA) and defect fill % (DF %) at baseline. The follow up period was decided according to the previous studies at three, six and nine months respectively. 

Results: There was a statistically significant enhancement in the clinical and radiographic parameters from baseline to three, six and nine months in each group. However, the treated group showed statistically significant than the control group. 

Conclusion: Within the limitations of the given study, use of PRF+CRN was efficacious in comparison to the use of PRF alone in the treatment of intrabony defect.

Context: Anticariogenic properties have been ascribed to polyphenolic compounds present in high concentrations in numerous fruits. Berries, in particular, have been reported as potentially having an inhibitory effect on the dental biofilm and subsequently on caries, but the evidence is unclear.

Objective: The objective of this review was to explore the literature and summarize the evidence for berries having an inhibitory effect on the dental biofilm and an anticariogenic effect.

Data sources: Following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, the PubMed, Web of Science, and SCOPUS databases were scanned using predefined and accessible terms, with a search strategy based on a structured PICO question.

Data extraction: After article selection, 23 studies met the inclusion criteria, most of them being in vitro studies. A risk assessment was performed, and data were extracted and presented in a table for qualitative analysis.

Data analysis: Meta-analyses were conducted using standardized mean differences (SMDs) with a 95% confidence interval (CI) by Review manager 5.4.

Results: Only 3 types of berries were found to have a reported anticaries effect: grape seed extract (GSE), cranberry, and sour cherry. Nine studies that fulfilled the eligibility criteria were subjected to quantitative analysis. Meta-analyses showed GSE was associated with enhanced remineralization of dental enamel (SMD = .96 95% CI [.45, 1.46], P < .0002) and of dentin (SMD = .65 95% CI [.13, 1.17], P = .01). Cranberry extracts positively influenced the cariogenic dental biofilm by decreasing the biofilm biomass (SMD = -2.23 95% CI [-4.40, -.05], P = .04), and biovolume (SMD = -2.86 95% CI [-4.34, -1.37], P = .0002), and increasing the biofilm pH (SMD = 7.9 95% CI [3.49, 12.31], P < .0004).

Conclusion: Within the limitations of this systematic review and metaanalysis, GSE and cranberries or their active compounds could represent an alternative for caries management. Further clinical trials are needed to verify this effect in a clinical setting.

Diet and salivary proteins influence the composition of the oral microbiome, and recent data suggest that TAS2R38 bitter taste genetics may also play a role. We investigated the effects of daily exposure to a cranberry polyphenol oral rinse on taste perception, salivary proteins, and oral microbiota. 6-n-Propylthiouracil (PROP) super-tasters (ST, n = 10) and non-tasters (NT, n = 10) rinsed with 30 mL of 0.75 g/L cranberry polyphenol extract (CPE) in spring water, twice daily for 11 days while consuming their habitual diets. The 16S rRNA gene sequencing showed that the NT oral microbiome composition was different than that of STs at baseline (p = 0.012) but not after the intervention (p = 0.525). Principal coordinates analysis using unweighted UniFrac distance showed that CPE modified microbiome composition in NTs (p = 0.023) but not in STs (p = 0.096). The intervention also altered specific salivary protein levels (alpha-amylase, MUC-5B, and selected S-type Cystatins) with no changes in sensory perception. Correlation networks between oral microbiota, salivary proteins, and sensory ratings showed that the ST microbiome had a more complex relationship with salivary proteins, particularly proline-rich proteins, than that in NTs. These findings show that CPE modulated the oral microbiome of NTs to be similar to that of STs, which could have implications for oral health.

Vaccinium macrocarpon (cranberry) is a fruit that has an inhibitory effect on matrix metalloproteinases (MMPs) present in dentin and saliva. The inhibition of MMPs has been shown to prevent dentin erosion. The aim of this study was to analyze the effect of cranberry juice on the reduction of dentin erosion in vitro. Specimens of bovine dentin (4x4x2 mm) were randomized and divided into 4 groups (n = 17/group): distilled water (C-control, pH 7.2); green tea extract solution containing 400 microm epigallo-catechin-gallate (EGCg, positive control, pH 4.5); 10% cranberry extract (CrE, pH 3.9), and cranberry juice (CrJ, Cranberry JuxxTM, pH 2.8). Specimens were submitted to erosive pH cycles for 5 days. Each day, four demineralizations were carried out with 0.1% citric acid (90 s). After the acid challenges, specimens were rinsed and kept in treatment solutions for 1 min; afterwards, they were rinsed and stored in artificial saliva for 1 h at 37degreeC (or overnight at the end of each day). After the experimental period of 5 days, dentin loss was evaluated by contact profilometry. Data were analyzed by ANOVA and Tukey's test (p < 0.05). Dentin loss (microm +/- SD) was significantly lower for all treatments (EGCg = 9.93 +/- 2.90; CrE = 12.10 +/- 5.44; CrJ = 11.04 +/- 5.70) compared to control (21.23 +/- 11.96), but it did not significantly differ from each other. These results indicate that the commercial cranberry juice, despite its low pH, is able to reduce dentin erosion, which might be due to the ability of cranberry components to inhibit MMPs.

The emergence of bacteria resistant to antimicrobial agents has led to a shortage of options when choosing effective treatment agents. Further, some antibiotics used at therapeutic doses can produce undesired side effects.ABSTRACT Dental caries is caused by the buildup of acidic end products that result from the metabolism of dental plaque microbes. Natural products that are widely available could be used as an alternative or adjunctive anti-caries therapy. Sometimes, when two products are used together, they yield a more powerful antimicrobial effect than the anticipated additive effect. These synergistic combinations are often better treatment options because individual agents may not have sufficient antimicrobial action to be effective when used alone. Cranberries contain phenolic compounds like proanthocyanidins (PAC) that disrupt biofilm formation. Manuka honey has high concentrations of the agent methylglyoxal (MGO), which is cariostatic. Because these agents have varied modes of antimicrobial action, they show potential for possible synergistic effects when paired. Various cranberry extracts were tested pairwise with manuka honey or MGO by well-diffusion assays and 96-well checkerboard assays in the presence of Streptococcus mutans to test for synergy. Synergy was demonstrated in cranberry extracts Type R and RE when paired with manuka honey and MGO. The synergistic combinations found in this research thus can be considered candidates for the formulation of a dentifrice that could be used to inhibit the formation of dental plaque and thereby avoid the development of caries. IMPORTANCE The emergence of bacteria resistant to antimicrobial agents has led to a shortage of options when choosing effective treatment agents. Further, some antibiotics used at therapeutic doses can produce undesired side effects. An alternative to traditional antibiotics, natural antimicrobial agents can be used in combination to obtain synergistic outcomes without subjecting the patient to toxic or irritating doses of individual agents. Streptococcus mutans growth and biofilm formation are major contributors to the formation of dental caries. In this study, a synergistic combination of Manuka honey and cranberry extracts gives evidence that it can be used as an alternative or adjunctive anti-caries therapy.

The oral cavity harbors hundreds of microorganisms that may be uncontrolled and provoke several diseases. In this sense, periodontitis is a complex multifactorial disease with an essential microbial component in its etiology. Periodontal treatment involves mechanical control of the supra- and subgingival biofilm, but not all patients respond predictably to treatment. In this way, the biofilm chemical control helps in the reduction of periodontal pathogens during treatment or in the delay of bacterial re-colonization after scaling and root planning. Several products have been studied as adjunctive therapy and have shown promising results. Therefore, the present article reviews the biological effects of propolis, aloe vera, green tea, cranberry, calendula, myrrha and salvia that may support their use in the control of subgingival biofilm in patients with periodontitis. All the natural products cited above showed exciting results against microorganisms related to oral diseases, mainly periodontitis. These substances also have anti-inflammatory and antioxidant activities. The natural agents propolis, aloe vera, green tea, cranberry, calendula, myrrha and salvia demonstrated potential to be used as oral hygiene products, based on their antimicrobial and anti-inflammatory actions.