Anti-Biofilm Formation of an Adhesive Containing Calcium Salts of Acidic Monomers against Oral Candida Related to Root Caries

The proportion of older people within the general population is expanding due to the decline of birth rate and the increase of life expectancy. Increasing elderly populations, which is retaining its teeth longer, leads to oral health problems, for example, root caries. The main etiological factor for the initiation and development of root caries is the appearance of cariogenic biofilm. The acid-producing and acid-tolerant bacteria and oral yeast, such as Candida albicans are the major contributors in root caries formation. A new generation of adhesives is developed with several modifications for the prevention of dental caries by incorporating antimicrobial components. The aim of this study was to investigate the antimicrobial effect of adhesive containing calcium salt of acidic monomers on the biofilm formation of oral Candida related to root caries. In the experiments, the flat-bottom surfaces of 96-well plate were painted with an adhesive containing calcium salts of 4-methacryloxyethyl trimellitic acid (CMET) and 10-methacryloyloxydecyl dihydrogen calcium phosphate (MDCP) (Bio-Coat, CA, Sun Medical, Japan). Then they were LED light-cured and coated with sterile saliva at 37 °C for 60 min. The biofilm formation was made by adding of Candida albicans (ATCC 10238 and two clinical strains) suspensions (107 colony forming unit/mL) and incubated at 37°C for 24 h. The amount of vital biofilm was determined by WST-8 Microbial Cell Counting Kit (Dojindo Molecular Technologies, USA). All experiments were done in triplicate and repeated three times. Statistical analysis was performed using Student’s t-test. The results clearly showed that adhesive could significantly inhibit biofilm formation of all tested Candida compared with a control. This suppressive effect was not different among the strains of Candida. The percentages of vital biofilm reduction were 25% to 40%. The ability of this adhesive to suppress biofilm of oral yeast may be its antimicrobial property of acidic monomer or the effect of calcium ion within the adhesive, which can alter Candida cell morphology, and influence their structures or process of biofilm formation. In conclusion, an adhesive containing calcium salts of acidic monomers could significantly inhibit biofilm formation of C. albicans. This adhesive could be effectively applied to exposed root surfaces to prevent or inhibit the progression of root caries. Further studies are necessary to clarify the effect on multispecies biofilm, on long-term activity, and in vivo conditions.