CC BY 4.0 · Eur J Dent 2019; 13(02): 287-290
DOI: 10.1055/s-0039-1695657
Review Article
Dental Investigation Society

Hydroxyapatite in Oral Biofilm Management

Frederic Meyer
1   Research Department, Dr. Kurt Wolff GmbH and Co. KG, Bielefeld, Germany
,
Joachim Enax
1   Research Department, Dr. Kurt Wolff GmbH and Co. KG, Bielefeld, Germany
› Author Affiliations
Funding None.
Further Information

Publication History

Publication Date:
01 October 2019 (online)

Abstract

Particulate hydroxyapatite, Ca5 (PO4)3 (OH), shows a good biocompatibility and is used as a biomimetic ingredient in dental care formulations due to its similarity to human enamel. Numerous studies show its efficiency, for example, in reducing dentin hypersensitivity, and in the remineralization of enamel and dentin. In addition, oral care products with hydroxyapatite improve periodontal health under in vivo conditions. This review article summarizes data on the effects of hydroxyapatite particles in oral biofilm management. Two databases (PubMed and SciFinder) were searched for studies using specific search terms. In contrast to frequently used antibacterial agents for biofilm control, such as chlorhexidine, stannous salts, and quaternary ammonium salts, hydroxyapatite particles in oral care products lead to a reduction in bacterial attachment to enamel surfaces in situ without having pronounced antibacterial effects or showing unwanted side effects such as tooth discoloration. Furthermore, antibacterial agents might lead to dysbiosis of the oral ecology, which was recently discussed regarding pros and cons. Remarkably, the antiadherent properties of hydroxyapatite particles are comparable to those of the gold standard in the field of oral care biofilm management, chlorhexidine in situ. Although biomimetic strategies have been less well analyzed compared with commonly used antibacterial agents in oral biofilm control, hydroxyapatite particles are a promising biomimetic alternative or supplement for oral biofilm management.

 
  • References

  • 1 Flemming HC, Wingender J, Szewzyk U, Steinberg P, Rice SA, Kjelleberg S. Biofilms: an emergent form of bacterial life. Nat Rev Microbiol 2016; 14 (09) 563-575
  • 2 Haussler S, Fuqua C. Biofilms 2012: new discoveries and significant wrinkles in a dynamic field. J Bacteriol 2013; 195 (13) 2947-2958
  • 3 Marsh PD, Head DA, Devine DA. Ecological approaches to oral biofilms: control without killing. Caries Res 2015; 49 (Suppl. 01) 46-54
  • 4 Meyer F, Enax J. Biomimetic approaches for the dental plaque control. Biol Unserer Zeit 2018; 48: 62-68
  • 5 Marsh PD, Zaura E. Dental biofilm: ecological interactions in health and disease. J Clin Periodontol 2017; 44 (Suppl. 18) S12-S22
  • 6 Sanz M, Beighton D, Curtis MA. et al. Role of microbial biofilms in the maintenance of oral health and in the development of dental caries and periodontal diseases. Consensus report of group 1 of the Joint EFP/ORCA workshop on the boundaries between caries and periodontal disease. J Clin Periodontol 2017; 44 (Suppl. 18) S5-S11
  • 7 Vos T, Abajobir AA, Abate KH. et al. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390 (10100) 1211-1259
  • 8 Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: a call for global action. J Clin Periodontol 2017; 44 (05) 456-462
  • 9 Enax J, Epple M. Characterization of abrasives in toothpastes. Dtsch Zahnarztl Z 2018; 73: 116-124
  • 10 Epple M, Enax J. Moderne zahnpflege aus chemischer Sicht. Chem Unserer Zeit 2018; 4: 218-228
  • 11 Epple M, Enax J. The Chemistry of Dental Care. Chem Views DOI:10.1002/chemv.201800053 2018; 00
  • 12 Fejerskov O, Nyvad B, Kidd E. eds. Dental Caries: The Disease and Its Clinical Management. 3rd ed. Oxford: Wiley Blackwell. 2015
  • 13 Yaacob M, Worthington HV, Deacon SA. et al. Powered versus manual toothbrushing for oral health. Cochrane Database Syst Rev 2014; (06) CD002281
  • 14 Marsh PD. Contemporary perspective on plaque control. Br Dent J 2012; 212 (12) 601-606
  • 15 Brading MG, Marsh PD. The oral environment: the challenge for antimicrobials in oral care products. Int Dent J 2003; 53 (06) (Suppl. 01) 353-362
  • 16 ten Cate JM. The need for antibacterial approaches to improve caries control. Adv Dent Res 2009; 21 (01) 8-12
  • 17 Latimer J, Munday JL, Buzza KM, Forbes S, Sreenivasan PK, McBain AJ. Antibacterial and anti-biofilm activity of mouthrinses containing cetylpyridinium chloride and sodium fluoride. BMC Microbiol 2015; 15: 169
  • 18 Marsh PD. Controlling the oral biofilm with antimicrobials. J Dent 2010; 38 (Suppl. 01) S11-S15
  • 19 Ellingsen JE, Eriksen HM, Rölla G. Extrinsic dental stain caused by stannous fluoride. Scand J Dent Res 1982; 90 (01) 9-13
  • 20 Addy M, Moran J. Mechanisms of stain formation on teeth, in particular associated with metal ions and antiseptics. Adv Dent Res 1995; 9: 450-456
  • 21 Cieplik F, Kara E, Muehler D. et al. Antimicrobial efficacy of alternative compounds for use in oral care toward biofilms from caries-associated bacteria in vitro. Microbiologyopen 2019; 8 (04) e00695
  • 22 Cieplik F, Tabenski L, Buchalla W, Maisch T. Antimicrobial photodynamic therapy for inactivation of biofilms formed by oral key pathogens. Front Microbiol 2014; 5: 405
  • 23 Adams SE, Arnold D, Murphy B. et al. A randomised clinical study to determine the effect of a toothpaste containing enzymes and proteins on plaque oral microbiome ecology. Sci Rep 2017; 7: 43344
  • 24 Kensche A, Holder C, Basche S, Tahan N, Hannig C, Hannig M. Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ. Arch Oral Biol 2017; 80: 18-26
  • 25 Freires IA, Rosalen PL. How natural product research has contributed to oral care product development? A critical view. Pharm Res 2016; 33 (06) 1311-1317
  • 26 Enax J, Epple M. Synthetic hydroxyapatite as a biomimetic oral care agent. Oral Health Prev Dent 2018; 16 (01) 7-19
  • 27 Meyer F, Amaechi BT, Fabritius HO, Enax J. Overview of calcium phosphates used in biomimetic oral care. Open Dent J 2018; 12: 406-423
  • 28 Fratzl P. Biomimetic materials research: what can we really learn from nature’s structural materials?. J R Soc Interface 2007; 4 (15) 637-642
  • 29 Meyer F, Enax J. Early childhood caries: epidemiology, aetiology, and prevention. Int J Dent 2018; 2018: 1415873
  • 30 Hannig M, Hannig C. Nanomaterials in preventive dentistry. Nat Nanotechnol 2010; 5 (08) 565-569
  • 31 Loveren CV. Toothpastes. Monogr Oral Sci 2013; 23 ISBN: 978–3-318–02206–3 00
  • 32 Brown PW, Constantz B. Hydroxyapatite and Related Materials. Boca Raton; FL: CRC Press: 1994
  • 33 Harks I, Jockel-Schneider Y, Schlagenhauf U. et al. Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A Randomized trial. PLoS One 2016; 11 (07) e0160142
  • 34 Najibfard K, Ramalingam K, Chedjieu I, Amaechi BT. Remineralization of early caries by a nano-hydroxyapatite dentifrice. J Clin Dent 2011; 22 (05) 139-143
  • 35 Hannig C, Basche S, Burghardt T, Al-Ahmad A, Hannig M. Influence of a mouthwash containing hydroxyapatite microclusters on bacterial adherence in situ. Clin Oral Investig 2013; 17 (03) 805-814
  • 36 Dorozhkin SV, Epple M. Biological and medical significance of calcium phosphates. Angew Chem Int Ed Engl 2002; 41 (17) 3130-3146
  • 37 Epple M. Review of potential health risks associated with nanoscopic calcium phosphate. Acta Biomater 2018; 77: 1-14
  • 38 Ramis J, Coelho C, Córdoba A, Quadros P, Monjo M. Safety assessment of nano-hydroxyapatite as an oral care ingredient according to the EU cosmetics regulation. Cosmetics 2018; 5: 53
  • 39 Kani K, Kani M, Isozaki A, Shintani H, Ohashi T, Tokumoto T. Effect of apatite-containing dentifrices on dental caries in school children. J Dent Health 1989; 19: 104-109
  • 40 Schlagenhauf U, Kunzelmann KH, Hannig C. et al. Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: A randomized, controlled 6-month trial. J Investig Clin Dent 2019; 10 (222) e12399
  • 41 Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enamel and dentine remineralization by nano-hydroxyapatite toothpastes. J Dent 2011; 39 (06) 430-437
  • 42 Hegazy SA, Salama IR. Antiplaque and remineralizing effects of biorepair mouthwash: a comparative clinical trial. Pediatr Dent J 2016; 26: 89-94
  • 43 Orsini G, Procaccini M, Manzoli L, Giuliodori F, Lorenzini A, Putignano A. A double-blind randomized-controlled trial comparing the desensitizing efficacy of a new dentifrice containing carbonate/hydroxyapatite nanocrystals and a sodium fluoride/potassium nitrate dentifrice. J Clin Periodontol 2010; 37 (06) 510-517
  • 44 Orsini G, Procaccini M, Manzoli L. et al. A 3-day randomized clinical trial to investigate the desensitizing properties of three dentifrices. J Periodontol 2013; 84 (11) e65-e73
  • 45 Hiller KA, Buchalla W, Grillmeier I, Neubauer C, Schmalz G. In vitro effects of hydroxyapatite containing toothpastes on dentin permeability after multiple applications and ageing. Sci Rep 2018; 8 (01) 4888
  • 46 Cosola S, Marconcini S, Giammarinaro E. et al. Antimicrobial efficacy of mouthwashes containing zinc-substituted nanohydroxyapatite and zinc L-pyrrolidone carboxylate on suture threads after surgical procedures. J Oral Sci Rehabil 2017; 3: 24-30
  • 47 Marinone MG, Savoldi E. Chlorhexidine and taste. Influence of mouthwashes concentration and of rinsing time. Minerva Stomatol 2000; 49 (05) 221-226
  • 48 Jones CG. Chlorhexidine: is it still the gold standard?. Periodontol 2000 1997; 15: 55-62
  • 49 Shani S, Friedman M, Steinberg D. Relation between surface activity and antibacterial activity of amine-fluorides. Int J Pharm 1996; 131: 33-39
  • 50 Young A, Jonski G, Rölla G. Inhibition of orally produced volatile sulfur compounds by zinc, chlorhexidine or cetylpyridinium chloride—effect of concentration. Eur J Oral Sci 2003; 111 (05) 400-404
  • 51 Lynch RJ. Zinc in the mouth, its interactions with dental enamel and possible effects on caries; a review of the literature. Int Dent J 2011; 61 (Suppl. 03) 46-54
  • 52 Fatima T, Haji Abdul Rahim ZB, Lin CW, Qamar Z. Zinc: a precious trace element for oral health care?. J Pak Med Assoc 2016; 66 (08) 1019-1023
  • 53 Gilbert RJ, Ingram GS. The oral disposition of zinc following the use of an anticalculus toothpaste containing 0.5% zinc citrate. J Pharm Pharmacol 1988; 40 (06) 399-402
  • 54 Mira A, Simon-Soro A, Curtis MA. Role of microbial communities in the pathogenesis of periodontal diseases and caries. J Clin Periodontol 2017; 44 (Suppl. 18) S23-S38
  • 55 Chatterjee I, Somerville GA, Heilmann C, Sahl HG, Maurer HH, Herrmann M. Very low ethanol concentrations affect the viability and growth recovery in post-stationary-phase Staphylococcus aureus populations. Appl Environ Microbiol 2006; 72 (04) 2627-2636
  • 56 Palmieri C, Magi G, Orsini G, Putignano A, Facinelli B. Antibiofilm activity of zinc-carbonate hydroxyapatite nanocrystals against Streptococcus mutans and mitis group streptococci. Curr Microbiol 2013; 67 (06) 679-681
  • 57 Arakawa T, Fujimaru T, Ishizak T. et al. Unique functions of hydroxyapatite with mutans streptococci adherence. Quintessence Int 2010; 41 (01) e11-e19
  • 58 Zhang M, He LB, Exterkate RA. et al. Biofilm layers affect the treatment outcomes of NaF and Nano-hydroxyapatite. J Dent Res 2015; 94 (04) 602-607
  • 59 Nocerino N, Fulgione A, Iannaccone M. et al. Biological activity of lactoferrin-functionalized biomimetic hydroxyapatite nanocrystals. Int J Nanomedicine 2014; 9: 1175-1184