Comparison of antimicrobial effects of titanium tetrafluoride, chlorhexidine, xylitol and sodium fluoride on streptococcus mutans

An in-vitro study

Authors

  • Zahra Abdoli Pedodontist, Resident of Pediatric Dentistry, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Keywords:

Antimicrobial; Titanium tetrafluoride; Chlorhexidine; Sodium fluoride; Xylitol; Caries

Abstract

Introduction: No studies have yet documented the bactericidal effects of TiF4, and its role in the treatment of dental caries, and no definite protocol has been introduced to regulate its use. The aim of this study was to determine the antimicrobial/bactericidal effects of TiF4 on Streptococcus Mutans (S. Mutans) and to compare it with chlorhexidine (Chx), sodium fluoride (NaF) and xylitol.

Methods: This study was conducted at the Shiraz University of Medical Sciences microbiology laboratory during March 2015 to September 2015. In this in-vitro study, first a bacterial suspension was prepared and adjusted to a 0.5 McFarland standard (equivalent to 1×108 CFU/ml). The minimal inhibitory concentration (MIC) and minimal bactericidal concentrations (MBC) of TiF4, Chx, NaF and xylitol were assessed using broth microdilution assay and disk diffusion methods. In order to neutralize the acidic nature of TiF4, we used a sodium hydroxide preparation to obtain a pH of 7.2 and repeated all of the previous tests with the neutralized TiF4 solution. We reported the final results as percentages where appropriate.

Results: The MIC of TiF4, NaF and Chx for S. Mutans were 12.5%, 12.5% and 6.25%, respectively. At a concentration of 12.5% the inhibition zone diameters were 9 mm, 15mm and 14mm for TiF4, NaF and Chx, respectively. The MBC was 25%, 12.5% and 12.5% for TiF4, NaF and Chx, respectively. Xylitol failed to show any bactericidal or growth inhibitory effect in all of its concentrations. When we repeated the tests with an adjusted pH, identical results were obtained.

Conclusion: TiF4 solutions have anti-growth and bactericidal effects on S. Mutans at a concentration of 12.5% which is comparable with chlorhexidine and NaF, indicating the possible use of this solution in dental practice as an anti-cariogenic agent, furthermore the antimicrobial activity is unaffected by pH of the environment.

 

References

Rezazadeh F, Bazargani A, Roozbeh-Shahroodi J, Pooladi A, Arasteh P, Zamani K. Comparison of oral

Lactobacillus and Streptococcus mutans between diabetic dialysis patients with non-diabetic dialysis

patients and healthy people. Journal of Renal Injury Prevention. 2016;5(3):148-52. doi:

15171/jrip.2016.31, PMid: 27689112, PMCid: PMC5040002.

Jeevarathan J, Deepti A, Muthu MS, Rathna Prabhu V, Chamundeeswari GS. Effect of fluoride varnish on

Streptococcus mutans counts in plaque of caries-free children using Dentocult SM strip mutans test: a

randomized controlled triple blind study. J Indian Soc Pedod Prev Dent. 2007; 25(4): 157-63. doi:

4103/0970-4388.37010. PMID: 18007100.

Moradian H, Bazargani A, Rafiee A, Nazarialam A. In vitro comparison of antimicrobial activity of

aqueous decoction of Coriandrum sativum, and Dentol Drop with chlorhexidine on Streptococcus mutans.

Iran J Microbiol. 2013; 5(3): 239-43. PMID: 24475330, PMCID: PMC3895561.

Marinho VC, Higgins JP, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children

and adolescents. Cochrane Database Syst Rev. 2002; (3): CD002279. doi: 10.1002/14651858.cd002279.

PMID: 12137653.

Van Strydonck DA, Slot DE, Van der Velden U, Van der Weijden F. Effect of a chlorhexidine mouthrinse

on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin

Periodontol. 2012; 39(11): 1042-55. doi: 10.1111/j.1600-051X.2012.01883.x. PMID: 22957711.

Van Loveren C. Sugar alcohols: what is the evidence for caries-preventive and caries-therapeutic effects?

Caries Res. 2004; 38(3): 286-93. doi: 10.1159/000077768. PMID: 15153702.

Vieira A, Ruben JL, Huysmans MC. Effect of titanium tetrafluoride, amine fluoride and fluoride varnish on

enamel erosion in vitro. Caries Research. 2005; 39(5): 371-9. doi: 10.1159/000086843. PMID: 16110208.

Vieira A, Lugtenborg M, Ruben JL, Huysmans MC. Brushing abrasion of eroded bovine enamel pretreated

with topical fluorides. Caries Research. 2006; 40(3): 224-30. doi: 10.1159/000092230. PMID: 16707871.

Wahengbam P, Tikku AP, Lee WB. Role of titanium tetrafluoride (TiF4) in conservative dentistry: A

systematic review. J Conserv Dent. 2011; 14(2): 98-102. doi: 10.4103/0972-0707.82598. PMID: 21814345,

PMCID: PMC3146121.

Tezel H, Ergücü Z, Onal B. Effects of topical fluoride agents on artificial enamel lesion formation in vitro.

Quintessence Int. 2002; 33(5): 347-52. PMID: 12014163.

Magalhães AC, Comar LP, Rios D, Delbem AC, Buzalaf MA. Effect of a 4% titanium tetrafluoride (TiF4)

varnish on demineralisation and remineralisation of bovine enamel in vitro. J Dent. 2008; 36(2): 158-62.

doi: 10.1016/j.jdent.2007.12.001. PMID: 18187248.

Moi GP, Tenuta LM, Cury JA. Anticaries potential of a fluoride mouthrinse evaluated in vitro by validated

protocols. Braz Dent J. 2008; 19(2): 91-6. doi: 10.1590/S0103-64402008000200001. PMID: 18568220. 13) Hals E, Tveit AB, Tötdal B, Isrenn R. Effect of NaF, TiF4 and APF solutions on root surfaces in vitro with

special reference to uptake of F. Caries Res. 1981; 15(6): 468-76. doi: 10.1159/000260554. PMID:

Nassur C, Alexandria AK, Pomarico L, de Sousa VP, Cabral LM, Maia LC. Characterization of a new TiF4

and beta-cyclodextrin inclusion complex and its in vitroevaluation on inhibiting enamel demineralization.

Arch Oral Biol. 2013; 58(3): 239-47. doi: 10.1016/j.archoralbio.2012.11.001. PMID: 23246339.

Souza BM, Lima LL, Comar LP, Buzalaf MA, Magalhaes AC. Effect of experimental mouthrinses

containing the combination of NaF and TiF4 on enamel erosive wear in vitro. Arch Oral Biol. 2014; 59(6):

-4. doi: 10.1016/j.archoralbio.2014.03.008. PMID: 24727005.

Castilho AR, Salomao PM, Buzalaf MA, Magalhaes AC. Protective effect of experimental mouthrinses

containing NaF and TiF4 on dentin erosive loss in vitro. J Appl Oral Sci. 2015; 23(5): 486-90. doi:

1590/1678-775720150127. PMID: 26537719, PMCID: PMC4621941.

Vieira AM, Ruben JL, Bronkhorst EM, Huysmans MC. In vitro reduction of dental erosion by low- concentration TiF4 solutions. Caries Res. 2011; 45(2): 142-7. doi: 10.1159/000324805. PMID: 21454977.

Lepri TP, Colucci V, Turssi CP, Corona SA. In situ investigation of the effect of TiF4 and CO2 laser

irradiation on the permeability of eroded enamel. Arch Oral Biol. 2015; 60(6): 941-7. doi:

1016/j.archoralbio.2015.02.001. PMID: 25835379.

Bridi EC, do Amaral FL, Franca FM, Turssi CP, Basting RT. Inhibition of demineralization around the

enamel-dentin/restoration interface after dentin pretreatment with TiF4 and self-etching adhesive systems.

Clin Oral Investig. 2016; 20(4): 857-63. doi: 10.1007/s00784-015-1573-6. PMID: 26319980.

Comar LP, Cardoso Cde A, Charone S, Grizzo LT, Buzalaf MA, Magalhaes AC. TiF4 and NaF varnishes

as anti-erosive agents on enamel and dentin erosion progression in vitro. J Appl Oral Sci. 2015; 23(1): 14- 8. doi: 10.1590/1678-775720140124. PMID: 25760263, PMCID: PMC4349114.

Wiegand A, Magalhaes AC, Attin T. Is titanium tetrafluoride (TiF4) effective to prevent carious and

erosive lesions? A review of the literature. Oral Health Prev Dent. 2010; 8(2): 159-64. PMID: 20589250.

Bridi EC, Amaral Flávia Lucisano Botelho, França Fabiana Mantovani Gomes, Turssi Cecilia Pedroso,

Florio FM, Basting RT. In Vitro Effects of 2.5% Titanium Tetrafluoride on Streptococcus Mutans and

Lactobacillus Casei in Dentin Followed by Self-Etching Adhesive Systems. The European journal of

prosthodontics and restorative dentistry. 2015; 23(4): 179-86. PMID: 26767239.

McCann HG. The effect of fluoride complex formation on fluoride uptake and retention in human enamel.

Arch Oral Biol. 1969; 14(5): 521-31. doi: 10.1016/0003-9969(69)90145-9. PMID: 5255464.

Skartveit L, Spak CJ, Tveit AB, Selvig KA. Caries-inhibitory effect of titanium tetrafluoride in rats. Acta

Odontol Scand. 1991; 49(2): 85-8. doi: 10.3109/00016359109005891. PMID: 2053433.

Milgrom P, Ly KA, Roberts MC, Rothen M, Mueller G, Yamaguchi DK. Mutans streptococci dose

response to xylitol chewing gum. J Dent Res. 2006; 85(2): 177-81. doi: 10.1177/154405910608500212.

PMID: 16434738, PMCID: PMC2225984.

Published

2022-01-18

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