An Innovative Strategy for Oral Biofilm Control in Early Childhood Based on a Resveratrol-Cyclodextrin Nanotechnology Approach.

Giovanni Nicolao Berta,Roberta Vallone,Patrizia Defabianis,Giuliana Abbadessa,Federica Romano,Federica Di Scipio

doi:10.3390/ma14143801

Abstract

The purpose of this randomized controlled study was to evaluate the clinical efficacy of a novel oral spray containing resveratrol (RV) in controlling bacterial biofilm and gingival inflammation in early childhood. RV, a natural polyphenol, known for its anti-inflammatory and anti-infective activities, was included in a nanovector of 2-hydroxypropyl-beta-cyclodextrins (HPβCD) to improve its bioavailability. A total of 64 children between two and five years of age with plaque-induced gingivitis were randomly included in two equal groups. Both groups were enrolled in a mechanical plaque control program for a period of four weeks, while the test group was also instructed to use the RV-HPβCD mouthwash (in spray formulation) once daily, after toothbrushing. All children underwent three oral hygiene motivation sessions, 14 days apart, during which the full-mouth presence of bacterial plaque, gingival inflammation, dental stain and salivary pH were recorded. At two-week appointment, they also received professional plaque removal. The use of RV-based oral spray significantly reduced the amount of dental plaque and the percentage of bleeding sites and improved salivary pH compared to the control group at both two- and four-week examinations. Based on these promising results, the local delivery of RV-HPβCD via oral spray could enhance the control of dental biofilm in early childhood, when antiseptic mouthwashes are not recommended.

Highlights

Despite the great commitment of parents, oral hygiene in early childhood has proved to be inadequate in many cases, increasing the risk of dental decay in primary dentition [1].A recent study demonstrated that caries prevalence at the age of five was significantly related to toothbrushing procedures performed less than twice a day [2]
Bacterial biofilm is an essential etiological factor in gingival inflammation [4]. In early childhood, this response to plaque accumulation is clinically less evident in gingival tissues [5], about one third of five-year old children are affect by gingivitis [6]
Parents/guardians of each recruited child signed informed consent. Children of both genders were screened for enrolment according to the following criteria: (i) diagnosis of plaque-induced gingivitis with full-mouth bleeding score (FMBS) >

Summary

Introduction

Despite the great commitment of parents, oral hygiene in early childhood has proved to be inadequate in many cases, increasing the risk of dental decay in primary dentition [1].A recent study demonstrated that caries prevalence at the age of five was significantly related to toothbrushing procedures performed less than twice a day [2]. The presence of erupting teeth may further increase the biofilm retention resulting in a more severe gingival inflammation [7]; for all these reasons supplementing normal oral hygiene with chemicals may be useful. The use of antiseptics in mouthrinse formulation, even if effective in controlling plaque and gingival inflammation [8], is often associated with negative local side effects. These formulations are not recommended in children younger than six years who do not split effectively with the risk of severe gastrointestinal and systemic adverse effects [9]

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