Penetration and bactericidal efficacy of two oral care products in an oral biofilm model.

PURPOSE: To investigate the immediate penetration and bactericidal effect of two oral care products marketed in China on an intact natural plaque biofilm model at different time points. METHODS: Eight subjects (aged 20 to 30 years; Turesky Plaque Index Score 2 to 3) were enrolled in the study according to the inclusion criteria. Plaque accumulators were worn by the subjects for 6 and 48 hours for harvesting the dental biofilm. Then the biofilms from different groups were stained with the LIVE/DEAD BacLight fluorescence system to investigate the changes in thickness and fluorescence intensity of living bacteria in biofilm 5 and 15 minutes post-treatment with a mouthrinse containing 0.074% cetylpyridinium chloride (1-minute treatment) or a toothpaste supernatant containing 1.16% stannous chloride (2-minute treatment). In addition, a specific Sn2+ probe was utilized to evaluate the penetration of Sn2+ in the biofilm. Fluorescent images were collected using confocal laser scanning microscopy. Analysis of covariance was used for statistical analyses. All comparisons were two-sided using a 5% level of significance. RESULTS: The thickness of generated plaque biofilm increased gradually from 7.352±4.22 µm at 6 hours to 16.73±7.38 µm at 48 hours (P< 0.05), whereas the thickness and fluorescence intensity of living bacteria stayed unchanged over time. After the treatment of toothpaste supernatant, the ratios of living bacteria thickness and fluorescence intensity of 6- and 48-hour plaque biofilm were significantly decreased (P< 0.05). Treatment of mouthrinse reduced the ratio of living bacteria thickness, but showed no significant impact on overall fluorescence intensity of living bacteria. For 48-hour biofilm, toothpaste supernatant significantly reduced fluorescence intensity of living bacteria from outer layer through inner layer, whereas the mouthrinse showed bactericidal effect only in the outer layer and middle layer. A wide distribution of Sn2+ was shown in the biofilm with the treatment of the tested toothpaste. CLINICAL SIGNIFICANCE: This biofilm model proved to be useful and appropriate for pre-clinical testing of anti-plaque agents. A brief exposure of the biofilm to the tested toothpaste produced significant losses in bacteria viability across outer-middle-inner layers. The tested mouthrinse exerted its bactericidal effect mostly in outer and middle layers of biofilm. The penetration of Sn2+ in the biofilm performed an important function in the bactericidal effect of the toothpaste.