Synergistic effect of persica mouthwash and Iranian ethanolic extract of propolis against biofilm formation of oral pathogens (in vitro study)

Synergistic effect of persica mouthwash and Iranian ethanolic extract of propolis against biofilm formation of oral pathogens (in vitro study) Efecto sinérgico del enjuague bucal persica y del extracto etanólico iraní de propolis contra la formación de biofilm de patógenos orales (estudio in vitro) Arefeh Ariamanesh1, Nadereh Ariamanesh2, Hosein Eslami2,3, Mohammad Asgharzadeh4, Elham Zeinalzadeh5, Hossein Samadi Kafil5 1 Pharmaceutical sciences branch, Islamic Azad University, Tehran, Iran. 2 Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran. 3 Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 4 Biotechnology Research Center, Tabriz University of Medical sciences, Tabriz, Iran. 5 Drug Applied Research Center, Tabriz University of Medical sciences, Tabriz, Iran. Artículo Original Original Article Correspondencia Correspondence Hossein Samadi Kafil. PhD. Assistant Professor Drug Applied Research Center, Faculty of Medical Sciences Tabriz University of Medical Sciences, Tabriz, Iran E-mail: Tel: +989127184735 Fax: +984113364661 Conflicto de interés Competing interest All Authors declare no conflicts of interest Agradecimientos Acknowledgment This study was granted by Drug Applied Research Center, Tabriz University of Medical Sciences and approved by Tabriz University of Medical Sciences. Author Thank all staff of Biomedicine (Medical Biology) Research Institute. Received: 05.10.2017 Accepted: 26.12.2017 ABSTRACT http://dx.doi.org/10.4321/S2340-98942017000400002 Aims: Several pathogens are responsible for oral diseases and dental plaque and their main mechanism is biofilm production. Natural products are point of interest for controlling these infections. persica mouthrinse, propolis and honey are some of these products with considerable antibacterial effects. In this study, we aimed to investigate synergy effect of these products on their antibiofilm and antibacterial effect. Material and Methods: Minimal Inhibitory effect and Minimial Biofilm inhibitory concentration of persica mouthrinse, propolis, honey solely and in combination was calculated against Streptococcus mutans ATCC35668, methicillin-resistant Staphylococcus aureus ATCC 33591, Staphylococcus aureus ATCC 29213, Staphylococcus epidermidis, Enterococcus faecalis ATCC 29212 , Escherichia coli ATCC 25922. Results: Combination of persica and propolis had a better profile in biofilm's inhibition than honey. None of herbal combinations had synergistic effect against studied bacteria; MIC of the persica mouth had the best effect against Streptococcus mutans, which causes caries. Conclusions: There was no synergistic effect of persica and propolis and the best antimicrobial effect was observed on subminimum inhibitory concentration of persica mouthwash. Findings of the present study suggest use of other combination than honey, propolis and persica for improving antimicrobial activity of these components. Keywords: Streptococcus mutans, Staphylococcus aureus, biofilm, plaque, persica, propolis, honey. RESUMEN Objetivos: Varios patógenos son responsables de enfermedades orales y la placa dental y su mecanismo principal es la producción de biofilm. Los productos naturales son puntos de interés para controlar estas infecciones. persica mouthrinse, propolis y miel son algunos de estos productos con considerables efectos antibacterianos. En este estudio, se buscó investigar el efecto sinérgico de estos productos sobre su antibiótico y efecto antibacteriano. Material y Métodos: Se calculó el efecto inhibidor mínimo y la concentración inhibitoria mínima de biofilm de enjuague bucal de persica, propóleos, miel únicamente y en combinación, contra Staphylococcus aureus ATCC 29213, S. epidermidis, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922. Resultados: La combinación de persica y propóleo tuvo un mejor perfil en la inhibición de la biopelícula que la miel. Ninguna de las combinaciones de hierbas tuvo efecto sinérgico contra las bacterias estudiadas; La Se calculó el efecto inhibidor mínimo de la boca de la persica tuvo el mejor efecto contra Streptococcus mutans, que causa la caries. Conclusiones: No hubo efectos sinérgicos de la persica y el propóleo y se observó el mejor efecto antimicrobiano en la concentración mínima inhibitoria de enjuague bucal de persica. Los hallazgos del LICENSE 3.0 UNPORTED. Ars Pharm. 2017; 58(4): 155-161 155 Ariamanesh et al. presente estudio sugieren el uso de otra combinación que la miel, el propóleo y la persica para mejorar la actividad antimicrobiana de estos componentes. Palabras clave: Streptococcus mutans, Staphylococcus aureus, biofilm, placa, persica, propóleos, miel. INTRODUCTION Dental plaque is one of biofilm's kind that plays a major role in pathogenesis of oral disease1 such as calculus formation, periodontal disease & gingivitis, and above all caries that is so important and prevalent2. Since the disruption of biofilm & killing the bacteria in this structure requires a concentration that is 10-1000 times higher than Minimum inhibitory concentration (MIC) of antimicrobial agents; so in order to control the biofilm or plaque, we should prevent the biofilm formation that is possible even with subMIC amounts of proper antimicrobial agents. To control the plaque formation, we can use the antimicrobial and antibiofilm agents as a mouthwash. Recent approaches are to find natural mouth rinses with higher antimicrobial and antibiofilm effect with less toxicity and tolerable flavor, less irritation and without any changing in the color of teeth3. Among the bacteria producing biofilm, the acidogenic bacteria have a greater effect in cariogenic cycle4,5. In oral medicine, propolis has been used as a remedy for surgical traumas, root canal irrigation solution, cariogenic process inhibitor, periodontitis treatment, dentin hypersensitivity and as the antibacterial and antifungal substance in root canals and showed good results in most of these experiences2. The role of propolis in inhibitory mechanisms of plaque formation by the main accused bacterium for caries namely S. mutans have been approved6. In addition to antibacterial & anti-biofilm effect of propolis and its synergic effect with other antibiotics, its anti-inflammatory and anesthetic effects makes it as good choice for developing new mouthwashes2,4. Persica mouthwash includes three herbal extracts (Salvadora persica, achillea millefolium, mentha spicata) and among them Salvadora persica has a great history in oral health but studies revealed that antimicrobial effect of persica mouthwash is higher than persica extract6. Also the prophylactic effect of persica mouthrinse against caries, periodontal disease has been approved 3. So due to improving the effective bacterial spectrum and tendency to use natural substances and possibility of getting the synergic effect and afterward decreasing the toxic effects and gaini (...truncated)