Antimicrobial Capacity of a Hydroxyapatite-Lysozyme-Lactoferrin-Lactoperoxidase Combination against Streptococcus mutans for the Treatment of Dentinal Caries

Abstract

Context: Hydroxyapatite has shown to regenerate the mineralized layer of dentin, whereas the combination of the enzymes lysozyme, lactoferrin, and lactoperoxidase may exhibit antimicrobial properties against oral pathogens. Aims: To evaluate a combination of hydroxyapatite and lysozyme, lactoferrin, and lactoperoxidase for the treatment of dentinal caries by measuring viable Streptococcus mutans. Settings and Design: Laboratory study with experimental groups. Methods and Material: Carious lesions in 20 permanent third molars were treated with a combination of hydroxyapatite and the enzymes lysozyme, lactoferrin, and lactoperoxidase. Carious dentin was collected and homogenized in a vortex shaker. After homogenization, five decimal dilutions were performed. Three aliquots of 25 µL of each dilution were seeded onto the surface of mitis salivarius bacitracin (MSB) medium. All plates were incubated in anaerobic jars. After incubation, the viable bacterial count was determined. S. mutans counts were obtained before and 24 h, 1 month, and 6 months after treatment. Statistical Analysis Used: Descriptive statistical analysis and the Kruskal-Wallis test, supplemented by the Student-Newman-Keuls test. Results: A significant reduction in S. mutans counts was observed 24 h after sealing with a combination of hydroxyapatite, lysozyme, lactoferrin, and lactoperoxidase as compared to counts after 1 month and after 6 months (P < 0.05). Conclusions: The combination of hydroxyapatite with lysozyme, lactoferrin, and lactoperoxidase may be an alternative for S. mutans control in dentinal caries.