Chenicheri Smitha, R Usha, Ramachandran Rajesh, Thomas Vinoy, Wood Andrew
Department of Microbiology, Karpagam University, Coimbatore, Tamil Nadu, India.
Microbiology Division, Biogenix Research Center for Molecular Biology and Applied Sciences, Thiruvananthapuram, Kerala, India.
Open Dent J. 2017 Jun 30;11:312-333. doi: 10.2174/1874210601711010312. eCollection 2017.
Dental caries is known to be one of the most widespread, chronic infections affecting all ages and populations worldwide. The plethora of oral microbial population paves way for various endogenous infections and plays a crucial role in polymicrobial interactions contributing to biofilm-mediated diseases like caries and periodontal diseases.
Extensive literature survey was conducted using the scientific databases like PubMed, Google scholar, Science Direct, . using the key words like dental caries, orodental infections, dental microbes, dental biofilm, secondary caries, phytotherapy, . The literature was analyzed thoroughly and critical review was performed.
The risk of development of secondary caries and residual caries further results in treatment failure. Drug resistance developed by oral microbes and further side effects pose serious hurdles in the current therapeutic strategies. The hyperactivities of various MMPs and the resulting massive ECM degradation are the challenging part in the design of effective therapeutic approaches. Anticariogenic phytotherapy is well appreciated owing to lesser side effects and versatility of their action. But appreciable outcomes regarding the phytochemical bioavailability and bioretention are still challenging. Site-specific delivery of phytoagents at the infected site may enhance the efficiency of these drugs. Accordingly emerging phytodentistry can be promising for the management of secondary and residual caries.
This article presents major cariogens and their mechanisms in initiating and aggravating dental caries. Effectiveness of phytotherapy and different mode of action of phytochemicals against cariogens are outlined. The article also raises major concerns and possibilities of phytochemical based therapeutics to be applied in the clinical arena of caries management.
众所周知，龋齿是影响全球所有年龄和人群的最普遍的慢性感染之一。大量的口腔微生物群体为各种内源性感染铺平了道路，并在导致龋齿和牙周病等生物膜介导疾病的多种微生物相互作用中发挥关键作用。
使用PubMed、谷歌学术、科学Direct等科学数据库进行了广泛的文献调查，使用了龋齿、口腔牙齿感染、牙齿微生物、牙齿生物膜、继发龋、植物疗法等关键词。对文献进行了全面分析并进行了批判性综述。
继发龋和残留龋的发生风险进一步导致治疗失败。口腔微生物产生的耐药性以及进一步的副作用在当前的治疗策略中构成了严重障碍。各种基质金属蛋白酶的过度活性以及由此导致的细胞外基质大量降解是有效治疗方法设计中的挑战性部分。抗龋植物疗法因其副作用较小和作用的多功能性而备受赞赏。但是，关于植物化学物质的生物利用度和生物保留的可观结果仍然具有挑战性。在感染部位进行植物制剂的定点递送可能会提高这些药物的效率。因此，新兴的植物牙科学在继发龋和残留龋的管理方面可能很有前景。
本文介绍了主要的致龋菌及其引发和加重龋齿的机制。概述了植物疗法的有效性以及植物化学物质对致龋菌的不同作用方式。本文还提出了基于植物化学物质的疗法在龋齿管理临床领域应用的主要问题和可能性。
