Investigation of the effect of cannabidiol, tetrahydrocannabinol, and vancomycin combination on cariogenic bacterial retention due to microleakage under prosthetic restorations

Abstract

Aims: Oral and dental infections develop due to many different bacterial activities, and with the increasing resistance mechanism against conventional antimicrobial agents, the formation of biofilms in the microleakage under prosthetic restorations, which cause dental caries, has become a major clinical challenge to overcome. This study aims to reveal the antibiofilm effect of vancomycin (VAN) combined with cannabidiol (CBD) and tetrahydrocannabinol (THC) against biofilm formation caused by Streptococcus mutans (S. mutans) and Staphylococcus aureus (S. aureus) on dental dentin under prosthetic restorations. Methods: Freshly extracted human teeth without caries, resorption, or fracture were collected and obtained by slicing 2 mm dentin discs. A total of 64 dentin discs were inoculated with S. mutans and S. aureus and randomly allocated into control and five experimental groups consisting of CBD, THC, CBD+VAN, THC+VAN, and CBD+THC+VAN. Antibiofilm activity and combination index were analyzed by the MTT viability test and the Chou–Talalay method, respectively. Biofilm structure was assessed by scanning electron microscopy. Analysis of variance and post hoc Tukey tests were applied for comparisons. Results: CBD and VAN showed antimicrobial effects against S. aureus and S. mutans bacteria in unary combinations, while THC was ineffective. However, no apparent synergistic interaction was observed in the binary combinations of VAN. Interestingly, a high synergistic effect (CI<1) occurred in the triple combination against both bacterial species. When this effect in the triple combination was examined, it was seen that VAN exhibited a suitable dose reduction index (DRI>1). When these synergistic and dose reduction results are evaluated together with SEM image analysis, it can be said that the triple combination of VAN+CBD+THC probably causes the most optimum antibiofilm effect on dental caries bacteria. Conclusion: Combining VAN with CBD and THC may offer a new approach to combat microleakage-induced bacterial retention in dental dentin under prosthetic restorations.

Keywords

• Cannabidiol
• tetrahydrocannabinol
• vancomycin
• prosthetic restorations
• microleakage

Protez restorasyonları altında mikrosızıntıya bağlı kariyojenik bakteriyel tutunma üzerine kanabidiol, tetrahidrokanabinol ve vankomisin kombinasyonunun etkisinin araştırılması

Abstract

Amaç: Ağız ve diş enfeksiyonları birçok farklı bakteri aktivitesi nedeniyle gelişir ve geleneksel antimikrobiyal ajanlara karşı artan direnç mekanizmasıyla birlikte, protez restorasyonların altındaki mikrosızıntıda diş çürüğüne neden olan biyofilm oluşumu, üstesinden gelinmesi gereken önemli bir klinik zorluk haline gelmiştir. Bu çalışma, vankomisinin (VAN) kanabidiol (CBD) ve tetrahidrokanabinol (THC) ile kombinasyonunun, protez restorasyonların altındaki diş dentini üzerinde Streptococcus mutans ve Staphylococcus aureus'un neden olduğu biyofilm oluşumuna karşı antibiyofilm etkisini ortaya koymayı amaçlamaktadır. Materyal ve Yöntem: Çürük, rezorpsiyon veya kırık olmayan yeni çekilmiş insan dişleri toplandı ve 2 mm dentin diskleri kesilerek elde edildi. Toplam 64 dentin diski S. mutans ve S. aureus ile aşılandı ve rastgele kontrol ve CBD, THC, CBD+VAN, THC+VAN ve CBD+THC+VAN'dan oluşan beş deney grubuna ayrıldı. Antibiyofilm aktivitesi ve kombinasyon indeksi sırasıyla MTT canlılık testi ve Chou-Talalay yöntemi ile analiz edildi. Biyofilm yapısı taramalı elektron mikroskobu ile değerlendirildi. Karşılaştırmalar için varyans analizi ve post hoc Tukey testleri uygulandı. Sonuçlar: CBD ve VAN, tekli kombinasyonlarda S. aureus ve S. mutans bakterilerine karşı antimikrobiyal etki gösterirken, THC etkisizdi. Ancak, VAN'ın ikili kombinasyonlarında belirgin bir sinerjistik etkileşim gözlenmedi. İlginç bir şekilde, üçlü kombinasyonda her iki bakteri türüne karşı yüksek bir sinerjistik etki (CI < 1) meydana geldi. Üçlü kombinasyondaki bu etki incelendiğinde, VAN'ın uygun bir doz azaltma indeksi (DRI>1) sergilediği görüldü. Bu sinerjistik ve doz azaltma sonuçları SEM görüntü analizi ile birlikte değerlendirildiğinde, VAN+CBD+THC üçlü kombinasyonunun muhtemelen diş çürüğü bakterileri üzerinde en optimum antibiyofilm etkisine neden olduğu söylenebilir. Sonuç: VAN'ın CBD ve THC ile kombinasyonu, protetik restorasyonlar altında dental dentinlerde mikrosızıntıya bağlı bakteriyel retansiyonla mücadelede yeni bir yaklaşım sunabilir.

Keywords

• Kannabidiol
• Tetrahidrokanabinol
• Vankomisin
• Protetik restorasyonlar
• Mikrosızıntı

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