BACKGROUND: Pre and probiotics may help restore a dysbiotic oral ecosystem. The first years of life provide a window of opportunity to modulate the composition of the oral microbiota and prevent disease. OBJECTIVES: The aim of the present study was to investigate the effect of a tablet containing inactivated Ligilactobacillus salivarius CECT 5317 and the cranberry extract on the development of caries in cariesactive preschool children. 

MATERIAL AND METHODS: The study employed a randomized, placebo-controlled, double-blind design. Preschool children (N = 73) with at least one active carious lesion were enrolled and randomly assigned to the test group or the placebo group. The intervention period was 3 months. Caries was assessed according to the International Caries Detection and Assessment System (ICDAS) II criteria at baseline and after 9 months, and oral hygiene was evaluated with the simplified oral hygiene index (OHI-S). The salivary counts of Streptococcus mutans and Lactobacillus spp. were determined at baseline, and then after 3 and 9 months through the conventional cultivation on TYCSB and MRS agar, respectively. 

RESULTS: Sixty children completed the trial (a dropout rate of 19%). The baseline caries prevalence was high in both groups (~71%) and there were no major differences between the groups with regard to background variables. The 9-month incidence of initial carious lesions (ICDAS 1+2) was significantly lower in the test group as compared to the placebo group (p < 0.05). The plaque levels, and the salivary counts of S. mutans and Lactobacillus spp. remained unchanged in both groups throughout the study. 

CONCLUSIONS: A daily intake of a tablet containing a paraprobiotic and the cranberry extract reduced the 9-month incidence of initial non-cavitated carious lesions in caries-active preschool children. The present study is one of the first to show the impact of synbiotics on the development of caries in children.

OBJECTIVES: To formulate crosslinker-modified etchants with phosphoric acid (PA) and an organic acid for effective dentin demineralization while addressing solubility issues, and to evaluate their impact on bond strength, nanoleakage, and matrix metalloproteinases (MMP) activity in sound dentin (SD) and caries-affected dentin (CAD) before and after thermocycling. 

METHODS: Crosslinker-modified etchants were prepared by mixing 35% tartaric acid (TA) and 10% PA and adding 1% of theaflavins (TF), cranberry extract (CR), or EDC/NHS (EDC). The etchants without crosslinker were used as controls. Dentin surfaces of 74 human molars were exposed, and 35 of them were submitted to a microbiological cariogenic challenge to create CAD. Specimens from SD and CAD were randomly allocated into 10 groups according to the different etchants. Resin-dentin interfacial bonding properties were evaluated after 24h and after 10,000 thermocycling through microtensile bond strength (mcTBS), nanoleakage and MMPs activity via in situ zymography. Statistical analysis was performed using ANOVA followed by Games-Howell or Tukey's tests.

RESULTS: Compared to the control and EDC-modified groups, TF- and CR-modified etchants maintained stable bond strength and significantly reduced MMP activity, preserving this protection even after thermocycling, which simulates one year of clinical aging, regardless of dentin type (both SD and CAD). While their impact on nanoleakage in CAD was less pronounced after thermocycling, it remained below 50% of the levels observed in the control and EDC-modified groups.

SIGNIFICANCE: Crosslinker-modified etchants, particularly TF and CR, provide a promising approach for simultaneous etching and biomodification of clinically relevant dentin substrates, enhancing bonding durability.

Objectives: Despite the increasing scientific evidence regarding the application of Cranberries in dentistry, a comprehensive understanding of their potential benefits, active constituents, and mechanisms of action remains lacking. Consequently, this narrative review aims to meticulously analyze and consolidate the existing scientific literature on the utilization of Cranberries for the prevention and treatment of oral diseases. 

Materials and Methods: Electronic databases (PubMed, Scopus, and Web of Science) were searched up to October 2025. This review included in vitro, in vivo, and clinical research studies. A two-phase selection process was carried out. In phase 1, two reviewers independently screened titles and abstracts to identify potentially eligible studies. In phase 2, the same reviewers performed the full-text assessments of the eligible articles. 

Results: Among the 93 eligible articles, most assessed Cranberry use in Cariology (n = 28) and Periodontics (n = 26). Biofilm and microbial virulence factors (n = 46) were the most frequently studied topics. Cranberry extract (n = 32) and high-molecular-weight non-dialyzable material (NDM) (n = 23) were the most evaluated Cranberry fractions. Overall, Cranberry-derived compounds were identified as non-toxic and demonstrated promising antimicrobial activity against dental caries-related microorganisms in preclinical studies (n = 20). Regarding periodontal and peri-implant diseases, Cranberry demonstrated host immune modulator effects, counteracting the inflammatory and destructive mechanisms (n = 8). Additionally, Cranberries presented benefits in reducing the inflammation associated with periodontal disease and temporal mandibular joint lesions (n = 1). Regarding dental erosion, Cranberry inhibited dentin erosion (n = 4); however, no effect was observed on enamel lesions (n = 2). As an antioxidant agent, Cranberry showed effectiveness in preventing dental erosion (n = 18). Beyond that, Cranberry neutralized reactive oxygen species generated immediately after dental bleaching, enhancing bond strength (n = 2) and counteracting the oxygen ions formed on the tooth surface following bleaching procedures (n = 3). In osteoclastogenesis assays, A-type proanthocyanidins inhibited bone resorption (n = 1). In osteogenic analysis, preservation of hydroxycarbonate apatite deposition and an increase in early and late osteogenic markers were observed (n = 2). 

Conclusions: Cranberry bioactive compounds, both individually and synergistically, exhibit substantial potential for diverse applications within dentistry, particularly in the prevention and management of oral and maxillofacial diseases. This review provides insights into the plausible incorporation of Cranberries in contemporary dentistry, offering readers an informed perspective on their potential role.

OBJECTIVE: The antimicrobial efficacy of cranberry (CA) against oral infections was well evidenced. Influence of cranberry on the mechanical properties of heat-activated polymethyl methacrylate (HA-PMMA) denture base resin (DBR) is unexplored till date and is significant for a better understanding of the reinforcement. This study aimed to evaluate the flexural strength (FS), impact strength (IS), and surface microhardness (VHN) of heat-cure PMMA DBR reinforced with varying concentrations of Vaccinium macrocarpon (cranberry) extract. 

MATERIAL AND METHODS: A total of 150 samples were categorized into five groups (n = 10) by weight percentage of 0, 0.5, 1.0, 1.5, and 2.0 cranberry extract added into HA-PMMA polymer after the performance of antimicrobial efficacy testing of CA. Three-point bending test for FT, Izod impact testing for IS, and Vickers microhardness test were performed. Fractured sample surface was characterized by a high-resolution scanning electron microscope (HR-SEM). Raw data were statistically analyzed with one-way ANOVA and post hoc Bonferroni test. 

RESULTS: A significant improvement in flexural strength of 76.88 +/- 0.73 MPa, impact strength of 6.66 +/- 0.24 kJ/m2, and microhardness of 18.44 +/- 0.27 kg/mm2 was observed at 2 wt.% (p < 0.0001). Fractured surface topography showed dispersion of cranberry particles as a thin fibrous band intermeshed within resin matrix. 

CONCLUSIONS: Addition of up to 2 wt.% cranberry improved the FS, IS, and VHN on comparison to 0 wt.% control HA-PMMA.

Background: Dental caries remains a prevalent oral health concern among children worldwide, necessitating effective preventive measures. This study evaluates the efficacy of cranberry extract mouthwash and fluoride mouthwashes in reducing Streptococcus mutans counts among children aged 6–12 years with moderate to severe dental caries. 

Materials and methods: A randomized controlled trial was conducted involving children with three or more carious lesions [Caries Assessment Spectrum and Treatment (CAST) types 3–9]. Participants were assigned to receive either cranberry extract mouthwash or fluoride mouthwash, administered weekly for 6 months. S. mutans colony-forming units (CFUs) were assessed at baseline, 3 months, and 6 months to measure bacterial load reduction. 

Results: Both cranberry extract mouthwash and fluoride mouthwashes demonstrated statistically significant reductions in S. mutans CFUs at 3 months (p < 0.01) and 6 months (p < 0.01) compared to baseline. No significant difference was observed between the two mouthwashes, suggesting comparable efficacy in bacterial count reduction. 

Conclusion: This study supports the use of cranberry extract mouthwash as a natural alternative to fluoride mouthwash in managing dental caries among children. Both interventions effectively reduced S. mutans counts, highlighting their potential as adjuncts to conventional caries management strategies.

The aim of the study was to compare the effect of salivary pellicle modification with polyphenol-rich solutions containing fluoride on enamel erosion and abrasion. Human enamel specimens (n = 14/group) were assigned to five pellicle-modifying groups: GSE+F (grape seed extract +500 ppm F-); CRA+F (cranberry extract +500 ppm F-); NaF (sodium fluoride solution -5 00ppm F-); Sn+F (commercial solution, SnCl2/NaF/AmF); and DW (deionized water, negative control). The specimens were submitted to 5 cycles, each one consisting of pellicle formation (120mcl, 30 min, 37degreeC, no agitation), followed by pellicle modification with the experimental solutions (5 ml, 2 min, 25C, 70 rpm), and subsequent salivary pellicle formation (120 mcl, 60 min, 37degreeC, no agitation). The specimens were then submitted to erosion (1% citric acid, 10 ml, 1 min, pH 3.6, 70 rpm, 25C). Subsequently, they were submitted to abrasion with a fluoride-based toothpaste slurry in a toothbrushing machine (50 strokes, 200 g load, 2 min exposed to slurry). The enamel surface was evaluated with an optical profilometer at baseline and after the 5 cycles to assess the surface loss. Data were submitted to Kruskal-Wallis followed by a multiple comparisons test (alpha = 0.05). Significant differences were found between the tested solutions (p <0.001). The highest surface loss was verified in the DW group (p < 0.001). The other tested solutions (GSE+F, CRA+F, Sn+F, NaF) promoted significant enamel protection against the erosive-abrasive challenges with no differences between them. In conclusion, the modification of salivary pellicle with both polyphenol-rich, commercial solution and fluoride solutions were able to protect the enamel surface from erosion and abrasion

Introduction: Cranberry (Vaccinium macrocarpon) and Vitamin D have both demonstrated significant potential in combating microbial infections, particularly in the oral environment. Cranberry is known for its bioactive compounds, such as proanthocyanidins, flavonoids and organic acids, which exhibit antibacterial properties, while Vitamin D plays a crucial role in bone metabolism and immune response. This study aims to evaluate the antimicrobial efficacy of dental implants coated with cranberry extract and Vitamin D to inhibit bacterial biofilm formation and improve osseointegration. 

Materials and Methods: Titanium dental implants were coated with a cranberry hydrogel solution containing Vitamin D. The process involved surface preparation, dip coating and curing of the implants. Sub-gingival plaque samples were collected from patients with peri-implantitis for microbial analysis. In vitro biofilm formation was assessed on both coated and uncoated implants, followed by a colony reduction ability assessment where biofilm from the implant surfaces was dislodged and cultured to quantify bacterial colony-forming units (CFUs). 

Results: The results indicated a significant reduction in bacterial colonies in the test group (coated implants) compared to the control group (uncoated implants). The cranberry/Vitamin D coating effectively inhibited the growth of black-pigmented microbes. The test group showed a notable decrease in CFU count, confirming the antimicrobial properties of the coating. 

Conclusion: Cranberry and Vitamin D-coated dental implants exhibit significant antimicrobial activity, reducing bacterial colonisation and promoting better clinical outcomes in terms of infection control and bone healing. The use of natural bioactive compounds on implant surfaces represents a viable option to enhance the success rate of dental implants. However, further clinical trials are needed to validate long-term efficacy.

The search has been ongoing for safe and effective antimicrobial agents for control and prevention of oral biofilm associated with disease. Clinical trials for oral specific anti-bacterials are costly and often provide inconclusive results. The simple approach of ex vivo testing of these agents has not demonstrated utility, likely due to variability of effects observed even with a single donor. We show how shed oral biofilms, easily obtained from donor saliva, and tested under optimized conditions, respond reproducibly to anti-bacterial challenges measured by reductions in rRNA accumulation in susceptible taxa. Responses are in part donor specific, but many bacteria taxa were shown to be reproducibly susceptible over a group of donors. For two antibiotics, vancomycin and penicillin G tested at pharmacologic levels, a subset of Gram-positive bacteria was inhibited. A natural product with antibacterial properties, diluted Vaccinium macrocarpon (cranberry) juice, was shown to inhibit a range of oral taxa, including Alloprevotella sp__HMT_473, Granulicatella adiacens, Lachnoanaerobaculum umeaense, Lepotrichia sp__HMT_215, Peptostreptococcus stomatis, Prevotella nanceiensis, Stomatobaculum sp__HMT_097, Veillonella parvula, and kill some targets. The model discussed in this study has promise as a rapid, precise, and reproducible ex vivo method to test and identify potential clinically useful antimicrobial agents active against the oral biofilm community.

Background: The aim of this double-blind randomized placebo-controlled clinical trial was to evaluate the efficacy of a multinutrient supplement as an add-on therapy to scaling and root planing for patients with periodontitis. 

Methods: Forty-two patients with stage III or IV periodontitis were randomly allocated to a 2-month treatment of either a multinutrient supplement containing vitamin C, vitamin E, zinc, selenium, alpha-lipoic-acid, cranberry extract, grapeseed extract, and coenzyme Q10 or placebo capsules as an adjunct to conservative periodontal therapy. Periodontal parameters, including probing pocket depth, gingival recession, bleeding on probing, approximal plaque index, and papillary bleeding index, were assessed. Clinical attachment loss, periodontal inflamed surface area, periodontal epithelial surface area, and percentages of pocket sites with <=3, <=4, >=5, >=6, >=7, and >=4 mm with bleeding on probing were calculated. 

Results: All clinical parameters significantly improved from baseline to reevaluation within each group (p < 0.05). Multinutrient intake resulted in a significantly higher reduction of probing-pocket-depth (-0.75 +or- 0.42 mm) and bleeding-on-probing (-21.9 +or- 16.1%) from baseline to reevaluation compared with placebo (-0.51 +or- 0.30 mm, p = 0.040 and -12.5 +or- 9.8%, p = 0.046, respectively). All periodontal parameters showed insignificantly higher improvements in patients receiving the supplement compared with those receiving the placebo (p > 0.05). 

Conclusion: Multinutrient supplementation as an adjunct to nonsurgical treatment of periodontitis showed some additional benefit regarding probing-pocket-depth and bleeding-on-probing. However, the clinical relevance needs to be further explored.

A promising approach for managing root caries is the use of cross-linking agents to stabilize collagen. However, despite testing various natural and synthetic agents in vitro, their efficacy remains uncertain. The aim of this review was to examine which cross-linking agent performs better in reducing root caries lesion depth and the release of hydroxyproline, which is a marker of collagen degradation. Studies evaluating the impact of cross-linking agents on dentin were included, while studies performed on enamel surface/cell cultures and studies evaluating collagenase inhibitors were excluded, among others. A comprehensive search covered eight databases, and study quality was assessed using the QUINN Tool for in vitro dental studies. Synthesis of the results was done using a Bayesian network meta-analysis to compare agents. Fifty studies involving 31 cross-linking agents were included for qualitative synthesis. The network meta-analysis for lesion depth involved 284 samples across 36 comparisons and ranked cross-linking agents in terms of their caries lesion depth-reducing effect (from best to worst): naringin > quercetin > riboflavin > proanthocyanidins > hesperidin > glutaraldehyde > cranberry > grape seed extract > untreated controls. Only naringin, quercetin, proanthocyanidins, and glutaraldehyde showed statistically significant efficacy over untreated controls. Cranberry extract excelled in reducing hydroxyproline release, followed by proanthocyanidins. In conclusion, proanthocyanidins positively affected both outcomes, suggesting they are prime candidates for translational research. Clinical studies are now essential to evaluate their real-world effectiveness against root caries. PROSPERO-CRD42023404911. Copyright © 2024 Scandinavian Division of the International Association for Dental Research. Published by John Wiley & Sons Ltd.