In vitro effects of different sugar alcohol concentrations on the cariogenic biofilm formed on fissure sealants

Background: This study aimed to evaluate the effects of erythritol and xylitol, alone or in different combinations, on cariogenic biofilm formation on various fissure sealants. Methods: The triple biofilm formation of Streptococcus mutans ((American Type Culture Collection) ATCC-25175), Streptococcus sobrinus (ATCC-33478), and Scardovia wiggsiae ((German Collection of Microorganisms and Cell Cultures) DSM-22547), was evaluated on samples of hydroxyapatite (HA) disks and disks prepared from resin-based and glass ionomer fissure sealants. The biofilm formations on the samples were determined by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Results: The lowest biomass and biofilm thickness, indicating a notable inhibitory effect on bacterial growth, corresponded to the combination of 2.5%xylitol + 7.5% erythritol. In addition, biofilm formation on glass ionomer surfaces was lower than on HA and resin-based surfaces. Conclusions: Based on these results, erythritol shows antimicrobial activity at high concentrations and, combined with xylitol, it seems to exhibit a synergistic bacteriostatic effect useful for anti-cariogenic agents. Nevertheless, validation using well-designed clinical trials is needed to assess the long-term safety and efficacy of these sugar alcohols in oral health applications.