Apical periodontitis is caused by biofilm-mediated root canal
infection. Early phase oral bacterial biofilms are inhibited by
Lactobacillus plantarum lipoteichoic acid (Lp.LTA). However,
mature biofilms that develop over 3 weeks are more resistant
to traditional endodontic medicaments. Therefore, this study
examined the effectiveness of Lp.LTA on disrupting mature
Enterococcus faecalis biofilms, and on enhancing the effects
of endodontic medicaments. LTA was purified from L. plantarum
through butanol extraction followed by hydrophobic
and ion-exchange chromatography. E. faecalis biofilms were
formed over 3 weeks on glass bottom dishes and in dentin
blocks obtained from human single-rooted premolars. These
mature biofilms were treated with or without Lp.LTA for 1 h,
followed by additional treatment with either chlorhexidine
digluconate (CHX), calcium hydroxide (CH), or triple antibiotics
for 24 h. Biofilms on glass were live/dead stained and
quantified by ZEN through confocal laser microscopy. Biofilms
in dentin were fixed, sputter coated and analyzed by
ImageJ with scanning electron microscopy. Preformed E. faecalis
mature biofilms on the culture dishes were dose-dependently
disrupted by Lp.LTA. Lp.LTA potentiated the effects
of CHX or CH on the disruption of mature biofilm. Interestingly,
CHX-induced disruption of preformed E. faecalis
mature biofilms was synergistically enhanced only when pretreated
with Lp.LTA. Furthermore, in the dentin block model,
Lp.LTA alone reduced E. faecalis mature biofilm and
pre-treatment with Lp.LTA promoted the anti-biofilm activity
of CHX. Lp.LTA could be an anti-biofilm or supplementary
agent that can be effective for E. faecalis-biofilminduced
diseases.
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