**11. Prunella vulgaris & Macleya cordata**

In recent years has studied the biological activity of an extract of Prunella vulgaris L. (Labiatae), and it found marked cytoprotective, antioxidant/radical scavenging, antiviral and anti-inflammatory effects both in vitro and in vivo. This plant, known as the "self-heal", was popular in traditional European medicine during the 17th century as a remedy for alleviating sore throat, reducing fever, and accelerating wound healing. A major constituent of P. vulgaris is rosmarinic acid, a phenolic antioxidant whose content can be as high as 6 %. Phytochemical studies indicate that P. vulgaris further contains oleanolic, betulinic, ursolic, 2α,3α-dihydroxyurs-12-en-28-oic and 2α,3α-ursolic acids, triterpenoids, flavonoids, tannins and anionic polysaccharide prunelline. Isoquinoline alkaloids from Macleya cordata R. Br. (Papaveraceae) are another group of biologically active components studied recently. The main alkaloids of this plant, quaternary benzo[c]phenanthridines (QBA) sanguinarine and chelerythrine, are among the most active of antimicrobials natural substances. These alkaloids display a plethora of species- and tissue-specific actions but the molecular basis of their pharmacological activities remains obscure. They exhibit antimicrobial, antiinflammatory, antimitotic, adrenolytic, sympatholytic, cytostatic and local anesthetic effects. A double blind, placebo-controlled clinical trial was performed to investigate the effectiveness of a herbal-based dentifrice, containing Prunella vulgaris and Macleya cordata, in the control gingivitis. The result showed the dentifrice was effective in reducing plaque and symptoms of gingivitis (Adamkova et al 2004).

#### **12. Chitosan plus herbal extracts**

Chitosan, an abundant natural polymer, is obtained by alkaline N-deacetylation of chitin. Chitosan being a binding agent, bio-adhesive, bio-compatible, bio-degradable, and non-toxic

The Effects of Plant Extracts on Dental Plaque and Caries 401

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polymer also possessing medicinal activities, such as antifungal, antibacterial, antiprotozoal, anticancer, antiplaque, ant tartar, hemostatic, wound healing, and potentiates antiinflammatory response, inhibits the growth of cariogenic bacteria, immunopotentiation, antihypertensive, serum cholesterol lowering, increases salivary secretion (anti-xerostomia), and helps in the formation of bone substitute materials. The adherence of oral bacteria on the tooth surface leads to plaque formation. It is believed that the adhesion between the bacteria and the tooth surface is due to electrostatic and hydrophobic interactions. These interactions are disrupted by chitosan derivatives because of competition by the positively charged amine group. The antibacterial activity of chitosan could be due to the electrostatic interactions between the amine groups of chitosan and the anionic sites on bacterial cell wall because of the presence of carboxylic acid residues and phospholipids. Use of most of the currently used gelling agents, such as tragacanth, Irish moss, and sodium alginate mucilage, in the toothpaste was limited only to their gelling capacity and also require antimicrobial preservatives due to their carbohydrate nature, whereas chitosan being a good gelling agent, does not require any preservatives as chitosan possess antimicrobial activities. Chitosan nanoparticles have found as drug carriers. In a study was evaluated anti-plaque activity a chitosan-based poly herbal toothpaste. The toothpaste significantly reduced the plaque index by 70.47% and bacterial count by 85.29%(34). (Mohire & Yadav 2010).

#### **13. Conclusion**

In conclusion, the herbal extracts can be effect on the growth of dental plaque bacteria and dental caries. Therefore, the herbal extracts can be used in mouth rinses and toothpastes and can be beneficial in controlling dental caries.

#### **14. References**


polymer also possessing medicinal activities, such as antifungal, antibacterial, antiprotozoal, anticancer, antiplaque, ant tartar, hemostatic, wound healing, and potentiates antiinflammatory response, inhibits the growth of cariogenic bacteria, immunopotentiation, antihypertensive, serum cholesterol lowering, increases salivary secretion (anti-xerostomia), and helps in the formation of bone substitute materials. The adherence of oral bacteria on the tooth surface leads to plaque formation. It is believed that the adhesion between the bacteria and the tooth surface is due to electrostatic and hydrophobic interactions. These interactions are disrupted by chitosan derivatives because of competition by the positively charged amine group. The antibacterial activity of chitosan could be due to the electrostatic interactions between the amine groups of chitosan and the anionic sites on bacterial cell wall because of the presence of carboxylic acid residues and phospholipids. Use of most of the currently used gelling agents, such as tragacanth, Irish moss, and sodium alginate mucilage, in the toothpaste was limited only to their gelling capacity and also require antimicrobial preservatives due to their carbohydrate nature, whereas chitosan being a good gelling agent, does not require any preservatives as chitosan possess antimicrobial activities. Chitosan nanoparticles have found as drug carriers. In a study was evaluated anti-plaque activity a chitosan-based poly herbal toothpaste. The toothpaste significantly reduced the plaque

index by 70.47% and bacterial count by 85.29%(34). (Mohire & Yadav 2010).

In conclusion, the herbal extracts can be effect on the growth of dental plaque bacteria and dental caries. Therefore, the herbal extracts can be used in mouth rinses and toothpastes and

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**13. Conclusion** 

**14. References** 

can be beneficial in controlling dental caries.

*Health Prev Dent* , 1(4):301-7.


**Part 6** 

**Others** 


**Part 6** 

402 Contemporary Approach to Dental Caries

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glucosyltransferases, adherence and biofilm formation of streptococcus mutans.

**Others** 

**21** 

*1Germany 2P.R. China* 

**Secondary Caries** 

Guang-yun Lai1 and Ming-yu Li2

 *Ludwig-Maximilians-University, Munich,* 

*1Department of Restorative Dentistry and Periodontology,* 

*2Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Ninth People's Hospital, Medical College, Shanghai Jiao Tong University, Shanghai,* 

Secondary caries, the lesion at the margin of a restoration, has been widely considered as the most important and common reason for restoration replacement, regardless of the restorative material type [Collins et al., 1998; Dahl and Eriksen, 1978; Deligeorgi et al., 2001; Friedl et al., 1995; Mjör, 2005; Mjör and Toffenetti, 2000;]. As it develops after the initial caries has been removed and replaced by a restoration, 'secondary caries', which is often referred to as 'recurrent caries' by practitioners in North America, is used more commonly in Europe[Mjör, 2005]. The Fédération Dentaire Internationale defined secondary caries as a 'positively diagnosed carious lesion, which occurs at the margins of an existing restoration' [Fédération Dentaire Internationale, 1962]. Then two kinds of lesion may exist adjacent to the restorations: secondary caries and residual caries (remaining caries). The latter one is residual demineralized tissue left, due to the failure of eliminating all infected dentine or/and enamel during the cavity preparation. Therefore it is very difficult for clinicians to make an accurate diagnosis of secondary caries and provide a clear terminology. Nowadays it is generally acknowledged that secondary caries or recurrent caries is a primary carious lesion of tooth at the margin of an existing restoration, which occurs after the restoration has

Due to its importance to the longevity of the restorations and human oral health, over the past few decades, multiple of studies have been conducted both in vivo and in vitro to understand and prevent secondary caries, including the etiology and histopathology of secondary caries, the detective and diagnostic methods of secondary caries, the relationship between microleakage and secondary caries, as well as the cariostatic effects of various restorative materials. The purpose of this chapter is to present a systematic and brief review of secondary caries in order to draw people's attention to this common but also complicated dental disease.

In the 1970s, Hals et al. did a comprehensive investigation of the secondary caries lesions around various restorative materials both in vitro and in vivo, and natural secondary caries

**1. Introduction** 

been used for some time [Mjör and Toffenetti, 2000].

**2. Diagnosis of secondary caries 2.1 Histology of secondary caries** 
