JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Evaluation of antibiofilm effect of vancomycin, melatonin, and boric acid combination on caries due to microleakage under prosthetic restoration
Abstract
Aims: Drug-resistant oral bacteria causing dental caries under prosthetic restorations have become a significant clinical challenge that needs to be addressed. This study aims to demonstrate the antibiofilm effect of vancomycin (VAN) combined with melatonin (MEL) and boric acid (BOR) against biofilm formation caused by Escherichia coli (E. coli) and Lactobacillus acidophilus (L. acidophilus) on dentin of tooth surfaces under restorations due to microleakage.
Methods: Extracted human teeth, free from caries, resorption, or fractures, were collected by slicing 2 mm dentin discs. A total of 64 dentin discs were inoculated with E. coli and L. acidophilus and randomly assigned to five experimental groups: MEL, BOR, MEL+VAN, BOR+VAN, and MEL+BOR+VAN, along with a control group. Antibiofilm activity and combination indices were analyzed using the MTT viability test and the Chou-Talalay method, respectively. The biofilm structure was examined using scanning electron microscopy.
Results: MEL and VAN demonstrated antimicrobial effects against E. coli and L. acidophilus bacteria in unary combinations, while BOR showed ineffectiveness. However, a notable synergistic interaction was observed in the binary combinations of VAN. Interestingly, a significant synergistic effect (CI<1) was noted in the triple combination against both bacterial species (p<0.05). Upon examining this effect within the triple combination, it became apparent that VAN exhibited a Favorable Dose Reduction Index (DRI>1) (p<0.05). When evaluating these synergistic and dose reduction results alongside scanning electron microscopy image analysis, it can be concluded that the triple combination of MEL+BOR+VAN likely induces the most optimal antibiofilm effect on dental caries bacteria. 
Conclusion: The tendency of cements used in the luting of prosthetic restorations to microbial colonization and their tendency to dissolve in oral fluids increases the formation of caries under crowns and bridges due to microleakage, which may lead to tooth loss. Combining melatonin and boric acid with vancomycin may offer a potential treatment option for preventing this problem, as it exhibits strong antimicrobial properties. Thanks to this combination, the microbial load in the areas under prosthetic restorations can be reduced, and both the development of caries and the progression of existing active caries can be stopped. Thus, oral infections resulting from microleakage and their associated systemic complications can be reduced, and the longevity of restorations, as well as patient comfort, can be increased.

Keywords : Melatonin, boric acid, vancomycin, dentin, caries

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Article available in :
Volume 8, Issue 3, 2025
Page : 483-488
https://doi.org/10.32322/jhsm.1680759
Article Information
Received : 21 Nis 2025
Accepted : 12 May 2025
Published : 30 May 2025
Corresponding Author :

Süha Kuşçu: Department of Prosthodontics, Faculty of Dentistry, Yozgat Bozok University, Yozgat, Turkiye

[email protected]
Citation : Kuşçu S, Hayran Y Aydın A. Evaluation of antibiofilm effect of vancomycin, melatonin, and boric acid combination on caries due to microleakage under prosthetic restoration. J Health Sci Med. 2025;8(3):483-488.

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