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Pre-clinical evaluation of the anticaries effect of an experimental Malva sylvestris extract mouthwash using a cariogenic model in situ.

Aline Silva Braga·Laís Guilhen Torres Figueira·Rafaela Ricci Kim·Mariele Vertuan·Marcella Esteves-Oliveira·Ana Carolina Magalhães
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Abstract

OBJECTIVE: The aim of this study was to evaluate the antimicrobial and anticariogenic potential of Malva sylvestris extract on enamel and dentin in situ. METHODS: A double-blind crossover in situ study was conducted with 12 participants wearing palatal appliances containing two bovine enamel and two dentin specimens per 3 phases, a total of 72 enamel and dentin specimens. Biofilm formation and daily sucrose exposure were allowed. Treatments were applied twice daily in three phases: Malva sylvestris (2.5%, MS); fluoride (225 ppm, F); and placebo (P). After seven days, biofilm was collected from the bovine specimens for analysis of Lactobacillus spp. and mutans streptococci by Colony Forming Unit counts (CFU log₁₀/mL). Dental demineralization of the bovine specimens was assessed by transverse microradiography (TMR). RESULTS: MS did not reduce Lactobacillus spp. counts (CFU log₁₀/mL: enamel 6.63±0.81; dentin 6.68±0.92) compared to P (6.63±0.70; 6.62±0.51). F also did not differ (6.29±0.75; 6.32±0.41; ANOVA/Tukey, p>0.38). Mutans streptococci data were inconclusive. In enamel, both MS (2320.8±768.2 %vol·µm; 101.6±27.0 µm) and F (1777.3±733.3 %vol·µm; 95.8±23.5 µm) significantly reduced integrated mineral loss and lesion depth compared to P (3517.2±1119.9 %vol·µm; 138.6±19.5 µm; ANOVA/Tukey, p≤0.0003). In dentin, MS significantly reduced integrated mineral loss (322.5 [250-580] %vol·µm) and lesion depth (30.1 [15-42.2] µm) compared to P (880 [580-1705]; 58.3 [32.2-88.6] µm; Kruskal-Wallis/Dunn, p≤0.001), while F (587.5 [305-720]; 25.2 [16.5-38.8] µm) did not differ significantly (p>0.05). CONCLUSIONS: Malva sylvestris extract had no antimicrobial effect on Lactobacillus spp. counts, but significantly reduced enamel and dentin demineralization, showing anticaries effect comparable to fluoride. CLINICAL RELEVANCE: Malva sylvestris has demonstrated promising biological activity. This study investigates the antimicrobial efficacy of Malva sylvestris against cariogenic microorganisms in situ. Our findings provide relevant evidence that M. sylvestris exert significant anticaries effects using an in situ model.

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BiofilmsAnimalsPlant ExtractsCariostatic AgentsCattleDental EnamelHumansDouble-Blind MethodDentinStreptococcus mutansCross-Over StudiesLactobacillusTooth DemineralizationSucroseMalvaFluoridesMouthwashesMicroradiographyDental CariesColony Count, MicrobialFluoride TreatmentCariogenic AgentsBacterial LoadPlacebosDental demineralizationFluorideXylitolJournal ArticleRandomized Controlled TrialComparative Study

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Aline Silva Braga, Laís Guilhen Torres Figueira, Rafaela Ricci Kim, Mariele Vertuan, Marcella Esteves-Oliveira, Ana Carolina Magalhães. 2026-07-08. Pre-clinical evaluation of the anticaries effect of an experimental Malva sylvestris extract mouthwash using a cariogenic model in situ.. https://doi.org/10.1016/j.jdent.2026.106879

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Journal Article; Randomized Controlled Trial; Comparative Study resourceAnimals subjectCattle subjectComparative Study subjectCross-Over Studies subjectDental Caries subjectDouble-Blind Method subjectFluorides subjectHumans subjectJournal Article subjectMouthwashes subjectRandomized controlled trials study

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