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In vitro and in vivo antimicrobial effects of mastic chewing gum against Streptococcus mutans and mutans streptococci.

BACKGROUND AND OBJECTIVE: Dental caries is associated with oral pathogens and Streptococcus mutans (S. mutans) is one of the primary cariogenic organisms. Mastic gum, from Pistacia lentiscus, has been shown to have antibacterial properties. The objective of this study was to determine antibacterial activity of mastic chewing gum against S. mutans and mutans streptococci in vitro and in vivo conditions. SETTING: Cukurova University, Dental School, in 2002. MATERIALS AND METHODS: Antimicrobial activity of mastic gum was evaluated using standard S. mutans strain by disc diffusion method in vitro. Cytotoxicity effect of mastic gum on HEp-2 cells was evaluated by conventional haemocytometer using the trypan blue exclusion method. Clinical studies were then performed on 25 periodontally healthy volunteers. The inhibitory effect of chewing mastic gum against mutans streptococci in saliva was compared to a placebo gum. Saliva samples were taken from the subjects immediately before and after chewing the mastic gum and the placebo gum for 15 min. Additional saliva samples were collected every 30 min. The samples were inoculated onto mitis salivarius-bacitracin agar and incubated for 48 h anaerobically at 37 degrees C. The total number of viable bacteria was then counted. RESULTS: Among tested solvents (chloroform, acetone, petrolium ether and ethanol), it was found that the acetone was found to be more convenient than the others to dissolve the mastic gum. In the cytotoxicity assay, concentrations up to 75 mg/ml of the mastic gum were not toxic for the replication of HEp-2 cells. Thus, lower concentrations of mastic gum (20 and 50 mg/ml) were used for the experiments. In vitro experiments, the diameters of growth inhibition zones of mastic gum were in the range 9.0-27.0 mm. In the clinical trials, the mean number of bacteria in samples taken after chewing the mastic gum and placebo gum were following; at minute 15 was 112 x 10(4)+/-268 x 10(3) and 175 x 10(4)+/-417 x 10(3)cfu/ml, for minute 45 was 85 x 10(4)+/-219 x 10(3) and 165 x 10(4)+/-329 x 10(3)cfu/ml, at minute 75 was 65 x 10(4)+/-100 x 10(3) and 160 x 10(4)+/-216 x 10(3)cfu/ml, at minute 105 was 60 x 10(4)+/-127 x 10(3) and 150 x 10(4)+/-138 x 10(3)cfu/ml, and at minute 135 was 55 x 10(4)+/-65 x 10(3) and 145 x 10(4)+/-354 x 10(3)cfu/ml, respectively. Significantly fewer bacteria was found in saliva samples collected after chewing mastic gum compared to those after chewing paraffin (p<0.001). CONCLUSIONS: This preliminary study showed that mastic gum had significant antibacterial activity against S. mutans and mutans streptococci and it may be a useful adjunct in the prevention of caries.

Adult↗

Evaluation of the toxicity of mastic gum with 13 weeks dietary administration to F344 rats.

Dietary toxicity of mastic gum, a natural food additive, was studied in male and female F344 rats fed 0%, 0.22%, 0.67% and 2% levels mixed into powdered basal diet for 13 weeks. No mortality or obvious clinical signs were observed in any of the animals throughout the experimental period. Body weights were significantly reduced in the high dose-treated group from week 2 to the end of the experiment in males, and at weeks 8 and 13 in females. There were increased absolute and relative liver weights in a dose-related manner or limited to the high dose group males or females, along with changes in hematological parameters, including increased WBC and platelet in high dose males. Altered serum biochemistry parameters included increases of total proteins, albumin, and total cholesterol in both sexes, and gamma-GTP in females only. However, macroscopic examination at necropsy revealed no gross lesions, and microscopic examination also revealed no treatment-related findings in any organs examined. As dietary treatment of mastic gum for 13 weeks in the present study caused decreased body weights at the high dose, especially in males, and increased liver weights in a dose-related manner in both genders without any morphological findings, it is concluded that the administration of it has a no observed adverse effect level (NOAEL) of 0.67% in the diet.

Administration, Oral↗

Chios mastic gum modulates serum biochemical parameters in a human population.

INTRODUCTION: Current research suggests that Chios mastic (Pistacia lentiscus var. chia) possesses beneficial (antimicrobial, antioxidant, hepatoprotective) properties. This study aims to assess its effects on cardiologic and hepatic biochemical indices of human subjects. MATERIALS AND METHODS: Subjects (n=133, aged over 50) were randomly assigned to two groups, the first (high-dose group) ingesting daily 5g of mastic powder and the second receiving daily a Chios mastic solution (low-dose group). Serum biochemical parameters were determined on a monthly basis for an 18-month (high-dose group) and a 12-month (low-dose group) follow-up period. Generalized least squares random-effects linear regression was performed. RESULTS: The group ingesting Chios mastic powder (high-dose group) exhibited a decrease in serum total cholesterol, LDL, total cholesterol/HDL ratio, lipoprotein (a), apolipoprotein A-1, apolipoprotein B (apoB/apoA-1 ratio did not change), SGOT, SGPT and gamma-GT levels; in the second (low-dose) group, glucose levels decreased in males. DISCUSSION: Chios mastic powder could have a hepatoprotective/cardioprotective role in vivo in humans.

Alanine Transaminase↗

Allergic contact dermatitis to compound tincture of benzoin.

Nineteen cases of allergic contact dermatitis to compound tincture of benzoin are described. Patch testing to individual components revealed positive reactions to all ingredients except aloe. An alternative preparation, Mastisol, was successfully used without primarily inducing allergy. It should be considered for use before benzoin because once allergy to benzoin exists, cross-reactions to Mastisol usually occur. This is probably due to the presence of a common ingredient, styrax gum.

Adolescent↗

Chemical composition and antibacterial activity of the essential oil and the gum of Pistacia lentiscus Var. chia.

The essential oil and gum of Pistacia lentiscus var. chia, commonly known as the mastic tree, are natural antimicrobial agents that have found extensive uses in medicine in recent years. In this work, the chemical composition of mastic oil and gum was studied by GC-MS, and the majority of their components was identified. alpha-Pinene, beta-myrcene, beta-pinene, limonene, and beta-caryophyllene were found to be the major components. The antibacterial activity of 12 components of mastic oil and the oil itself was evaluated using the disk diffusion method. Furthermore, attempts were made to separate the essential oil into different fractions in order to have a better picture of the components responsible for its antibacterial activity. Several trace components that appear to contribute significantly to the antibacterial activity of mastic oil have been identified: verbenone, alpha-terpineol, and linalool. The sensitivity to these compounds was different for different bacteria tested (Escherichia coli, Staphylococcus aureus, and Bacillus subtilis), which suggests that the antibacterial efficacy of mastic oil is due to a number of its components working synergistically. The establishment of a correlation between the antibacterial activity of mastic oil and its components was the main purpose of this research. Mastic gum was also examined, but it proved to be more difficult to handle compared to the essential oil.

Acyclic Monoterpenes↗

Tacky but refined: a "slick" technique for dressings that hold better.

For decades benzoin has been used to enhance the "stickiness" of the skin for improved adherence complementing the protective and functional aspects of well-constructed surgical bandages/dressings. The fully adherent and longer-lasting pressure dressing is both aesthetically pleasing to the patient (and surgeon) and, at the same time, functions to decrease seroma or hematoma formation, enhances antisepsis by blocking transient bacterial contamination, and inhibits traumatic sabotage of surgical wounds due to patient overactivity or inadvertent collision with a door jam, car door, table leg, or grandchild, etc. Also, when the bandage looks good, the patient realizes the operation was a success (at least aesthetically). Although simple, our additional steps of deoiling the skin with acetone, followed by multiple compress/release cycles of gauze to the Mastisol area reaps benefits to the patient and surgeon both in function (adherence) and in the production of a truly "dressy" beautiful and long-lasting dressing. In this way, the dressing "bed" is not only more receptive to one's aesthetically pleasing bandage, but is more tacky, yet refined. This same technique can be utilized prior to application of adhesive strips to healing wounds after sutures have been removed, allowing them to "stay on" longer with potentially better cosmesis and less spreading of the scar.

Adhesiveness↗

Antimicrobial effect of mastic gum methanolic extract against Porphyromonas gingivalis.

The antimicrobial effect of mastic gum, an ancient remedy for oral malodor, against Porphyromonas gingivalis, a known odorogenic periopathogenic oral bacterium, was tested using the agar diffusion test. Paper discs impregnated with mastic gum methanolic extract (MME) [0.5-4% (wt/vol)] produced inhibition zones of 10.5-13.7 mm, respectively, without showing signs of hemolysis, whereas chlorhexidine (0.2%)-impregnated discs, which showed greater inhibition (33.5 mm), also produced large and distinctive hemolytic zones (17 mm). Further analysis of the antimicrobial traits of MME revealed a logarithmic ratio between inhibition zone diameter and MME concentration (r = .99), indicating limited water solubility of this material. These results suggest that mastic gum may be used as a potential nontoxic local agent in treating oral malodor and gum disease.

Anti-Infective Agents↗

Monotherapy with mastic does not eradicate Helicobacter pylori infection from mice.

OBJECTIVE: To determine the ability of mastic monotherapy to eradicate Helicobacter pylori infection from mice. MATERIALS AND METHODS: The susceptibility of H. pylori SS1 to mastic was assessed by broth dilution determination of the MIC and MBC. Mice were inoculated intragastrically with either a suspension of H. pylori SS1 (n = 70) or brain-heart infusion broth alone (n = 10). Mice were given antimicrobial chemotherapy 4 weeks after infection and were administered the mouse equivalent of either 2 g of mastic twice daily for 7 days or a triple therapy regimen containing the mouse equivalent of 400 mg of metronidazole, 250 mg of clarithromycin and 20 mg of omeprazole twice daily for 7 days. Mice were killed either immediately or 1 month after the completion of treatment, and their stomachs cultured for H. pylori. RESULTS: The mastic MIC and MBC of H. pylori SS1 were 7.80 and 31.25 mg/L, respectively. The triple therapy regimen eradicated infection from 19 of 20 SS1-infected mice. Mastic failed to eradicate infection from any of the 18 SS1-infected mice (P < 0.001) and there was no signifi- cant reduction in gastric bacterial load in mice treated with this regimen. CONCLUSION: Despite reported beneficial effects in ulcer patients and the good in vitro activity of mastic against H. pylori, this compound is unable to eradicate H. pylori infection from mice.

Animals↗

Mastic gum has no effect on Helicobacter pylori load in vivo.

OBJECTIVE: To determine whether mastic gum suppresses or eradicates Helicobacter pylori infection in humans. PATIENTS AND METHODS: Nine patients with H. pylori infection, and without gastroduodenal ulceration, were recruited from day-case endoscopy lists and treated with mastic 1 g four times daily for 14 days. [13C]Urea breath tests (UBTs) were carried out immediately before, on day 15 and 5 weeks after treatment with mastic. RESULTS: Mastic had no effect on H. pylori status in any of the eight completed patients; all remained H. pylori positive by UBT with no change in delta scores [pre-treatment mean +/- s.e.m. 19.1 +/- 3.7, day 15 (post-treatment) 18.7 +/- 3.8, P = 0.8, paired t-test]. CONCLUSION: Despite reported anti-H. pylori action in vitro, this preliminary study shows that mastic has no effect on H. pylori in humans.

Breath Tests↗

The efficacy of adhesives in the application of wound dressings.

The use of adhesive preparations to reinforce surgical tapes and to secure dressings to the skin is standard practice. BioBrane is a biosynthetic membrane for use in dressing clean, well-debrided wounds, particularly partial-thickness burns and skin graft donor sites. The close and undisturbed contact of this material with the wound surface is important during the first 2 days after its application to achieve adherence. This has prompted a study to test the relative anchoring strength of four methods of securing the dressing to the normal skin around the wound: 1/2-inch (1.27-cm) Steri-Strips only; Mastisol, a mastic compound, with and without 1/2-inch Steri-Strips; and compound tincture of benzoin, USP, in combination with 1/2-inch Steri-Strips. The results obtained with a tension of 1.1 pounds/square inch (0.5 kg/6.5 cm2) were not conclusive as to the superiority of any one method. However, with a tension of 2.2 pounds/square inch (1 kg/6.5 cm2), the combination of mastic compound and 1/2-inch Steri-Strips provided the strongest adhesion. This type of application should also prove useful when other types of surgical dressings must be anchored in place.

Adhesives↗

A double-blind controlled clinical trial of mastic and placebo in the treatment of duodenal ulcer.

A double-blind clinical trial was carried out on thirty-eight patients with symptomatic and endoscopically proven duodenal ulcer to compare the therapeutic responses to mastic (1 g daily, twenty patients) and placebo (lactose, 1 g daily, eighteen patients) given orally over a period of 2 weeks. Symptomatic relief was obtained in sixteen (80%) patients on mastic and in nine (50%) patients on placebo, while endoscopically proven healing occurred in fourteen (70%) patients on mastic and four (22%) patients on placebo. The differences between treatments were highly significant (P less than 0.01). Mastic was well tolerated and did not produce side effects. It is concluded that mastic has an ulcer healing effect, but further studies are needed to establish its role in treating peptic ulcer.

Adult↗

Reinforcement of surgical adhesive strips.

Surgical adhesive strips are often used for closure of some wounds or to minimize tension on sutures after closures. The package insert of the type most commonly used (Steri-Strip), indicates that the application of compound tincture of benzoin, U.S.P. (CTB) increases strip adhesion. The increase in adhesive power by CTB was compared with a preparation containing gum mastic (Mastisol). The study clearly demonstrated that the latter preparation provided a markedly more adhesive strength than that obtained with CTB.

Adhesiveness↗

The postoperative use of wound adhesives. Gum mastic versus benzoin, USP.

Our results, combined with the work of previous authors, show that gum mastic not only offers superior adhesive qualities compared with benzoin, USP but also has a lower incidence of postoperative contact dermatitis and subsequent skin discoloration. In light of the widespread use of surgical adhesives, this study is important in documenting the low incidence of complications and the advantages of gum mastic compared with benzoin, USP.

Adult↗