title: Differential effects of the combination of tyrosol with chlorhexidine gluconate on oral biofilms.
abstract: OBJECTIVE
  This study assessed the effect of tyrosol and chlorhexidine gluconate in combination against Candida albicans, Candida glabrata, and Streptococcus mutans in the planktonic state or forming biofilms in vitro.
  
  
  METHODS
  Checkerboard assays were performed for determination of minimum inhibitory concentration. Biofilms were cultivated during 24 h on specimens of acrylic resin and hydroxyapatite and treated with the drugs alone or in combination twice a day for 1 min, during 3 days. The antibiofilm effect was determined by quantification of the metabolic activity and cultivable cells. The drug combination was also applied on C. albicans to investigate its action on the number of hyphae. Data were statistically examined by two-way ANOVA and Holm-Sidak test (P < 0.05).
  
  
  RESULTS
  The effect of drug combination on planktonic cells was classified as antagonistic for C. albicans and indifferent for the other strains. Also, the drugs were ineffective against the tested biofilms. However, the drug combination showed a synergistic effect in reducing the number of hyphae by C. albicans.
  
  
  CONCLUSIONS
  The combination of tyrosol with chlorhexidine gluconate was only effective in reducing the number of hyphae by C. albicans, a relevant virulence factor of this species.
authors.affiliation: Department of Pediatric Dentistry and Public Health, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
authors.forename: L R
authors.initials: LR
authors.lastname: do Vale
authors.affiliation: Department of Pediatric Dentistry and Public Health, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
authors.forename: Acb
authors.initials: A
authors.lastname: Delbem
authors.affiliation: Department of Pediatric Dentistry and Public Health, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
authors.forename: L S
authors.initials: LS
authors.lastname: Arias
authors.affiliation: Department of Pediatric Dentistry and Public Health, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.|Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
authors.forename: R A
authors.initials: RA
authors.lastname: Fernandes
authors.affiliation: Department of Pediatric Dentistry and Public Health, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
authors.forename: Apm
authors.initials: A
authors.lastname: Vieira
authors.affiliation: Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.
authors.forename: D B
authors.initials: DB
authors.lastname: Barbosa
authors.affiliation: Department of Pediatric Dentistry and Public Health, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil.|Graduate Program in Dentistry (GPD - Master's Degree), University of Western São Paulo (UNOESTE), Presidente Prudente, São Paulo, Brazil.
authors.forename: D R
authors.identifier: http://orcid.org/0000-0001-5229-5259
authors.initials: DR
authors.lastname: Monteiro
mesh_terms: D000180:Acrylic Resins; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects*; D002176:Candida albicans / Q000187:drug effects* / Q000502:physiology; D041221:Candida glabrata / Q000187:drug effects* / Q000502:physiology; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D004357:Drug Synergism; D017886:Durapatite; D006801:Humans; D025301:Hyphae / Q000187:drug effects; D008826:Microbial Sensitivity Tests; D010626:Phenylethyl Alcohol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D012463:Saliva / Q000382:microbiology; D013295:Streptococcus mutans / Q000187:drug effects* / Q000502:physiology
chemical_list: D000180:Acrylic Resins; D000891:Anti-Infective Agents, Local; C011867:4-hydroxyphenylethanol; D017886:Durapatite; D010626:Phenylethyl Alcohol; C010882:chlorhexidine gluconate; D002710:Chlorhexidine
keywords: 
  Candida
  ; 
  Streptococcus mutans
  ; Tyrosol; biofilms; chlorhexidine gluconate