Bactericidal Kinetics and Antibiofilm Efficacy of Pimarane-Type Diterpenes from Viguiera arenaria against Cariogenic Bacteria

Ferreira, Garcia, Abrão, Fernandez, Pires, Ambrósio, Veneziani, and Martins: Bactericidal Kinetics and Antibiofilm Efficacy of Pimarane-Type Diterpenes from Viguiera arenaria against Cariogenic Bacteria



Despite the widespread use of different sources of fluoride, dental caries continues to be the most prevalent and costly infectious disease worldwide.1,2 According to Bowen and Koo,3 virulent biofilms tightly adhered to oral surfaces are a primary cause of dental caries. Dental caries results from interactions of specific bacteria and their metabolic products with teeth. In particular, Streptococcus mutans, an acidogenic and acid-tolerant bacteria, plays a specific role in the development of biofilms in the presence of extracellular polysaccharide (EPS) from dietary sucrose.4,5 Streptococcus and Lactobacillus species are also involved in the pathogenesis of the disease and in later formation of the dental biofilm.6

Mechanical removal of dental biofilm is the most efficient procedure to prevent caries. However, the use of chemicals to control dental biofilm formation is also necessary to reduce the emergence of biofilm.7 Chlorhexidine (CHD) is the most often employed agent to prevent dental biofilm formation. However, CHD modifies the perception of food taste and leaves a burning sensation at the tip of the tongue.8,9,1

According to Cragg and Newman,10 natural products are a promising source for the discovery of biologically active compounds. The use of natural products to prevent or treat oral diseases dates back to several thousand years, and they remain a largely unexplored source of effective antibiofilm molecules.1 The term natural products is related to secondary metabolites produced by an organism and which often have the function to defend said organism against microorganisms, herbivores, insects, and competing plants.11 Among the various classes of metabolites, diterpenes are recognized as a class displaying a wide spectrum of biological activities including their significant antibacterial activity.1217

The species V. arenaria contains a class of pimarane type-diterpenes that have been proven to exhibit potential action against cariogenic bacteria, as reported in previous studies by our research group. Indeed,12 have found Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) values lower than 10 µg/mL for such diterpenes.

Based on a previous study of pimarane type-diterpenes against oral pathogens and on the high incidence of dental caries, the present study aims to analyze the bactericidal kinetics, verify the ability of cariogenic bacteria to form biofilms, evaluate the antibiofilm efficacy of pimarane type-diterpenes, and determine the effect of these compounds on the morphology and architecture of the S. mutans biofilm.



Two pimarane type-diterpenes isolated from Viguiera arenaria Baker, ent-pimara-8(14),15-dien-19-oic acid (compound 1) and ent-8(14), 15-pimaradien-3β-ol (compound 2) were obtained by PORTO et al.12


The tested strains were obtained from the American Type Culture Collection (ATCC). The following microorganisms were used in the present work: Streptococcus mutans (ATCC 25175 and clinical isolate), Streptococcus sobrinus (ATCC 33478 and clinical isolate), Streptococcus sanguinis (ATCC 10556 and clinical isolate), Streptococcus mitis (ATCC 49456 and clinical isolate), and Lactobacillus casei (ATCC 11578 and clinical isolate).

Antibiofilm activity

The Minimum Inhibitory Concentration of Biofilm (MICB50) of compounds 1 and 2 against the bacteria evaluated in this study was determined on the basis of the minimum concentration of the antimicrobial agent that was able to inhibit 50% of biofilm formation or more.18 For this purpose, a microtitration plate assay was used on the basis of the CLSI guidelines,19 with some modifications. This method was similar to the MIC assay conducted for planktonic cells. Twofold serial dilutions of each sample were prepared in the wells of a 96-well polystyrene tissue culture plate (Costar) containing TSB broth (Difco) at a volume of 200 mL per well. The final concentration of compounds 1 and 2 ranged from 0.19 to 400 µg/mL. Chlorhexidine dichlorohydrate (CHD, Sigma) at concentrations between 0.115 and 59 µg/mL was the positive control; the bacterial strains in the absence of the antibacterial agent were the negative control. The cell suspension was added at concentrations of 109 CFU/mL. After 24 hs of incubation, biofilm inhibition was quantified by the following methodology. The plates were incubated in appropriate atmosphere, at a temperature of 37 ºC (98.6 °F), for 24 hs. The concentration of the inoculum was adjusted according to McFarland standard 0.5. After incubation, the culture supernatants from each well were decanted, and planktonic cells were removed by washing with PBS, pH 7.2. The biofilm was fixed with methanol for 15 min and air dried at room temperature. It was then stained with 0.2% (w/v) crystal violet (Sigma) for 5 min and rinsed thoroughly with water until the control wells became colorless. To quantify biofilm formation, 200 µL of 33% acetic acid were added to each crystal violet-stained well. The plate was shaken at room temperature for 30 min, and the absorbance at 595 nm (A595) was determined by using a microplate reader (ASYS, Eugendorf, Salzburg, Austria). The percentage of inhibition was calculated by using the equation [1 – (A595 of the test/A595 of non-treated control) × 100] as described by Wei et al.18

Bactericidal kinetics

The bactericidal kinetics of compound 1 was investigated in triplicate assays against S. mutans (ATCC 25175 and clinical isolate), S. mitis (ATCC 9811 and clinical isolate), S. sanguinis (ATCC 10557 and clinical isolate), S. sobrinus (ATCC 27609 and clinical isolate), and L. casei (ATCC 7469 and clinical isolate) as described by D’Arrigo et al.20 Tubes containing compound 1 at final concentrations of one, two, and three times the MBC value were inoculated with the tested microorganism, to give a starting bacterial density of 5 × 105 CFU/mL. Next, the tubes were incubated at 37 °C. Samples were removed for determination of viable strains at 0, 30 min, 6 h, 12 h, 18 h, and 24 h after incubation, followed by dilution, when necessary, in sterile fresh medium. The diluted samples (50 mL) were spread onto tryptic soy agar plate supplemented with 5% sheep blood, incubated at 37 °C, and counted after 48 h. Time-kill curves were constructed by plotting log10CFU/mL versus time. The assays were performed in triplicate for each concentration and also for the positive (CHD) and negative controls (suspension of bacteria without added compounds 1). CHD was used at its MBC.

Scanning electron microscopy (SEM)

Streptococcus mutans was selected for SEM processing. To determine the effect of antibacterial drugs on the morphology and architecture of the S. mutans biofilm, the latter was prepared according to a previously published protocol.21,22 Biofilm formation was tested in the absence of the tested compounds and in the presence of compound 1 to evaluate its possible mechanism of action. S. mutans biofilms were formed on sterile polyvinylchloride (PVC) disks within 12-well cell culture plates (Corning) by dispensing cell suspensions containing 109 cells/mL in BHI onto appropriate disks at 37 °C. The biofilms formed on these disks were fixed with 2% formaldehyde (v/v) and 3% glutaraldehyde (v/v) in 0.1 M potassium phosphate buffer (pH 7.2-7.4)] for 48 h. After three washes (30-100%), the biofilms were critical-point dried in CO2 (MS 850, Electron Microscopy Sciences) and coated with gold in a Denton Vacuum Desk II coater. Following processing, the specimens were visualized by SEM (JSM 5410: JEOL, Tokyo, Japan). Experiments were repeated three times with at least three replicates for each time point.


According to studies on V. arenaria published by our research group, the diterpenes isolated from this plant are a potential source of compounds for the development of new drugs to combat oral pathogens.14,15,16 However, additional studies are important to evaluate the real ability of these compounds to act against oral bacteria in both the sessile and planktonic modes. Here, we have investigated the bactericidal kinetics of compound 1 and its antibiofilm activity against cariogenic bacteria.

Figure 1 shows the bactericidal kinetics of different concentrations of compound 1 against cariogenic bacteria in the planktonic mode, for different periods of incubation.

In a previous paper,13 established the MBC concentrations evaluated in the present study. Here, we also assayed two and three times the MBC values for each bacteria. The times of death of the 10 cariogenic bacteria studied herein ranged from 30 min to 24 h.

Exposure of S. sobrinus (ATCC 27609) to compound 1 at concentrations of 5, 10, and 15 µg/mL eliminated the viable microorganisms within 24, 12, and 6 h, respectively. Increasing concentration of compound 1 decreased the time that was necessary to eliminate the microorganisms. A similar behavior emerged for S. sobrinus (clinical isolate), with the exception that at a concentration of 10 µg/mL compound 1 eliminated this bacterium within 24 h of incubation.

Exposure to compound 1 killed S. sanguinis (ATCC 10557) within 12 h (compound 1 at 6.75 µg/mL) and 24 h (compound 1 at 2.25 and 4.5 µg/mL). On the other hand, at the three tested concentrations (5, 10, and 15 µg/mL), compound 1 eliminated the clinical isolate within 24 h. At the three tested concentrations, compound 1 eliminated S. mutans (ATCC 25175 and clinical isolate) within 24 h of incubation. CFU/mL decreased after 12 h of incubation; total elimination only happened within 24 h.

At concentrations of 15, 10, and 5 µg/mL, compound 1 eliminated viable S. mitis (ATCC 9811) cells within 30 min, 6 h, and 24 h, respectively. At concentrations of 8, 16, and 24 µg/mL, compound 1 killed S. mitis (clinical isolate) within 24, 12, and 6 h of incubation, respectively. Finally, at the three assessed concentrations, compound 1 eliminated L. casei (ATCC 7469 and clinical isolate) within 24 h of incubation.

Figure 1

Bactericidal kinetics plots for pimara-ent-8(14),15-dien-19-oic acid (compound 1) against cariogenic bacteria.

Severiano et al.23 evaluated the bactericidal kinetics of S. mutans (ATCC 25175) exposed to ent-8(14),15-pimaradien-19-ol and found that this compound only avoided growth of the inoculum within the first 12 h (bacteriostatic effect); however, its bactericidal effect became clear thereafter (between 12 and 24 h). These authors also combined ent-8(14), 15-pimaradien-19-ol with CHD. The bactericidal kinetics revealed that a significantly shorter time was necessary for the combination ent-8(14),15-pimaradien-19-ol + CHD to kill S. mutans as compared with the two chemicals alone. These results resembled the data obtained for this same pathogen in the present study—compound 1 required 24 h to eliminate this bacterium.

Souza et al.14 examined the bactericidal kinetics of CHD against the primary causative agent of caries (S. mutans). Within the first 12 h of incubation, CHD only inhibited bacterial growth (bacteriostatic effect). However, its bactericidal effect became evident thereafter (between 12 and 24 h). These results were similar to the ones found here and confirmed the antibacterial activity of compound 1.

We also evaluated the antibiofilm activity of compounds 1 and 2 against cariogenic bacteria and determined the MICB50, listed in Table 1.

In the biofilm, the bacteria displayed high resistance to antibiotics, disinfectants, and host immune system clearance. The importance of biofilm is well recognized in medical, environmental, and industrial contexts.24 According to Ramage,25 biofilms tend to be 10 to 1000 times more resistant to antimicrobial agents as compared with the planktonic mode.

In the present study, compound 1 gave the best MICB50 results against S. mitis ATCC 49465 and clinical isolate—12.5 and 50 µg/mL, respectively. This compound was also effective against L. casei (clinical isolate) and S. sanguinis (ATCC 10556 and clinical Isolate), with MICB50 of 50, 100, and 200 µg/mL, respectively. At the tested concentrations, compound 2 was not effective against the evaluated bacteria: MICB50 results were higher than 400 µg/mL.

Finally, we also evaluated the effect of antibacterial metabolites on the morphology and architecture of S. mutans biofilm. Figure 2 presents the SEM image.

As described by Carvalho et al.,16 the mechanisms behind the antibacterial activity of this class of compounds have not yet been elucidated. Urzúa et al.26 and Wilkens et al.27 have suggested that these metabolites promote lysis when they insert into the lipophilic cell membrane, consequently disrupting it. Carvalho et al.16 have provided support for the mechanism of action suggested by Urzúa et al.26 and Wilkens et al.27

Both ent-pimara-8(14),15-dien-19-oic acid (compound 1) as well ent-8(14),15-pimaradien-3β-ol (compound 2) contain a HBD at C-3 or C-19 in their structure, different from another isolated molecules by Porto et al. (12) which has no HBD or has two HBD in their structure. According to Úrzua et al.26 the presence of two HBDs decrease the lipophilicity of the hydrophobic moiety, hindering its interaction with the bacterial membrane and the intramolecular HBD group interactions compete with intermolecular hydrogen bonds between each HBD and the cell membrane. The results appointed in this work corroborate.26,12

According to the SEM images, compound 1 acted by disrupting the bacterial cell membrane and/or cell wall and killing the microorganism; i.e., the pimarane type-diterpene attacked the membrane of the bacteria in the sessile mode, which confirmed the suggestion.16,28 have assayed the Copaifera duckei oleoresin, which is rich in diterpenes, against bacteria of clinical and food interest and have determined its possible mechanism of action. These authors found that this oleoresin acted on the bacterial cell wall by removing proteins and the S-layer, thereby interfering in the cell-division process.

Lee et al.,29 examined the effect of garlic extract on the formation of Streptococcus mutans biofilms on orthodontic wire. Despite its antibacterial function, garlic extract increased S. mutans biofilm formation on orthodontic wire as desmonstrated by SEM via activaction of glucosyltransferase expression.

Jeong et al.,30 investigated the anticariogenic properties of ent-kaur-16-en-19-oic acid (KA) isolated from Aralia continentalis. SEM confirmed the inhibitory effect of KA on biofilm formation. Treatment with 3 and 4 µg/mL KA inhibited and completely inhibited biofilm formation, respectively. The authors suggested that KA exerts its bactericidal effect by disrupting the S. mutans cell membrane.

Figure 2

Scanning electron microscopy (SEM) images of Streptotoccus mutans biofilms. Biofilms emerged after 24-hour incubation in 12-well plates. Preparation and observation under SEM were carried out as described in the text. The images showed thick S. mutans biofilms on the surface; these biofilms consisted of groups of cells separated by water channels. A: note a mature S. mutans biofilm consisting of a dense network; B: S. mutans after 24 hours of incubation with the tested metabolite (compound 1).
Table 1

MICB50 of diterpene type-pimarane against cariogenic bacteria.

MicroorganismsCompound 1Compound 2
S. mutans (ATCC 25175)>400>400
S. mutans (Clinical Isolate)>400>400
S. mitis (ATCC 49456)12.5>400
S. mitis (Clinical Isolate)50>400
S. sanguinis (ATCC 10556)100>400
S. sanguinis (Clinical Isolate)200>400
S. sobrinus (ATCC 33478)>400>400
S. sobrinus (Clinical Isolate)>400>400
L. casei (ATCC 11578 )>400>400
L. casei (Clinical Isolate)25>400

MICB50 - The Minimum Inhibitory Concentration Biofilm is the lowest tested concentration of the plant compound that was able to inhibit ≥ 50% of the bacterial biofilm.


In summary, our results have shown that ent-pimara-8(14),15-dien-19-oic acid is an important metabolite in the search for new antibacterial agents against cariogenic bacteria in both the sessile and planktonic modes.



  • Pimarane-type diterpene demonstrated being a promising metabolite that can be used in treatment of dental biofilms.

  • The authors suggested that pimara-ent-8(14),15-dien-19-oic acid exert its bactericidal effect by disrupting the S. mutans cell membrane and/or cell wall.

  • Secondary metabolites Viguiera arenaria can be an important hole in the development of new anticaries agent.


Juarez Henrique Ferreira: Ph.D. in the General and Applied Biology program of the Institute of Biosciences (IB) of Universidade Estadual Paulista - UNESP / Botucatu. Currently he is part of the faculty in the Biomedicine and Pharmacy courses of the University Center of Rio Preto (UNIRP).

Rafael Martinez Garcia: Graduate in dentistry in Universidade de Franca. Currently he works in the dentistry clinic and specializes in Implants.

Fariza Abrão: Ph.D. student in Science of Universidade de Franca. Profesor at Universidade de Franca in Biomedicine course.

Yadira Arnet Fernandez: She holds a degree in Food Science at University de la Habana. Actually she is Ph.D. student in Health Promotion of Universidade de Franca.

Regina Helena Pires: She holds a degree in Pharmacy from the Faculty of Pharmacy and Dentistry of Ribeirão Preto (USP-Ribeirão Preto), a degree in Biochemistry from the Faculty of Pharmacy and Dentistry of Ribeirão Preto (USP-Ribeirão Preto), a master’s degree in Clinical Analyzes, a mycology (UNESP-Araraquara), Ph.D. in Biosciences and Biotechnology Applied to Pharmacy by the Faculty of Pharmaceutical Sciences (UNESP-Araraquara), post-doctorate at the Faculty of Pharmaceutical Sciences (UNESP-Araraquara). Currently, she is researcher of the Postgraduate Program in Health Promotion of the University of Franca.

Sérgio Ricardo Ambrósio: Master’s and Ph.D. in Chemistry from the Faculty of Philosophy, Sciences and Letters of Ribeirão Preto - USP. He is currently coordinator of the Graduate Program in Sciences of the University of Franca-UNIFRAN. He develops research in the area of Natural Products Chemistry, working mainly in the following subjects: Isolation, purification, structural elucidation, analytical studies, biological assays and biotransformation of bioactive vegetable secondary metabolites.

Rodrigo Cássio Sola Veneziani: He holds a PhD in Pharmaceutical Sciences from the University of São Paulo (1994), a Masters in Chemistry from the University of São Paulo (1997) and a PhD in Chemistry from the University of São Paulo (2001). He is currently a full professor at the University of France. Has experience in the field of Pharmacy and Chemistry, with emphasis on Natural Products. Currently, his research is focused on phytochemistry (mainly diterpenoids), the evaluation of various biological activities and the development of analytical formulations and methodologies.

Carlos Henrique Gomes Martins: Master’s Degree in Biological Sciences (Applied Microbiology) by the State University of São Paulo (1996) - Rio Claro / SP and PhD in Clinical Analyzes (currently Biosciences and Biotechnology Applied to Pharmacy) by State University of São Paulo (2002) - Araraquara/SP. He is currently a researcher at the University of Franca (UNIFRAN). Professor and adviser of the Master Course and Doctorate in Sciences and the Master’s and Health Promotion of UNIFRAN.


[2] Conflicts of interest CONFLICT OF INTEREST The authors declare that there is no conflict of interests regarding the publication of this paper.



Jeon JG, Rosalen PL, Falsetta ML, Koo H , authors. Natural products in caries research: current (limited) knowledge, challenges and future perspectives. Caries Res. 2011;45(3):243–63


Dye BA, Tan S, Smith V, Lewis BG, Barker LK, Thornton-Evans G, et al. , authors. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat 11. 2007;248:1–92


Bowen WH, Koo H , authors. Biology of Streptococcus mutans-derived glucosyltransferases: role in extracellular matrix formation of cariogenic biofilms. Caries Res. 2011;45(1):69–86


Bowen WH , author. Do we need to be concerned about dental caries in the coming millennium? Crit Rev Oral Biol Med. 2002;13(2):126–31


Beighton D , author. The complex oral microflora of high-risk individuals and groups and its role in the caries process. Community Dent Oral Epidemiol. 2005;33(4):248–55


Chung JY, Choo JH, Lee MH, Hwang JK , authors. Anticariogenic activity of macelignan isolated from Myristica fragrans (nutmeg) against Streptococcus mutans. Phytomedicine. 2006;13(4):261–6


Furiga A, Lonvaud-Funel A, Dorignac G, Badet C , authors. In vitro anti-bacterial and anti-adherence effects of natural polyphenolic compounds on oral bacteria. J Appl Microbiol. 2008;105(5):1470–6


Greenberg M, Dodds M, Tian M , authors. Naturally occurring phenolic antibacterial compounds show effectiveness against oral bacteria by a quantitative structure-activity relationship study. J Agric Food Chem. 2008;56(23):11151–6


More G, Tshikalange TE, Lall N, Botha F, Meyer JJM , authors. Antimicrobial activity of medicinal plants against oral microorganisms. J Ethnopharmacology. 2008;119(3):473–7


Cragg GM, Newman DJ , authors. Natural products: a continuing source of novel drug leads. Biochim Biophys Acta. 2013;1830(6):3670–95


Singer AC, Crowley DE, Thompson IP , authors. Secondary plant metabolites in phytoremediation and biotransformation. Trends Biotechnol. 2003;21(3):123–30


Porto TS, Rangel R, Furtado NAJC, Carvalho TC, Martins CHG, Veneziani RCS, et al. , authors. Pimarane-type diterpenes: antimicrobial activity against oral pathogens. Molecules. 2009a. 14(1):191–9


Porto TS, Furtado NAJC, Heleno VCG, Martins CHG, Costa FB, Severiano ME, et al. , authors. Antimicrobial ent-pimarane diterpenes from Viguiera arenaria against Gram-positive bacteria. Fitoterapia. 2009b. 80(7):432–6


Souza AB, Martins CHG, Souza MGM, Furtado NAJC, Heleno VCG, Sousa JPB, et al. , authors. Antimicrobial activity of terpenoids from Copaifera langsdorffii Desf. against cariogenic bacteria. Phytother Res. 2011a. 25(2):215–20


Souza AB, Souza MGM, Moreira MA, Moreira MR, Furtado NAJC, Martins CHG, et al. , authors. Antimicrobial evaluation of diterpenes from Copaifera langsdorffii oleoresin against periodontal anaerobic bacteria. Molecules. 2011b. 16(11):9611–9


Carvalho TC, Simão MR, Ambrosio SR, Furtado NAJC, Veneziani RCS, Heleno VCG, et al. , authors. Antimicrobial activity of diterpenes from Viguiera arenaria against endodontic bactéria. Molecules. 2011;16(1):543–51


Silva SCD, Souza MGM, Cardoso MJO, Moraes TS, Ambrosio SR, Veneziani RCS, et al. , authors. Antibacterial activity of Pinus elliottii against anaerobic bacteria present in primary endodontic infections. Anaerobe. 2014;30:146–52


Wei GX, Campagna AN, Bobek LA , authors. Effect of MUC7 peptides on the growth of bacteria and on Streptococcus mutans biofilm. J Antimicrob Chemother. 2006;57(6):1100–9


Clinical and Laboratory Standards Institute (CLSI). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. CLSI document M7-A7. Clinical and Laboratory Standards Institute (CLSI); Philadelphia, Pa, USA: 2006


D’Arrigo M, Ginestra G, Mandalari G, Furneri PM, Bisignano G , authors. Synergism and postantibiotic effect of tobramycin and Melaleuca alternifolia (tea tree) oil against Staphylococcus aureus and Escherichia coli. Phytomedicine. 2010;17(5):317–22


Reed SJB , author. Electron microprobe analysis and scanning electron microscopy in geology. Cambridge University Press; New York: 1996. p. 201


Pires RH, Santos JM, Zaia JE, Martins CHG , authors. Mendes-Giannini MJS. “Candida parapsilosis complex water isolates from a haemodialysis unit: biofilm production and in vitro evaluation of the use of clinical antifungals. Mem Inst Oswaldo Cruz. 2011;106(6):646–54


Severiano ME, Simao MR, Porto TS, Martins CHG, Veneziani RCS, Furtado NAJC, et al. , authors. Anticariogenic properties of ent-pimarane diterpenes obtained by microbial transformation. Molecules. 2010;15(12):8553–66


Stepanovic S, Vukovic D, Hola V, Di Bonaventura G, Djukic S, Cirkovic I, et al. , authors. Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci. APMIS. 2007;115(8):891–9


Ramage G, Walle KV, Wickes BL , authors. López-Ribot JL. Standardized method for in vitro antifungal susceptibility testing of Candida albicans biofilms. Antimicrob Agents Chemother. 2001;45(9):2475–9


Urzúa A, Rezende MC, Mascayano C, Vasquez L , authors. A structure-activity study of antibacterial diterpenoids. Molecules. 2008;13(4):882–91


Wilkens M, Alarcon C, Urzúa A, Mendoza L , authors. Characterization of the bactericidal activity of the natural diperpene of kaurenoic acid. Planta Med. 2002;68(5):452–4


Santos ECG, Donnici CL, Camargos ERC, Rezende AA, Andrade EHA, Soares LAL, et al. , authors. Effects of Copaifera duckei Dwyer oleoresin on the cell wall and cell division of Bacillus cereus. J Med Microbiol. 2013;62(7):1032–7


Lee HJ, Park HY, Kwon TY, Hong SW , authors. Effect of garlic on bacterial biofilm formation on orthodontic wire. Angle Orthod. 2011;81(5):895–900


Jeong SI, Kim BS, Keum KS, Lee KH, Kang SY, Park BI, et al. , authors. Kaurenoic Acid from Aralia continentalis Inhibits Biofilm Formation of Streptococcus mutans. Evid Based Complement Alternat Med. 2013;160592.