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Lim TW, Burrow MF, McGrath C. Efficacy of ultrasonic home-care denture cleaning versus conventional denture cleaning: A randomised crossover clinical trial. J Dent 2024; 148:105215. [PMID: 38944265 DOI: 10.1016/j.jdent.2024.105215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/24/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE To compare the efficacy of test (ultrasonic cleaner combined with immersion in denture cleanser solution) and control (immersion in denture cleanser solution followed by conventional brushing) denture cleaning interventions in enhancing denture cleanliness, reducing denture stomatitis, and improving patient satisfaction. METHODS A prospective, single-blind, block-randomised, two-period crossover, superiority-controlled clinical trial was conducted of a 3-month intervention. The study design included a pre-intervention period (2 weeks), intervention period one (3 months), washout period (2 weeks), and intervention period two (3 months). A total of 56 community-dwelling elders were block-randomized into either sequence Test/Control or sequence Control/Test. The intervention, period, and carryover effects for the changes in the cleanliness of extensive partial and complete acrylic dentures, denture stomatitis, and changes in patient satisfaction were estimated using Generalized Estimating Equations models. RESULTS Percentage plaque area coverage, patient satisfaction, and denture stomatitis were significantly improved for both intervention and control arms after 3 months (P < 0.05). The intervention arm was found to significantly improve denture cleanliness (P < 0.001) and patient satisfaction (P = 0.002) more than the control arm. Denture-wearing habits and denture age were also significantly associated with the changes in denture plaque coverage (P < 0.05). However, the effect of the test intervention on denture stomatitis was not significantly different compared to the control arm (P = 0.284). CONCLUSION This study revealed that the test intervention group was significantly more effective than the control group in improving denture cleanliness and patient satisfaction among community-dwelling elders. This test intervention is recommended for maintaining optimum denture hygiene among older adults. CLINICAL SIGNIFICANCE Removable dentures can harbor opportunistic pathogens, emphasizing the need for effective denture hygiene intervention using ultrasonic cleaner combined with immersion in denture cleanser solution to eliminate denture biofilm in community-dwelling elders.
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Affiliation(s)
- Tong Wah Lim
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR
| | - Michael Francis Burrow
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong SAR
| | - Colman McGrath
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.
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Almeida NLM, Peralta LCF, Pontes FML, Rinaldo D, Porto VC, Lara VS. Anti-Candida activity and biocompatibility of silver nanoparticles associated with denture glaze: a new approach to the management of denture stomatitis. Folia Microbiol (Praha) 2024:10.1007/s12223-024-01161-4. [PMID: 38652435 DOI: 10.1007/s12223-024-01161-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
The association of silver nanoparticles (AgNps) to sealant agent Palaseal® can be a promising alternative for complete denture wearers who may develop denture stomatitis (DS). The study aimed to evaluate the anti-Candida and biocompatible potential of silver nanoparticles synthesized by three routes associated with denture glaze to prevent and/or treat oral candidiasis. Surface acrylic resin specimens were treated with different associations of glaze with AgNps (VER+AgUV, VER+AgTurk and VER+AgGm). As controls, specimens were treated with glaze+nystatin (VER+Nyst), glaze only (VER) or submerged in PBS (PBS). Afterwards, Candida albicans biofilm was developed for 24 h, 15 d and 30 d. Subsequently, the biofilm was quantified by CFU/mL, XTT assay and confocal laser scanning microscopy. Fibroblasts were submitted to conditioned medium with the same associations for 24, 48 and 72 h and LIVE/DEAD® viability test was carried out. Regardless of the period, there was a significant reduction (p < 0.01) of viable fungal cells load, as well as inhibition of fungal metabolic activity, in specimens treated with glaze+AgNps associations, compared to VER and PBS. The anti-Candida effects of the associations were similar to the VER+Nyst group, with emphasis on VER+AgGm, which showed the highest percentage values of non-viable fungal cells maintained over time. The associations did not prove toxicity to fibroblasts. The AgNps exerted antimicrobial activity against C. albicans biofilms and are biocompatible. The most effective results were achieved with the association of glaze+silver nanoparticles synthesized by the green chemistry method (AgGm), proving to be an innovative alternative in the management of DS.
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Affiliation(s)
- Nara Lígia Martins Almeida
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, 17012-901, Brazil
| | - Laura Catalí Ferreira Peralta
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, Brazil
| | | | - Daniel Rinaldo
- Department of Chemistry, São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Vinicius Carvalho Porto
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru 17012-901, Brazil
| | - Vanessa Soares Lara
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo (USP), Bauru, 17012-901, Brazil.
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Schierz O, Hirsch C, Krey KF, Ganss C, Kämmerer PW, Schlenz MA. DIGITAL DENTISTRY AND ITS IMPACT ON ORAL HEALTH-RELATED QUALITY OF LIFE. J Evid Based Dent Pract 2024; 24:101946. [PMID: 38401951 DOI: 10.1016/j.jebdp.2023.101946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 02/26/2024]
Abstract
Over the past 50 years, digitization has gradually taken root in dentistry, starting with computer tomography in the 1970s. The most disruptive events in digital dentistry were the introduction of digital workflow and computer-aided manufacturing, which made new procedures and materials available for dental use. While the conventional lab-based workflow requires light or chemical curing under inconsistent and suboptimal conditions, computer-aided manufacturing allows for industrial-grade material, ensuring consistently high material quality. In addition, many other innovative, less disruptive, but relevant approaches have been developed in digital dentistry. These will have or already impact prevention, diagnosis, and therapy, thus impacting patients' oral health and, consequently, their oral health-related quality of life. Both software and hardware approaches attempt to maintain, restore, or optimize a patient's perceived oral health. This article outlines innovations in dentistry and their potential impact on patients' oral health-related quality of life in prevention and therapy. Furthermore, possible future developments and their potential implications are characterized.
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Affiliation(s)
- Oliver Schierz
- Department of Prosthetic Dentistry and Material Sciences, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Christian Hirsch
- Clinic of Pediatric and Preventive Dentistry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Karl-Friedrich Krey
- Department of Orthodontics and Craniofacial Orthopedics, University Medicine Greifswald, Greifswald, Germany
| | - Carolina Ganss
- Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Section Cariology, Philipps-University Marburg, Marburg, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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Lima LFG, de Paula Castro V, Álvarez CMO, Ambrósio SR, Rodrigues MA, Pires RH. Assessing the efficacy of gutiferone E in photodynamic therapy for oral candidiasis. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 250:112834. [PMID: 38157703 DOI: 10.1016/j.jphotobiol.2023.112834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
The rise in antifungal resistance and side effects of conventional treatments drive the search for innovative therapies like Photodynamic Therapy (PDT). This study explored the efficacy of PDT mediated by gutiferone, an isolated compound from red propolis, for candidiasis treatment. Multiple evaluation methods were employed, including determining the minimum inhibitory concentration (MIC) via broth microdilution, quantifying biomass using crystal violet detachment, and cell counting through total plate count. PDT mediated by gutiferone was also assessed in five groups of mice, followed by histopathological examination and agar plating of lingual tissue samples. Among the seven Candida species tested, gutiferone displayed efficacy against C. albicans, C. glabrata, and C. tropicalis, with MIC values of 1000 μg/mL. In C. tropicalis biofilms, exposure to gutiferone led to a reduction of 1.61 Log10 CFU/mL. PDT mediated by gutiferone achieved an average reduction of 3.68 Log10 CFU/mL in C. tropicalis biofilm cells, underscoring its potent fungicidal activity. Histopathological analysis revealed fungal structures, such as pseudohyphae and hyphae, in infected groups (G2) and irradiated mice. In contrast, groups treated with gutiferone or subjected to gutiferone-assisted PDT (G5) exhibited only few blastoconidia. Furthermore, CFU/mL assessments in lingual tissue post-treatment demonstrated a significantly lower count (0.30 Log10 CFU/mL) in the G5 group compared to G2 (2.43 Log10 CFU/mL). These findings highlight the potential of PDT mediated by gutiferone as a promising alternative for managing denture stomatitis. Future research and clinical investigations offer the promise of validating its clinical applicability and improving outcomes in the treatment of oral candidiasis.
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Koenig A, Rotenburg L, Fuchs F, Sander S, Lethaus B, Hahnel S. Influence of aging of PEEK attachment inserts on the pull-off force of implant-retained overdentures - A laboratory study. Clin Oral Implants Res 2023; 34:1363-1372. [PMID: 37694944 DOI: 10.1111/clr.14180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES The aim of the current study is to investigate the influence of mechanical stress as well as cleaning agents on the performance of various polyether ether ketone (PEEK) inserts for implant-retained overdentures (IOD). MATERIALS AND METHODS Three different standard PEEK inserts were subjected to rapid artificial aging through storage in chemical denture cleaning agents (acetic acid, sodium hypochlorite, or sparkling denture cleaner) as well as demineralized water. The pre-aged PEEK inserts were then placed in unilateral IOD and subjected to 200,000 chewing loads (5 kg ~ 50 N), with 5000 thermal cycles (5/55°C), and 1100 removal/insertion cycles (vertical movement 2 mm). RESULTS For all the PEEK inserts, the retention forces decreased significantly with an increasing number of mechanical load cycles and after exposure to all the cleaning agents. PEEK inserts aged by exposure to chemical cleaning agents showed a significantly higher decline in retention force than the inserts stored in water. Confocal laser scanning microscopy indicated that the decline in retention force might be caused by wear on the internal insert surface in contact with the patrix. CONCLUSIONS Within the limitations of this study, it can be concluded that the application of chemical cleaning agents accelerates the decline in the retention forces of PEEK retentive inserts in IODs.
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Affiliation(s)
- Andreas Koenig
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Laura Rotenburg
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Florian Fuchs
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Stephan Sander
- Department of Prosthodontics and Material Sciences, Leipzig University, Leipzig, Germany
| | - Bernd Lethaus
- Department of Cranio Maxillofacial Surgery, Leipzig, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, Regensburg, Germany
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Ribeiro AB, Tinelli BM, Clemente LM, Poker BDC, Oliveira VDC, Watanabe E, Silva-Lovato CH. Effect of Hygiene Protocols on the Mechanical and Physical Properties of Two 3D-Printed Denture Resins Characterized by Extrinsic Pigmentation as Well as the Mixed Biofilm Formed on the Surface. Antibiotics (Basel) 2023; 12:1630. [PMID: 37998832 PMCID: PMC10669351 DOI: 10.3390/antibiotics12111630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
To assess the effect of hygiene protocols and time on the physical-mechanical properties and colony-forming units (CFU) of Candida albicans, Staphylococcus aureus, and Streptococcus mutans on 3D-printed denture resins (SmartPrint and Yller) with extrinsic pigmentation compared to conventional resin (CR). The protocols were evaluated: brushing (B), brushing and immersion in water (W), 0.25% sodium hypochlorite (SH), and 0.15% triclosan (T), simulating 0, 1, 3, and 5 years. The data were analyzed by ANOVA with repeated measurements, ANOVA (Three-way) and Tukey's post-test, generalized linear model with Bonferroni adjustment, and ANOVA (Two-way) and Tukey's post-test (α = 0.05). The protocols influenced color (p = 0.036) and Knoop hardness (p < 0.001). Surface roughness was influenced by protocols/resin (p < 0.001) and time/resin (p = 0.001), and flexural strength by time/protocols (p = 0.014). C. albicans showed interactions with all factors (p = 0.033). Staphylococcus aureus was affected by protocols (p < 0.001). Streptococcus mutans exhibited no count for SH and T (p < 0.001). Yller resin showed more color changes. The 3D-printed resins displayed lower microhardness, increased roughness, and decreased flexural strength compared to CR with all protocols in a simulated period of 5 years. The indication of printed resins should be restricted to less than 3 years.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil; (A.B.R.); (B.M.T.); (L.M.C.); (B.d.C.P.); (V.d.C.O.)
| | - Beatriz Marcatto Tinelli
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil; (A.B.R.); (B.M.T.); (L.M.C.); (B.d.C.P.); (V.d.C.O.)
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil; (A.B.R.); (B.M.T.); (L.M.C.); (B.d.C.P.); (V.d.C.O.)
| | - Beatriz de Camargo Poker
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil; (A.B.R.); (B.M.T.); (L.M.C.); (B.d.C.P.); (V.d.C.O.)
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil; (A.B.R.); (B.M.T.); (L.M.C.); (B.d.C.P.); (V.d.C.O.)
| | - Evandro Watanabe
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil;
| | - Cláudia Helena Silva-Lovato
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil; (A.B.R.); (B.M.T.); (L.M.C.); (B.d.C.P.); (V.d.C.O.)
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Freiria de Oliveira CA, Moraes LGDS, Vilela Teixeira AB, Pagnano VO. Antimicrobial activity of cleansers on the cobalt-chromium surface of removable partial denture: a systematic review. BIOFOULING 2023; 39:916-927. [PMID: 38047547 DOI: 10.1080/08927014.2023.2290120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
This study aimed to review systematically the literature about the antimicrobial action of evaluated cleansers on the Co-Cr alloy of RPD. The search was conducted in MEDLINE/PubMed, Scopus, Lilacs, Embase and Science Direct May, 2022. The review was performed based on PRISMA guidelines and recorded in Open Science Framework. Independent reviewers performed the search, selection, extraction, and analysis of the data. The risk of bias of the in vitro and clinical trials studies was analyzed by the Joanna Briggs Institute tool. A total of 187 articles were found and 9 were included. The cleansers that showed antimicrobial action were 2% and 5.25% sodium hypochlorite, 0.12% chlorhexidine and NitrAdine effervescent tablet. Polident, Corega Tabs effervescent tablets and 5 mg/mL chitosan solution showed intermediate effects. Propolis and green tea toothpaste were not effective. Three articles presented a high risk of bias and 6, low risk. The cleansers that showed the highest antimicrobial efficacy on Co-Cr alloy were 0.12% chlorhexidine digluconate and NitrAdine and can be safely used on RPD framework.
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Affiliation(s)
| | - Leonardo Guedes da Silva Moraes
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Beatriz Vilela Teixeira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - Valéria Oliveira Pagnano
- Department of Dental Materials and Prosthodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
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Schmutzler A, Stingu CS, Günther E, Lang R, Fuchs F, Koenig A, Rauch A, Hahnel S. Attachment of Respiratory Pathogens and Candida to Denture Base Materials-A Pilot Study. J Clin Med 2023; 12:6127. [PMID: 37834772 PMCID: PMC10573319 DOI: 10.3390/jcm12196127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Denture prostheses are an ideal and extensive reservoir for microorganisms to attach to their surfaces. The aim of the study was to elucidate interactions between materials for the fabrication of denture bases and the attachment of microorganisms, focusing on respiratory pathogens and Candida species. Specimens (6 mm × 1 mm) with a standardized surface roughness (Sa = 0.1 µm) were prepared from heat-pressed polymethyl methacrylate (PMMA), CAD/CAM-processed PMMA, and CAD/CAM-processed polyether ether ketone (PEEK). The specimens were randomly placed in the vestibular areas of complete upper dentures in seven patients and were removed either after 24 h without any oral hygiene measures or after a period of four weeks. The microorganisms adherent to the surface of the specimens were cultivated and subsequently analyzed using mass spectrometry (MALDI-TOF). The means and standard deviations were calculated, and the data were analyzed using a two-way analysis of variance (ANOVA) and Tukey post-hoc test where appropriate (α = 0.05). There was a significant increase (p ≤ 0.004) in the total bacterial counts (CFU/mL) between the first (24 h) and the second (four weeks) measurements. Regarding quantitative microbiological analyses, no significant differences between the various materials were identified. Respiratory microorganisms were detected in all samples at both measurement time points, with a large variance between different patients. Only after four weeks, Candida species were identified on all materials but not in all participants. Candida species and respiratory microorganisms accumulate on various denture base resins. While no significant differences were identified between the materials, there was a tendency towards a more pronounced accumulation of microorganisms on conventionally processed PMMA.
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Affiliation(s)
- Anne Schmutzler
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
| | - Catalina Suzana Stingu
- Institute for Medical Microbiology and Virology, Leipzig University Clinics, 04103 Leipzig, Germany
| | - Elena Günther
- Department of Prosthetic Dentistry and Dental Materials Science, Leipzig University, 04103 Leipzig, Germany
| | - Reinhold Lang
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
| | - Florian Fuchs
- Department of Prosthetic Dentistry and Dental Materials Science, Leipzig University, 04103 Leipzig, Germany
| | - Andreas Koenig
- Department of Prosthetic Dentistry and Dental Materials Science, Leipzig University, 04103 Leipzig, Germany
| | - Angelika Rauch
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
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Lehfeld AS, Reber F, Lewandowsky MM, Jahn HJ, Lück C, Petzold M, Schaefer B, Germelmann AR, Lorenz K, Buchholz U. Could oral hygiene prevent cases of at-home-acquired Legionnaires' disease? - Results of a comprehensive case-control study on infection sources, risk, and protective behaviors. Front Microbiol 2023; 14:1199572. [PMID: 37396377 PMCID: PMC10311500 DOI: 10.3389/fmicb.2023.1199572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The "LeTriWa study" on community-acquired cases of Legionnaires' disease (LD) found that most cases likely acquired their infection at home (AHALD). However, which sources confer the infection is largely unknown. We therefore analyzed the data set from the LeTriWa study to find out if individual sources were associated with AHALD and if specific behavioral habits may increase or lower the risk for AHALD. Methods During the study we had used two comparison groups: (i) controls matched for age group and hospital ("controls"), (ii) household members of cases with AHALD ("AHALD-HHM"). We inquired about exposure to water sources, such as showering or wearing dentures, as well as behavioral factors and habits related to oral hygiene. We took standardized household bathroom water and biofilm samples of both cases with AHALD and controls, and in addition from households of cases with AHALD only samples from suspect residential (non-)drinking water sources. We first conducted bivariate analyses for infection sources and behaviors, followed by multivariable analyses. Results There were 124 cases with AHALD, 217 controls and 59 AHALD-HHM. In bivariate analyses using controls for comparison, wearing dentures was the only variable significantly positively associated (odds ratio (OR) = 1.7, 95% confidence interval (CI) = 1.1-2.7, p-value = 0.02). Behavioral factors such as showering, letting water run before use and not being alcohol abstinent were significantly negatively associated, smoking was significantly positively associated. In a multivariable analysis, we identified good oral hygiene as a preventive factor for both denture wearers (OR = 0.33, 95% CI = 0.13-0.83, p-value = 0.02) and non-denture wearers (OR = 0.32, 95% CI = 0.10-1.04, p-value = 0.06). Analyses of comparisons with AHALD-HHM showed similar effects but lacked statistical power. We identified Legionella in 16 residential (non-)drinking water sources, one of which was a PCR-positive scratch sample of dentures. Discussion Wearing (inadequately cleaned) dentures or poor oral hygiene might confer an increased risk for AHALD, and oral hygiene may prevent AHALD. The hypothesis that Legionella in oral biofilm or dental plaque may be the cause of cases with AHALD should be examined further. If confirmed this may open new and simple avenues for the prevention of LD.
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Affiliation(s)
- Ann-Sophie Lehfeld
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Franziska Reber
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Marina M. Lewandowsky
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Heiko J. Jahn
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Christian Lück
- Faculty of Medicine Carl Gustav Carus, Institute of Medical Microbiology and Virology, National Consulting Laboratory for Legionella, Technische Universität Dresden, Dresden, Germany
| | - Markus Petzold
- Faculty of Medicine Carl Gustav Carus, Institute of Medical Microbiology and Virology, National Consulting Laboratory for Legionella, Technische Universität Dresden, Dresden, Germany
| | - Benedikt Schaefer
- Section II 3.5 Microbiology of Drinking Water and Swimming Pool Water, German Environment Agency, Bad Elster, Germany
| | | | - Katrin Lorenz
- Department of Periodontology, Technische Universität Dresden, Dresden, Germany
| | - Udo Buchholz
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
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