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Leventis M, Deliberador T, Alshehri F, Alghamdi H. Topical oxygen therapy as a novel strategy to promote wound healing and control the bacteria in implantology, oral surgery and periodontology: A review. Saudi Dent J 2024; 36:841-854. [PMID: 38883907 PMCID: PMC11178966 DOI: 10.1016/j.sdentj.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 06/18/2024] Open
Abstract
Globally, oral infections and inflammatory lesions persist as substantial public health concerns, necessitating the introduction of novel oral treatment protocols. Oral diseases are linked to various causative factors, with dental plaque/biofilm resulting from inadequate hygiene practices playing a predominant role. The strategic implementation of novel topical therapies holds promise for effectively controlling the biofilms, addressing oral infections and promoting enhanced oral wound healing. This review aims to providing a comprehensive overview of the available evidence pertaining to the potential efficacy of topical oxygen and lactoferrin-releasing biomaterials, exemplified by the blue®m formula, as novel oral care interventions within the scope of contemporary implantology, oral surgery and periodontology.
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Affiliation(s)
- Minas Leventis
- Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian University of Athens, Greece
| | - Tatiana Deliberador
- Department of Periodontics, Saveetha Dental College, Chennai, India, and Latin American Institute of Dental Research and Education - ILAPEO, Curitiba/PR, Brazil
| | - Fahad Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hamdan Alghamdi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Del Rey YC, Parize H, Assar S, Göstemeyer G, Schlafer S. Effect of mutanase and dextranase on biofilms of cariogenic bacteria: A systematic review of in vitro studies. Biofilm 2024; 7:100202. [PMID: 38846328 PMCID: PMC11154121 DOI: 10.1016/j.bioflm.2024.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Matrix-degrading enzymes are promising non-biocidal adjuncts to dental biofilm control and caries prevention. By disrupting the biofilm matrix structure, enzymes may prevent biofilm formation or disperse established biofilms without compromising the microbial homeostasis in the mouth. This study reviewed whether treatment with mutanase and/or dextranase inhibits cariogenic biofilm growth and/or removes cariogenic biofilms in vitro. An electronic search was conducted in PubMed, EMBASE, Scopus, Web of Science, Cochrane, and LIVIVO databases. Manual searches were performed to identify additional records. Studies that quantitatively measured the effect of mutanase and/or dextranase on the inhibition/removal of in vitro cariogenic biofilms were considered eligible for inclusion. Out of 809 screened records, 34 articles investigating the effect of dextranase (n = 23), mutanase (n = 10), and/or combined enzyme treatment (n = 7) were included in the review. The overall risk of bias of the included studies was moderate. Most investigations used simple biofilm models based on one or few bacterial species and employed treatment times ≥30 min. The current evidence suggests that mutanase and dextranase, applied as single or combined treatment, are able to both inhibit and remove in vitro cariogenic biofilms. The pooled data indicate that enzymes are more effective for biofilm inhibition than removal, and an overall higher effect of mutanase compared to dextranase was observed.
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Affiliation(s)
- Yumi C. Del Rey
- Section for Oral Ecology, Cariology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark
| | - Hian Parize
- Department of Prosthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Sahar Assar
- Section for Oral Ecology, Cariology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark
| | - Gerd Göstemeyer
- Department of Operative, Preventive and Pediatric Dentistry, Charité – Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Sebastian Schlafer
- Section for Oral Ecology, Cariology, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, 8000, Aarhus C, Denmark
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Laumen JGE, Van Dijck C, Manoharan-Basil SS, de Block T, Abdellati S, Xavier BB, Malhotra-Kumar S, Kenyon C. The effect of daily usage of Listerine Cool Mint mouthwash on the oropharyngeal microbiome: a substudy of the PReGo trial. J Med Microbiol 2024; 73. [PMID: 38833520 DOI: 10.1099/jmm.0.001830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Introduction. ListerineÒ is a bactericidal mouthwash widely used to prevent oral health problems such as dental plaque and gingivitis. However, whether it promotes or undermines a healthy oral microbiome is unclear.Hypothesis/Gap Statement. We hypothesized that the daily use of Listerine Cool Mint would have a significant impact on the oropharyngeal microbiome.Aim. We aimed to assess if daily usage of Listerine Cool Mint influenced the composition of the pharyngeal microbiome.Methodology. The current microbiome substudy is part of the Preventing Resistance in Gonorrhoea trial. This was a double-blind single-centre, crossover, randomized controlled trial of antibacterial versus placebo mouthwash to reduce the incidence of gonorrhoea/chlamydia/syphilis in men who have sex with men (MSM) taking HIV pre-exposure prophylaxis (PrEP). Fifty-nine MSM taking HIV PrEP were enrolled. In this crossover trial, participants received 3 months of daily Listerine followed by 3 months of placebo mouthwash or vice versa. Oropharyngeal swabs were taken at baseline and after 3 months use of each mouthwash. DNA was extracted for shotgun metagenomic sequencing (Illumina Inc.). Non-host reads were taxonomically classified with MiniKraken and Bracken. The alpha and beta diversity indices were compared between baseline and after each mouthwash use. Differentially abundant bacterial taxa were identified using ANOVA-like differential expression analysis.Results. Streptococcus was the most abundant genus in most samples (n = 103, 61.7 %) with a median relative abundance of 31.5% (IQR 20.6-44.8), followed by Prevotella [13.5% (IQR 4.8-22.6)] and Veillonella [10.0% (IQR 4.0-16.8)]. Compared to baseline, the composition of the oral microbiome at the genus level (beta diversity) was significantly different after 3 months of Listerine (P = 0.006, pseudo-F = 2.29) or placebo (P = 0.003, pseudo-F = 2.49, permutational multivariate analysis of variance) use. Fusobacterium nucleatum and Streptococcus anginosus were significantly more abundant after Listerine use compared to baseline.Conclusion. Listerine use was associated with an increased abundance of common oral opportunistic bacteria previously reported to be enriched in periodontal diseases, oesophageal and colorectal cancer, and systemic diseases. These findings suggest that the regular use of Listerine mouthwash should be carefully considered.
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Affiliation(s)
- J G E Laumen
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - C Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S S Manoharan-Basil
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
| | - T de Block
- Department of Clinical Sciences, Clinical Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - S Abdellati
- Department of Clinical Sciences, Clinical Reference Laboratory, Institute of Tropical Medicine, Antwerp, Belgium
| | - B B Xavier
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - S Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - C Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, STI Unit, Antwerp, Belgium
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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Li Y, Stewart CA, Finer Y. Advanced Antimicrobial and Anti-Infective Strategies to Manage Peri-Implant Infection: A Narrative Review. Dent J (Basel) 2024; 12:125. [PMID: 38786523 PMCID: PMC11120417 DOI: 10.3390/dj12050125] [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: 03/12/2024] [Revised: 04/21/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Despite reductions in bacterial infection and enhanced success rate, the widespread use of systemic antibiotic prophylaxis in implant dentistry is controversial. This use has contributed to the growing problem of antimicrobial resistance, along with creating significant health and economic burdens. The basic mechanisms that cause implant infection can be targeted by new prevention and treatment methods which can also lead to the reduction of systemic antibiotic exposure and its associated adverse effects. This review aims to summarize advanced biomaterial strategies applied to implant components based on anti-pathogenic mechanisms and immune balance mechanisms. It emphasizes that modifying the dental implant surface and regulating the early immune response are promising strategies, which may further prevent or slow the development of peri-implant infection, and subsequent failure.
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Affiliation(s)
- Yihan Li
- Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6, Canada; (Y.L.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6, Canada; (Y.L.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, ON M5S 3E2, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, 124 Edward St., Toronto, ON M5G 1G6, Canada; (Y.L.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, ON M5S 3E2, Canada
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Wojtyłko M, Froelich A, Jadach B. Hypromellose-, Gelatin- and Gellan Gum-Based Gel Films with Chlorhexidine for Potential Application in Oral Inflammatory Diseases. Gels 2024; 10:265. [PMID: 38667684 PMCID: PMC11048945 DOI: 10.3390/gels10040265] [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: 03/29/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
The oral cavity is constantly exposed to contact with an external environment. Pathogens can easily access and colonize it, causing a number of medical conditions that are usually accompanied by inflammation, which in turn require medical intervention and cause the deterioration of wellbeing. The aim of this study was to obtain polymer films that could be a carrier for chlorhexidine, an active substance used in the treatment of inflammation in the oral cavity, and at the same time act as a dressing for the application on the mucous membrane. Combinations of three biocompatible and biodegradable polymers were used to prepare the films. The obtained samples were characterized by assessing their water loss after drying, swelling ability, hygroscopicity and tensile strength. It was shown that the mixture of HPMC and gellan gum or gelatin could be used to prepare transparent, flexible polymer films with chlorhexidine. All tested films showed high hygroscopicity and swelling ability. However, it was observed that the composition containing gellan gum was more suitable for obtaining films with prolonged stay at the site of administration, which predisposes it to the role of a local dressing.
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Affiliation(s)
- Monika Wojtyłko
- 3D Printing Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznań, Poland
- Doctoral School, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812 Poznań, Poland
| | - Anna Froelich
- 3D Printing Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznań, Poland
| | - Barbara Jadach
- Division of Industrial Pharmacy, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 3 Rokietnicka Street, 60-806 Poznań, Poland
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Goh CE, Bohn B, Genkinger JM, Molinsky R, Roy S, Paster BJ, Chen CY, Yuzefpolskaya M, Colombo PC, Rosenbaum M, Knight R, Desvarieux M, Papapanou PN, Jacobs DR, Demmer RT. Dietary nitrate intake and net nitrite-generating capacity of the oral microbiome interact to enhance cardiometabolic health: Results from the Oral Infections Glucose Intolerance and Insulin Resistance Study (ORIGINS). MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.10.24305636. [PMID: 38645157 PMCID: PMC11030477 DOI: 10.1101/2024.04.10.24305636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background We investigated the association between dietary nitrate intake and early clinical cardiometabolic risk biomarkers, and explored whether the oral microbiome modifies the association between dietary nitrate intake and cardiometabolic biomarkers. Methods Cross-sectional data from 668 (mean [SD] age 31 [9] years, 73% women) participants was analyzed. Dietary nitrate intakes and alternative healthy eating index (AHEI) scores were calculated from food frequency questionnaire responses and a validated US food database. Subgingival 16S rRNA microbial genes (Illumina, MiSeq) were sequenced, and PICRUSt2 estimated metagenomic content. The Microbiome Induced Nitric oxide Enrichment Score (MINES) was calculated as a microbial gene abundance ratio representing enhanced net capacity for NO generation. Cardiometabolic risk biomarkers included systolic and diastolic blood pressure, HbA1c, glucose, insulin, and insulin resistance (HOMA-IR), and were regressed on nitrate intake tertiles in adjusted multivariable linear models. Results Mean nitrate intake was 190[171] mg/day. Higher nitrate intake was associated with lower insulin, and HOMA-IR but particularly among participants with low abundance of oral nitrite enriching bacteria. For example, among participants with a low MINES, mean insulin[95%CI] levels in high vs. low dietary nitrate consumers were 5.8[5.3,6.5] vs. 6.8[6.2,7.5] (p=0.004) while respective insulin levels were 6.0[5.4,6.6] vs. 5.9[5.3,6.5] (p=0.76) among partcipants with high MINES (interaction p=0.02). Conclusion Higher dietary nitrate intake was only associated with lower insulin and insulin resistance among individuals with reduced capacity for oral microbe-induced nitrite enrichment. These findings have implications for future precision medicine-oriented approaches that might consider assessing the oral microbiome prior to enrollment into dietary interventions or making dietary recommendations.
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Affiliation(s)
- Charlene E Goh
- Faculty of Dentistry, National University of Singapore, Singapore
| | - Bruno Bohn
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jeanine M Genkinger
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA
| | - Rebecca Molinsky
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Sumith Roy
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Bruce J Paster
- The Forsyth Institute, Cambridge, MA, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Ching-Yuan Chen
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - Melana Yuzefpolskaya
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Paolo C Colombo
- Division of Cardiology, Department of Medicine, New York Presbyterian Hospital, Columbia University, New York, NY, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics, Departments of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | - Rob Knight
- Department of Computer Science & Engineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
| | - Moïse Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- INSERM UMR 1153, Centre de Recherche Epidemiologie et Statistique Paris Sorbonne Cité (CRESS), METHODS Core, Paris, France
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Ryan T Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, College of Medicine and Science
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Chai X, Liu L, Chen F. Oral nitrate-reducing bacteria as potential probiotics for blood pressure homeostasis. Front Cardiovasc Med 2024; 11:1337281. [PMID: 38638884 PMCID: PMC11024454 DOI: 10.3389/fcvm.2024.1337281] [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: 11/17/2023] [Accepted: 03/12/2024] [Indexed: 04/20/2024] Open
Abstract
Hypertension is a leading cause of morbidity and mortality worldwide and poses a major risk factor for cardiovascular diseases and chronic kidney disease. Research has shown that nitric oxide (NO) is a vasodilator that regulates vascular tension and the decrease of NO bioactivity is considered one of the potential pathogenesis of essential hypertension. The L-arginine-nitric oxide synthase (NOS) pathway is the main source of endogenous NO production. However, with aging or the onset of diseases, the function of the NOS system becomes impaired, leading to insufficient NO production. The nitrate-nitrite-NO pathway allows for the generation of biologically active NO independent of the NOS system, by utilizing endogenous or dietary inorganic nitrate and nitrite through a series of reduction cycles. The oral cavity serves as an important interface between the body and the environment, and dysbiosis or disruption of the oral microbiota has negative effects on blood pressure regulation. In this review, we explore the role of oral microbiota in maintaining blood pressure homeostasis, particularly the connection between nitrate-reducing bacteria and the bioavailability of NO in the bloodstream and blood pressure changes. This review aims to elucidate the potential mechanisms by which oral nitrate-reducing bacteria contribute to blood pressure homeostasis and to highlight the use of oral nitrate-reducing bacteria as probiotics for oral microbiota intervention to prevent hypertension.
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Affiliation(s)
- Xiaofen Chai
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Libing Liu
- Department of Nutrition and Health, China Agricultural University, Beijing, China
| | - Feng Chen
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
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Yazicioglu O, Ucuncu MK, Guven K. Ingredients in Commercially Available Mouthwashes. Int Dent J 2024; 74:223-241. [PMID: 37709645 PMCID: PMC10988267 DOI: 10.1016/j.identj.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Mouthwashes, a cornerstone of oral and dental hygiene, play a pivotal role in combating the formation of dental plaque, a leading cause of periodontal disease and dental caries. This study aimed to review the composition of mouthwashes found on retail shelves in Turkey and evaluate their prevalence and side effects, if any. METHODS The mouthwashes examined were sourced from the 5 largest chain stores in each district of Istanbul. A comprehensive list of the constituents was meticulously recorded. The research was supported by an extensive compilation of references from scholarly databases such as Google Scholar, PubMed, and ScienceDirect. Through rigorous analysis, the relative proportions of mouthwash ingredients and components were determined. RESULTS A total of 45 distinctive variations of mouthwashes, representing 17 prominent brands, were identified. Amongst the 116 ingredients discovered, 70 were evaluated for potential adverse effects and undesirable side effects. The aroma of the mouthwash (n = 45; 100%), as welll as their sodium fluoride (n = 28; 62.22%), sodium saccharin (n = 29; 64.44%), sorbitol (n = 21; 46.6%), and propylene glycol (n = 28; 62.22%) content were the main undesireable features. CONCLUSIONS The limited array of mouthwashes found on store shelves poses a concern for both oral and public health. Furthermore, the intricate composition of these products, consisting of numerous ingredients with the potential for adverse effects, warrants serious attention. Both clinicians and patients should acknowledge the importance and unwarranted side effects of the compnents of the mouthwashes.
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Affiliation(s)
- Oktay Yazicioglu
- Istanbul University, Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - Musa Kazim Ucuncu
- Altinbas University, Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey.
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Paiva B, Laranjinha J, Rocha BS. Do oral and gut microbiota communicate through redox pathways? A novel asset of the nitrate-nitrite-NO pathway. FEBS Lett 2024. [PMID: 38523057 DOI: 10.1002/1873-3468.14859] [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: 12/12/2023] [Revised: 02/16/2024] [Accepted: 02/29/2024] [Indexed: 03/26/2024]
Abstract
Nitrate may act as a regulator of •NO bioavailability via sequential reduction along the nitrate-nitrite-NO pathway with widespread health benefits, including a eubiotic effect on the oral and gut microbiota. Here, we discuss the molecular mechanisms of microbiota-host communication through redox pathways, via the production of •NO and oxidants by the family of NADPH oxidases, namely hydrogen peroxide (via Duox2), superoxide radical (via Nox1 and Nox2) and peroxynitrite, which leads to downstream activation of stress responses (Nrf2 and NFkB pathways) in the host mucosa. The activation of Nox2 by microbial metabolites is also discussed. Finally, we propose a new perspective in which both oral and gut microbiota communicate through redox pathways, with nitrate as the pivot linking both ecosystems.
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Affiliation(s)
- Beatriz Paiva
- Faculty of Pharmacy, University of Coimbra, Portugal
| | - João Laranjinha
- Faculty of Pharmacy, University of Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, Portugal
| | - Bárbara S Rocha
- Faculty of Pharmacy, University of Coimbra, Portugal
- Center for Neuroscience and Cell Biology, University of Coimbra, Portugal
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Rath A, Wong M, Li K, Wong A, Tan L, Tan K, Pannuti CM. Efficacy of adjunctive octenidine hydrochloride as compared to chlorhexidine and placebo as adjuncts to instrumentation in stage I-II periodontitis: A double-blinded randomized controlled trial. Int J Dent Hyg 2024. [PMID: 38461488 DOI: 10.1111/idh.12795] [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: 06/01/2021] [Revised: 10/02/2023] [Accepted: 02/25/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVES This randomized, controlled, double-blinded clinical trial aimed to evaluate the efficacy of octenidine hydrochloride and chlorhexidine mouthwashes as adjuncts to instrumentation in stage I-II periodontitis patients. METHODS Forty-five patients with mild-to-moderate periodontitis were randomly allocated to three groups: 0.1% octenidine dihydrochloride (OCT), placebo, and 0.12% chlorhexidine (CHX) mouthwashes. Patients were instructed to use the mouthwash after instrumentation for twice a day up to 3 weeks. Periodontal parameters such as probing pocket depth (PPD), clinical attachment loss (CAL), O'Leary plaque index (PI), Loe and Silness gingival index (GI), Lobene stain index (SI), and oral soft tissue changes were recorded at baseline and once every week for 3 weeks. The visual analogue scale (VAS) was also recorded as a self-administered questionnaire at the end of the study. The one-way ANOVA was used to compare VAS scores between the groups. The repeated measures ANOVA and post hoc Newman-Keuls tests were used to assess the differences in the periodontal parameters between groups at different time intervals. The Kruskal-Wallis test was used to compare the mean SI. RESULTS There was a significant reduction in the mean GI of the OCT and CHX groups compared to placebo (p < 0.05). OCT usage resulted in significantly less staining, according to mean SI, when compared to CHX. Furthermore, VAS scores revealed that OCT was significantly the preferred mouthwash (p < 0.01). CONCLUSION Adjunctive octenidine hydrochloride may be an alternative to chlorhexidine in its ability to control the periodontal parameters in patients with stage I-II periodontitis. Further larger studies are necessary to confirm these findings.
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Affiliation(s)
- Avita Rath
- Faculty of Dentistry, SEGi University, Petaling Jaya, Malaysia
| | - Melissa Wong
- Faculty of Dentistry, SEGi University, Petaling Jaya, Malaysia
| | - Keehon Li
- Ministry of Health, Putrajaya, Wilayah Perseketuan Putrajaya, Malaysia
| | - Amanda Wong
- Ministry of Health, Putrajaya, Wilayah Perseketuan Putrajaya, Malaysia
| | - Lisa Tan
- Ministry of Health, Putrajaya, Wilayah Perseketuan Putrajaya, Malaysia
| | - Kenneth Tan
- Ministry of Health, Putrajaya, Wilayah Perseketuan Putrajaya, Malaysia
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Moran SP, Rosier BT, Henriquez FL, Burleigh MC. The effects of nitrate on the oral microbiome: a systematic review investigating prebiotic potential. J Oral Microbiol 2024; 16:2322228. [PMID: 38420038 PMCID: PMC10901185 DOI: 10.1080/20002297.2024.2322228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Background Nitrate (NO3-) has been suggested as a prebiotic for oral health. Evidence indicates dietary nitrate and nitrate supplements can increase the proportion of bacterial genera associated with positive oral health whilst reducing bacteria implicated in oral disease(s). In contrast, chlorhexidine-containing mouthwashes, which are commonly used to treat oral infections, promote dysbiosis of the natural microflora and may induce antimicrobial resistance. Methods A systematic review of the literature was undertaken, surrounding the effects of nitrate on the oral microbiota. Results Overall, n = 12 in vivo and in vitro studies found acute and chronic nitrate exposure increased (representatives of) health-associated Neisseria and Rothia (67% and 58% of studies, respectively) whilst reducing periodontal disease-associated Prevotella (33%). Additionally, caries-associated Veillonella and Streptococcus decreased (25% for both genera). Nitrate also altered oral microbiome metabolism, causing an increase in pH levels (n = 5), which is beneficial to limit caries development. Secondary findings highlighted the benefits of nitrate for systemic health (n = 5). Conclusions More clinical trials are required to confirm the impact of nitrate on oral communities. However, these findings support the hypothesis that nitrate could be used as an oral health prebiotic. Future studies should investigate whether chlorhexidine-containing mouthwashes could be replaced or complemented by a nitrate-rich diet or nitrate supplementation.
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Affiliation(s)
- Siobhan P. Moran
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK
| | - Bob T. Rosier
- Department of Health and Genomics, Center for Advanced Research in Public Health, FISABIO Foundation, Valencia, Spain
| | - Fiona L. Henriquez
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK
| | - Mia C. Burleigh
- School of Health and Life Sciences, University of the West of Scotland, Blantyre, UK
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Carvalho LRRA, Boeder AM, Shimari M, Kleschyov AL, Esberg A, Johansson I, Weitzberg E, Lundberg JO, Carlstrom M. Antibacterial mouthwash alters gut microbiome, reducing nutrient absorption and fat accumulation in Western diet-fed mice. Sci Rep 2024; 14:4025. [PMID: 38369624 PMCID: PMC10874955 DOI: 10.1038/s41598-024-54068-y] [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: 11/02/2023] [Accepted: 02/08/2024] [Indexed: 02/20/2024] Open
Abstract
Prolonged use of antibacterial mouthwash is linked to an increased risk of systemic disease. We aimed to investigate if disturbing the oral microbiota would impact the lower gut microbiome with functional effects in diet-induced obesity. Mice were exposed to oral chlorhexidine and fed a Western diet (WD). Food intake and weight gain were monitored, and metabolic function, blood pressure, and microbiota were analyzed. Chlorhexidine reduced the number of viable bacteria in the mouth and lowered species richness in the gut but with proportional enrichment of some bacteria linked to metabolic pathways. In mice fed a Western diet, chlorhexidine reduced weight gain, body fat, steatosis, and plasma insulin without changing caloric intake, while increasing colon triglycerides and proteins, suggesting reduced absorption of these nutrients. The mechanisms behind these effects as well as the link between the oral microbiome and small intestinal function need to be pinpointed. While the short-term effects of chlorhexidine in this model appear beneficial, potential long-term disruptions in the oral and gut microbiota and possible malabsorption should be considered.
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Affiliation(s)
| | - Ariela M Boeder
- Department of Physiology and Pharmacology, Karolinska Institutet, Biomedicum, 5B, 17165, Solna, Stockholm, Sweden
- Department of Pharmacology, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Miho Shimari
- Department of Physiology and Pharmacology, Karolinska Institutet, Biomedicum, 5B, 17165, Solna, Stockholm, Sweden
| | - Andrei L Kleschyov
- Department of Physiology and Pharmacology, Karolinska Institutet, Biomedicum, 5B, 17165, Solna, Stockholm, Sweden
| | - Anders Esberg
- Department of Odontology, Umeå University, Umeå, Sweden
| | | | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Biomedicum, 5B, 17165, Solna, Stockholm, Sweden
- Department of Perioperative Medicine and Intensive Care, Karolinska Hospital, Stockholm, Sweden
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Biomedicum, 5B, 17165, Solna, Stockholm, Sweden.
| | - Mattias Carlstrom
- Department of Physiology and Pharmacology, Karolinska Institutet, Biomedicum, 5B, 17165, Solna, Stockholm, Sweden.
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Czarnowski M, Słowińska M, Sawieljew M, Wnorowska U, Daniluk T, Król G, Karasiński M, Okła S, Savage PB, Piktel E, Bucki R. Efficacy of Ceragenins in Controlling the Growth of Oral Microorganisms: Implications for Oral Hygiene Management. Pharmaceuticals (Basel) 2024; 17:204. [PMID: 38399419 PMCID: PMC10893225 DOI: 10.3390/ph17020204] [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: 12/06/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Ensuring proper dental hygiene is of paramount importance for individuals' general well-being, particularly for patients receiving medical care. There is a prevailing utilization of conventional oral hygiene items, including toothbrushes and mouthwashes, which have gained widespread acceptance; nevertheless, their limitations encourage investigating novel options in this domain. Our study indicates that ceragenins (CSAs) being lipid analogs of host defense peptides, well-recognized for their wide-ranging antimicrobial properties, may be a potentially efficacious means to augment oral hygiene in hospitalized individuals. We demonstrate that ceragenins CSA-13, CSA-44, and CSA-131 as well as undescribed to date CSA-255 display potent antimicrobial activities against isolates of fungi, aerobic, and anaerobic bacteria from Candida, Streptococcus, Enterococcus, and Bacteroides species, which are well-recognized representatives of microbes found in the oral cavity. These effects were further confirmed against mono- and dual-species fungal and bacterial biofilms. While the ceragenins showed similar or slightly diminished efficacy compared to commercially available mouthwashes, they demonstrated a highly favorable toxicity profile toward host cells, that may translate into better maintenance of host mucosal membrane stability. This suggests that incorporating ceragenins into oral hygiene products could be a valuable strategy for reducing the risk of both oral cavity-localized and secondary systemic infections and for improving the overall health outcomes of individuals receiving medical treatment.
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Affiliation(s)
- Michał Czarnowski
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
| | - Monika Słowińska
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
| | - Mariusz Sawieljew
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
| | - Urszula Wnorowska
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
| | - Tamara Daniluk
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
| | - Grzegorz Król
- Institute of Medical Science, Collegium Medicum, Jan Kochanowski University of Kielce, 25-317 Kielce, Poland; (G.K.); (S.O.)
| | - Maciej Karasiński
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
| | - Sławomir Okła
- Institute of Medical Science, Collegium Medicum, Jan Kochanowski University of Kielce, 25-317 Kielce, Poland; (G.K.); (S.O.)
- Holy Cross Cancer Center, 25-734 Kielce, Poland
| | - Paul B. Savage
- Department of Chemistry and Biochemistry, Brigham Young University, Provo, UT 84602, USA;
| | - Ewelina Piktel
- Independent Laboratory of Nanomedicine, Medical University of Białystok, 15-222 Białystok, Poland;
| | - Robert Bucki
- Department of Medical Microbiology and Nanobiomedical Engineering, Medical University of Białystok, 15-222 Białystok, Poland; (M.C.); (M.S.); (M.S.); (U.W.); (T.D.); (M.K.)
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14
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Farook FF, Alnasyan B, Alhamid R, AlAmri Z, Alshammari A, Nizam MNM, Alorf RA. Association between mouth rinse use and changes in blood pressure: A systematic review and meta-analysis with trial sequential analysis. Int J Dent Hyg 2024; 22:65-77. [PMID: 37486884 DOI: 10.1111/idh.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 12/26/2022] [Accepted: 06/14/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Previous randomized controlled trials have shown that the use of antiseptic mouth rinses not only eradicates oral bacteria but also disrupts their ability to convert nitrate to nitrite, which is the key molecule in regulating blood pressure (BP). OBJECTIVE This study aimed to evaluate the association between the use of mouth rinses and changes in BP. METHODS The PubMed, Web of Science, EMBASE, Scopus, and Cochrane Library databases were systematically searched from their respective inception dates to 18th December 2022 to identify potential interventional studies with information on the association between the use of mouth rinse and changes in BP. Five trials using a controlled, crossover design were identified for data analysis. RESULTS The weighted mean difference was pooled using a random-effects model. The pooled results of five trials together showed that the use of mouth rinses did not result in a statistically or clinically significant increase in the systolic BP (SBP) (1.59 mmHg; 95% confidence interval [CI], -0.15 to 3.33) or diastolic BP (DBP) (0.46 mmHg; 95% CI, -0.72 to 1.64). The trial sequential analysis did not present conclusive evidence supporting the association between mouth rinse use and BP elevation. CONCLUSION Within the limits of the available evidence, our review and meta-analysis showed that mouth rinse use did not result in a statistically significant increase in the SBP, DBP, or mean arterial pressure (MAP). Nevertheless, the results should be interpreted cautiously due to the high degree of inconsistency across the studies.
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Affiliation(s)
- Fathima Fazrina Farook
- College of Dentistry, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Bothinah Alnasyan
- College of Dentistry, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Reem Alhamid
- College of Dentistry, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Zahra AlAmri
- College of Dentistry, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulsalam Alshammari
- College of Dentistry, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | | | - Roaa Ali Alorf
- College of Dentistry, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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15
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Vitiello F, Monterubbianesi R, Sparabombe S, Bourgeois D, Tosco V, Alshehri FA, Carrouel F, Putignano A, Orsini G. Use of over-the-counter mouthwashes as an additional measure in individual oral prophylaxis on adults with plaque-induced gingivitis: a double-blind, parallel, randomized controlled trial. BMC Oral Health 2024; 24:83. [PMID: 38229032 DOI: 10.1186/s12903-023-03779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Plaque-induced gingivitis is a chronic inflammatory condition characterized by complete reversibility of tissue damage once the periodontal biofilm has been disorganised. The aim of this study was to evaluate the efficacy of two commercially available mouthwashes (MWs) versus a chlorhexidine (CHX) 0.12% MW in reducing gingival bleeding (GB) in adults with plaque-induced gingivitis. METHODS The present study was a double-blind, parallel, randomized controlled trial involving 6492 gingival sites (i.e. 39 subjects × 28 teeth × 6 sites/tooth) aged 18-75 years. During a 2-week period, subjects were randomized to receive MWs: a control CHX 0.12% MW (group C, 1818 sites); a MW test containing CHX 0.09% + Citrox®/P complex (group CX, 2628 sites); a MW test based on natural compounds (group P, 2016 sites). GB was assessed at the inclusion visit (T0) and after 2 weeks of MW use (T1). Analyses of GB were compared between groups and then restricted to subjects with bleeding sites between 10 and 30% (moderate gingivitis) or ≥ 30% (severe gingivitis) at T0. Pairwise comparisons were made between groups and logistic regression was used to identify correlates of GB (T1). RESULTS For total bleeding site analysis, GB reduction between T0 and T1 ranged from 23% (C), 26% (CX) and 36% (P), respectively (all p < 0.05). Multiple comparison between groups showed that group C was significantly less effective (p < 0.05) than groups CX and P. Splitting the analysis, in patients with severe gingivitis (≥ 30% bleeding sites at T0), all MWs had a positive effect on GB with a reduction at T1 of 36% (C), 33% (CX) and 42% (P), respectively. While GB reduction between T0 and T1, was significant for all groups, the comparison among groups showed no significant difference between group C and CX, whereas the improvement was significant for group P. On the other hand, in adults with moderate gingivitis (< 30% bleeding sites at T0), only CX and P had a positive effect on GB reduction at T1(9% in CX and 2% in P, respectively), although the differences between the three groups were not significant. CONCLUSION The daily use of MWs with natural components (groups P and CX) for 2 weeks should be considered positively as an adjunct to individual oral prophylaxis to reduce GB compared to the control MW containing CHX 0.12% (group C) in healthy adults with plaque-induced gingivitis. For subjects with severe gingivitis, it is advisable to first use natural MW (P) and then MW based on CHX 0.09% with natural components (CX), compared to MW with CHX 0.12% (C). For adults with moderate gingivitis, P and CX can be advisable, even if no definitive recommendations can be drawn. TRIAL REGISTRATION ACTRN12622000215729, 07/02/2022.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Scilla Sparabombe
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Denis Bourgeois
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Fahad Ali Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia
| | - Florence Carrouel
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- National Institute of Health and Science of Aging (INRCA), Ancona, 60124, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy.
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16
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Cato LE, McKay AKA, L’Heureux JE, Vanhatalo A, Jones AM, Askew CD, Slater GJ, Burke LM. Low Carbohydrate, High Fat Diet Alters the Oral Microbiome without Negating the Nitrite Response to Beetroot Juice Supplementation. Nutrients 2023; 15:5123. [PMID: 38140382 PMCID: PMC10745889 DOI: 10.3390/nu15245123] [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: 10/17/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
A low carbohydrate, high fat (LCHF) diet in athletes increases fat oxidation but impairs sports performance, potentially due to impaired exercise economy. Dietary nitrate supplementation can improve exercise economy via an increase in nitric oxide production, which is initiated by the reduction of nitrate to nitrite within the oral cavity. This reaction is dependent on the presence of nitrate-reducing oral bacteria, which can potentially be altered by dietary changes, including a LCHF diet. This study explored the effect of a LCHF diet on the oral microbiome and subsequent changes to plasma nitrite concentration following nitrate supplementation. Following five days of LCHF or high carbohydrate (HCHO) control dietary intervention, highly trained male race walkers consumed 140 mL beetroot juice containing 8.4 mmol nitrate; they then provided (a) blood samples for plasma nitrate and nitrite analysis and (b) saliva samples for 16S rRNA sequencing of the oral microbiome. The LCHF diet (n = 13) reduced oral bacterial diversity and changed the relative abundance of the genera Neisseria (+10%), Fusobacteria (+3%), Prevotella (-9%), and Veillonella (-4%), with no significant changes observed following the HCHO diet (n = 11). Following beetroot juice ingestion, plasma nitrite concentrations were higher for the LCHF diet compared to the HCHO diet (p = 0.04). However, the absence of an interaction with the trial (pre-post) (p = 0.71) suggests that this difference was not due to the dietary intervention. In summary, we found an increase in plasma nitrate and nitrite concentrations in response to nitrate supplementation independent of diet. This suggests the oral microbiome is adaptive to dietary changes and can maintain a nitrate reduction capacity despite a decrease in bacterial diversity following the LCHF diet.
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Affiliation(s)
- Louise E. Cato
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia; (C.D.A.); (G.J.S.)
| | - Alannah K. A. McKay
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.K.A.M.); (L.M.B.)
| | - Joanna E. L’Heureux
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK; (J.E.L.); (A.V.); (A.M.J.)
| | - Anni Vanhatalo
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK; (J.E.L.); (A.V.); (A.M.J.)
| | - Andrew M. Jones
- University of Exeter Medical School, University of Exeter, Exeter EX1 2LU, UK; (J.E.L.); (A.V.); (A.M.J.)
| | - Christopher D. Askew
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia; (C.D.A.); (G.J.S.)
| | - Gary J. Slater
- School of Health, University of the Sunshine Coast, Maroochydore, QLD 4558, Australia; (C.D.A.); (G.J.S.)
| | - Louise M. Burke
- Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia; (A.K.A.M.); (L.M.B.)
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Doble A, Bescos R, Witton R, Shivji S, Brookes Z. Uncontrolled hypertension at the dentist: a case report of integrated healthcare. Br Dent J 2023; 235:866-868. [PMID: 38066140 DOI: 10.1038/s41415-023-6546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/10/2023] [Accepted: 08/22/2023] [Indexed: 12/18/2023]
Abstract
Hypertension is a risk factor for major cardiovascular events and it is usually detected and managed by general medical practitioners (GPs) in primary care. However, it is estimated that 4.8 million adults are living with untreated high blood pressure (BP) in the UK. Health authorities are encouraging more collaborative work across health professions to find and refer individuals with undiagnosed hypertension. In this case, in 2022, a 65-year-old man with a previous history of hypertension, taking antihypertensive medication, attended a BP clinic at the University of Plymouth, Peninsula Dental School as part of a hypertension case finding pilot. His systolic and diastolic BP were 150 and 85 mmHg, respectively, and as per the trial protocol, a referral letter was sent to his GP for suspected further assessment and investigation. Then, an onward referral was made to secondary care and the participant was subsequently hospitalised for 13 days for treatment of heart failure and suspected acute coronary syndrome. This case report highlights that BP readings taken in a primary care dental setting can be very useful and recommends better integration of dental services into primary care to reduce the risk of major cardiovascular events.
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Affiliation(s)
- Amazon Doble
- Peninsula Dental School, University of Plymouth, United Kingdom.
| | - Raul Bescos
- School of Health Professions, University of Plymouth, Plymouth, PL4 8AA, United Kingdom
| | - Robert Witton
- Peninsula Dental School, University of Plymouth, United Kingdom
| | - Shabir Shivji
- Office of the Chief Dental Officer, London, SE1 6LH, United Kingdom
| | - Zoë Brookes
- Peninsula Dental School, University of Plymouth, United Kingdom
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18
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Ashfaq R, Sisa B, Kovács A, Berkó S, Szécsényi M, Burián K, Vályi P, Budai-Szűcs M. Factorial design of in situ gelling two-compartment systems containing chlorhexidine for the treatment of periodontitis. Eur J Pharm Sci 2023; 191:106607. [PMID: 37821010 DOI: 10.1016/j.ejps.2023.106607] [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: 05/22/2023] [Revised: 09/15/2023] [Accepted: 10/09/2023] [Indexed: 10/13/2023]
Abstract
Periodontitis is one of the most widespread bacterial infectious oral diseases that affects a significant percentage of the population worldwide. Different bacterial strains are responsible for the chronic inflammation and subgingival plaque that could be effectively treated with prolonged exposure to therapeutic levels of antibiotics and antiseptics in the periodontal pockets. Medicated in situ gels of chlorhexidine (CHX), for extended drug release and long-lasting antiseptic effect in the targeted cavities, were prepared in a two-compartment system. One compartment was loaded with sodium alginate solution while other was filled with CHX and calcium solution. The mixing of the solutions during the application resulted in gelation. Two 33 full factorial designs were applied in this study in order to optimize the gel formulation. Initially, the effects of concentration of gelling agent, crosslinker, and pH of the system on the dependent variables such as gel formation and structure characteristics were investigated. Then, the concentration of the crosslinker was optimized. Afterwards, the effect of gelling agent, loading of the drug, and pH of the gel system were correlated with the gel characteristics through another factorial design. Optimized formulations were tested for mucoadhesion, in vitro drug release, and microbiological investigation. Based on the results of the factorial design, mucoadhesiveness, antimicrobial investigation, and drug release, a 4 % alginate composition can be considered optimal. Overall, the optimized in situ periodontal gel was found to be effective with prolonged retention time and desirable outcomes.
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Affiliation(s)
- Rabia Ashfaq
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Eötvös 6, Szeged H-6720, Hungary
| | - Bianka Sisa
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Eötvös 6, Szeged H-6720, Hungary
| | - Anita Kovács
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Eötvös 6, Szeged H-6720, Hungary
| | - Szilvia Berkó
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Eötvös 6, Szeged H-6720, Hungary
| | - Mária Szécsényi
- Department of Medical Microbiology, University of Szeged, Szeged H-6720, Hungary
| | - Katalin Burián
- Department of Medical Microbiology, University of Szeged, Szeged H-6720, Hungary
| | - Péter Vályi
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Budapest H-1088, Hungary
| | - Mária Budai-Szűcs
- Institute of Pharmaceutical Technology and Regulatory Affairs, Faculty of Pharmacy, University of Szeged, Eötvös 6, Szeged H-6720, Hungary.
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19
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Saha S, Boesch C, Maycock J, Wood S, Do T. Sweet Orange Juice Processing By-Product Extracts: A Caries Management Alternative to Chlorhexidine. Biomolecules 2023; 13:1607. [PMID: 38002290 PMCID: PMC10669069 DOI: 10.3390/biom13111607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Dental caries is one of the most prevalent chronic diseases globally in both children and adults. This study investigated the potential of industrial sweet orange waste extracts (ISOWE) as a substitute for chlorhexidine (CHX) in managing dental caries. First, the cytotoxicity of ISOWE (40, 80, 120 mg/mL) and CHX (0.1 and 0.2%) on buccal epithelial cells was determined. ISOWE exhibited no overall toxicity, whereas CHX strongly affected cell viability. The combination of ISOWE and CHX significantly enhanced cell proliferation compared to CHX alone. Next, the antimicrobial efficacy of ISOWE, CHX, and their combination was assessed against a 7-day complex biofilm model inoculated with oral samples from human volunteers. CHX exhibited indiscriminate antimicrobial action, affecting both pathogenic and health-associated oral microorganisms. ISOWE demonstrated lower antimicrobial efficacy than CHX but showed enhanced efficacy against pathogenic species while preserving the oral microbiome's balance. When applied to a cariogenic biofilm, the combined treatment of ISOWE with 0.1% CHX showed similar efficacy to 0.2% CHX treatment alone. Overall, the findings suggest that ISOWE is a promising natural anti-cariogenic agent with lower toxicity and enhanced selectivity for pathogenic species compared to CHX.
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Affiliation(s)
- Suvro Saha
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds LS2 9JT, UK; (S.S.)
- School of Dentistry, Division of Oral Biology, Faculty of Medicine & Health, University of Leeds, Leeds LS9 7TF, UK
| | - Christine Boesch
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds LS2 9JT, UK; (S.S.)
| | - Joanne Maycock
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds LS2 9JT, UK; (S.S.)
| | - Simon Wood
- School of Dentistry, Division of Oral Biology, Faculty of Medicine & Health, University of Leeds, Leeds LS9 7TF, UK
| | - Thuy Do
- School of Dentistry, Division of Oral Biology, Faculty of Medicine & Health, University of Leeds, Leeds LS9 7TF, UK
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20
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Brookes Z, Teoh L, Cieplik F, Kumar P. Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced? Int Dent J 2023; 73 Suppl 2:S74-S81. [PMID: 37867065 PMCID: PMC10690560 DOI: 10.1016/j.identj.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
This narrative review describes the oral microbiome, and its role in oral health and disease, before considering the impact of commonly used over-the-counter (OTC) mouthwashes on oral bacteria, viruses, bacteriophages, and fungi that make up these microbial communities in different niches of the mouth. Whilst certain mouthwashes have proven antimicrobial actions and clinical effectiveness supported by robust evidence, this review reports more recent metagenomics evidence, suggesting that mouthwashes such as chlorhexidine may cause "dysbiosis," whereby certain species of bacteria are killed, leaving others, sometimes unwanted, to predominate. There is little known about the effects of mouthwashes on fungi and viruses in the context of the oral microbiome (virome) in vivo, despite evidence that they "kill" certain viral pathogens ex vivo. Evidence for mouthwashes, much like antibiotics, is also emerging with regards to antimicrobial resistance, and this should further be considered in the context of their widespread use by clinicians and patients. Therefore, considering the potential of currently available OTC mouthwashes to alter the oral microbiome, this article finally proposes that the ideal mouthwash, whilst combatting oral disease, should "balance" antimicrobial communities, especially those associated with health. Which antimicrobial mouthwash best fits this ideal remains uncertain.
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Affiliation(s)
- Zoë Brookes
- Peninsula Dental School, Plymouth University, Plymouth, UK.
| | - Leanne Teoh
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, USA
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Singer L, Karacic S, Szekat C, Bierbaum G, Bourauel C. Biological properties of experimental dental alginate modified for self-disinfection using green nanotechnology. Clin Oral Investig 2023; 27:6677-6688. [PMID: 37775587 PMCID: PMC10630233 DOI: 10.1007/s00784-023-05277-8] [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: 07/06/2023] [Accepted: 09/23/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES Disinfection of alginate impression materials is a mandatory step to prevent cross-infection in dental clinics. However, alginate disinfection methods are time-consuming and exert a negative impact on accuracy and mechanical properties. Thus, this study aimed to prepare disinfecting agents (CHX and AgNO3) and silver nanoparticles reduced by a natural plant extract to produce a self-disinfecting dental alginate. METHODS Conventional alginate impression material was used in this study. Silver nitrate (0.2% AgNO3 group) and chlorohexidine (0.2% CHX group) solutions were prepared using distilled water, and these solutions were later employed for alginate preparation. Moreover, a 90% aqueous plant extract was prepared from Boswellia sacra (BS) oleoresin and used to reduce silver nitrate to form silver nanoparticles that were incorporated in the dental alginate preparation (BS+AgNPs group). The plant extract was characterized by gas chromatography/mass spectrometry (GC/MS) analysis while green-synthesized silver nanoparticles (AgNPs) were characterized by UV-visible (UV-vis) spectroscopy and scanning electron microscopy (SEM). An agar disc diffusion assay was used to test the antimicrobial activity against Candida albicans, Streptococcus mutans, Escherichia coli, methicillin-resistant and susceptible Staphylococcus aureus strains, and Micrococcus luteus. Agar plates were incubated at 37 ± 1 °C for 24 h to allow microbial growth. Diameters of the circular inhibition zones formed around each specimen were measured digitally by using ImageJ software. RESULTS Chemical analysis of the plant extract revealed the presence of 41 volatile and semi-volatile active compounds. UV-Vis spectrophotometry, SEM, and EDX confirmed the formation of spherical silver nanoparticles using the BS extract. CHX, AgNO3, and the BS+AgNPs modified groups showed significantly larger inhibition zones than the control group against all tested strains. BS+AgNPs and CHX groups showed comparable efficacy against all tested strains except for Staphylococcus aureus, where the CHX-modified alginate had a significantly higher effect. CONCLUSIONS AND CLINICAL RELEVANCE CHX, silver nitrate, and biosynthesized silver nanoparticles could be promising inexpensive potential candidates for the preparation of a self-disinfecting alginate impression material without affecting its performance. Green synthesis of metal nanoparticles using Boswellia sacra extract could be a very safe, efficient, and nontoxic way with the additional advantage of a synergistic action between metal ions and the phytotherapeutic agents of the plant extract.
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Affiliation(s)
- Lamia Singer
- Oral Technology, Medical Faculty, University Hospital Bonn, Bonn, Germany.
- Department of Orthodontics, Medical Faculty, University Hospital Bonn, Bonn, Germany.
| | - Sabina Karacic
- Institute of Medical Microbiology, Immunology, and Parasitology, Medical Faculty, University Hospital Bonn, 53127, Bonn, North Rhine-Westphalia, Germany
| | - Christiane Szekat
- Institute of Medical Microbiology, Immunology, and Parasitology, Medical Faculty, University Hospital Bonn, 53127, Bonn, North Rhine-Westphalia, Germany
| | - Gabriele Bierbaum
- Institute of Medical Microbiology, Immunology, and Parasitology, Medical Faculty, University Hospital Bonn, 53127, Bonn, North Rhine-Westphalia, Germany
| | - Christoph Bourauel
- Oral Technology, Medical Faculty, University Hospital Bonn, Bonn, Germany
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22
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Alrashdan MS, Leao JC, Doble A, McCullough M, Porter S. The Effects of Antimicrobial Mouthwashes on Systemic Disease: What Is the Evidence? Int Dent J 2023; 73 Suppl 2:S82-S88. [PMID: 37867067 PMCID: PMC10690546 DOI: 10.1016/j.identj.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
The potential association between antimicrobial mouthwash use and systemic health has gained attention in recent years with reports highlighting how some common systemic conditions are influenced by the use of different types of mouthwashes. In this context, links between mouthwash use and cardiovascular disease, diabetes mellitus, oral cancer, Alzheimer's disease, and preeclampsia have been proposed, albeit with limited levels of evidence. Chlorhexidine mouthwash in particular has been the most widely studied agent while available data on other types of over-the-counter mouthwashes are generally scarce. Furthermore, there is currently no evidence-based recommendations on the appropriate use of mouthwashes during pregnancy. This article will present the current evidence on the association between mouthwash use and the aforementioned conditions with emphasis on the mechanisms that may underlie such an association.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE; Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Jair Carneiro Leao
- Universidade Federal de Pernambuco, Programa de Pós-Graduação em Odontologia, Recife PE, Brazil
| | - Amazon Doble
- Peninsula Dental School, Plymouth University, Portland Square, Plymouth, UK
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia.
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Liu H, Huang Y, Huang M, Wang M, Ming Y, Chen W, Chen Y, Tang Z, Jia B. From nitrate to NO: potential effects of nitrate-reducing bacteria on systemic health and disease. Eur J Med Res 2023; 28:425. [PMID: 37821966 PMCID: PMC10566198 DOI: 10.1186/s40001-023-01413-y] [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: 01/19/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
Current research has described improving multisystem disease and organ function through dietary nitrate (DN) supplementation. They have provided some evidence that these floras with nitrate (NO3-) reductase are mediators of the underlying mechanism. Symbiotic bacteria with nitrate reductase activity (NRA) are found in the human digestive tract, including the mouth, esophagus and gastrointestinal tract (GT). Nitrate in food can be converted to nitrite under the tongue or in the stomach by these symbiotic bacteria. Then, nitrite is transformed to nitric oxide (NO) by non-enzymatic synthesis. NO is currently recognized as a potent bioactive agent with biological activities, such as vasodilation, regulation of cardiomyocyte function, neurotransmission, suppression of platelet agglutination, and prevention of vascular smooth muscle cell proliferation. NO also can be produced through the conventional L-arginine-NO synthase (L-NOS) pathway, whereas endogenous NO production by L-arginine is inhibited under hypoxia-ischemia or disease conditions. In contrast, exogenous NO3-/NO2-/NO activity is enhanced and becomes a practical supplemental pathway for NO in the body, playing an essential role in various physiological activities. Moreover, many diseases (such as metabolic or geriatric diseases) are primarily associated with disorders of endogenous NO synthesis, and NO generation from the exogenous NO3-/NO2-/NO route can partially alleviate the disease progression. The imbalance of NO in the body may be one of the potential mechanisms of disease development. Therefore, the impact of these floras with nitrate reductase on host systemic health through exogenous NO3-/NO2-/NO pathway production of NO or direct regulation of floras ecological balance is essential (e.g., regulation of body homeostasis, amelioration of diseases, etc.). This review summarizes the bacteria with nitrate reductase in humans, emphasizing the relationship between the metabolic processes of this microflora and host systemic health and disease. The potential effects of nitrate reduction bacteria on human health and disease were also highlighted in disease models from different human systems, including digestive, cardiovascular, endocrine, nervous, respiratory, and urinary systems, providing innovative ideas for future disease diagnosis and treatment based on nitrate reduction bacteria.
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Affiliation(s)
- Hongyu Liu
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yisheng Huang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Mingshu Huang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Min Wang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yue Ming
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Weixing Chen
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yuanxin Chen
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Zhengming Tang
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Bo Jia
- Department of Oral Surgery, School of Stomatology, Southern Medical University, Guangzhou, China.
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24
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Stachurski P, Świątkowski W, Ciszewski A, Sarna-Boś K, Michalak A. A Short Review of the Toxicity of Dentifrices-Zebrafish Model as a Useful Tool in Ecotoxicological Studies. Int J Mol Sci 2023; 24:14339. [PMID: 37762640 PMCID: PMC10531698 DOI: 10.3390/ijms241814339] [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: 08/01/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
This review aims to summarize the literature data regarding the effects of different toothpaste compounds in the zebrafish model. Danio rerio provides an insight into the mechanisms of the ecotoxicity of chemicals as well as an assessment of their fate in the environment to determine long-term environmental impact. The regular use of adequate toothpaste with safe active ingredients possessing anti-bacterial, anti-inflammatory, anti-oxidant, and regenerative properties is one of the most effective strategies for oral healthcare. In addition to water, a typical toothpaste consists of a variety of components, among which three are of predominant importance, i.e., abrasive substances, fluoride, and detergents. These ingredients provide healthy teeth, but their environmental impact on living organisms are often not well-known. Each of them can influence a higher level of organization: subcellular, cellular, tissue, organ, individual, and population. Therefore, it is very important that the properties of a chemical are detected before it is released into the environment to minimize damage. An important part of a chemical risk assessment is the estimation of the ecotoxicity of a compound. The zebrafish model has unique advantages in environmental ecotoxicity research and has been used to study vertebrate developmental biology. Among others, the advantages of this model include its external, visually accessible development, which allows for providing many experimental manipulations. The zebrafish has a significant genetic similarity with other vertebrates. Nevertheless, translating findings from zebrafish studies to human risk assessment requires careful consideration of these differences.
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Affiliation(s)
- Piotr Stachurski
- Department of Paediatric Dentistry, Medical University of Lublin, 20-059 Lublin, Poland
| | - Wojciech Świątkowski
- Department of Oral Surgery, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Andrzej Ciszewski
- Department of Paediatric Orthopaedics and Rehabilitation, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Katarzyna Sarna-Boś
- Department of Dental Prosthetics, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Agnieszka Michalak
- Independent Laboratory of Behavioral Studies, Medical University of Lublin, 20-059 Lublin, Poland;
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Kaur J, Grover V, Gupta J, Gupta M, Kapur V, Mehta M, Lyle DM, Samujh T, Jain A. Effectiveness of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease: A 4-month randomized controlled trial. J Indian Soc Periodontol 2023; 27:515-523. [PMID: 37781333 PMCID: PMC10538506 DOI: 10.4103/jisp.jisp_509_21] [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: 08/13/2021] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 10/03/2023] Open
Abstract
Background There is a bidirectional link between diabetes and periodontal disease. Control of active periodontal infection is an essential requisite to maintain optimal oral and systemic health in diabetic patients. The purpose of this study was to evaluate the efficacy of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease compared to routine oral hygiene. Materials and Methods Forty (n = 40) diabetic (HbA1c >7%) patients were enrolled in this parallel, examiner-blind, interventional clinical trial. Patients were randomized into two groups: Group A (sonic toothbrush and irrigation with water twice daily) or Group B (manual toothbrush and mouth rinsing with 0.12% Chlorhexidine gluconate (CHX) twice daily)). All patients received Phase I therapybefore the start of the study. Clinical parameters (plaque index [PI], gingival index [GI], oral hygiene index [OHI], pocket depth [PD], clinical attachment level [CAL], and bleeding index [BI]) were assessed at baseline, 1, 2, and 4 months. Levels of C-reactive protein (CRP), HbA1c, and interleukin (IL)-1 β were assessed at baseline and 4 months only. Verbal and written instructions were provided to each subject specific to their intervention allocation. Descriptive, parametric, and nonparametric analyses were used where appropriate. Results Sixteen (n = 16) patients in Group A and fifteen (n = 15) patients in Group B completed the 4-month study. Both groups showed a significant difference in BI, PD, CAL, and HbA1c from baseline to 4 months. There were no differences within groups for OHI, GI, or PI and CRP, IL-1 β. The results are based on an underpowered study due to the drop out of 9 patients reducing the number below the needed 19 patients per group based on the power analysis. Conclusion Results from this study provide information for future studies on self-care regimens for individuals living with Type 2 diabetes.
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Affiliation(s)
- Jaspreet Kaur
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Vishakha Grover
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Jyoti Gupta
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Mili Gupta
- Department of Biochemistry, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Vinay Kapur
- Department of Medicine, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Manjula Mehta
- Department of Microbiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | | | - Tanvi Samujh
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Ashish Jain
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
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Murugesan S, Al Khodor S. Salivary microbiome and hypertension in the Qatari population. J Transl Med 2023; 21:454. [PMID: 37422685 PMCID: PMC10329805 DOI: 10.1186/s12967-023-04247-8] [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: 03/30/2023] [Accepted: 06/06/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND The prevalence of hypertension in Qatar is 33 percent of the adult population. It is postulated that the salivary microbiome can regulate blood pressure (BP). However, limited investigations exist to prove this hypothesis. Therefore, we examined the difference in the salivary microbiome composition between hypertensive and normotensive Qatari subjects. METHODS A total of 1190 Qatar Genome Project (QGP) participants (Mean age = 43 years) were included in this study. BP for all participants was classified into Normal (n = 357), Stage1 (n = 336), and Stage2: (n = 161) according to the American Heart Association guidelines. 16S-rRNA libraries were sequenced and analyzed using QIIME-pipeline, and PICRUST was used to predict functional metabolic routes. Machine Learning (ML) strategies were applied to identify salivary microbiome-based predictors of hypertension. RESULTS Differential abundant analysis (DAA) revealed that Bacteroides and Atopobium were the significant members of the hypertensive groups. Alpha and beta diversity indices indicated dysbiosis between the normotensive and hypertensive groups. ML-based prediction models revealed that these markers could predict hypertension with an AUC (Area under the curve) of 0.89. Functional predictive analysis disclosed that Cysteine and Methionine metabolism and the sulphur metabolic pathways involving the renin-angiotensin system were significantly higher in the normotensive group. Therefore, members of Bacteroides and Atopobium can serve as predictors of hypertension. Likewise, Prevotella, Neisseria, and Haemophilus can be the protectors that regulate BP via nitric acid synthesis and regulation of the renin-angiotensin system. CONCLUSION It is one of the first studies to assess salivary microbiome and hypertension as disease models in a large cohort of the Qatari population. Further research is needed to confirm these findings and validate the mechanisms involved.
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Affiliation(s)
- Selvasankar Murugesan
- Maternal and Child Health Division, Research Department, Sidra Medicine, 26999, Doha, Qatar
| | - Souhaila Al Khodor
- Maternal and Child Health Division, Research Department, Sidra Medicine, 26999, Doha, Qatar.
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27
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Ahmed MM. A Cross-Sectional Study to Evaluate Dental Professionals' Knowledge of Antiplaque Mouth Rinse Agents and their Application in Periodontal Practice. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S1006-S1009. [PMID: 37694042 PMCID: PMC10485443 DOI: 10.4103/jpbs.jpbs_251_23] [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: 03/14/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 09/12/2023] Open
Abstract
Background Mouth rinse agents reduce inflammation and microbial burden, improving periodontal clinical parameters. Yet, improper clinical use of these compounds might have several deleterious repercussions. Given the lack of research on the knowledge and application of antiplaque mouth rinse agents, this research was conducted. Methods The research is an electronic survey wherein responses were gathered for ten items with predetermined answers in addition to covariate data. The questions were conceived to illuminate the level of knowledge possessed by dental professionals and their utilization pattern in periodontal practice. The data gathered underwent quantitative statistical analysis. Results Participants in the study included 100 dental professionals from various disciplines, all of whom agreed that mouth rinses are a vital adjuvant in periodontal therapy. Most acknowledged being aware of the various mouth rinse agents, but their knowledge and application of mouth rinses were largely confined to chlorhexidine gluconate, with little consideration being given to alternative antiplaque agents. Conclusion Little knowledge exists among dental professionals regarding mouth rinse agents and their appropriate application. Dental schools, clinical advisory organizations, and other establishments could educate dental professionals on the specific guidelines for utilizing antiplaque mouth rinses in a dental context, especially as an adjunct to periodontal therapy.
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Affiliation(s)
- Muzammil Moin Ahmed
- Department of Dental Hygiene, College of Applied Health Sciences in Ar Rass, Qassim University, Al Qassim, Kingdom of Saudi Arabia
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28
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Bruno JS, Al-Qadami GH, Laheij AMGA, Bossi P, Fregnani ER, Wardill HR. From Pathogenesis to Intervention: The Importance of the Microbiome in Oral Mucositis. Int J Mol Sci 2023; 24:ijms24098274. [PMID: 37175980 PMCID: PMC10179181 DOI: 10.3390/ijms24098274] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Oral mucositis (OM) is a common and impactful toxicity of standard cancer therapy, affecting up to 80% of patients. Its aetiology centres on the initial destruction of epithelial cells and the increase in inflammatory signals. These changes in the oral mucosa create a hostile environment for resident microbes, with oral infections co-occurring with OM, especially at sites of ulceration. Increasing evidence suggests that oral microbiome changes occur beyond opportunistic infection, with a growing appreciation for the potential role of the microbiome in OM development and severity. This review collects the latest articles indexed in the PubMed electronic database which analyse the bacterial shift through 16S rRNA gene sequencing methodology in cancer patients under treatment with oral mucositis. The aims are to assess whether changes in the oral and gut microbiome causally contribute to oral mucositis or if they are simply a consequence of the mucosal injury. Further, we explore the emerging role of a patient's microbial fingerprint in OM development and prediction. The maintenance of resident bacteria via microbial target therapy is under constant improvement and should be considered in the OM treatment.
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Affiliation(s)
- Julia S Bruno
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo 01308-060, Brazil
| | - Ghanyah H Al-Qadami
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - Alexa M G A Laheij
- Department of Oral Medicine, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
- Department of Oral Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Eduardo R Fregnani
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo 01308-060, Brazil
| | - Hannah R Wardill
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5005, Australia
- The Supportive Oncology Research Group, Precision Cancer Medicine Theme, The South Australian Health and Medical Research Institute, Adelaide 5000, Australia
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29
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Weber J, Bonn EL, Auer DL, Kirschneck C, Buchalla W, Scholz KJ, Cieplik F. Preprocedural mouthwashes for infection control in dentistry-an update. Clin Oral Investig 2023:10.1007/s00784-023-04953-z. [PMID: 37079156 PMCID: PMC10116478 DOI: 10.1007/s00784-023-04953-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/17/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners. METHODS Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized. RESULTS Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered. CONCLUSIONS The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof. CLINICAL RELEVANCE Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects.
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Affiliation(s)
- Johanna Weber
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
| | - Eva L Bonn
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - David L Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | | | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
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Berlanga LA, Lopez-Samanes A, Martin-Lopez J, de la Cruz RM, Garces-Rimon M, Roberts J, Bertotti G. Dietary Nitrate Ingestion Does Not Improve Neuromuscular Performance in Male Sport Climbers. J Hum Kinet 2023; 87:47-57. [PMID: 37229410 PMCID: PMC10203837 DOI: 10.5114/jhk/161812] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/28/2022] [Indexed: 05/27/2023] Open
Abstract
Beetroot juice (BJ) is commonly used as an ergogenic aid in endurance and team sports, however, the effect of this supplement on climbing performance is barely studied. The purpose of the current study was to investigate the effect of acute BJ ingestion on neuromuscular and biochemical variables in amateur male sport climbers. Ten physically active sport climbers (28.8 ± 3.7 years) underwent a battery of neuromuscular tests consisting of the half crimp test, the pull-up to failure test, the isometric handgrip strength test, the countermovement jump (CMJ) and the squat jump (SJ). Participants performed the neuromuscular test battery twice in a cross-over design separated by 10 days, 150 min after having consumed either 70-mL of BJ (6.4 mmol NO3-) or a 70-mL placebo (0.0034 mmol NO3-). In addition, nitrate (NO3-) and nitrite (NO2-) saliva concentrations were analysed, and a side effect questionnaire related to ingestion was administrated. No differences were reported in particular neuromuscular variables measured such as the CMJ (p = 0.960; ES = 0.03), the SJ (p = 0.581; ES = -0.25), isometric handgrip strength (dominant/non dominant) (p = 0.459-0.447; ES = 0.34-0.35), the pull-up failure test (p = 0.272; ES = 0.51) or the maximal isometric half crimp test (p = 0.521-0.824; ES = 0.10-0.28). Salivary NO3- and NO2- increased significantly post BJ supplementation compared to the placebo (p < 0.001), while no side effects associated to ingestion were reported (p = 0.330-1.000) between conditions (BJ/placebo ingestion). Acute dietary nitrate supplementation (70-mL) did not produce any statistically significant improvement in neuromuscular performance or side effects in amateur sport climbers.
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Affiliation(s)
- Luis A. Berlanga
- Physical Activity and Sport, Centro de Estudios Universitarios Cardenal Spínola CEU, Sevilla, Spain
- Exercise Physiology Group, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Alvaro Lopez-Samanes
- Exercise Physiology Group, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Julio Martin-Lopez
- Exercise Physiology Group, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Marta Garces-Rimon
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, Madrid, Spain
| | - Justin Roberts
- Cambridge Centre for Sport and Exercise Sciences (CCSES), School of Psychology and Sport Science, Anglia Ruskin University, East Road, Cambridge, UK
| | - Gabriele Bertotti
- Exercise Physiology Group, Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
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Del Rey YC, Rikvold PD, Johnsen KK, Schlafer S. Clinical Trial Data on the Mechanical Removal of 14-Day-Old Dental Plaque Using Accelerated Micro-Droplets of Air and Water (Airfloss). DATA 2023. [DOI: 10.3390/data8040070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Novel strategies to combat dental biofilms aim at reducing biofilm stability with the ultimate goal of facilitating mechanical cleaning. To test the stability of dental biofilms, they need to be subjected to a defined mechanical stress. Here, we employed an oral care device (Airfloss) that emits microbursts of compressed air and water to apply a defined mechanical shear to 14-day-old dental plaque in 20 healthy participants with no signs of oral diseases (clinical trial no. NCT05082103). Exclusion criteria included pregnant or nursing women, users of oral prostheses, retainers or orthodontic appliances, and recent antimicrobial or anti-inflammatory therapy. Plaque accumulation, before and after treatment, was assessed using fluorescence images of disclosed dental plaque on the central incisor, first premolar, and first molar in the third quadrant (120 images). For each tooth, the pre- and post-treatment plaque percentage index (PPI) and Turesky modification of the Quigley-Hein plaque index (TM-QHPI) were recorded. The mean TM-QHPI significantly decreased after treatment (p = 0.03; one-sample sign test), but no significant difference between the mean pre- and post-treatment PPI was observed (p = 0.09; one-sample t-test). These data are of value for researchers that seek to apply a defined mechanical shear to remove and/or disrupt dental biofilms.
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Belfield L. From dental nursing to senior academic in dentistry: a personal career journey. Prim Dent J 2023; 12:33-34. [PMID: 36916629 DOI: 10.1177/20501684231153911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Affiliation(s)
- Louise Belfield
- Louise Belfield BSc (Hons), PGCert, PhD, SFHEA, AssocFCGDent Associate Professor in Biomedical and Oral Health Sciences, Peninsula Dental School, Plymouth, UK
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Rud I, Almli VL, Berget I, Tzimorotas D, Varela P. Taste perception and oral microbiota: recent advances and future perspectives. Curr Opin Food Sci 2023. [DOI: 10.1016/j.cofs.2023.101030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
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Hussain U, Alam S, Rehman K, Antonoglou GN, Papageorgiou SN. Effects of chlorhexidine use on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis. Eur J Orthod 2023; 45:103-114. [PMID: 36001494 DOI: 10.1093/ejo/cjac044] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Proper oral hygiene and absence of periodontal inflammation is pre-requisite for orthodontic treatment. Chlorhexidine (CHX) is an established oral antiseptic used in the treatment of periodontal disease, but its role in orthodontic therapy is unclear. OBJECTIVES To assess the efficacy of adjunct use of CHX-containing products in maintaining gingival health among orthodontic patients with fixed appliances. SEARCH METHODS Five databases were searched without limitations up to August 2021. SELECTION CRITERIA Randomized clinical trials (RCTs) assessing Gingival Index (GI) (primary outcome), Plaque Index (PI), Bleeding Index (BI), or Pocket Probing Depth (PPD). DATA COLLECTION AND ANALYSIS Study selection, data extraction, and risk of bias assessment were done independently in duplicate. Random-effects meta-analyses of mean differences (MDs) or standardized mean differences (SMDs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity and Grades of Recommendations, Assessment, Development and Evaluation analysis. RESULTS Twenty RCTs (1001 patients) were included assessing CHX-containing mouthwashes (n = 11), toothpastes (n = 2), gels (n = 3), or varnishes (n = 4) compared to placebo/control (n = 19) or sodium fluoride-products (n = 4). In the short-term, CHX-containing mouthwash was associated with lower GI (n = 9; MD = -0.68; 95% CI = -0.97 to -0.38; P < 0.001; high quality), lower PI (n = 9; MD = -0.65; 95% CI = -0.86 to -0.43; P < 0.001; high quality), lower BI (n = 2; SMD = -1.61; 95% CI = -2.99 to -0.22; P = 0.02; low quality), and lower PPD (n = 2; MD = -0.60 mm; 95% CI = -1.06 to -0.14 mm; P = 0.01; low quality). No considerable benefits were found from the use of CHX-gel or CHX-varnish in terms of GI, PI, or PPD (P > 0.05/low quality in all instances). Use of a CHX-containing toothpaste was more effective in lowering PI (Heintze-index) than adjunct use of fluoride-containing mouthwash (n = 2; MD = -5.24; 95% CI = -10.46 to -0.02; P = 0.04), but not GI (P = 0.68) or BI (P = 0.27), while sensitivity analyses indicated robustness. CONCLUSIONS Adjunct use of CHX mouthwash during fixed-appliance treatment is associated with improved gingival inflammation, plaque control, and pocket depths, but caution is warranted and recommendations about CHX use during orthodontic treatment of children/adults should consider the heterogeneous patient response, cost-effectiveness, and potential adverse effects. REGISTRATION PROSPERO registration (CRD42021228759).
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Affiliation(s)
- Umar Hussain
- Department of Orthodontics, Saidu College of Dentistry, Swat, Pakistan
| | - Shamsul Alam
- Health Department Khyber Pakhtunkhwa, Peshawar, Pakistan
| | - Khalid Rehman
- Department of Public Health, Khyber Medical University, Peshawar, Pakistan
| | - Georgios N Antonoglou
- Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Liu T, Chen YC, Jeng SL, Chang JJ, Wang JY, Lin CH, Tsai PF, Ko NY, Ko WC, Wang JL. Short-term effects of Chlorhexidine mouthwash and Listerine on oral microbiome in hospitalized patients. Front Cell Infect Microbiol 2023; 13:1056534. [PMID: 36816590 PMCID: PMC9932516 DOI: 10.3389/fcimb.2023.1056534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Chlorhexidine (CHX) and essential oil containing mouthwashes like Listerine® can improve oral hygiene via suppressing oral microbes. In hospitalized patients, CHX mouthwash reduces the incidence of ventilator-associated pneumonia. However, CHX use was also associated with increased mortality, which might be related to nitrate-reducing bacteria. Currently, no study determines oral bacteria targeted by essential oils mouthwash in hospitalized patients using a metagenomic approach. Methods We recruited 87 hospitalized patients from a previous randomized control study, and assigned them to three mouthwash groups: CHX, Listerine, and normal saline (control). Before and after gargling the mouthwash twice a day for 5-7 days, oral bacteria were examined using a 16S rDNA approach. Results Alpha diversities at the genus level decreased significantly only for the CHX and Listerine groups. Only for the two groups, oral microbiota before and after gargling were significantly different, but not clearly distinct. Paired analysis eliminated the substantial individual differences and revealed eight bacterial genera (including Prevotella, Fusobacterium, and Selenomonas) with a decreased relative abundance, while Rothia increased after gargling the CHX mouthwash. After gargling Listerine, seven genera (including Parvimonas, Eubacterium, and Selenomonas) showed a decreased relative abundance, and the magnitudes were smaller compared to the CHX group. Fewer bacteria targeted by Listerine were reported to be nitrate-reducing compared to the CHX mouthwash. Discussion In conclusion, short-term gargling of the CHX mouthwash and Listerine altered oral microbiota in our hospitalized patients. The bacterial genera targeted by the CHX mouthwash and Listerine were largely different and the magnitudes of changes were smaller using Listerine. Functional alterations of gargling CHX and Listerine were also different. These findings can be considered for managing oral hygiene of hospitalized patients.
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Affiliation(s)
- Tsunglin Liu
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Nursing, National Cheng Kung University, Tainan, Taiwan
| | - Shuen-Lin Jeng
- Department of Statistics, Institute of Data Science, Center for Innovative FinTech Business Models, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Jen Chang
- Graduate Institute of Integrated Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Jiu-Yao Wang
- Center of Allergy, Immunology and Microbiome (AIM), Department of Allergy and Immunology, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Cheng-Han Lin
- Center of Allergy, Immunology and Microbiome (AIM), Department of Allergy and Immunology, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Pei-Fang Tsai
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Nursing, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jiun-Ling Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan,*Correspondence: Jiun-Ling Wang,
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do Amaral GCLS, Hassan MA, Sloniak MC, Pannuti CM, Romito GA, Villar CC. Effects of antimicrobial mouthwashes on the human oral microbiome: Systematic review of controlled clinical trials. Int J Dent Hyg 2023; 21:128-140. [PMID: 35946140 DOI: 10.1111/idh.12617] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/15/2022] [Accepted: 08/06/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVES This review aimed to assess the impact of mouthwashes on the composition of the human oral microbiome. METHOD An electronic search algorithm was adapted to MEDLINE-PubMed, Scopus, Embase and ISI Web of Science, and reference lists of relevant sources were manually searched. Inclusion criteria were controlled clinical trials published in English whose population were adult individuals who rinse with antimicrobial mouthwashes and that analysed changes in the oral microbiome by metataxonomy, metagenomics or phylogenetic microarray. Identified studies were screened and assessed following the PRISMA guidelines, and results were compiled into qualitative synthesis of the evidence. RESULTS Five controlled clinical studies were included. These studies found associations between the daily use of mouthwashes and changes in the oral microbiome, but the nature of the effect varied according to the mouthwash. Chlorhexidine (CHX) rinses lowered microbial diversity. While 7-day use of CHX led to increases in the abundance of Neisseria, Streptococcus and Granulicatella and a decrease in the abundance of Actinomyces, its prolonged use led to widespread reductions in several genera and species. Cetylpyridinium chloride-containing mouthwashes specifically lowered the abundance of gingivitis-associated genera. In contrast, N-acetyl cysteine-based mouthwashes did not promote changes in the oral microbiome. CONCLUSIONS Despite substantial heterogeneity, we found evidence to support the hypothesis that CHX and CPC mouthwashes promote changes in oral microbial structure and/or reductions in community diversity that favour the resolution of dysbiosis. However, future large population-based studies of adequate duration are needed to fully understand the extent to which antimicrobial mouthwashes modulate the microbiome.
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Affiliation(s)
| | - Mohamed Ahmed Hassan
- Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | | | - Cláudio Mendes Pannuti
- Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Giuseppe A Romito
- Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Cristina Cunha Villar
- Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
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Lee J, Cho S, Kim HE. Antimicrobial Effects of Non-Thermal Atmospheric Pressure Plasma on Oral Microcosm Biofilms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2447. [PMID: 36767814 PMCID: PMC9915355 DOI: 10.3390/ijerph20032447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
We comparatively evaluated the antibacterial effects of non-thermal atmospheric pressure plasma (NTAPP) on oral microcosm biofilms. Oral microcosm biofilms, which are derived from inoculation with human saliva, were cultured on 48 hydroxyapatite disks for 6 days. The prepared biofilms were divided into three different daily treatment groups: distilled water for 1 min, 0.12% chlorhexidine (CHX) for 1 min, and NTAPP for 5 min. Using a quantitative light-induced fluorescence-digital camera, the red fluorescence intensity of the biofilms was measured as red/green ratios (RatioR/G) before and after treatment. Total and aciduric bacteria were counted as colony-forming units. Using live/dead bacterial staining, bacterial viability was calculated as the RatioG/G+R. RatioR/G was approximately 0.91-fold lower in the NTAPP group than in the CHX group on day 1 of treatment (p = 0.001), and approximately 0.94-fold lower on both days 2 and 3 (p < 0.001). The number of total bacteria was higher in the NTAPP group than in the CHX group, but not significantly different. The number of aciduric bacteria was lowest in the CHX group (p < 0.001). However, bacterial viability was lowest in the NTAPP group. Restricted bacterial aggregation was observed in the NTAPP group. These findings suggest that NTAPP may more effectively reduce the pathogenicity of oral microcosm biofilms than 0.12% CHX.
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Affiliation(s)
- Jiyeon Lee
- Department of Health Science, Gachon University Graduate School of Public Health, Incheon 21936, Republic of Korea
| | - Sungbo Cho
- Department of Electronic Engineering, Gachon University, Seongnam-si 13120, Republic of Korea
| | - Hee-Eun Kim
- Department of Health Science, Gachon University Graduate School of Public Health, Incheon 21936, Republic of Korea
- Department of Dental Hygiene, Gachon University College of Health Science, Incheon 21936, Republic of Korea
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Vasconcelos BM, Pereira AMG, Coelho PAT, Cavalcante RMB, Carneiro-Torres DS, Bandeira PN, da Silva FF, Rodrigues THS, Gomes GA, Carneiro VA. Enhancement of chlorhexidine activity against planktonic and biofilm forms of oral streptococci by two Croton spp. essential oils from the Caatinga biome. BIOFOULING 2023; 38:1-10. [PMID: 36597191 DOI: 10.1080/08927014.2022.2159393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 06/19/2023]
Abstract
This work investigates the ability of two Croton spp. essential oils (EO) to enhance chlorhexidine (CHX) activity against oral streptococci. EO's chemical composition of Croton argyrophyllus and C. pluriglandulosus was determined by GC-MS/FID. The microbial growth kinetics and minimum inhibitory concentration (MIC) of EOs and CHX were determined, followed by their synergism against S. mutans UA159 and ATCC 25175, S. salivarius ATCC 7073 and S. sp. ATCC 15300. The microplate-based method was used to determine the EO/CHX activity against 24-h-old biofilms. The major compounds were α-pinene (54.74%) and bicyclogermacrene (16.08%) for EOAr and 1,8-cineole (17.41%), methyleugenol (16.06%) and elemicin (15.99%) for EOPg. Both EO had MIC around 16,000 µg/mL. EOs/CHX presented a synergistic effect against most strains (FICi from 0.133 to 0.375), and OE/CHX-treated biofilms showed a reduction in biomass and cell viability compared to CHX, only (p < 0.01). Thus, the EOs works as natural adjuvants for CHX.
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Affiliation(s)
- Brendda Miranda Vasconcelos
- Center of Molecular Bioprospecting and Applied Experimentation (NUBEM), University Center INTA - UNINTA, Sobral, Ceará, Brazil
| | - Antônio Mateus Gomes Pereira
- Center of Molecular Bioprospecting and Applied Experimentation (NUBEM), University Center INTA - UNINTA, Sobral, Ceará, Brazil
| | - Paulo Adenes Teixeira Coelho
- Center of Molecular Bioprospecting and Applied Experimentation (NUBEM), University Center INTA - UNINTA, Sobral, Ceará, Brazil
| | | | | | - Paulo Nogueira Bandeira
- Center of Exact Science and Technology, Vale of Acaraú State University, Sobral, Ceará, Brazil
| | | | | | - Geovany Amorim Gomes
- Center of Exact Science and Technology, Vale of Acaraú State University, Sobral, Ceará, Brazil
| | - Victor Alves Carneiro
- Center of Molecular Bioprospecting and Applied Experimentation (NUBEM), University Center INTA - UNINTA, Sobral, Ceará, Brazil
- Laboratory of Biofilms and Antimicrobial Agents (LaBAM), Federal University of Ceará, Sobral, Brazil
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AlSheddi M, Rahman I, Mohammed A, Algazlan A, Alwably A, Hebbal M, Omar M. Nigella sativa oil as a treatment for gingivitis: A randomized active–control trial. ASIAN PAC J TROP MED 2023. [DOI: 10.4103/1995-7645.372290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Pascual J, Mira Otal J, Torrent-Silla D, Porcar M, Vilanova C, Vivancos Cuadras F. A mouthwash formulated with o-cymen-5-ol and zinc chloride specifically targets potential pathogens without impairing the native oral microbiome in healthy individuals. J Oral Microbiol 2023; 15:2185962. [PMID: 36891194 PMCID: PMC9987754 DOI: 10.1080/20002297.2023.2185962] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
Abstract
Background Many antimicrobial compounds in mouthwashes can have a negative impact on the oral microbiome. O-cymen-5-ol, a compound derived from a phytochemical, has a targeted mode of action and is being used as an alternative. However, its effect on the native oral microbiome is unknown. Aim To assess the effect of a mouthwash formulated with o-cymen-5-ol and zinc chloride on the oral microbiome of healthy individuals. Methods A mouthwash formulated with o-cymen-5-ol and zinc chloride was administered to a cohort of 51 volunteers for 14 days, while another cohort of 49 volunteers received a placebo. The evolution of the oral microbiome in both groups was analysed using a metataxonomic approach. Results Analysis of the oral microbiome showed that the mouthwash selectively targeted potential oral pathogens while maintaining the integrity of the rest of the microbiome. Specifically, the relative abundance of several potentially pathogenic bacterial taxa, namely Fusobacteriota, Prevotella, Actinomyces, Granulicatella, Abiotrophia, Lautropia, Lachnoanaerobaculum, Eubacterium (nodatum group) and Absconditabacteriales (SR1) decreased, while the growth of Rothia, a nitrate-reducing bacterium beneficial for blood pressure, was stimulated. Conclusions The use of o-cymen-5-ol and zinc chloride as antimicrobial agents in oral mouthwashes is a valuable alternative to classical antimicrobial agents.
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Affiliation(s)
| | | | | | - Manuel Porcar
- Darwin Bioprospecting Excellence S.L., Paterna, Spain.,Institute for Integrative Systems Biology I2SysBio (University of Valencia - CSIC), Paterna, Spain
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Merchant AT, Gupta RD, Akonde M, Reynolds M, Smith-Warner S, Liu J, Tarannum F, Beck J, Mattison D. Association of Chlorhexidine Use and Scaling and Root Planing With Birth Outcomes in Pregnant Individuals With Periodontitis: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2247632. [PMID: 36534397 PMCID: PMC9856591 DOI: 10.1001/jamanetworkopen.2022.47632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
IMPORTANCE Chlorhexidine mouthwash enhances treatment effects of conventional periodontal treatment, but data on chlorhexidine as a source of heterogeneity in meta-analyses assessing the treatment of maternal periodontitis in association with birth outcomes are lacking. OBJECTIVE To assess possible heterogeneity by chlorhexidine use in randomized clinical trials (RCTs) evaluating the effect of periodontal treatment (ie, scaling and root planing [SRP]) vs no treatment on birth outcomes. DATA SOURCES Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE Ovid, Embase Ovid, LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database), US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov), and the WHO International Clinical Trials Registry Platform were searched through March 2022. STUDY SELECTION RCTs were included if they were conducted among pregnant individuals with periodontitis, used interventions consisting of SRP vs no periodontal treatment, and assessed birth outcomes. DATA EXTRACTION AND SYNTHESIS Data were abstracted with consensus of 2 reviewers using Rayyan and assessed for bias with the Cochrane Risk of Bias 2 tool before random effects subgroup meta-analyses. Analyses were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. MAIN OUTCOMES AND MEASURES Outcomes of interest were preterm birth (ie, <37 weeks' gestation) and low birth weight (ie, <2500 g). RESULTS There were 12 studies with a total of 5735 participants evaluating preterm birth. Control group participants did not receive any treatment or use chlorhexidine during pregnancy. All intervention group participants received SRP; in 5 of these studies (with 2570 participants), pregnant participants in the treatment group either received chlorhexidine mouthwash or advice to use it, but participants in the remaining 7 studies (with 3183 participants) did not. There were 8 studies with a total of 3510 participants evaluating low birth weight, including 3 studies with SRP plus chlorhexidine (with 594 participants) and 6 studies with SRP only (with 2916 participants). The SRP plus chlorhexidine groups had lower risk of preterm birth (relative risk [RR], 0.56; 95% CI, 0.34-0.93) and low birth weight (RR, 0.47; 95% CI, 0.32-0.68) but not the SRP-only groups (preterm birth: RR, 1.03; 95% CI, 0.82-1.29; low birth weight: RR, 0.82; 95% CI, 0.62-1.08). CONCLUSIONS AND RELEVANCE These findings suggest that treating maternal periodontitis with chlorhexidine mouthwash plus SRP was associated with reduced risk of preterm and low birth weight. Well-conducted RCTs are needed to test this hypothesis.
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Affiliation(s)
- Anwar T. Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Mark Reynolds
- School of Dentistry, University of Maryland Baltimore, Baltimore
| | - Stephanie Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Fouzia Tarannum
- M. R. Ambedkar Dental College and Hospital, Bangalore, India
| | - James Beck
- Division of Comprehensive Oral Health and Periodontology, University of North Carolina, Chapel Hill
| | - Donald Mattison
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
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Li Y, Zhu M, Liu Y, Luo B, Cui J, Huang L, Chen K, Liu Y. The oral microbiota and cardiometabolic health: A comprehensive review and emerging insights. Front Immunol 2022; 13:1010368. [PMID: 36466857 PMCID: PMC9716288 DOI: 10.3389/fimmu.2022.1010368] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/26/2022] [Indexed: 08/26/2023] Open
Abstract
There is mounting evidence demonstrating that oral dysbiosis causes periodontal disease and promotes the development of cardiovascular disease. The advancement of omics techniques has driven the optimization of oral microbiota species analysis and has provided a deeper understanding of oral pathogenic bacteria. A bi-directional relationship exists between the oral microbiota and the host, and oral-gut microbiota transfer is known to alter the composition of the gut microbiota and may cause local metabolic disorders. Furthermore, cardiovascular health can also be highly affected by oral microbiota functions and metabolites, including short-chain fatty acids (SCFAs), nitric oxide (NO), hydrogen sulfide (H2S), and some lipid metabolites. Studies have found that trimethylamine oxide (TMAO) may have adverse effects on cardiovascular health, whereas SCFAs, NO, and H2S have cardioprotective effects. SCFAs and H2S exert varying oral and cardiovascular effects, however reports on this specific topic remain controversial. Previous evidences are accustomed to summarizing the functions of oral microbiota in the context of periodontitis. The direct relationship between oral microbiota and cardiovascular diseases is insufficient. By systematically summarizing the methods associated with oral microbiota transplantation (OMT), this review facilitates an investigation into the causal links between oral microbiota and cardiovascular disease. The concomitant development of omics, bioinformatics, bacterial culture techniques, and microbiota transplantation techniques is required to gain a deeper understanding of the relationship between oral microbiota and cardiovascular disease occurrence.
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Affiliation(s)
- Yiwen Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Mengmeng Zhu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yanfei Liu
- The Second Department of Gerontology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Binyu Luo
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Jing Cui
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Luqi Huang
- China Center for Evidence-based Medicine of Traditional Chinese Medicine (TCM), China Academy of Chinese Medical Sciences, Beijing, China
| | - Keji Chen
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
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Chen L, Cao H, Wu X, Xu X, Ji X, Wang B, Zhang P, Li H. Effects of oral health intervention strategies on cognition and microbiota alterations in patients with mild Alzheimer's disease: A randomized controlled trial. Geriatr Nurs 2022; 48:103-110. [PMID: 36155316 DOI: 10.1016/j.gerinurse.2022.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
We explored the effects of an oral health intervention on the oral microbiome and cognitive function of patients with mild Alzheimer's disease (AD) and determined the influence on disease progression. Sixty-six patients with mild AD were randomly assigned to intervention or control groups and received a 24-week oral health intervention and routine care, respectively. Data were collected at baseline and week 24. 16 S rRNA sequencing was used to analyze oral microbiota. After 24 weeks of oral health intervention, Kayser-Jones Brief Oral Health Status Examination (BOHSE), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Nursing Home Adjustment Scale (NHAS), and Alzheimer's Disease Cooperative Study-ADL (ADCS-ADL) scores were different between groups (p < 0.05). Subgingival plaque in patients with AD showed significant differences in the diversity and abundance of oral microbiomes, with a higher abundance of normal oral flora in the intervention group. We found oral health intervention strategies are effective in modifying subgingival microbiota differences and slowing cognitive decline in mild AD patients.
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Affiliation(s)
- Lili Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China; Fujian Provincial Hospital, Fuzhou, China.
| | - Huizhen Cao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Fujian Provincial Hospital, Fuzhou, China
| | - Xiaoqi Wu
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xinhua Xu
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xinli Ji
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Bixia Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Ping Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hong Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China; Fujian Provincial Hospital, Fuzhou, China.
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44
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Park T, Im J, Kim AR, Lee D, Jeong S, Yun CH, Han SH. Propionate Attenuates Growth of Oral Streptococci through Enhancing Methionine Biosynthesis. J Microbiol Biotechnol 2022; 32:1234-1244. [PMID: 36198670 PMCID: PMC9668084 DOI: 10.4014/jmb.2205.05037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 12/15/2022]
Abstract
Oral streptococci are considered as an opportunistic pathogen associated with initiation and progression of various oral diseases. However, since the currently-available treatments often accompany adverse effects, alternative strategy is demanded to control streptococci. In the current study, we investigated whether short-chain fatty acids (SCFAs), including sodium acetate (NaA), sodium propionate (NaP), and sodium butyrate (NaB), can inhibit the growth of oral streptococci. Among the tested SCFAs, NaP most potently inhibited the growth of laboratory and clinically isolated strains of Streptococcus gordonii under anaerobic culture conditions. However, the growth inhibitory effect of NaP on six different species of other oral streptococci was different depending on their culture conditions. Metabolic changes such as alteration of methionine biosynthesis can affect bacterial growth. Indeed, NaP enhanced intracellular methionine levels of oral streptococci as well as the mRNA expression level of methionine biosynthesis-related genes. Collectively, these results suggest that NaP has an inhibitory effect on the growth of oral streptococci, which might be due to alteration of methionine biosynthesis. Thus, NaP can be used an effective bacteriostatic agent for the prevention of oral infectious diseases caused by oral streptococci.
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Affiliation(s)
- Taehwan Park
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea
| | - Jintaek Im
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea
| | - A Reum Kim
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea
| | - Dongwook Lee
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea
| | - Sungho Jeong
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea
| | - Cheol-Heui Yun
- Department of Agricultural Biotechnology, and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Republic of Korea,Institute of Green Bio Science and Technology, Seoul National University, Pyeongchang 25354, Republic of Korea
| | - Seung Hyun Han
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea,Corresponding author Phone +82-2-880-2310 Fax: +82-2-743-0311 E-mail:
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45
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Chen J, Liu K, Sun X, Shi X, Zhao G, Yang Z. Microbiome landscape of lesions and adjacent normal mucosal areas in oral lichen planus patient. Front Microbiol 2022; 13:992065. [PMID: 36338092 PMCID: PMC9630593 DOI: 10.3389/fmicb.2022.992065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022] Open
Abstract
The pathogenesis of oral lichen planus (OLP) remains unclear, and microbial dysbiosis has been proposed to play a role in the pathogenesis of OLP. Oral mucosal swabs from 77 OLP patients and 76 healthy subjects were collected. The bacterial community among the OLP lesion, the adjacent normal mucosal, and the oral mucosal surface in healthy people were analyzed by 16S sequencing. The factor of gender and age that may affect the flora distribution of OLP patients were explored. Results indicate no significant difference in microbiota between OLP and the adjacent group. Compared with the healthy group, Neisseria, Haemophilus, Fusobacterium, Porphyromonas, Rothia, Actinomyces, and Capnocytophaga significantly increased in the OLP group. Actinomyces increased in male OLP patients, and the other six bacteria increased in female OLP patients. In female OLP patients, Lautropia and Dialister were positively correlated with age. While in male OLP patients, Moraxella, Porphyromonas, and Fusobacterium were positively correlated with age. Functional enrichment analysis suggested that abnormal energy metabolism related to ATP synthases, abnormal transport and metabolism of glycans, amino acids, and vitamins, and disorders of the local immune microenvironment might exist in OLP lesion.
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Affiliation(s)
- Jian Chen
- Department of Stomatology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Kaikai Liu
- Department of Stomatology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Xiaona Sun
- Department of Stomatology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Xuanxuan Shi
- School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Guanghui Zhao
- Medical Laboratory Center, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
| | - Zhongjun Yang
- Department of Stomatology, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, China
- *Correspondence: Zhongjun Yang,
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Pereira AP, Antunes P, Willems R, Corander J, Coque TM, Peixe L, Freitas AR, Novais C. Evolution of Chlorhexidine Susceptibility and of the EfrEF Operon among Enterococcus faecalis from Diverse Environments, Clones, and Time Spans. Microbiol Spectr 2022; 10:e0117622. [PMID: 35862993 PMCID: PMC9430118 DOI: 10.1128/spectrum.01176-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/17/2022] [Indexed: 11/20/2022] Open
Abstract
Chlorhexidine (CHX) is widely used to control the spread of pathogens (e.g., human/animal clinical settings, ambulatory care, food industry). Enterococcus faecalis, a major nosocomial pathogen, is broadly distributed in diverse hosts and environments facilitating its exposure to CHX over the years. Nevertheless, CHX activity against E. faecalis is understudied. Our goal was to assess CHX activity and the variability of ChlR-EfrEF proteins (associated with CHX tolerance) among 673 field isolates and 1,784 E. faecalis genomes from the PATRIC database from different sources, time spans, clonal lineages, and antibiotic-resistance profiles. The CHX MIC (MICCHX) and minimum bactericidal concentration (MBCCHX) against E. faecalis presented normal distributions (0.5 to 64 mg/L). However, more CHX-tolerant isolates were detected in the food chain and recent human infections, suggesting an adaptability of E. faecalis populations in settings where CHX is heavily used. Heterogeneity in ChlR-EfrEF sequences was identified, with isolates harboring incomplete ChlR-EfrEF proteins, particularly the EfrE identified in the ST40 clonal lineage, showing low MICCHX (≤1mg/L). Distinct ST40-E. faecalis subpopulations carrying truncated and nontruncated EfrE were detected, with the former being predominant in human isolates. This study provides a new insight about CHX susceptibility and ChlR-EfrEF variability within diverse E. faecalis populations. The MICCHX/MBCCHX of more tolerant E. faecalis (MICCHX = 8 mg/L; MBCCHX = 64 mg/L) remain lower than in-use concentrations of CHX (≥500 mg/L). However, increased CHX use, combined with concentration gradients occurring in diverse environments, potentially selecting multidrug-resistant strains with different CHX susceptibilities, signals the importance of monitoring the trends of E. faecalis CHX tolerance within a One Health approach. IMPORTANCE Chlorhexidine (CHX) is a disinfectant and antiseptic used since the 1950s and included in the World Health Organization's list of essential medicines. It has been widely applied in hospitals, the community, the food industry, animal husbandry and pets. CHX tolerance in Enterococcus faecalis, a ubiquitous bacterium and one of the leading causes of human hospital-acquired infections, remains underexplored. Our study provides novel and comprehensive insights about CHX susceptibility within the E. faecalis population structure context, revealing more CHX-tolerant subpopulations from the food chain and recent human infections. We further show a detailed analysis of the genetic diversity of the efrEF operon (previously associated with E. faecalis CHX tolerance) and its correlation with CHX phenotypes. The recent strains with a higher tolerance to CHX and the multiple sources where bacteria are exposed to this biocide alert us to the need for the continuous monitoring of E. faecalis adaptation toward CHX tolerance within a One Health approach.
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Affiliation(s)
- Ana P. Pereira
- UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Patrícia Antunes
- UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Rob Willems
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jukka Corander
- Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway
- Parasites and Microbes, Wellcome Sanger Institute, Cambridge, United Kingdom
- Helsinki Institute of Information Technology, Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
| | - Teresa M. Coque
- Servicio de Microbiologia, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Enfermedades Infecciosas (CIBER-EII), Madrid, Spain
| | - Luísa Peixe
- UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Ana R. Freitas
- UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
- TOXRUN, Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal
| | - Carla Novais
- UCIBIO-Applied Molecular Biosciences Unit, Laboratory of Microbiology, Department of Biological Sciences, REQUIMTE Faculty of Pharmacy, University of Porto, Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, Porto, Portugal
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Lähteenmäki H, Tervahartiala T, Räisänen IT, Pärnänen P, Sorsa T. Fermented lingonberry juice's effects on active MMP-8 (aMMP-8), bleeding on probing (BOP), and visible plaque index (VPI) in dental implants-A clinical pilot mouthwash study. Clin Exp Dent Res 2022; 8:1322-1330. [PMID: 35894289 PMCID: PMC9760138 DOI: 10.1002/cre2.638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES We aimed to study the effects of fermented lingonberry juice (FLJ) as a mouthwash on the levels of active matrix metalloproteinase-8 (aMMP-8) in peri-implant sulcular fluid (PISF), bleeding on probing (BOP), and visible plaque index (VPI). We hypothesized that FLJ rinsing could reduce inflammation (aMMP-8 and BOP) and microbial load (VPI) in the oral cavity, especially around dental implants. MATERIALS AND METHODS A clinical pilot study was performed using FLJ as a mouthwash. The inclusion criteria were at least one dental implant in the anterior or posterior areas with a screw-retained crown. Ten participants used 10 ml of mouthwash twice a day for 15 days, and 10 participants served as the control group. Point-of-care tests (POCTs) were used to measure aMMP-8 levels in the PISF, and BOP and VPI were recorded at the beginning of the trial and after 15 and 30 days. RESULTS The FLJ mouthwash had a reductive effect on aMMP-8, VPI, and BOP in the mouthwash group; however, there was no significant difference compared to the control group. The difference in VPI and BOP levels between the groups diminished after the lingonberry regimen ended. The decrease in aMMP-8 levels appeared to continue even after discontinuation of the mouthwash regimen. CONCLUSION The reduction in the amount of plaque, aMMP-8, and BOP by FLJ was promising and continuous considering the relatively short study period and sample size. FLJ is a natural and safe supplement for oral and dental implant home care. Further studies are required to verify these promising results.
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Affiliation(s)
- Hanna Lähteenmäki
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Ismo T. Räisänen
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Pirjo Pärnänen
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Head and Neck CenterUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland,Department of Dental Medicine, Division of PeriodontologyKarolinska InstitutetHuddingeSweden
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Mao X, Hiergeist A, Auer DL, Scholz KJ, Muehler D, Hiller KA, Maisch T, Buchalla W, Hellwig E, Gessner A, Al-Ahmad A, Cieplik F. Ecological Effects of Daily Antiseptic Treatment on Microbial Composition of Saliva-Grown Microcosm Biofilms and Selection of Resistant Phenotypes. Front Microbiol 2022; 13:934525. [PMID: 35847089 PMCID: PMC9280182 DOI: 10.3389/fmicb.2022.934525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/25/2022] [Indexed: 01/17/2023] Open
Abstract
Antiseptics are widely used in dental practice and included in numerous over-the-counter oral care products. However, the effects of routine antiseptic use on microbial composition of oral biofilms and on the emergence of resistant phenotypes remain unclear. Microcosm biofilms were inoculated from saliva samples of four donors and cultured in the Amsterdam Active Attachment biofilm model for 3 days. Then, they were treated two times daily with chlorhexidine digluconate (CHX) or cetylpyridinium chloride (CPC) for a period of 7 days. Ecological changes upon these multiple antiseptic treatments were evaluated by semiconductor-based sequencing of bacterial 16S rRNA genes and identification of amplicon sequence variants (ASVs). Furthermore, culture-based approaches were used for colony-forming units (CFU) assay, identification of antiseptic-resistant phenotypes using an agar dilution method, and evaluation of their antibiotic susceptibilities. Both CHX and CPC showed only slight effects on CFU and could not inhibit biofilm growth despite the two times daily treatment for 7 days. Both antiseptics showed significant ecological effects on the microbial compositions of the surviving microbiota, whereby CHX led to enrichment of rather caries-associated saccharolytic taxa and CPC led to enrichment of rather gingivitis-associated proteolytic taxa. Antiseptic-resistant phenotypes were isolated on antiseptic-containing agar plates, which also exhibited phenotypic resistance to various antibiotics. Our results highlight the need for further research into potential detrimental effects of antiseptics on the microbial composition of oral biofilms and on the spread of antimicrobial resistance in the context of their frequent use in oral healthcare.
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Affiliation(s)
- Xiaojun Mao
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Andreas Hiergeist
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - David L. Auer
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Konstantin J. Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Denise Muehler
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Elmar Hellwig
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - André Gessner
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Ali Al-Ahmad
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- *Correspondence: Fabian Cieplik,
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Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects. Antibiotics (Basel) 2022; 11:antibiotics11060727. [PMID: 35740134 PMCID: PMC9219991 DOI: 10.3390/antibiotics11060727] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/19/2022] [Accepted: 05/26/2022] [Indexed: 12/14/2022] Open
Abstract
Antimicrobial mouthwash improves supragingival biofilm control when used in conjunction with mechanical removal as part of an oral hygiene routine. Mouthwash is intended to suppress bacterial adhesion during biofilm formation processes and is not aimed at mature biofilms. The most common evidence-based effects of mouthwash on the subgingival biofilm include the inhibition of biofilm accumulation and its anti-gingivitis property, followed by its cariostatic activities. There has been no significant change in the strength of the evidence over the last decade. A strategy for biofilm control that relies on the elimination of bacteria may cause a variety of side effects. The exposure of mature oral biofilms to mouthwash is associated with several possible adverse reactions, such as the emergence of resistant strains, the effects of the residual structure, enhanced pathogenicity following retarded penetration, and ecological changes to the microbiota. These concerns require further elucidation. This review aims to reconfirm the intended effects of mouthwash on oral biofilm control by summarizing systematic reviews from the last decade and to discuss the limitations of mouthwash and potential adverse reactions to its use. In the future, the strategy for oral biofilm control may shift to reducing the biofilm by detaching it or modulating its quality, rather than eliminating it, to preserve the benefits of the normal resident oral microflora.
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Bryan NS, Burleigh MC, Easton C. The oral microbiome, nitric oxide and exercise performance. Nitric Oxide 2022; 125-126:23-30. [PMID: 35636654 DOI: 10.1016/j.niox.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 12/15/2022]
Abstract
The human microbiome comprises ∼1013-1014 microbial cells which form a symbiotic relationship with the host and play a critical role in the regulation of human metabolism. In the oral cavity, several species of bacteria are capable of reducing nitrate to nitrite; a key precursor of the signaling molecule nitric oxide. Nitric oxide has myriad physiological functions, which include the maintenance of cardiovascular homeostasis and the regulation of acute and chronic responses to exercise. This article provides a brief narrative review of the research that has explored how diversity and plasticity of the oral microbiome influences nitric oxide bioavailability and related physiological outcomes. There is unequivocal evidence that dysbiosis (e.g. through disease) or disruption (e.g. by use of antiseptic mouthwash or antibiotics) of the oral microbiota will suppress nitric oxide production via the nitrate-nitrite-nitric oxide pathway and negatively impact blood pressure. Conversely, there is preliminary evidence to suggest that proliferation of nitrate-reducing bacteria via the diet or targeted probiotics can augment nitric oxide production and improve markers of oral health. Despite this, it is yet to be established whether purposefully altering the oral microbiome can have a meaningful impact on exercise performance. Future research should determine whether alterations to the composition and metabolic activity of bacteria in the mouth influence the acute responses to exercise and the physiological adaptations to exercise training.
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Affiliation(s)
- Nathan S Bryan
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Mia C Burleigh
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK
| | - Chris Easton
- Institute for Clinical Exercise and Health Science, University of the West of Scotland, Blantyre, UK.
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