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Szalai E, Tajti P, Szabó B, Kói T, Hegyi P, Czumbel LM, Varga G, Kerémi B. ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2023; 23:101862. [PMID: 37689445 DOI: 10.1016/j.jebdp.2023.101862] [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: 10/18/2022] [Revised: 03/12/2023] [Accepted: 03/25/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis? METHODS This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot. RESULTS A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01. DISCUSSION None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.
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Affiliation(s)
- Eszter Szalai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Tajti
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - László Márk Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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Yitzhaki S, Reshef L, Gophna U, Rosenberg M, Sterer N. Microbiome associated with denture malodour. J Breath Res 2018; 12:027103. [PMID: 29341956 DOI: 10.1088/1752-7163/aa95e0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the past, our inability to cultivate most of the oral microorganisms has limited our view of this complex ecosystem. In the present study, we utilized next generation deep sequencing techniques to revisit the microbiome associated with denture malodour, a growing field with the rise in life expectancy. The study population comprised 26 full dentures patients (mean age 71 ± 6.4, 10 males, 16 females) who visited the Tel Aviv University dental geriatric clinic. Denture malodour was rated organoleptically by a single odour judge, and dentures scoring 2 and above were considered malodour positive. DNA was extracted from the swab samples and analysed using next generation deep sequencing 16 s rDNA technology. Taxa identified could be classified into nine phyla, 29 genera and 117 species. Malodour positive samples showed a higher abundance of the phyla Firmicutes and Fusobacteria and the genera Leptotrichia, Atopobium, Megasphaera, Oribacterium and Campylobacter. Microbiome analysis demonstrated higher bacterial diversity within the malodourous samples and a significant difference in the microbial profile within the two groups. Taken together these results suggest a difference between the microbial populations of malodourous and non-malodourous dentures both in composition and diversity.
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Affiliation(s)
- S Yitzhaki
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv 6997801, Israel
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Jeffet U, Nasrallah R, Sterer N. Effect of red dyes on blue light phototoxicity against VSC producing bacteria in an experimental oral biofilm. J Breath Res 2016; 10:046011. [DOI: 10.1088/1752-7155/10/4/046011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nallabelli N, Patil PP, Pal VK, Singh N, Jain A, Patil PB, Grover V, Korpole S. Biochemical and genome sequence analyses of Megasphaera sp. strain DISK18 from dental plaque of a healthy individual reveals commensal lifestyle. Sci Rep 2016; 6:33665. [PMID: 27651180 PMCID: PMC5030485 DOI: 10.1038/srep33665] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/30/2016] [Indexed: 11/08/2022] Open
Abstract
Much of the work in periodontal microbiology in recent years has focused on identifying and understanding periodontal pathogens. As the majority of oral microbes have not yet been isolated in pure form, it is essential to understand the phenotypic characteristics of microbes to decipher their role in oral environment. In this study, strain DISK18 was isolated from gingival sulcus and identified as a Megasphaera species. Although metagenomics studies revealed Megasphaera species as a major group within the oral habitat, they have never been isolated in cultivable form to date. Therefore, we have characterized the DISK18 strain to better understand its role in the periodontal ecosystem. Strain Megasphaera sp. DISK18 displayed the ability to adhere and self-aggregate, which are essential requisite features for inhabiting and persisting in oral cavity. It also coaggregated with other pioneer oral colonizers like Streptococcus and Lactobacillus species but not with Veillonella. This behaviour points towards its role in the ecologic succession of a multispecies biofilm as an early colonizer. The absence of virulence determining genes as observed in whole genome sequence analysis coupled with an inability to degrade collagen reveals that Megasphaera sp. strain DISK18 is likely not a pathogenic species and emphasizes its commensal lifestyle.
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Affiliation(s)
| | | | | | - Namrata Singh
- CSIR-Institute of Microbial Technology, Chandigarh, India
| | - Ashish Jain
- Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | | | - Vishakha Grover
- Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Suresh Korpole
- CSIR-Institute of Microbial Technology, Chandigarh, India
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Sterer N, Jeffet U, Dadoun A, Greenstein RBN, Kohavi D. Zinc enhances the phototoxic effect of blue light against malodour-producing bacteria in an experimental oral biofilm. J Med Microbiol 2014; 63:1071-1075. [PMID: 24913560 DOI: 10.1099/jmm.0.075044-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Oral malodour is thought to be caused mainly by the production of volatile sulfide compounds (VSCs) by anaerobic Gram-negative oral bacteria. Previous studies have shown that these bacteria are susceptible to blue light (400-500 nm wavelength). In the present study, we tested the effect of blue light in the presence of zinc, erythrosine B or both on malodour production in an experimental oral biofilm. Biofilms were exposed to a plasma-arc light source for 30, 60 and 120 s (equal to energy fluxes of 41, 82 and 164 J cm(-2), respectively) with or without the addition of zinc acetate, erythrosine B or both. After the light exposure, biofilm samples were examined for malodour production (by an odour judge) and VSC production (with a Halimeter), and VSC-producing bacteria were quantified using a microscopy-based sulfide assay (MSA) and in situ confocal laser scanning microscopy (CLSM). Results showed that exposing experimental oral biofilm to both blue light and zinc reduced malodour production, which coincided with a reduction in VSC-producing bacteria in the biofilm. These results suggest that zinc enhances the phototoxicity of blue light against malodour-producing bacteria.
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Affiliation(s)
- Nir Sterer
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, PO Box 39796, Ramat Aviv, Tel Aviv 69978, Israel
| | - Uziel Jeffet
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, PO Box 39796, Ramat Aviv, Tel Aviv 69978, Israel
| | - Aurel Dadoun
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, PO Box 39796, Ramat Aviv, Tel Aviv 69978, Israel
| | - Ronit Bar-Ness Greenstein
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, PO Box 39796, Ramat Aviv, Tel Aviv 69978, Israel
| | - David Kohavi
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel Aviv University, PO Box 39796, Ramat Aviv, Tel Aviv 69978, Israel
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Sterer N, Slutzky H, Kohavi D, Matalon S. In vitro CPC retention and VSC adsorption by IPM oil droplets: possible mechanisms of action of a two phase mouthwash. J Breath Res 2013; 7:031001. [PMID: 23867541 DOI: 10.1088/1752-7155/7/3/031001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Two phase oil-water mouthwash has been previously shown to efficiently bind oral microorganisms, relying on their cell surface hydrophobicity. The aim of the present in vitro study was to test the cetylpyridinium chloride (CPC) retention and volatile sulfide compounds (VSCs) adsorption abilities of the oil droplets created by mixing of a two phase oil-water solution. VSC adsorption was assayed using a salivary incubation assay and garlic powder solutions, and demonstrated using microscopic sulfide assay. CPC retention was assayed by kinetic and endpoint measurement of Streptococcus salivarius outgrowth using microplate (ELISA) reader. Results showed that the isopropyl myristate (IPM) oil droplets in the two phase solutions were able to adsorb 68-80% of VSCs. CPC at a concentration of 0.05% was most affectively retained by the oil droplets showing a significantly increase in residual antibacterial activity against Streptococcus salivarius. These results taken together, suggests that VSC adsorption and CPC retention by IPM oil droplets may be two additional mechanisms in the activity of the two phase mouthwash formulation.
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Affiliation(s)
- N Sterer
- Department of Prosthodontics, Goldschleger School of Dental Medicine, Tel-Aviv University, Ramat-Aviv 69978, Israel.
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Gov Y, Sterer N, Rosenberg M. In vitro
effect of coffee on oral malodor-related parameters. J Breath Res 2010; 4:026004. [DOI: 10.1088/1752-7155/4/2/026004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Thekedar B, Szymczak W, Höllriegl V, Hoeschen C, Oeh U. Investigations on the variability of breath gas sampling using PTR-MS. J Breath Res 2009; 3:027007. [DOI: 10.1088/1752-7155/3/2/027007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Sterer N, Shaharabany M, Rosenberg M. β-Galactosidase activity and H(2)S production in an experimental oral biofilm. J Breath Res 2009; 3:016006. [PMID: 21383454 DOI: 10.1088/1752-7155/3/1/016006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We recently suggested that oral malodor production involves two steps: (i) deglycosylation of glycoproteins and (ii) proteolysis and amino acid utilization of the protein core to yield volatiles such as volatile sulfide compounds (VSCs). Our aim was to test the hypothesis that β-galactosidase activity and VSC production occur in distinct areas of the biofilm by two different bacterial populations. Biofilms were grown anaerobically for seven days with or without antibiotics (i.e. vancomycin and metronidazole). Biofilms were stained for β-galactosidase activity and VSC production and studied using confocal laser scanning microscopy. Results showed that β-galactosidase activity occurs in the outer layers and disappears following vancomycin addition, whereas VSC production occurs deeper within the biofilm and disappears following metronidazole application. These findings suggest that β-galactosidase activity is produced mainly by Gram-positive oral bacteria at the outer portion of the biofilm, and VSC production occurs in the deeper layers by Gram-negative oral bacteria.
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Affiliation(s)
- N Sterer
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
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