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Van Holm W, Zayed N, Lauwens K, Saghi M, Axelsson J, Aktan MK, Braem A, Simoens K, Vanbrabant L, Proost P, Van Holm B, Maes P, Boon N, Bernaerts K, Teughels W. Oral Biofilm Composition, Dissemination to Keratinocytes, and Inflammatory Attenuation Depend on Probiotic and Synbiotic Strain Specificity. Probiotics Antimicrob Proteins 2024:10.1007/s12602-024-10253-z. [PMID: 38619794 DOI: 10.1007/s12602-024-10253-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
Several inflammatory diseases are characterized by a disruption in the equilibrium between the host and its microbiome. Due to the increase in resistance, the use of antibiotics for the widespread, nonspecific killing of microorganisms is at risk. Pro-microbial approaches focused on stimulating or introducing beneficial species antagonistic toward pathobionts may be a viable alternative for restoring the host-microbiome equilibrium. Unfortunately, not all potential probiotic or synbiotic species and even subspecies (to strain level) are equally effective for the designated pathology, leading to conflicting accounts of their efficacy. To assess the extent of these species- and strain-specific effects, 13 probiotic candidates were evaluated for their probiotic and synbiotic potential with glycerol on in vitro oral biofilms, dissemination from biofilms to keratinocytes, and anti-inflammatory activity. Species- and strain-specific effects and efficacies were observed in how they functioned as probiotics or synbiotics by influencing oral pathobionts and commensals within biofilms and affected the dissemination of pathobionts to keratinocytes, ranging from ineffective strains to strains that reduced pathobionts by 3 + log. In addition, a minority of the candidates exhibited the ability to mitigate the inflammatory response of LPS-stimulated monocytes. For a comprehensive assessment of probiotic therapy for oral health, a judicious selection of fully characterized probiotic strains that are specifically tailored to the designated pathology is required. This approach aims to challenge the prevailing perception of probiotics, shifting the focus away from "form over function." Rather than using unproven, hypothetical probiotic strains from known genera or species, one should choose strains that are actually functional in resolving the desired pathology before labelling them probiotics.
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Affiliation(s)
- Wannes Van Holm
- KU Leuven, Department of Oral Health Sciences, Periodontology and Oral Microbiology, B-3000, Leuven, Belgium
- Ghent University (UGent), Centre for Microbial Ecology and Technology (CMET), Ghent, Belgium
| | - Naiera Zayed
- KU Leuven, Department of Oral Health Sciences, Periodontology and Oral Microbiology, B-3000, Leuven, Belgium
- Ghent University (UGent), Centre for Microbial Ecology and Technology (CMET), Ghent, Belgium
- Faculty of Pharmacy, Menoufia University, Shebeen El-Kom, Egypt
| | - Katalina Lauwens
- KU Leuven, Department of Oral Health Sciences, Periodontology and Oral Microbiology, B-3000, Leuven, Belgium
| | - Mehraveh Saghi
- KU Leuven, Department of Oral Health Sciences, Periodontology and Oral Microbiology, B-3000, Leuven, Belgium
| | | | - Merve Kübra Aktan
- KU Leuven, Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering, B-3000, Leuven, Belgium
| | - Annabel Braem
- KU Leuven, Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering, B-3000, Leuven, Belgium
| | - Kenneth Simoens
- KU Leuven, Department of Chemical Engineering, Bio- and Chemical Systems Technology, B-3000, Leuven, Belgium
| | - Lotte Vanbrabant
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Research Group Immunity and Inflammation, B-3000, Leuven, Belgium
| | - Paul Proost
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Research Group Immunity and Inflammation, B-3000, Leuven, Belgium
| | - Bram Van Holm
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, B-3000, Leuven, Belgium
| | - Piet Maes
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, B-3000, Leuven, Belgium
| | - Nico Boon
- Ghent University (UGent), Centre for Microbial Ecology and Technology (CMET), Ghent, Belgium
| | - Kristel Bernaerts
- KU Leuven, Department of Chemical Engineering, Bio- and Chemical Systems Technology, B-3000, Leuven, Belgium
| | - Wim Teughels
- KU Leuven, Department of Oral Health Sciences, Periodontology and Oral Microbiology, B-3000, Leuven, Belgium.
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Mermans F, De Baets H, García-Timermans C, Teughels W, Boon N. Unlocking the mechanism of action: a cost-effective flow cytometry approach for accelerating antimicrobial drug development. Microbiol Spectr 2024; 12:e0393123. [PMID: 38483479 DOI: 10.1128/spectrum.03931-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
Antimicrobial resistance is one of the greatest challenges to global health. While the development of new antimicrobials can combat resistance, low profitability reduces the number of new compounds brought to market. Elucidating the mechanism of action is crucial for developing new antimicrobials. This can become expensive as there are no universally applicable pipelines. Phenotypic heterogeneity of microbial populations resulting from antimicrobial treatment can be captured through flow cytometric fingerprinting. Since antimicrobials are classified into limited groups, the mechanism of action of known compounds can be used for predictive modeling. We demonstrate a cost-effective flow cytometry approach for determining the mechanism of action of new compounds. Cultures of Actinomyces viscosus and Fusobacterium nucleatum were treated with different antimicrobials and measured by flow cytometry. A Gaussian mixture mask was applied over the data to construct phenotypic fingerprints. Fingerprints were used to assess statistical differences between mechanism of action groups and to train random forest classifiers. Classifiers were then used to predict the mechanism of action of cephalothin. Statistical differences were found among the different mechanisms of action groups. Pairwise comparison showed statistical differences for 35 out of 45 pairs for A. viscosus and for 32 out of 45 pairs for F. nucleatum after 3.5 h of treatment. The best-performing random forest classifier yielded a Matthews correlation coefficient of 0.92 and the mechanism of action of cephalothin could be successfully predicted. These findings suggest that flow cytometry can be a cheap and fast alternative for determining the mechanism of action of new antimicrobials.IMPORTANCEIn the context of the emerging threat of antimicrobial resistance, the development of novel antimicrobials is a commonly employed strategy to combat resistance. Elucidating the mechanism of action of novel compounds is crucial in this development but can become expensive, as no universally applicable pipelines currently exist. We present a novel flow cytometry-based approach capable of determining the mechanism of action swiftly and cost-effectively. The workflow aims to accelerate drug discovery and could help facilitate a more targeted approach for antimicrobial treatment of patients.
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Affiliation(s)
- Fabian Mermans
- Center for Microbial Ecology and Technology, Faculty of Bioscience Engineering, Ghent University, Gent, Belgium
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Hanna De Baets
- Center for Microbial Ecology and Technology, Faculty of Bioscience Engineering, Ghent University, Gent, Belgium
| | - Cristina García-Timermans
- Center for Microbial Ecology and Technology, Faculty of Bioscience Engineering, Ghent University, Gent, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology, Faculty of Bioscience Engineering, Ghent University, Gent, Belgium
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Zayed N, Munjaković H, Aktan MK, Simoens K, Bernaerts K, Boon N, Braem A, Pamuk F, Saghi M, Van Holm W, Fidler A, Gašperšič R, Teughels W. Electrolyzed Saline Targets Biofilm Periodontal Pathogens In Vitro. J Dent Res 2024; 103:243-252. [PMID: 38185942 DOI: 10.1177/00220345231216660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Preventing the development and recurrence of periodontal diseases often includes antimicrobial mouthrinses to control the growth of the periodontal pathogens. Most antimicrobials are nonselective, targeting the symbiotic oral species as well as the dysbiosis-inducing ones. This affects the overall microbial composition and metabolic activity and consequently the host-microbe interactions, which can be detrimental (associated with inflammation) or beneficial (health-associated). Consequently, guiding the antimicrobial effect for modulating the microbial composition to a health-associated one should be considered. For such an approach, this study investigated electrolyzed saline as a novel rinse. Electrolyzed saline was prepared from sterile saline using a portable electrolysis device. Multispecies oral homeostatic and dysbiotic biofilms were grown on hydroxyapatite discs and rinsed daily with electrolyzed saline (EOS). Corresponding positive (NaOCl) and negative (phosphate-buffered saline) controls were included. After 3 rinses, biofilms were analyzed with viability quantitative polymerase chain reaction and scanning electron microscopy. Supernatants of rinsed biofilms were used for metabolic activity analysis (high-performance liquid chromatography) through measuring organic acid content. In addition, human oral keratinocytes (HOKs) were exposed to EOS to test biocompatibility (cytotoxicity and inflammation induction) and also to rinsed biofilms to assess their immunogenicity after rinsing. Rinsing the dysbiotic biofilms with EOS could reduce the counts of the pathobionts (>3 log10 Geq/mm2 reduction) and avert biofilm dysbiosis (≤1% pathobiont abundance), leading to the dominance of commensal species (≥99%), which altered both biofilm metabolism and interleukin 8 (IL-8) induction in HOKs. EOS had no harmful effects on homeostatic biofilms. The scanning electron micrographs confirmed the same. In addition, tested concentrations of EOS did not have any cytotoxic effects and did not induce IL-8 production in HOKs. EOS showed promising results for diverting dysbiosis in in vitro rinsed biofilms and controlling key periopathogens, with no toxic effects on commensal species or human cells. This novel rinsing should be considered for clinical applications.
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Affiliation(s)
- N Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - H Munjaković
- Department of Oral Medicine and Periodontology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - M K Aktan
- Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, Leuven, Belgium
| | - K Simoens
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - K Bernaerts
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - N Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - A Braem
- Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, Leuven, Belgium
| | - F Pamuk
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | - M Saghi
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | - W Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - A Fidler
- Department of Endodontic and Restorative Dentistry, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - R Gašperšič
- Department of Oral Medicine and Periodontology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - W Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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Pimentel I, Henriques B, Silva F, Carvalho O, Teughels W, Özcan M, Souza JCM. Morphological aspects and distribution of granules composed of deproteinized bovine bone or human dentin into a putty mixture: an in vitro study. Head Face Med 2023; 19:55. [PMID: 38110992 PMCID: PMC10726580 DOI: 10.1186/s13005-023-00398-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVE The main aim of this study was to evaluate the morphological aspects and distribution of granules composed of deproteinized bovine bone mineral (DBBM) and human dentin-derived bone graft (HDBG) into a putty consistency mixture. MATERIALS AND METHODS DBBM or HDBG were mixed with an alginate-based hydrogel at two different granule/hydrogel ratio (1:1 and 1:3) and divided into four test groups while two control groups were composed of DBBM or HDBG free of hydrogel. Groups of specimens were cross-sectioned for morphological evaluation by scanning electron microscopy (SEM) at backscattered electrons mode. Details on the dimensions and pores' size of DBBM and HDBG were evaluated after mixing different amounts of particles and alginate-based hydrogels. RESULTS Microscopic analyses revealed a size of DBBM granules ranging from 750 up to 1600 μm while HDBG particles showed particle size ranging from 375 up to 1500 μm. No statistical differences were identified regarding the size of granules (p > 0.5). The mean values of pores' size of DBBM particles were noticed at around 400 μm while HDBG particles revealed micro-scale pores of around 1-3 μm promoted by the dentin tubules (p < 0.05). The lowest distance between particles was at 125 μm for HDBG and 250 μm for DBBM when the particle content was increased. On decreasing the particles' content, the distance between particles was larger for DBBM (~ 1000 μm) and HDBG (~ 1100 μm). In fact, statistically significant differences were found when the content of granules increased (p < 0.05). CONCLUSIONS The increased content of bioactive ceramic granules in a putty consistency mixture with hydrogel decreased the space among granules that can promote a high ceramic density and stimulate the bone growth over the healing process. Macro-scale pores on bovine bone mineral granules stimulate the formation of blood vessels and cell migration while the micro-scale pores of dentin-derived granules are proper for the adsorption of proteins and growth of osteogenic cells on the bone healing process. CLINICAL SIGNIFICANCE A high amount of bioactive ceramic granules should be considered when mixing with hydrogels as a putty material since that result in small spaces among granules maintaining the bone volume over the bone healing process. Deproteinized bovine bone mineral granules have macro-scale pores providing an enhanced angiogenesis while dentin-derived granules possess only micro-scale pores for the adsorption of proteins and proliferation of osteogenic cells on the bone healing process. Further studies should evaluate the combination of different bioactive ceramic materials for enhanced bone healing.
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Affiliation(s)
- Inês Pimentel
- University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, 4585-116, Portugal
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, 4800-058, Portugal
- Associate laboratory (LABBELS), University of Minho, Guimarães, Braga, 4710-057, Portugal
- Ceramic and Composite Materials Research Group (CERMAT), Dept. of Mechanical Engineering (EMC), Federal University of Santa Catarina (UFSC), Florianópolis, SC, 88040-900, Brazil
| | - Filipe Silva
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, 4800-058, Portugal
- Associate laboratory (LABBELS), University of Minho, Guimarães, Braga, 4710-057, Portugal
| | - Oscar Carvalho
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, 4800-058, Portugal
- Associate laboratory (LABBELS), University of Minho, Guimarães, Braga, 4710-057, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, Dentistry, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, 3000, Belgium
| | - Mutlu Özcan
- Clinic for Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, 8032, Switzerland.
| | - Júlio C M Souza
- Center for Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, 4800-058, Portugal.
- Associate laboratory (LABBELS), University of Minho, Guimarães, Braga, 4710-057, Portugal.
- Center for Interdisciplinary Research in Health (CIIS), Faculty of Dental Medicine (FMD), Universidade Católica Portuguesa (UCP), Viseu, 3504-505, Portugal.
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Ghesquière J, Simoens K, Koos E, Boon N, Teughels W, Bernaerts K. Spatiotemporal monitoring of a periodontal multispecies biofilm model: demonstration of prebiotic treatment responses. Appl Environ Microbiol 2023; 89:e0108123. [PMID: 37768099 PMCID: PMC10617495 DOI: 10.1128/aem.01081-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/26/2023] [Indexed: 09/29/2023] Open
Abstract
Biofilms are complex polymicrobial communities which are often associated with human infections such as the oral disease periodontitis. Studying these complex communities under controlled conditions requires in vitro biofilm model systems that mimic the natural environment as close as possible. This study established a multispecies periodontal model in the drip flow biofilm reactor in order to mimic the continuous flow of nutrients at the air-liquid interface in the oral cavity. The design is engineered to enable real-time characterization. A community of five bacteria, Streptococcus gordonii-GFPmut3*, Streptococcus oralis-GFPmut3*, Streptococcus sanguinis-pVMCherry, Fusobacterium nucleatum, and Porphyromonas gingivalis-SNAP26 is visualized using two distinct fluorescent proteins and the SNAP-tag. The biofilm in the reactor develops into a heterogeneous, spatially uniform, dense, and metabolically active biofilm with relative cell abundances similar to those in a healthy individual. Metabolic activity, structural features, and bacterial composition of the biofilm remain stable from 3 to 6 days. As a proof of concept for our periodontal model, the 3 days developed biofilm is exposed to a prebiotic treatment with L-arginine. Multifaceted effects of L-arginine on the oral biofilm were validated by this model setup. L-arginine showed to inhibit growth and incorporation of the pathogenic species and to reduce biofilm thickness and volume. Additionally, L-arginine is metabolized by Streptococcus gordonii-GFPmut3* and Streptococcus sanguinis-pVMCherry, producing high levels of ornithine and ammonium in the biofilm. In conclusion, our drip flow reactor setup is promising in studying spatiotemporal behavior of a multispecies periodontal community.ImportancePeriodontitis is a multifactorial chronic inflammatory disease in the oral cavity associated with the accumulation of microorganisms in a biofilm. Not the presence of the biofilm as such, but changes in the microbiota (i.e., dysbiosis) drive the development of periodontitis, resulting in the destruction of tooth-supporting tissues. In this respect, novel treatment approaches focus on maintaining the health-associated homeostasis of the resident oral microbiota. To get insight in dynamic biofilm responses, our research presents the establishment of a periodontal biofilm model including Streptococcus gordonii, Streptococcus oralis, Streptococcus sanguinis, Fusobacterium nucleatum, and Porphyromonas gingivalis. The added value of the model setup is the combination of simulating continuously changing natural mouth conditions with spatiotemporal biofilm profiling using non-destructive characterization tools. These applications are limited for periodontal biofilm research and would contribute in understanding treatment mechanisms, short- or long-term exposure effects, the adaptation potential of the biofilm and thus treatment strategies.
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Affiliation(s)
- Justien Ghesquière
- Chemical and Biochemical Reactor Engineering and Safety (CREaS), Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Kenneth Simoens
- Chemical and Biochemical Reactor Engineering and Safety (CREaS), Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Erin Koos
- Soft Matter, Rheology and Technology, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven) and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Kristel Bernaerts
- Chemical and Biochemical Reactor Engineering and Safety (CREaS), Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
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Quirynen M, Siawasch S, Temmerman A, Cortellini S, Dhondt R, Teughels W, Castro AB. Do autologous platelet concentrates (APCs) have a role in intra-oral bone regeneration? A critical review of clinical guidelines on decision-making process. Periodontol 2000 2023; 93:254-269. [PMID: 37845802 DOI: 10.1111/prd.12526] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 07/05/2023] [Accepted: 08/15/2023] [Indexed: 10/18/2023]
Abstract
In the past decades, personalized regenerative medicine has gained increased attention. Autologous platelet concentrates (APCs) such as PRP, PRGF, and L-PRF, all serving as a source of a large variety of cells and growth factors that participate in hard and soft tissue healing and regeneration, could play a significant role in regenerative periodontal procedures. This narrative review evaluated the relative impact of APCs in alveolar ridge preservation, sinus floor augmentation, and the regeneration of bony craters around teeth, both as a single substitute or in combination with a xenograft. L-PRF has a significant beneficial effect on alveolar ridge preservation ( bone quality). The data for PRGF are less convincing, and PRP is controversial. L-PRF can successfully be used as a single substitute during transcrestal (≥3.5 mm bone gain) as well as 1-stage lateral window sinus floor elevation (>5 mm bone gain). For PRGF and especially PRP the data are very scarce. In the treatment of bony craters around teeth, during open flap debridement, L-PRF as a single substitute showed significant adjunctive benefits (e.g., >PPD reduction, >CAL gain, >crater depth reduction). The data for PRP and PRGF were non-conclusive. Adding PRP or L-PRF to a xenograft during OFD resulted in additional improvements (>PPD reduction, >CAL gain, >bone fill), for PRGF no data were found. Autologous platelet concentrates demonstrated to enhance bone and soft tissue healing in periodontal regenerative procedures. The data for L-PRF were most convincing. L-PRF also has the advantage of a greater simplicity of production, and its 100% autologous character.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Sam Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Anna B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Cadenas de Llano-Pérula M, Castro AB, Danneels M, Schelfhout A, Teughels W, Willems G. Risk factors for gingival recessions after orthodontic treatment: a systematic review. Eur J Orthod 2023; 45:528-544. [PMID: 37432131 DOI: 10.1093/ejo/cjad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
BACKGROUND/OBJECTIVES To systematically review the available evidence concerning the risk factors for gingival recessions (GR) after orthodontic treatment (OT). DATA COLLECTION AND ANALYSIS Data was obtained and collected by systematically searching 3 data bases: Pubmed, EMBASE, and Web of Science until 20 April 2023. Controlled trials, cohort, case-control or cross-sectional studies describing GR or clinical crown height (CCH) after OT were included. The risk of bias in the selected studies was evaluated with the methodological index for non-randomized studies. RESULTS Forty-eight articles were included, investigating the following six risk factors for GR: 1. OT (n = 21), 2. Type of orthodontic intervention (n = 32), 3. Patient's baseline occlusal and skeletal characteristics (n = 14), 4. Mucogingival characteristics (n = 10), 5. Oral hygiene (n = 9), and 6. Others (n = 12). Significantly higher prevalence, severity and extent of GR were found in orthodontic patients by 10/15, 4/10, and 2/2 articles respectively. 10/16 articles reported significantly more GR and increased CCH in patients where orthodontic incisor proclination was performed. The evidence surrounding maxillary expansion and orthodontic retention was too heterogeneous to allow for? definitive conclusions. Pre-treatment angle classification, ANB, overjet, overbite, arch width and mandibular divergence were found not to be associated with GR (9/14), while pre-treatment crossbite, symphysis height and width were (5/7 studies). A thin gingival biotype, presence of previous GR, baseline width of keratinized gingiva and facial gingival margin thickness were correlated with increased risk of GR after OT by nine articles, while pocket depth was not. Oral hygiene, sex, treatment duration, and oral piercings were found not to be linked with GR in orthodontic patients, while GR was reported to increase with age in orthodontic patients by 50 per cent of the articles investigating this factor. The mean risk of bias for comparative and not comparative studies was 14.17/24 and 9.12/16. LIMITATIONS The selected studies were quite heterogeneous regarding study settings, variables reported and included very limited sample sizes. CONCLUSION Although studies regarding the risk factors for GR are relatively abundant, they are very heterogeneous concerning design, studied factors, methodology and reporting, which often leads to contradictory results. Uniform reporting guidelines are urgently needed for future research. PROSPERO REGISTRATION CRD42020181661. FUNDING This research received no funding.
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Affiliation(s)
- Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
| | - Ana Belén Castro
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Periodontology and Oral Microbiology, KU Leuven, Belgium
| | - Margaux Danneels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
| | - Alix Schelfhout
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Periodontology and Oral Microbiology, KU Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Belgium
- Research group Orthodontics, KU Leuven, Belgium
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Alkaya B, Kayhan HG, Temmerman A, Haytac MC, Teughels W. Pre-operative, chair-side Zn-containing surgical stents affect morbidity and wound healing after free gingival graft harvesting: a randomized clinical trial. Clin Oral Investig 2023; 27:5519-5527. [PMID: 37468598 DOI: 10.1007/s00784-023-05171-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To compare a pre-operatively, chair-side made, zinc-containing surgical stent (ZN) and suturing of a gelatin-based hemostatic agent (HA) on palatal wound healing and patient morbidity after free gingival graft surgery (FGG). MATERIALS AND METHODS Sixty patients requiring FGG were randomly divided into two groups to receive either a ZN or a sterile HA sutured on the surgical area. Patients were evaluated at 1st, 3rd, 7th, 14th, 28th, and 56th days following surgery. Overall surgical time, donor site surgical time, postoperative pain (PP), delayed bleeding (DB), changes in dietary habits (DH), burning sensation (BS), completion of re-epithelialization (CE), and patients' discomfort (PD) were evaluated. RESULTS Donor site surgical time, PP, DB, DH, BS were statistically significantly lower in the ZN group together with faster completion of re-epithelialization compared to the HA group. CONCLUSION Pre-operatively, chair-side made, zinc-containing surgical stents provided significant benefits for wound healing parameters and patients' postoperative morbidity after FGG harvesting. CLINICAL RELEVANCE The results show that using Zn-containing palatal stent after free gingival graft surgery significantly reduces pain and patient morbidity during the postoperative period.
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Affiliation(s)
- Bahar Alkaya
- Department of Periodontology Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Hamza Gokhan Kayhan
- Department of Periodontology Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Andy Temmerman
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Louvain, Belgium
| | - Mehmet Cenk Haytac
- Department of Periodontology Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Louvain, Belgium
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9
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Arredondo A, Àlvarez G, Isabal S, Teughels W, Laleman I, Contreras MJ, Isbej L, Huapaya E, Mendoza G, Mor C, Nart J, Blanc V, León R. Comparative 16S rRNA gene sequencing study of subgingival microbiota of healthy subjects and patients with periodontitis from four different countries. J Clin Periodontol 2023; 50:1176-1187. [PMID: 37246304 DOI: 10.1111/jcpe.13827] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 03/15/2023] [Accepted: 05/02/2023] [Indexed: 05/30/2023]
Abstract
AIM To investigate the differences between the subgingival microbiota of healthy subjects (HS) and periodontitis patients (PP) from four different countries through a metagenomic approach. MATERIALS AND METHODS Subgingival samples were obtained from subjects from four different countries. Microbial composition was analysed through high-throughput sequencing of the V3-V4 region of the 16S rRNA gene. The country of origin, diagnosis and clinical and demographic variables of the subjects were used to analyse the microbial profiles. RESULTS In total, 506 subgingival samples were analysed: 196 from HS and 310 from patients with periodontitis. Differences in richness, diversity and microbial composition were observed when comparing samples pertaining to different countries of origin and different subject diagnoses. Clinical variables, such as bleeding on probing, did not significantly affect the bacterial composition of the samples. A highly conserved core of microbiota associated with periodontitis was detected, while the microbiota associated with periodontally HS was much more diverse. CONCLUSIONS Periodontal diagnosis of the subjects was the main variable explaining the composition of the microbiota in the subgingival niche. Nevertheless, the country of origin also had a significant impact on the microbiota and is therefore an important factor to consider when describing subgingival bacterial communities.
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Affiliation(s)
- A Arredondo
- Department of Microbiology, DENTAID Research Center, Barcelona, Spain
| | - G Àlvarez
- Department of Microbiology, DENTAID Research Center, Barcelona, Spain
| | - S Isabal
- Department of Microbiology, DENTAID Research Center, Barcelona, Spain
| | - W Teughels
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - I Laleman
- Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - M J Contreras
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - L Isbej
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Pharmacology and Toxicology Programme, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - E Huapaya
- Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - G Mendoza
- Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
- Department of Periodontics, University of Pennsylvania, School of dental Medicine, Philadelphia, Pennsylvania, USA
| | - C Mor
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - J Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - V Blanc
- Department of Microbiology, DENTAID Research Center, Barcelona, Spain
| | - R León
- Department of Microbiology, DENTAID Research Center, Barcelona, Spain
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10
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Garcia de Carvalho G, Maquera-Huacho PM, Silva Pontes C, Annunzio SRD, Fontana Mendonça CR, Nara de Souza Rastelli A, de Oliveira KT, Teughels W, Chorilli M, Leal Zandim-Barcelos D, Palomari Spolidorio DM. Chlorin-e6 conjugated to the antimicrobial peptide LL-37 loaded nanoemulsion enhances photodynamic therapy against multi-species biofilms related to periodontitis. Photodiagnosis Photodyn Ther 2023; 43:103725. [PMID: 37500031 DOI: 10.1016/j.pdpdt.2023.103725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
In our previous studies, Chlorin-e6 (Ce6) demonstrated a significant reduction of microorganisms' viability against multi-species biofilm related to periodontitis while irradiated with blue light. However, the conjugation of Ce6 and antimicrobial peptides, and the incorporation of this photosensitizer in a nanocarrier, is still poorly explored. We hypothesized that chlorin-e6 conjugated to the antimicrobial peptide LL-37 loaded nanoemulsion could inhibit a multi-species biofilm related to periodontitis during photodynamic therapy (PDT), the pre-treatment with hydrogen peroxide was also tested. The nanoemulsion (NE) incorporated with Ce6 was characterized regarding the physiochemical parameters. Images were obtained by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Later, the Ce6 and LL-37 incorporated in NE was submitted to UV-Vis analysis and Reactive Oxygen Species (ROS) assay. Finally, the combined formulation (Ce6+LL-37 in nanoemulsion) was tested against multi-species biofilm related to periodontitis. The formed nanoformulation was kinetically stable, optically transparent with a relatively small droplet diameter (134.2 unloaded and 146.9 loaded), and weak light scattering. The NE system did not impact the standard UV-VIS spectra of Ce6, and the ROS production was improved while Ce6 was incorporated in the NE. The combination of Ce6 and LL-37 in NE was effective to reduce the viability of all bacteria tested. The treatment with hydrogen peroxide previous to PDT significantly impacted bacterial viability. The current aPDT regimen was the best already tested against periodontal biofilm by our research team. Our results suggest that this combined protocol must be exploited for clinical applications in localized infections such as periodontal disease. - Nanoemulsion demonstrated to be an excellent nanocarrier for photodynamic application. - Chlorin-e6 incorporated in nanoemulsion showed great physicochemical and biophotonic parameters. - The combination of chlorin-e6 and LL-37 peptide in nanoemulsion is effective to eliminate periodontal pathogenic bacteria. - The treatment with hydrogen peroxide previous to PDT significantly impacted bacterial viability.
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Affiliation(s)
- Gabriel Garcia de Carvalho
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil.
| | - Patricia Milagros Maquera-Huacho
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
| | - Cristiano Silva Pontes
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
| | - Sarah Raquel de Annunzio
- São Paulo State University (Unesp), School of Pharmaceutical Sciences, Araraquara, São Paulo, Brazil
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
| | | | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven & Dentistry University Hospitals Leuven, Leuven, Belgium
| | - Marlus Chorilli
- Department of Drugs and Medicines, International School of Pharmaceuticals Sciences, São Paulo State University, Araraquara, São Paulo, Brazil
| | - Daniela Leal Zandim-Barcelos
- Department of Oral Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry at Araraquara, Araraquara, São Paulo, Brazil
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11
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Van Holm W, Lauwens K, De Wever P, Schuermans A, Zayed N, Pamuk F, Saghi M, Fardim P, Bernaerts K, Boon N, Teughels W. Probiotics for oral health: do they deliver what they promise? Front Microbiol 2023; 14:1219692. [PMID: 37485503 PMCID: PMC10358723 DOI: 10.3389/fmicb.2023.1219692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Probiotics have demonstrated oral health benefits by influencing the microbiome and the host. Although promising, their current use is potentially constrained by several restrictions. One such limiting factor lies in the prevailing preparation of a probiotic product. To commercialize the probiotic, a shelf stable product is achieved by temporarily inactivating the live probiotic through drying or freeze drying. Even though a lyophilized probiotic can be kept dormant for an extended period of time, their viability can be severely compromised, making their designation as probiotics questionable. Additionally, does the application of an inactive probiotic directly into the oral cavity make sense? While the dormancy may allow for survival on its way towards the gut, does it affect their capacity for oral colonisation? To evaluate this, 21 probiotic product for oral health were analysed for the number of viable (probiotic), culturable (CFU) and dead (postbiotic) cells, to verify whether the commercial products indeed contain what they proclaim. After isolating and uniformly lyophilizing three common probiotic species in a simple yet effective lyoprotective medium, the adhesion to saliva covered hydroxyapatite discs of lyophilized probiotics was compared to fresh or reactivated lyophilized probiotics. Unfortunately, many of the examined products failed to contain the claimed amounts of viable cells, but also the strains used were inadequately characterized and lacked clinical evidence for that unknown strain, questioning their label of a 'probiotic'. Additionally, lyophilized probiotics demonstrated low adhesive capacity compared to their counterparts, prompting the question of why fresh or reactivated probiotics are not currently used.
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Affiliation(s)
- Wannes Van Holm
- Department of Oral Health Sciences, University of Leuven KU Leuven, Leuven, Belgium
- Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Ghent, Belgium
| | - Katalina Lauwens
- Department of Oral Health Sciences, University of Leuven KU Leuven, Leuven, Belgium
| | - Pieter De Wever
- Bio-and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven KU Leuven, Leuven, Belgium
| | | | - Naiera Zayed
- Department of Oral Health Sciences, University of Leuven KU Leuven, Leuven, Belgium
- Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Ghent, Belgium
- Faculty of Pharmacy, Menoufia University, Shebeen El-Kom, Egypt
| | - Ferda Pamuk
- Department of Oral Health Sciences, University of Leuven KU Leuven, Leuven, Belgium
| | - Mehraveh Saghi
- Department of Oral Health Sciences, University of Leuven KU Leuven, Leuven, Belgium
| | - Pedro Fardim
- Bio-and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven KU Leuven, Leuven, Belgium
| | - Kristel Bernaerts
- Bio-and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven KU Leuven, Leuven, Belgium
| | - Nico Boon
- Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Ghent, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven KU Leuven, Leuven, Belgium
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12
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Herrera D, van Winkelhoff AJ, Matesanz P, Lauwens K, Teughels W. Europe's contribution to the evaluation of the use of systemic antimicrobials in the treatment of periodontitis. Periodontol 2000 2023. [PMID: 37314038 DOI: 10.1111/prd.12492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
This narrative review celebrates Europe's contribution to the current knowledge on systemically administered antimicrobials in periodontal treatment. Periodontitis is the most frequent chronic noncommunicable human disease. It is caused by dysbiotic bacterial biofilms and is commonly treated with subgingival instrumentation. However, some sites/patients do not respond adequately, and its limitations and shortcomings have been recognized. This has led to the development of alternative or adjunctive therapies. One is the use of antimicrobials to target bacteria in subgingival biofilms in the periodontal pocket, which can be targeted directly through the pocket entrance with a locally delivered antibiotic or systemically by oral, intravenous, or intramuscular methods. Since the early 20th century, several studies on systemic antibiotics have been undertaken and published, especially between 1990 and 2010. Europe's latest contribution to this topic is the first European Federation of Periodontology, S3-level Clinical Practice Guideline, which incorporates recommendations related to the use of adjuncts to treat stage I-III periodontitis. Understanding the etiopathogenesis of periodontal diseases, specifically periodontitis, has influenced the use of systemic periodontal antibiotic therapy. Randomized clinical trials and systematic reviews with meta-analyses have demonstrated the clinical advantages of adjunctive systemic antimicrobials. However, current recommendations are restrictive due to concerns about antibiotic misuse and the increase in microbial antibiotic resistance. European researchers have contributed to the use of systemic antimicrobials in the treatment of periodontitis through clinical trials and by providing rational guidelines. Nowadays, European researchers are exploring alternatives and directing clinical practice by providing evidence-based guidelines to limit the use of systemic antimicrobials.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Katalina Lauwens
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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13
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Zayed N, Ghesquière J, Kamarudin NHN, Bernaerts K, Boon N, Braem A, Van Holm W, Teughels W. Oral Biofilm Cryotherapy as a Novel Ecological Modulation Approach. J Dent Res 2023:220345231172688. [PMID: 37278360 DOI: 10.1177/00220345231172688] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Oral cryotherapy is used in dentistry as a safe, simple, and low-cost treatment for a variety of oral lesions. It is well known for its ability to aid in the healing process. However, its effect on oral biofilms is unknown. As a result, the purpose of this study was to assess the effects of cryotherapy on in vitro oral biofilms. In vitro multispecies oral biofilms were grown on the surface of hydroxyapatite discs in symbiotic or dysbiotic states. CryoPen X+ was used to treat the biofilms, whereas untreated biofilms served as control. One set of biofilms was collected for study immediately after cryotherapy, whereas another group was reincubated for 24 h to permit biofilm recovery. Changes in biofilm structure were analyzed with a confocal laser scanning microscope (CLSM) and a scanning electron microscope (SEM), while biofilm ecology and community compositional changes were analyzed with viability DNA extraction and quantitative polymerase chain reaction (v-qPCR) analysis. One cryo-cycle immediately reduced biofilm load by 0.2 to 0.4 log10 Geq/mL, which increased with additional treatment cycles. Although the bacterial load of the treated biofilms recovered to the same level as the control biofilms within 24 h, the CLSM detected structural alterations. Compositional alterations were also detected by SEM, corroborating the v-qPCR findings that showed ≈≤10% incidence of pathogenic species compared to nontreated biofilms that encompassed ≈45% and 13% pathogenic species in dysbiotic and symbiotic biofilms, respectively. Spray cryotherapy showed promising results in a novel conceptual approach to the control of oral biofilms. Acting selectively by targeting oral pathobionts and retaining commensals, spray cryotherapy could modify the ecology of in vitro oral biofilms to become more symbiotic and prevent the evolution of dysbiosis without the use of antiseptics/antimicrobials.
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Affiliation(s)
- N Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - J Ghesquière
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven Chem&Tech, Leuven, Belgium
| | - N H N Kamarudin
- Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, KU Leuven, Belgium
| | - K Bernaerts
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven Chem&Tech, Leuven, Belgium
| | - N Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - A Braem
- Department of Materials Engineering (MTM), Biomaterials and Tissue Engineering Research Group, KU Leuven, Belgium
| | - W Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - W Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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14
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Quirynen M, Lahoud P, Teughels W, Cortellini S, Dhondt R, Jacobs R, Temmerman A. Individual "alveolar phenotype" limits dimensions of lateral bone augmentation. J Clin Periodontol 2023; 50:500-510. [PMID: 36574768 DOI: 10.1111/jcpe.13764] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/29/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
AIM Alveolar ridge resorption following tooth extraction often renders a lateral bone augmentation inevitable. Some patients, however, suffer from severe early (during graft healing, Eres ) and/or late (during follow-up, Lres ) graft resorption. We explored the hypothesis that the "individual phenotypic dimensions" may partially explain the degree of such resorptions. MATERIALS AND METHODS Patients who underwent a guided bone regeneration (GBR) procedure were screened for inclusion according to the following criteria: (1) a relatively symmetrical maxillary arch; (2) an intact contra-lateral alveolar bone dimension; (3) the availability of a pre-operative cone-beam CT (CBCT); (4) a CBCT taken immediately after GBR, and (5) at least one CBCT scan ≥6 months after surgery. CBCT scans from different timepoints were registered and imported into the Mimics software (Materialise, Leuven, Belgium). Bone dimensions of the contra-lateral site of the augmentation, representing the "individual phenotypical dimension (IPD) of the alveolar crest", were superimposed on the augmented site and registered accordingly. As such, Eres and Lres could be measured over time, in relation to the IPD (in two dimensions; per millimetre apically from the alveolar crest, in the centre of the GBR), as well as in three dimensions (the entire GBR, 2 mm away from the mesial, distal, and apical border for standardization). RESULTS A total of 17 patients (23 augmented sites) were included. After Eres , the outline of the augmentation was in general located ±1 mm outside the IPD, but ≥1.5 years after GBR, it further moved towards the IPD (85% within 0.5 mm distance). CONCLUSIONS Within the limitations of this study, the results indicate that the dimensions of a lateral bone augmentation are defined by the "individual phenotypic bone boundaries" of the patient.
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Affiliation(s)
- Marc Quirynen
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery and Department of Imaging and Pathology, UZ Leuven, OMFS-IMPATH Research Group, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Simone Cortellini
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Rutger Dhondt
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery and Department of Imaging and Pathology, UZ Leuven, OMFS-IMPATH Research Group, KU Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Andy Temmerman
- Department of Oral Health Sciences, KU Leuven and Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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15
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Van Holm W, Carvalho R, Delanghe L, Eilers T, Zayed N, Mermans F, Bernaerts K, Boon N, Claes I, Lebeer S, Teughels W. Antimicrobial potential of known and novel probiotics on in vitro periodontitis biofilms. NPJ Biofilms Microbiomes 2023; 9:3. [PMID: 36681674 PMCID: PMC9867767 DOI: 10.1038/s41522-023-00370-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
Several oral diseases are characterized by a shift within the oral microbiome towards a pathogenic, dysbiotic composition. Broad-spectrum antimicrobials are often part of patient care. However, because of the rising antibiotic resistance, alternatives are increasingly desirable. Alternatively, supplying beneficial species through probiotics is increasingly showing favorable results. Unfortunately, these probiotics are rarely evaluated comparatively. In this study, the in vitro effects of three known and three novel Lactobacillus strains, together with four novel Streptococcus salivarius strains were comparatively evaluated for antagonistic effects on proximal agar growth, antimicrobial properties of probiotic supernatant and the probiotic's effects on in vitro periodontal biofilms. Strain-specific effects were observed as differences in efficacy between genera and differences within genera. While some of the Lactobacillus candidates were able to reduce the periodontal pathobiont A. actinomycetemcomitans, the S. salivarius strains were not. However, the S. salivarius strains were more effective against periodontal pathobionts P. intermedia, P. gingivalis, and F. nucleatum. Vexingly, most of the Lactobacillus strains also negatively affected the prevalence of commensal species within the biofilms, while this was lower for S. salivarius strains. Both within lactobacilli and streptococci, some strains showed significantly more inhibition of the pathobionts, indicating the importance of proper strain selection. Additionally, some species showed reductions in non-target species, which can result in unexpected and unexplored effects on the whole microbiome.
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Affiliation(s)
- Wannes Van Holm
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium ,grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Rita Carvalho
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
| | - Lize Delanghe
- grid.5284.b0000 0001 0790 3681Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Tom Eilers
- grid.5284.b0000 0001 0790 3681Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Naiera Zayed
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium ,grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium ,grid.411775.10000 0004 0621 4712Faculty of Pharmacy, Menoufia University, Shibin el Kom, Egypt
| | - Fabian Mermans
- grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Kristel Bernaerts
- grid.5596.f0000 0001 0668 7884Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Nico Boon
- grid.5342.00000 0001 2069 7798Centre for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | | | - Sarah Lebeer
- grid.5284.b0000 0001 0790 3681Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Wim Teughels
- grid.5596.f0000 0001 0668 7884Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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16
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Teughels W, Seyssens L, Christiaens V, Temmerman A, Castro AB, Cosyn J. Adjunctive locally and systemically delivered antimicrobials during surgical treatment of peri-implantitis: A systematic review. J Clin Periodontol 2023. [PMID: 36644805 DOI: 10.1111/jcpe.13773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 12/23/2022] [Accepted: 01/09/2023] [Indexed: 01/17/2023]
Abstract
AIM To answer the following PICOS question: "In patients with peri-implantitis, what is the efficacy of surgical therapy with adjunctive systemic or local antimicrobials, in comparison with surgical therapy alone, in terms of pocket probing depth reduction, as assessed in randomized controlled trials (RCTs) with at least 6 months of follow-up?" MATERIALS AND METHODS A systematic literature search was conducted. Reduction in mean probing pocket depth (PPD) was the primary outcome. Secondary clinical outcomes were changes in suppuration (%), changes in bleeding on probing (BOP) (%), marginal bone level changes (mm), disease resolution (%), and implant/prosthesis loss (%). Patient-reported outcome measures, possible adverse effects, and oral-health-related quality of life were also extracted if such data were available. RESULTS Four RCTs assessing the use of locally (two RCTs) and systemically (two RCTs) administered antimicrobial adjuncts to surgical treatment of peri-implantitis, with 6-36-month follow-up, were included. Because of the substantial heterogeneity of interventions between the studies, meta-analysis could not be performed. A reduction in the mean PPD was observed following all the involved surgical treatments, irrespective of the addition of antimicrobials. Except for the effect of systemic antimicrobials on marginal bone level changes and local antimicrobials on BOP, the effect of systemic and local antimicrobials was equivocal for all secondary outcome measures. CONCLUSIONS Based on the limited available evidence, the adjunctive use of the currently tested systemic or local antimicrobials during surgical therapy, in comparison with surgical therapy alone, in patients with peri-implantitis does not seem to improve the clinical efficacy. With regard the use of systemic antimicrobials, only 50% of the cases showed disease resolution after 1 year. There is a lack of studies that consider the sole use of local antimicrobials. Therefore, their true effect remains unclear.
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Affiliation(s)
- Wim Teughels
- Department of Oral Health Sciences, Periodontology and Oral Microbiology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Véronique Christiaens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Andy Temmerman
- Department of Oral Health Sciences, Periodontology and Oral Microbiology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Ana B Castro
- Department of Oral Health Sciences, Periodontology and Oral Microbiology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Àlvarez G, Arredondo A, Isabal S, Teughels W, Laleman I, Contreras MJ, Isbej L, Huapaya E, Mendoza G, Mor C, Nart J, Blanc V, León R. Association of nine pathobionts with periodontitis in four South American and European countries. J Oral Microbiol 2023; 15:2188630. [PMID: 36950255 PMCID: PMC10026778 DOI: 10.1080/20002297.2023.2188630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Aim Our aim was to compare the prevalence and load of nine pathobionts in subgingival samples of healthy individuals and periodontitis patients from four different countries. Methods Five hundred and seven subgingival biofilm samples were collected from healthy subjects and periodontitis patients in Belgium, Chile, Peru and Spain. The prevalence and load of Eubacterium brachy, Filifactor alocis, Fretibacterium fastidiosum, Porphyromonas endodontalis, Porphyromonas gingivalis, Selenomonas sputigena, Treponema denticola, Tannerella forsythia and Treponema socranskii were measured by quantitative PCR. Results The association with periodontitis of all species, except for T. socranskii, was confirmed in all countries but Peru, where only P. endodontalis, P. gingivalis and T. denticola were found to be significantly associated. Moreover, most species showed higher loads at greater CAL and PPD, but not where there was BOP. Through Principal Component Analysis, samples showed clearly different distributions by diagnosis, despite observing a smaller separation in Peruvian samples. Conclusions Unlike prevalence, relative load was found to be a reliable variable to discriminate the association of the species with periodontitis. Based on this, F. alocis, P. endodontalis, P. gingivalis, T. denticola and T. forsythia may be biomarkers of disease in Belgium, Chile and Spain, due to their significantly higher abundance in periodontitis patients.
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Affiliation(s)
- Gerard Àlvarez
- Department of Microbiology, DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - Alexandre Arredondo
- Department of Microbiology, DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - Sergio Isabal
- Department of Microbiology, DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven, Belgium & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven, Belgium & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - María José Contreras
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lorena Isbej
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Pharmacology and Toxicology Programme, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Enrique Huapaya
- Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - Gerardo Mendoza
- Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
- Department of Periodontics, University of Pennsylvania, School of dental Medicine, Philadelphia, Pennsylvania, USA
| | - Carolina Mor
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - José Nart
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Vanessa Blanc
- Department of Microbiology, DENTAID Research Center, Cerdanyola del Vallès, Spain
| | - Rubén León
- Department of Microbiology, DENTAID Research Center, Cerdanyola del Vallès, Spain
- CONTACT Rubén León Department of Microbiology, DENTAID Research Center, Ronda Can Fatjó no. 10, 08290, Cerdanyola del Vallès, Spain
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18
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Zayed N, Figueiredo J, Van Holm W, Boon N, Bernaerts K, Teughels W. Mode of killing determines the necrotrophic response of oral bacteria. J Oral Microbiol 2023; 15:2184930. [PMID: 36926228 PMCID: PMC10013485 DOI: 10.1080/20002297.2023.2184930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Bacteria respond to changes in their environment, such as nutrient depletion and antimicrobials exposure. Antimicrobials result not only in bacterial death, but also have a hand in determining species abundances and ecology of the oral biofilms. Proximity of dead bacterial cells to living ones is an important environmental change or stress factor. Dead bacteria represent high concentrations of nutrients, such as proteins, lipids, sugars, and nucleic acids. Living bacteria can use these biomasses as a nutrients source, which is termed necrotrophy. Aim This study investigates the effect of exposing living oral bacteria (planktonic and biofilms) to their dead siblings after being killed by heat or hydrogen peroxide. Results Tested bacterial species showed different responses towards the dead cells, depending on the mode of killing, the nutritional value of the culture media, and the the dead cells density. The multispecies oral biofilms showed different responses towards the supplementation of dead cells during biofilm development, while matured biofilms were more resilient. Conclusion This study indicates that dead bacteria resulting from antiseptics use may imbalance the nutrient availability in the oral cavity, resulting in overgrowth of opportunistic species, and hence ecological changes in oral communities, or introducing new bacterial phenotypes.
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Affiliation(s)
- Naiera Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium.,Faculty of Pharmacy, Menoufia University, Shebin El-Kom, Egypt
| | - Joana Figueiredo
- Faculty of bioscience engineering, University of Minho, Braga, Portugal
| | - Wannes Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Kristel Bernaerts
- Chemical and Biochemical Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven Chem&Tech, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium
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19
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Siawasch SAM, Castro AB, Quirynen M, Teughels W, Temmerman A. [Innovative methods and developments in oral care. L-PRF: from evidence to clinical use]. Ned Tijdschr Tandheelkd 2022; 129:563-569. [PMID: 36472310 DOI: 10.5177/ntvt.2022.12.22061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Leukocyte- and platelet-rich fibrin (L-PRF) is a fully autologous biomaterial made from venous blood drawn from the patient. Due to its regenerative potency, antibacterial capacity, and analgesic activity, L-PRF can be used during surgical procedures as a sole biomaterial or as a bioactive additive along with other natural and synthetic biomaterials. There is sufficient scientific evidence available for applying L-PRF for various indications. The preparation protocol of L-PRF is simple, inexpensive and not time-consuming, making it possible to implement it in the daily practice. The type of centrifuge and blood collection tubes used, the settings of the centrifuge (rotation time and force) as well as the time between the different steps in the protocol have an influence on the biological and mechanical properties of L-PRF.
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20
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Van Holm W, Verspecht T, Carvalho R, Bernaerts K, Boon N, Zayed N, Teughels W. Glycerol strengthens probiotic effect of Limosilactobacillus reuteri in oral biofilms: a synergistic synbiotic approach. Mol Oral Microbiol 2022; 37:266-275. [PMID: 36075698 DOI: 10.1111/omi.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/13/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022]
Abstract
Both in vitro and in vivo studies have shown that the probiotic Limosilactobacillus reuteri can improve oral health. L. reuteri species are known to produce the antimicrobial 'reuterin' from glycerol. In order to further increase its antimicrobial activity, this study evaluated the effect of the combined use of glycerol and Limosilactobacillus reuteri (ATCC PTA 5289) in view of using a synergistic synbiotic over a probiotic. An antagonistic agar growth and a multispecies biofilm model showed that the antimicrobial potential of the probiotic was significantly enhanced against periodontal pathobionts and anaerobic commensals when supplemented with glycerol. Synbiotic biofilms also showed a significant reduction in inflammatory expression of human oral keratinocytes (HOK-18A), but only when the keratinocytes were preincubated with the probiotic. Probiotic preincubation of keratinocytes or probiotic- and synbiotic treatment of biofilms alone were insufficient to significantly reduce inflammatory expression. Overall, this study shows that combining glycerol with the probiotic L. reuteri into a synergistic synbiotic can greatly improve the effectiveness of the latter. One sentence summary: The use of a synbiotic formulation of Limosilactobacillus reuteri with glycerol over the probiotic improves antimicrobial effects and reduced inflammatory response to oral biofilms. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wannes Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Kapucijnenvoer 33, Leuven, 3000, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Coupure links 653, Gent, 9000, Belgium
| | - Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Kapucijnenvoer 33, Leuven, 3000, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Coupure links 653, Gent, 9000, Belgium
| | - Rita Carvalho
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Kapucijnenvoer 33, Leuven, 3000, Belgium
| | - Kristel Bernaerts
- Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven Chem&Tech, Celestijnenlaan 200F (bus 2424), Leuven, 3001, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Coupure links 653, Gent, 9000, Belgium
| | - Naiera Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Kapucijnenvoer 33, Leuven, 3000, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Coupure links 653, Gent, 9000, Belgium.,Faculty of Pharmacy, Menoufia University, Egypt
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Kapucijnenvoer 33, Leuven, 3000, Belgium
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21
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Dhondt R, Quirynen M, Tarce M, Teughels W, Temmerman A, Jacobs R. The accuracy of probing, ultrasound and cone-beam CT scans for determining the buccal bone plate dimensions around oral implants - A systematic review. J Periodontal Res 2022; 57:754-767. [PMID: 35612409 DOI: 10.1111/jre.12998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of this review was to assess the accuracy of available means of determining the BBT (buccal bone thickness) and/or BBL (buccal bone level). This was translated into the following research question: What is the accuracy of the available means of visualizing the BBP (buccal bone plate) to establish the BBT and/or the BBL, when compared to control measurements? As control measurements histomorphometric measurements, direct measurements and cone-beam computed tomography (CBCT) measurements in the absence of metal are accepted. BACKGROUND DATA METHODS: The literary search was performed by searching the databases of MEDLINE, Embase, and Web of Science, up to July 13, 2021. Types of studies included were clinical, in vitro and animal trials, specifically looking into the bone level and/or bone thickness of the buccal bone plate at oral implants. Reference lists were hand searched for relevant articles. Two reviewers performed the data extraction and analysis. Only studies using reliable control measurements to evaluate the accuracy of the tested means of visualizing BBT and/or BBL were included for analysis. The QUADAS-2 tool was used to perform bias analysis on the relevant studies. Extracted data was tabulated to show the differences between test and control measurements for BBT and BBL. For in vitro studies on CBCT measurements of BBT meta-analysis could be performed. RESULTS A total of 1176 papers were identified in the search. Twenty-two articles were used for data extraction and qualitative analysis. Of these studies nine were animal studies, 9 were in vitro studies and four were human studies. Six animal studies and three human studies provided data on probing. CBCT and sonography as techniques for visualizing the buccal bone plate. Probing at implant sites seems to provide data that correlates with a consistent distance from the BBP. Meta-analysis for probing studies could not be performed due to heterogeneity in the setups of these studies. Eleven studies on CBCT were eligible for inclusion. Of these three were animal studies, the remaining 8 studies were all in vitro studies. Meta-analysis was performed on the accuracy of CBCT for in vitro studies, finding a significant underestimation of the BBT when compared to control measurements by a mean difference of -0.15 mm with 95%CI [-0.26,-0.03]. Three studies were identified on measurement of BBT and/or BBL by sonography. This included one human study and two in vitro studies. The identified studies show a low error when determining the buccal bone level or thickness using sonography. All included studies possess a high risk of bias according to risk of bias analysis, mostly due to selection of the patient. CONCLUSION A strong limitation of this systematic review is the inclusion of different studies with heterogeneous designs. Within the limits of this analysis it cannot be concluded that probing is an accurate way of visualizing the BBP. CBCT cannot yet be recommended as a standard diagnostic tool for follow-up of the BBP at oral implants. The application of sonography as a diagnostic tool to visualize the BBP needs further scientific validation.
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Affiliation(s)
- Rutger Dhondt
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Marc Quirynen
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Mihai Tarce
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Wim Teughels
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Andy Temmerman
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Leuven, Belgium
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22
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Siawasch SAM, Andrade C, Castro AB, Teughels W, Temmerman A, Quirynen M. Impact of local and systemic antimicrobials on leukocyte- and platelet rich fibrin: an in vitro study. Sci Rep 2022; 12:2710. [PMID: 35177676 PMCID: PMC8854700 DOI: 10.1038/s41598-022-06473-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/24/2022] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to evaluate the effect of local and systemic administration of antimicrobials to leukocyte- and platelet-rich fibrin (L-PRF). For part A, 16 tubes of venous blood were collected from each of eight systemically healthy subjects. Prior to blood centrifugation, 12 of the 16 tubes were injected with 0.125 ml, 0.25 ml or 0.50 ml metronidazole solution. One set of L-PRF membranes was used to assess the release of vascular endothelial growth factor AB, platelet-derived growth factor, transforming growth factor beta 1, and bone morphogenetic protein 2 at indicated time points. The metronidazole release over time by L-PRF membranes was also evaluated. The remaining L-PRF membranes were placed on the surface of agar plates inoculated with three different periodontal pathogens to determine their antibacterial activity. For part B, another six subjects were enrolled with three subjects taking 2 g amoxicillin and three subjects 500 mg metronidazole as prophylaxis prior to a periodontal treatment. Before and 2 h after consuming one of the prescribed antimicrobials, three tubes of blood were collected for preparing L-PRF membranes. These membranes were used to measure the antibacterial activity against periodontal pathogens. No statistically significant difference could be found in the release of growth factors between L-PRF membranes with and without incorporation of metronidazole solution. The release of metronidazole could be detected up to day 3, however with the highest concentration during the first 4 h. This concentration was dose dependent. The antibacterial capacity of L-PRF membranes increased significantly for both the systemic intake, and after the addition of metronidazole solution to the blood tubes before centrifugation, the latter again dose dependent. The antibacterial capacity of L-PRF against the periodontal pathogens tested can significantly be enhanced by the addition of antimicrobials, without disadvantage for the release of growth factors.
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Affiliation(s)
- S A M Siawasch
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, blok a - bus 07001, 3000, Leuven, Belgium.
| | - C Andrade
- Faculty of Dentistry, Postgraduate Implant Program, University of the Andes, Santiago, Chile
| | - A B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, blok a - bus 07001, 3000, Leuven, Belgium
| | - W Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, blok a - bus 07001, 3000, Leuven, Belgium
| | - A Temmerman
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, blok a - bus 07001, 3000, Leuven, Belgium
| | - M Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, blok a - bus 07001, 3000, Leuven, Belgium
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Salhi L, Rijkschroeff P, Van Hede D, Laine ML, Teughels W, Sakalihasan N, Lambert F. Blood Biomarkers and Serologic Immunological Profiles Related to Periodontitis in Abdominal Aortic Aneurysm Patients. Front Cell Infect Microbiol 2022; 11:766462. [PMID: 35096635 PMCID: PMC8798408 DOI: 10.3389/fcimb.2021.766462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background Periodontitis is a chronic inflammatory gum disease associated with systemic diseases such as cardiovascular diseases. Aim To investigate the association of systemic blood biomarkers, C-reactive protein (CRP), levels of lipopolysaccharide (LPS), and IgG levels against periodontal pathogens Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) with the stability, based on the aortic diameter, the growth rate and the eligibility for surgical intervention, of patients with abdominal aortic aneurysm (AAA). Methods Patients with stable AAA (n = 30) and unstable AAA (n = 31) were recruited. The anti-A. actinomycetemcomitans and anti-P. gingivalis IgG levels were analyzed by ELISA, the LPS analysis was performed by using the limulus amebocyte lysate (LAL) test, and plasma levels of CRP were determined using an immune turbidimetric method. The association between these blood systemic biomarkers, AAA features, periodontal clinical parameters and oral microbial profiles were explored. Regression models were used to test the relationship between variables. Results The presence of antibodies against Pg and Aa, LPS and high CRP concentrations were found in all AAA patients. The IgG levels were similar in patients with stable and unstable AAA (both for Aa and Pg). Among investigated blood biomarkers, only CRP was associated with AAA stability. The amount of LPS in saliva, supra, and subgingival plaque were significantly associated with the systemic LPS (p <0.05). Conclusions This post-hoc study emphasizes the presence of antibodies against Pg and Aa, LPS and high CRP concentrations in all AAA patients. The presence of Pg in saliva and subgingival plaque was significantly associated with the blood LPS levels. For further studies investigating periodontitis and systemic diseases, specific predictive blood biomarkers should be considered instead of the use of antibodies alone.
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Affiliation(s)
- Leila Salhi
- Department of Periodontology, Buccal Surgery and Implantology, Faculty of Medicine, Liège, Belgium
- *Correspondence: Leila Salhi, ; orcid.org/0000-0003-3529-8452
| | - Patrick Rijkschroeff
- Department of Periodontology , Academic Centre for Dentistry Amsterdam, Vrije Universiteit (VU) Amsterdam, Amsterdam, Netherlands
| | - Dorien Van Hede
- Department of Periodontology, Buccal Surgery and Implantology, Faculty of Medicine, Liège, Belgium
| | - Marja L. Laine
- Department of Periodontology , Academic Centre for Dentistry Amsterdam, Vrije Universiteit (VU) Amsterdam, Amsterdam, Netherlands
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Natzi Sakalihasan
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Liège, Belgium
| | - France Lambert
- Department of Periodontology, Buccal Surgery and Implantology, Faculty of Medicine, Liège, Belgium
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24
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Rodríguez Sánchez F, Verspecht T, Castro AB, Pauwels M, Andrés CR, Quirynen M, Teughels W. Antimicrobial Mechanisms of Leucocyte- and Platelet Rich Fibrin Exudate Against Planktonic Porphyromonas gingivalis and Within Multi-Species Biofilm: A Pilot Study. Front Cell Infect Microbiol 2021; 11:722499. [PMID: 34722331 PMCID: PMC8548765 DOI: 10.3389/fcimb.2021.722499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/20/2021] [Indexed: 12/28/2022] Open
Abstract
Leucocyte- and platelet rich fibrin (L-PRF) is an autologous biomaterial used in regenerative procedures. It has an antimicrobial activity against P. gingivalis although the mechanism is not fully understood. It was hypothesized that L-PRF exudate releases hydrogen peroxide and antimicrobial peptides that inhibit P. gingivalis growth. Agar plate and planktonic culture experiments showed that the antimicrobial effect of L-PRF exudate against P. gingivalis was supressed by peroxidase or pepsin exposure. In developing multi-species biofilms, the antimicrobial effect of L-PRF exudate was blocked only by peroxidase, increasing P. gingivalis growth with 1.3 log genome equivalents. However, no effect was shown on other bacteria. Pre-formed multi-species biofilm trials showed no antimicrobial effect of L-PRF exudate against P. gingivalis or other species. Our findings showed that L-PRF exudate may release peroxide and peptides, which may be responsible for its antimicrobial effect against P. gingivalis. In addition, L-PRF exudate had an antimicrobial effect against P. gingivalis in an in vitro developing multi-species biofilm.
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Affiliation(s)
- Fabio Rodríguez Sánchez
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Tim Verspecht
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Ana B Castro
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Martine Pauwels
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Carlos Rodríguez Andrés
- Department of Preventive Medicine and Public Health, University of the Basque Country, Bilbao, Spain
| | - Marc Quirynen
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium
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Namour M, Mobadder ME, Mulongo B, Fagnart O, Harb A, Peremans A, Verspecht T, Teughels W, Nammour S, Rompen E. Assessment of Disinfection Potential of Q-Switch Nd: YAG Laser on Contaminated Titanium Implant Surfaces. Materials (Basel) 2021; 14:ma14206078. [PMID: 34683666 PMCID: PMC8537820 DOI: 10.3390/ma14206078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 12/21/2022]
Abstract
Peri-implantitis (PI) is a relatively frequent pathology that compromises the overall survival of the dental implant. Adjunctive approaches for the conventional mechanical debridement are being suggested to optimize the treatment of PI. The goal of the study was the assessment of the disinfection potential of the Q-Switch Nd: YAG laser on contaminated titanium implant surfaces. A total of 72 sterile titanium discs were used and divided into three groups: 24 contaminated titanium discs treated with the laser (study Group L), 24 contaminated titanium discs with no treatment (control 1—Group C), and 24 sterile titanium discs with no treatment (control 2—Group S). Multi-species biofilm was used: Porphyromonas gingivalis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Streptococcus mutans, Streptococcus sobrinus, and Prevotella intermedia. Commensal bacteria were included also: Actinomyces naeslundii, Actinomyces viscosus, Streptococcus cristatus, Streptococcus gordonii, Streptococcus mitis, Streptococcus oralis, Streptococcus sanguinis, Streptococcus parasanguinis, and Veillonella parvula. Parameters delivered per pulse on the targeted surfaces of the titanium discs were an energy density of 0.597 J/cm2 each pulse, a pulse power of 270 mW, a laser beam spot of 2.4 mm in diameter, and a rate of repetition of 10 Hertz (Hz) for a pulse duration of 6 nanoseconds (ns). The mode was no contact, and a distance of 500 micrometers was used with a total time of irradiation equal to 2 s (s). The collection of microbiological samples was made for all groups; colony-forming units (CFU) were identified by two different practitioners, and the average of their examinations was considered for each sample. The average of the TBC (CFU/mL) was calculated for each group. Values were 0.000 CFU/mL, 4767 CFU/mL, and 0.000 CFU/mL for Group L, Group C, and Group S, respectively. Therefore, the suggested treatment protocol was able to provoke a total disinfection of the contaminated titanium surfaces. A statistical difference was only found between Group L vs. Group C and between Group S vs. Group C. The difference was not significant between Group S and Group L. In conclusion, the present study confirmed that the Q-Switch Nd: YAG laser under our specific conditions can provide a total disinfection of the contaminated titanium surfaces.
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Affiliation(s)
- Melanie Namour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (M.N.); (M.E.M.); (E.R.)
| | - Marwan El Mobadder
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (M.N.); (M.E.M.); (E.R.)
| | - Baudouin Mulongo
- Laboratoire de Microbiologie CEBIODI, Hospital Saint Jean, 32, Boulevard du Jardin Botanique, 1000 Bruxelles, Belgium; (B.M.); (O.F.)
| | - Olivier Fagnart
- Laboratoire de Microbiologie CEBIODI, Hospital Saint Jean, 32, Boulevard du Jardin Botanique, 1000 Bruxelles, Belgium; (B.M.); (O.F.)
| | - Assaf Harb
- Laboratoire CEBIODI, Hospital Saint Anne, Saint Remi, 1070 Brussels, Belgium;
| | - André Peremans
- Laboratoire Physique de la Matière et du Rayonnement, Université de Namur, 5000 Namur, Belgium;
| | - Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Kapucijnenvoer 33, 3000 Leuven, Belgium;
| | - Wim Teughels
- Department of Oral Health Sciences, Dentistry, University of Leuven (KU Leuven), University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium;
| | - Samir Nammour
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (M.N.); (M.E.M.); (E.R.)
- Correspondence: ; Tel.: +32-478-508-724
| | - Eric Rompen
- Department of Dental Sciences, Faculty of Medicine, University of Liege, 4000 Liege, Belgium; (M.N.); (M.E.M.); (E.R.)
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Teughels W, Celik GU, Tarce M, De Cock I, Persyn SM, Haytac MC. The effect of choline-stabilized orthosilicic acid in patients with peri-implantitis: an exploratory randomized, double-blind, placebo controlled study. BMC Oral Health 2021; 21:485. [PMID: 34587941 PMCID: PMC8480141 DOI: 10.1186/s12903-021-01817-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Choline-stabilized orthosilicic acid (CS-OSA) was previously found to stimulate bone collagen formation in osteopenia and to improve biomarkers of cartilage degradation in knee osteoarthritis. The aim of the present study was to investigate the effect of oral administration of CS-OSA on clinical symptoms of peri-implantitis and the associated bone loss. Methods Twenty-one patients with peri-implantitis were randomized in CS-OSA or placebo groups. After initial clinical and cone beam computed tomography (CBCT) measurements [probing pocket depth (PPD), bleeding on probing (BOP), mucosal recession (REC), distance from implant shoulder to alveolar crest (IS-AC) and distance from implant shoulder to first bone-to-implant contact (IS-BIC)], flap operations were performed at the peri-implantitis sites. All patients were instructed to use either placebo or CS-OSA capsules twice a day for 1 year. Measurements were repeated 6 and 12 months after randomization. Results The data of 18 patients (36 implants) were used in the per protocol analysis. PPD and BOP improved significantly (p < 0.05) compared to baseline for both groups after 6 and 12 months. However, REC significantly increased in the placebo group but not in the CS-OSA group. The change in REC over 6 and 12 months was significantly different between groups (p < 0.01). IS-BIC and IS-AC measurements remained stable in the CS-OSA group whereas in the placebo group, both parameters increased significantly after 6 and 12 months. The change in IS-BIC over 12 months was significantly different between groups (p < 0.05). Conclusion The results of this preliminary study suggest that CS-OSA may stabilize and even prevent further bone loss after surgical peri-implantitis treatment and support mucosal tissue healing. Trial registration The trial was retrospectively registered at ISRCTN registry, registration number: ISRCTN14348802, registration date: 24/06/2020. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01817-4.
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Affiliation(s)
- Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, Leuven, Belgium
| | - Gizem Unal Celik
- Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mihai Tarce
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals, Leuven, Belgium
| | - Ine De Cock
- Research and Development, Bio Minerals NV, Zenderstraat 12, 9070, Destelbergen, Belgium
| | - Sara M Persyn
- Research and Development, Bio Minerals NV, Zenderstraat 12, 9070, Destelbergen, Belgium.
| | - Mehmet C Haytac
- Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey
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Zayed N, Boon N, Bernaerts K, Chatzigiannidou I, Van Holm W, Verspecht T, Teughels W. Differences in chlorhexidine mouthrinses formulations influence the quantitative and qualitative changes in in-vitro oral biofilms. J Periodontal Res 2021; 57:52-62. [PMID: 34581434 DOI: 10.1111/jre.12937] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Chlorhexidine mouthrinses are marketed in different formulations. This study aimed at investigating qualitative and quantitative changes in in-vitro multispecies oral biofilms, induced by different chlorhexidine-containing mouthrinses. BACKGROUND DATA Earlier studies comparing chlorhexidine mouthrinses are either clinical studies or in-vitro studies assessing the antimicrobial efficacy of the mouthrinses. However, no clear investigations are available regarding ecological impact of different chlorhexidine formulations on in-vitro multispecies oral biofilms after rinsing with different chlorhexidine formulations. METHODS Nine commercially available chlorhexidine mouthrinses were selected. Multispecies oral communities (14 species) were grown for 48 h in a Biostat-B Twin bioreactor. After that, they were used to develop biofilms on the surface of hydroxyapatite disks in 24-well pates for 48 h. Biofilms were then rinsed once or multiple times with the corresponding mouthrinse. Biofilms were collected before starting the rinsing experiment and every 24 h for 3 days and vitality quantitative PCR was performed. The experiment was repeated 3 independent times on 3 different days and the results were analyzed using a linear mixed model. RESULTS The mouthrinses provoked different effects in terms of change in total viable bacterial load (VBL), ecology, and community structure of the multispecies biofilms. There was no relation between chlorhexidine concentrations, presence, or absence of cetylpyridinium chloride and/or alcohol, and the observed effects. Some tested chlorhexidine mouthrinses (MC, HG, HH, and HI) strongly lowered the total VBL (≈1007 Geq/ml), but disrupted biofilm symbiosis (≥40% of the biofilms communities are pathobionts). On the other hand, other tested chlorhexidine mouthrinses (MD, ME, and HF) had limited impact on total VBL (≥1010 Geq/ml), but improved the biofilm ecology and community structure (≤10% of the biofilms communities are pathobionts). CONCLUSION Not all chlorhexidine mouthrinses have the same effect on oral biofilms. Their effect seems to be strongly product dependent and vary according to their compositions and formulations.
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Affiliation(s)
- Naiera Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium.,Department of Microbiology and Immunology, Faculty of Pharmacy, Menoufia University, Menoufia, Egypt
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Kristel Bernaerts
- Department of Chemical Engineering, Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Leuven Chem&Tech, University of Leuven (KU Leuven), Leuven, Belgium
| | - Ioanna Chatzigiannidou
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Wannes Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Dentistry, University Hospitals Leuven, Leuven, Belgium
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Meschi N, EzEldeen M, Garcia AET, Lahoud P, Van Gorp G, Coucke W, Jacobs R, Vandamme K, Teughels W, Lambrechts P. Regenerative Endodontic Procedure of Immature Permanent Teeth with Leukocyte and Platelet-rich Fibrin: A Multicenter Controlled Clinical Trial. J Endod 2021; 47:1729-1750. [PMID: 34400199 DOI: 10.1016/j.joen.2021.08.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The aim of this nonrandomized, multicenter controlled clinical trial was to evaluate the impact of leukocyte-platelet-rich fibrin (LPRF) on regenerative endodontic procedures (REPs) of immature permanent teeth in terms of periapical bone healing (PBH) and further root development (RD). METHODS Healthy patients between 6-25 years with an inflamed or necrotic immature permanent tooth were included and divided between the test (= REP + LPRF) and control (= REP-LPRF) group depending on their compliance and the clinical setting (university hospital or private practice). After receiving REP ± LPRF, the patients were recalled after 3, 6, 12, 24, and 36 months. At each recall session, the teeth were clinically and radiographically (by means of a periapical radiograph [PR]) evaluated. A cone-beam computed tomographic (CBCT) imaging was taken preoperatively and 2 and 3 years postoperatively. PBH and RD were quantitatively and qualitatively assessed. RESULTS Twenty-nine teeth with a necrotic pulp were included, from which 23 (9 test and 14 control) were analyzed. Three teeth in the test group had a flare-up reaction in the first year after REP. Except for 2 no shows, all the analyzed teeth survived up to 3 years after REP, and, in case of failure, apexification preserved them. Complete PBH was obtained in 91.3% and 87% of the cases based on PR qualitative and quantitative evaluation, respectively, with no significant difference between the groups with respect to the baseline. The PR quantitative change in RD at the last recall session with respect to the baseline was not significant (all P values > .05) in both groups. The qualitative assessment of the type of REP root healing was nonuniform. In the test group, 55.6% of the teeth presented no RD and no apical closure. Only 50% of the 14 teeth assessed with CBCT imaging presented complete PBH. Regarding volumetric measurements on RD 3 years after REP for the change with respect to the baseline in root hard tissue volume, mean root hard tissue thickness, and apical area, the control group performed significantly in favor of RD than the test group (P = .03, .003, and 0.05 respectively). For the volumetric change 3 years after REP with respect to the baseline in root length and maximum root hard tissue thickness, no significant difference (P = .72 and .4, respectively) was found between the groups. The correlation between the PR and CBCT variables assessing RD was weak (root lengthening) to very weak (root thickening). CONCLUSIONS REP-LPRF seems to be a viable treatment option to obtain PBH and aid further RD of necrotic immature permanent teeth. Caution is needed when evaluating REP with PR.
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Affiliation(s)
- Nastaran Meschi
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium; Department of Oral Health Sciences, BIOMAT-Biomaterials Research Group, KU Leuven and Dentistry, Leuven, Belgium.
| | - Mostafa EzEldeen
- OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Andres Eduardo Torres Garcia
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium; OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Gertrude Van Gorp
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Coucke
- Freelance Statistical Consultant, Heverlee, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH-Research Group, Faculty of Medicine, Department of Imaging and Pathology, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Katleen Vandamme
- Department of Oral Health Sciences, Restorative Dentistry, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium; Department of Oral Health Sciences, BIOMAT-Biomaterials Research Group, KU Leuven and Dentistry, Leuven, Belgium
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29
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Verspecht T, Van Holm W, Boon N, Bernaerts K, Daep CA, Masters JG, Zayed N, Quirynen M, Teughels W. Potential prebiotic substrates modulate composition, metabolism, virulence and inflammatory potential of an in vitro multi-species oral biofilm. J Oral Microbiol 2021; 13:1910462. [PMID: 33968313 PMCID: PMC8079042 DOI: 10.1080/20002297.2021.1910462] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Modulation of the commensal oral microbiota constitutes a promising preventive/therapeutic approach in oral healthcare. The use of prebiotics for maintaining/restoring the health-associated homeostasis of the oral microbiota has become an important research topic. Aims: This study hypothesised that in vitro 14-species oral biofilms can be modulated by (in)direct stimulation of beneficial/commensal bacteria with new potential prebiotic substrates tested at 1 M and 1%(w/v), resulting in more host-compatible biofilms with fewer pathogens, decreased virulence and less inflammatory potential. Methods: Established biofilms were repeatedly rinsed with N-acetyl-D-glucosamine, α-D-lactose, D-(+)-trehalose or D-(+)-raffinose at 1 M or 1%(w/v). Biofilm composition, metabolic profile, virulence and inflammatory potential were eventually determined. Results: Repeated rinsing caused a shift towards a more health-associated microbiological composition, an altered metabolic profile, often downregulated virulence gene expression and decreased the inflammatory potential on oral keratinocytes. At 1 M, the substrates had pronounced effects on all biofilm aspects, whereas at 1%(w/v) they had a pronounced effect on virulence gene expression and a limited effect on inflammatory potential. Conclusion: Overall, this study identified four new potential prebiotic substrates that exhibit different modulatory effects at two different concentrations that cause in vitro multi-species oral biofilms to become more host-compatible.
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Affiliation(s)
- Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Department of Biotechnology, Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Wannes Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Department of Biotechnology, Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Nico Boon
- Department of Biotechnology, Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Kristel Bernaerts
- Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, University of Leuven (KU Leuven), Leuven Chem & Tech, Leuven, Belgium
| | - Carlo A Daep
- Colgate-Palmolive Technology Center, Piscataway, NJ USA
| | | | - Naiera Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Department of Biotechnology, Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium.,Faculty of Pharmacy, Menoufia University, Egypt
| | - Marc Quirynen
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Dentistry, University Hospitals Leuven, Leuven, Belgium
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Retamal-Valdes B, Teughels W, Oliveira LM, da Silva RN, Fritoli A, Gomes P, Soares GMS, Temporão N, Furquim CP, Duarte PM, Doyle H, Faveri M, Figueiredo LC, Feres M. Clinical, microbiological, and immunological effects of systemic probiotics in periodontal treatment: study protocol for a randomized controlled trial. Trials 2021; 22:283. [PMID: 33858486 PMCID: PMC8048221 DOI: 10.1186/s13063-021-05246-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association of scaling and root planing (SRP) with systemic metronidazole (MTZ) plus amoxicillin (AMX) has shown to be an effective treatment protocol, particularly for periodontitis stages III and IV, generalized. More recently, probiotics have also been suggested as a promising adjunctive treatment for periodontal diseases due to their antimicrobial and anti-inflammatory properties. Therefore, the aim of this randomized clinical trial (RCT) is to evaluate the clinical, microbiological, and immunological effects of probiotics as adjuncts to SRP alone or with MTZ+AMX in the treatment of periodontitis. METHODS Subjects with periodontitis are being randomly assigned to receive (i) SRP alone, or with (ii) two probiotic lozenges/day for 90 days (Prob), (iii) MTZ (400 mg) and AMX (500 mg) thrice a day (TID) for 14 days (MTZ+AMX), or (iv) Prob and MTZ+AMX. Subjects are being monitored for up to 12 months post-treatment. Nine subgingival plaque samples per patient are being collected at baseline and at 3, 6, and 12 months post-therapy and analyzed by checkerboard DNA-DNA hybridization for 40 bacterial species. Peripheral blood and gingival crevicular fluid (GCF) of four randomly selected periodontal sites will be analyzed by means of a multiplex fluorescent bead-based immunoassay for 17 cyto/chemokines. STATISTICAL ANALYSES The significance of differences in each group (over the course of the study) will be sought using repeated measures ANOVA or Friedman tests and among groups (at each time point) using either ANOVA/ANCOVA or Kruskal-Wallis tests, depending on normality of the data. The chi-square test will be used to compare differences in the frequency of subjects achieving the clinical endpoint for treatment (≤ 4 sites with PD ≥ 5 mm) at 1 year and of self-perceived adverse effects. A stepwise forward logistic regression analysis will be performed in order to investigate the impact of different predictor variables on the percentage of patients achieving the clinical endpoint for treatment. The Number Needed to Treat (NNT) with different treatment protocols will be also calculated. Statistical significance will be set at 5%. TRIAL REGISTRATION ClinicalTrials.gov NCT03733379. Registered on November 7, 2018.
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Affiliation(s)
- Belen Retamal-Valdes
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, Katholieke Universiteit Leuven (KULeuven), Leuven, Belgium
| | - Laryssa Macedo Oliveira
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Rebeca Nascimento da Silva
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Aretuza Fritoli
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Patricia Gomes
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | | | - Natalie Temporão
- Department of Stomatology, Federal University of Parana, Curitiba, Parana, Brazil
| | - Camila Pinheiro Furquim
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil.,Department of Stomatology, Federal University of Parana, Curitiba, Parana, Brazil
| | - Poliana Mendes Duarte
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil.,Department of Periodontology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Helio Doyle
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Marcelo Faveri
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
| | - Luciene Cristina Figueiredo
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil.
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Centro de Pós-Graduação e Pesquisa-CEPPE, Guarulhos University, Praça Tereza Cristina, 229 Centro, Guarulhos, SP, 07023-070, Brazil
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31
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Castro AB, Andrade C, Li X, Pinto N, Teughels W, Quirynen M. Impact of g force and timing on the characteristics of platelet-rich fibrin matrices. Sci Rep 2021; 11:6038. [PMID: 33727689 PMCID: PMC7971031 DOI: 10.1038/s41598-021-85736-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 02/08/2023] Open
Abstract
Recently, new centrifugation protocols for the preparation of platelet-rich fibrin (PRF) have been introduced in an attempt to further improve the beneficial impact of these 2nd generation platelet concentrate membranes. This in-vitro study aimed to compare the biological and physical characteristics of three types of PRF membranes using two different centrifuges with adapted relative centrifugal forces (RCF): leucocyte- and platelet-rich fibrin, advanced platelet-rich fibrin, and advanced platelet-rich fibrin+. Release of growth factors, macroscopic dimensions, cellular content and mechanical properties of the respective membranes, prepared from blood of the same individual were explored. Furthermore, the impact of timing (blood draw-centrifugation and centrifugation-membrane preparation) was assessed morphologically as well as by electron microscopy scanning. No statistically significant differences amongst the three PRF modifications could be observed, neither in their release of growth factors or the cellular content, nor in clot/membrane dimensions. The difference between both centrifuges were negligible when the same g-force was used. A lower g-force, however, reduced membrane tensile strength. Timing in the preparation process had a significant impact. Adaptation of RCF only had a minimal impact on the final characteristics of PRF membranes.
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Affiliation(s)
- Ana B Castro
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a - bus 07001, 3000, Leuven, Belgium.
| | - C Andrade
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, University of Los Andes, Santiago, Chile
| | - X Li
- Department of Oral Health Sciences, KU Leuven, BIOMAT and University Hospitals Leuven Dentistry, Leuven, Belgium
| | - N Pinto
- Department of Periodontology and Oral Implantology, Faculty of Dentistry, School of Dentistry, University of Los Andes, Santiago, Chile
| | - W Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a - bus 07001, 3000, Leuven, Belgium
| | - M Quirynen
- Department of Oral Health Sciences, Periodontology, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, blok a - bus 07001, 3000, Leuven, Belgium
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Herrera D, Matesanz P, Martín C, Oud V, Feres M, Teughels W. Adjunctive effect of locally delivered antimicrobials in periodontitis therapy: A systematic review and meta-analysis. J Clin Periodontol 2021; 47 Suppl 22:239-256. [PMID: 31912531 DOI: 10.1111/jcpe.13230] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To answer the following PICOS question: in adult patients with periodontitis, which is the efficacy of adjunctive locally delivered antimicrobials, in comparison with subgingival debridement alone or plus a placebo, in terms of probing pocket depth (PPD) reduction, in randomized clinical trials with at least 6 months of follow-up. MATERIAL AND METHODS A systematic search was conducted: 59 papers, reporting 50 different studies, were included. Data on clinical outcome variables changes were pooled and analysed using weighted mean differences (WMDs) and 95% confidence intervals (CI), and prediction intervals (PI), in case of significant heterogeneity. RESULTS Statistically significant differences were observed, in 6- to 9-month studies, for PPD (WMD = 0.365, 95% CI [0.262; 0.468], PI [-0.29; 1.01]) and clinical attachment level (CAL) (WMD = 0.263, 95% CI [0.123; 0.403], PI [-0.43; 0.96]). For long-term studies, significant differences were observed for PPD (WMD = 0.190, 95% CI [0.059; 0.321]), but not for CAL. For adverse events, no differences were observed. Results were affected by study design (split-mouth versus parallel studies) and assessment (full- or partial-mouth), as well as by the formulation tested. CONCLUSIONS The use adjunctive locally delivered antimicrobials in periodontitis therapy results in statistically significant benefits in clinical outcomes, without relevant side effects.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Conchita Martín
- BIOCRAN (Craniofacial Biology) Research Group, University Complutense, Madrid, Spain
| | - Valerie Oud
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Brazil
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Gonçalves IMR, Herrero ER, Carvalho O, Henriques B, Silva FS, Teughels W, Souza JCM. Antibiofilm effects of titanium surfaces modified by laser texturing and hot-pressing sintering with silver. J Biomed Mater Res B Appl Biomater 2021; 109:1588-1600. [PMID: 33622023 DOI: 10.1002/jbm.b.34817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 11/07/2022]
Abstract
Peri-implant diseases are one of the main causes of dental implant failure. New strategies for dental implants manufacturing have been developed to prevent the accumulation of bacteria and related inflammatory reactions. The main aim of this work was to develop laser-treated titanium surfaces covered with silver that generate a electrical dipole to inhibit the oral bacteria accumulation. Two approaches were developed for that purpose. In one approach a pattern of different titanium dioxide thickness was produced on the titanium surface, using a Q-Switched Nd:YAG laser system operating at 1064 nm. The second approach was to incorporate silver particles on a laser textured titanium surface. The incorporation of the silver was performed by laser sintering and hot-pressing approaches. The anti-biofilm effect of the discs were tested against biofilms involving 14 different bacterial strains growth for 24 and 72 hr. The morphological aspects of the surfaces were evaluated by optical and field emission guns scanning electronical microscopy (FEGSEM) and therefore the wettability and roughness were also assessed. Physicochemical analyses revealed that the test surfaces were hydrophilic and moderately rough. The oxidized titanium surfaces showed no signs of antibacterial effects when compared to polished discs. However, the discs with silver revealed a decrease of accumulation of Porphyromonas gingivalis and Prevotella intermedia strains. Thus, the combination of Nd:YAG laser irradiation and hot-pressing was effective to produce silver-based patterns on titanium surfaces to inhibit the growth of pathogenic bacterial species. The laser parameters can be optimized to achieve different patterns, roughness, and thickness of the modified titanium layer regarding the type and region of the implant.
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Affiliation(s)
- Inês M R Gonçalves
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Esteban R Herrero
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, 3000, Belgium
| | - Oscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Bruno Henriques
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Filipe S Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, 3000, Belgium
| | - Júlio C M Souza
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal.,Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, 4585-116, Portugal
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Wylleman A, Vuylsteke F, Dekeyser C, Teughels W, Quirynen M, Laleman I. Alternative therapies in controlling oral malodour: a systematic review. J Breath Res 2021; 15. [PMID: 33227726 DOI: 10.1088/1752-7163/abcd2b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/23/2020] [Indexed: 11/12/2022]
Abstract
Is there a role for alternative therapies in controlling intra-oral halitosis? Treatments other than tongue cleaning and anti-halitosis products containing zinc, chlorhexidine and cetylpyridinium chloride were considered as alternative therapies. Four databases were searched (PubMed, EMBASE, Web of Science and The Cochrane Library). Inclusion criteria were: examination of alternative halitosis therapies, study population with oral malodour, a (negative or positive) control group and evaluation of breath odour via organoleptic and/or instrumental assessment. Data were extracted for descriptive analysis. The screening of 7656 titles led to the inclusion of 26 articles. Analysis showed heterogeneity concerning the population of interest (from cysteine-induced to genuine halitosis), the examined treatment and the reported outcomes. This made a meta-analysis impossible. Essential oils, fluoride-containing products and herbal substances were the most studied. Results varied enormously and none of the active ingredients had an unambiguously positive effect on the malodour. The risk of bias was assessed as high in all articles. Given the fact that little evidence was found for each of the investigated treatments, it could be concluded that there is currently insufficient evidence that alternative therapies are of added value in the treatment of halitosis.Clinical relevanceScientific rationale:Halitosis is a common problem causing social isolation. Out of embarrassment, patients search the internet, leading to many questions about alternative solutions (e.g. oil pulling, herbs). This is the first systematic review on these alternative therapies.Principal findings: Results varied among studies. Some promising results were found for fluoride-containing toothpastes and probiotics. For other products (such as herbal and antibacterial products and essential oils) results were inconsistent. Long-term follow-up studies on these products are scarce. Moreover, the quality of the studies was poor.Practical implications:No clear evidence was found to support a certain alternative anti-halitosis therapy.
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Affiliation(s)
- A Wylleman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium.,Equally contributing first authors.,Author to whom any correspondence should be addressed
| | - F Vuylsteke
- KU, Leuven, Belgium.,Equally contributing first authors
| | - C Dekeyser
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
| | - W Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
| | - M Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
| | - I Laleman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
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Barreiros P, Braga J, Faria-Almeida R, Coelho C, Teughels W, Souza JCM. Remnant oral biofilm and microorganisms after autoclaving sterilization of retrieved healing abutments. J Periodontal Res 2020; 56:415-422. [PMID: 33368278 DOI: 10.1111/jre.12834] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 11/18/2020] [Accepted: 12/02/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the sterilization effectiveness against biofilms on retrieved healing abutments used in implant dentistry. BACKGROUND A large number of clinicians reuse healing abutments to decrease treatment costs although it can promote infection due to the presence of remnant biofilm biomass. METHODS One hundred and eighty-five titanium healing abutments previously used for 3 months in oral cavity were assessed in this study. Abutments were submitted to cleaning, chemical disinfection, and autoclave sterilization according to clinical guidelines. The abutments were aseptically placed into glass tubes containing specific bacterial growth medium and then incubated for 10 days. From glass tubes with bacterial growth, 100 µl medium was transferred to Schaedler's agar for morphological identification and counting of strict anaerobes and to Columbia blood agar for presumptive identification of facultative anaerobes after incubation. Isolated strains were then identified at species level by enzymatic and biochemical tests within API microorganism detection platform. Also, polymerase chain reaction (PCR) was performed for identification of undefined strains. RESULTS After the standard cleaning and sterilization procedures, fifty-six (approximately 30%) retrieved abutments showed the presence of remnant biofilm biomass. The bacteria identified into the remnant biofilms covering the abutments were representative of the commensal oral microbiota including Aggregatibacter actinomycetemcomitans, Prevotella intermedia, and Enterococcus faecalis. CONCLUSION Although some healing abutments did not reveal the existence of bacteria, organic components from biofilm biomass are still strongly adhered on the retentive micro-regions and surfaces of abutments and therefore that would support the accumulation of biofilm including pathogenic species leading to patients' cross-infections. Further studies should be performed on the assessment of different materials, design, and connections of the healing abutments associated with clinical disinfection procedures in implant dentistry.
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Affiliation(s)
- Pedro Barreiros
- Division of Oral Surgery, School of Dentistry (FMDUP), University of Porto, Porto, 4200-393, Portugal.,Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, 4585-116, Portugal
| | - João Braga
- Division of Oral Surgery, School of Dentistry (FMDUP), University of Porto, Porto, 4200-393, Portugal
| | - Ricardo Faria-Almeida
- Division of Oral Surgery, School of Dentistry (FMDUP), University of Porto, Porto, 4200-393, Portugal
| | - Cristina Coelho
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, 4585-116, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, Dentistry, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, 3000, Belgium
| | - Júlio C M Souza
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, 4585-116, Portugal.,Center for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Guimarães, Braga, 4800-058, Portugal
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De Greef A, De Mars G, Vandamme K, Coucke W, Teughels W, Quirynen M. 3‐year follow‐up of the NobelActive implant. Clin Oral Implants Res 2020. [DOI: 10.1111/clr.141_13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Alexander De Greef
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Greet De Mars
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Katleen Vandamme
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Wim Coucke
- Scientific Institute of Public Health Section Quality of Medical Laboratories, Brussels, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Affiliation(s)
- Isabelle Laleman
- Department of Oral Health Sciences KU Leuven& Dentistry University Hospitals Leuven Leuven Belgium
| | - Wim Teughels
- Department of Oral Health Sciences KU Leuven& Dentistry University Hospitals Leuven Leuven Belgium
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Rodríguez Sánchez F, Arteagoitia I, Teughels W, Rodríguez Andrés C, Quirynen M. Antibiotic dosage prescribed in oral implant surgery: A meta-analysis of cross-sectional surveys. PLoS One 2020; 15:e0236981. [PMID: 32810135 PMCID: PMC7446810 DOI: 10.1371/journal.pone.0236981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/18/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess the dosage and types of antibiotics prescribed in oral implant surgery, compare them among the different subpopulations (country and prescription regimens) and against the evidence-based recommended dosage: a 2-gram single preoperative dose of amoxicillin. A meta-analysis of cross-sectional surveys was conducted, which reports the overall dosage (and type) of antibiotics prescribed in combination with implant placement. PubMed, Cochrane, Science, Direct, and EMBASE via OVID were searched until April 2019. Three reviewers independently undertook data extraction and risk of bias assessment. The outcome variable was set on the average of prophylactic antibiotics prescribed per oral implant surgery. Overall, 726 participants from five cross-sectional surveys, representing five different countries were finally included. Amoxicillin was the most prescribed antibiotic. On average, 10,724 mg of antibiotics were prescribed per implant surgery. This average was significantly (p<0.001) higher than 2,000 mg. Overall, amoxicillin doses were significantly higher than 2,000 mg (9,700 mg, p<0.001). All prescribed amoxicillin regimens independently contained more than 2,000 mg, including those comprising only preoperative amoxicillin (2,175 mg, p = 0.006). Exclusive preoperative antibiotic regimens were the only subgroup with prescription dosages below this threshold (p = 0.091). Significant variations in antibiotic prescriptions were found among different countries and antibiotic regimens (p<0.001). In conclusion, the average dose of antibiotics prescribed per oral implant surgery was larger than the evidence-based recommended dose in healthy patients and straightforward conditions. In addition, variations in the average antibiotic dosages were found among different countries and prescription regimens.
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Affiliation(s)
- Fabio Rodríguez Sánchez
- Department of Preventive Medicine and Public Health, University of the Basque Country, Bilbao, Spain
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium
- * E-mail:
| | - Iciar Arteagoitia
- Department of Stomatology, University of the Basque Country, Bilbao, Spain
- Bioruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain
| | - Wim Teughels
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium
| | - Carlos Rodríguez Andrés
- Department of Preventive Medicine and Public Health, University of the Basque Country, Bilbao, Spain
| | - Marc Quirynen
- Department of Oral Health Sciences, Section Periodontology, Catholic University of Leuven & University Hospitals Leuven, Leuven, Belgium
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Teughels W, Feres M, Oud V, Martín C, Matesanz P, Herrera D. Adjunctive effect of systemic antimicrobials in periodontitis therapy: A systematic review and meta‐analysis. J Clin Periodontol 2020; 47 Suppl 22:257-281. [DOI: 10.1111/jcpe.13264] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Wim Teughels
- Department of Oral Health Sciences KU Leuven & Dentistry (Periodontology) University Hospitals Leuven Leuven Belgium
| | - Magda Feres
- Department of Periodontology Dental Research Division Guarulhos University Guarulhos Brazil
| | - Valerie Oud
- Department of Oral Health Sciences KU Leuven & Dentistry (Periodontology) University Hospitals Leuven Leuven Belgium
| | - Conchita Martín
- BIOCRAN (Craniofacial Biology) Research Group University Complutense Madrid Spain
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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Salhi L, Sakalihasan N, Okroglic AG, Labropoulos N, Seidel L, Albert A, Teughels W, Defraigne JO, Lambert F. Further evidence on the relationship between abdominal aortic aneurysm and periodontitis: A cross-sectional study. J Periodontol 2020; 91:1453-1464. [PMID: 32329066 DOI: 10.1002/jper.19-0671] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Periodontitis is a chronic inflammatory disease characterized by Gram-negative bacteria responsible for the degradation of tissues surrounding tooth. Moreover, periopathogens can invade the bloodstream, disseminate and promote cardiovascular disease, such as the link between Porphyromonas gingivalis and atherosclerosis. The aim of this study was to explore the relationship between the severity of periodontitis and of abdominal aortic aneurysm (AAA). METHODS This cross-sectional study compared patients with stable AAA (n = 30) and patients with unstable AAA (n = 31) based on aortic diameter, growth rate, and eligibility for surgical intervention. Periodontal clinical parameters were recorded as well as the Periodontal Inflamed Surface Area and the Periodontal Index for Risk of Infectiousness (PIRI). Microbiological analyses were performed on saliva and supragingival and subgingival plaque. Quantification of Tannerella forsythia (Tf), Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), and Prevotella intermedia (Pi) was done by quantitative polymerase chain reaction. RESULTS The two AAA groups were homogeneous for age, sex, and most risk factors except hypertension and chronic obstructive pulmonary disease. Periodontal parameters were comparable but the proportion of patients with high PIRI scores was greater in those with unstable AAA (51.6% versus 23.3%). The probing depth (PD) and the proportion of PD >6 mm were positively correlated with AAA size and thrombus volume. Several associations were found between periopathogens such as Pg and AAA diameters and volumes, but no difference could be evidenced between stable and unstable AAA groups. CONCLUSIONS Periodontitis was highly prevalent in both stable and unstable AAA patients. Severe and progressive periodontitis (stage IV and grade C) tended to be more frequent in the group of patients with unstable AAA. Moreover, Pg was observed in all the samples (saliva, supragingival, and subgingival plaque) and was correlated with AAA diameters and volumes. The study evidenced potential relationships between periodontitis severity and size of AAA.
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Affiliation(s)
- Leila Salhi
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Natzi Sakalihasan
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Ambre Gau Okroglic
- Department of Medical Imagery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - Nicos Labropoulos
- Department of Surgery, Stony Brook University School of Medicine, Stony Brook, USA
| | - Laurence Seidel
- Department of Biostatistics, University of Liège, Liège, Belgium
| | - Adelin Albert
- Department of Public Health Sciences, University of Liège, Liège, Belgium
| | - Wim Teughels
- Department of Periodontology, Research Group for Microbial Adhesion, Catholic University Leuven, Leuven, Belgium
| | - Jean-Olivier Defraigne
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
| | - France Lambert
- Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
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Bins-Ely L, Suzuki D, Magini R, Benfatti CAM, Teughels W, Henriques B, Souza JCM. Enhancing the bone healing on electrical stimuli through the dental implant. Comput Methods Biomech Biomed Engin 2020; 23:1041-1051. [DOI: 10.1080/10255842.2020.1785437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Letícia Bins-Ely
- School of Dentistry (ODT), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Daniela Suzuki
- Institute of Biomedical Engineering, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Ricardo Magini
- School of Dentistry (ODT), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Cesar A. M. Benfatti
- School of Dentistry (ODT), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Wim Teughels
- Department of Oral Health Sciences, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Bruno Henriques
- CERMAT, Department of Mechanical Engineering (EMC), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
- Department Mechanical Engineering (DEM), Center Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, Portugal
| | - Júlio C. M. Souza
- Department Mechanical Engineering (DEM), Center Microelectromechanical Systems (CMEMS), University of Minho, Guimarães, Portugal
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra PRD, Portugal
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Chatzigiannidou I, Teughels W, Van de Wiele T, Boon N. Oral biofilms exposure to chlorhexidine results in altered microbial composition and metabolic profile. NPJ Biofilms Microbiomes 2020; 6:13. [PMID: 32198347 PMCID: PMC7083908 DOI: 10.1038/s41522-020-0124-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/27/2020] [Indexed: 01/31/2023] Open
Abstract
Oral diseases (e.g., dental caries, periodontitis) are developed when the healthy oral microbiome is imbalanced allowing the increase of pathobiont strains. Common practice to prevent or treat such diseases is the use of antiseptics, like chlorhexidine. However, the impact of these antiseptics on the composition and metabolic activity of the oral microbiome is poorly addressed. Using two types of oral biofilms—a 14-species community (more controllable) and human tongue microbiota (more representative)—the impact of short-term chlorhexidine exposure was explored in-depth. In both models, oral biofilms treated with chlorhexidine exhibited a pattern of inactivation (>3 log units) and fast regrowth to the initial bacterial concentrations. Moreover, the chlorhexidine treatment induced profound shifts in microbiota composition and metabolic activity. In some cases, disease associated traits were increased (such as higher abundance of pathobiont strains or shift in high lactate production). Our results highlight the need for alternative treatments that selectively target the disease-associated bacteria in the biofilm without targeting the commensal microorganisms.
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Affiliation(s)
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Tom Van de Wiele
- Center for Microbial Ecology and Technology, Coupure Links 653, 9000, Gent, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology, Coupure Links 653, 9000, Gent, Belgium.
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Wylleman A, Van der Veken D, Teughels W, Quirynen M, Laleman I. Alveolar bone level at deciduous molars in Flemish children: A retrospective, radiographic study. J Clin Periodontol 2020; 47:660-667. [PMID: 32144794 DOI: 10.1111/jcpe.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 02/22/2020] [Accepted: 03/02/2020] [Indexed: 11/28/2022]
Abstract
AIM The aim of this retrospective radiographic study in Flemish children was to examine the bone level and bone loss around deciduous molars and factors influencing this. MATERIALS AND METHODS Two thousand eight hundred ninety six digital intra-oral radiographs of children younger than 18 years old were screened for eligibility. The distance from the cementoenamel junction to the alveolar bone crest was measured, and tooth surfaces were screened for local risk factors that are presumably related to changes in the bone level. A distance >2 mm was defined as bone loss based on previous literature. All measurements were performed by two examiners. RESULTS One thousand four hundred ninety one radiographs of 796 patients (mean age 6.46 ± 2.38 years) were included. The distance between the cementoenamel junction and the alveolar bone crest ranged from 0.07 to 2.88 mm, and the mean distance was 0.93 ± 0.37 mm. This distance was positively correlated with age (p < .001). In 3.5% of patients, bone loss was diagnosed. Caries, fillings and pulp pathology were associated with bone loss and higher cementoenamel junction-alveolar bone crest distances (p < .05). CONCLUSION This study found a low prevalence of alveolar bone loss in the primary dentition. Both the bone level and bone loss were strongly correlated with local factors.
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Affiliation(s)
- Astrid Wylleman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,Dentistry Department, University Hospitals Leuven, Leuven, Belgium
| | - Dominique Van der Veken
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,Dentistry Department, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,Dentistry Department, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,Dentistry Department, University Hospitals Leuven, Leuven, Belgium
| | - Isabelle Laleman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,Dentistry Department, University Hospitals Leuven, Leuven, Belgium
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Slomka V, Herrero ER, Boon N, Bernaerts K, Trivedi HM, Daep C, Quirynen M, Teughels W. Oral prebiotics and the influence of environmental conditions in vitro. J Periodontol 2019; 89:708-717. [PMID: 29577296 DOI: 10.1002/jper.17-0437] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 11/26/2017] [Accepted: 12/20/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Only recently the concept of prebiotics has been introduced in oral health. Few potential oral prebiotics have already been identified in dual species competition assays, showing a stimulatory effect on beneficial bacteria and by this suppressing the outgrowth of pathogenic species. This study aimed to validate the effect of previously identified potential prebiotic substrates on multispecies cultures by shifting the biofilm composition towards a more beneficial species dominated microbiota. METHODS A chemostat culture containing 14 model oral bacterial species was used to grow biofilms for 24 hours which subsequently were treated with prebiotic solutions three times a day for 3 consecutive days. Further the influence of environmental factors such as pH, nutrient availability, oxygen concentration and prebiotic dose on the efficacy of the prebiotic substances was investigated. RESULTS Three potential prebiotic substrates N-acetyl-D-mannosamine, succinic acid and Met-Pro were able to bring the beneficial proportion to > 95%. While the pH of the prebiotic solution did not have an influence on the prebiotic effect, the interplay of nutrient availability, oxygen concentration and prebiotic treatment resulted in significant changes of the microbial composition identifying N-acetyl-D-mannosamine as the most promising oral prebiotic substrate. Showing a clear dose dependent effect, concentrations of N-acetyl-D-mannosamine of 1.0 and 1.5 M resulted in a biofilm composition of 97% beneficial species. CONCLUSION Introducing the prebiotic concept in oral health might reveal a valid approach for treatment and prevention of oral diseases and promote oral health.
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Affiliation(s)
- Vera Slomka
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Esteban Rodriguez Herrero
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University, Coupure links 653, 9000, Gent, Belgium
| | - Kristel Bernaerts
- Bio- and Chemical Systems Technology, Reactor Engineering and Safety Section, Department of Chemical Engineering, KU Leuven, Celestijnenlaan 200F (bus 2424), 3001, Leuven, Belgium
| | | | - Carlo Daep
- Colgate-Palmolive Technology Center, Piscataway, NJ
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Cortellini S, Favril C, De Nutte M, Teughels W, Quirynen M. Patient compliance as a risk factor for the outcome of implant treatment. Periodontol 2000 2019; 81:209-225. [PMID: 31407429 DOI: 10.1111/prd.12293] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Peri-implantitis can be explained using a multicausality model. Many factors are involved in the etiology of peri-implantitis, but patient compliance also plays a key role. Oral hygiene, attending recall visits, smoking behavior, and therapy comprehension are relevant factors that contribute to peri-implant health. The clinician should create the most optimal conditions for patients to facilitate adequate oral self-care and to help patients improve their oral hygiene skills. Implementation of a supportive periodontal therapy program is mandatory to control inflammation and plaque accumulation, as well as to keep the incidence of peri-implant diseases low. Patient compliance, including plaque control and dental follow-up, must be optimal. Consequently, precautions must be taken with patients treated with dental implants.
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Affiliation(s)
- Simone Cortellini
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Charlotte Favril
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Mathieu De Nutte
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Wim Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - Marc Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2019; 89 Suppl 1:S74-S84. [PMID: 29926944 DOI: 10.1002/jper.17-0719] [Citation(s) in RCA: 306] [Impact Index Per Article: 61.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/11/2018] [Accepted: 03/12/2018] [Indexed: 12/21/2022]
Abstract
Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.
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Affiliation(s)
- Iain L C Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, UK
| | - Brian L Mealey
- University of Texas Health Science Center at San Antonio, USA
| | | | | | - Henrik Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - Peter Eickholz
- Department of Periodontology, Center for Oral Medicine, Johann Wolfgang Goethe-University Frankfurt, Germany
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, USA
| | | | | | - Moshe Goldstein
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Terrence J Griffin
- Periodontal Department, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Palle Holmstrup
- Periodontology, Section 1, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Georgia K Johnson
- Department of Periodontology, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Yvonne Kapila
- Orofacial Sciences, University of California San Francisco, USA
| | - Niklaus P Lang
- Department of Periodontology, University of Bern, Switzerland
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Germany
| | - Shinya Murakami
- Department of Periodontology, Graduate School of Dentistry, Osaka University, Japan
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M College of Dentistry, Dallas, TX, USA
| | - Giuseppe A Romito
- Division of Periodontology, Department of Stomatology, Dental School, University of São Paulo, Brazil
| | - Lior Shapira
- Department of Periodontology, Faculty of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, Ohio State University, Columbus, OH, USA
| | - Wim Teughels
- Department of Oral Health Sciences, Periodontology, KU Leuven & Dentistry, University Hospitals Leuven, Belgium
| | - Leonardo Trombelli
- Research Center for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Italy
| | - Clemens Walter
- Department of Periodontology, Endodontology & Cariology, University Centre for Dental Medicine, University of Basel School of Dentistry, Switzerland
| | - Gernot Wimmer
- Department of Prosthodontics, School of Dentistry, Medical University Graz, Austria
| | - Pinelopi Xenoudi
- Orofacial Sciences, School of Dentistry, University of California San Francisco, USA
| | - Hiromasa Yoshie
- Division of Periodontology, Niigata University Graduate School of Medical and Dental Sciences, Japan
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Laleman I, Pauwels M, Quirynen M, Teughels W. A dual-strain Lactobacilli reuteri probiotic improves the treatment of residual pockets: A randomized controlled clinical trial. J Clin Periodontol 2019; 47:43-53. [PMID: 31520543 PMCID: PMC6973056 DOI: 10.1111/jcpe.13198] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/16/2019] [Accepted: 09/09/2019] [Indexed: 01/08/2023]
Abstract
Aim To examine the adjunctive effect of a Lactobacillus reuteri probiotic (ATCC PTA 5289 & DSM 17938) on the re‐instrumentation of residual pockets. Materials and Methods This randomized, double‐blind, placebo‐controlled study included 39 previously non‐surgically treated periodontitis patients. A re‐instrumentation was carried out, and probiotic and/or placebo drops were applied according to the study protocoll. Patients afterwards received lozenges to use 2×/day for 12 weeks. Probing pocket depth (PPD), recession, bleeding on probing and plaque levels were analysed, next to the microbiological impact. Results No effects of the probiotic drops could be found. However, after 24 weeks, the overall PPD in the probiotic lozenges group (2.64 ± 0.33 mm) was significantly lower compared to the control lozenges (2.92 ± 0.42 mm). This difference was even more pronounced in moderate (4–6 mm) and deep (≥7 mm) pockets. In the probiotic lozenges group, there were also significantly more pockets converting from ≥4 mm at baseline to ≤3 mm at 24 weeks (67 ± 18% versus 54 ± 17%) and less sites in need for surgery (4 ± 4% versus 8 ± 6%). However, the probiotic products did not influence the microbiological counts of the periodontopathogens. Conclusion The adjunctive consumption of L. reuteri lozenges after re‐instrumentation improved the PPD reduction, without an impact on pocket colonization with periodontopathogens.
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Affiliation(s)
- Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Martine Pauwels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Laleman I, Pauwels M, Quirynen M, Teughels W. The usage of a lactobacilli probiotic in the non-surgical therapy of peri-implantitis: A randomized pilot study. Clin Oral Implants Res 2019; 31:84-92. [PMID: 31705683 DOI: 10.1111/clr.13555] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/09/2019] [Accepted: 10/19/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Examine the clinical and microbiological benefits of a dual-strain Lactobacillus reuteri probiotic on the non-surgical therapy of initial peri-implantitis. MATERIALS AND METHODS This randomized, double-blind study targeted patients with initial peri-implantitis, that is peri-implantitis with a maximum mean probing pocket depth of 6 mm and maximum 3 mm bone loss compared with loading. A full-mouth prophylaxis was performed and the peri-implantitis sites were debrided. Subsequently, local application of the study drops was carried out at the peri-implantitis sites and the study lozenges were handed out. The patients in the probiotic group received drops and lozenges containing L. reuteri (ATCC PTA 5289 & DSM 17938), those in the control group received placebo products. At the implant level the measurements of interest were bleeding, probing pocket depth and plaque. Full-mouth bleeding and plaque scores were also recorded. Microbiological samples were taken from the tongue, saliva and subgingivally around the implants. RESULTS All clinical parameters were significantly decreased after 12 and 24 weeks. At the implant level the only statistically significant difference was a greater decrease in plaque levels in the probiotic versus the control group (p = .002 at 24 weeks). At the full-mouth level, the only intergroup difference was the greater decrease in full-mouth bleeding on probing sites in the probiotic group compared with the control group (p < .001 at 24 weeks). Concerning the microbiological outcomes, no significant differences could be found at any time point, neither intra- nor intergroup. CONCLUSIONS No adjunctive effects of the use of L. reuteri probiotics in the treatment of peri-implantitis were found.
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Affiliation(s)
- Isabelle Laleman
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Martine Pauwels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Temmerman A, Cortellini S, Van Dessel J, De Greef A, Jacobs R, Dhondt R, Teughels W, Quirynen M. Bovine‐derived xenograft in combination with autogenous bone chips versus xenograft alone for the augmentation of bony dehiscences around oral implants: A randomized, controlled, split‐mouth clinical trial. J Clin Periodontol 2019; 47:110-119. [DOI: 10.1111/jcpe.13209] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/29/2019] [Accepted: 10/03/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Andy Temmerman
- Section of Periodontology Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals, KU Leuven Leuven Belgium
| | - Simone Cortellini
- Section of Periodontology Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals, KU Leuven Leuven Belgium
| | - Jeroen Van Dessel
- OMFS‐Impath Research Group Department of Oral & Maxillofacial Surgery KU Leuven & UZ University Hospitals Leuven Belgium
| | - Alexander De Greef
- Section of Periodontology Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals, KU Leuven Leuven Belgium
| | - Reinhilde Jacobs
- OMFS‐Impath Research Group Department of Oral & Maxillofacial Surgery KU Leuven & UZ University Hospitals Leuven Belgium
| | - Rutger Dhondt
- Section of Periodontology Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals, KU Leuven Leuven Belgium
| | - Wim Teughels
- Section of Periodontology Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals, KU Leuven Leuven Belgium
| | - Marc Quirynen
- Section of Periodontology Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals, KU Leuven Leuven Belgium
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Namour M, El Mobadder M, Magnin D, Peremans A, Verspecht T, Teughels W, Lamard L, Nammour S, Rompen E. Q-Switch Nd:YAG Laser-Assisted Decontamination of Implant Surface. Dent J (Basel) 2019; 7:dj7040099. [PMID: 31581536 PMCID: PMC6960958 DOI: 10.3390/dj7040099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 01/04/2023] Open
Abstract
Peri-implantitis (PI) is an inflammatory disease of peri-implant tissues, it represents the most frequent complication of dental implants. Evidence revealed that microorganisms play the chief role in causing PI. The purpose of our study is to evaluate the cleaning of contaminated dental implant surfaces by means of the Q-switch Nd:YAG (Neodymium-doped Yttrium Aluminum Garnet) laser and an increase in temperature at lased implant surfaces during the cleaning process. Seventy-eight implants (titanium grade 4) were used (Euroteknika, Sallanches, France). Thirty-six sterile implants and forty-two contaminated implants were collected from failed clinical implants for different reasons, independent from the study. Thirty-six contaminated implants were partially irradiated by Q-switch Nd:YAG laser (1064 nm). Six other contaminated implants were used for temperature rise evaluation. All laser irradiations were calibrated by means of a powermetter in order to evaluate the effective delivered energy. The irradiation conditions delivered per pulse on the target were effectively: energy density per pulse of 0.597 J/cm2, pick powers density of 56 mW/cm2, 270 mW per pulse with a spot diameter of 2.4 mm, and with repetition rate of 10 Hz for pulse duration of 6 ns. Irradiation was performed during a total time of 2 s in a non-contact mode at a distance of 0.5 mm from implant surfaces. The parameters were chosen according to the results of a theoretical modeling calculation of the Nd:YAG laser fluency on implant surface. Evaluation of contaminants removal showed that the cleaning of the irradiated implant surfaces was statistically similar to those of sterile implants (p-value ≤ 0.05). SEM analysis confirmed that our parameters did not alter the lased surfaces. The increase in temperature generated at lased implant surfaces during cleaning was below 1 °C. According to our findings, Q-switch Nd:YAG laser with short pulse duration in nanoseconds is able to significantly clean contaminated implant surfaces. Irradiation parameters used in our study can be considered safe for periodontal tissue.
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Affiliation(s)
- Melanie Namour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
| | - Marwan El Mobadder
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
| | - Delphine Magnin
- Bio- and Soft Matter Division, Institute of Condensed and Nanosciences, Université Catholique de Louvain (UCL), 1348-Louvain-la-Neuve, Belgium.
| | - André Peremans
- Laboratoire Physique de la Matière et du Rayonnement (P.M.R.), Université de Namur, 5000 Namur, Belgium.
| | - Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (K.U. Leuven), 3000 Leuven, Belgium.
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (K.U. Leuven) and Dentistry, University Hospitals Leuven, 3000 Leuven, Belgium.
| | | | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
| | - Eric Rompen
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium.
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