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Antibiotics
Special Issues
Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment
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Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiofilm Strategies".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 7622

Special Issue Editors

Dr. Naiera Zayed

E-Mail Website
Guest Editor
Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
Interests: oral microbiology; antimicrobials; microbial ecology; oral biofilms; pharmaceutical sciences
Dr. Cher Farrugia

E-Mail Website
Guest Editor
Bristol Dental School, University of Bristol, Bristol, UK
Interests: microbiology; host-pathogen interactions; periodontology; restorative dentistry; antimicrobial testing of medical devices/materials

Special Issue Information

Dear Colleagues,

Oral diseases represent a significant global health challenge, affecting billions worldwide and imposing a profound impact on overall health, quality of life, and the economy. Central to the development and persistence of many oral diseases is the role of biofilms, the complex microbial communities that adhere to surfaces in the oral cavity and exhibit increased resistance to conventional treatments. These resilient biofilms are key contributors to a spectrum of oral conditions, including dental caries, periodontal diseases, peri-implant infections, and endodontic lesions. Furthermore, the intricate interplay between biofilms and host factors plays a critical role in disease pathogenesis and progression.

This Special Issue, Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment, seeks to advance our understanding of the mechanisms underlying biofilm-associated oral diseases and to explore innovative diagnostic and therapeutic strategies to overcome current challenges. This Special Issue aims to cover recent advancements in

  • The role of host–biofilm interactions in disease progression and resolution.
  • The molecular and ecological dynamics of oral biofilms.
  • Novel antimicrobial strategies to combat biofilm resilience.
  • Personalized treatment approaches based on microbial profiling.

We welcome contributions that address the multifaceted nature of oral biofilms, including original research, clinical studies, reviews, and case reports. By integrating scientific and clinical perspectives, this Special Issue aims to provide a comprehensive resource for researchers, clinicians, and policymakers dedicated to mitigating the burden of biofilm-associated oral diseases.

Together, let us advance the field of oral health by addressing the persistent challenges posed by biofilm-related diseases through innovative, evidence-based solutions.

Dr. Naiera Zayed
Dr. Cher Farrugia
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oral diseases
  • oral biofilms
  • host–biofilm interactions
  • novel antimicrobial strategies
  • molecular dynamics

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

22 pages, 3260 KB  
Article
Comparative Clinical Evaluation of Chamomile, Sage, and Ginger Mouthwashes in Reducing Plaque and Gingival Inflammation
by Ioana Elena Lile, Anda Olivia Jesamine Samoilă, Carolina Cojocariu, Gianina Tapalagă, Neli-Kinga Oláh, Otilia Lavinia Stana, Adelina Berari and Diana Marian
Antibiotics 2026, 15(5), 433; https://doi.org/10.3390/antibiotics15050433 - 27 Apr 2026
Viewed by 515
Abstract
Background: Despite mechanical hygiene, plaque-related illnesses like gingivitis and periodontitis affect over 3.5 billion people globally. Natural mouthwashes are becoming increasingly popular as consumers shift toward plant-based alternatives to chlorhexidine, which may have drawbacks that limit long-term acceptability. This study aimed to evaluate [...] Read more.
Background: Despite mechanical hygiene, plaque-related illnesses like gingivitis and periodontitis affect over 3.5 billion people globally. Natural mouthwashes are becoming increasingly popular as consumers shift toward plant-based alternatives to chlorhexidine, which may have drawbacks that limit long-term acceptability. This study aimed to evaluate the short-term clinical potential of three herbal mouthwashes—Matricaria chamomilla (chamomile), Salvia officinalis (sage), and Zingiber officinale (ginger)—in reducing dental plaque and clinical signs of gingival inflammation in young adults. (2) Materials and Methods. A randomised controlled clinical trial was conducted on 175 systemically healthy participants, allocated equally into five groups (three herbal groups, placebo, and chlorhexidine). Each herbal group used a 2% aqueous infusion three times daily for twelve weeks. The 2% aqueous infusion concentration was selected based on commonly reported concentrations in previous phytotherapeutic and clinical studies evaluating herbal mouthwashes, balancing potential efficacy with safety and tolerability. The plant materials were sourced from certified suppliers, and standardized dried plant parts were used under controlled preparation conditions. Clinical assessments were performed at baseline (T0), week 1 (T1), week 5 (T2), and week 9 (T3), corresponding to the beginning of each evaluation interval within the 12-week study, using the Silness–Löe Plaque Index and the modified Löe–Silness Gingival Index. Data were analyzed using repeated-measures ANOVA with Bonferroni post hoc correction. (3) Results. Repeated-measures ANOVA revealed a significant main effect of time for both plaque accumulation and gingival index scores. For the Silness–Löe Plaque Index, a marked time-dependent reduction was observed across the active treatment groups (p < 0.001; η2p = 0.56), with a significant time × group interaction (p < 0.001; η2p = 0.49). Similarly, the modified Löe–Silness Gingival Index showed a significant reduction over time (p < 0.001; η2p = 0.22), with a significant interaction effect between time and mouthwash type (p < 0.001; η2p = 0.17). No statistically significant differences were found among the three herbal mouthwashes in post hoc Bonferroni comparisons (all p > 0.05), whereas all active treatments showed significantly better outcomes compared with the placebo. (4) Discussion. All three rinses showed similar clinical effects on plaque and gingival scores. However, without mechanistic assays, no claims can be made about comparable antibacterial or anti-inflammatory activity. Compared with conventional antiseptics such as chlorhexidine, herbal rinses offer important advantages in terms of biocompatibility, safety, and tolerability, with no staining, taste alteration, or mucosal irritation reported. At T3, the correlation between plaque and gingival indices was weak (Spearman’s ρ = 0.18, p = 0.09), suggesting limited linear association; this finding should be interpreted cautiously, as the low end-range values and limited variability of both indices at this time point may have masked a true association. This exploratory observation raises, but does not confirm, the possibility that factors other than plaque reduction may contribute to gingival improvement. (5) Conclusions. Significant reductions in dental plaque and clinical signs of gingival inflammation were observed following regular use of chamomile, sage, and ginger mouthwashes for twelve weeks. All herbal formulations exhibit similar clinical results. Longer-term controlled trials incorporating microbiological and phytochemical analyses are recommended to validate these findings further. Full article
(This article belongs to the Special Issue Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment)
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14 pages, 1572 KB  
Article
Comparative Assessment of Microbial Colonization and Tissue Reaction Among Three Suture Materials: A Randomized Controlled Trial
by José Manuel Alarcón Cordovilla, María Victoria Olmedo-Gaya, María Teresa Arias-Moliz, Adela Baca García, David Sánchez-Porras, María Pilar Quesada-García and María Nuria Romero-Olid
Antibiotics 2025, 14(12), 1265; https://doi.org/10.3390/antibiotics14121265 - 15 Dec 2025
Viewed by 842
Abstract
Background: The aim of this study was to evaluate and compare the bacterial colonization, cytotoxicity, immune response, and clinical parameters of three different suture materials: multifilament silk (Silk®), monofilament nylon (Daclon®), and expanded polytetrafluoroethylene monofilament (PTFE®), in [...] Read more.
Background: The aim of this study was to evaluate and compare the bacterial colonization, cytotoxicity, immune response, and clinical parameters of three different suture materials: multifilament silk (Silk®), monofilament nylon (Daclon®), and expanded polytetrafluoroethylene monofilament (PTFE®), in surgical extractions of impacted mandibular third molars. Methods: This randomized controlled clinical trial was conducted on twenty-one patients requiring surgical extraction of an impacted third mandibular molar. A bayonet-shaped flap was sutured using all three materials in each patient. Bacterial cell counting and qPCR were assessed for microbiological analysis. In vitro cytotoxicity was studied with the metabolic activity WST-1 assay. Inflammatory response was evaluated through histological analysis. Clinical parameters—healing, handling, slack, pain, swelling and trimus—were recorded. Statistical significance was set at p ≤ 0.05. Results: Monofilament sutures accumulated fewer bacteria and DNA copies than Silk® (p < 0.05). The WST-1 assay revealed non-cytotoxic effects. Silk® presented an immune response with lymphocyte-like cells. The highest values of pain and inflammation were reached at 48 h, with a significant correlation between them (p < 0.05). Silk and nylon were more manageable than PTFE (p < 0.001), and nylon had less slack (p < 0.001). Conclusions: Silk showed the poorest microbiological and histological performance, with higher levels of bacterial colonization and a more pronounced inflammatory response compared to the other types of suture. Clinically, it offered better handling than PTFE (PTFE®), comparable to nylon (Daclon®), but it exhibited greater slack, which could prove less favorable for wound stability. None of the sutures showed in vitro cytotoxicity. Monofilament sutures, particularly nylon (Daclon®), showed better outcomes, acceptable handling, less bacterial colonization, and a milder inflammatory response. Full article
(This article belongs to the Special Issue Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment)
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14 pages, 1027 KB  
Article
The Effect of Chlorhexidine Mouthwashes on the Microbiota Associated with Peri-Implantitis Lesions: A Pilot Study
by Félix Pose-Otero, Alexandre Arredondo, Ana Parga, Andrea Muras, Mercedes Gallas, Paz Otero-Casal, José Manuel Pose-Rodríguez and Ana Otero
Antibiotics 2025, 14(10), 1032; https://doi.org/10.3390/antibiotics14101032 - 15 Oct 2025
Viewed by 3914
Abstract
Background/Objectives: Chlorhexidine (CHX)-based mouthwashes are the most commonly used chemical methods as adjuvants for the treatment of peri-implant diseases, but there is a lack of information on their effect on the peri-implant microbiota. The objective of this study was to evaluate the impact [...] Read more.
Background/Objectives: Chlorhexidine (CHX)-based mouthwashes are the most commonly used chemical methods as adjuvants for the treatment of peri-implant diseases, but there is a lack of information on their effect on the peri-implant microbiota. The objective of this study was to evaluate the impact of short-time (15 days) self-administered 0.05% and 0.12% commercial chlorhexidine mouthwashes on the peri-implant pocket microbiota of patients with peri-implantitis. Methods: In this pilot study, we analyzed the microbial composition of peri-implant lesions in 22 patients before and after a 15-day regimen of thrice-daily use of two commercial chlorhexidine mouthwashes containing 0.05% (n = 11) and 0.12% chlorhexidine (n = 11). Microbial samples were collected using paper points, and the taxonomic composition was determined through sequencing of 16S rRNA gene amplicons using Illumina MiSeq. Results: Although individual responses to chlorhexidine mouthwash treatment varied significantly, neither concentration produced a statistically significant change in the microbial diversity associated with peri-implantitis, suggesting limited treatment penetration into peri-implant lesions. Similarly, changes in the abundance of specific odontopathogens were not statistically significant. Conclusions: We found no significant differences in the effect of mouthwashes with different chlorhexidine concentrations on the peri-implant microbiota in short-period applications. Even though more extensive studies are required, the observed patient-dependent outcomes of both chlorhexidine mouthwashes on the peri-implant microbiota and their limited effect in controlling the abundance of oral pathogens indicate that prescription of chlorhexidine mouthwashes for the treatment of peri-implantitis should be carried out with caution. Novel presentations of chlorhexidine with better penetration capacities should be developed, as they could offer enhanced benefits in managing peri-implant diseases. Full article
(This article belongs to the Special Issue Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment)
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14 pages, 3522 KB  
Article
Thermoplastic Zinc-Infused Polymer for Chairside Socket Seal Abutments Enhances Antimicrobial and Tissue-Integrative Properties
by Wannes Van Holm, Katleen Vandamme, Jill Hadisurya, Ferda Pamuk, Naiera Zayed, Merve Kübra Aktan, Annabel Braem, Andy Temmerman and Wim Teughels
Antibiotics 2025, 14(5), 441; https://doi.org/10.3390/antibiotics14050441 - 27 Apr 2025
Viewed by 1626
Abstract
Background/Objectives: The essential trace element zinc (Zn) has a pivotal role in wound healing and can show antibacterial activity, but its application in oral implant materials is underexplored. Customized healing abutments can modulate the peri-implant tissue health when appropriate bioactive materials promoting [...] Read more.
Background/Objectives: The essential trace element zinc (Zn) has a pivotal role in wound healing and can show antibacterial activity, but its application in oral implant materials is underexplored. Customized healing abutments can modulate the peri-implant tissue health when appropriate bioactive materials promoting mucosal healing are used. The present study investigated a novel Zn-containing polymer for its potential in soft-tissue engineering applications. Methods: Four traditional materials—titanium, glass ionomer, a composite, and the novel Zn-containing polymer—were tested in vitro for bacterial growth using a multispecies oral bacterial model compared to hydroxyapatite. The biocompatibility of the materials was also evaluated by evaluating the adhesion, proliferation, and cytotoxicity of human oral keratinocytes (HOK-18A) onto these materials, compared to tissue culture plastic. Results: The Zn-containing polymer exhibited a significantly lower biofilm formation compared to conventional materials as it was composed of less pathogenic bacteria. The Zn-containing material also demonstrated a superior biocompatibility towards HOK-18A, approximating the adhesion and proliferation of the keratinocytes to optimal tissue culture conditions. Moreover, these properties did not seem to degrade and were maintained over a period of 31 days. The cytotoxicity assessment revealed no significant reduction in metabolic activity for any material. Conclusions: This study highlights the potential of the novel Zn-containing polymer in soft-tissue engineering, owing to its antimicrobial and biocompatible assets. These properties, combined with the ease of chairside modeling, position the material as a promising alternative for creating customized healing abutments. Further research is needed to explore its mechanism of wound healing modulation and its clinical performance. Full article
(This article belongs to the Special Issue Biofilm-Associated Oral Diseases: Advances in Diagnosis and Challenges in Treatment)
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