Antimicrobial Therapy in Oral Diseases

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: closed (5 July 2025) | Viewed by 15544

Special Issue Editors


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Guest Editor
Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
Interests: periodontal medicine; periodontal regeneration; oral stem cell biology; dental materials; biosafety and tooth-periodontal interactions; animal models for ridge preservation; muco-gingival surgery

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Guest Editor
Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, 400012 Cluj-Napoca, Romania
Interests: periodontal regeneration; periodontal surgery; oral stem cell biology; biomaterials; dental materials; tooth-periodontal interactions; dental adhesion
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Special Issue Information

Dear Colleagues,

This Special Issue of Antibiotics, "Antimicrobial Therapy in Oral Diseases", invites articles focused on the clinical use of antibiotics and antiseptic products as replacements of antibiotherapy in dentistry, as well as in-depth research focused on the antibiotic resistance of oral bacteria, effects of antibiotics and antiseptics on oral cell behavior and oral healing, and new antimicrobial-based products for oral use. In particular, clinical and preclinical studies on the use of antimicrobials in periodontal and peri-implant diseases will be highly welcomed.

Aging associated with increased life expectancy augments the frequency of some oral pathologies of infectious aetiology, and their association with some general diseases modifies host response and therapeutical outcomes, complicating clinical and scientific reasoning.

Experimental and well-designed clinical studies based on the above-mentioned topics, but not limited to them, under the umbrella of multi-disciplinarity are highly encouraged.

We invite you to submit your valuable contributions to this Special Issue.

Prof. Dr. Alexandra Roman
Dr. Andrada Soanca
Guest Editors

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Keywords

  • oral
  • antibiotic
  • antiseptic
  • tooth
  • periodontium
  • dental caries
  • implant
  • healing
  • cell
  • biomaterials
  • periodontitis
  • biocompatibility
  • toxicity
  • periodontology
  • periodontal pocket
  • bacteria
  • nonsurgical treatment
  • oral surgery
  • clinical trial

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Published Papers (5 papers)

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Research

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12 pages, 1047 KB  
Article
In Vitro Assessment of Antifungal and Antibiofilm Efficacy of Commercial Mouthwashes against Candida albicans
by Marzena Korbecka-Paczkowska and Tomasz M. Karpiński
Antibiotics 2024, 13(2), 117; https://doi.org/10.3390/antibiotics13020117 - 25 Jan 2024
Cited by 13 | Viewed by 4816
Abstract
Candida albicans is the most critical fungus causing oral mycosis. Many mouthwashes contain antimicrobial substances, including antifungal agents. This study aimed to investigate the in vitro activity of 15 commercial mouthwashes against 12 strains of C. albicans. The minimal inhibitory concentrations (MICs), [...] Read more.
Candida albicans is the most critical fungus causing oral mycosis. Many mouthwashes contain antimicrobial substances, including antifungal agents. This study aimed to investigate the in vitro activity of 15 commercial mouthwashes against 12 strains of C. albicans. The minimal inhibitory concentrations (MICs), minimal fungicidal concentrations (MFCs), and anti-biofilm activity were studied. MICs were determined by the micro-dilution method using 96-well plates, and MFCs were determined by culturing MIC suspensions on Sabouraud dextrose agar. Anti-biofilm activity was evaluated using the crystal violet method. The mouthwashes containing octenidine dihydrochloride (OCT; mean MICs 0.09–0.1%), chlorhexidine digluconate (CHX; MIC 0.12%), and CHX with cetylpyridinium chloride (CPC; MIC 0.13%) exhibited the best activity against C. albicans. The active compound antifungal concentrations were 0.5–0.9 µg/mL for OCT products and 1.1–2.4 µg/mL for CHX rinses. For mouthwashes with CHX + CPC, concentrations were 1.56 µg/mL and 0.65 µg/mL, respectively. Products with polyaminopropyl biguanide (polyhexanide, PHMB; MIC 1.89%) or benzalkonium chloride (BAC; MIC 6.38%) also showed good anti-Candida action. In biofilm reduction studies, mouthwashes with OCT demonstrated the most substantial effect (47–51.1%). Products with CHX (32.1–41.7%), PHMB (38.6%), BAC (35.7%), Scutellaria extract (35.6%), and fluorides + essential oils (33.2%) exhibited moderate antibiofilm activity. The paper also provides an overview of the side effects of CHX, CPC, and OCT. Considering the in vitro activity against Candida albicans, it can be inferred that, clinically, mouthwashes containing OCT are likely to offer the highest effectiveness. Meanwhile, products containing CHX, PHMB, or BAC can be considered as promising alternatives. Full article
(This article belongs to the Special Issue Antimicrobial Therapy in Oral Diseases)
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13 pages, 3242 KB  
Article
Novel Iron Chelators, Super-Polyphenols, Show Antimicrobial Effects against Cariogenic Streptococcus mutans
by Yuki Shinoda-Ito, Kazuhiro Omori, Takashi Ito, Masaaki Nakayama, Atsushi Ikeda, Masahiro Ito, Toshiaki Ohara and Shogo Takashiba
Antibiotics 2023, 12(11), 1562; https://doi.org/10.3390/antibiotics12111562 - 24 Oct 2023
Cited by 3 | Viewed by 2471
Abstract
Dental caries are an oral infectious disease that can affect human health both orally and systemically. It remains an urgent issue to establish a novel antibacterial method to prevent oral infection for a healthy life expectancy. The aim of this study was to [...] Read more.
Dental caries are an oral infectious disease that can affect human health both orally and systemically. It remains an urgent issue to establish a novel antibacterial method to prevent oral infection for a healthy life expectancy. The aim of this study was to evaluate the inhibitory effects of novel iron chelators, super-polyphenols (SPs), on the cariogenic bacterium Streptococcus mutans, in vitro. SPs were developed to reduce the side effects of iron chelation therapy and were either water-soluble or insoluble depending on their isoforms. We found that SP6 and SP10 inhibited bacterial growth equivalent to povidone-iodine, and viability tests indicated that their effects were bacteriostatic. These results suggest that SP6 and SP10 have the potential to control oral bacterial infections such as Streptococcus mutans. Full article
(This article belongs to the Special Issue Antimicrobial Therapy in Oral Diseases)
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Review

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23 pages, 1362 KB  
Review
A Comprehensive Review of Antibiotic Resistance in the Oral Microbiota: Mechanisms, Drivers, and Emerging Therapeutic Strategies
by Ena Kulis, Ivan Cvitkovic, Nikola Pavlovic, Marko Kumric, Doris Rusic and Josko Bozic
Antibiotics 2025, 14(8), 828; https://doi.org/10.3390/antibiotics14080828 - 15 Aug 2025
Cited by 1 | Viewed by 2011
Abstract
Recent advances in microbiome research have highlighted the oral cavity as a complex and dynamic ecosystem, home to over 700 microbial species that play critical roles in both oral and systemic health. The oral microbiota not only maintains local tissue homeostasis but also [...] Read more.
Recent advances in microbiome research have highlighted the oral cavity as a complex and dynamic ecosystem, home to over 700 microbial species that play critical roles in both oral and systemic health. The oral microbiota not only maintains local tissue homeostasis but also serves as a reservoir for antimicrobial resistance (AMR) genes, contributing to the global spread of resistance. Frequent and sometimes inappropriate antibiotic use in dental practice, along with exposure to antiseptics and biocides, drives the emergence and horizontal transfer of resistance determinants within oral biofilms. This review synthesizes current knowledge on the molecular mechanisms and ecological drivers of AMR in the oral microbiome, emphasizing the clinical implications of dysbiosis and drug-resistant infections. The authors advocate for the development of dental clinical guidelines tailored to the unique characteristics of the oral microbiota, focusing on personalized therapy through molecular diagnostics, standardized AMR risk assessment, and the integration of non-antibiotic strategies such as probiotics and photodynamic therapy. Continuous education in antimicrobial stewardship and the implementation of oral-specific AMR surveillance is also highlighted as an essential component of effective resistance management. To support rational prescribing, a dedicated mobile application has been developed, leveraging microbiota data and resistance profiles to guide evidence-based, targeted therapy and reduce unnecessary antibiotic use. Collectively, these strategies aim to preserve antibiotic efficacy, ensure patient safety, and promote sustainable infection management in the dental field. Full article
(This article belongs to the Special Issue Antimicrobial Therapy in Oral Diseases)
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19 pages, 972 KB  
Review
Effects of Antiseptic Formulations on Oral Microbiota and Related Systemic Diseases: A Scoping Review
by Angela Angjelova, Elena Jovanova, Alessandro Polizzi, Rosalia Leonardi and Gaetano Isola
Antibiotics 2025, 14(8), 815; https://doi.org/10.3390/antibiotics14080815 - 8 Aug 2025
Viewed by 1903
Abstract
Background: Oral antiseptic formulations are widely used as adjuncts in oral hygiene to reduce pathogenic microorganisms and prevent oral diseases. While these agents are effective in controlling biofilm, their broader effects may disrupt the oral microbiota’s balance, potentially contributing to systemic health implications. [...] Read more.
Background: Oral antiseptic formulations are widely used as adjuncts in oral hygiene to reduce pathogenic microorganisms and prevent oral diseases. While these agents are effective in controlling biofilm, their broader effects may disrupt the oral microbiota’s balance, potentially contributing to systemic health implications. The complex relationship between antiseptic use, microbial composition, and systemic outcomes remains insufficiently mapped. Objective: This scoping review aimed to explore and map the current evidence regarding the impact of antiseptic formulations on oral microbiota composition and to examine their potential associations with systemic diseases. Methods: A comprehensive literature search was performed using PubMed, Scopus, and Web of Science up to June 2025. Studies were included if they investigated antiseptic formulations commonly used in oral healthcare—such as chlorhexidine, essential oils, and cetylpyridinium chloride—and reported effects on oral microbiota and/or systemic health. Eligible study types included human clinical trials, observational studies, in vitro, and animal studies. Two reviewers independently screened and selected studies, with disagreements resolved by consensus. Data extraction focused on study design, antiseptic agents, microbial outcomes, and systemic implications. A total of 12 studies were included and charted. Results: The included studies demonstrated that oral antiseptics effectively reduce pathogenic microorganisms and improve clinical outcomes in oral diseases such as gingivitis and periodontitis. However, several studies also reported alterations in commensal microbial communities, suggesting a potential for dysbiosis. Some studies indicated possible links between antiseptic-induced microbial changes and systemic conditions, including cardiovascular and respiratory diseases. Conclusions: The evidence highlights a dual effect of antiseptic formulations: while beneficial in controlling oral pathogens, they may disrupt microbial homeostasis with possible systemic consequences. Further research is needed to evaluate long-term effects and develop targeted, microbiota-preserving oral hygiene strategies. Full article
(This article belongs to the Special Issue Antimicrobial Therapy in Oral Diseases)
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11 pages, 1221 KB  
Review
Systemic Impact of Subgingival Infection Control in Periodontitis Patients with Cardiovascular Disease: A Narrative Review
by Carmen Silvia Caloian, Andreea Ciurea, Marius Negucioiu, Alexandra Roman, Iulia Cristina Micu, Andrei Picoș and Andrada Soancă
Antibiotics 2024, 13(4), 359; https://doi.org/10.3390/antibiotics13040359 - 15 Apr 2024
Viewed by 3335
Abstract
Introduction: Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial [...] Read more.
Introduction: Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial burden and local inflammation, while also potentially bringing systemic benefits for patients with both periodontitis and CVD. This review examines systemic effects of subgingival instrumentation with or without antimicrobial products in individuals with periodontitis and CVD, and explores intricate pathogenetic interactions between periodontitis and CVD. Material and Methods: English-language databases (PubMed MEDLINE and Cochrane Library) were searched for studies assessing the effects of nonsurgical periodontal therapies in periodontitis patients with or without CVD. Results: While the ability of periodontal therapy to reduce mortality- and morbidity-related outcomes in CVD patients with periodontitis remains uncertain, some studies indicate a decrease in inflammatory markers and blood cell counts. Subgingival mechanical instrumentation delivered over multiple short sessions carries lower risks of adverse effects, particularly systemic inflammation, compared to the full-mouth delivery, making it a preferable option for CVD patients. Conclusions: Subgingival mechanical instrumentation, ideally conducted in a quadrant-based therapeutic approach, to decontaminate periodontal pockets has the potential to reduce both local and systemic inflammation with minimal adverse effects in patients suffering from periodontitis and concurrent CVD. Full article
(This article belongs to the Special Issue Antimicrobial Therapy in Oral Diseases)
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