Search Results (29)

Cutaneous adverse reactions (CARs) are common complications of epidermal growth factor receptor (EGFR) inhibitor therapy, with papulopustular eruptions and paronychia being the most frequent. Growing scientific evidence implies that Staphylococcus aureus is involved in the pathogenesis of these reactions. This observational prospective study characterized 42 S. aureus strains isolated from CARs, analyzing antibiotic resistance, biofilm formation, soluble virulence factors, and virulence/resistance genes using multiplex polymerase chain reaction (PCR). S. aureus was identified in 90% of lesions; in 33% of cases, nasal and skin isolates were genetically identical. High resistance rates were noted for penicillins (85%) and tetracyclines (57%), while all strains remained susceptible to fluoroquinolones, vancomycin, and rifampicin. All isolates formed biofilms, and DNase/esculinase production significantly correlated with CAR severity. An enzymatic score based on these markers was associated with an 18-fold increased risk of severe reactions. Genotypically, clfA and clfB were prevalent (85.7%), while exotoxin genes were less common. These findings support a key role for S. aureus in exacerbating CARs via antibiotic resistance, biofilm production, and the expression of virulence factor. Additionally, we emphasize the role of routine microbial screening—including nasal swabs—and therapy guided by antibiograms. Furthermore, the enzymatic score may further be validated as a predictive biomarker. Full article

Invasive fungal infections (IFIs), primarily caused by Candida species, represent a significant global public health concern due to their high mortality rates and growing antifungal resistance. In Honduras, data on their epidemiology remains scarce. This study aimed to characterize Candida species associated with candidemia and assess key virulence factors. A total of 80 clinical isolates were collected from four hospitals in Honduras’s major cities, Tegucigalpa and San Pedro Sula. Identification was performed using both phenotypic and molecular methods. Hemolytic activity, phospholipase and protease production, and biofilm formation were evaluated. C. albicans and C. tropicalis were the most prevalent species (30% each), followed by C. parapsilosis (27.5%). Phenotypic methods misidentified 13.8% of the isolates. Most strains (96.3%) exhibited strong hemolytic activity. C. albicans showed the highest phospholipase activity, while C. tropicalis was the most robust film producer. These findings highlight an evolving epidemiological landscape characterized by an increasing prevalence of non-albicans Candida species, often less susceptible to antifungal agents, and diverse virulence profiles such as strong biofilm formation. This underscores the clinical need for accurate species-level identification through molecular diagnostics and ongoing surveillance to guide targeted antifungal therapy and enable early, locally adapted interventions. Full article

Oral infections, caused by bacterial, fungal, and viral pathogens, are a significant source of dental morbidity and can lead to systemic complications, especially in immunocompromised individuals. Complex microbial interactions and host immune responses drive common conditions such as dental caries, periodontal disease, oral candidiasis, and herpetic lesions. Conventional antimicrobial therapies face limitations due to resistance and adverse effects, prompting interest in alternative treatments. Cannabidiol (CBD), a non-psychoactive compound derived from Cannabis sativa, has emerged as a promising candidate due to its antimicrobial, anti-inflammatory, and immunomodulatory properties. CBD targets various molecular pathways, including cannabinoid receptors, TRP channels, adenosine receptors, and PPARs, contributing to its multifaceted therapeutic effects. It has demonstrated efficacy against oral pathogens such as Streptococcus mutans, Enterococcus faecalis, and Candida albicans, disrupting biofilms and bacterial membranes. Additionally, CBD modulates inflammatory responses by reducing cytokine production and oxidative stress, particularly relevant in chronic conditions like periodontal disease. Emerging evidence also suggests synergistic effects with conventional antimicrobials and benefits in tissue regeneration. This review highlights the therapeutic potential of CBD in managing oral infections, offering a novel approach to overcoming current treatment limitations and guiding future research into safer and more effective oral health interventions. Full article

Background: Dental anxiety is a significant barrier to dental care, leading to avoidance behaviors and compromised oral health. This study aimed to analyze fear and anxiety during dental hygiene visits with Guided Biofilm Therapy (GBT), focusing on gender differences in psychological and physiological responses to develop a more personalized approach to dental care. Methods: A total of 247 patients participated in this study. Psychological assessments included the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI X2), while physiological responses were measured through heart rate monitoring before and after procedures. Multivariate regression analysis was conducted to identify predictors of anxiety levels. Results: Multivariate regression analysis identified gender, sensory sensitivity (e.g., absence of tools in the field of view), past traumatic dental experiences, and individual preferences for anxiety reduction as significant predictors of anxiety levels. Gender differences were also observed in anxiety management strategies, with women more frequently preferring the elimination of sensory triggers and direct communication with dental professionals. Conclusions: The findings highlight the importance of personalized anxiety management protocols in dentistry. Tailored communication strategies, optimized clinical environments, and individualized pre- and post-procedure care plans can enhance patient experience and treatment acceptance. Implementing such patient-centered, data-driven approaches aligns with the broader principles of precision medicine in dental care. Full article

The rapid rise of antibiotic resistance has become a global health crisis, necessitating the development of innovative strategies to combat multidrug-resistant (MDR) pathogens. Nanomaterials have emerged as promising tools in this fight, offering unique physicochemical properties that enhance antibiotic efficacy, overcome resistance mechanisms, and provide alternative therapeutic approaches. This review explores the diverse nanomaterial-based strategies used to combat antibiotic resistance, focusing on their mechanisms of action and practical applications. Nanomaterials such as metal nanoparticles, carbon-based nanomaterials, and polymeric nanostructures exhibit antibacterial properties through various pathways, including the generation of reactive oxygen species (ROS), disruption of bacterial membranes, and enhancement of antibiotic delivery. Additionally, the ability of nanomaterials to bypass traditional resistance mechanisms, such as biofilm formation and efflux pumps, has been demonstrated in numerous studies. This review also discusses the synergistic effects observed when nanomaterials are combined with conventional antibiotics, leading to increased bacterial susceptibility and reduced required dosages. By highlighting the recent advancements and clinical applications of nanomaterial–antibiotic combinations, this paper provides a comprehensive overview of how nanomaterials are reshaping the future of antibacterial therapies. Future research directions and challenges, including toxicity and scalability, are also addressed to guide the development of safer, more effective nanomaterial-based antibacterial treatments. Full article

Background: The aim of the present narrative review is to synthesize the available scientific evidence on the effects of submarginal instrumentation with periodontal endoscopy and evaluate its’ potential efficacy in terms of the non-surgical therapy of peri-implantitis. Methods: The literature search was performed via electronic databases, including PubMed, Web of Science, Cochrane, and Scopus, and was supplemented by manual searching. A literature review was conducted addressing the following PICOS questions: (1) What is the efficacy of non-surgical submarginal instrumentation of the implant surface with the aid of a periodontal endoscope in patients with peri-implantitis? (2) What is the efficacy of non-surgical subgingival instrumentation performed with the aid of a periodontal endoscope compared with conventional subgingival instrumentation in patients with periodontitis, in terms of clinical parameters and patient-reported outcomes? Mechanical decontamination of the implant surface is crucial for resolving inflammation and arresting further bone loss. However, there is no consensus on the most effective treatment. Non-surgical therapy remains the initial intervention, focused on biofilm removal to control the disease, although with limited capability to achieve complete disease resolution as the presence of threads and the complex-structured implant surface hinder effective biofilm removal. This evokes the need for providing supporting technologies such as periodontal endoscopy, which enables direct visualization and precision, potentially enhancing the outcomes and reducing the necessity for surgical procedures and their associated risks. Within the limitations of this narrative review, periodontal endoscopy may offer a less tissue-invasive approach. Larger prospective studies and RCTs are needed to confirm these findings and guide clinicians in determining periodontal endoscopy’s suitability based on specific case characteristics. Full article

Background: Oral candidiasis, predominantly caused by Candida albicans, presents significant challenges in treatment due to increasing antifungal resistance and biofilm formation. Antimicrobial photodynamic therapy (aPDT) using natural photosensitizers like riboflavin and hypericin offers a potential alternative to conventional antifungal therapies. Material and Methods: A systematic review was conducted to evaluate the efficacy of riboflavin- and hypericin-mediated aPDT in reducing Candida infections. The PRISMA framework guided the selection and analysis of 16 eligible studies published between 2014 and 2024. Data on light parameters, photosensitizer concentrations, and outcomes were extracted to assess antifungal effects. Results: Both riboflavin- and hypericin-mediated aPDT demonstrated significant antifungal activity, achieving substantial reductions in Candida biofilm and planktonic cell viability. Riboflavin activated by blue light and hypericin activated by yellow or orange light effectively targeted fluconazole-resistant Candida strains with minimal cytotoxicity to host tissues. However, complete biofilm eradication remained challenging, and variations in protocols highlighted the need for standardization. Conclusions: Riboflavin- and hypericin-mediated aPDT present promising, biocompatible alternatives for managing antifungal resistance in Candida infections. Further clinical trials and standardized protocols are essential to optimize outcomes and confirm efficacy in broader clinical settings. Full article

Background: Biofilm-associated infections frequently span multiple body sites and represent a significant clinical challenge, often requiring a multidisciplinary approach involving surgery and antimicrobial therapy. These infections are commonly healthcare-associated and frequently related to internal or external medical devices. The formation of biofilms complicates treatment, as they create environments that are difficult for most antimicrobial agents to penetrate. Fluoroquinolones play a critical role in the eradication of biofilm-related infections. Numerous studies have investigated the synergistic potential of combining fluoroquinolones with other chemical agents to augment their efficacy while minimizing potential toxicity. Comparative research suggests that the antibiofilm activity of fluoroquinolones is superior to that of beta-lactams and glycopeptides. However, their activity remains less effective than that of minocycline and fosfomycin. Noteworthy combinations include fluoroquinolones with fosfomycin and aminoglycosides for enhanced activity against Gram-negative organisms and fluoroquinolones with minocycline and rifampin for more effective treatment of Gram-positive infections. Despite the limitations of fluoroquinolones due to the intrinsic characteristics of this antibiotic, they remain fundamental in this setting thanks to their bioavailability and synergisms with other drugs. Methods: A comprehensive literature search was conducted using online databases (PubMed/MEDLINE/Google Scholar) and books written by experts in microbiology and infectious diseases to identify relevant studies on fluoroquinolones and biofilm. Results: This review critically assesses the role of fluoroquinolones in managing biofilm-associated infections in various clinical settings while also exploring the potential benefits of combination therapy with these antibiotics. Conclusions: The literature predominantly consists of in vitro studies, with limited in vivo investigations. Although real world data are scarce, they are in accordance with fluoroquinolones’ effectiveness in managing early biofilm-associated infections. Also, future perspectives of newer treatment options to be placed alongside fluoroquinolones are discussed. This review underscores the role of fluoroquinolones in the setting of biofilm-associated infections, providing a comprehensive guide for physicians regarding the best use of this class of antibiotics while highlighting the existing critical issues. Full article

Periodontal regeneration is a multifaceted therapeutic approach to restore the tooth-supporting structures lost due to periodontal diseases. This manuscript explores the intricate interactions between regenerative therapies and the oral microbiome, emphasizing the critical role of microbial balance in achieving long-term success. While guided tissue regeneration (GTR), bone grafting, and soft tissue grafting offer promising outcomes in terms of tissue regeneration, these procedures can inadvertently alter the oral microbial ecosystem, potentially leading to dysbiosis or pathogenic recolonization. Different grafting materials, including autografts, allografts, xenografts, and alloplasts, influence microbial shifts, with variations in the healing timeline and microbial stabilization. Biologics and antimicrobials, such as enamel matrix derivatives (EMD) and sub-antimicrobial dose doxycycline (SDD), play a key role in promoting microbial homeostasis by supporting tissue repair and reducing pathogenic bacteria. Emerging strategies, such as enzyme-based therapies and antifouling materials, aim to disrupt biofilm formation and enhance the effectiveness of periodontal treatments. Understanding these microbial dynamics is essential for optimizing regenerative therapies and improving patient outcomes. The future of periodontal therapy lies in the development of advanced materials and strategies that not only restore lost tissues but also stabilize the oral microbiome, ultimately leading to long-term periodontal health. Full article

Background/Objectives: Less often employed as a rinsing solution for controlling oral biofilms, NaOCL was used in oral rinses at various concentrations in steps 1 and 4 of periodontal therapy. The aim of this study was to quantitatively evaluate the biofilm-disruptive properties of a 0.2% NaOCl solution in standardized oral rinses using dedicated plaque-disclosing agents and 3D scanning methods in patients undergoing the regular Guided Biofilm Therapy^® protocol. Methods: Eight patients with at least 20 teeth present evenly distributed between the two arches were included. After 24 h of refraining from oral hygiene, dental arches were stained with a disclosing agent, the subjects rinsed for 20 s, clinical photographs and 3D scans were performed, subjects rinsed again for 20 s, photographs and 3D scans were performed again, and then the GBT^® protocol was resumed as usual. Data representing areas covered with dental plaque were acquired using the “Medit Scan for Clinics” software and then underwent a post-processing and rendering process. The outcome variable was the percent reduction in the plaque-covered areas. Results: For the upper jaw, the estimated mean percent reduction in the biofilm-covered area was 39.65%, while for the mandible, it was 38.26%. The analysis of individual photographs revealed changes in the plaque-covered areas and reductions in the color intensity of the residual plaque-covered areas under identical lighting conditions. Conclusions: When analyzed using 3D intraoral scanning, the 0.2% NaOCl rinsing solution seems to be a clinically efficient disruptor/dissolvent of the oral biofilm, both when integrated into modern protocols of periodontal therapy like GBT^® and for home self-care. Full article

Helicobacter pylori (H. pylori) is a bacterium known to be associated with a significant risk of gastric cancer in addition to chronic gastritis, peptic ulcer, and MALT lymphoma. Although only a small percentage of patients infected with H. pylori develop gastric cancer, Gastric cancer causes more than 750,000 deaths worldwide, with 90% of cases being caused by H. pylori. The eradication of this bacterium rests on multiple drug regimens as guided by various consensus. However, the efficacy of empirical therapy is decreasing due to antimicrobial resistance. In addition, biofilm formation complicates eradication. As the search for new antibiotics lags behind the bacterium’s ability to mutate, studies have been directed toward finding new anti-H. pylori agents while also optimizing current drug functions. Targeting biofilm, repurposing outer membrane vesicles that were initially a virulence factor of the bacteria, phage therapy, probiotics, and the construction of nanoparticles might be able to complement or even be alternatives for H. pylori treatment. This review aims to present reports on various compounds, either new or combined with current antibiotics, and their pathways to counteract H. pylori resistance. Full article

Background: Desquamative gingivitis is a clinical manifestation often associated with various mucocutaneous disorders, characterized by red, painful, and friable gingiva. It is predominantly seen in middle-aged to elderly females and is typically linked to autoimmune conditions such as lichen planus, pemphigoid, and pemphigus, among others. Due to the chronic pain and difficulty in maintaining personal oral hygiene, professional care becomes crucial. Methods: This article explores the application of guided biofilm therapy as a novel, gentle approach for managing desquamative gingivitis, focusing on three clinical cases. This therapy employs erythritol-based powders for biofilm removal, offering a less abrasive and more comfortable alternative to traditional mechanical plaque removal techniques. Results: The cases demonstrate the effectiveness of guided biofilm therapy in reducing discomfort and improving clinical outcomes in desquamative gingivitis patients, particularly those suffering from mucous membrane pemphigoid, pemphigus vulgaris, and oral lichen planus. Conclusions: The guided biofilm approach underscores the importance of tailored periodontal therapy in managing nonplaque-induced gingival lesions, improving patient compliance and oral health outcomes. Full article

Fear and anxiety during dental visits are common issues that can lead to avoidance of appointments and deterioration of oral health. Effectively managing patients’ emotions during dental treatments is crucial to improving their experiences, increasing adherence to regular visits, and achieving better treatment outcomes. This study aimed to assess the levels of fear and anxiety in patients undergoing hygiene treatments utilizing Guided Biofilm Therapy (GBT) and identify factors that could reduce these negative emotions. A total of 247 patients were evaluated using standardized questionnaires (MDAS, STAI X1, STAI X2, and Gatchel), custom questions, and heart rate monitoring as a physiological stress indicator. Clinical factors, including dental status confirmed by AI-based radiographic analysis (Diagnocat system), as well as sociodemographic influences, were analyzed. Results indicated significant reductions in fear and anxiety after the procedure, as shown by both heart rate and questionnaire scores. Factors such as pain, the presence of caries, and implants were linked to higher anxiety, while strategies like avoiding visible needles and postprocedure interaction with staff were associated with lower stress levels. The findings underscore the importance of personalized care and emotional support to enhance patient experiences. Full article

The growing threat of antimicrobial-resistant (AMR) pathogens to human health worldwide emphasizes the need for more effective infection control strategies. Bacterial and fungal biofilms pose a major challenge in treating AMR pathogen infections. Biofilms are formed by pathogenic microbes encased in extracellular polymeric substances to confer protection from antimicrobials and the host immune system. Biofilms also promote the growth of antibiotic-resistant mutants and latent persister cells and thus complicate therapeutic approaches. Biofilms are ubiquitous and cause serious health risks due to their ability to colonize various surfaces, including human tissues, medical devices, and food-processing equipment. Detection and characterization of biofilms are crucial for prompt intervention and infection control. To this end, traditional approaches are often effective, yet they fail to identify the microbial species inside biofilms. Recent advances in artificial intelligence (AI) have provided new avenues to improve biofilm identification. Machine-learning algorithms and image-processing techniques have shown promise for the accurate and efficient detection of biofilm-forming microorganisms on biotic and abiotic surfaces. These advancements have the potential to transform biofilm research and clinical practice by allowing faster diagnosis and more tailored therapy. This comprehensive review focuses on the application of AI techniques for the identification of biofilm-forming pathogens in various industries, including healthcare, food safety, and agriculture. The review discusses the existing approaches, challenges, and potential applications of AI in biofilm research, with a particular focus on the role of AI in improving diagnostic capacities and guiding preventative actions. The synthesis of the current knowledge and future directions, as described in this review, will guide future research and development efforts in combating biofilm-associated infections. Full article

Background: Oral hygiene is crucial for the success of orthodontic therapy involving temporary anchoring devices like miniscrews. Plaque buildup, exacerbated by orthodontic appliances, causes inflammation that can undermine treatment outcomes. Individualized prevention plans based on patient risk factors are essential. This review emphasizes the importance of oral hygiene in orthodontic therapy with miniscrews, identifies optimal devices for ensuring long-term stability, and explores protocols for high-risk patients. Materials And Methods: A comprehensive search was conducted on two primary databases, PubMed and Google Scholar, for relevant articles on oral hygiene and inflammation. Fourteen articles meeting the inclusion criteria were selected, covering topics such as “orthodontic miniscrew”, “miniscrew and laser”, “miniscrew and mouthwash”, “electric toothbrush”, and “GBT”. Results: Inflammation can compromise miniscrew stability by damaging surrounding bone. Miniscrews of 10 mm length have lower failure rates due to better bone contact and stability. Chlorhexidine reduces inflammation risk and inhibits epithelialization around the implant head. Laser therapy enhances miniscrew stability and reduces inflammation. Chitosan effectively suppresses inflammatory mediators and prevents microorganism adhesion. Both sonic and roto-oscillating electric toothbrushes remove plaque effectively, with roto-oscillating brushes showing superior results. The Guided Biofilm Therapy (GBT) protocol offers professional hygiene benefits similar to traditional methods, with improved patient engagement and motivation. Conclusions: Home oral hygiene maintenance is paramount for preventing inflammatory complications. Professional interventions such as diode laser usage, particularly in adult patients with a history of periodontitis or underlying systemic conditions, can mitigate orthodontic therapy failure risks. The GBT protocol fosters a more comfortable and participatory professional hygiene experience for patients, promoting better oral health awareness and compliance. Full article