Search Results (87)

The aim of this work is to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) against oral MDR (multi-drug-resistant) Candida spp. infections related to orthodontic treatment with palatal expanders through in vitro study. Methods: PDT protocol: Curcumin + H₂O₂ was used as a photosensitizer activated by a 460 nm diode LED lamp, with an 8 mm blunt tip for 2 min in each spot of interest. In vitro simulation: A palatal expander sterile device was inserted into a custom-designed orthodontic bioreactor, realized with 10 mL of Sabouraud dextrose broth plus 10% human saliva and infected with an MDR C. albicans clinical isolate CA95 strain to reproduce an oral palatal expander infection. After 48 h of incubation at 37 °C, the device was treated with the PDT protocol. Two samples before and 5 min after the PDT process were taken and used to contaminate a Petri dish with a Sabouraud field to evaluate Candida spp. CFUs (colony-forming units). Results: A nearly 99% reduction in C. albicans colonies in the palatal expander biofilm was found after PDT. Conclusion: The data showed the effectiveness of using aPDT to treat palatal infection; however, specific patient oral micro-environment reproduction (Ph values, salivary flow, mucosal adhesion of photosensitizer) must be further analyzed. Full article

Periodontal diseases in pediatric subjects represent a challenging and relatively underexplored area compared to the extensive data available about periodontal diseases in adults. The present narrative review aims to explore the periodontal status and the related subgingival and/or salivary microbial profiles in pediatric subjects (≤18 years), focusing also on the state of health or systemic diseases. In healthy periodontium, early colonizers, such as Streptococcus and Actinomyces spp., dominate the subgingival microbiota, supporting an eubiosis state. Low levels of Candida albicans and latent Herpesviridae may be detected. In gingivitis, the microbial profile shifts towards more pathogenic species, including Prevotella intermedia and Fusobacterium nucleatum. In necrotizing gingivitis, typically affecting systemically compromised children, the microbial profile is characterized by spirochetes, Fusobacterium, and Prevotella intermedia. Viral coinfections—especially with HSV, CMV, and EBV—are more frequently detected. In periodontitis, the microbiota was dominated by red complex pathogens along with Aggregatibacter actinomycetemcomitans in the aggressive forms, especially in systemically compromised children, as Herpesviridae reactivation and co-infections. Fungal involvement is less well characterized; Candida albicans may be present, particularly in cases of severe immune suppression. Nevertheless, the lack of pediatric longitudinal studies investigating periodontal disease progression after periodontal treatment and related changes in microbiological composition limited the understanding and exploration of the oral microbiota over time. Full article

Background: Oral candidiasis (OC) and vulvovaginal candidiasis (VVC) are infections caused by species belonging to the genus Candida. In Chile, epidemiological studies on OC/VVC are scarce, leading to an overestimation of the prevalence of C. albicans. Additionally, awareness of the prevalence of species phenotypically and genotypically similar to C. albicans is lacking. The clinical impact of non-albicans species in cases of OC/VVC is also often underestimated. This study aims to determine the distribution of Candida species, their phenotypic and molecular characteristics, and their antifungal susceptibility patterns in incidents of oral and vulvovaginal candidiasis in Chile. Methods: A descriptive analysis was conducted on 101 isolates of Candida spp. obtained from OC/VVC cases. The identification of Candida species was performed using both phenotypic and molecular techniques. Antifungal susceptibility testing was carried out using the Sensititre YeastOne system. Results: Among the analyzed isolates, 89.1% were identified as C. albicans, while 10.9% were categorized as non-albicans species, including C. dubliniensis, C. glabrata sensu stricto, C. bracarensis, C. tropicalis, C. lusitaniae, and C. parapsilosis sensu stricto. The susceptibility pattern was predominantly susceptible, with only 10.9% of the total strains demonstrating resistance, and low antifungal activity in vitro was observed for Fluconazole, Voriconazole, and Posaconazole. Conclusions: The most prevalent species causing OC/VVC in Chile is C. albicans. This study also presents the first report of C. lusitaniae as a causal agent of VVC in the country. The identification of azole-resistant strains emphasizes the critical role of laboratory diagnosis in VVC cases, thereby preventing potential treatment failures. No resistance was observed in the strains associated with OC. Full article

Background/Objectives: Children with an oral presence of Candida spp. have an elevated prevalence of dental caries. As an alternative to conventional antifungal drugs, the use of biofilm-modulating strategies, such as probiotic bacteria, may be a sustainable option. Probiotics are live microorganisms that have beneficial health effects, while prebiotics are compounds in food that foster the growth or activity of the beneficial microorganisms. The aim of this paper was to review current clinical findings regarding the antifungal effects of pre- and probiotic supplements, including syn- and postbiotics, in children. Methods: We searched two databases (PubMed and Google Scholar) for controlled clinical trials published in English up to 20 April 2025, and two authors scanned the abstracts independently for relevance. The selected full-text papers were reviewed and assessed for risk of bias. Results: Four articles published between 2013 and 2025 were included in this review, covering a total number of 208 caries-active children between 3 and 14 years of age. Study designs were heterogeneous, and we observed conflicting results: two studies with probiotic streptococci failed to demonstrate any beneficial effects on the counts of salivary C. albicans, while interventions with L. plantarum and L. rhamnosus significantly reduced C. albicans compared with controls. None of the included reports displayed a low risk of bias. No clinical studies utilizing prebiotics, synbiotics, or postbiotics were retrieved. Conclusions: We found insufficient evidence concerning the antifungal effects of probiotic supplements in children. Therefore, we recommend future clinical trials to explore the ability of pre-, pro-, and postbiotic interventions to affect cross-kingdom biofilms in order to support a balanced and health-associated composition of the dental biofilm in children. Full article

The global burden of fungal infections is rising at an alarming rate, with superficial, cutaneous, and mucosal mycoses among the most prevalent. Conventional treatments rely on oral and topical antifungal agents; however, these therapies are often limited by adverse effects, toxicity, frequent recurrence, and poor patient adherence due to prolonged treatment regimens. Moreover, the emergence of antifungal resistance and multidrug-resistant species such as Candidozyma auris and Trichophyton indotineae highlights the urgent need for alternative therapeutic strategies, such as antimicrobial photodynamic therapy (aPDT). aPDT is based on photophysical and photochemical processes involving a photosensitizer (PS), a light source, and molecular oxygen. When combined, these elements generate reactive oxygen species that selectively destroy microbial cells. In this review, we explore various PSs and their effectiveness in aPDT against infections caused by dermatophytes, Candida spp., and other pathogenic fungi. Promisingly, aPDT has demonstrated antifungal activity against both susceptible and resistant strains. In addition, aPDT has been successfully used in cases of mycoses unresponsive to conventional therapies, showing favorable clinical outcomes and overall safety. Current evidence supports aPDT as a valuable strategy for the management of cutaneous, mucosal, and superficial fungal infections and as a potential strategy to combat antifungal resistance. Full article

Oral candidiasis, commonly caused by Candida (C.) albicans and other non-albicans Candida species, increases resistance to conventional antifungal therapies. This study aimed to evaluate the in vitro efficacy of antimicrobial photodynamic therapy (aPDT) using a 450 nm diode laser in combination with curcumin and riboflavin against Candida spp. and Staphylococcus (S.) aureus. Reference strains of C. albicans, C. glabrata, C. krusei, and S. aureus were exposed to aPDT under varying incubation times and laser parameters, then viable microorganism cells (CFU) counts were assessed the microbial reduction, and statistical analyses were performed to evaluate significance. aPDT significantly reduced microbial viability in a time- and dose-dependent manner. Optimal incubation times were 20 min for Candida spp. and 10 min for S. aureus, with the highest efficacy observed at 400 mW and 120 s irradiation. The photosensitizer or laser alone had no significant antimicrobial effect. Curcumin/riboflavin-mediated aPDT is a promising alternative or adjunctive approach to conventional antimicrobial therapy, particularly for resistant oral infections. Full article

Previous studies have demonstrated that Candida spp. isolates exposed in vitro to the folic acid antagonist methotrexate may develop multidrug cross-resistance to azole antifungals. The aim of this study was to determine whether systemic therapy with antineoplastic antifolates—pemetrexed or methotrexate—constitutes a risk factor for colonization or infection with fluconazole-resistant yeasts. The study group comprised 44 cancer patients who received high-dose systemic antifolate therapy, while the control group consisted of 48 patients without prior exposure to either methotrexate or pemetrexed. Oral swabs and relevant clinical data were collected from all participants. In total, 109 fungal strains representing 13 species were isolated, identified, and subsequently tested for fluconazole susceptibility. Fluconazole-resistant isolates were identified in 4 out of 44 (9.1%) antifolate-treated patients and in 3 out of 48 (6.3%) control patients. Our findings suggest that, although this phenomenon occurs in vitro, systemic antineoplastic antifolate therapy does not induce azole resistance among endogenous yeast species in vivo. Full article

Background/Objectives: Patients with head and neck cancer frequently develop oral complications such as oral mucositis, infections, necrosis, and periodontal disease among others as a consequence of antineoplastic therapy. It is mainly radiotherapy that promotes oral dysbiosis, favouring the overgrowth of opportunistic microorganisms. Identifying effective adjunctive strategies to prevent or mitigate these adverse effects is crucial. Recent studies have suggested that probiotics could be used to restore microbial homeostasis and modulate inflammatory responses in the oral cavity. This systematic review and meta-analysis assessed the efficacy of probiotics in alleviating oral complications associated with antineoplastic treatments in this patient population. Methods: A comprehensive search was conducted in PubMed, LILACS, Scopus and the Cochrane Central Register of Controlled Trials, following the PRISMA 2020 guidelines. Only randomised controlled trials (RCTs) were included. Results: Nine eligible RCTs were analysed using a random-effects meta-analysis. Probiotic use was significantly associated with a reduced incidence of severe (grade 3–4) oral mucositis (RR = 0.58; 95% CI: 0.41–0.81). Moderate benefits were also observed in modulating the oral microbiota and reducing levels of pathogenic bacteria and Candida spp. However, no significant improvements were noted in periodontal parameters or plaque indices. Conclusions: Probiotics show promise in the management of oral mucositis, but further well-designed trials are needed to evaluate their broader impact on oral health during cancer therapy. This review is not registered on PROSPERO. Full article

Serious oral infections are frequently caused by Candida species, which have lately demonstrated resistance to antifungal medications. As a result, new therapeutic strategies, like photodynamic therapy (PDT), are desperately needed. Lactoferrin (LF), a salivary enzyme, is a natural protein that binds iron and has antifungal properties. Given its chemical structure and light absorption at 310–350 nm, LF appears to be a good photosensitizer in a PDT process for treating oral candidiasis. The purpose of this work was to assess the effectiveness of lactoferrin (LF) as a photosensitizer (PS) in photodynamic treatment (PDT) against oral multidrug-resistant (MDR) isolates of Candida spp. using an in vitro investigation. For this in vitro investigation, oral MDR isolates of Candida albicans, Candida kruseii, and Candida glabrata were employed. Using a Kirby–Bauer test (Eucast protocol), a solution of 20 mg of bovine lactoferrin dissolved in 1 mL of Sabouraud’s broth was tested in four different experimental combinations: (i) the solution as it is; (ii) the solution activated with 3% H₂O₂; (iii) the solution activated by light at 310–350 nm; and (iv) the solution activated with both 3% H₂O₂ and light at 310–350 nm. A control group and one with only H₂O₂ were also tested. After that, the Petri plates were incubated for 48 h at 37 °C. With inhibitory halos ranging from 30 to 40 mm for all Candida spp. MDR analyzed, group (iv) displayed the greatest results. H₂O₂ + lactoferrin-based solutions are thought to be potential PS in PDT for MDR Candida spp. eradication. Full article

Background/Objectives: Growing evidence suggests that oral microbiota dysbiosis may contribute to the development of systemic conditions, including neurodegenerative diseases. This dysregulation promotes immunoinflammatory responses that are increasingly associated with dementia. This systematic review aimed to evaluate the association between oral microbiota dysbiosis and the risk of dementia in older adults. Methods: Eligible studies evaluated oral microbial composition using validated methods such as genetic sequencing, bacterial culture, or metagenomic analysis. Following PRISMA guidelines and a PICO framework, the review included cohort, case–control, and cross-sectional studies. Searches were conducted across PubMed, Scopus, Web of Science, Embase, and Cochrane Library. Two independent reviewers screened and selected studies, resolving disagreements through a third evaluator. Results: This systematic review revealed that Tannerella forsythia, Fusobacterium nucleatum, Porphyromonas, Prevotella, Leptotrichia, Fusobacteriota, Peptostreptococcaceae, and Candida spp. were consistently associated with Alzheimer’s disease and mild cognitive impairment, indicating their potential role in neurodegeneration. In contrast, Streptococcus gordonii, Gemella haemolysans, Rothia, Neisseria, and Haemophilus were reduced in cognitively impaired individuals, suggesting a link with healthy cognition. Studies also showed decreased microbial diversity in Alzheimer’s disease and the possible modifying effect of the APOE4 allele. Oral health interventions improved microbial composition and slowed cognitive decline, supporting the diagnostic and therapeutic potential of oral microbiota modulation. Conclusions: The findings suggest that oral microbiota dysbiosis may not only result from cognitive decline but also contribute to its pathogenesis. Future studies with larger and more diverse cohorts are recommended to validate these associations. Full article

Background/Objectives: The main objective was to evaluate and compare the antifungal efficacy against Candida spp. in commercially available mouthwashes distributed in the European market. Indeed, the solution to emerging infectious diseases may no longer lie in costly new drug development but rather in unlocking the untapped potential of existing substances. Materials and Methods: Eighteen mouthwashes, chosen based on their composition, were tested in vitro against ten Candida strains, including clinical isolates of oral origin and reference strains, in both planktonic and biofilm forms. The antifungal susceptibility testing was conducted using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) disc diffusion method and the evaluation of the kinetic growth in planktonic Candida. Biofilm reduction was determined by the evaluation of the minimal biofilm eradication concentration (MBEC). Scanning electron microscopy (SEM) analysis was performed to evaluate potential morphological alterations of Candida biofilms. Results: Most mouthwashes effectively reduced biomass production and colony-forming unit (CFU) count. Parodontax Extra showed the highest efficacy. In the disc diffusion assay, Gum Paroex 0.12% exhibited the largest average inhibition zone diameter. Some unusual trends in the data may be explained by a higher reaction of fungal cells and the release of excess biomass during co-incubation in higher concentration of mouthwashes. SEM images revealed significant morphological alterations. Conclusion: Mouthwashes containing chlorhexidine digluconate, either alone or in combination with cetylpyridinium chloride and other active compounds, emerged as a common factor among the most efficacious formulations. In vivo studies will be essential to validate these findings, but mouthwashes may serve as a valuable adjuvant in the treatment of oral candidiasis. Full article

Histatin 5 (Hst5) is an antifungal peptide (AFP) naturally produced by parotid glands with strong activity against Candida albicans. One of its mechanisms of action is the generation of reactive oxygen species (ROS) inside the C. albicans cells. Despite being an important peptide for the human innate immune response, its activity is reduced or inactivated by proteolytic degradation caused by salivary enzymes. To overcome this barrier, we used solid phase peptide synthesis (SPPS) to modify the Hst5 amino acid sequence improving its antifungal action and minimizing its degradation. We synthesized five peptides, three of which were based on the Hst5 functional domain. We determined that the smallest peptides (8WH5, 7WH5 and 6WH5) demonstrated the greatest antifungal action against C. albicans, including one fluconazole-resistant strain. Besides that, cationic-PAGE and HPLC assays showed that the degradation in saliva was slower for the smaller peptides than for 0WHst5 and WP113. Furthermore, 8WH5, 7WH5 and 6WH5 were found in the samples even after 8 h in whole saliva, while 0WHst5 and WP113 completely disappear after 1.5 h. Finally, we found that the smaller peptides were less fragmented than the 0WHst5 and WP113, so they were the smallest fragments of Hst5 to preserve its antifungal action with reduced degradation in whole saliva. Thus, they can be considered promising molecules for the treatment of C. albicans in the oral cavity. Full article

The role of oral yeasts in oral squamous cell carcinoma (OSCC) has gained attention due to evidence linking fungal dysbiosis to carcinogenesis. While Candida albicans has been the primary focus, emerging studies highlight the importance of non-Candida species yeast genera. This scoping review synthesises the evidence on the role of oral yeasts, including Candida spp. and non-Candida species, in the development and progression of OSCC. A PRISMA-ScR-guided search was conducted in Medline, Embase, EBM Reviews, and CINAHL. Observational and experimental studies involving humans with OSCC, oral potentially malignant disorders (OPMDs), or oral epithelial dysplasia (OED) were included. This review analysed 75 studies. Research on oral yeast in OSCC has progressed since the 1970s, with advancements in identification techniques—from conventional culture methods to metagenomic sequencing and multi-omics approaches—alongside improved animal and cellular models of OSCC. These methodological advancements have identified notable distinctions in the oral mycobiome between carcinomatous and healthy states. Clinical findings reinforce the hypothesis that oral yeasts, particularly Candida spp., actively contribute to the dysplasia–carcinoma sequence. Emerging evidence suggests that oral yeasts may significantly modulate events contributing to OSCC progression. However, further mechanistic studies and robust clinical evidence are essential to establish causality and clarify their role in OSCC. Full article

Background/Objectives: Oral candidiasis is an opportunistic infection caused by Candida species. Recently, antifungal drugs have become less effective due to yeast resistance, emphasizing the need for new treatment strategies. This study aimed to assess the effect of the Er:YAG laser on the inhibition of growth and elimination of mature single-species Candida biofilms. Methods: The study utilized reference strains of C. albicans, C. glabrata, C. parapsilosis, and C. krusei organized in single-species biofilms on Sabouraud dextrose agar (SDA). First part: Candida suspensions (0.5 McFarland standard) were spread on SDA plates—two for each strain. Er:YAG laser irradiation was applied in a single pulse mode, 30 to 400 mJ, to 32 predetermined points. The growth inhibition zones (GIZs) were measured at 24–96 h of incubation. Second part: biofilms were prepared similarly and, after 96 h of incubation, exposed to Er:YAG laser irradiation at different energies (50, 100, 150, 200 mJ) for 180 s, per 1.44 cm area. Post-irradiation, impressions were taken using Rodac Agar to determine yeast counts. The count of colony-forming units (CFU) after irradiation was measured and results were analysed statistically. Results: First part: GIZ was found in all irradiated sites, with various Candida strains. The results showed a significant increase in the width of GIZ in the energy range of 30–280 mJ and a non-significant increase in the energy range of 300–400 mJ. Second part: the number of CFU remaining after the irradiation of biofilms with 150 mJ energy differed statistically significantly from other results obtained after using 50, 100, or 200 mJ energy, regardless of the Candida strain tested. Conclusions: The Er:YAG is shown to have good disinfecting properties (inhibiting biofilm growth, even at low-energy doses (50 mJ), and eliminating maturity, Candida spp. biofilms most effective on the 150 mJ energy dose). Full article

Oral candidiasis is one of the most common infections in the immunocompromised. Biofilms of Candida species can make treatments difficult, leading to oral infection recurrence. This research aimed to isolate a Lactobacillus with anti-Candida effects from the oral cavity. An oral Lactobacillus was isolated in caries-free individuals. The best isolate was evaluated against Candida spp. planktonic and biofilm forms. The bacterial impacts on Candida biofilms’ adhesion to acrylic discs were analyzed through an in vitro test. L. reuteri AJCR4 had the best anti-Candida activity in the preliminary screening. Results were promising in both planktonic and biofilms, particularly with C. albicans SC5314 and C. tropicalis ATCC750, where no viable cells were detected when using the cell-free supernatant (undiluted). In C. glabrata ATCC2001 and C. parapsilosis ATCC22019 biofilms, reductions of 3 Log₁₀ and more than 2 Log₁₀, respectively, were noted when using a cell suspension of L. reuteri ACJR4 (10⁸ CFU/mL). On polymethyl methacrylate acrylic discs, the cell-free supernatant reduced Candida adhesion, resulting in no viable cell detection on the surface. In conclusion, L. reuteri AJCR4 demonstrated notable antifungal activity against Candida biofilms. This oral isolate and its postbiotic can be a potential alternative strategy to oral candidiasis, especially to treat recalcitrant infections. Full article