Search Results (215)

Periodontitis is one of the most common inflammatory diseases and it is linked to the presence of a dysbiotic subgingival microbiome. The purpose of this review is to evaluate the impact of antimicrobial photodynamic therapy (aPDT) on the subgingival microbiome. Herein, based on an extensive evaluation of randomized controlled trials (RCTs), the effects of aPDT as a supplement to non-surgical periodontal therapy (NSPT) were found to be the main focus of these works. Studies that focused on analyzing microbiological results were selected, yielding contradictory results. The observed microbiological changes were variable, even though some studies showed notable improvements in clinical indicators such as bleeding on probing (BOP), clinical attachment level (CAL), and probing depth (PD). Several studies found that aPDT did not significantly reduce important periodontal pathogens such Tannerella forsythia, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans. Nevertheless, after multiple aPDT sessions, other studies reported positive changes in the subgingival microbiome, with a rise in beneficial bacteria and a decrease in periodontopathogens. While aPDT seems to be a safe and well-tolerated adjuvant to non-surgical periodontal therapy, there is still conflicting evidence regarding how well it modulates the subgingival microbiota. Additional long-term research with larger sample sizes is required to evaluate the microbiological and clinical advantages of aPDT. Full article

The involvement of oral bacteria in the pathogenesis of distant organs, such as the heart, lungs, brain, liver, and intestine, has been shown. We analyzed the distribution of bacterial species in the resected aortic valve by 16S rRNA metagenomic analysis and directly compared their gene sequences with those in the oral cavity. Thirty-two patients with aortic stenosis or aortic regurgitation who underwent aortic valve replacement were enrolled in this study. Antibody titer against periodontal pathogenic bacteria in the patient’s serum was analyzed. The genetic background and distribution of bacterial species on subgingival plaque, the dorsal surface of the tongue, and the resected aortic valve were analyzed. Patients with aortic valve disease were shown to have more severe periodontal disease by the detection of antibodies against Socransky’s red-complex bacteria of periodontitis. Bacterial DNA was detected in the aortic valves of 12 out of 32 patients. The genomic sequences of the V3-V4 region of the 16S rRNA in some bacteria isolated from the aortic valves of six patients who underwent metagenomic analysis were identical to those found in the oral cavity. The findings indicate that bacteria detected in the aortic valve may be introduced through oral dysbiosis, a condition characterized by an imbalance in the oral microbiota that increases the risk of periodontal disease and dental caries. Oral dysbiosis and the resulting potential bacteremia are associated with the pathogenesis of aortic valve diseases. Full article

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant to antiseptic therapy, often resulting in tooth or implant loss. The question therefore arises as to which mouthwashes have eradication potential against oral biofilm. Methods: A human oral biofilm model was developed based on donated blood plasma combined with buffy coats, inoculated with oral pathogenic bacterial species found in periodontal disease (Actinomyces naeslundii, Fusobacterium nucleatum, Streptococcus mitis, and Porphyromonas gingivalis). Over a span of 7 days, we tested different mouth rinsing and antiseptic solutions (Chlorhexidine, Listerine^®, NaOCl, Octenisept^®, and Octenident^®) covering the matured biofilm with 24 h renewal. Phosphate-buffered saline (PBS) was used as a control. Bacterial growth patterns were detected via quantitative polymerase chain reaction (qPCR) after 2, 4, and 7 days of treatment. Results: While all groups showed initial bacterial reduction, the control group demonstrated strong regrowth from day 2 to 4. Listerine showed a near-significant trend toward bacterial suppression. Additionally, strain-specific efficacy was observed, with Octenisept^® being most effective against Streptococcus mitis, Octenident^® and NaOCl showing superior suppression of Actinomyces naeslundii, and Listerine^® outperforming other solutions in reducing Fusobacterium nucleatum. Donor-specific, individual variability further influenced treatment outcomes, with distinct trends in bacterial suppression and regrowth observed across donors. Conclusions: These findings underscore the complexity of biofilm-associated infections and highlight the importance of targeted therapeutic approaches for managing bacterial biofilms. In this experiment, the donor-specific outcomes of the antimicrobial effects of the solutions may indicate that genetic predisposition/tolerance to oral infections appears to play a critical role in the control of oral biofilms. Full article

Background: The oral microbiome differs in obese patients compared to normal-weight subjects. Microbiologic shifts very often appear after surgical interventions such as bariatric surgery (BS) and in immunocompromised patients. However, the oral microbiome composition and load in subjects after bariatric surgery are unclear. Aim: The aim of this review is to summarize the current state of the art related to the oral microbiome shift induced by bariatric surgery and to discuss its implications on oral cavity health. Methods: Electronic databases: PubMed/Medline, Web of Science, and Cochrane Library were searched for articles published up to March 30, 2025, describing prospective studies focused on changes in the oral microbiota of patients who underwent bariatric surgery. Results: Eight studies measuring the oral microbiome with different approaches—16S ribosomal RNA (16S rRNA) sequencing, polymerase chain reaction (PCR), culture, and matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI TOF MS)—were included in this review. The following bariatric techniques were used: sleeve gastrectomy, Roux-en-Y gastric bypass, Omega loop gastric bypass, and laparoscopic gastric plication. The follow-up period ranged from 3 to 12 months. The results of microbiologic studies were unequivocal. There was an increment in Streptococcus mutans reported, high levels of Candida species, and increased rates of some periodontitis-associated bacteria (Porphyromonas gingivalis) in the post-bariatric surgery period, though some studies suggested a shift towards non-pathogenic composition of the oral microbiome in prospective observations. Conclusions: The local oral microbial homeostasis becomes strongly impacted by the bariatric surgical treatment itself as well as its consequences in the further post-operative period. Therefore, obese patients undergoing BS require very careful dental observation. Full article

Background: Research suggests that periodontal disease may exacerbate symptoms of coronavirus disease (COVID-19). The etiology of this condition has been associated with cytokines such as IL-6. The inflammatory response in COVID-19 can be partially attributed to periodontopathic bacteria and their metabolites. Furthermore, the aspiration of periodontal pathogens and the stimulation of ACE2 expression may lead to an increased production of inflammatory cytokines, potentially worsening COVID-19 symptoms in patients with periodontitis. Materials and Methods: A cross-sectional study was conducted involving patients with both periodontal disease and COVID-19, patients with either condition alone, and healthy subjects. All participants underwent RT-PCR testing for SARS-CoV-2, and a self-reported periodontal disease (Self-RPD) questionnaire was administered. Saliva samples were collected to assess IL-6 levels using the ELISA technique. Results: A total of 28 patients were classified as COVID-19/Self-RPD+, 32 patients had only COVID-19, 25 were Self-RPD+ only, and 17 were healthy controls. The COVID-19/Self-RPD+ group frequently exhibited symptoms such as fever, body aches, nasal congestion, and olfactory disturbances and showed significantly higher IL-6 levels compared to the other groups. Cough with phlegm was significantly more frequent in the COVID-19-only group. Additionally, IL-6 levels in saliva were elevated in patients with nasal congestion and in those with 11 or more symptoms in the Self-RPD+ group. Full article

Dental implant papilla (DIP) is susceptible to bacterial adhesion and biofilm formation, and oral pathogenic biofilms can cause persistent oral infections. Enrichment of bacterial biofilms on implants can lead to soft tissue irritation and adjacent bone resorption, severely compromising dental health and potentially leading to periodontitis, implant loss and costly follow-up care. Nanozymes (NZs) are recently used in biofilm removal as they can induce the production of reactive oxygen species (ROS), which can kill bacteria. However, the short lifespan of ROS limits their diffusion distance, and affects their therapeutic efficacy. In this study, we prepared Fe₃O₄ nanoparticles (NZs) with different morphologies: flower-like (F-Fe₃O₄), hollow spherical (M-Fe₃O₄), octahedral (O-Fe₃O₄), and conventional nanoparticles (N-Fe₃O₄). The ferromagnetic properties of Fe₃O₄ NZs allow them to move and penetrate the biofilm under the action of a magnetic field. The saturation magnetic intensities of the four samples were as follows: F-Fe₃O₄ (23.1 emu g⁻¹), M-Fe₃O₄ (73.34 emu g⁻¹), O-Fe₃O₄ (96.06 emu g⁻¹), and N-Fe₃O₄ (52.15 emu g⁻¹). The synergistic combination of photothermal action and catalytic sterilization can effectively remove the biofilm. In addition, the prepared Fe₃O₄ nanozymes were able to maintain high biological activity on the implant surface with some osteogenic effect. 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

Gram-negative enteric rods (GNERs) are transient members of the oral microbiota and are considered a superinfection in patients with periodontitis that poses local and systemic risks due to associations with infections and multidrug resistance, including extended-spectrum beta-lactamases. These pathogens often resist antibiotics such as amoxicillin, doxycycline, and ciprofloxacin, complicating dental treatments. Though their resistance patterns vary, links between specific resistance genes and phenotypic resistance remain unclear. Objectives: To determine the correlation between resistance genes (blaTEM, blaSHV, tetQ, tetM, qnrB, qnrS, and mph(A)) and phenotypic resistance in GNERs isolated from oral cavity samples. Methods: A total of 90 oral isolates of GNERs were isolated from patients in a dental clinic, and bacteria were identified by the BD BBL Crystal biochemical panel. The antibiotic susceptibility testing was conducted through broth microdilution following CLSI standards for drives such as amoxicillin, amoxicillin/clavulanic acid, doxycycline, ciprofloxacin, and azithromycin. Resistance genes, including blaTEM, blaSHV, tetQ, tetM, qnrS, qnrB, and mph(A), were detected using polymerase chain reaction and gel electrophoresis. The proportions of species, resistance genes, and minimum inhibitory concentration values were statistically analyzed. Conclusions: As expected, most enteric bacteria showed natural resistance to beta-lactams. Significant resistance to azithromycin was observed in some species. Genotypic and phenotypic profiles suggest the existence of alternative resistance mechanisms; therefore, other mechanisms associated with antibiotic resistance should be investigated. Full article

Background and Objectives: The most common method for treating malocclusions today is fixed orthodontic therapy, during which brackets and tubes are bonded to the surface of the teeth, which makes oral hygiene difficult to maintain. Increased plaque retention, gingival bleeding, and gingivitis can be diagnosed in the early phases of treatment. The periodontal response to plaque accumulation can be explained by quantitative and qualitative changes in the subgingival microbiota. The aim of our research was to investigate the changes in the subgingival microbiota that occurred within 6–8 weeks after bonding when two different orthodontic adhesives were used. Materials and Methods: Thirty patients were followed; molar tubes were bonded with a composite (C) in fifteen cases, and in the other fifteen cases, they were bonded with glass ionomer cementum (GIC). A microbiological sample was taken from the gingival sulcus of the maxillary first molars at the time of appliance placement (T1) and 6–8 weeks (T2) after bonding. Bacterial DNA detection was performed using the micro-IDent^®plus11 (Hain Lifescience GmbH, Germany) PCR (polymerase chain reaction) method. The statistical analysis included McNemar’s test to analyze the paired binary data and Fisher’s Exact Test to compare the prevalence of each of the 11 bacteria at T1 and, ultimately, T2 between the two studied groups. The Bonferroni correction was also applied. Results: When analyzing GIC vs. C at T1 and T2, none of the studied pathogens showed significant differences. Conclusions: Given the lack of statistical significance, these trends do not confirm a definitive impact of the procedure on bacterial presence. The increased presence of periodontal pathogens might suggest that bonding does not reduce the bacterial loading of subgingival microbiota. Less protective effects of the GIC intervention against Tannerella forsythia and Eubacterium nodatum bacteria were detected. Full article

Until recently, bacterial species were the primary etiological factor of periodontal disease, but recent studies have shown that their effective removal from tooth surfaces does not necessarily prevent the progression of the disease. A logical hypothesis leads to the conclusion that various etiological factors contribute to the etiopathogenesis of this disease. Recent evidence also indicates protozoa as potential pathogens. In this review, the role of Entamoeba gingivalis, Acanthamoeba spp., and Trichomonas tenax in periodontal disease was analyzed, and the various aspects of the role of protozoa in the etiopathogenesis of periodontal disease, the bacterial–protozoa model of the disease, and the therapeutic implications were categorized. The multifactorial nature of periodontal disorders requires further research to better identify individuals at risk and prescribe earlier and more definitive treatments. The evidence supporting the role of protozoa in periodontal disease is compelling. These organisms are essential contributors to this complex disease. The key to developing more effective prevention and treatment strategies lies in understanding the intricate interactions between protozoa, bacteria, and the host. A better understanding of the protozoa aspect of periodontal disease progression could significantly change the future perspective of diagnosing, preventing, and treating periodontal disease. Full article

The human oral microbiome plays a vital role in maintaining oral and systemic health. This diverse microbial community includes over 700 bacterial species, some of which are implicated in developing systemic diseases, particularly cardiovascular diseases (CVDs). Research highlights a strong association between periodontal disease and increased cardiovascular risk, suggesting that good oral hygiene practices may reduce the incidence of CVDs. Porphyromonas gingivalis and Fusobacterium nucleatum drive chronic inflammation in periodontal disease; these bacteria can extend beyond the mouth and contribute to systemic inflammatory responses. The inflammatory factors, including C-reactive protein (CRP), interleukins (IL-1, IL-6), and tumor necrosis factor-alpha (TNF-α), damage blood vessels, impair endothelial functions, and promote atherosclerosis, all key events in CVD progression. Additionally, oral pathogens may accelerate plaque formation in arteries, increasing the risk of ischemic heart and brain diseases. Studies show a 28% increased risk of heart disease in individuals with periodontal disease. Treating periodontal disease can improve endothelial function and reduce inflammatory markers, emphasizing oral health management as a potential preventive strategy for CVD. Public health initiatives that emphasize oral hygiene and early periodontal disease treatment are crucial for broader cardiovascular care. Full article

Background: Gingivitis and periodontitis are microbially associated diseases, with some features characteristic of pediatric age and others linked to systemic diseases. While the role of periodontal pathogenic bacteria is well recognized, the contribution of fungi and viruses, particularly Herpesviridae, remains controversial. Studies in adults have highlighted the presence of Herpesviridae, but evidence in pediatric subjects, especially systemically compromised, is limited. This systematic review aimed to assess periodontal status (e.g., health, gingivitis, periodontitis, necrotizing gingivitis, and/or periodontitis) and the subgingival and/or salivary microbial (bacterial, viral, and fungal) profile in systemically compromised pediatric (≤18 years) subjects with gingivitis and/or periodontitis compared to clinical periodontal health. Methods: The review protocol was registered on PROSPERO (CRD42024597695) and followed the PRISMA statement. Data from eight studies were descriptively analyzed and qualitatively assessed through ROBINS-I and JBI tools. Results: CMV was frequently detected, particularly in necrotizing gingivitis (19.40%). EBV was found in necrotizing gingivitis (20.69%) and periodontitis (10.34%); HSV was mainly associated with gingivitis and necrotizing gingivitis. Bacteria species in periodontitis included Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium, and Campylobacter species. Candida albicans was detected in periodontitis, suggesting a fungal involvement in the disease’s pathogenesis. Although the bacterial and fungal profile was not investigated, limited viral presence was noted in subjects with healthy periodontium, indicating a stable microbiome. Conclusions: These findings underscore the dynamics of microbial interactions in the progression of periodontal disease in systemically compromised pediatric subjects. Full article

Background/Objectives: Periodontal disease (PD) is a chronic inflammatory condition caused by dysbiosis of the oral microbiome. PD is linked to systemic inflammation and endothelial dysfunction, which associate it with cardiovascular disease (CVD). This systematic review explores the molecular and microbial mechanisms through which periodontal pathogens, including “Red Complex” bacteria (Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) and Fusobacterium nucleatum, influence cardiovascular health via inflammatory pathways, immune modulation, and microbial dissemination. Methods: A systematic review was conducted following PRISMA guidelines. A literature search was conducted in the PubMed and ScienceDirect databases using relevant keywords, with strict inclusion and exclusion criteria, from the first week of September 2024 to the first week of October 2024. Studies addressing the relationship between PD and CVD were assessed for methodological rigor, relevance, and data availability. The outcomes were synthesized using a descriptive narrative approach. Out of 591 records screened, 421 full-text articles were sought for retrieval. The final review included 58 articles providing supplementary aggregated data after eligibility assessment. Results: The pathogenesis of PD involves the activation of immune cells and the release of pro-inflammatory cytokines (such as IL-1, IL-6, TNF-α, and PGE2) and chemokines (including IL-8 and MCP-1) along with oxidative stress driven by reactive oxygen species (ROS). Periodontal pathogens trigger endothelial oxidative stress and systemic inflammation via Toll-like receptors (TLRs), NF-κB signaling, and nitric oxide (NO) dysregulation, contributing to endothelial dysfunction and atherogenesis. Biomarkers, such as C-reactive protein, interleukins, and matrix metalloproteinases (MMPs), further highlight the systemic inflammatory response. Conclusions: This review underscores the significant role of periodontal pathogens and inflammatory mediators in systemic health, particularly in the progression of CVD. Although existing evidence illustrates these associations, the underlying molecular mechanisms remain inadequately understood, indicating a need for further research to advance precision medicine and therapeutic strategies. Full article

Objective: This study aimed to identify periodontal pathogens involved in the onset and progression of OSCC. Methods: Saliva samples were collected from 112 patients without oral mucosal diseases (OMDs) as controls; 36 patients with oral potentially malignant disorders (OPMDs); and 104 patients with OSCC. Periodontal examinations were performed on all patients. Endpoint PCR was performed for seven species of oral pathogens. The 16S rRNA analysis was performed using 20 DNA samples from each group. Results: Periodontitis tended to worsen in the OMDs group compared to the control group. The number of oral bacteria was significantly higher in the OSCC group than in the other groups. The detection rates of P. gingivalis and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) were significantly higher in the OSCC group than those in the control group. From 16S rRNA analysis, the relative abundance of Prevotella buccae and intermedia was significantly higher in OSCC than in the control. Moreover, LPS derived from P. gingivalis contributes to the early development of oral epithelial precancerous lesions and carcinomas in mice. Conclusions: Specific periodontal pathogens are present in the oral cavities of patients with OPMDs and OSCC, and changes in the bacterial flora due to their presence may contribute to the onset and progression of OMDs. Full article

Oral bacterial pathogens, including Bacillus species, form biofilms that enhance antibiotic resistance, promote bacterial adherence, and maintain structural integrity. The ability of bacteria to form biofilms is directly linked to several oral diseases, including gingivitis, dental caries, periodontitis, periapical periodontitis, and peri-implantitis. These biofilms act as a predisposing factor for such infections. Nanoparticles, known for their strong antibacterial properties, can target specific biofilm-forming microorganisms without disturbing the normal microflora of the oral cavity. This study focuses on the biofilm-forming ability and clindamycin (CM) resistance of Bacillus species found in the oral cavity. It aims to evaluate the antibacterial and antibiofilm properties of zinc oxide nanoparticles (ZnO-NPs) against oral Bacillus species and assess the effectiveness of combining CM with ZnO-NPs in reducing antibiotic resistance. The antibacterial susceptibility of Bacillus isolates was tested using ZnO-NPs and CM, demonstrating synergistic effects that reduced the minimum inhibitory concentrations by up to 8-fold. The fractional inhibitory concentration (FIC) index indicated a significant synergistic effect in most strains, with FIC values ranging from 0.375 to 0.5. It was found that the majority of Bacillus strains exhibited significant biofilm-forming capabilities, which were reduced when treated with the ZnO-NPs and CM combination. The study also evaluated the cytotoxicity of ZnO-NPs on cancer cells (CAL27) and normal fibroblasts (HFB4). CAL27 cells showed stronger cytotoxicity, with an IC₅₀ of 52.15 µg/mL, compared to HFB4 cells, which had an IC₅₀ of 36.3 µg/mL. Genetic analysis revealed the presence of biofilm-associated genes such as sipW and tasA, along with antibiotic resistance genes (ermC), which correlated with the observed biofilm phenotypes. Overall, this study demonstrates the potential of combining ZnO-NPs with CM to overcome antibiotic resistance and biofilm formation in the oral bacterial pathogens, Bacillus species. These findings suggest new approaches for developing more effective dental treatments targeting oral biofilm-associated infections and antibiotic resistance. Full article