Search Results (78)

Low-level laser therapy (LLLT) is gaining attention as an effective adjunct to non-surgical periodontal treatment. This study evaluates the potential of LLLT to reduce bacterial load in a clinically relevant in vitro subgingival biofilm model and its impact on the inflammatory response. A subgingival biofilm model consisting of seven bacterial species was established. Primary human gingival fibroblasts (GFs) and periodontal ligament cells (PDLs) were cultured. Both biofilms and host cells were treated with the DenLase Diode Laser (980 nm) under various clinically relevant settings. The composition and structure of the seven-species biofilms were evaluated using quantitative PCR and fluorescence microscopy, respectively. The inflammatory response in host cells was analyzed by measuring the gene and protein expression levels of various inflammatory mediators. Laser treatment at power outputs ranging from 0.3 to 2 W had no significant effect on biofilm composition or architecture. LLLT, particularly at higher power settings, reduced the viability in both GFs and PDLs up to 70%. Gene expression levels of inflammatory mediators were only minimally influenced by laser treatment. However, LLLT significantly decreased the secretion of all examined cytokines. These findings suggest that LLLT with a 980 nm diode laser, under clinically relevant conditions, exerts anti-inflammatory rather than antimicrobial effects. Full article

Objective: The present review aims to compare the oral microbial profile (OMP) of patients undergoing fixed orthodontic therapy (OT) versus clear aligner therapy (CAT) for the treatment of malocclusions. Methods: Clinical studies were included. Case-reports/-series, letters to the editor, reviews, perspectives, and expert opinions were excluded. Indexed databases (MEDLINE/PubMed, Embase, Scopus, and Web of Science) were searched up to the end point of May 2025, without time and language barriers. The study was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias (RoB) and quality of evidence were assessed. Results: Three randomized clinical trials (RCTs) and seven non-RCTs were included. In all RCTs and five non-RCTs, OMP was assessed using subgingival plaque samples. Periodontopathogenic bacteria and Gram-negative anaerobic microbes were more often identified in patients undergoing fixed OT than CAT. The biofilm mass was higher in patients undergoing fixed OT than CAT. In two RCTs, periodontopathogenic bacteria were dominant among patients undergoing fixed OT than CAT. All RCTs and two non-RCTs had a high RoB. The certainty of evidence was “moderate” in 70% of the studies. Conclusions: Due to a high RoB, variability in study designs, and lack of power analysis, direct comparisons remain limited. Full article

Periodontitis is a highly prevalent, irreversible inflammatory disease characterized by the destruction of tooth-supporting tissues, eventually leading to tooth loss. Conventional treatment involves the mechanical removal of the subgingival biofilm, which is a major cause of gingival inflammation. However, the inaccessibility of deep-seated polymicrobial biofilms limits its effectiveness. Despite the adjunct use of systemic antimicrobials, their low site-specific bioavailability and systemic side effects remain concerns. Local drug administration offers a targeted alternative. However, the dynamic oral environment, which is characterized by continuous salivary and gingival crevicular fluid flow, poses challenges in maintaining therapeutic drug levels. Drug delivery systems (DDSs) provide technical solutions to overcome these limitations. With advancements in materials science and nanotechnology, diverse local DDS (LDDS) formulations tailored for periodontal applications have been developed. While traditionally focused on infection control, the application of LDDSs has expanded beyond antimicrobial therapy. Increasing attention has been paid to LDDS-based regenerative strategies, which aim to overcome the limitations of conventional regenerative therapies. This review aims to provide a comprehensive overview of the current and emerging DDS strategies in periodontal therapy, focusing on their applications in infection management and bone regeneration and discussing their limitations and prospects for clinical translation. Full article

Clear aligner treatment seems to be a good option for the periodontal patient by the reason of being removable. Multibracket appliances are more difficult to mantain clean and some bacteria might prefer to adhere on the archwire. A systematic review was carried out using 4 electronic databases (Pubmed-Medline, Scopus, Cochrane and Web of Science). The selected trials included quantitative (Shannon index, Simpson index, relative abundances) and/or qualitative (alpha and beta diversity) analysis in patients using clear aligners and multibracket appliances. Initially, a total of 123 articles were found after selecting clinical trials. The inclusion and exclusion criteria were applied by two authors. Finally, 20 articles were selected for the systematic review. The results showed that clear aligner treatment produced less dysbiosis in the selected bacteria compared to multibracket appliances. However, some microbiological changes were observed in some articles during clear aligner use. Oral dysibiosis was related with intestinal dysbiosis, inflammatory response and even cancer. The Firmicutes/Bacteroidetes ratio showed to have a very important role in this development. Periodontitis is also a bacterial disease and clear aligners were recommended to periodontal risk patients. Clear aligner treatment obtained less supra and subgingival biofilm changes compared with multibracket appliances but some bacteria were altered during treatment. Full article

Background: Periodontal disease (PD) is a chronic inflammatory condition associated with dysbiotic biofilm, leading to the destruction of bone and periodontal ligament. Scaling and root planing (SRP) is the gold-standard treatment for PD, but some patients may not respond adequately, necessitating adjunctive therapies. This study investigated the antimicrobial activity of diacetylcurcumin (DAC), a modified curcumin, against multispecies subgingival biofilm associated with periodontitis. Methods: The biofilm, containing 40 bacterial species, was cultured for seven days in the Calgary apparatus. Treatments with DAC (200 μg/mL), 0.12% chlorhexidine (CHX), and a vehicle (control) were applied twice daily for 1 min, starting on the third day. On the seventh day, biofilms were analyzed for metabolic activity (MA) and bacterial counts via DNA-DNA hybridization. DAC toxicity was tested on Galleria mellonella larvae. Results: DAC reduced biofilm metabolic activity by 51%, while CHX achieved 88% reduction compared to the vehicle (p < 0.05). DAC also significantly decreased counts of key periodontal pathogens, including P. gingivalis, T. forsythia, P. intermedia, and A. actinomycetemcomitans (p < 0.05). At the tested concentration, DAC showed no toxicity in larvae. Conclusions: These findings suggest that DAC effectively reduces biofilm activity and periodontal pathogen counts, presenting a promising adjunctive therapy for PD. Full article

We investigated the antimicrobial properties and effects on bone resorption of Brazilian organic honeydew (OHD) from the Bracatinga tree (Mimosa scabrella Benth.), a rare honey certified with Denomination of Origin, using a periodontal disease model. Antibiofilm activity was assessed using a subgingival biofilm adhered to the Calgary device. Biofilms were treated with OHD, chlorhexidine (0.12%), or a vehicle twice daily for 1 min starting on day 3, at concentrations of 2× and 10× the minimum inhibitory concentration (MIC). We employed a ligature-induced chronic periodontal disease model and challenged it with Porphyromonas gingivalis in C57BL/6 mice. The chemical profile of OHD was analyzed using LC-ESI-IT-MS/MS. Results were evaluated by measuring bone loss and microbial composition of the ligature biofilm through DNA–DNA hybridization. OHD demonstrated significant activity against P. gingivalis (MIC 4%, MBC 6%) and reduced biofilm viability by 80% in vitro. In vivo, OHD decreased microbial populations and decreased bone loss associated with periodontal disease. Chemical analysis identified seven compounds in OHD, including five flavonoids and two lignans. This Brazilian honeydew from the Atlantic Forest exhibits strong antimicrobial properties and potential as a functional food for oral health, offering a promising alternative for the control and prevention of periodontal disease. Full article

Background: Machine learning (ML) techniques have been recently proposed as a solution for aiding in the prevention and diagnosis of microbiome-related diseases. Here, we applied auto-ML approaches on real-case metagenomic datasets from saliva and subgingival peri-implant biofilm microbiomes to explore a wide range of ML algorithms to benchmark best-performing algorithms for predicting peri-implantitis (PI). Methods: A total of 100 metagenomes from the NCBI SRA database (PRJNA1163384) were used in this study to construct biofilm and saliva metagenomes datasets. Two AI-driven auto-ML approaches were used on constructed datasets to generate 100 ML-based models for the prediction of PI. These were compared with statistically significant single-microorganism-based models. Results: Several ML algorithms were pinpointed as suitable bespoke predictive approaches to apply to metagenomic data, outperforming the single-microorganism-based classification. Auto-ML approaches rendered high-performing models with Receiver Operating Characteristic–Area Under the Curve, sensitivities and specificities between 80% and 100%. Among these, classifiers based on ML-driven scoring of combinations of 2–4 microorganisms presented top-ranked performances and can be suitable for clinical application. Moreover, models generated based on the saliva microbiome showed higher predictive performance than those from the biofilm microbiome. Conclusions: This feasibility study bridges complex AI research with practical dental applications by benchmarking ML algorithms and exploring oral microbiomes as foundations for developing intuitive, cost-effective, and clinically relevant diagnostic platforms. Full article

Background: The human oral microbiome is a critical reservoir for antibiotic resistance; however, subgingival peri-implant biofilms remain underexplored in this context. We aimed to explore the prevalence and distribution of antibiotic resistance genes (ARGs) in metagenomes derived from saliva and subgingival peri-implant biofilms. Methods: A total of 100 metagenome datasets from 40 individuals were retrieved from the Sequence Read Archive (SRA) database. Of these, 20 individuals had exclusively healthy implants and 20 had both healthy and affected implants with peri-implantitis. ARGs and their taxonomic assignments were identified using the ABRicate tool, and plasmid detection was performed with PlasmidFinder. Results: Four plasmid replicons were identified in 72 metagenomes, and 55 distinct ARGs from 13 antibiotic classes were detected in 89 metagenomes. ARGs conferring resistance to macrolides–lincosamides–streptogramins, tetracyclines, beta-lactams, and fluoroquinolones were the most prevalent. The msr(D) and mef(A) genes showed the highest prevalence, except in saliva samples from individuals with healthy implants, where mef(A) ranked fourth. A pairwise PERMANOVA of principal coordinate analysis based on Jaccard distances revealed that saliva samples exhibited significantly greater ARG diversity than subgingival biofilm samples (p < 0.05). However, no significant differences were observed between healthy and peri-implantitis-affected subgingival biofilm groups (p > 0.05). The taxonomic origins of ARGs were also analyzed to understand their distribution and potential impact on oral microbial communities. Conclusions: Resistome profiles associated with both peri-implant health and disease showed no significant differences and higher salivary abundance of ARGs compared to subgingival biofilm samples. 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

This study evaluated the microbial growth profile of subgingival multispecies biofilm on 3D-printable resin-based composites (PRBCs). A 96-well cell plate cultivated a 39-species biofilm associated with periodontitis over 7 days. Cylindrical specimens with 12 mm high and 3 mm diameters were prepared by the PRBC group (Cosmos Temp-Yller; Prizma 3D Bio Crown; Prizma 3D Bio Prov) and an acrylic resin as control. Further, these specimens were immersed in the well plate to allow biofilm formation. After growing for 7 days, the metabolic biofilm activity was evaluated by colorimetric assay and the microbial profile by DNA-DNA hybridization. Kruskal–Wallis and Mann–Whitney tests evaluated each bacteria count and complex group. A greater biofilm formation was observed on PRBC groups than on acrylic resin. The microbiological profile of PRBC was associated with a less pathogenic biofilm, with an absence of a red complex. Acrylic resin showed low biofilm growth, but the biofilm profile was related to periodontal disease, characterized by red-complex bacteria. The selection of PRBC may contribute more effectively to maintaining periodontal health than acrylic resin. Full article

Objectives: This systematic review assesses and compares the presence and relative abundance of periodontal pathogens, human herpesviruses (HHVs), and fungi in subgingival and/or saliva samples from pediatric subjects (≤18 years of age) with periodontally healthy status and with gingivitis and/or periodontitis. Methods: The study protocol was conducted under the PRISMA statement and registered on PROSPERO (CRD42024593007). Data from seven studies were descriptively analyzed and qualitatively assessed through the ROBINS-1 and JBI tools. Results: Pediatric subjects with clinically healthy periodontium exhibited a balanced microbiome, with early colonizers (Streptococcus species) supporting biofilm development and late colonizers like Fusobacterium nucleatum, Treponema denticola (82.35%), and Porphyromonas gingivalis (29.7%) present at low levels, suggesting subclinical dysbiosis. Viruses such as HSV-I (100%), CMV (17.8%), and EBV-I (22.09%) coexisted in a likely latent state, maintained by effective immune responses. In pediatric periodontitis, biofilms were more diverse and pathogenic, with increased prevalence of A. actinomycetemcomitans (56.09%), P. gingivalis (55.4%), and T. forsythia (35.9%). Generalized periodontitis showed higher CMV (36.36%) and EBV-I (36.24%) prevalence than gingivitis (HSV-I 18.75%). Coinfections were frequent in periodontitis, suggesting bacterial–viral synergy in exacerbating inflammation and tissue destruction. Fungi, although not studied, may also contribute under specific conditions. Conclusions: These findings highlight the role of microbial interactions in periodontal health and disease progression. Full article

This narrative review delves into the molecular mechanisms of hyaluronic acid (HA) and re-epithelializing agents in the context of periodontal regeneration. Periodontitis, characterized by chronic inflammation and the destruction of tooth-supporting tissues, presents a significant challenge in restorative dentistry. Traditional non-surgical therapies (NSPTs) sometimes fail to fully manage subgingival biofilms and could benefit from adjunctive treatments. HA, with its antibacterial, antifungal, anti-inflammatory, angiogenic, and osteoinductive properties, offers promising therapeutic potential. This review synthesizes the current literature on the bioactive effects of HA and re-epithelializing agents, such as growth factors and biomaterials, in promoting cell migration, proliferation, and extracellular matrix (ECM) synthesis. By modulating signaling pathways like the Wnt/β-catenin, TGF-β, and CD44 interaction pathways, HA enhances wound healing processes and tissue regeneration. Additionally, the role of HA in facilitating cellular crosstalk between epithelial and connective tissues is highlighted, as it impacts the inflammatory response and ECM remodeling. This review also explores the combined use of HA with growth factors and cytokines in wound healing, revealing how these agents interact synergistically to optimize periodontal regeneration. Future perspectives emphasize the need for further clinical trials to evaluate the long-term outcomes of these therapies and their potential integration into periodontal treatment paradigms. Full article

The aim of this in vitro study was to evaluate the effect of xanthohumol and thymol on the impact of Candida albicans on the structure, size and cell viability of subgingival biofilms formed on dental implant surfaces. The structure and microbial biomass of biofilms developed after 72 h, treated and untreated with both extracts, were compared by scanning electron microscopy (SEM) and confocal laser microscopy (CLSM). Quantitative polymerase chain reaction (qPCR) was used to quantify the number of viable and total microorganisms of each of the biofilm-forming strains in each condition. A general linear model was used to compare and validate the CLSM and qPCR results. The presence of xanthohumol and thymol during biofilm development inhibited the filamentous growth of C. albicans. The biofilm incubated with xanthohumol had significantly lower bacterial biomass and cell viability than the biofilm not exposed to the extract (p < 0.05). In contrast, these global parameters showed no differences when the biofilm was incubated with thymol. In the presence of xanthohumol, there was a decrease in counts and cell viability of Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans. Thymol treatment reduced the viability of F. nucleatum and P. gingivalis. The presence of these vegetable extracts during the development of a dynamic in vitro multispecies biofilm model inhibited the filamentous growth of C. albicans, partially reversing the effect that the fungus exerted on the structure, size and vitality of periodontopathogenic bacteria. Full article

Background/Objectives: The purpose of this study was to assess the microbial composition and density of subgingival plaque samples for periodontal pathogens while correlating the values with glycemic control levels via glycated hemoglobin (HbA1c), a type of hemoglobin that has chemically linked glucose, in type I diabetes individuals who will undergo complex oral rehabilitation through orthodontic treatment and implant surgery. Methods: A cohort of 42 adults with type I diabetes were included in this study. The subjects sustained a comprehensive periodontal clinical examination as well as microbiological assessments of their subgingival plaque samples through quantitative real-time PCR. The samples were collected from the two deepest pockets of each subject. Results: The highest number of periodontopathogenic bacteria was observed in the pockets of 5–7 mm. T. forsythia showed the highest prevalence (20.48%), with decreasing numbers as follows: T. denticola (13.31%), P. gingivalis (11.26%), A. actinomycetemcomitans (7%), and P. intermedia (4.9%). T. denticola and T. forsythia were significantly more commonly observed in individuals with elevated HbA1c serum levels. No correlation was observed between P. gingivalis, A. actinomycetemcomitans, P. intermedia presence, and the HbA1c value. Conclusions: Periodontopathogenic agents’ presence in subgingival biofilm samples varied in accordance with the pocket probing depth and metabolic control of the diabetic individuals. In our study, the appearance of these periodontopathogenic agents was linked to lowered metabolic control in patients with type I diabetes mellitus. Full article

The goal of this comprehensive review was to verify if the prevalence of Helicobacter pylori (Hp) bacteria in patients with dyspepsia is higher in the oral cavity of periodontal or non-periodontal patients. The bibliographic search was conducted on scientific studies published in PubMed, Cochrane Library, SciELO, and BVS. The focus question was: “In patients with dyspepsia and periodontitis, is the prevalence of Hp bacteria in the oral cavity higher than in patients with only dyspepsia or without any disease?” The inclusion criteria were human studies in English, Portuguese, or Spanish languages, published between 2000 and 2022, that included patients over the age of 18 and aimed to evaluate the presence of Hp bacteria in the oral cavity and in the protective mucosal layer of the gastric lining of patients with the diseases (periodontitis and dyspepsia) or without disease; clinical trials, randomized controlled clinical trials, comparative studies, case-control studies, cross-sectional studies, and cohort studies. The methodological quality evaluation of the included articles was performed using the Joanna Briggs Institute tools. The final scores could be of “Low” quality (at least two “no” [red] or ≥ five “unclear” found), “Moderate” quality (one “no” [red] was found or up to four “unclear” criteria were met), or “High” quality (all green [yes] or at maximum two “unclear”). Of 155 potentially eligible articles, 10 were included in this comprehensive review after the application of the eligibility criteria. The selected studies were scrutinized regarding the relationship between Hp colonization in the oral cavity and stomach, its impact on severity and complications of gastric infection, as well as the effect of the presence of oral and gastric Hp on dental and systemic parameters. Hp can colonize periodontal pockets regardless of its presence in the stomach. There was a higher prevalence of oral biofilm in dyspeptic patients with periodontal disease, and worse control of bleeding and low oral hygiene was observed in periodontal compared to non-periodontal patients. For que quality assessment, the scientific studies included presented low to moderate methodological quality. Conclusions: It is possible to conclude that Hp is a bacterium that can colonize dental plaque independently of the stomach and vice versa; however, when both diseases are found, its presence may be more significant. Supra and subgingival dental plaque may be a reservoir of Hp, suggesting that patients with gastric infections are more likely to have Hp in the oral cavity. The results must be carefully analyzed due to the limitations present in this review. Full article