Antimicrobial Agents in Oral Diseases: Prophylaxis and Therapy between New and Old Molecules

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Pharmacokinetics and Pharmacodynamics of Drugs".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 20449

Special Issue Editor

Special Issue Information

Dear Colleagues,

Antibiotic resistance represents a huge problem that the scientific community is called upon to tackle as a matter of priority. The Centers for Disease Control and Prevention reports that, each year, 2.8 million Americans experience an antibiotic-resistant infection, with the death of more than 35,000 people.

Safeguarding the effectiveness of old antimicrobial agents is fundamental today, as is the need to discover new ones. Studies will be pivotal to further elucidate the mechanism of action of old molecules to better understand, counteract, and prevent the spread of resistant bacteria. Research is also aimed at identifying new ones as well as proposing molecules which are capable of acting as adjuvants.

Common oral diseases (e.g., orofacial infection, periodontitis) in particular are treated using the support of antibiotics and antiseptics, representing the most prescribed medications by dentists, who are, thus, called to the fore to fight inappropriate prescriptions in their routine practice.

This Special Issue will publish papers focusing on the management of oral diseases with a particular focus on the activity of old and new antiseptics and antibiotics, on the use of these medications in dental setting, and on the education of dental professionals regarding their correct prescription.

Dr. Elena Maria Varoni
Guest Editor

Manuscript Submission Information

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Keywords

  • Antibiotics
  • Antiseptics
  • Oral Medicine
  • Periodontology
  • Oral Infections

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Published Papers (6 papers)

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Research

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14 pages, 3606 KiB  
Article
The Antibacterial and Antifungal Capacity of Eight Commercially Available Types of Mouthwash against Oral Microorganisms: An In Vitro Study
by Silvia Di Lodovico, Tatiane Cristina Dotta, Luigina Cellini, Giovanna Iezzi, Simonetta D’Ercole and Morena Petrini
Antibiotics 2023, 12(4), 675; https://doi.org/10.3390/antibiotics12040675 - 30 Mar 2023
Cited by 3 | Viewed by 2155
Abstract
This work aimed to evaluate and compare the antimicrobial actions and effects over time of eight types of mouthwash, based on the impact of chlorhexidine on the main microorganisms that are responsible for oral diseases: Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans [...] Read more.
This work aimed to evaluate and compare the antimicrobial actions and effects over time of eight types of mouthwash, based on the impact of chlorhexidine on the main microorganisms that are responsible for oral diseases: Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans. The mouthwashes’ antimicrobial action was determined in terms of their minimum inhibitory concentration (MIC), minimum bactericidal/fungicidal concentration (MBC/MFC), and time-kill curves at different contact times (10 s, 30 s, 60 s, 5 min, 15 min, 30 min, and 60 min), against selected oral microorganisms. All the mouthwashes showed a notable effect against C. albicans (MICs ranging from 0.02% to 0.09%), and higher MIC values were recorded with P. aeruginosa (1.56% to >50%). In general, the mouthwashes showed similar antimicrobial effects at reduced contact times (10, 30, and 60 s) against all the tested microorganisms, except with P. aeruginosa, for which the most significant effect was observed with a long time (15, 30, and 60 min). The results demonstrate significant differences in the antimicrobial actions of the tested mouthwashes, although all contained chlorhexidine and most of them also contained cetylpyridinium chloride. The relevant antimicrobial effects of all the tested mouthwashes, and those with the best higher antimicrobial action, were recorded by A—GUM® PAROEX®A and B—GUM® PAROEX®, considering their effects against the resistant microorganisms and their MIC values. Full article
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16 pages, 2563 KiB  
Article
In Vitro Study on Green Propolis as a Potential Ingredient of Oral Health Care Products
by Achille Coluccia, Fabienne Matti, Xilei Zhu, Adrian Lussi, Alexandra Stähli, Anton Sculean and Sigrun Eick
Antibiotics 2022, 11(12), 1764; https://doi.org/10.3390/antibiotics11121764 - 6 Dec 2022
Cited by 1 | Viewed by 1765
Abstract
Propolis is increasingly being discussed as an alternative to commonly used antiseptics. This in vitro study focused on the ethanolic extract of green Brazilian propolis (EEPg) as an additive in an oral health care product. We investigated (i) a potential inflammation-modulation activity of [...] Read more.
Propolis is increasingly being discussed as an alternative to commonly used antiseptics. This in vitro study focused on the ethanolic extract of green Brazilian propolis (EEPg) as an additive in an oral health care product. We investigated (i) a potential inflammation-modulation activity of EEPg when a periodontal or Candida biofilm was exposed to monocytic (MONO-MAC-6) cells, (ii) the adhesion of oral pathogens to gingival keratinocytes and (iii) the antimicrobial and antibiofilm effect of different toothpaste formulations. EEPg decreased the levels of interleukin (IL)-1β and increased IL-10 in MONO-MAC cells challenged with a periodontal biofilm. In contact with TIGK cells, EEPg reduced the numbers of adherent Porphyromonas gingivalis to 0.5% but did not affect the adhesion of Candida albicans. The frequent brushing of a cariogenic biofilm with a toothpaste supplemented with EEPg reduced the surface microhardness loss of enamel specimens. Mixing an experimental erythritol toothpaste with 25 and 50 mg/mL of EEPg confirmed the antibacterial activity of EEPg against oral bacteria and particularly inhibited periodontal biofilm formation. The suggested toothpaste formulations seem to have potential in the prevention of caries, gingivitis and periodontitis and should be evaluated in further in vitro research and in clinical trials. Full article
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11 pages, 3023 KiB  
Article
Activity of Two Antimicrobial Peptides against Enterococcus faecalis in a Model of Biofilm-Mediated Endodontic Infection
by Giovanni Mergoni, Maddalena Manfredi, Pio Bertani, Tecla Ciociola, Stefania Conti and Laura Giovati
Antibiotics 2021, 10(10), 1220; https://doi.org/10.3390/antibiotics10101220 - 7 Oct 2021
Cited by 10 | Viewed by 2139
Abstract
Enterococcus faecalis is a common cause of biofilm-associated opportunistic infections, which are often difficult to treat. The formation of E. faecalis biofilms on the dentinal walls of the root canal is frequently the cause of endodontic treatment failure and secondary apical periodontitis. In [...] Read more.
Enterococcus faecalis is a common cause of biofilm-associated opportunistic infections, which are often difficult to treat. The formation of E. faecalis biofilms on the dentinal walls of the root canal is frequently the cause of endodontic treatment failure and secondary apical periodontitis. In a preliminary work, two recognized antifungal peptides, KP and L18R, showed antibacterial activity against planktonic E. faecalis cells at micromolar concentrations. Moreover, L18R proved to reduce the biomass in the early stage of E. faecalis biofilm development on polystyrene plates, while a qualitative biofilm inhibition was demonstrated on hydroxyapatite disks by confocal laser scanning microscopy (CLSM). The aim of this study was to better characterize the effect of both peptides on E. faecalis biofilm. A reduction in metabolic activity after peptide treatment was detected by Alamar Blue assay, while a remarkable impairment in the architecture of E. faecalis biofilms on hydroxyapatite disks, along with a significant reduction in viable bacteria, was caused mostly by L18R, as assessed by CLSM and scanning electron microscopy. The lack of cytotoxicity of the investigated peptides against L929 murine fibroblasts was also determined. Obtained results suggest L18R as a promising candidate for the development of new strategies for endodontic infection control. Full article
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Review

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25 pages, 1240 KiB  
Review
Induction of Endogenous Antimicrobial Peptides to Prevent or Treat Oral Infection and Inflammation
by Kimberly A. Morio, Robert H. Sternowski and Kim A. Brogden
Antibiotics 2023, 12(2), 361; https://doi.org/10.3390/antibiotics12020361 - 9 Feb 2023
Cited by 5 | Viewed by 2124
Abstract
Antibiotics are often used to treat oral infections. Unfortunately, excessive antibiotic use can adversely alter oral microbiomes and promote the development of antibiotic-resistant microorganisms, which can be difficult to treat. An alternate approach could be to induce the local transcription and expression of [...] Read more.
Antibiotics are often used to treat oral infections. Unfortunately, excessive antibiotic use can adversely alter oral microbiomes and promote the development of antibiotic-resistant microorganisms, which can be difficult to treat. An alternate approach could be to induce the local transcription and expression of endogenous oral antimicrobial peptides (AMPs). To assess the feasibility and benefits of this approach, we conducted literature searches to identify (i) the AMPs expressed in the oral cavity; (ii) the methods used to induce endogenous AMP expression; and (iii) the roles that expressed AMPs may have in regulating oral inflammation, immunity, healing, and pain. Search results identified human neutrophil peptides (HNP), human beta defensins (HBD), and cathelicidin AMP (CAMP) gene product LL-37 as prominent AMPs expressed by oral cells and tissues. HNP, HBD, and LL-37 expression can be induced by micronutrients (trace elements, elements, and vitamins), nutrients, macronutrients (mono-, di-, and polysaccharides, amino acids, pyropeptides, proteins, and fatty acids), proinflammatory agonists, thyroid hormones, and exposure to ultraviolet (UV) irradiation, red light, or near infrared radiation (NIR). Localized AMP expression can help reduce infection, inflammation, and pain and help oral tissues heal. The use of a specific inducer depends upon the overall objective. Inducing the expression of AMPs through beneficial foods would be suitable for long-term health protection. Additionally, the specialized metabolites or concentrated extracts that are utilized as dosage forms would maintain the oral and intestinal microbiome composition and control oral and intestinal infections. Inducing AMP expression using irradiation methodologies would be applicable to a specific oral treatment area in addition to controlling local infections while regulating inflammatory and healing processes. Full article
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13 pages, 1068 KiB  
Review
Revisiting Periodontal Disease in Dogs: How to Manage This New Old Problem?
by Eva Cunha, Luís Tavares and Manuela Oliveira
Antibiotics 2022, 11(12), 1729; https://doi.org/10.3390/antibiotics11121729 - 1 Dec 2022
Cited by 4 | Viewed by 8743
Abstract
Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, [...] Read more.
Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, several procedures focusing on the prevention and control of dental plaque establishment, as well as on the prevention of local and systemic PD-related consequences, are essential. The removal of dental plaque and the inhibition of its formation can be achieved by a combination of dental hygiene homecare procedures including tooth brushing, the application of different oral products and the use of specific diet and chew toys, and regular professional periodontal procedures. Additionally, in some cases, periodontal surgery may be required to reduce PD progression. Associated with these measures, host modulation therapy, antimicrobial therapy, and other innovative therapeutic options may be useful in PD management. Moreover, PD high prevalence and its relation with potential local and systemic consequences reinforce the need for investment in the development of new preventive measures, treatments, and oral procedures to improve the control of this disease in dogs. Knowledge on the specific guidelines and diversity of the available products and procedures are fundamental to apply the most adequate treatment to each dog with PD. Full article
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Other

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14 pages, 402 KiB  
Systematic Review
Antibiotics as Adjunctive Therapy in the Non-Surgical Treatment of Peri-Implantitis: A Systematic Review and Meta-Analysis
by Maria Gabriella Grusovin, Alberto Pispero, Massimo Del Fabbro, Matteo Sangiorgi, Massimo Simion, Martina Stefanini and Elena Maria Varoni
Antibiotics 2022, 11(12), 1766; https://doi.org/10.3390/antibiotics11121766 - 7 Dec 2022
Cited by 4 | Viewed by 1865
Abstract
The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy [...] Read more.
The role of antibiotics as adjunctive therapy in the non-surgical treatment of peri-implantitis is uncertain. The aim of this systematic review of randomized controlled trials was to assess the efficacy of antibiotic therapy, local or systemic, as an adjunctive to the non-surgical therapy of peri-implantitis. Primary outcomes were: implant success rate and complications, changes in radiographic bone level, probing pocket depth (PPD), probing attachment level (PAL), bleeding on probing (BOP) and peri-implantitis resolution. Six studies were included: two using topical and four systemic antibiotics. Adjunctive local antibiotics improved PPD (mean difference (MD) = 0.6 mm; 95% CI 0.42–0.78), BOP (MD = 0.15% (95% CI 0.10, 0.19)) and the success rate (risk ratio = 9.89; 95% CI 2.39–40.84). No significant difference in bone level and success rate were found with the use of systemic antibiotics, although they appeared to improve PPD (MD = 1.15 mm; 95% CI 0.31–1.99) and PAL (MD = 1.10 mm; 95% CI 0.13–2.08). Within the limitations of this review, the adjunctive local antibiotics showed improved outcomes in terms of success rate, PPD and BOP, while adjunctive systemic antibiotics improved PPD and PAL only. Peri-implantitis resolution was about 20–30% using adjunctive local antibiotics, whilst it ranged from 2% to 65% with adjunctive systemic antibiotics. Findings are still controversial, since they are based on few studies with high heterogeneity, at the uncertain or high risk of bias and involve few patients. Non-surgical debridement and maintenance periodontal support therapy remain pivotal and the adjunctive use of antibiotics for peri-implantitis cannot be routinely recommended, even considering the increasing concern on antibiotic resistance. Full article
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