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MBio Jun 2023Pathogenic microbial ecosystems are often polymicrobial, and interbacterial interactions drive emergent properties of these communities. In the oral cavity,...
Pathogenic microbial ecosystems are often polymicrobial, and interbacterial interactions drive emergent properties of these communities. In the oral cavity, Streptococcus gordonii is a foundational species in the development of plaque biofilms, which can contribute to periodontal disease and, after gaining access to the bloodstream, target remote sites such as heart valves. Here, we used a transposon sequencing (Tn-Seq) library of S. gordonii to identify genes that influence fitness in a murine abscess model, both as a monoinfection and as a coinfection with an oral partner species, Porphyromonas gingivalis. In the context of a monoinfection, conditionally essential genes were widely distributed among functional pathways. Coinfection with P. gingivalis almost completely changed the nature of gene essentiality. Community-dependent essential (CoDE) genes under the coinfection condition were primarily related to DNA replication, transcription, and translation, indicating that robust growth and replication are required to survive with P. gingivalis . Interestingly, a group of genes in an operon encoding streptococcal receptor polysaccharide (RPS) were associated with decreased fitness of S. gordonii in a coinfection with P. gingivalis. Individual deletion of two of these genes (SGO_2020 and SGO_2024) resulted in the loss of RPS production by S. gordonii and increased susceptibility to killing by neutrophils. P. gingivalis protected the RPS mutants by inhibiting neutrophil recruitment, degranulation, and neutrophil extracellular trap (NET) formation. These results provide insight into genes and functions that are important for S. gordonii survival and the nature of polymicrobial synergy with P. gingivalis. Furthermore, we show that RPS-mediated immune protection in S. gordonii is dispensable and detrimental in the presence of a synergistic partner species that can interfere with neutrophil killing mechanisms. Bacteria responsible for diseases originating at oral mucosal membranes assemble into polymicrobial communities. However, we know little regarding the fitness determinants of the organisms that initiate community formation. Here, we show that the extracellular polysaccharide of Streptococcus gordonii, while important for streptococcal survival as a monoinfection, is detrimental to survival in the context of a coinfection with Porphyromonas gingivalis. We found that the presence of P. gingivalis compensates for immune protective functions of extracellular polysaccharide, rendering production unnecessary. The results show that fitness determinants of bacteria in communities differ substantially from those of individual species in isolation. Furthermore, constituents of communities can undertake activities that relieve the burden of energetically costly biosynthetic reactions on partner species.
Topics: Animals; Mice; Streptococcus gordonii; Coinfection; Ecosystem; Biofilms; Mouth
PubMed: 37042761
DOI: 10.1128/mbio.00658-23 -
Archives of Academic Emergency Medicine 2023Differentiating the soft tissue abscess from other types of skin and soft tissue infections (SSTIs) poses a particular challenge because they have similar physical... (Review)
Review
INTRODUCTION
Differentiating the soft tissue abscess from other types of skin and soft tissue infections (SSTIs) poses a particular challenge because they have similar physical evaluation findings, but each disease has a different course, outcome, and treatment. This meta-analysis aimed to investigate the diagnostic accuracy of point-of-care ultrasonography for diagnosis of soft tissue abscess in the emergency departments.
METHODS
A comprehensive literature search of MEDLINE, Scopus, Web of Science, Embase, and Google Scholar, from inception to January 2023, was conducted to identify relevant studies investigating the diagnostic performance of point-of-care ultrasonography for identification of abscess. Methodological quality of the included studies was assessed using a revised tool for the quality assessment of diagnostic accuracy studies (QUADAS-2).
RESULTS
The pooled estimates of diagnostic parameters of ultrasonography for diagnosis of abscess were as follows: sensitivity, 0.93 (95% CI: 0.92-0.94); specificity, 0.87 (95% CI: 0.85-0.89), and the area under the summary receiver-operating characteristic (SROC), 0.95. The pooled sensitivity, specificity, and area under the SROC of studies in adult patients were 0.98 (95% CI: 0.92-1), 0.92 (95% CI: 0.86-0.95), and 0.99, respectively. The pooled sensitivity, specificity, and area under the SROC of studies in pediatric patients were 0.9 (95% CI: 0.87-0.92), 0.78 (95% CI: 0.73-0.82), and 0.91, respectively.
CONCLUSION
Our meta-analysis demonstrated that the point-of-care ultrasonography has excellent diagnostic value for the abscess in the emergency department. Furthermore, we found that the diagnostic performance of point-of-care ultrasonography for diagnosis of abscess was higher for adult cases than for pediatric patients.
PubMed: 37609534
DOI: 10.22037/aaem.v11i1.2021 -
Journal of Education and Health... 2023Medicinal plants and herbal drugs are being used increasingly as part of primary health care in most parts of the world. As important adjunctive and alternative... (Review)
Review
Medicinal plants and herbal drugs are being used increasingly as part of primary health care in most parts of the world. As important adjunctive and alternative treatments for oral health care, herbal products' use may continue to increase and become more widespread. The objective of this study is to present a comprehensive systematic review of the current published literature on the effectiveness of medicinal plants and herbal products employed to improve oral health in adolescents with a health promotion approach. The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The keywords "herbal medicine," "herbal extract," "herbal supplements," "plant extract," "natural drug," "pulpitis," "dental caries," "oral viral diseases," and "abscess" were used in combination with the Boolean operators OR and AND. PubMed, Embase, Scopus, and Web of Science were searched. Quality assessment of the included studies was performed using the Cochrane Handbook for Systematic Reviews of Interventions. The search yielded 49 original research studies. A total of 22 studies had low or unclear risk bias. The geographical distribution of included studies was primarily concentrated on western countries. Overall, studies reported herbal product users' age, ranging from young adults aged 18 years to elderly people aged 75 years or older. Most studies reported multiple compounds, including herbal drugs and herbal extracts. Chamomile and Aloe vera were the most frequently reported herbal compounds. The most commonly described herbal products to treat oral diseases were gels, mouth rinses, and pastes. The studies included a range of people with oral diseases, including periodontal and gingival diseases, recurrent aphthous stomatitis, oral lichen planus, and oral candidiasis. Herbal product interventions were found to be effective and safe alternatives for oral health care. One of the most important goals of the World Health Organization (until 2015) is the oral health index, so it is important that dental services be followed up more seriously. Considering the problems in reaching this goal of the World Health Organization in our country, herbal products have the ability to improve clinical oral health outcomes in adolescents. Limited adverse side effects indicate the overall safety of these treatments for a wide range of oral diseases. Therefore, the use of medicinal plants as well as alternative medicine is one of the useful methods in achieving this important goal of public health.
PubMed: 38023092
DOI: 10.4103/jehp.jehp_1297_22 -
Infection and Immunity Mar 2024Oral streptococci, key players in oral biofilm formation, are implicated in oral dysbiosis and various clinical conditions, including dental caries, gingivitis,...
Oral streptococci, key players in oral biofilm formation, are implicated in oral dysbiosis and various clinical conditions, including dental caries, gingivitis, periodontal disease, and oral cancer. Specifically, is associated with esophageal, gastric, and pharyngeal cancers, while is linked to oral cancer. However, no study has investigated the mechanistic links between these species and cancer-related inflammatory responses. As an initial step, we probed the innate immune response triggered by and in RAW264.7 macrophages. These bacteria exerted time- and dose-dependent effects on macrophage morphology without affecting cell viability. Compared with untreated macrophages, macrophages infected with exhibited a robust proinflammatory response characterized by significantly increased levels of inflammatory cytokines and mediators, including TNF, IL-6, IL-1β, NOS2, and COX2, accompanied by enhanced NF-κB activation. In contrast, -infected macrophages failed to elicit a robust inflammatory response. Seahorse Xfe96 analysis revealed an increased extracellular acidification rate in macrophages infected with compared with . At the 24-h time point, the presence of led to reduced extracellular itaconate, while triggered increased itaconate levels, highlighting distinct metabolic profiles in macrophages during infection in contrast to aconitate decarboxylase expression observed at the 6-h time point. This initial investigation highlights how and , two Gram-positive bacteria from the same genus, can prompt distinct immune responses and metabolic shifts in macrophages during infection.IMPORTANCEThe surge in head and neck cancer cases among individuals devoid of typical risk factors such as Human Papilloma Virus (HPV) infection and tobacco and alcohol use sparks an argumentative discussion around the emerging role of oral microbiota as a novel risk factor in oral squamous cell carcinoma (OSCC). While substantial research has dissected the gut microbiome's influence on physiology, the oral microbiome, notably oral streptococci, has been underappreciated during mucosal immunopathogenesis. , a viridans streptococci group, has been linked to abscess formation and an elevated presence in esophageal cancer and OSCC. The current study aims to probe the innate immune response to compared with the early colonizer as an important first step toward understanding the impact of distinct oral species on the host immune response, which is an understudied determinant of OSCC development and progression.
Topics: Humans; Streptococcus anginosus; Carcinoma, Squamous Cell; Mouth Neoplasms; Dental Caries; Streptococcus; Macrophages; Succinates
PubMed: 38289109
DOI: 10.1128/iai.00536-23 -
Annals of African Medicine 2023The aim of this study was to describe the use patterns of antibiotics in periodontal therapy among Moroccan dentists.
AIM
The aim of this study was to describe the use patterns of antibiotics in periodontal therapy among Moroccan dentists.
MATERIALS AND METHODS
It was a cross-sectional study. An online survey among 2440 registered dentists was conducted in public, private, and semi-public sectors in Morocco. Within the interrogated dentists, 255 answer the online survey. Data analysis was done by the laboratory of biostatistics-epidemiology of the Faculty of Medicine of Casablanca.
RESULTS
The antibiotics were prescribed for different pathologies. 26.8% of dentists prescribed antibiotics for gingivitis, 91.5% in case of ulcero-necrotizing gingivitis, 92.7% for aggressive periodontitis, 77% to chronic periodontitis patients, and 97.6% in the presence of periodontal abscess. Dentists prescribed penicillin to 37.3% of cases presenting ulcero-necrotizing gingivitis and 62.3% of patients presenting periodontal abscess. Cyclins are prescribed at a rate of 60% to aggressive periodontitis patients. The association of penicillin + metronidazole is prescribed to 37.3% of ulcero-necrotizing gingivitis patients, 47% of patients presenting aggressive periodontitis, 42.5% of chronic periodontitis patients, and 65.5% of cases presenting periodontal abscess.
DISCUSSION
There are major discrepancies among dentists in antibiotic prescription patterns. Some dentists prescribe antibiotics to patients with gingivitis or patients undergoing noninvasive oral procedures such as air polishing and scaling which is worrisome. Dentists are prescribing antibiotics when local treatment would have sufficed. Dentists also commonly prescribed antibiotics as an adjunct to mechanical therapy for the treatment of periodontal disease.
CONCLUSION
Systemic antibiotics are prescribed for different conditions according to variable protocols. The appropriateness of antibiotic prescription must be reassessed critically to improve antibiotic stewardship among dentists.
Topics: Humans; Anti-Bacterial Agents; Aggressive Periodontitis; Periodontal Abscess; Chronic Periodontitis; Cross-Sectional Studies; Morocco; Dentists; Gingivitis; Penicillins; Surveys and Questionnaires
PubMed: 37417016
DOI: 10.4103/aam.aam_50_22 -
Journal of Indian Society of... 2023An escalation in cases of rhinomaxillary mucormycosis among post-COVID patients is being reported. However, there is limited information about periodontal features in...
BACKGROUND
An escalation in cases of rhinomaxillary mucormycosis among post-COVID patients is being reported. However, there is limited information about periodontal features in mucormycosis cases. This study explored the periodontal signs and symptoms among post-COVID mucormycosis individuals.
MATERIALS AND METHODS
This cross-sectional study was carried out with a total of 25 post-COVID mucormycosis patients attending tertiary care public teaching hospital. Clinical and radiographic assessments were done.
RESULTS
An elevation in mean probing pocket depth (PPD) up to 6.21 ± 2.7 mm was noted. Nearly 16%-40% of patients had Miller's Grade III mobility in the affected site. Forty-four per cent had localized single or multiple abscess, 40% had palatal swelling, 32% had necrosis of soft tissue and bone exposure, and 52% had maxillary dentoalveolar segmental mobility in the affected site. Radiographic examination revealed varying stages of interdental bone loss.
CONCLUSION
The present study observed an increase in mobility and mean PPD which did not commiserate with interdental bone loss in the affected maxillary region.
PubMed: 37593554
DOI: 10.4103/jisp.jisp_429_22 -
Journal of Periodontal & Implant Science Dec 2023No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized...
PURPOSE
No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions.
METHODS
Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery.
RESULTS
For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups.
CONCLUSIONS
Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.
TRIAL REGISTRATION
Clinical Research Information Service Identifier: KCT0007305.
PubMed: 37154106
DOI: 10.5051/jpis.2203660183 -
Journal of Periodontal & Implant Science Sep 2023The objective of this retrospective clinical study was to provide evidence supporting the adjunctive local application of doxycycline solution or minocycline ointment,...
Comparing the clinical effects of local administration of minocycline ointment and doxycycline solution in the treatment of acute periodontal abscesses: a retrospective clinical study.
PURPOSE
The objective of this retrospective clinical study was to provide evidence supporting the adjunctive local application of doxycycline solution or minocycline ointment, in conjunction with drainage, for the treatment of acute periodontal abscesses.
METHODS
The study included 63 patients who had received treatment for acute periodontal abscesses through drainage supplemented with 1 of 3 types of adjunctive medications during their initial visit (visit 1; baseline): 1) saline irrigation (the control group), 2) 2% minocycline ointment (the TM group), or 3) 300 mg/mL doxycycline irrigation (the TD group). The same adjunctive medication was administered at visit 2, which took place 1 week after visit 1. Probing depth (PD), bleeding on probing (BOP), plaque index, gingival recession, clinical attachment level, and tooth mobility were clinically evaluated at visits 1, 2, and a third visit (visit 3; 4 weeks after visit 1). Statistical significance was considered to be indicated by values <0.05.
RESULTS
By visit 3, all clinical indices and tooth mobility had significantly decreased in each group. At this visit, PD and BOP on the abscess side were significantly lower in the TM and TD groups compared to the control group. The TD group showed a significantly greater improvement than the TM group, with mean PD reductions of 1.09 mm in the control group, 1.88 mm in the TM group, and 2.88 mm in the TD group. Similarly, mean BOP reductions were 45% in the control group, 73.02% in the TM group, and 95.45% in the TD group.
CONCLUSIONS
Local and adjunctive administration of doxycycline and minocycline in combination with drainage exhibited clinical advantages over drainage alone in improving PD and BOP. Notably, a doxycycline solution of 300 mg/mL was more effective than a 2% minocycline ointment.
PubMed: 37857519
DOI: 10.5051/jpis.2300800040 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Jun 2023To analyze the composition, incidence and clinical characteristics of oral and maxillofacial infections in oral emergency.
OBJECTIVE
To analyze the composition, incidence and clinical characteristics of oral and maxillofacial infections in oral emergency.
METHODS
A retrospective study on patients with oral and maxillofacial infections who visited the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2017 to December 2019 was conducted. General characteristics, such as disease composition, gender, age distribution and position of involved teeth were analyzed.
RESULTS
A total of 8 277 patients with oral and maxillofacial infections were finally collected, including 4 378 male patients (52.9%) and 3 899 female patients (47.1%), with gender ratio of 1.12:1. The common diseases were periodontal abscess (3 826 cases, 46.2%), alveolar abscess (3 537 cases, 42.7%), maxillofacial space infection (740 cases, 9.0%), sialadenitis (108 cases, 1.3%), furuncle & carbuncle (56 cases, 0.7%) and osteomyelitis (10 cases, 0.1%). Male patients were more easily affected by periodontal abscess, space infection and furuncle & carbuncle than female patients with the gender ratios 1.24:1, 1.26:1, 2.50:1 individually, while the incidence of alveolar abscess, sialadenitis, furuncle & carbuncle had no significant gender difference. Different diseases were prone to occur at different ages. The peak ages of alveolar abscess were 5-9 and 27-67 years, while the peak age of periodontal abscess was 30-64 years. Space infection tended to occur between 21-67 years. There were 7 363 patients with oral abscess (3 826 patients with periodontal abscess and 3 537 patients with alveolar abscess), accounting for 88.9% of all the patients with oral and maxillofacial infections, involving 7 999 teeth, including 717 deciduous teeth and 7 282 permanent teeth. Periodontal abscess usually occurred in permanent teeth, especially the molar teeth. Alveolar abscess may occur in both primary teeth and permanent teeth. In primary teeth, the most vulnerable sites were primary molar teeth and maxillary central incisors while in permanent teeth the most vulnerable sites were first molar teeth.
CONCLUSION
Understanding the incidence of oral and maxillofacial infection was conducive to the correct diagnosis and effective treatment of clinical diseases, as well as targeted education for patients of different ages and genders to prevent the occurrence of diseases.
Topics: Humans; Male; Female; Animals; Adult; Middle Aged; Abscess; Retrospective Studies; Periodontal Abscess; Carbuncle; Furunculosis; Incisor; Sialadenitis
PubMed: 37291932
DOI: 10.19723/j.issn.1671-167X.2023.03.022