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Nutrients Jun 2024The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial,... (Review)
Review
The use of natural products as alternatives to traditional pharmacological treatments in orthodontics is gaining interest due to their anti-inflammatory, antibacterial, and antioxidant properties. This systematic review synthesizes evidence from clinical trials to evaluate the efficacy of natural products in reducing inflammation and bacterial presence in orthodontic and orthognathic treatment settings. The database search was conducted across PubMed, Scopus, and Embase up to January 2024. The review focused on randomized controlled trials only. The selected studies centered on the anti-inflammatory, antibacterial, and antioxidant effects of natural products, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for data extraction. Nine studies, totaling 358 participants, were included. Significant findings demonstrated a reduction in gingival inflammation by over 40% with the use of Aloe vera compared to chlorhexidine. Another study noted a decrease in bleeding on probing by 13.6 points in the treatment group over placebo. Additionally, honey showed a rapid modulation of plaque pH and significantly reduced bacterial counts of . Furthermore, the use of resveratrol emulgel was linked to substantial improvements in gingival health, with a reduction in the gingival index and probing pocket depth. The results indicate that natural products can significantly enhance orthodontic treatment outcomes by reducing inflammation and bacterial levels. These products offer effective alternatives to traditional treatments and show potential for integration into routine orthodontic care protocols. Further research is encouraged to standardize application methods and dosages to maximize clinical benefits and patient satisfaction.
Topics: Humans; Aloe; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antioxidants; Biological Products; Chlorhexidine; Dentofacial Deformities; Gingivitis; Honey; Orthodontics; Plant Preparations; Randomized Controlled Trials as Topic; Resveratrol; Streptococcus mutans; Treatment Outcome
PubMed: 38931295
DOI: 10.3390/nu16121941 -
Medical Science Monitor : International... Jun 2024Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and...
Orthodontic treatments, while essential for achieving optimal oral health, present challenges in infection control due to the propensity for bacterial adhesion and biofilm formation on orthodontic appliances. Silver-coated orthodontic materials have emerged as a promising solution, leveraging the potent antimicrobial properties of silver nanoparticles (AgNPs). Antibacterial coatings are used in orthodontics to prevent the formation of bacterial biofilms. This systematic review evaluated the literature on antimicrobial silver coatings on fixed orthodontic appliances, including archwires, brackets, and microimplants. Two evaluators, working independently, rigorously conducted a comprehensive search of various databases, including PubMed, PubMed Central, Embase, Scopus and Web of Science. This systematic review comprehensively examined in vitro studies investigating the antimicrobial efficacy of silver-coated orthodontic archwires, brackets, and microimplants. The review registered in PROSPERO CRD42024509189 synthesized findings from 18 diverse studies, revealing consistent and significant reductions in bacterial adhesion, biofilm formation, and colony counts with the incorporation of AgNPs. Key studies demonstrated the effectiveness of silver-coated archwires and brackets against common oral bacteria, such as Streptococcus mutans and Staphylococcus aureus. Microimplants coated with AgNPs also exhibited notable antimicrobial activity against a range of microorganisms. The systematic review revealed potential mechanisms underlying these antimicrobial effects, highlighted implications for infection prevention in orthodontic practice, and suggested future research avenues. Despite some study heterogeneity and limitations, the collective evidence supports the potential of silver-coated orthodontic materials in mitigating bacterial complications, emphasizing their relevance in advancing infection control measures in orthodontics.
Topics: Silver; Humans; Biofilms; Orthodontic Brackets; Metal Nanoparticles; Orthodontic Wires; Orthodontic Appliances, Fixed; Anti-Infective Agents; Coated Materials, Biocompatible; Anti-Bacterial Agents; Streptococcus mutans; Bacterial Adhesion; Staphylococcus aureus
PubMed: 38843112
DOI: 10.12659/MSM.944255 -
BMC Oral Health Jun 2024To provide an overview of the available scientific evidence from in vitro studies regarding the effect induced by the flavonoids contained in grape seed extracts (GSE)... (Review)
Review
OBJECTIVE
To provide an overview of the available scientific evidence from in vitro studies regarding the effect induced by the flavonoids contained in grape seed extracts (GSE) and cranberry on the microbiological activity of Streptococcus mutans (S. mutans).
METHODS
This systematic review was performed following the parameters of the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). Electronic and manual searches were conducted using PubMed, ScienceDirect, Web of Science, EBSCO, and Cochrane databases. Reference lists of selected articles were reviewed to identify relevant studies. The search was not limited by year and was conducted solely in English. Eligible studies comprised publications describing in vitro studies that evaluated the effect of flavonoids derived from GSE and cranberry extracts on the microbiological activity of S. mutans. Common variables were identified to consolidate the data. Authors of this review independently screened search results, extracted data, and assessed the risk of bias.
RESULTS
Of the 420 studies identified from the different databases, 22 publications were finally selected for review. The risk of bias was low in 13 articles and moderate in 9. The studies analyzed in this review revealed that cranberry extract has an inhibitory effect on the bacterial growth of S. mutans in ranges from 0.5 mg/mL to 25 mg/mL, and GSE exerts a similar effect from 0.5 mg/mL to 250 mg/mL. Additionally, the extracts or their fractions showed reduced biofilm formation capacity, decreased polymicrobial biofilm biomass, deregulation of glycosyltransferases (Gtf) B and C expression, and buffering of pH drop. In addition to adequate antioxidant activity related to polyphenol content.
CONCLUSIONS
The overall results showed that the extracts of cranberry and grape seed were effective in reducing the virulence factors of the oral pathogen. According to the data, proanthocyanidins are the active components in cranberry and grape seed that effectively resist S. mutans. They can inhibit the formation of insoluble polysaccharides in the extracellular matrix and prevent glycan-mediated adhesion, cohesion, and aggregation of the proteins in S. mutans. This suggests that these natural extracts could play an important role in the prevention of cariogenic bacterial colonization, as well as induce a decrease in their microbiological activity.
Topics: Streptococcus mutans; Vaccinium macrocarpon; Plant Extracts; Flavonoids; Grape Seed Extract; Biofilms; Humans; Vitis; Proanthocyanidins
PubMed: 38840232
DOI: 10.1186/s12903-024-04263-0 -
JAMA Cardiology Apr 2024The association between antibiotic prophylaxis and infective endocarditis after invasive dental procedures is still unclear. Indications for antibiotic prophylaxis were...
IMPORTANCE
The association between antibiotic prophylaxis and infective endocarditis after invasive dental procedures is still unclear. Indications for antibiotic prophylaxis were restricted by guidelines beginning in 2007.
OBJECTIVE
To systematically review and analyze existing evidence on the association between antibiotic prophylaxis and infective endocarditis following invasive dental procedures.
DATA SOURCES
PubMed, Cochrane-CENTRAL, Scopus, Web of Science, Proquest, Embase, Dentistry and Oral Sciences Source, and ClinicalTrials.gov were systematically searched from inception to May 2023.
STUDY SELECTION
Studies on the association between antibiotic prophylaxis and infective endocarditis following invasive dental procedures or time-trend analyses of infective endocarditis incidence before and after current antibiotic prophylaxis guidelines were included.
DATA EXTRACTION AND SYNTHESIS
Study quality was evaluated using structured tools. Data were extracted by independent observers. A pooled relative risk (RR) of developing infective endocarditis following invasive dental procedures in individuals who were receiving antibiotic prophylaxis vs those who were not was computed by random-effects meta-analysis.
MAIN OUTCOMES AND MEASURES
The outcome of interest was the incidence of infective endocarditis following invasive dental procedures in relation to antibiotic prophylaxis.
RESULTS
Of 11 217 records identified, 30 were included (1 152 345 infective endocarditis cases). Of them, 8 (including 12 substudies) were either case-control/crossover or cohort studies or self-controlled case series, while 22 were time-trend studies; all were of good quality. Eight of the 12 substudies with case-control/crossover, cohort, or self-controlled case series designs performed a formal statistical analysis; 5 supported a protective role of antibiotic prophylaxis, especially among individuals at high risk, while 3 did not. By meta-analysis, antibiotic prophylaxis was associated with a significantly lower risk of infective endocarditis after invasive dental procedures in individuals at high risk (pooled RR, 0.41; 95% CI, 0.29-0.57; P for heterogeneity = .51; I2, 0%). Nineteen of the 22 time-trend studies performed a formal pre-post statistical analysis; 9 found no significant changes in infective endocarditis incidence, 7 demonstrated a significant increase for the overall population or subpopulations (individuals at high and moderate risk, streptococcus-infective endocarditis, and viridans group streptococci-infective endocarditis), whereas 3 found a significant decrease for the overall population and among oral streptococcus-infective endocarditis.
CONCLUSIONS AND RELEVANCE
While results from time-trend studies were inconsistent, data from case-control/crossover, cohort, and self-controlled case series studies showed that use of antibiotic prophylaxis is associated with reduced risk of infective endocarditis following invasive dental procedures in individuals at high risk, while no association was proven for those at low/unknown risk, thereby supporting current American Heart Association and European Society of Cardiology recommendations. Currently, there is insufficient data to support any benefit of antibiotic prophylaxis in individuals at moderate risk.
PubMed: 38581643
DOI: 10.1001/jamacardio.2024.0873 -
Archives of Oral Biology May 2024This systematic review summarizes the current knowledge on the association between the oral microbiota and dental caries in adolescents. (Review)
Review
OBJECTIVE
This systematic review summarizes the current knowledge on the association between the oral microbiota and dental caries in adolescents.
DESIGN
An electronic search was carried out across five databases. Studies were included if they conducted research on generally healthy adolescents, applied molecular-based microbiological analyses and assessed caries status. Data extraction was performed by two reviewers and the Newcastle-Ottawa Scale was applied for quality assessment.
RESULTS
In total, 3935 records were reviewed which resulted in a selection of 20 cross-sectional studies (published 2005-2022) with a sample size ranging from 11 to 614 participants including adolescents between 11 and 19 years. The studies analyzed saliva, dental biofilm or tongue swabs with Checkerboard DNA-DNA hybridization, (q)PCR or Next-Generation Sequencing methods. Prevotella denticola, Scardoviae Wiggsiae, Streptococcus sobrinus and Streptococcus mutans were the most frequently reported species presenting higher abundance in adolescents with caries. The majority of the studies reported that the microbial diversity was similar between participants with and without dental caries.
CONCLUSION
This systematic review is the first that shows how the oral microbiota composition in adolescents appears to differ between those with and without dental caries, suggesting certain taxa may be associated with increased caries risk. However, there is a need to replicate and expand these findings in larger, longitudinal studies that also focus on caries severity and take adolescent-specific factors into account.
Topics: Humans; Adolescent; Dental Caries; Cross-Sectional Studies; Streptococcus mutans; Saliva; Microbiota; DNA
PubMed: 38447351
DOI: 10.1016/j.archoralbio.2024.105933 -
International Journal of Molecular... Oct 2023We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on . The... (Meta-Analysis)
Meta-Analysis Review
We conducted a meta-analysis and systematic review to investigate the efficacy of chitosan-containing chewing gums, and to test their inhibitory effects on . The systematic search was performed in three databases (Cochrane Library, EMBASE, and PubMed) and included English-language randomized-controlled trials to compare the efficacy of chitosan in reducing the number of . To assess the certainty of evidence, the GRADE tool was used. Mean differences were calculated with a 95% confidence interval for one outcome: bacterial counts in CFU/mL. The protocol of the study was registered on PROSPERO, registration number CRD42022365006. Articles were downloaded ( = 6758) from EMBASE ( = 2255), PubMed ( = 1516), and Cochrane ( = 2987). After the selection process, a total of four articles were included in the qualitative synthesis and three in the quantitative synthesis. Our results show that chitosan reduced the number of bacteria. The difference in mean quantity was -4.68 × 10. The interval of the random-effects model was [-2.15 × 10; 1.21 × 10] and the prediction interval was [1.03 × 10; 9.40 × 10]. The I2 value was 98% ( = 0.35), which indicates a high degree of heterogeneity. Chitosan has some antibacterial effects when used as a component of chewing gum, but further studies are needed. It can be a promising antimicrobial agent for prevention.
Topics: Humans; Streptococcus mutans; Saliva; Chitosan; Anti-Infective Agents; Anti-Bacterial Agents; Chewing Gum; Dental Caries
PubMed: 37894948
DOI: 10.3390/ijms242015270 -
BMC Oral Health Sep 2023The review aims to determine the risk predictability of mutans streptococci in the development of carious lesions in children with primary dentition. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The review aims to determine the risk predictability of mutans streptococci in the development of carious lesions in children with primary dentition.
METHODS
Longitudinal observational studies with at least 6 months follow-up and evaluating mutans streptococci presence in caries-free children under 6 years of age for the development of any cavitated or non-cavitated carious lesion. Six databases and grey literature were searched without any restrictions. Risk of bias was evaluated using the New Castle Ottawa scale for longitudinal studies, and the certainty of the evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation using GRADEpro software. Meta-analysis was performed using a random effect (DerSimonian and Laird, DL) model, and heterogeneity was evaluated using tau-squared, I statistics and prediction interval. Sensitivity analysis was performed to assess the relationship between the mutans streptococci presence at baseline and the caries development, according to the sample and methods used for the microbiological assessment and the length of follow-up of the studies. Publication bias was checked by funnel plot using a random effect (DerSimonian and Laird, DL) model.
RESULTS
Twelve studies met the inclusion criteria and were included in the review. Four studies received a maximum of 9 stars, and among the remaining eight studies, six received 8 stars and the rest two studies were assigned 7 stars in the risk of bias scale. After pooling the results quantitatively, odds ratio (OR) was found to be 4.13 (95% CI: 3.33, 5.12), suggesting that children with mutans streptococci had 4 times higher odds of developing caries later (p < 0.001). Four studies were pooled to compare future caries experience among children with and without mutans streptococci at baseline, obtaining standardized mean difference (SMD) of 0.85 (95% CI: 0.33, 1.37), indicating a large effect (p < 0.001). Certainty of evidence was found to be moderate, and no publication bias was reported by the funnel plot criteria of symmetry.
CONCLUSIONS
Presence of mutans streptococci in a preschool child is a risk predictor for future caries experience. Early identification of children with increased caries-risk may facilitate in implementation of appropriate preventive strategies.
Topics: Humans; Child, Preschool; Dental Caries; Databases, Factual; Odds Ratio; Publication Bias; Software; Streptococcus mutans
PubMed: 37679718
DOI: 10.1186/s12903-023-03346-8 -
European Journal of Orthodontics Sep 2023The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
The effect of probiotics on oral health maintenance in orthodontic patients remains controversial. The aim of the study is to systematically review and assess the effects of probiotics on the oral health and microbiome of patients undergoing orthodontic treatment.
SEARCH METHODS AND SELECTION CRITERIA
Databases including PubMed, Web of Science, Cochrane Library, ClinicalTrials.gov, and ProQuest Dissertations & Theses Global databases were searched from their inception until June 2022. Randomised controlled trials that assessed the effects of probiotics on clinical and microbial outcomes in patients undergoing orthodontic treatment were included.
DATA COLLECTION AND ANALYSIS
Data screening and collection were performed, and the risk of bias (RoB) was assessed using the Cochrane RoB 2 tool. The meta-analysis evaluated the effects of probiotics on Streptococcus mutans (S. mutans) and Lactobacillus counts. The quality of the evidence from the meta-analyses was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS
A total of 405 records were identified, of which 15 studies were included in the qualitative synthesis and 4 in the meta-analysis. The patients in all the included studies were treated with fixed orthodontic appliances. Results regarding clinical outcomes were controversial; four out of five studies reported no significant changes in plaque in the probiotic group (P > .05), and two out of three studies reported no significant changes in the gingival index (P > .05). Regarding microbial outcomes, the meta-analysis results revealed that probiotics significantly increased the likelihood of reducing the abundance of S. mutans to below 105 CFU/ml (risk ratio: 2.05 [1.54, 2.72], P < .001) and reduced the likelihood of increasing the abundance of S. mutans to beyond 106 CFU/ml (risk ratio: 0.48 [0.28, 0.83], P = .009). However, the quality of evidence according to the GRADE was moderate.
CONCLUSIONS AND IMPLICATIONS
There is insufficient evidence to determine the clinical benefits of probiotics as a supplement for the oral health of patients undergoing orthodontic treatment. However, probiotics may have benefits in reducing the salivary S. mutans counts in orthodontic patients.
REGISTRATION
PROSPERO (CRD42022366650).
Topics: Humans; Oral Health; Probiotics; Dietary Supplements; Orthodontic Appliances, Fixed; Streptococcus mutans
PubMed: 37552088
DOI: 10.1093/ejo/cjad046 -
Antibiotics (Basel, Switzerland) Jul 2023, a normal inhabitant of the oral cavity, is a member of Viridans Group Streptococci (VGS). Generally recognized as a causative agent of invasive diseases in... (Review)
Review
, a normal inhabitant of the oral cavity, is a member of Viridans Group Streptococci (VGS). Generally recognized as a causative agent of invasive diseases in immunocompromised patients, is considered to have low pathogenic potential in immunocompetent individuals. We present a rare case of sinusitis complicated by meningitis and cerebral sino-venous thrombosis (CSVT) caused by in a previously healthy 12-year-old boy with poor oral health status. With the aim of understanding the real pathogenic role of this microorganism, an extensive review of the literature about invasive diseases due to in pediatric patients was performed. Our data define the critical role of this microorganism in invasive infections, especially in immunocompetent children and in the presence of apparently harmful conditions such as sinusitis and caries. Attention should be paid to the choice of therapy because of VGS's emerging antimicrobial resistance patterns.
PubMed: 37508318
DOI: 10.3390/antibiotics12071222 -
European Journal of Clinical... Sep 2023Hematogenous osteomyelitis caused by Streptococcus intermedius is rare, particularly in immunocompetent adults. The aim of this paper is to provide an overview of the... (Review)
Review
Hematogenous osteomyelitis caused by Streptococcus intermedius is rare, particularly in immunocompetent adults. The aim of this paper is to provide an overview of the clinical presentation, prognosis as well as treatment of this disease, with the focus on immunocompetent adults. Six medical literature libraries were searched to identify studies reporting on Streptococcus intermedius induced hematogenous osteomyelitis in immunocompetent adults. In addition, we presented a case of a 44-year-old man from our institution that is illustrative for this disease. Four case reports describing four patients were identified by this systematic literature review. Hence, the data of five patients (including our case) were assessed. The most common presenting symptom was localised pain, followed by fever. Portal entries were found in two patients (general periodontitis and necrotic dentition). The localisations of osteomyelitis were diverse: femoral (two patients), lumbar spine (two patients), and the iliac bone (one patient). Treatment strategies varied strongly, but antibiotics (penicillins) were administered in each case, and two patients underwent surgical debridement. Follow-up ranged from 2 weeks to more than 6 months; one patient died from septic shock. Only a very limited number of immunocompetent adults with Streptococcus intermedius induced hematogenous osteomyelitis have been described. Based on the available data, we summarised the clinical presentation, prognosis as well as treatment of hematogenous osteomyelitis caused by Streptococcus intermedius in this patient population.
Topics: Male; Humans; Adult; Streptococcus intermedius; Anti-Bacterial Agents; Prognosis; Osteomyelitis
PubMed: 37468663
DOI: 10.1007/s10096-023-04640-7