Advancing antimicrobial strategies for managing oral biofilm infections

Abstract

Effective control of oral biofilm infectious diseases represents a major global challenge. Microorganisms in biofilms exhibit increased drug tolerance compared with planktonic cells. The present review covers innovative antimicrobial strategies for controlling oral biofilm-related infections published predominantly over the past 5 years. Antimicrobial dental materials based on antimicrobial agent release, contact-killing and multi-functional strategies have been designed and synthesized for the prevention of initial bacterial attachment and subsequent biofilm formation on the tooth and material surface. Among the therapeutic approaches for managing biofilms in clinical practice, antimicrobial photodynamic therapy has emerged as an alternative to antimicrobial regimes and mechanical removal of biofilms, and cold atmospheric plasma shows significant advantages over conventional antimicrobial approaches. Nevertheless, more preclinical studies and appropriately designed and well-structured multi-center clinical trials are critically needed to obtain reliable comparative data. The acquired information will be helpful in identifying the most effective antibacterial solutions and the most optimal circumstances to utilize these strategies.

Fighting Mixed-Species Microbial Biofilms With Cold Atmospheric Plasma

“…Therefore, methods that destroy the EPS are effective for biofilm prevention. For instance, eDNA is widely present in biofilms and DNase treatment is currently considered effective in curing biofilm infections (Jiao et al, 2019). A study reported that a SigB(Q225P) mutation can enhance the S. aureus biofilm by downregulating the expression of the nuc gene, and the biofilm is evidently reduced after DNase I treatment compared with the untreated strain (Liu et al, 2018).…”

“…The "cocktail" constituents of plasma, including molecules and neutral atoms, charged particles, metastable radicals, and photons, play synergistic functions in microbial inactivation (Guo et al, 2018). In recent years, cold atmospheric plasma (CAP) has been extensively investigated for its potential as an alternative treatment in wound healing, dental cure, oncological therapy, and food decontamination (Scholtz et al, 2015;Jiao et al, 2019;Eggers et al, 2020). Significant progress has been made in controlling mixed-species biofilms with CAP, which is considered a rapid, environmentally friendly, energy saving, and versatile antimicrobial technology (Šimončicová et al, 2019).…”

Novel Bioactive and Therapeutic Root Canal Sealers with Antibacterial and Remineralization Properties

“…Antimicrobial agents exert their effects based on one of three different strategies: (1) through their local release; (2) through contact-killing; or (3) through multi-functional strategy to produce synergetic properties [34]. The latter offers the advantage of overcoming the drawbacks associated with the exhaustion of the releasing agents and the short-distance killing of the contact-mediated agents.…”

“…Back in the 1950s, Colten introduced the idea of releasing antimicrobial agents when he incorporated antibiotics into dental fillings [34,36]. This strategy allows for the local delivery of high concentrations of the preloaded antimicrobial agents without dealing with the adverse toxic effects related to systemic drug delivery [34]. Since then, this strategy has gained wide popularity.…”

“…Since then, this strategy has gained wide popularity. However, due to the emerging antibacterial resistance and allergic host response to antibiotics, their frequent use is not recommended [34]. Other releasing antimicrobial agents have been introduced and incorporated into various dental materials.…”