Prevalence of Enterococcus species in adults with periodontal health or with periodontitis: a systematic review

Abstract The aim of this study was to evaluate the prevalence of Enterococcus species in the mouth of adults with periodontal health and periodontitis. A systematic search was made in databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search for articles was conducted in Medline/PubMed, Latin American and Caribbean Health Sciences Literature Database (LILACS), Cochrane Library, Scopus, Embase, Web of Science databases and in the System of Information on Grey Literature in Europe (SINGLE) and included articles published in English up to April 25th, 2021. Observational studies in humans with and without periodontitis were evaluated to identify the prevalence of Enterococcus species. Articles that met the inclusion criteria were analyzed and classified to determine the quality rating in good, fair, and poor. A new detailed checklist for quality assessment was developed based on the information required for applicable data extraction in reviews. The study design, sample size, demographic data, periodontal clinical parameters, microbial analysis method, biological sample, prevalence of Enterococcus spp., and correlations with periodontal clinical parameters were assessed. After screening and full-text reading, 8 articles met the inclusion criteria. All selected studies showed a significantly higher prevalence of Enterococcus spp. in patients with periodontitis compared with periodontally healthy patients. Thus, the present systematic review suggests that the prevalence of Enterococcus faecalis in the mouth of periodontitis individuals is higher than that of periodontally healthy individuals.

Long-term evaluation of the antimicrobial susceptibility and microbial profile of subgingival biofilms in individuals with aggressive periodontitis

This study evaluates the antimicrobial susceptibility and composition of subgingival biofilms in generalized aggressive periodontitis (GAP) patients treated using mechanical/antimicrobial therapies, including chlorhexidine (CHX), amoxicillin (AMX) and metronidazole (MET). GAP patients allocated to the placebo (C, n = 15) or test group (T, n = 16) received full-mouth disinfection with CHX, scaling and root planning, and systemic AMX (500 mg)/MET (250 mg) or placebos. Subgingival plaque samples were obtained at baseline, 3, 6, 9 and 12 months post-therapy from 3–4 periodontal pockets, and the samples were pooled and cultivated under anaerobic conditions. The minimum inhibitory concentrations (MICs) of AMX, MET and CHX were assessed using the microdilution method. Bacterial species present in the cultivated biofilm were identified by checkerboard DNA-DNA hybridization. At baseline, no differences in the MICs between groups were observed for the 3 antimicrobials. In the T group, significant increases in the MICs of CHX (p < 0.05) and AMX (p < 0.01) were detected during the first 3 months; however, the MIC of MET decreased at 12 months (p < 0.05). For several species, the MICs significantly changed over time in both groups, i.e., Streptococci MICs tended to increase, while for several periodontal pathogens, the MICs diminished. A transitory increase in the MIC of the subgingival biofilm to AMX and CHX was observed in GAP patients treated using enhanced mechanical therapy with topical CHX and systemic AMX/MET. Both protocols presented limited effects on the cultivable subgingival microbiota.

Análise ultra-estrutural e microbiológica da associação de clorexidina e hidroxiapatita: potencial material para terapia de doença periodontal / Ultrastructural analysis of the association of chlorhexidine and hydroxyapatite: potential material for periodontal disease therapy

O objetivo deste trabalho foi realizar as avaliações ultra-estrutural e microbiológica de um biomaterial constituído de microesferas de hidroxiapatita associadas à clorexidina visando à aplicação no tratamento das periodontopatias. Foram desenvolvidos estudos sobre associação hidroxiapatita e clorexidina e feitas caracterizações físicas e morfológicas. Ensaios microbiológicos foram realizados para avaliação da capacidade de microesferas de hidroxiapatita contendo clorexidina de inibir o crescimento de E. faecalis. Os resultados demonstraram uma ligação estável entre hidroxiapatita e clorexidina sem prejudicar a estrutura cristalina da hidroxiapatita após a adsorção de clorexidina. A clorexidina presente na hidroxiapatita manteve atividade antimicrobiana inibindo o crescimento de E. faecalis. Os resultados obtidos sinalizam para a realização de testes in vivo e a aplicação do material obtido em estudos pré-clínicos.

The aim of this study was the ultrastructural and microbiological evaluations of a biomaterial composed of hydroxyapatite microspheres associated with chlorhexidine designing their application in the treatment of periodontal diseases. Studies were conducted on hydroxyapatite and chlorhexidine association and made physical and morphological characterizations. Microbiological tests were conducted to evaluate the ability of hydroxyapatite microspheres containing chlorhexidine to inhibit the proliferation of E. faecalis. The results demonstrated a stable Bond between hydroxyapatite and chlorhexidine, with maintenance of the crystalline structure of hydroxyapatite after adsorption of chlorhexidine. Chlorhexidine present in hydroxyapatite maintained antimicrobial activity inhibiting the growth of E. faecalis. The results point out the in vivo testing and application of the material obtained in preclinical studies.