Injectable Platelet-Rich Fibrin and Advanced Platelet-Rich Fibrin Demonstrate Enhanced Anti-Biofilm Effect Compared to Enamel Matrix Derivatives on Decontaminated Titanium Surfaces.

BACKGROUND: The search for effective antimicrobial agents to mitigate peri-implant infections remains a crucial aspect of implant dentistry. This study aimed to evaluate and compare the antimicrobial efficacy of i-PRF, A-PRF+, and enamel matrix derivative (EMD) on decontaminated rough and smooth titanium (Ti) discs. MATERIALS AND METHODS: Rough and smooth Ti discs were coated with multispecies biofilm and thoroughly debrided using a chitosan-bristled brush. Subsequently, i-PRF, A-PRF+, and EMD were applied. Untreated discs served as control. Residual adherent bacteria present on the treated Ti discs were visualized by SEM and quantified using culture technique, and colony-forming units (CFUs) were measured after 48 h and 7 days. RESULTS: i-PRF demonstrated better antimicrobial effectiveness on both smooth and rough implant surfaces as compared to A-PRF+ and EMD (p < 0.001). In all the experimental groups, smooth Ti discs displayed a greater reduction in microbes compared to rough Ti discs when treated with the biologics. The major reduction in CFU values was determined after seven days. CONCLUSIONS: i-PRF as a regenerative material may also be suitable for decontaminating implant surfaces, which could influence tissue healing and regenerative outcomes positively.

Polymeric functionalization of mesoporous silica nanoparticles: Biomedical insights.

Mesoporous silica nanoparticles (MSNs) endowed with polymer coatings present a versatile platform, offering notable advantages such as targeted, pH-controlled, and stimuli-responsive drug delivery. Surface functionalization, particularly through amine and carboxyl modification, enhances their suitability for polymerization, thereby augmenting their versatility and applicability. This review delves into the diverse therapeutic realms benefiting from polymer-coated MSNs, including photodynamic therapy (PDT), photothermal therapy (PTT), chemotherapy, RNA delivery, wound healing, tissue engineering, food packaging, and neurodegenerative disorder treatment. The multifaceted potential of polymer-coated MSNs underscores their significance as a focal point for future research endeavors and clinical applications. A comprehensive analysis of various polymers and biopolymers, such as polydopamine, chitosan, polyethylene glycol, polycaprolactone, alginate, gelatin, albumin, and others, is conducted to elucidate their advantages, benefits, and utilization across biomedical disciplines. Furthermore, this review extends its scope beyond polymerization and biomedical applications to encompass topics such as surface functionalization, chemical modification of MSNs, recent patents in the MSN domain, and the toxicity associated with MSN polymerization. Additionally, a brief discourse on green polymers is also included in review, highlighting their potential for fostering a sustainable future.

Antimicrobial, anti-adhesion, anti-biofilm properties of goji berry (Lycium barbarum) against periodontal bacteria: potential benefits for periodontal diseases.

OBJECTIVES: Lycium barbarum, commonly known as goji berry, Himalayan berry, or Tibetian berry, is emerging as a popular "superfood" with anti-inflammatory and antioxidant properties. However, its use for the management of oral inflammatory diseases has not been explored. The present study aims to evaluate the antimicrobial, anti-adhesion, anti-biofilm, and cytotoxic properties of an ethanolic extract of L. barbarum (LBE) against common oral and periodontal pathogens. METHODS: The antimicrobial properties of LBE against five potential periodontal pathogens (Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Prevotella intermedia, Tanerella forsythia) were tested and compared to chlorhexidine and doxycycline using serial dilution and disc diffusion assay. The MTT Assay was performed for evaluating the cytotoxicity and cell viability of the LBE on the gingival fibroblast and modified keratinocyte cell lines. The anti-adhesion and anti-biofilm properties of LBE against P. gingivalis at its minimal bactericidal value were also assessed. RESULTS: LBE inhibited the growth of periodontal pathogens as compared to control, however, the zone of inhibition of LBE was less when compared to doxycycline and chlorhexidine. The de novo extract showed a maximum zone of inhibition against Tf and Aa. The LBE extract was also compatible to gingival fibroblast tissues and oral keratinocytes at 1 mg/mL. CONCLUSIONS: L. barbarum is a promising alternative to Chlorhexidine for the management of oral and periodontal infections.

Effect of Maleic Acid Root Conditioning on Release of Transforming Growth Factor Beta 1 from Infected Root Canal Dentin.

INTRODUCTION: Chemically released growth factors play a vital role in regenerative endodontics. Transforming growth factor beta 1 (TGF-ß1) is 1 of the most extensively studied bioactive molecules that promotes cell proliferation, differentiation, and chemotaxis. The goal of the current research was to analyze the effect of 7% maleic acid (MA) root conditioning of an infected root canal on the release of TGF-ß1. METHODS: Single-rooted human teeth were decoronated, and the canals were enlarged with a Peeso reamer. The samples were divided into biofilm and nonbiofilm groups. Subsequently, all the samples of both groups were flushed with 10 mL of each irrigant, namely, 1.5% sodium hypochlorite (NaOCl), 7% MA, 17% EDTA, and a combination of 1.5% NaOCl with 17% EDTA or 7% MA, for 10 minutes each. TGF-ß1 was estimated quantitatively using an enzyme-linked immunosorbent assay kit. RESULTS: TGF-ß1 release was lowest among the biofilm samples compared with nonbiofilm among all the groups. MA 7% with 1.5% NaOCl rendered higher amounts of growth factor release in contrast to the combination of 17% EDTA and 1.5% NaOCl in both the biofilm and nonbiofilm groups (P < .048). The nonbiofilm samples treated with 7% MA alone illustrated higher growth factor release compared with 17% EDTA only (P < .006), but there was no significant difference in growth factor release among the biofilm samples treated with 7% MA and 17% EDTA. CONCLUSIONS: Bacterial biofilms modified the release of TGF-ß1. MA 7% was observed to be significantly more efficacious than 17% EDTA in TGF-ß1 growth factor release from radicular dentin.

Clinico-microbiological profile of Bacteroides fragilis with focus on molecular detection of emerging resistance.

Background & objective: Bacteroides fragilis is a Gram-negative anaerobic opportunistic pathogen which is managed by empirical anaerobic coverage as a hospital norm. However, with rising reports of resistance among B. fragilis strains, antibiotic susceptibility testing for this pathogen may be the only way to understand the magnitude of the problem. This study aimed to characterize resistance patterns among clinical isolates and identify resistance genes. Methods: A prospective observational study was conducted which included all samples requesting anaerobic cultures within the study period. Minimum inhibitory concentration (MIC) was detected for metronidazole, clindamycin and chloramphenicol by agar dilution. E-test strips were used for imipenem and piperacillin, followed by polymerase chain reaction to detect nim and cfiA genes. Results: Among a total of 50 isolates, 94 per cent (47/50) were susceptible and six per cent (3/50) showed intermediate resistance to metronidazole. Susceptibility to clindamycin and piperacillin was noted in 70 and 50 per cent of strains; intermediate resistance in 14 and 2 per cent and resistance in 16 and 48 per cent, respectively. No resistance was observed for chloramphenicol and imipenem. Nim gene was found in 26 per cent (13/50) and cfiA gene was found in 52 per cent (26/50) of isolates. Isolates with high metronidazole MIC of 8-16 µg/ml were found to carry nim gene (χ2 test, P<0.001). Interpretation & conclusions: Rising resistance among B. fragilis is evident and there is a significant association between nim gene and metronidazole resistance. Improving awareness among clinicians is paramount in tackling AMR among these pathogens, as empirical anaerobic coverage may not be effective in all cases.

Evaluation of various irrigation activation systems to eliminate bacteria from the root canal system: A randomized controlled single blinded trial.

OBJECTIVE: To evaluate the effect of NaOCl irrigant activation using passive ultrasonic activation, F-files, XP-endo Finisher files and or needle irrigation alone on the reduction of intracanal bacteria from root canals in teeth undergoing root canal treatment. METHODS: Eighty patients with asymptomatic apical periodontitis were randomly divided into four groups. Access cavities were prepared and pre-treatment samples were taken (S1). Canals were then prepared and post-instrumentation samples (S2) taken. NaOCl was then activated with the various irrigant activation systems and post-irrigation samples (S3) taken. The samples were processed and colony forming units (CFUs) of bacteria were determined. The reduction in CFUs among the experimental groups were analysed using the Kruskal Wallis test and pairwise comparisons with the Mann-Whitney test. The Friedman test was used to compare the differences in the reduction of CFUs within the groups. RESULTS: Overall, for all groups there was a significant reduction in the CFUs from S1 to S2 (P < 0.05) and from S2 to S3 (P < 0.05). Both XP-endo Finisher and passive ultrasonic activation techniques were associated with the greatest reduction in CFUs with no significant difference between them (P = 0.24). However, both were associated with significantly lower CFUs when compared to F-file activation and needle irrigation (P < 0.05). F-file activation reduced the CFUs significantly more compared to needle irrigation (P = 0.04). CONCLUSIONS: XP-endo Finisher file activation and passive ultrasonic activation were equivalent in terms of reduction in CFUs. F-file activation did not reduce the CFUs to the same extent as the XP-endo Finisher file and ultrasonic activation but reduced the CFUs more than needle irrigation. CLINICAL SIGNIFICANCE: The present study highlights the effect of new XP-endo Finisher file and passive ultrasonic activation in reducing the bacterial load from the root canal system which is important for the success of root canal treatment.

Microbiological profile of chronic osteomyelitis with special reference to anaerobic osteomyelitis in a tertiary care hospital of coastal Karnataka.

Chronic osteomyelitis is a relapsing, persistent, low-grade inflammation of bone caused by various infectious agents. The present study, conducted over a two-year period, on specimens received from cases of chronic osteomyelitis was, to determine the frequency of isolation of aerobic and anaerobic bacteria and to analyse their antimicrobial susceptibility pattern. Specimens were processed for Gram stain, aerobic and anaerobic culture, and were identified according to standard techniques. Significant growth was observed in 102/204 specimens, in which aerobic growth was observed in 62 (60.8%) and anaerobic in 40 (39.2%). Resistance to metronidazole and clindamycin was observed in 6.7% and 30% of the anaerobic isolates, respectively. None of these were resistant to meropenem. A significant proportion of anaerobic isolates were found to be resistant to commonly used empirical drugs, such as clindamycin, thus necessitating a need for routine anaerobic susceptibility testing.

Correlation Between Microbiological Profiles of Adenoid Tissue and Nasal Discharge in Children with Co-existent Chronic Adenoiditis and Chronic Rhinosinusitis.

Chronic adenoiditis leading to adenoid hypertrophy is common in children. Many cases would also have co-existing chronic rhinosinusitis (CRS). Infact, long lasting bacterial infection of the adenoids has been hypothesized to be the cause for CRS in these children. A cross-sectional study was conducted in the departments of ENT and Micro-biology at Kasturba Hospital, Manipal, India between 2016 and 2017. 20 subjects who were diagnosed with CRS and adenoid hypertrophy took part in the study. Aerobic, anaerobic and fungal culture sensitivity of adenoid tissue was done along with aerobic and fungal culture sensitivity of nasal swabs from middle meatus. 2 out of 20 adenoid samples showed positive culture for aerobes and 19 adenoid samples grew anaerobic organisms. 7 out of 20 nasal swabs grew some aerobes and 2 were positive for fungal organisms. The correlation of microorganisms between adenoid hypertrophy and CRS was seen only in one patient in which methicillin resistant Staphylococcus aureus was grown. The present study showed mixed flora in the adenoid samples with anaerobic predominance. Aerobes were predominantly grown in nasal swabs from patients with CRS along with fungal colonizers. Though the study does not establish any bacteriological association with the CRS in our cohorts, the significant growth of the anaerobes from the core of the inflamed adenoids has prompted us to suggest the inclusion of the antibiotics against the anaerobes in the medical management of these children, whenever feasible. We think the addition of specific antibiotics to tackle anaerobes helps by hampering the further inflammatory hypertrophy of adenoid tissue.