Comparative evaluation of antioxidant activity, total phenolic content, anti-inflammatory, and antibacterial potential of Euphorbia-derived functional products.

This study assessed the medicinal properties of Euphorbia resinifera O. Berg (E. resinifera) and Euphorbia officinarum subsp echinus (Hook.f. and Coss.) Vindt (Euphorbia echinus, known for their pharmaceutical benefits. Extracts from their flowers, stems, propolis, and honey were examined for phenolic content, antioxidant, anti-inflammatory, and antibacterial activities. Total phenolic content (TPC), total flavonoid content (TFC), and total condensed tannin (TCC) were determined using specific methods. Antioxidant potential was assessed through various tests including DPPH, FRAP, ABTS, and Total antioxidant capacity. Anti-inflammatory effects were evaluated using phenol-induced ear edema in rats, while antibacterial activity was measured against Gram-positive (Staphylococcus aureus ATCC 6538) and Gram-negative (E. coli ATCC 10536) bacteria. Among the extracts, the aqueous propolis extract of E. resinifera demonstrated exceptional antioxidant capabilities, with low IC50 values for DPPH (0.07 ± 0.00 mg/mL) and ABTS (0.13 ± 0.00 mg/mL), as well as high TAC (176.72 ± 0.18 mg AA/mg extract) and FRAP (86.45 ± 1.45 mg AA/mg extract) values. Furthermore, the anti-inflammatory effect of E. resinifera propolis extracts surpassed that of indomethacin, yielding edema percentages of 3.92% and 11.33% for the aqueous and ethanolic extracts, respectively. Microbiological results indicated that the aqueous extract of E. resinifera flower exhibited the most potent inhibitory action against S. aureus, with an inhibition zone diameter (IZD) of 21.0 ± 0.00 mm and a minimum inhibitory concentration (MIC) of 3.125 mg/mL. Additionally, only E. resinifera honey displayed the ability to inhibit E. coli growth, with an inhibition zone diameter of 09.30 ± 0.03 mm and a MIC of 0.0433 mg/mL.

Salivary Biomarkers in Periodontitis Patients: A Pilot Study.

Materials and Methods: Forty subjects were included: 10 periodontally healthy subjects and 30 periodontitis patients. Periodontal examination and saliva sampling were performed in all patients. Levels of salivary cytokines including IL-1ß, IL-6, MMP-8, and IL-10 were evaluated by a sandwich ELISA test kit. Data were analyzed by SPSS for Windows. Results: Regarding individual biomarkers, IL-1ß, IL-6, and MMP-8 levels were significantly higher in periodontitis patients (p ≤ 0.001, p < 0.05, respectively). The concentration of these proteins in saliva showed a significant association with gingival index and pocket depth measurements and may reflect the clinical status of healthy and diseased periodontium. However, no significant differences were observed for the IL-10 component. Conclusion: IL-1ß and IL-6 concentrations were statistically higher in periodontitis patients and may be used as potential tools in periodontitis diagnosis.

Oral Hygiene Status in Rheumatoid Arthritis Patients and Related Factors.

OBJECTIVES: To evaluate oral hygiene status in Rheumatoid arthritis (RA) patients, to analyse possible related factors, and to investigate the role of the rheumatologist in information about importance of adequate oral hygiene status in RA patients. METHODS: A cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 ± 11.7 years). For each patient, we recorded oral symptoms, oral hygiene status and role of rheumatologist in information on the oral hygiene status. Factors associated with regular brushing (≥2/day) were also analysed. RESULTS: Median disease duration was 8 years (4;2). Dental pain was reported by 74% of patients and bleeding by 51% of them. Regular brushing was noted in 45% of patients. The use of a correct brushing method was noted in 14% of cases. Two patients reported visiting a dentist regularly. Information explaining that poor oral hygiene has a negative impact on RA was delivered by rheumatologist to 11 patients. Regular brushing of teeth was recommended by rheumatologist to 8 patients and 10 patients were advised by their rheumatologist to consult a dentist. Regular brushing was more important in women (48,3% vs 18,2%; p=0.05) and in the literate patients (57,6 vs 31,2%, p<0.01). No association was found between regular brushing, Disease Activity Score 28 (DAS28) and health Assessment Questionnaire (HAQ). CONCLUSION: This study illustrates bad oral hygiene status in RA patients, which seems more important in men and illiterate patients. It also highlights poor information given by the rheumatologist.

In Vitro Antibacterial Activity of Myrtus communis L. and Marrubium vulgare L. Leaves against Aggregatibacter actinomycetemcomitans and Eikenella corrodens.

MATERIALS AND METHODS: Clinical strains of Aggregatibacter actinomycetemcomitans and Eikenella corrodens and two reference strains of A. actinomycetemcomitans were tested. The antibacterial activity of each studied plant extract was evaluated using agar diffusion and broth microdilution assays. RESULTS: Both aqueous and methanolic extracts of M. communis exhibited high antibacterial activity against periodontal pathogens as compared to M. vulgare extracts. At concentrations of 2.5-0.32 mg/disc, inhibition zones of the methanolic extract of M. communis ranged from 19.66 ± 0.57 to 12.33 ± 0.57 mm. The methanolic extract of M. vulgare showed at concentrations of 5-0.63 mg/disc inhibition zones ranging from 15.66 ± 0.57 to 12 ± 0.00 mm. Its aqueous extract at concentration of 0.63 mg/disc showed no antimicrobial activity against the clinical and reference strain of A. actinomycetemcomitans. Conclusion. This study showed that methanolic and aqueous extracts of M. communis and M. vulgare have in vitro an antibacterial activity against periodontal pathogens. They could be use as ingredients of an oral antimicrobial agent for prevention or treatment of periodontal diseases. Further research on isolating the compounds from these plant extracts and their toxicity effect could be conducted.

Handwashing revisited in dental practice during the COVID-19 outbreak.

Healthcare-associated infections are well-studied in the literature, but remain a significant challenge for healthcare workers (HCWs) in dental practice. This type of infection is strongly correlated with the hand route of transmission of infectious agents. Thus, hand hygiene can be considered a crucial element in the prevention and control of infections.The coronavirus disease 2019 (COVID-19) outbreak is an experience of a new human coronavirus infection that has been difficult for HCWs, such as dentists and dental assistants, to control. Handwashing (HW) is a keystone method for the prevention and control of spreading severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).In healthcare settings, contrary to the general consideration of HW as a simple practice, HW is regarded as a specific procedure that should be clearly instructed to HCWs. Handwashing is based on using a correct method and the necessary equipment, and its role should be continually emphasized to reinforce compliance. Proper HW might contribute to avoiding possible cross-infection during healthcare activities, particularly in the pandemic situation.The aim of this article was to report on different HW techniques in medical and dental practice, and appropriate HW equipment to perform this simple but important procedure to prevent cross-infection, particularly during the current COVID-19 outbreak.

Etiology of aggressive periodontitis in individuals of African descent.

Aggressive periodontitis (AgP) is a form of periodontitis that affects adolescents and has a significantly higher prevalence in individuals of African descent. AgP typically shows familial aggregation, suggesting a genetic predisposition. Young age, good health status, rapid attachment loss, and familial aggregation are the primary features of this disease. AgP has been closely linked to specific bacterial strains of Aggregatibacter actinomycetemcomitans. A. actinomycetemcomitans strains isolated from patients with AgP produce leukotoxin (LtxA), which specifically affects polymorphonuclear leukocytes in primates, especially humans. High-throughput 16S rRNA gene sequencing and bioinformatics analyses revealed differences in the subgingival microbiota between patients with AgP and those with chronic periodontitis (ChP). The genera Atopobium and Prevotella show increased prevalences in AgP than in ChP. According to AgP susceptibility, several single nucleotide polymorphisms have been detected in different genes in individuals of African descent. Interleukin (IL)-1α and IL-1ß genetic polymorphisms may be associated with the severity of both ChP and AgP. An elevated serum level of IL-17 produced by Th17 cells may be a characteristic of AgP. Analyses of the relationships among bacteria, host defenses, genetic predisposition, and numerous other factors are required to understand the progression of this disease.

Chemical Composition, Antimicrobial activity, in Vitro Cytotoxicity and Leukotoxin Neutralization of Essential Oil from Origanum vulgare against Aggregatibacter actinomycetemcomitans.

In this study, the essential oil of Origanum vulgare was evaluated for putative antibacterial activity against six clinical strains and five reference strains of Aggregatibacter actinomycetemcomitans, in comparison with some antimicrobials. The chemical composition of the essential oil was analyzed, using chromatography (CG) and gas chromatography-mass spectrometry coupled (CG-MS). The major compounds in the oil were Carvacrol (32.36%), α-terpineol (16.70%), p-cymene (16.24%), and Thymol (12.05%). The antimicrobial activity was determined by an agar well diffusion test. A broth microdilution method was used to study the minimal inhibitory concentration (MIC). The minimal bactericidal concentration (MBC) was also determined. The cytotoxicity of the essential oil (IC50) was <125 µg/mL for THP-1 cells, which was high in comparison with different MIC values for the A. actinomycetemcomitans strains. O. vulgare essential oil did not interfere with the neutralizing capacity of Psidium guajava against the A. actinomycetemcomitans leukotoxin. In addition, it was shown that the O. vulgare EO had an antibacterial effect against A. actinomycetemcomitans on a similar level as some tested antimicrobials. In view of these findings, we suggest that O.vulgare EO may be used as an adjuvant for prevention and treatment of periodontal diseases associated to A. actinomycetemcomitans. In addition, it can be used together with the previously tested leukotoxin neutralizing Psidium guajava.

Global prevalence of aggressive periodontitis: A systematic review and meta-analysis.

AIM: The prevalence of aggressive periodontitis (AgP) varies considerably between studies. The aim of this meta-analysis was to estimate, throughout the world, the prevalence of this disease. MATERIALS AND METHODS: Pubmed/Medline, Scopus, Science Direct, EBSCO and Cochrane library were systematically searched up to March 2018. Study selection criteria included cross-sectional studies reporting prevalence of AgP in non-specific population and permanent dentition. We assessed risk of bias using the Joanna Briggs Institute tool. A random effect meta-analysis model was used to estimate the prevalence of AgP. Publication bias was assessed by Begg and Egger's tests and visual aspect of funnel plot. RESULTS: A total of 33 articles were included. Pooled prevalence for AgP was 1.6% (95% CI 1.1-2.3). Higher pooled prevalence rates were reported in Africa (4.2%, 95% CI 2.0-7.1) and South America (4.0%, 95% CI 0.9-9.1) compared with Europe (0.1%, 95% CI 0.1-0.2). A pooled prevalence of 1.2%, 95% CI 0.5-2.2 was found in Asia and 0.8%, 95% CI 0.4-1.4 in North America. Heterogeneity between groups was statistically significant (Q statistic p < .001). CONCLUSIONS: A relatively high prevalence of AgP was found in Africa. However, the data support the weakness of the definition of this form of periodontal disease. Studies with less heterogeneity are needed to address accurately the prevalence of AgP.

Decision-Making for Residual Periodontal Pockets after Aetiological Treatment.

The practitioner may have difficulties making decisions regarding the most appropriate therapeutic approach in the case of the persistence of periodontal pockets after initial periodontal treatment. Several options may be considered: aetiologic retreatment, maintenance, surgery of the pocket or extraction of the tooth for strategic reasons or when the conservation of the tooth is impossible. There are no clear guidelines for the treatment decision. The aim of this article is to present the main factors involved in making a treatment decision. An algorithm and its background rationale are presented to help the practitioner make a decision about residual periodontal pockets after aetiological treatment.

Outcomes of nonsurgical periodontal therapy in severe generalized aggressive periodontitis.

PURPOSE: Aggressive periodontitis, especially in its severe form, was traditionally considered to have an unfavourable prognosis. It required a complex treatment and its stabilization was often achieved by surgical therapy. The aim of this study was to investigate the results of nonsurgical periodontal treatment in severe generalized forms of aggressive periodontitis. METHODS: Patients with advanced generalized aggressive periodontitis were included in the study. Probing depth (PD) of pockets ≥7 mm and clinical attachment level (CAL) of sites with attachment loss ≥5 mm were measured at baseline before nonsurgical periodontal treatment, at re-evaluation, and after treatment. The following other parameters were recorded: resolution of inflammation and bone fill. We compared the baseline values with re-evaluation and posttreatment values using the Friedman test. The Wilcoxon test with the Bonferroni correction was used for both re-evaluation and posttreatment values. RESULTS: Seven patients with 266 periodontal sites were examined. A significant difference was found between values, reported as medians with interquartile ranges, for PD at baseline (7.94 [7.33-8.19] mm) and both re-evaluation (4.33 [3.63-5.08] mm) and posttreatment (3.54 [3.33-4.11] mm) values (P=0.002). A significant difference was also found between values for CAL at baseline (9.02 [7.5-9.2] mm) and both re-evaluation (6.55 [6.30-6.87] mm) and posttreatment (6.45 [5.70-6.61] mm) (P=0.002). Inflammation was resolved and angular bone defects were repaired in all cases. CONCLUSIONS: These therapeutic results suggest that this form of periodontitis could have positive outcomes after nonsurgical periodontal treatment. The reparative potential of tissue affected by severe aggressive periodontitis should encourage clinicians to save apparently hopeless teeth in cases of this form of periodontitis.

Chlorhexidine alcohol base mouthrinse versus Chlorhexidine formaldehyde base mouthrinse efficacy on plaque control: double blind, randomized clinical trials.

BACKGROUND: Chlorhexidine is well known for its antiplaque effect. However, the mouthrinse based chlorhexidine antiplaque efficiency may vary according to the formulation of the final product. The aim of the present study was to compare anti-plaque effectiveness of two commercial mouthrinses: 0.12 % Chlorhexidine alcohol base (CLX-A) versus a diluted 0.1% Chlorhexidine non-alcohol base with 0.1% of Formaldehyde (CLX-F). MATERIALS AND METHODS: the study was a seven day randomized, double-blind, placebo-controlled trial including 30 volunteers. At the start, all participants received a dental prophylaxis. Over 7 days experimental non-brushing period, during which subjects abstained from all forms of mechanical oral hygiene, one group test rinsed twice daily with 15 ml of an alcohol base 0.12% Chlorhexidine mouthrinse. The second group test used 15 ml of alcohol free 0.1% Chlorhexidine mouthrinse base 0.1% formaldehyde twice daily. The negative control group used a placebo. Plaque indexes were recorded in all volunteers prior to treatment at Day 0, 1 and 7. RESULTS: After 7 days, the mean plaque index for the first group was 0.76 ± 0.38 compared with a mean plaque index of 1.43 ± 0.56 for the second group. The difference in plaque scores between the groups was statistically significant. CONCLUSION: the results of this study showed that rinsing with an alcohol base 0.12% Chlorhexidine mouthrinse is significantly different from rinsing with an alcohol free 0.1% Chlorhexidine mouthrinse on plaque inhibition.

Effect of periodontal therapy on prevention of gastric Helicobacter pylori recurrence: a systematic review and meta-analysis.

AIM: The aim of this review is to assess the effect of dental plaque control and periodontal therapy on prevention of gastric Helicobacter pylori (H. pylori) recurrence. MATERIALS AND METHODS: We conducted searches of electronic databases, and included controlled trials comparing periodontal treatment and eradication therapy of H. pylori with eradication therapy alone for prevention of recurrence of gastric H. pylori. We used the absence of recurrence of gastric H. pylori after the first 3 months as an outcome measure to determine relative risk of persistence of gastric H. pylori. We estimated the degree of heterogeneity among trial results using Q and I(2) statistics. RESULTS: Three trials including 298 patients were eligible according to our inclusion criteria. As significant heterogeneity was indicated by the Q statistics (p = 0.04) and I(2) (69%), we used a random-effects model to combine the data. Compared with eradication therapy alone, the adjunction of periodontal therapy significantly reduced the relative risk of persistence of gastric H. pylori by 63% (0.37 [95% CI 0.21-0.64], p = 0.0004) in patients with gastric diseases. CONCLUSIONS: The adjunction of periodontal treatment to eradication therapy appears to reduce gastric H. pylori recurrence compared with eradication therapy alone among patients with gastric diseases associated with H. pylori. The results of this meta-analysis should be taken with caution because of the limitations in the primary data.

Quantitative discrimination of Aggregatibacter actinomycetemcomitans highly leukotoxic JP2 clone from non-JP2 clones in diagnosis of aggressive periodontitis.

BACKGROUND: Aggregatibacter actinomycetemcomitans is the etiological agent of periodontitis, and there is a strong association between clone JP2 and aggressive periodontitis in adolescents of African descent. The JP2 clone has an approximately 530-bp deletion (∆530) in the promoter region of the lkt/ltx gene, which encodes leukotoxin, and this clone has high leukotoxic activity. Therefore, this clone is very important in aggressive periodontitis. To diagnose this disease, culture methods and conventional PCR techniques are used. However, quantitative detection based on qPCR for the JP2 clone has not been developed due to genetic difficulties. In this study, we developed a qPCR-based quantification method specific to the JP2 clone. METHODS: Based on our analysis of the DNA sequence of the lkt/ltx gene and its flanking region, we designed a reverse primer specific for the ∆530 deletion border sequence and developed a JP2-specific PCR-based quantification method using this primer. We also analyzed the DNA sequence of the ∆530 locus and found it to be highly conserved (97-100%) among 17 non-JP2 strains. Using the ∆530 locus, we designed a qPCR primer-probe set specific to non-JP2 clones. Next, we determined the numbers of JP2 and non-JP2 clone cells in the periodontal pockets of patients with aggressive periodontitis. RESULTS: The JP2-specific primers specifically amplified the genomic DNA of the A. actinomycetemcomitans JP2 clone and did not react with other bacterial DNA, whereas the non-JP2 specific primers reacted only with A. actinomycetemcomitans non-JP2 clones. Samples from the 88 periodontal sites in the 11 patients with aggressive periodontitis were analyzed. The bacterial cell numbers in 88 periodontal sites ranged from 0 to 4.8 × 10(8) (mean 1.28 × 10(7)) for JP2 clones and from 0 to 1.6 × 10(6) for non-JP2 clones (mean 1.84 × 10(5)). There were significant differences in the JP2 cell number between a clinical attachment level (CAL) ≤6 mm and a level ≥7 mm (p < 0.01). Our new qPCR-based JP2- and non-JP2-specific quantitative detection assay is applicable to the diagnosis of aggressive periodontitis with A. actinomycetemcomitans. CONCLUSIONS: We successfully developed a quantitative and discriminative PCR-based method for the detection of A. actinomycetemcomitans JP2 and non-JP2 clones. This technique will contribute to future analyses of the quantitative relationship between this organism and aggressive periodontitis.

Proteomic and immunoproteomic analysis of Aggregatibacter actinomycetemcomitans JP2 clone strain HK1651.

The proteome of Aggregatibacter actinomycetemcomitans HK1651 (JP2 clone) and immunoreactive antigens were studied by two-dimensional (2D) gel electrophoresis, matrix-assisted laser desorption time-of-flight mass spectrometry (MALDI-TOF-MS), and 2D immunoblotting. The highly leukotoxic JP2 clone of A. actinomycetemcomitans is strongly associated with aggressive periodontitis (AgP) in adolescents of North-West African descent and the pathogenicity of this bacterium is of major interest. Hence, we developed a comprehensive 2D proteome reference map of A. actinomycetemcomitans proteins with 167 identified spots representing 114 different proteins of which 15 were outer membrane proteins. To unravel immunoreactive antigens, we applied 2D-gel and subsequent immunoblotting analyses using sera from five individuals with A. actinomycetemcomitans infections and one healthy control. The analysis revealed 32 immunoreactive proteins. Antibodies to two outer membrane proteins, YaeT (85 kDa) and Omp39 (39 kDa), not previously described as immunoreactive, were found only in subjects with current or previous A. actinomycetemcomitans JP2 infection. Further proteome-based studies of A. actinomycetemcomitans combined with analyses of the humoral immune response and targeted against outer membrane proteins may provide important insight into the host relationship of this important pathogen.

Risk of aggressive periodontitis in adolescent carriers of the JP2 clone of Aggregatibacter (Actinobacillus) actinomycetemcomitans in Morocco: a prospective longitudinal cohort study.

BACKGROUND: Periodontitis is a loss of supporting connective tissue and alveolar bone around teeth, and if it occurs in an aggressive form it can lead to tooth loss before the age of 20 years. Although the cause of periodontitis in general remains elusive, a particular clone (JP2) of the gram-negative rod Aggregatibacter (Actinobacillus) actinomycetemcomitans is considered a possible aetiological agent of the aggressive form in adolescents living in or originating from north and west Africa, where the disease is highly prevalent. We did a population-based longitudinal study of adolescents to assess the role of the JP2 clone in the initiation of aggressive periodontitis. METHODS: A total of 700 adolescents from public schools in Rabat, Morocco, were enrolled in the study. We used PCR to detect A actinomycetemcomitans in plaque samples (taken from molar and incisor sites) and to differentiate between the JP2 clone and other non-JP2 genotypes of the bacterium. 18 individuals were found to already have periodontitis and were excluded. The 682 periodontally healthy adolescents (mean age 12.5 years; SD 1.0) were classified according to their A actinomycetemcomitans carrier status at baseline. After 2 years, 428 (62.8%) individuals returned for re-examination, which included recording of periodontal attachment loss measured from the cemento-enamel junction to the bottom of the periodontal pockets of all teeth present. FINDINGS: Individuals who carried the JP2 clone of A actinomycetemcomitans alone (relative risk 18.0; 95% CI 7.8-41.2, p<0.0001) or together with non-JP2 clones of A actinomycetemcomitans (12.4; 5.2-29.9, p<0.0001) had a significantly increased risk of periodontal attachment loss. A much less pronounced disease risk was found in those carrying non-JP2 clones only (3.0; 1.3-7.1, p=0.012). INTERPRETATION: The JP2 clone of A actinomycetemcomitans is likely to be an important aetiological agent in initiation of periodontal attachment loss in children and adolescents. Co-occurrence of non-JP2 clones of A actinomycetemcomitans reduces the risk of development of periodontitis, suggesting competition for the ecological niche between the JP2 and non-JP2 clones of this species.

Improved PCR for detection of the highly leukotoxic JP2 clone of Actinobacillus actinomycetemcomitans in subgingival plaque samples.

The JP2 clone of Actinobacillus actinomycetemcomitans is associated with early-onset periodontitis in certain ethnic populations of African origin. Here, we describe and evaluate a set of primers for PCR to assay for the presence of A. actinomycetemcomitans and to discriminate between JP2-like strains and other genotypes in subgingival plaque samples.