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, 11 (3), 28

Advancing Antimicrobial Strategies for Managing Oral Biofilm Infections


Advancing Antimicrobial Strategies for Managing Oral Biofilm Infections

Yang Jiao et al. Int J Oral Sci.


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.

Conflict of interest statement

The authors declare no competing interests.


Fig. 1
Fig. 1
The application of antimicrobial dental materials. a Schematic illustration of antimicrobial dental materials. Proper incorporation of antimicrobial agents endows dental materials with antimicrobial function (dead microorganisms in red) and good biocompatibility (well-stretched viable cells in purple). b Antibacterial activity of polymerized dental adhesives containing MDPB or DMAE-CB. Representative confocal laser scanning microscopy images of S. mutans adhered on the control adhesive A, adhesive containing MDPB B and adhesive containing DMAE-CB C after 24-h incubation. Bacteria with integral membranes were stained with green fluorescence and those with compromised membranes were stained with red fluorescence. D Fluorescence intensity values of the two channels for adhesives derived from the three groups. E Schematic representation of polymerized adhesive containing DMAE-CB. Representative scanning electron microscopy images of S. mutans biofilms on the control adhesive F, adhesive containing MDPB G, and adhesive containing DMAE-CB H after 4-h incubation. Representative scanning electron microscopy images of S. mutans biofilms on the control adhesive I, adhesive containing MDPB J, and adhesive containing DMAE-CB K after 24-h incubation. Copyright 2017. Reproduced with permission from Elsevier Ltd
Fig. 2
Fig. 2
Antimicrobial mechanism for cold atmospheric plasma. The plasma-derived RONS that diffuse into the biofilm and cause oxidative damages to their cell membrane, DNA, and proteinaceous enzymes, resulting in disruption of the cell membrane and cell death. eDNA extracellular DNA, RONS reactive oxygen and nitrogen species. Copyright 2018. Reproduced with permission from Elsevier Ltd

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