Abstract
Infections of the oral cavity are caused by multicellular communities of microbes, referred to as biofilms. Due to the high tolerance of biofilms to antibiotics and specific conditions within the oral cavity, there is an ongoing search for carriers that are able to deliver high local concentrations of potent antimicrobials that can eradicate pathogenic biofilms. Bacterial cellulose, owing to its high flexibility, absorbance, and release potential, meets these demands. In this work we chemisorbed bacterial cellulose with antiseptics containing povidone-iodine or polihexanide and analyzed their ability to eradicate in vitro biofilms formed by oral pathogens, such as Aggregatibacter actinomycetemcomitans, Enterococcus faecalis, Candida albicans, Streptococcus mutans, Staphylococcus aureus, and Pseudomonas aeruginosa. In tests performed by means of standard laboratory methods and with a long contact time (24 h), all antiseptics released from the cellulose dressings displayed a very high antibiofilm efficacy. On the other hand, when conditions imitating the oral cavity were used and cellulose dressings were applied for a 0.5–1 h contact time, the antiseptics released from the dressings displayed lower, though still acceptable, activity. Our findings indicate that besides species-specific resistance to particular antiseptic agents, environmental and experimental settings play an essential role in outcomes. Finally, in a proof-of-concept experiment performed in an oral cavity typodont model, we demonstrated the high flexibility and adhesiveness of antiseptic-containing cellulose dressings. Our novel findings, if developed in further studies, may lead to the introduction of new types of dressings that are able to efficiently deal with biofilm infections of the oral cavity.
Highlights
Most oral diseases are of infectious origin
We evaluated the in vitro ability of prototypical Bacterial cellulose (BC) dressings, chemisorbed with antiseptics, to eradicate biofilms formed by oral pathogens
It should be noted that the microdilution technique is one of the most basic experimental settings in microbiology and it does not reflect the in vivo conditions of the oral cavity or any other sites of the human body
Summary
Most oral diseases are of infectious origin. Periodontal infections, dental caries, jawbone osteomyelitis and osteonecrosis, and mucosal fungal infections like thrush are all caused by microorganisms forming persistent and hard-to-eradicate structures referred to as biofilms [1]. Untreated, aggressive oral infections can lead to life-threatening infection and inflammation in virtually any body organ, including the brain, heart, and skeleton, to name a few [4,5,6]. Another key feature of biofilm infections is the high tolerance to antibiotics and antiseptics [7]. The antiseptics broadly used against bacterial biofilms are, among others, povidone-iodine, polihexanide, and chlorhexidine [17,18,19] The latter one, due to a quickly growing bulk of evidence indicating increasing microbial cross-resistance following application [20,21,22], is being substituted with other antiseptic substances
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