Biofilm Control Research Articles

Understanding of food biofilms by the application of omics techniques.

Biofilms constitute a protective barrier for foodborne pathogens to survive under stressful food processing conditions. Therefore, studies into the development and control of biofilms by novel techniques are vital for the food industry. In recent years, foodomics techniques have been developed for biofilm studies, which contributed to a better understanding of biofilm behavior, physiology, composition, as well as their response to antibiofilm methods at different molecular levels including genes, RNA, proteins and metabolic metabolites. Throughout this review, the main studies where foodomics tools used to explore the mechanisms for biofilm formation, dispersal and elimination were reviewed. The data summarized from relevant studies are important to design novel and appropriate biofilm elimination methods for enhancing food safety at any point of food processing lines.

How effective are three methods of teaching oral hygiene for adolescents undergoing orthodontic treatment? The MAHO protocol: an RCT comparing visual, auditory and kinesthetic methods

BackgroundFixed orthodontic appliances hamper oral hygiene procedures. The consequences are gingivitis and white spot lesions. Fifty to 70% of patients treated with braces encounter these problems. Their care in the USA represents an annual cost of five hundred million dollars. Initial education and motivation for oral hygiene depend on two categories of factors: firstly, practical prophylactic measures (instruments and medication, professional care) and secondly, the educational component: choice of communication technique, frequency, and nature of hygiene instructions. This trial aims to study this last component. Its main objective is to compare three methods’ effectiveness of oral hygiene education in adolescent patients treated with braces in terms of biofilm (plaque) control. The secondary objectives are the evaluation of these methods’ effectiveness regarding gingival inflammation and the maintenance of hygiene during the first 6 months of treatment.MethodsThis study is a prospective randomized controlled trial of superiority. It evaluates the effectiveness of three hygiene education techniques. A total of 90 patients from the University Hospital Center of Rennes will be randomized into 3 parallel groups with a 1:1:1 ratio. Each will benefit from a different educational method: oral and/or practical. The main outcome will be the average plaque index for each group after 6 months of treatment. Additional outcomes will be the average gingival index for each group and the plaque and gingival indices over 6 months.DiscussionThe effectiveness of preventive procedures for optimizing oral hygiene during orthodontics is based on ambiguous literature. As a result, it is difficult to draw conclusions and to translate them into everyday practice. Sixty-eight percent of the orthodontists support the development of guidelines for education. The aim of this study is to standardize methods of oral hygiene education during orthodontic fixed treatment. The purpose of this study would be to provide practitioners with a concrete education program through guidelines dedicated to the method having the best results.Trial registrationClinicalTrials.gov NCT04444154. Registered on 22 June 2020. SI CNRIPH ID 8011N° 20.04.27.58337. Registered on 29 July 2020

Biofilm control by ionic liquids

Ionic liquids (ILs) are remarkable chemical compounds with applications in many areas of modern science. They are increasingly recognized as promising compounds to fight microorganisms in both planktonic and biofilm states, contributing to reinvent the antimicrobial pipeline. Biofilm-related infections are particularly challenging given that the scientific community has not yet identified a reliable control strategy. Understanding of the action of ILs in biofilm control is is still in a very early stage. However, given the highly tunable nature and exceptional properties of ILs, they are excellent candidates for biofilm control. Here, we review the major advances in, and challenges tothe use of ILs for effective biofilm control.

Staphylococcus aureus Interferes with Streptococci Spatial Distribution and with Protein Expression of Species within a Polymicrobial Oral Biofilm.

We asked whether transient Staphylococcus aureus in the oral environment synergistically interacts with orally associated bacterial species such as Actinomyces oris, Candida albicans, Fusobacterium nucleatum, Streptococcus oralis, Streptococcus mutans, and Veillonella dispar (six-species control biofilm 6S). For this purpose, four modified biofilms with seven species that contain either the wild type strain of the S. aureus genotype (USA300-MRSA WT), its isogenic mutant with MSCRAMM deficiency (USA300-MRSA ΔMSCRAMM), a methicillin-sensitive S. aureus (ST72-MSSA-) or a methicillin-resistant S. aureus (USA800-MRSA) grown on hydroxyapatite disks were examined. Culture analyses, confocal-laser-scanning microscopy and proteome analyses were performed. S. aureus strains affected the amount of supragingival biofilm-associated species differently. The deletion of MSCRAMM genes disrupted the growth of S. aureus and the distribution of S. mutans and S. oralis within the biofilms. In addition, S. aureus caused shifts in the number of detectable proteins of other species in the 6S biofilm. S. aureus (USA300-MRSA WT), aggregated together with early colonizers such as Actinomyces and streptococci, influenced the number of secondary colonizers such as Fusobacterium nucleatum and was involved in structuring the biofilm architecture that triggered the change from a homeostatic biofilm to a dysbiotic biofilm to the development of oral diseases.

Comparison of disinfectants for drinking water: chlorine gas vs. on-site generated chlorine

The feasibility of on-site generated chlorine (OSG chlorine) as an alternative disinfectant to chlorine gas was evaluated in terms of total organic carbon (TOC) removal, disinfection efficiency, biofilm control, disinfection by-products (DBPs) formation, chlorine decay rate, and volatility. Chlorine gas decreased the pH of the treated water by -0.1 per mg/L of free available chlorine (FAC) while OSG chlorine increased the pH by + 0.06 per mg/L. OSG chlorine with more hypochlorite ion (OCl-) at higher pH was less effective in the inactivation of suspended bacteria and TOC removal but remained in the distribution system longer and controlled biofilm formation more effectively than chlorine gas. The DBPs formation by OSG chlorine was not significantly different from that by chlorine gas except for the reduction of Haloacetonitriles. Hypochlorous acid (HOCl) was more volatile than OCl-, indicating the lower volatility of FAC in the OSG chlorine-treated water. Two types of OSG systems, “Mixed oxidants” and OSG hypochlorite, did not show any significant difference in disinfection, DBPs formation, and chlorine decay rate (paired t-test, p = 0.40, 0.11 ~ 0.70, > 0.42). A significant synergy effect by oxidants other than FAC cannot be expected in the use of “mixed oxidants” at a water treatment plant.

Sampling, separation, and quantification of N‐acyl homoserine lactones from marine intertidal sediments

AbstractN‐acyl homoserine lactones (AHLs) are molecules produced by many Gram‐negative bacteria as mediators of cell‐cell signaling in a mechanism known as quorum sensing (QS). QS is widespread in marine bacteria regulating diverse processes, such as virulence or excretion of polymers that mediate biofilm formation. Associated eukaryotes, such as microalgae, respond to these cues as well, leading to an intricate signaling network. To date, only very few studies attempted to measure AHL concentrations in phototrophic microbial communities, which are hot spots for bacteria‐bacteria as well as microalgae‐bacteria interactions. AHL quantification in environmental samples is challenging and requires a robust and reproducible sampling strategy. However, knowing about AHL concentrations opens up multiple perspectives from answering fundamental ecological questions to deriving guidelines for manipulation and control of biofilms. Here, we present a method for sampling and AHL identification and quantification from marine intertidal sediments. The use of contact cores for sediment sampling ensures reproducible sample surface area and volume at each location. Flash‐freezing of the samples with liquid nitrogen prevents enzymatic AHL degradation between sampling and extraction. After solvent extraction, samples were analyzed with an ultra‐high performance liquid chromatography‐high resolution mass spectrometry (UHPLC‐HRMS) method that allows to baseline‐separate 16 different AHLs in less than 10 min. The sensitivity of the method is sufficient for detection and quantification of AHLs in environmental samples of less than 16 cm3.

Use of air polishing for supra- and subgingival biofilm removal for treatment of residual periodontal pockets and supportive periodontal care: a systematic review

To systematically review the literature to compare the efficacy of air polishing to hand or ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care. Electronic searches were performed in five different databases, and two databases were used to capture the "grey literature partially." Clinical trials that compared the use of an air-polishing device to either conventional scaling and root planing (hand and/or ultrasonic instrumentation) or no treatment during periodontal therapy were included without restriction of year and publication status. The Joanna Briggs Institute instrument for clinical trials was used to appraise the studies critically. The results were submitted to qualitative descriptive analysis. The systematic review protocol was registered in PROSPERO (CRD420220156176). Electronic searches found 1100 hits published between 2008 and 2019. Thirteen studies were included in the review, out of which four had a follow-up longer than 180 days. Results indicated no differences between the efficacy of air polishing and hand or ultrasonic instruments to reduce periodontal inflammation. Our findings suggest that there is no difference in the efficacy of air polishing and hand or ultrasonic instrumentation to control biofilm and reduce periodontal inflammation. However, these findings must be carefully interpreted owing to methodological issues, including a short follow-up, and a potential conflict of interest related to industry funding. Air polishing for biofilm control may be used as an alternative to hand and ultrasonic instrumentation to reduce periodontal inflammation during treatment of residual pockets or supportive periodontal care.

Development, dynamics and control of antimicrobial-resistant bacterial biofilms: a review

Antimicrobial resistance is a major health issue inducing the inefficiency of antimicrobial drugs. Indeed, pathogenic microorganisms become resistant when frequently exposed to antimicrobial drugs. In particular, when bacteria are attached to a surface and expand as a biofilm, they become more resistant to antimicrobials because single or multiple bacterial species are embedded in a slimy extracellular polymeric substance that acts like a shield. Biofilms often contaminate medical devices and food industrial equipment, thus leading to infections and food spoilage. Here, we review the basics of biofilm development from a planktonic bacterium; signaling in biofilm and relationship with antimicrobial resistance; biofilm control and destruction strategies using quorum sensing inhibitors, ultrasound, acidic electrolyzed water, and enzymatic and combination killing; and emerging approaches, such as bacteriophage-mediated disruption and antimicrobial peptides to control bacterial biofilms.

2-(2-Methyl-2-nitrovinyl)furan but Not Furvina Interfere with Staphylococcus aureus Agr Quorum-Sensing System and Potentiate the Action of Fusidic Acid against Biofilms.

Quorum sensing (QS) plays an essential role in the production of virulence factors, in biofilm formation and antimicrobial resistance. Consequently, inhibiting QS is being considered a promising target for antipathogenic/anti-virulence therapies. This study aims to screen 2-nitrovinylfuran derivatives structurally related to Furvina (a broad-spectrum antibiotic already used for therapeutic purposes) for their effects on QS and in biofilm prevention/control. Furvina and four 2-nitrovinylfuran derivatives (compounds 1–4) were tested to assess the ability to interfere with QS of Staphylococcus aureus using bioreporter strains (S. aureus ALC1742 and ALC1743). The activity of Furvina and the most promising quorum-sensing inhibitor (QSI) was evaluated in biofilm prevention and in biofilm control (combined with fusidic acid). The biofilms were further characterized in terms of biofilm mass, viability and membrane integrity. Compound 2 caused the most significant QS inhibition with reductions between 60% and 80%. Molecular docking simulations indicate that this compound interacts preferentially with the protein hydrophobic cleft in the LytTR domain of AgrA pocket. Metabolic inactivations of 40% for S. aureus ALC1742 and 20% for S. aureus ALC1743 were reached. A 24 h-old biofilm formed in the presence of the QSI increased the metabolic inactivation by fusidic acid to 80%, for both strains. The overall results highlight the effects of compound 2 as well as the potential of combining QSI with in-use antibiotics for the management of skin and soft tissues infections.

Antibacterial Amphiphilic Copolymers of Dimethylamino Ethyl Methacrylate and Methyl Methacrylate to Control Biofilm Adhesion for Antifouling Applications.

Amphiphilic copolymers are recognized as important biomaterials and used as antibacterial agents due to their effective inhibition of bacterial growth. In current study, the amphiphilic copolymers of P(DMAEMA-co-MMA) were synthesized using free radical polymerization by varying the concentrations of hydrophilic monomer 2-dimethylamino ethylmethacrylate (DMAEMA) and hydrophobic monomer methyl methacrylate (MMA) having PDI value of 1.65–1.93. The DMAEMA monomer, through ternary amine with antibacterial property optimized copolymers, P(DMAEMA-co-MMA), compositions to control biofilm adhesion. Antibacterial activity of synthesized copolymers was elucidated against Gram-positive Staphylococcus aureus (ATCC 6538) and Gram-negative Escherchia coli (ATCC 8739) by disk diffusion method, and zones of inhibition were measured. The desired composition that was PDM1 copolymer had shown good zones of inhibition i.e., 19 ± 0.33 mm and 20 ± 0.33 mm for E. coli and S. aureus respectively. The PDM1 and PDM2 have exhibited significant control over bacterial biofilm adhesion as tested by six well plate method. SEM study of bacterial biofilm formation has illustrated that these copolymers act in a similar fashion like cationic biocide. These compositions viz. PDM1 and PDM2, may be useful in development of bioreactors, sensors, surgical equipment and drug delivery devices.

Attenuation of Pseudomonas aeruginosa biofilm by thymoquinone: an individual and combinatorial study with tetrazine-capped silver nanoparticles and tryptophan.

Microbial biofilm indicates a cluster of microorganisms having the capability to display drug resistance property, thereby increasing its proficiency in spreading diseases. In the present study, the antibiofilm potential of thymoquinone, a black seed-producing natural molecule, was contemplated against the biofilm formation by Pseudomonas aeruginosa. Substantial antimicrobial activity was exhibited by thymoquinone against the test organism wherein the minimum inhibitory concentration of the compound was found to be 20 μg/mL. Thereafter, an array of experiments (crystal violet staining, protein count, and microscopic observation, etc.) were carried out by considering the sub-MIC doses of thymoquinone (5 and 10 μg/mL), each of which confirmed the biofilm attenuating capacity of thymoquinone. However, these concentrations did not show any antimicrobial activity. Further explorations on understanding the underlying mechanism of the same revealed that thymoquinone accumulated reactive oxygen species (ROS) and also inhibited the expression of the quorum sensing gene (lasI) in Pseudomonas aeruginosa. Furthermore, by taking up a combinatorial approach with two other reported antibiofilm agents (tetrazine-capped silver nanoparticles and tryptophan), the antibiofilm efficiency of thymoquinone was expanded. In this regard, the highest antibiofilm activity was observed when thymoquinone, tryptophan, and tetrazine-capped silver nanoparticles were applied together against Pseudomonas aeruginosa. These combinatorial applications of antibiofilm molecules were found to accumulate ROS in cells that resulted in the inhibition of biofilm formation. Thus, the combinatorial study of these antibiofilm molecules could be applied to control biofilm threats as the tested antibiofilm molecules alone or in combinations showed negligible or very little cytotoxicity.

Innovative Control of Biofilms on Stainless Steel Surfaces Using Electrolyzed Water in the Dairy Industry.

Biofilms on food-contact surfaces can lead to recurrent contamination. This work aimed to study the biofilm formation process on stainless steel plates used in the dairy industry: 304 surface finish 2B and electropolished; and the effect of a cleaning and disinfection process using alkaline (AEW) and neutral (NEW) electrolyzed water. Milk fouling during heat processing can lead to type A or B deposits, which were analyzed for composition, surface energy, thickness, and roughness, while the role of raw milk microbiota on biofilm development was investigated. Bacteria, yeasts, and lactic acid bacteria were detected using EUB-338, PF2, and Str-493 probes, respectively, whereas Lis-637 probe detected Listeria sp. The genetic complexity and diversity of biofilms varied according to biofilm maturation day, as evaluated by 16S rRNA gene sequence, denaturing gradient gel electrophoresis, and fluorescence in situ hybridization microscopy. From analysis of the experimental designs, a cleaning stage of 50 mg/L NaOH of AEW at 30 °C for 10 min, followed by disinfection using 50 mg/L total available chlorine of NEW at 20 °C for 5 min is a sustainable alternative process to prevent biofilm formation. Fluorescence microscopy was used to visualize the effectiveness of this process.

Discovery of Antibiofilm Activity of Elasnin against Marine Biofilms and Its Application in the Marine Antifouling Coatings.

Biofilms are surface-attached multicellular communities that play critical roles in inducing biofouling and biocorrosion in the marine environment. Given the serious economic losses and problems caused by biofouling and biocorrosion, effective biofilm control strategies are highly sought after. In a screening program of antibiofilm compounds against marine biofilms, we discovered the potent biofilm inhibitory activity of elasnin. Elasnin effectively inhibited the biofilm formation of seven strains of bacteria isolated from marine biofilms. With high productivity, elasnin-based coatings were prepared in an easy and cost-effective way, which exhibited great performance in inhibiting the formation of multi-species biofilms and the attachment of large biofouling organisms in the marine environment. The 16S amplicon analysis and anti-larvae assay revealed that elasnin could prevent biofouling by the indirect impact of changed microbial composition of biofilms and direct inhibitory effect on larval settlement with low toxic effects. These findings indicated the potential application of elasnin in biofilm and biofouling control in the marine environment.

Lactic Acid Bacteria against Listeria monocytogenes

Background: Listeria monocytogenes is a pathogenic bacterium that can contaminate food and cause public health problems due its ability to form biofilms and resistance to sanitizers, it is responsible for sanitary and economic losses in food producing establishments. The difficulties in controlling biofilms and increasing resistance to traditional antibacterial agents is motivating studies of alternative potential biological agents for the control of pathogenic biofilms, among which lactic acid bacteria (LABs) are included. The objective of this work was to evaluate the activity of LABs against Listeria monocytogenes biofilm formation on polystyrene plates, a surface commonly used in the food industry.Materials, Methods & Results: Lyophilized commercial strains of Bifidobacterium animalis, Lactobacillus fermentum, Lactobacillus plantarum, Lactobacillus salivaris and Lactobacillus acidophilus were used. The strain of Listeria monocytogenes (L4) was isolated from polystyrene mats from a poultry slaughterhouse cutting room and demonstrated the ability to attach to microplates and resistance to sanitizers (sodium hypochlorite and hydrogen peroxide) at all times, temperatures and tested surfaces. The antimicrobial activity of LABs was evaluated by the agar diffusion method. The LABs that presented action on Listeria monocytogenes were selected for the inhibition and/or removal of biofilms in microplates, and all experiments were carried out in triplicate. Only Bifidobacterium animalis and Lactobacillus plantarum demonstrated action against Listeria. monocytogenes in the agar diffusion assays and were selected for inhibition and competition assays. Furthermore, competition of LABs against Listeria monocytogenes adhesion was evaluated. There was no significant difference between LABs and Listeria monocytogenes, alone or in combination, at temperatures of 30ºC and 37ºC in the Listeria monocytogenes inhibition assays on polystyrene surface. The lactic acid bacteria evaluated did not demonstrate inhibition of Listeria monocytogenes adhesin testes with optical density visualization, however, it was possible to identify a reduction in Listeria monocytogenes counts with the application of Bifidobacterium animals and Lactobacillus plantarum in the testes of competition against biofilm formation. In competition tests Bifidobacterium animalis and Lactobacillus plantarum have an injunction in Listeria monocytogenes, indicating that these lactic acid bacteria can retard Listeria biofilm formation on polystyrene surfaces and thus help control the pathogen in the food industry.Discussion: A potential mechanism to control biofilm adhesion and formation of pathogens for nutrients and fixation on surfaces, multiplication factors and surfaces are a challenge in controlling biofilms of pathogenic microorganisms, alternative measures to traditional methods for inactivating pathogens and biofilm formers bacteria are necessary. In this sense, lactic acid bacteria generate high levels of bacteriocin and are effective in inhibiting the biofilm of pathogenic bacteria, however, our study did not reveal this. We verified that Bifidobacterium animalis and Lactobacillus plantarum have an inhibitory action on Listeria monocytogenes, indicating that these lactic acid bacteria can be used to delay the formation of biofilms by Listeria on polystyrene surfaces, helping to control this pathogen in food industry.Keywords: control of biofilm, pathogenic bacteria, food industry, polystyrene surface, FTDs.

Bacteriophage - A Promising Alternative Measure for Bacterial Biofilm Control.

Bacterial biofilms can enhance bacteria’s viability by providing resistance against antibiotics and conventional disinfectants. The existence of biofilm is a serious threat to human health, causing incalculable loss. Therefore, new strategies to deal with bacterial biofilms are needed. Bacteriophages are unique due to their activity on bacteria and do not pose a threat to humans. Consequently, they are considered safe alternatives to drugs for the treatment of bacterial diseases. They can effectively obliterate bacterial biofilms and have great potential in medical treatment, the food industry, and pollution control. There are intricate mechanisms of interaction between phages and biofilms. Biofilms may prevent the invasion of phages, and phages can kill bacteria for biofilm control purposes or influence the formation of biofilms. At present, there are various measures for the prevention and control of biofilms through phages, including the combined use of drugs and the application of phage cocktails. This article mainly reviews the function and formation process of bacterial biofilms, summarizes the different mechanisms between phages and biofilms, briefly explains the phage usage for the control of bacterial biofilms, and promotes phage application maintenance human health and the protection of the natural environment.

The role of cold atmospheric plasma (CAP) in the control of biofilms on titanium surfaces: A Literature review

Aim: Cold atmospheric plasma (CAP) is frequently used for the sterilization of biomaterials in the field of dentistry. The aim of this narrative review is to present the role of CAP in the control of biofilms on titanium surfaces. Materials and Methods: The PubMed, Scopus, and WOS databases were searched to identify scientific articles published between 2010 and 2020, with the keywords “biofilm,” “cold atmospheric temperature,” and “titanium,” using the logical operators AND and OR. Results: We found 8 articles in PubMed, 11 in Scopus, and 10 in WOS, including review articles and original studies, among others. All the articles were selected by two independent reviewers according to the eligibility criteria. Conclusions: Despite the restrictions of this review, CAP seems to have an effect on titanium surfaces in the oral area. Studies have shown that bacterial biofilms become inactive after 3 min of plasma treatment.

Effect of educational strategy combined with ART on oral health-related quality of life: a controlled clinical trial.

This study aimed to assess whether complementing atraumatic restorative treatment (ART) with oral health educational strategies (OHES) improves the perception of oral health-related quality of life (OHRQoL) and clinical oral outcomes. A controlled clinical trial included 93 six- to eight-year-old students from five public schools of Piracicaba, Saltinho, and Charqueada municipalities (State of São Paulo, Brazil) divided into 3 groups (31 children each) which received: OHES (caries-free), ART (dental caries), and ART plus OHES (dental caries). OHRQoL (CPQ8-10-ISF:16), dental caries, biofilm control, and gingivitis were assessed before and 1 month after interventions by one calibrated examiner. OHES consisted of an educational interactive activity performed once a week for four weeks. Data were analyzed using mixed model ANOVA, Chi-square, and Sign tests. After 1 month of follow-up, improvement in gingivitis status, OHRQoL total score, and Functional Limitations, Emotional Well-Being and Social Well-Being domains scores were found in all groups (p < 0.05). The improvement in biofilm control was observed only in the OHES group (p < 0.001; power = 0.98), while a decrease in Oral Symptoms scores was observed only in ART+OHES group (p <0.001; power = 0.99) and a significant change in the perception of oral health was observed in the two groups that received ART (p < 0.05). In conclusion, improvement in overall OHRQoL and oral status was observed in all children, although the effect of including health educational strategies in the treatment plan was determinant for the perception of an improved oral health after restorative treatment.

Implementation of Pre-Milking Udder Preparation to Improve Milk Quality in Small Buffalo Dairy Farm

Pre milking udder preparations play an important role in increasing quality and safety of milk. The objective of this study is to evaluate the effect of implementation of pre milking teat dipping technique by using different chemical sanitizers (Iodophore and Quaternary ammonium compounds QACs). Materials and Methods: Pre-milking udder preparation was carried out in a private small-scale buffalo dairy farm. A total number of 30 dairy buffalo, equal in their milk production and free from clinical and subclinical mastitis, were chosen for this study. They were divided into 3 groups (10 animals each). The first group was used as control group, the second group was treated with Iodophore-based pre-milking udder preparation while, the third group was treated with Quaternary Ammonium Compound-based pre-milking udder preparation. Raw milk samples were collected from individual dairy animals (20 samples) and bulk tank milk (20 samples) after application of the sanitizers for two successive weeks. Each sample was evaluated for prevalence Aerobic mesophilic count, Coliforms, Staphylococci and Enterococci counts. Results: By the end of the second week of application of sanitizers, the count of aerobic mesophilic count, Coliforms, enterococci and staphylococci counts showed reduction% by 30.22, 36.9, 53.17 and 94.38% for Iodophore-treated group while the Quaternary Ammonium Compound treated group showed reduction% by 22.12, 10.70, 17.71 and 85.41%, respectively in comparing with control group. Conclusion: Our study indicated that Iodophore was better than QACs in reducing the microbial counts of tested milk samples as Iodophore efficacy has a long-term residual disinfection including bacterial re-growth and biofilm control.

Periodontal diseases: is it possible to prevent them? A populational and individual approach.

Periodontal diseases are infectious inflammatory chronic diseases of a multifactorial nature. They are primarily caused by dysbiotic ecological changes in dental biofilm, which may be influenced by risk factors. The prevention of periodontal diseases may involve different strategies focused on reducing distal, intermediate, and proximal risk factors at both the population and individual levels. Effective prevention depends on interdisciplinary and common risk factor approaches. Also, patient-centered preventive models are more effective than professional-centered models in the management of periodontal diseases. Regular and periodic control of dental biofilm is an essential measure for the different levels of prevention of periodontal diseases. The effectiveness of periodontal disease prevention largely depends on positive modifications of behavior, knowledge, health literacy, patient empowerment, motivation, and compliance.

Targeting biofilms in medical devices using probiotic cells: a systematic review

<abstract> Biofilm-related infections are becoming a major clinical problem due to the increasingly widespread ability of pathogens to develop persistent biofilms in medical devices. The inadequate response of conventional antimicrobial strategies to counteract biofilm development demands urgent alternatives. An increasing interest in promoting a natural approach to health has intensified the research in the field of probiotics to battle pathogenic biofilms. This study aims to summarize the recent evidence supporting the effects of probiotic cells on the control and prevention of medical device-associated biofilms using a PRISMA-oriented (Preferred Reporting Items for Systematic reviews and Meta-Analyses) systematic search. This review demonstrated that probiotic cells have the potential to be used as biocontrol agents against biofilm formation by a broad spectrum of microorganisms. The restriction of biofilm growth caused by probiotics seemed to be strain-specific and independent of the antibiofilm strategy used (displacement, exclusion or competition). <italic>Lactobacillus</italic>, <italic>Lactococcus</italic> and <italic>Streptococcus</italic> were the most studied genus of probiotics and those with the higher capability to hinder biofilm formation, causing reductions up to 99.9%. These findings will pave the way to further experiments on the topic so that probiotic cells may become part of the clinical arsenal for the prevention and treatment of medical device-associated infections. </abstract>