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Controlling oral biofilms through modulation of the commensal oral microbiota. An alternative for antiseptics?

Boek - Dissertatie

Modulation of the commensal oral microbiota is a promising preventive or therapeutic strategy to battle the initiation and progression of biofilm-related oral pathologies such as periodontal diseases. Although established classical therapies, based on mechanical removal of dental plaque and sometimes supplemented with the use of antimicrobials, have proven clinical and microbiological benefits, their limitations justify the exploitation of alternative approaches. For instance, there is an increasing awareness that the widespread use of antimicrobials in the oral cavity could lead to phenomena like antiseptic adaptation or resistance development. Furthermore, due to the often aspecific removal and killing of oral biofilms, it can be hypothesized that these interventions might disrupt the oral health-associated homeostatic relationships that exist within the oral microbiota and between the oral microbiota and host. Therefore, the focus shifted to pro-microbial strategies like the use of pro- and prebiotics to modulate the commensal oral microbiota and the host response. Especially the use of probiotics for oral health is nowadays well-established, and the associated microbiological (e.g. decreased abundances of periodontal pathogens) and clinical (e.g. reduced periodontal pocket depth and clinical attachment loss) benefits have been well-documented. Since the use of probiotics is based on the administration of live, exogenous microorganisms, this approach also comes with certain risks and limitations. To circumvent these, the nutritional and/or metabolic stimulation of the endogenous commensal oral microbiota by prebiotic substrates has been recently introduced in the field and forms an important research topic. Finally, exploitation of important features of the commensal microbiota, such as H2O2 production that plays an important role in shaping oral biofilm ecology, represents another modulatory approach increasingly gaining interest. In this PhD project, it is hypothesized that the pathogenicity of oral biofilms can be reduced by modulation of the commensal oral microbiota, whereas repeated exposure of pathogens to antiseptics increases their virulence and hence pathogenicity. This modulation could be achieved through (in)direct stimulation of commensal/beneficial bacteria with potential prebiotics and/or stimulation of endogenous H2O2 production. The main goal of this project is to increase the 'host-compatibility' of oral biofilms (reduced amounts of pathogens, less virulence and lower inflammatory potential) through emerging strategies as an alternative for the use of antimicrobials. Therefore, this PhD project aims to (1) determine the effects of repeated in vitro exposure to antiseptics on oral pathogens, (2) investigate the effects of previously identified and novel potential prebiotic substrates and substrates that might affect endogenous H2O2 production on several aspects of in vitro multi-species oral biofilms and (3) evaluate the effects of these substrates on planktonic and biofilm H2O2 production.
Jaar van publicatie:2021
Toegankelijkheid:Open