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OBJECTIVE: This study investigated the antifungal and antibiofilm activity of Cymbopogon nardus essential oil (EO) and its major compound, citronellal, in association with miconazole and chlorhexidine on clinical strains of Candida albicans. The likely mechanism(s) of action of C. nardus EO and citronellal was further determined. MATERIALS AND METHODS: The EO was chemically characterized by gas chromatography coupled with mass spectrometry (GC-MS). The antifungal activity (MIC/MFC) and antibiofilm effects of C. nardus EO and citronellal were determined by the microdilution method, and their likely mechanism(s) of action was determined by the sorbitol and ergosterol assays. Then, the samples were tested for a potential association with standard drugs through the checkerboard technique. Miconazole and chlorhexidine were used as positive controls and the assays were performed in triplicate. RESULTS: The GC-MS analysis tentatively identified citronellal as the major compound in C. nardus EO. Both samples showed antifungal activity, with MIC of 256 µg/mL, as compared to 128 µg/mL and 8 µg/mL of miconazole and chlorhexidine, respectively. C. nardus EO and citronellal effectively inhibited biofilm formation (p < 0.05) and disrupted preformed biofilms (p < 0.0001). They most likely interact with the cell membrane, but not the cell wall, and did not present any synergistic activity when associated with standard drugs. CONCLUSION: C. nardus EO and citronellal showed strong in vitro antifungal and antibiofilm activity on C. albicans. CLINICAL RELEVANCE: Natural products have been historically bioprospected for novel solutions to control fungal biofilms. Our data provide relevant insights into the potential of C. nardus EO and citronellal for further clinical testing. However, additional bioavailability and toxicity studies must be carried out before these products can be used for the chemical control of oral biofilms.

A systematic review and meta-analysis was carried out to verify evidence regarding the efficacy and safety of the clinical applicability of natural products in the prevention and treatment of oral mucositis induced by chemotherapy and/or radiotherapy. An electronic research according to the PICOS strategy, using the terms “natural products” and “oral mucositis,” was carried out at Pubmed, Cochrane, Embase, and “gray literature.” The stages of eligibility, data extraction, and quality assessment of the studies were carried out independently and in duplicate. The number of studies identified as eligible was 151, including 47 randomized controlled trials, reporting a total of 3075 participants undergoing some therapy with natural products on oral mucositis. The included clinical trials covered a variety of 31 types of natural products. Considering the risk of bias of the clinical trials, 24 studies (51.1%) were considered to have a low overall risk of bias, nine (19.1%) were at moderate risk, and 14 clinical trials (29.8%) were at high risk of bias. Honey was the most assessed natural agent. Fourteen studies (3.4%) reported that natural agents reduced pain. The results of the meta-analysis support a positive effect of honey and Aloe vera in reducing mucositis in patients receiving cancer therapy. The results found add relevant information to the scientific community regarding the prevention and treatment of mucositis. Graphical abstract

Vascular anomalies of the head and neck are common lesions usually associated with functional and/or aesthetic limitations. The aim of the present paper was to report a case series of oral vascular malformations treated with Nd:YAG laser photocoagulation, highlighting the clinical evolution and post-surgical complications. Fifteen patients diagnosed with oral vascular malformations were treated with Nd:YAG laser followed by three sessions of biostimulation. None of the patients presented post-surgical pain, but 6 of 15 patients (40%) experienced minimal post-surgical complications. All cases presented complete resolution of the lesions after laser treatment. More importantly, 12 out of 15 (80%) resolved after a single session. Low morbidity, minimal patient discomfort, and satisfactory aesthetic results point Nd:YAG laser photocoagulation as a promising option for the management of benign oral vascular lesions.

A atividade antimicrobiana do extrato da casca do caule de Anacardium occidentale L., foi avaliada em três culturas de bactérias isoladas de biofilme dental. A atividade antimicrobiana foi conduzida em placa de Petri pelo método de difusão para determinação da Concentração Inibitória Mínima (CIM) e Concentração Inibitória Mínima de Aderência (CIMA). Inibição aureolar (CIM) foi observada com concentrações de 12,5 mg/mL em S. mutans e 6,25mg/mL em S. mitis e S. sanguis. Os resultados sugerem que o extrato tem efeito na CIMA em concentrações de 0,31 mg/mL em S. mutans e S. mitis e de 0,15 mg/mL em S. sanguis e pode ser usado terapeuticamente na odontologia como agente antibacteriano.