Search Results (945)

Objectives: To compare the adjunctive efficacy of a MicroRepair^® mouthwash containing an antibacterial complex (ABX), composed of cetylpyridinium chloride, magnolol, and honokiol, with 0.12% chlorhexidine (CHX) in the management of generalized plaque-induced gingivitis, assessing clinical periodontal parameters, salivary activated matrix metalloproteinase-8 (aMMP-8) levels, and patient-reported outcomes over 6 months. Methods: A randomized, controlled, parallel-group clinical trial included 40 systemically healthy adults with generalized gingivitis and was reported in accordance with CONSORT 2025 guidelines. Following professional oral hygiene according to the Guided Biofilm Therapy (GBT) protocol, participants were randomly allocated to ABX or 0.12% CHX, used twice daily for 14 days. Clinical parameters, including Full-Mouth Bleeding Score (FMBS, primary outcome), Full-Mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), Gingival Recession (REC), and Modified Lobene Stain Index (MLSI), were recorded at baseline, 2 weeks, 1, 3, and 6 months. Salivary aMMP-8 levels were assessed at baseline and 2 weeks. Heavy smokers were excluded, and smoking status was evaluated as a potential covariate. Non-parametric tests were applied (p < 0.05). Results: Both groups showed significant reductions in FMBS and FMPS over time (p < 0.05), with no intergroup differences for the primary outcome at any follow-up at the patient level. Patient-level analyses did not reveal consistent differences across secondary parameters. At the tooth level, lower FMPS values were observed in the trial group at 2 weeks and 1 month (p < 0.05), with earlier PPD reduction. CAL, and REC remained stable. Salivary aMMP-8 levels decreased significantly in both groups without intergroup differences. Patient-reported outcomes were comparable. Smoking status was balanced between groups and was not significantly associated with treatment allocation or the main clinical outcomes. Conclusions: No significant differences were observed between ABX and CHX for the main clinical and molecular outcomes, supporting its potential use as an adjunct in gingivitis management. Full article

Untreated dental caries in permanent teeth is the most frequent disease of all 371 diseases and traumas assessed by the Global Burden of Disease Study in 2021, and there are reported to be 2.24 billion cases worldwide. Demineralization is a disintegration process of minerals and apatite crystals in hard tissue, provoked by biofilm activities, dietary factors, and the micro-oral environment—the three main mechanisms of dental caries. Restoration of mineral ions in the crystal structure is defined as remineralization. Remineralization enables the deposition of new minerals within the crystal structure of demineralized enamel, aiming to increase mineral production. Environments suitable for remineralization and inhibiting demineralization could be created by using a caries prevention agent. Objectives: Providing scientific evidence regarding Aloe vera as an alternative agent for caries prevention. Materials and Method: The method used in this study is a scoping review, utilizing the PRISMA-ScR as a guideline to conduct article screening and further analysis, following a thematic analysis approach. Database searches were conducted in PubMed, EBSCOhost, and ScienceDirect, based on the keywords generated. Results: A total of 13 articles were gathered for further analysis. Conclusions: Aloe vera shows promising preliminary potential, but further standardized in vivo and randomized clinical studies are necessary to confirm its remineralizing efficacy and clarify its mechanisms of action as a cavity prevention agent. Clinical Relevance: Using Aloe vera as an alternative caries prevention agent. Full article

Background/Objectives: Halitosis in geriatric patients is multifactorial, but the joint contribution of prosthetic rehabilitation type and polypharmacy after routine dental procedures has rarely been quantified. We investigated how prosthesis type, polypharmacy, and salivary function were associated with volatile sulfur compound (VSC) burden and self-perceived halitosis in elderly dental patients. Methods: This cross-sectional study enrolled 88 patients aged ≥65 years, four weeks after completing routine dental procedures. Participants were stratified into three groups: complete denture wearers (n = 30), partial removable denture wearers (n = 28), and fixed prostheses/implants (n = 30). We measured unstimulated salivary flow rate (uSFR), tongue coating index (TCI), denture biofilm index, total VSCs (Halimeter^®), organoleptic score (0–5), and self-perceived halitosis. Polypharmacy, comorbidities, and the Geriatric Oral Health Assessment Index (GOHAI) were recorded. Analyses included one- and two-way ANOVA, Spearman correlations, theory-informed multivariable linear and logistic regression, exploratory mediation analysis, and ROC curves. Results: Forty-two participants (47.7%) reported halitosis. Mean VSC differed across groups (complete dentures 278.2 ± 38.6 ppb; partial 211.2 ± 46.3 ppb; fixed 164.4 ± 43.9 ppb; ANOVA p < 0.001). uSFR correlated inversely with VSC (ρ = −0.61, p < 0.001) and TCI correlated positively (ρ = 0.56, p < 0.001). A significant prosthesis × polypharmacy interaction was observed (F = 3.74, p = 0.029, η²_p = 0.082): polypharmacy was associated with higher VSC most clearly among partial and fixed prostheses wearers, whereas complete denture wearers showed high VSC levels regardless of polypharmacy status. Exploratory mediation findings were consistent with partial indirect association, with 45.9% of the polypharmacy–VSC association statistically explained by reduced uSFR; however, the cross-sectional design precludes causal or temporal interpretation. The full multivariable model showed apparent discrimination for self-perceived halitosis (AUC = 0.92), while the simplified four-item chairside composite model showed AUC = 0.89; neither estimate was optimism-corrected or externally validated. Conclusions: In elderly post-procedure patients, complete denture wearing, polypharmacy, and salivary hypofunction were independently and jointly associated with higher halitosis burden. Reduced salivary flow was consistent with a partial indirect statistical pathway in the polypharmacy–VSC association, supporting hydration counseling and meticulous prosthesis hygiene as low-cost geriatric interventions. Sensitivity analyses excluding implant-supported restorations, participants with MMSE scores of 24–26, and expanded mediation models including TCI and biofilm/plaque did not materially change the main inference. Full article

The oral cavity harbors a complex microbial community where pathogens implicated in dental caries and periodontitis can heavily colonize toothbrushes, transforming them into persistent sources of contamination that threaten both oral and systemic health. Consequently, this study evaluated the bactericidal efficacy of 275 nm ultraviolet light-emitting diode (UV-LED) irradiation against common oral bacteria in vitro and its practical utility for extraoral toothbrush sanitization. Suspensions of Streptococcus mutans, Streptococcus sanguinis, Porphyromonas gingivalis, and Fusobacterium nucleatum were irradiated for 3 min, 6 min, and 9 min. Bacterial growth and bactericidal effects were measured using growth curve and colony-forming unit assays, respectively. LIVE/DEAD staining and crystal violet staining were used to evaluate the bacterial viability and multispecies biofilm formation after irradiation. Additionally, the sanitization effects of a 275 nm UVC-based portable device on used toothbrushes were investigated. Direct UVC irradiation at 275 nm exhibited strong bactericidal effects against common oral bacteria in vitro. UVC irradiation also showed great sanitization effects on used toothbrushes. In summary, the vulnerability of common oral bacteria to 275 nm UVC, combined with its sanitizing efficacy on used toothbrushes, establishes a solid basis for extraoral sanitization, offering a reliable strategy to mitigate the risk of oral pathogen transmission from contaminated toothbrushes. Full article

Background: Dental caries is a chronic disease mediated by biofilm, which is caused by Streptococcus mutans, and enamel genetics modulates susceptibility. The variants of ENAM might alter the adhesion of enamel and bacteria. One important anti-viral target is sortase A (SrtA), which restricts colonization but does not have an impact on bacterial survival. Aim: The aim of this study was to find out the relationship between ENAM rs3796704 and dental caries vulnerability among adult Iraqi Arab females and to assess the antibiofilm capacity of eugenol and cinnamic acid against S. mutans SrtA using molecular docking, ADMET prediction, and molecular dynamics modeling. Methods: A case–control study was done on 240 women (aged 25–30 years; 120 caries, 120 controls). HRM real-time PCR was done to genotype ENAM rs3796704. An analysis of allelic and genotypic distributions was done using chi-square tests and odds ratios (p < 0.05). An in silico docking analysis aimed at SrtA (PDB: 4TQX) was performed in AutoDock Vina, and this was followed by ADMET profiling and a 50 ns molecular dynamics simulation (OPLS4/TIP3P, NPT 300 K/1 atm). Results: The level of the G allele was found to be lower in the cases than in the controls (60% vs. 70; OR = 0.6429; p = 0.02), but the level of the A allele was found to be higher in the cases (40% vs. 30; OR = 1.5556; p = 0.02). Docking showed a minor difference in binding affinities with eugenol (−4.961 kcal/mol) and cinnamic acid (−4.939 kcal/mol) as compared with chlorhexidine (−4.692 kcal/mol). Both compounds showed stable binding for more than 50 ns as well as desirable predicted pharmacokinetics. Conclusions: The caries vulnerability in this sample was associated with ENAM rs3796704. Eugenol and cinnamic acid undergo stable dissociative interactions with SrtA and were found to have favorable safety profiles in silico. Therefore, they may be considered as adjunctive anti-virulence agents in the prevention of caries. Full article

Objectives: Recurrent vulvovaginal candidiasis (RVVC) is a difficult-to-treat infection, most likely due to the growth of Candida biofilms on the human vaginal epithelium. We assessed in vitro efficacy of conventional antifungals and complementary and alternative medicine (CAM) used in clinical settings, and sought for Candida biofilm-effective single or combination therapies. Methods: Standard broth microdilution assay and XTT (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) assay were used for antifungal and anti-biofilm efficacies of three conventional antifungals, and selected CAM including boric acid, povidone-iodine, and allicin (garlic extract), against Candida clinical isolates grown at neutral and acidic pHs respectively. Fractional inhibitory concentration (FIC) indices were assessed to evaluate interactions between fluconazole and different CAM. Viable count-based cell enumeration and confocal laser scanning microscopy (CLSM) were performed to confirm the efficacy of single or combination therapies against Candida biofilms. Results: All selected conventional antifungals and CAM showed efficacies against planktonic Candida cells. Acidic vaginal microenvironments provided agent-specific protection to Candida cells against conventional antifungals and the CAM. Synergistic or additive interactions were observed between fluconazole at serum achievable concentrations and povidone-iodide at topically achievable concentrations against all tested Candida strains. Most antifungal agents except caspofungin had very limited activities against Candida biofilms. Combining fluconazole at 8 mg/L with povidone-iodine at 2048 mg/L effectively killed Candida biofilms in an acidic vaginal microenvironment to a level that is comparable to that of caspofungin. Conclusions: We provided robust in vitro evidence supporting the combinational use of oral fluconazole and topical CAM povidone-iodine against Candida biofilms in managing RVVC. Full article

Systemic antibiotics are among the most widely prescribed therapeutic agents worldwide, and their effects on host–microbe equilibrium extend well beyond the infection for which they are intended. Periodontitis is conventionally framed as a biofilm-initiated, host-mediated inflammatory disease, although recent work has shifted this framework toward microbial homeostasis as a regulator of periodontal stability. We hypothesize that antibiotics are not direct etiologic agents of periodontitis but instead act as risk-modifying factors that lower the threshold at which plaque-mediated inflammation progresses to destructive disease. We propose that this effect may operate through several mechanisms: broad-spectrum or repeated exposure could deplete protective commensals and narrow microbial diversity, creating ecological space for opportunistic and pathogenic taxa; antibiotics may also alter host neutrophil function, cytokine profiles, and antimicrobial peptide regulation and may interfere with the osteoblastic and osteoclastic dynamics governing alveolar bone remodelling; and antibiotic-induced gut dysbiosis may propagate systemic inflammatory signals that further modulate periodontal susceptibility. To evaluate this hypothesis, we synthesize the available clinical, epidemiological, and experimental data across four converging axes—oral microbial ecology, immune regulation, alveolar bone remodelling, and the gut–oral axis—and identify the predictions the hypothesis generates and the evidence gaps it exposes. We emphasize that no clinical study has yet demonstrated a causal link between antibiotic exposure and periodontitis; the framework advanced here is therefore intended to inform antimicrobial stewardship in dentistry and to define a research agenda for determining whether antibiotic exposure constitutes a clinically meaningful modifier of periodontal disease susceptibility. Full article

Background/Objectives: Methods of smoking have evolved over the years, including heated tobacco products. The impact of exposure to traditional tobacco smoke and heated/electronic tobacco products (IQOS) on biofilm formation has not been previously compared in vitro. Aims and objectives: The present study aimed to evaluate the impact of tobacco and electronic smoking on microbial biofilm formation on dental hard tissues. Materials and Methods: Thirty premolars were randomly assigned to six groups (n = 10 per group) according to tissue type and smoking exposure: Six experimental groups were defined: Group 1, non-exposed enamel; Group 2, enamel subjected to conventional cigarette smoke (CS); Group 3, enamel subjected to heated tobacco (HT); Group 4, non-exposed cementum; Group 5, cementum subjected to conventional cigarette smoke; and Group 6, cementum exposed to heated tobacco. Enamel and root discs were then immersed in 2 mL of an adjusted, standardized bacterial suspension of Streptococcus mutans (S. mutans) to allow bacterial biofilm adhesion after incubation for 48 h at 37 °C. The mean colony-forming unit (CFU) count was calculated, and the surface topography and roughness were assessed using scanning electron microscopy and ImageJ software with the SurfCharJ plugin, respectively. Results: Conventional cigarette smoking showed significantly higher S. mutans adhesion on the enamel and root discs compared with IQOS and control groups. Both IQOS and cigarette smoking increased roughness on enamel and root versus the control group, and cigarette smoking produced significantly higher roughness on the enamel surface when compared to IQOS; however, there were no significant differences in the roughness between the two smoking methods on the root surface. SEM analysis showed the most extensive enamel and root microtopography change in IQOS smoking. Conclusions: Aerosols from heated tobacco products (IQOS) alter the surface topography and roughness of enamel and root, while traditional cigarette smoking significantly increases bacterial colonization. Further in vivo studies are warranted to simulate the dynamic nature of the oral cavity. Full article

The gut microbiome has emerged as one of the most promising sources of non-invasive biomarkers for colorectal cancer (CRC). Over the past decade, fecal metagenomic studies have consistently identified a core CRC-associated signature enriched with oral-typical, biofilm-forming species, most notably Fusobacterium nucleatum, Parvimonas micra, Peptostreptococcus stomatis, and Bacteroides fragilis. The recent landmark pooled analysis by Piccinno et al., which combined 3741 metagenomes from 18 international cohorts, offers the most methodologically solid confirmation of this signature to date. It achieved a leave-one-dataset-out area under the curve (AUC) of around 0.85 and expanded resolution to previously unclassified species-level genome bins (SGBs) and strain-level phylogenies. In this narrative review, we critically evaluate the evidence supporting current universal CRC microbiome signatures, explore the mechanistic basis of the oral-to-gut microbial axis and the immunometabolic tumor microenvironment, and argue that increasing evidence indicates the field is nearing a point where investigating patient-level heterogeneity could be the most valuable next step. Because a strong average CRC signal has been convincingly established, an important next direction is to examine how much these signatures’ impact varies among individual patients, considering tumor molecular subtype, immune environment, metabolic profile, and host genetics. We review emerging evidence of such patient-level heterogeneity, outline analytical methods to assess it, and discuss its importance for developing microbiome-based screening, prognostics, and therapeutic strategies in CRC. Full article

Background: Streptococcus mutans is a key etiological agent of dental caries, and its ability to form biofilms significantly increases resistance to antimicrobial agents. This study evaluated the activity of selected oral antiseptics against both planktonic and biofilm forms of S. mutans. Methods: Seven pure antiseptic compounds and nine commercially available mouthwashes were tested. Minimal inhibitory concentrations (MICs) were determined using a microdilution method, and their clinical relevance was assessed using the Clinical Efficiency of MIC (CEMIC) index. Antibiofilm activity was evaluated using a crystal violet assay and by measuring biofilm thickness using 3D microscopy and the Biofilm Thickness Analyzer application. Results: The highest antibacterial and antibiofilm activity was observed for octenidine (OCT), chlorhexidine (CHX), and polyhexanide (PHMB), as well as for mouthwashes containing these agents, all showing high CEMIC values. Hydrogen peroxide (H₂O₂) and fluoride-containing formulations also demonstrated notable activity. In contrast, ethacridine lactate and boric acid showed variable effects, while sodium hypochlorite and potassium permanganate exhibited weak antibacterial activity and no antibiofilm effect. Conclusions: OCT, CHX, and PHMB were the most effective against both planktonic and biofilm forms of S. mutans. H₂O₂ and fluoride-containing formulations also showed promising activity. These findings support the role of selected antiseptics in reducing dental plaque formation, a key factor in the development of oral diseases. Full article

Periodontitis (P) and Type 2 Diabetes Mellitus (T2DM) are chronic inflammatory diseases that share pathophysiological pathways involving immune dysregulation and oxidative stress. Both conditions have been associated with increased susceptibility to viral infections, including SARS-CoV-2. In this regard, molecules associated with viral infection include angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). This study aimed to evaluate the clinical periodontal status, oral microbiota composition, and the expression of ACE2 and TMPRSS2 in the oral epithelium and gingival tissue of patients with and without T2DM and P. Methods: This cross-sectional study enrolled 120 participants allocated into four groups based on periodontal and glycemic status: periodontally healthy non-diabetic individuals (PH non-T2DM), periodontitis without diabetes (P non-T2DM), periodontally healthy individuals with type 2 diabetes mellitus (PH T2DM), and periodontitis with T2DM (P T2DM), with 30 participants per group. Full-mouth clinical periodontal parameters were recorded by a calibrated examiner. Oral microbiota was assessed from unstimulated whole saliva, labial swab samples, and subgingival biofilm by selective culture and checkerboard DNA-DNA hybridization. Gingival exfoliative cytology and full-thickness gingival biopsies were obtained for immunohistochemical evaluation of ACE2 and TMPRSS2 expression. Cytomorphometric analysis and polymorphonuclear cell counts were performed on epithelial smears. Additionally, primary human gingival fibroblasts (HGFs) isolated from each group were stimulated with bacterial ligands (LPS, LTA, and PGN) to assess ACE2 and TMPRSS2 modulation by Western blot. Intergroup comparisons were performed using one-way ANOVA with Bonferroni post hoc correction and the Mann–Whitney U test, with statistical significance set at p < 0.05. Results: Diabetic patients exhibited higher plaque accumulation, clinical attachment loss, and bleeding on probing compared with non-diabetic individuals (p < 0.05). The diabetic groups showed significantly higher levels of Actinomyces, Fusobacterium, and Streptococcus spp., with decreased Staphylococcus counts. ACE2 and TMPRSS2 expression were markedly elevated in gingival epithelial cells of P T2DM patients, predominantly in basal and suprabasal layers. The nuclear-to-cytoplasmic ratio and polymorphonuclear cell counts were also increased in diabetic subjects. Conclusions: T2DM and P synergistically upregulate ACE2 and TMPRSS2 expression and alter the oral microbiota. Full article

Probiotics are known to benefit human health through improving the gut environment. This study aimed to investigate whether Streptococcus salivarius (S. salivarius) G7 exhibits probiotic properties and evaluated its effectiveness and suitability for oral health applications. Whole-genome sequencing of S. salivarius was performed using Novo assembly and bioinformatics analysis. To determine probiotic suitability, the required metabolic profiles were obtained through performing a hemolysis test, antibiotic susceptibility test, D-lactate production assay, and cytotoxicity assay according to the methods recommended in World Health Organization guidelines. To investigate the oral health impacts of S. salivarius, the acidogenicity and antimicrobial activity of S. salivarius were investigated. Finally, oral biofilms treated and untreated with S. salivarius were investigated. The phylogenetic and bioinformatic analyses confirmed the taxonomic identity of S. salivarius. Also, it has been proven that this bacterium carries no virulence factors or transmissible antibiotic resistance genes. S. salivarius G7 exhibited low antibiotic resistance, cytotoxicity, and acidogenicity, while also displaying antimicrobial activity against oral disease-related bacteria, and was able to maintain eubiosis in oral biofilms. S. salivarius G7 met all the safety assessment criteria required by current probiotic guidelines and exhibited beneficial properties for oral health. Therefore, this strain may represent a safe and promising probiotic candidate for oral health applications. Full article

Periodontal disease is a chronic inflammatory condition driven by polymicrobial biofilms whose interaction with the host immune response drives the destruction of tooth-supporting tissues. Within these communities, bacterial cell–cell communication—particularly quorum sensing (QS)—coordinates virulence factor expression, biofilm maturation, and interspecies behaviour, allowing pathogens to mount population-dependent attacks on the host. Disrupting these signals has therefore drawn growing attention as an anti-virulence strategy for biofilm-associated oral infection. Quorum quenching (QQ)—the inhibition or disruption of QS pathways—prevents bacteria from coordinating these virulence-related activities. The candidate inhibitors investigated to date fall into three broad classes: conventional antibiotics used at sub-inhibitory concentrations, plant-derived natural compounds, and synthetic molecules designed to interfere with signal synthesis, signal reception, or signal transduction. In experimental work on periodontal pathogens, agents from each class reduce biofilm formation, suppress virulence factor production, and disrupt microbial communication within polymicrobial biofilms. Clinical translation, however, lags behind the laboratory evidence. Most data still come from in vitro systems and animal models, and the ecological complexity of the oral biofilm makes therapeutic targeting difficult: signals that drive virulence in pathogens also support cooperation among commensals. Toxicity profiles, pharmacokinetics, and well-powered clinical trials are needed before quorum-quenching agents can be considered for routine periodontal care. Even with these caveats, targeting bacterial communication offers a different therapeutic logic from conventional antimicrobials: attenuating virulence rather than killing cells, and so exerting weaker selective pressure for resistance. Further dissection of QS networks in oral biofilms—and the rational design of quenching agents that act on pathogenic rather than commensal signalling—may yield useful adjuncts to current periodontal therapy. Full article

Microbiome dysbiosis has become recognized as an important interface connecting environmental exposures to chronic inflammatory and degenerative diseases. Although prior research has largely considered heavy metals as biomarkers of exposure and toxicity, their function as ecological modulators of host-associated microbial communities remains underexplored. The oral cavity is a distinct exposome–microbiome interface where environmental, behavioral, and intraoral metal sources converge and interact with structured biofilms and mucosal immunity. This review adopts an ecological systems perspective, interpreting chronic low-dose exposure to metals such as cadmium, lead, mercury, nickel, chromium, arsenic, and aluminum as a sustained selective force on oral microbial networks. A resilience–threshold model is proposed in which cumulative metal pressure progressively diminishes microbial community stability, alters network topology, and drives transitions toward persistent dysbiosis. These modifications are further reinforced by oxidative–inflammatory feedback loops at the host–microbiome interface, facilitating a self-sustaining ecological imbalance. Sketching on insights from microbial ecology, environmental toxicology, and host response biology, this review presents a framework that links metallomic patterns to microbial restructuring, redox imbalance, immune activation, and regulatory adaptation. The analysis emphasizes ecological perturbations from stable dysbiotic states and identifies key methodological limitations that currently restrict causal inference. By conceptualizing heavy metals as active ecological drivers rather than passive exposure indicators, this work establishes a foundation for understanding microbiome-mediated disease susceptibility within an exposome-informed systems biology framework. Full article

Populus nigra buds contain resinous exudates rich in flavonoids, phenolic acids, terpenoids and other bioactive constituents. These exudates are the main botanical source of European Poplar-type propolis. Since hive-collected propolis shows strong botanical, geographical and hive contaminant variability, P. nigra bud resin exudate represents an attractive, standardizable and reproducible alternative for obtaining natural-complex ingredients. This study investigates the compositional relationship between Propolgemma^® standardized P. nigra buds (PBHE) and European propolis (PHE) hydroalcoholic extracts through integrated analytical approaches and evaluates the functional bioactivity of PBHE and a related oral spray formulation (Propolgemma^® spray forte, PBHE-SF). Untargeted metabolomic fingerprinting revealed clear clustering of P. nigra bud exudate with European propolis, demonstrating high compositional similarity. Targeted analyses confirmed that PBHE belongs to the poplar-type propolis family, while retaining additional bud-derived constituents such as salicylates, lignins and tannins, typical of bud tissue and largely absent from hive-collected propolis. Functionally, PBHE showed concentration-dependent antioxidant activity and significant inhibition of Streptococcus pyogenes biofilm at sub-MIC levels. PBHE, incorporated into a patented oral spray formulation (PBHE-SF), demonstrated strong mucoadhesion, high resistance to salivary wash-off, retention of antioxidant flavonoids on epithelial substrates and a mechanical barrier effect, reducing LPS-induced IL-6 release by 39%. It also showed dispersion of pre-formed S. pyogenes biofilms. PBHE emerges as a reproducible, plant-derived, bee-independent alternative to European propolis. Its chemical consistency, functional reliability, independence from bee foraging and from hive-derived contaminants improve the therapeutic potential on mucosal protection in medical device formulations and the suitability for scalable, controlled and industrially sustainable production. Full article