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Effects of Ultrasound-Mediated Treatments on Dental Biofilm Attachment and Viability.

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Title: Effects of Ultrasound-Mediated Treatments on Dental Biofilm Attachment and Viability.
Authors: De Grandi D; Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, UK., LuTheryn G; Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK., Stoffels M; Philips Oral Healthcare, Eindhoven, The Netherlands., Born M; Philips Oral Healthcare, Eindhoven, The Netherlands., Gottenbos B; Philips Oral Healthcare, Eindhoven, The Netherlands., Carugo D; Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK. Electronic address: dario.carugo@ndorms.ox.ac.uk., Stride E; Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, UK.
Source: Ultrasound in medicine & biology [Ultrasound Med Biol] 2026 Sep; Vol. 52 (9), pp. 1900-1911. Date of Electronic Publication: 2026 Jun 25.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Pergamon Press Country of Publication: England NLM ID: 0410553 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-291X (Electronic) Linking ISSN: 03015629 NLM ISO Abbreviation: Ultrasound Med Biol Subsets: MEDLINE
Imprint Name(s): Original Publication: Oxford, New York, Pergamon Press.
MeSH Terms: Biofilms*/radiation effects , Biofilms*/growth & development , Streptococcus mutans*/physiology , Ultrasonic Therapy*/methods , Bacterial Adhesion*/radiation effects, Chlorhexidine/pharmacology ; Microbubbles ; Microbial Viability ; Humans
Abstract: Objective: Dental biofilms are responsible for the majority of oral cavity diseases (e.g., caries, periodontitis and gingivitis). In this work, we evaluate the effects of therapeutic ultrasound on a Streptococcus mutans biofilm model. The research aim is to assess whether therapeutic ultrasound can be implemented in standard practice for the treatment and prevention of oral infections.
Methods: Streptococcus mutans biofilms were grown on a tooth-mimicking substrate and subsequently exposed to chlorhexidine (CHX) and therapeutic ultrasound treatments. We examined the effects of low duty cycle (1%) 0.5 MHz ultrasound treatment at varying peak negative pressures (0.75-3.00 MPa) and CHX concentrations (0.025, 0.050 and 0.100 % w/V), both in the presence and absence of lipid-coated gas microbubbles.
Results: Ultrasound treatment was effective at removing biofilm, particularly at peak negative pressures exceeding 2.25 MPa and in the presence of lipid-coated microbubbles as cavitation nuclei. Ultrasound exposure also resulted in improved bactericidal action of low-concentration CHX (0.050% w/V).
Conclusion: We demonstrated that 0.5 MHz therapeutic ultrasound treatment can be used for the mechanical removal of a fully formed and mechanically robust Streptococcus biofilm model. Although the ultrasound treatment alone did not reduce bacterial cell viability, its combination with low concentrations of CHX improved the antimicrobial treatment outcomes.
(Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.)
Competing Interests: Conflict of interest M.S., M.B. and B.G. are employees of Royal Philips N.V. D.D.G.’s DPhil project at the University of Oxford was partially funded by Royal Philips N.V. No products of Royal Philips N.V. are being investigated in this paper.
Contributed Indexing: Keywords: AMR; Antimicrobial treatment; Biofilm removal; Biofilms; Cavitation; Dental hygiene; Microbubbles; Streptococcus mutans; Therapeutic ultrasound
Substance Nomenclature: R4KO0DY52L (Chlorhexidine)
Entry Date(s): Date Created: 20260625 Date Completed: 20260801 Latest Revision: 20260801
Update Code: 20260802
DOI: 10.1016/j.ultrasmedbio.2026.05.008
PMID: 42350196
Database: MEDLINE
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  Data: Effects of Ultrasound-Mediated Treatments on Dental Biofilm Attachment and Viability.
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  Data: <searchLink fieldCode="AU" term="%22De+Grandi+D%22">De Grandi D</searchLink>; Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, UK.<br /><searchLink fieldCode="AU" term="%22LuTheryn+G%22">LuTheryn G</searchLink>; Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK.<br /><searchLink fieldCode="AU" term="%22Stoffels+M%22">Stoffels M</searchLink>; Philips Oral Healthcare, Eindhoven, The Netherlands.<br /><searchLink fieldCode="AU" term="%22Born+M%22">Born M</searchLink>; Philips Oral Healthcare, Eindhoven, The Netherlands.<br /><searchLink fieldCode="AU" term="%22Gottenbos+B%22">Gottenbos B</searchLink>; Philips Oral Healthcare, Eindhoven, The Netherlands.<br /><searchLink fieldCode="AU" term="%22Carugo+D%22">Carugo D</searchLink>; Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK. Electronic address: dario.carugo@ndorms.ox.ac.uk.<br /><searchLink fieldCode="AU" term="%22Stride+E%22">Stride E</searchLink>; Institute of Biomedical Engineering (IBME), Department of Engineering Science, University of Oxford, Oxford, UK.
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  Data: <searchLink fieldCode="JN" term="%220410553%22">Ultrasound in medicine & biology</searchLink> [Ultrasound Med Biol] 2026 Sep; Vol. 52 (9), pp. 1900-1911. <i>Date of Electronic Publication: </i>2026 Jun 25.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Pergamon+Press%22">Pergamon Press </searchLink><i>Country of Publication: </i>England <i>NLM ID: </i>0410553 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1879-291X (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2203015629%22">03015629 </searchLink><i>NLM ISO Abbreviation: </i>Ultrasound Med Biol <i>Subsets: </i>MEDLINE
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  Data: <i>Original Publication</i>: Oxford, New York, Pergamon Press.
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  Data: <searchLink fieldCode="MM" term="%22Biofilms%22">Biofilms*</searchLink>/<searchLink fieldCode="MM" term="%22Biofilms+radiation+effects%22">radiation effects</searchLink> <br /><searchLink fieldCode="MM" term="%22Biofilms%22">Biofilms*</searchLink>/<searchLink fieldCode="MM" term="%22Biofilms+growth+%26+development%22">growth & development</searchLink> <br /><searchLink fieldCode="MM" term="%22Streptococcus+mutans%22">Streptococcus mutans*</searchLink>/<searchLink fieldCode="MM" term="%22Streptococcus+mutans+physiology%22">physiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Ultrasonic+Therapy%22">Ultrasonic Therapy*</searchLink>/<searchLink fieldCode="MM" term="%22Ultrasonic+Therapy+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Bacterial+Adhesion%22">Bacterial Adhesion*</searchLink>/<searchLink fieldCode="MM" term="%22Bacterial+Adhesion+radiation+effects%22">radiation effects</searchLink><br /><searchLink fieldCode="MH" term="%22Chlorhexidine%22">Chlorhexidine</searchLink>/<searchLink fieldCode="MH" term="%22Chlorhexidine+pharmacology%22">pharmacology</searchLink> ; <searchLink fieldCode="MH" term="%22Microbubbles%22">Microbubbles</searchLink> ; <searchLink fieldCode="MH" term="%22Microbial+Viability%22">Microbial Viability</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Dental biofilms are responsible for the majority of oral cavity diseases (e.g., caries, periodontitis and gingivitis). In this work, we evaluate the effects of therapeutic ultrasound on a Streptococcus mutans biofilm model. The research aim is to assess whether therapeutic ultrasound can be implemented in standard practice for the treatment and prevention of oral infections.<br />Methods: Streptococcus mutans biofilms were grown on a tooth-mimicking substrate and subsequently exposed to chlorhexidine (CHX) and therapeutic ultrasound treatments. We examined the effects of low duty cycle (1%) 0.5 MHz ultrasound treatment at varying peak negative pressures (0.75-3.00 MPa) and CHX concentrations (0.025, 0.050 and 0.100 % w/V), both in the presence and absence of lipid-coated gas microbubbles.<br />Results: Ultrasound treatment was effective at removing biofilm, particularly at peak negative pressures exceeding 2.25 MPa and in the presence of lipid-coated microbubbles as cavitation nuclei. Ultrasound exposure also resulted in improved bactericidal action of low-concentration CHX (0.050% w/V).<br />Conclusion: We demonstrated that 0.5 MHz therapeutic ultrasound treatment can be used for the mechanical removal of a fully formed and mechanically robust Streptococcus biofilm model. Although the ultrasound treatment alone did not reduce bacterial cell viability, its combination with low concentrations of CHX improved the antimicrobial treatment outcomes.<br /> (Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.)
– Name: Abstract
  Label: Competing Interests
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  Data: Conflict of interest M.S., M.B. and B.G. are employees of Royal Philips N.V. D.D.G.’s DPhil project at the University of Oxford was partially funded by Royal Philips N.V. No products of Royal Philips N.V. are being investigated in this paper.
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  Data: <i>Keywords: </i>AMR; Antimicrobial treatment; Biofilm removal; Biofilms; Cavitation; Dental hygiene; Microbubbles; Streptococcus mutans; Therapeutic ultrasound
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        Value: 10.1016/j.ultrasmedbio.2026.05.008
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      – Code: eng
        Text: English
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        StartPage: 1900
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      – SubjectFull: Chlorhexidine pharmacology
        Type: general
      – SubjectFull: Microbubbles
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      – SubjectFull: Microbial Viability
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      – SubjectFull: Streptococcus mutans physiology
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