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OBJECTIVE: Single dose of systemic antibiotics and short-term use of mouthwashes reduce bacteremia. However, the effects of a single dose of preprocedural rinse are still controversial. This study evaluated, in periodontally diseased patients, the effects of a pre-procedural mouth rinse on induced bacteremia. MATERIAL AND METHODS: Systemically healthy individuals with gingivitis (n=27) or periodontitis (n = 27) were randomly allocated through a sealed envelope system to: 0.12% chlorhexidine pre-procedural rinse (13 gingivitis and 13 periodontitis patients) or no rinse before dental scaling (14 gingivitis and 15 periodontitis patients). Periodontal probing depth, clinical attachment level, plaque, and gingival indices were measured and subgingival samples were collected. Blood samples were collected before dental scaling, 2 and 6 minutes after scaling. Total bacterial load and levels of P. gingivalis were determined in oral and blood samples by real-time polymerase chain reaction, while aerobic and anaerobic counts were determined by culture in blood samples. The primary outcome was the antimicrobial effect of the pre-procedural rinse. Data was compared by Mann-Whitney and Signal tests (p<0.05). RESULTS: In all sampling times, polymerase chain reaction revealed higher blood bacterial levels than culture (p<0.0001), while gingivitis patients presented lower bacterial levels in blood than periodontitis patients (p<0.0001). Individuals who experienced bacteremia showed worse mean clinical attachment level (3.4 mm vs. 1.1 mm) and more subgingival bacteria (p<0.005). The pre-procedural rinse did not reduce induced bacteremia. CONCLUSIONS: Bacteremia was influenced by periodontal parameters. In periodontally diseased patients, pre-procedural rinsing showed a discrete effect on bacteremia control.

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Abstract Objective: Single dose of systemic antibiotics and short-term use of mouthwashes reduce bacteremia. However, the effects of a single dose of preprocedural rinse are still controversial. This study evaluated, in periodontally diseased patients, the effects of a pre-procedural mouth rinse on induced bacteremia. Material and Methods: Systemically healthy individuals with gingivitis (n=27) or periodontitis (n = 27) were randomly allocated through a sealed envelope system to: 0.12% chlorhexidine pre-procedural rinse (13 gingivitis and 13 periodontitis patients) or no rinse before dental scaling (14 gingivitis and 15 periodontitis patients). Periodontal probing depth, clinical attachment level, plaque, and gingival indices were measured and subgingival samples were collected. Blood samples were collected before dental scaling, 2 and 6 minutes after scaling. Total bacterial load and levels of P. gingivalis were determined in oral and blood samples by real-time polymerase chain reaction, while aerobic and anaerobic counts were determined by culture in blood samples. The primary outcome was the antimicrobial effect of the pre-procedural rinse. Data was compared by Mann-Whitney and Signal tests (p<0.05). Results: In all sampling times, polymerase chain reaction revealed higher blood bacterial levels than culture (p<0.0001), while gingivitis patients presented lower bacterial levels in blood than periodontitis patients (p<0.0001). Individuals who experienced bacteremia showed worse mean clinical attachment level (3.4 mm vs. 1.1 mm) and more subgingival bacteria (p<0.005). The pre-procedural rinse did not reduce induced bacteremia. Conclusions: Bacteremia was influenced by periodontal parameters. In periodontally diseased patients, pre-procedural rinsing showed a discrete effect on bacteremia control.

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Bacteriemia é a presença de microrganismos - bactérias, vírus e fungos - viáveis no sangue circulante. O objetivo do presente estudo foi revisar a literatura sobre bacteriemia enfocando principalmente seu impacto sistêmico e os estudos em odontologia/periodontia. Para isso foram acessadas as bases Pubmed e Scielo, sendo aceitos artigos publicados em português ou inglês, entre os anos 2002 a 2014. Os trabalhos demonstraram que os episódios de bacteriemia resolvem-se espontaneamente na maioria das ocorrências, mas que podem haver complicações graves embora pouco frequentes. Embora o efeito cumulativo dos episódios de bacteriemia ainda não tenha sido esclarecido, a bacteriemia sofre influência da condição periodontal. Em pacientes periodontalmente doentes, até atividades cotidianas podem desencadear o evento. Antibióticos profiláticos devem ser prescritos para pacientes de risco. Os estudos em periodontia ainda são relativamente escassos e inconsistentes. Inúmeras questões ainda precisam ser investigadas...

Bacteremia is the presence of viable microorganisms – bacteria, virus and fungi – in the blood. The aim of the present study was to review literature about bacteremia focusing on its systemic impact and studies in dentistry/ periodontics. Pubmed and Scielo databases were consulted. Manuscripts published in Portuguese and English between 2002 a 2014 were accepted. Data showed that bacteremia is frequently associated with spontaneous resolution although in same cases there could be severe comorbidity. Cumulative effect due to episodes of bacteremia has not been already investigated. Periodontal diseases influence bacteremia. In periodontally diseased patients, even daily activities can induce bacteremia. Prophylactic antibiotics should be prescribed for at-risk patients. Studies in periodontics are still scarce. Several questions should be investigated...

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Introduction: Patients seem to adhere better to short-term periodontal treatment schemes. Besides, time-reduced treatments are more cost-effective. However, the degree of benefits related to this type of treatment still requires additional investigations. Aim: The present short-term study evaluated clinical and microbiological outcomes, from baseline to 3-months, of chronic periodontitis subjects treated by the one-stage full-mouth disinfection protocol. Material and Method: Sixteen chronic periodontitis subjects (mean-age 49.87 ± 8.22) who met inclusion/exclusion criteria were included. A calibrated examiner measured whole-mouth plaque and gingival indices, periodontal pocket depth and clinical attachment level at baseline and at 3-months. Subgingival samples were also collected from the 5 most diseased periodontal sites to determine total bacterial load and levels of P. gingivalis and S. oralis by real time qPCR. Periodontal treatment consisted of full-mouth manual debridement plus wide intraoral use of chlorhexidine in gel and solution. Additionally, after debridement, individuals rinsed 0.12% chlorhexidine at home twice a day for the following 2 months. Data monitored were compared by paired Student-t test (p<0.05). Result: Statistical analysis revealed that, in general, one-stage full-mouth disinfection treatment provided significant clinical and microbiological improvements at 3-months. Total bacterial load showed one of the most pronounced reductions from baseline to 3-months (p=0.0001). Also, subgingival levels P. gingivalis and S. oralis reduced overtime. Conclusion: After a short period of monitoring, chronic periodontitis subjects showed clinical and microbial improvements following one-stage full-mouth disinfection treatment.

Introdução: Os pacientes parecem aderir melhor ao tratamento periodontal de curto prazo. Além disso, tratamentos de tempo curto possuem melhor custo-benefício. No entanto, os benefícios associados a este tipo de tratamento ainda requerem investigações adicionais. Objetivo: O presente estudo avaliou longitudinalmente indivíduos com periodontite crônica clínica e microbiologicamente tratados pelo protocolo one-stage full-mouth disinfection. Material e Método: Dezesseis indivíduos (49,87 ± 8,22), que se enquadraram nos critérios de inclusão/exclusão foram incluídos. Um examinador calibrado, avaliou índice de placa e gengival, profundidade de bolsa e nível clínico de inserção pré e pós terapia. Amostras subgengivais coletadas dos cinco sítios periodontais mais doentes estabeleceram a carga bacteriana total e níveis de P. gingivalis e S. oralis por qPCR. One-stage full-mouth disinfection foi realizado com instrumentos manuais associado a gel de clorexidina e solução. Após, os indivíduos utilizaram clorexidina 0,12% para bochecho, duas vezes ao dia, durante os dois meses. Dados foram comparados pelo teste pareado t de Student (p<0,05). Resultado: A análise estatística revelou que o tratamento proporcionou melhorias clínicas e microbianas significativas em três meses. A carga bacteriana total evidenciou reduções mais pronunciadas do pré para o pós-tratamento (p=0,0001). Similarmente, P. gingivalis e S. oralis mostraram redução no pós-tratamento. Conclusão: Após 3 meses de monitoramento, indivíduos com periodontite crônica apresentaram melhora clínica e microbiana com o protocolo one stage full-mouth disinfection.

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Introdução: O Centro de Atenção Psicossocial Álcool e Drogas visa a prevenção e o tratamento do usuário e família. Objetivos: Os objetivos foram levantar o perfil dos frequentadores do CAPSad, verificar as drogas mais utilizadas, os motivos para o início do uso e identificar o que levaram os pacientes a frequentar o CAPSad.Materiais e métodos: É uma pesquisa epidemiológica seccional, realizada por meio da coleta e análise de dados dos prontuários. Foram analisados 454 prontuários,noperíododemaioajunhode2008.Resultados: Osresultadosmostramque87,2% dos pacientes eram do sexo masculino; 27,3% na faixa etária de 41 ­ 50 anos; 71,5% não viviam com parceiros; 61% possuem bom relacionamento com a família e 59,3% estão desempregados. O tempo de uso das substâncias fica na faixa de 1 a 10 anos com 32,5%, sendo a adolescência a fase de vida que prevalece com 56,4%. O motivo que levou ao início do uso de drogas com 52,3% foram os amigos. O álcool prevalece como substância mais utilizada pelos usuários com 85,5%. Conclusão: Esta pesquisa mostra a necessidade de se desenvolverem ações de prevenção ao uso de drogas desde a infância a adolescência, no qual as ações devem acontecer de uma forma articulada entre os diversos segmentos locais

Introduction: The Center for Psychosocial Care Alcohol and drugs aimed at prevention and treatment of user and family. Objectives: The objectives were to raise the profile of the attendees CAPSad, check the most used drugs, the reasons for the initiation of use and identify the patient's reasons to attend the CAPSad. It is a cross sectional epidemiological survey carried out by collecting and analyzing data from medical records. We analyzed 560 medical records for the period May-June 2008. Results: The results show that 87,2% of patients were male, 27,3% aged 41to 50 years old, 71,5% not living with partners, 61% have good relationships with family, 59,3% are unemployed. The time substances use is in age from 1 to10 years old with 32,5%, the phase of life that prevails is adolescence with 56,4%. The reason that led to the initiation of drug ue with 52,3% was friends. Alcohol prevails as the most used substance by users with 85,5%. Conclusion: This study shows the need to develop measures for preventing drug use in childhood and adolescence, in which the actions should occur in a joint effort between the various local sectors.

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