RESUMEN
Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin) and prosthesis disinfection with sodium hypochlorite was prescribed for all patients. Seven patients were positive for C. albicans in the mucosa, with 1 negative result for the prosthetic surface in this group of patients. Post-treatment evaluation revealed the absence of C. albicans on prosthesis surface and on the oral mucosa of all patients. The severity of the candidal infection was significantly higher in the palatal mucosa than in the buccal mucosa, but similar in the palatal mucosa and prosthesis surface, indicating that the mucosa underlying the prosthesis is more susceptible to infection. The therapeutic protocol was effective in all cases, which emphasizes the need for denture disinfection in order to avoid reinfection of the mucosa.
Asunto(s)
Candida albicans/aislamiento & purificación , Candidiasis Bucal/diagnóstico , Labio Leporino/microbiología , Fisura del Paladar/microbiología , Obturadores Palatinos/microbiología , Adolescente , Adulto , Candidiasis Bucal/complicaciones , Candidiasis Bucal/microbiología , Labio Leporino/complicaciones , Labio Leporino/rehabilitación , Fisura del Paladar/complicaciones , Fisura del Paladar/rehabilitación , Desinfección/métodos , Femenino , Humanos , Masculino , Fístula Oral/complicaciones , Fístula Oral/microbiología , Adulto JovenRESUMEN
Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis disinfection with sodium hypochlorite was prescribed for all patients. Seven patients were positive for C. albicans in the mucosa, with 1 negative result for the prosthetic surface in this group of patients. Post-treatment evaluation revealed the absence of C. albicans on prosthesis surface and on the oral mucosa of all patients. The severity of the candidal infection was significantly higher in the palatal mucosa than in the buccal mucosa, but similar in the palatal mucosa and prosthesis surface, indicating that the mucosa underlying the prosthesis is more susceptible to infection. The therapeutic protocol was effective in all cases, which emphasizes the need for denture disinfection in order to avoid reinfection of the mucosa.
Os pacientes portadores de prótese obturadora freqüentemente apresentam estomatite protética. Com o objetivo de detectar a presença de Candida albicans oral em pacientes com comunicação oronasal e avaliar a eficácia de um tratamento tópico antifúngico foi realizada citologia esfoliativa da mucosa palatina e jugal e da superfície acrílica nasal da prótese obturadora. O protocolo terapêutico consistiu de nistatina (Mycostatin®) para tratamento da mucosa oral e uma solução de hipoclorito de sódio para desinfecção da prótese. Sete pacientes (70 por cento) apresentaram resultado positivo para C. albicans na mucosa, com um resultado negativo para a superfície protética neste grupo. A avaliação após o tratamento revelou ausência de C. albicans na mucosa oral de todos os pacientes, bem como na superfície protética. A infecção por C. albicans das mucosas jugal e palatina diferiram significantemente, enquanto que a mucosa palatina e a superfície protética apresentaram valores semelhantes. O grau de infecção da mucosa palatina foi significantemente maior quando comparado àquele da mucosa jugal e semelhante ao apresentado pela prótese, sugerindo que a mucosa subjacente à prótese é mais susceptível à infecção. O protocolo terapêutico foi efetivo em todos os casos, o que enfatiza a necessidade da desinfecção protética para se evitar a reinfecção da mucosa oral.
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Candida albicans/aislamiento & purificación , Candidiasis Bucal/diagnóstico , Labio Leporino/microbiología , Fisura del Paladar/microbiología , Obturadores Palatinos/microbiología , Candidiasis Bucal/complicaciones , Candidiasis Bucal/microbiología , Labio Leporino/complicaciones , Labio Leporino/rehabilitación , Fisura del Paladar/complicaciones , Fisura del Paladar/rehabilitación , Desinfección/métodos , Fístula Oral/complicaciones , Fístula Oral/microbiología , Adulto JovenRESUMEN
AIM: To examine the microbiological status of primary endodontic infections in teeth with and without a sinus tract. METHODOLOGY: Samples were collected by means of a size 15 H-type file and two sterile paper points from 30 cases of primary endodontic infections with (n = 15) or without (n = 15) a sinus tract. The presence of 40 bacterial species was determined by the checkerboard DNA-DNA hybridization method. RESULTS: The species found at the highest levels and prevalence were Fusobacterium nucleatum sp. vincentii, Porphyromonas gingivalis, Veillonella parvula, Enterococcus faecalis, Campylobacter gracilis and Neisseria mucosa. Total bacterial counts were similar between teeth with (44 x 10(5)) and without (50 x 10(5)) a sinus tract (t-test: P > 0.05). E. faecalis, Streptococcus anginosus, Capnocytophaga sputigena and Capnocytophaga gingivalis had significantly higher counts in the absence of sinus tract (Mann-Whitney test, P < 0.05). Higher levels of P. gingivalis and Fusobacterium nucleatum sp. nucleatum were observed in cases with a sinus tract. Leptotrichia buccalis (OR = 1.83; CI 95%) and Porphyromonas endodontalis (OR = 2.15; CI 95%) were associated with an increased chance of subjects having a sinus tract. CONCLUSIONS: Primary endodontic infections were associated with a large variety of bacterial species. Specific differences between the composition of the microbiota of primary root canal infections were observed in cases with or without a sinus tract.
Asunto(s)
Cavidad Pulpar/microbiología , Necrosis de la Pulpa Dental/microbiología , Infecciones por Bacterias Gramnegativas/diagnóstico , Infecciones por Bacterias Grampositivas/diagnóstico , Fístula Oral/microbiología , Absceso Periapical/microbiología , Adolescente , Adulto , Anciano , Bacteroides/clasificación , Bacteroides/aislamiento & purificación , Recuento de Colonia Microbiana , Necrosis de la Pulpa Dental/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fístula Oral/complicaciones , Absceso Periapical/complicaciones , Estadísticas no Paramétricas , Ápice del Diente/microbiologíaRESUMEN
This study evaluated the microbiological conditions of root canals, using smears and culture from anterior teeth and premolars with necrotic pulps associated with chronic periapical pathologies, before and after biomechanical preparation (BMP). During double-flared instrumentation, 1, 2.5 and 5% sodium hypochlorite (NaOCl)-based irrigants were used in 3 groups: GI (n=39), GII (n=36) and GIII (n=36), respectively. Before BMP, all cultures were positive and the smears showed microbiologically diverse morphotypes, including fusiforms, pleomorphic, rods, cocci and filaments. Quantitatively, 20, 20 and 23 morphotypes were identified in GI, GII and GIII, respectively). After BMP, the percentages of negative cultures in GI, GII and GIII were 74.2%, 86.3% and 93.4% (p>0.05) and the number of morphotypes decreased to 14, 15 and 5, respectively. All teeth with 2 root canals and/or associated fistulas were microbiologically negative after BMP, regardless of irrigant concentration. Gram-negative morphotypes were more susceptible to the action of irrigants. After irrigation with 5% NaOCl, only structural arrangements consisting of Gram-positive cocci and bacilli persisted. Thus, BMP plus 5% NaOCl offered the best antiseptic potential because in the few positive cultures a significant reduction in the number of microbiological morphotypes was also shown (p<0.05).
Asunto(s)
Antiinfecciosos Locales/uso terapéutico , Bacterias/efectos de los fármacos , Cavidad Pulpar/microbiología , Irrigantes del Conducto Radicular/uso terapéutico , Preparación del Conducto Radicular/métodos , Hipoclorito de Sodio/uso terapéutico , Adolescente , Adulto , Antiinfecciosos Locales/administración & dosificación , Bacterias/clasificación , Fenómenos Biomecánicos , Quelantes/uso terapéutico , Caries Dental/microbiología , Caries Dental/terapia , Necrosis de la Pulpa Dental/microbiología , Necrosis de la Pulpa Dental/terapia , Ácido Edético/uso terapéutico , Bacterias Gramnegativas/clasificación , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/clasificación , Bacterias Grampositivas/efectos de los fármacos , Cocos Grampositivos/efectos de los fármacos , Humanos , Persona de Mediana Edad , Fístula Oral/microbiología , Fístula Oral/terapia , Enfermedades Periapicales/microbiología , Enfermedades Periapicales/terapia , Irrigantes del Conducto Radicular/administración & dosificación , Preparación del Conducto Radicular/instrumentación , Hipoclorito de Sodio/administración & dosificaciónRESUMEN
This study evaluated the microbiological conditions of root canals, using smears and culture from anterior teeth and premolars with necrotic pulps associated with chronic periapical pathologies, before and after biomechanical preparation (BMP). During double-flared instrumentation, 1, 2.5 and 5 percent sodium hypochlorite (NaOCl)-based irrigants were used in 3 groups: GI (n=39), GII (n=36) and GIII (n=36), respectively. Before BMP, all cultures were positive and the smears showed microbiologically diverse morphotypes, including fusiforms, pleomorphic, rods, cocci and filaments. Quantitetively, 20, 20 and 23 morphotypes were identified in GI, GII and GIII, respectively). After BMP, the percentages of negative cultures in GI, GII and GIII were 74.2 percent, 86.3 percent and 93.4 percent (p>0.05) and the number of morphotypes decreased to 14, 15 and 5, respectively. All teeth with 2 root canals and/or associated fistulas were microbiologically negative after BMP, regardless of irrigant concentration. Gram-negative morphotypes were more susceptible to the action of irrigants. After irrigation with 5 percent NaOCl, only structural arrangements consisting of Gram-positive cocci and bacilli persisted. Thus, BMP plus 5 percent NaOCl offered the best antiseptic potential because in the few positive cultures a significant reduction in the number of microbiological morphotypes was also shown (p<0.05).
Este estudo avaliou as condições microbiológicas dos canais radiculares, por meio de esfregaços e culturas de dentes anteriores e pré-molares com necrose pulpar associada à radiolucidezes periapicais, antes e após o preparo biomecânico (PBM). Utilizou-se a técnica de instrumentação biescalonada coadjuvada por soluções de hipoclorito de sódio (NaOCl) a 1, 2,5 ou 5 por cento nos grupos I (n=39), II (n=36) e III (n=36), respectivamente. Antes do PBM havia 100 por cento de culturas positivas e os esfregaços proveram diversificados morfotipos microbiológicos, sendo 20, 20 e 23 nos grupos I, II e III, respectivamente. Após o PBM, o percentual de culturas negativas nos grupos I, II e III foi 74,2 por cento, 86,3 e 93,4 por cento (p>0,05) e a incidência de morfotipos declinou para 14, 15 e 5, respectivamente. Todos os dentes birradiculados e/ou portadores de fístulas apresentaram-se microbiologicamente negativos após o PBM, independentemente do irrigante utilizado. Os morfotipos Gram-negativos foram mais suscetíveis à ação do PBM. Após o PBM persistiram apenas cocos e bacilos Gram-positivos no grupo III. Portanto, o PBM coadjuvado por solução de NaOCl a 5 por cento, proporcionou o melhor desempenho anti-séptico, pois, nas poucas culturas positivas, houve também significativa redução do número de morfotipos microbiológicos (p<0.05).