RESUMO
INTRODUCTION: Infective endocarditis (IE) is still associated with high mortality, and antibiotic prophylaxis strategies are under intense debate. We evaluated the incidence of bacteremia after root canal preparation in teeth with necrotic pulps and apical periodontitis. METHODS: Blood samples were taken before and 5 and 30 minutes after endodontic treatment in teeth with apical periodontitis from individuals at high (n = 21) or no risk (n = 11) for IE. The former received prophylactic antibiotic therapy. Bacteriologic samples were taken from root canals before chemomechanical preparation to confirm pulp infection. Samples were subjected to aerobic and anaerobic culture and quantitative real-time polymerase chain reaction (qPCR), the latter to determine the total bacterial and streptococcal levels. RESULTS: Culture revealed no bacteremia in all individuals. Analysis by qPCR showed that bacterial DNA occurred in all root canal samples. qPCR showed a similar incidence of bacteremia between patients who received or did not receive prophylactic antibiotic therapy (P > .05). In blood samples taken 5 minutes after endodontic procedures, bacteria were detected in 2 of 11 (18%) individuals not taking antibiotics and in 4 of 21 (19%) patients under prophylaxis. After 30 minutes, the incidence of bacteremia decreased to 2 of 21 (10%) in patients taking antibiotics and was undetectable in patients at no risk of IE. The incidence of bacteremia by streptococci was identical as that for total bacteria. CONCLUSIONS: No detectable bacteremia was evident by culture after treatment of infected root canals. Molecular analysis revealed bacterial DNA and streptococci in blood from some patients without a significant difference between individuals receiving or not receiving antibiotic prophylaxis.
Assuntos
Bacteriemia/etiologia , Bacteriemia/prevenção & controle , Cardiopatias/complicações , Periodontite Periapical/complicações , Periodontite Periapical/terapia , Tratamento do Canal Radicular , Adulto , Idoso , Antibioticoprofilaxia , Bacteriemia/microbiologia , Cavidade Pulpar/microbiologia , Necrose da Polpa Dentária/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Risco , Irrigantes do Canal Radicular/uso terapêuticoRESUMO
OBJECTIVE: The present study is aimed to evaluate the antimicrobial action of Coltosol(®) in direct contact with human saliva. MATERIALS AND METHODS: Twelve different individuals were selected. Saliva samples were evaluated at four different time periods: Baseline 1 (T1-initial control), T2 (2 h), T4 (24 h after contact with a standardized sample of a coronary sealer) and baseline 2 (T3-final control). Seeded plates were incubated at 37°C in a bacterial incubator for a period of 48-72 h. After the incubation period, the colony forming units were counted, and the results compared. RESULTS: Differences were statistically significant. There was an inhibition of bacterial growth after the first 2 h of contact and an increase in the number of bacteria after 24 h of direct contact between the material and the saliva. Coltosol(®) presented bacterial growth inhibition in direct contact with saliva. This inhibitory effect tended to decrease over time, as shown by the two periods when the material was in contact with different samples of saliva. CONCLUSIONS: The antimicrobial activity of the material is an important feature; however, other physical and chemical properties of the coronary temporary sealer should be considered.
RESUMO
Introdução: Soluções de antissépticos bucais podem desempenhar importante papel no controle químico do biofilme dentário. No entanto, os procedimentos de controle de qualidade relacionados com a atividade antimicrobiana destes enxaguatórios contra bactérias da cavidade oral não são bem divulgados. Objetivo: Avaliar a atividade antimicrobiana in vivo de seis soluções de antissépticos bucais disponíveis no mercado brasileiro, empregadas como enxaguatórios contra bactérias da saliva humana. Material e métodos: Um estudo in vivo foi desenvolvido com indivíduos voluntários (8 do sexo masculino e 7 do sexo feminino, variando de 18 a 63 anos de idade ), independente do estado de saúde bucal. Os seguintes produtos comerciais foram testados durante 2 horas após um único procedimento de bochecho: 1) Plax®, 2) Listerine®, 3) Periogard®, 4) Cepacol®, 5) Sanifill Premium® e 6) Oral B®.Os resultados foram analisados pelo teste de ANOVA de medidas repetidas e ANOVA one-way com um nível de significância de 5%. Resultados: Houve diferença significativa (p <0,05) observada na diminuição da carga microbiana para Plax® entre o início (antes anti-séptico bucal) e imediatamente após o bochecho (T0); para Periogard® entre os valores iniciais e T60 (60 minutos após o bochecho), na linha de base e T120 (120 minutos após o bochecho) e B® Oral entre os valores iniciais e T-30 (30 minutos após o bochecho). Periogard® apresentou a maior redução da carga microbiana salivares. Conclusão: Dos seis bochechos testados, Plax®, Oral B® e Periogard ® apresentou atividade antibacteriana imediata. Periogard® foi o anti-séptico bucal que mostrou a atividade mais prolongada contra bactérias anaeróbias salivares (AU).
Introduction: Mouthwashes solutions can play an important role in the chemical control of dental biofilm. However, quality control procedures related to antimicrobial activity of these solutions against oral bacteria are not well known. Objective: To evaluate in vivo antimicrobial activity of six mouthwashes solutions available in the Brazilian market against anaerobic salivary bacteria. Material and methods: An in vivo study was developed in human volunteers (8 male and 7 female, ranging from 18 to 63 years old), despite their oral health status. The following commercial products were tested after 2 hours of a single mouthwash procedure: 1) Plax®, 2) Listerine®, 3) Periogard®, 4) Cepacol®, 5) Sanifill Premium® and 6)Oral B®. Data were analyzed by ANOVA to repeated measures and ANOVA one-way with a significance level of 5%. Results: Statistically significant difference (p<0.05) was observed in the decrease of microbial counts to Plax® between baseline (before mouthwash) and immediately after mouthwash (T0); to Periogard® between baseline and T60 (60 minutes after mouthwash), baseline and T120 (120 minutes after mouthwash) and to Oral B® between baseline and T-30 (30 minutes after mouthwash). Periogard® showed the highest and delayed reduction of salivary microbial counts. Conclusion: Out of six tested mouthwashes, Plax®, Oral B® and Periogard ® showed immediate antibacterial activity. Periogard® was the oral anti-septic that showed the best delayed activity against salivary anaerobic bacteria (AU).
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Antibacterianos/uso terapêutico , Bactérias Anaeróbias , Antissépticos Bucais/uso terapêutico , Produtos para Higiene Dental e Bucal , Saliva/microbiologia , Análise de Variância , BrasilRESUMO
O abscesso perirradicular agudo pode resultar em complicações sistêmicas, sendo necessária a antibioticoterapia coadjuvante ao tratamento clínico. No entanto, os antibióticos são frequentemente prescritos pelos cirurgiões-dentistas no tratamento destas infecções em algumas situações questionáveis. É importante destacar que o uso incorreto destes agentes terapêuticos pode levar ao surgimento de micro- -organismos resistentes. O objetivo da presente revisão de literatura é descrever a antibioticoterapia no tratamento de abscessos perirradiculares agudos, abordando suas indicações e drogas utilizadas, e discutir a resistência bacteriana a alguns antibióticos.
The acute periradicular abscess can result in systemic complications, being necessary a complementary antibiotic therapy to clinical treatment. However, antibiotics are often prescribed by dentists to treat these infections, but its use is questionable in some situations. Misuse of antibiotics can lead to the emergence of resistant micro-organisms. The aim of this present literature review is to describe the antibiotic treatment in acute periradicular abscesses by addressing its indications and drug use, and discuss about bacterial resistance to some antibiotics.
Assuntos
Abscesso Periapical , Endodontia , Antibacterianos , Terapêutica , Preparações Farmacêuticas , InfecçõesRESUMO
AIM: The aims of the current study were to compare the levels of HIV-1 in the subgingival biofilm (SHVL) between detectable and undetectable plasmatic HIV-1 viral load (PHVL) in HIV-infected patients as well as to determine the association of SHVL with PHVL and clinical periodontal parameters. MATERIAL AND METHODS: Forty-one HIV-infected individuals were divided into two groups: detectable (21) and undetectable (20) PHVL. Subgingival biofilm samples were obtained for detection and quantification of HIV-1 by real-time RT-PCR. To estimate the effect of co-variables on the outcome undetectable SHVL, the Generalized Estimation Equation (GEE) was employed. RESULTS: Detectable SHVL was observed only in the detectable PHVL group and the detection of the HIV-1 was observed in 40% of these individuals. In the bivariate analysis between co-variables from the individual level and the outcome SHVL, significant difference was observed only for the CD4+ T lymphocytes levels (p = 0.017). The multiple logistic model demonstrated that only CD4+ T lymphocytes levels had a significant effect on the outcome undetectable SHVL [OR 8.85 (CI 3.6-9.2), p = 0.002]. CONCLUSION: HIV-1 can be detected and quantified in the subgingival biofilm of HIV-infected individuals, but these findings are not associated with PHVL and periodontal clinical parameters.
Assuntos
Biofilmes , Gengiva/virologia , Infecções por HIV/virologia , HIV-1/isolamento & purificação , Carga Viral , Adulto , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Linfócitos T CD8-Positivos/patologia , Periodontite Crônica/classificação , Periodontite Crônica/virologia , Placa Dentária/virologia , Feminino , Hemorragia Gengival/classificação , Hemorragia Gengival/virologia , Humanos , Contagem de Linfócitos , Masculino , Perda da Inserção Periodontal/classificação , Perda da Inserção Periodontal/virologia , Bolsa Periodontal/classificação , Bolsa Periodontal/virologia , Viremia/virologia , Adulto JovemRESUMO
A etiologia das lesões perirradiculares e suas diferentes manifestações clínicas já estão bastante esclarecidas, porém o tratamento dos cistos radiculares ainda é um assunto controverso na Odontologia. O objetivo deste trabalho é realizar uma análise crítica, baseada na literatura, sobre o tratamento de cistos radiculares, buscando evidências que demonstrem que os cistos radiculares podem ser eliminados após tratamento endodôntico. Os cistos podem ser divididos em: cistos em bolsa e cistos verdadeiros, sendo que os cistos em bolsa respondem ao tratamento endodôntico, enquanto os cistos verdadeiros somente podem ser tratados através da cirurgia perirradicular. Pode-se concluir que sendo o agente microbiano o responsável pelas lesões perirradiculares, a maioria destas lesões, incluindo os cistos, regridem após a intervenção endodôntica não cirúrgica.
The etiology of apical periodontitis and its different clinical manifestations are already well versed, but the treatment of radicular cysts is still a controversial subject in Dentistry. The e aim of this study is to perform a critical analysis based on literature regarding treatment of radicular cysts, seeking evidence demonstrating that the radicular cysts can be eliminated after endodontic treatment. The cysts can be divided in: Apical Pocket Cysts and true cysts. Apical pocket cysts respond to endodontic treatment, while true cysts can only be treated by periradicular surgery. It can be concluded that since the microbial agent is responsible for the apical periodontitis, the majority of these lesions, including cysts regress after nonsurgical endodontic therapy.
Assuntos
Tratamento do Canal Radicular , Cisto Radicular , EndodontiaRESUMO
BACKGROUND: This study investigates the association between detectable plasmatic human immunodeficiency virus (HIV) viral load (HVL) and high levels of periodontal- and non-periodontal-related microorganisms in the subgingival microbiota of individuals with HIV. METHODS: Thirty-seven individuals with HIV were divided into two groups: 1) detectable HVL (n = 15); and 2) undetectable HVL (n = 22). Subgingival biofilm samples were obtained, and the levels of 35 microbial species were determined by the checkerboard DNA-DNA hybridization method. Periodontal clinical measures and laboratory and sociodemographic data were also registered. χ(2) test, Fisher exact test, and Mann-Whitney U test were used to compare groups. Multilevel ordinal regression models were used to test the association between HVL and the levels of 35 microbial species in subgingival biofilm, adjusted for confounders. RESULTS: Of the 35 species studied, 11 (31.4%) showed higher mean levels in the detectable HVL group than undetectable HVL group (P <0.001). These species included Actinomyces naeslundii II, Actinomyces israelii, Actinomyces odontolyticus, Veillonella parvula, Capnocytophaga gingivalis, Eikenella corrodens, Campylobacter concisus, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Candida albicans. Significant associations between detectable HVL and high levels of microorganisms, adjusted for confounders, were observed for A. naeslundii I, Actinomyces gerencseriae, C. gingivalis, E. corrodens, C. concisus, Prevotella nigrescens, T. forsythia, and Dialister pneumosintes. CONCLUSION: Detectable plasmatic HVL in individuals with HIV was associated with elevated levels of known periodontal pathogens, such as P. nigrescens, T. forsythia, and E. corrodens, as well as C. concisus, C. gingivalis, and D. pneumosintes in the subgingival biofilm.
Assuntos
Biofilmes/classificação , Infecções por HIV/virologia , HIV/isolamento & purificação , Doenças Periodontais/microbiologia , Carga Viral , Viremia/sangue , Actinomyces/classificação , Adulto , Idoso , Bactérias/classificação , Carga Bacteriana , Bacteroides/isolamento & purificação , Brasil , Campylobacter/isolamento & purificação , Candida albicans/isolamento & purificação , Capnocytophaga/isolamento & purificação , Placa Dentária/microbiologia , Eikenella corrodens/isolamento & purificação , Feminino , Gengiva/microbiologia , Infecções por HIV/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Porphyromonas gingivalis/isolamento & purificação , Treponema denticola/isolamento & purificação , Veillonella/isolamento & purificação , Adulto JovemRESUMO
O objetivo do trabalho foi comparar a atividade antimicrobiana in vitro de 6 seladores coronários temporários. Foram testados: Vitro Molar®, IRM®, Coltosol®, Citodur, Maxxion R® e Cavit®. O método utilizado foi o teste de determinação da ação antimicrobiana de difusão em ágar inoculado com amostras de saliva humana de 30 indivíduos. Os testes ANOVA e Mann-Whitney foram utilizados para a análise estatística da medida dos halos de inibição do crescimento bacteriano. A correção de Bonferroni foi aplicada para as comparações múltiplas. Coltosol® foi selador coronário que apresentou a maior média de halo de inibição do crescimento microbiano in vitro, sendo estatisticamente superior ao IRM® (p<0,001) e Citodur® (p<0,001). As demais comparações dos pares dos outros seladores não demonstraram significância.
The purpose of this study was to compare the in vitro antimicrobial activity of six temperary coronary sealers. The materiais tested were: Vitro Molar®, IRM®, Coltosol®, Citodur®, Maxxion R® and Cavit®. The method used for determining antimicrobial activity was the agar diffusion test with human saliva samples from 30 individuals. The ANOVA and Mann-Whitney test were used for statistical analysis of measurements of the halos of bacterial growth inhibition. The Bouferroni correction was applied for multiple comparisons. Coltoso® was the sealer with the highest average of bacterial growth inhibition, statistically superior to IRM® (p<0.001) and Citodu® (p<0.001). The comparisons of pairs of other sealers showed no significant differences concerning to bacterial growth inhibition.
Assuntos
Humanos , Masculino , Feminino , Restauração Dentária Temporária , Endodontia , Materiais Dentários/análise , Produtos com Ação AntimicrobianaRESUMO
Probióticos são definidos como micro-organismos vivos que, quando administrados em quantidade adequada, podem trazer benefícios ao hospedeiro melhorando seu equilíbrio intestinal. Estudos recentes têm sugerido que alguns probióticos funcionam como um método auxiliar no controle da doença cárie, pois podem diminuir os níveis salivares de Streptococcusmutans. Muitas bactérias, incluindo os gêneros Lactobacillus e Bifidobacterium possuem propriedades probióticas. Diversos veículos podem ser utilizados para administrá-los, entretanto o mais comum é o iogurte. Porém mais estudos sobre probióticos são necessários para comprovar seus reais benefícios na cavidade oral, permitindo aos dentistas indicarem seu consumo com segurança.
Assuntos
Cárie Dentária , Lactobacillus , Probióticos/farmacologia , Streptococcus mutansRESUMO
O objetivo desta revisão foi adequar, à realidade atual, uma proposição anterior para o emprego de antibióticos em Endodontia, devido ao crescente número de relatos de resistência bacteriana entre os isolados bacterianos de cavidade oral. Dentre os novos medicamentos surgidos na última década não se encontram antibióticos que ofereçam uma opção viável para seu emprego na antibioticoterapia em Odontologia, mas uma releitura das drogas já existentes permitiu a proposição de algumas alterações no protocolo usualmente empregado pelos clínicos. Em virtude da grande importância de um critério rigoroso para a indicação do uso de antibióticos na clínica odontológica moderna, este estudo apresenta também uma proposição quanto aos casos clínicos que se enquadram no uso destas drogas.
The aim of this review was to adjust to the current reality, a previous proposition for the employment of antibiotics in Endodontics, caused by the growing number of reports about bacterial resistance among isolates recovered from the oral cavity. Among the new drugs that emerged in the last decade, none of them provides a viableoption for it employment in antibiotic therapy in Dentistry. However, a reinterpretation of the existing drugs allowed proposing some changes to the protocol usually employed by clinicians. Given the great importance of a rigorouscriterion to use antibiotics in modern dentistry, this study also presents a proposition about the clinical cases wherethese drugs are indicated.
Assuntos
Antibacterianos , Resistência Microbiana a Medicamentos , EndodontiaRESUMO
The purpose of this study was to investigate the influence of serum and necrotic soft tissue on the antimicrobial activity of intracanal medicaments. The medicaments tested were: calcium hydroxyde/glycerin paste, calcium hydroxide/chlorhexidine paste, calcium hydroxide/camphorated paramonochlorophenol/glycerin paste, and chlorhexidine/zinc oxide paste. Survival of Enterococcus faecalis and Candida albicans exposed to the medicaments tested in the presence or absence of serum or necrotic tissue was monitored in three in vitro experiments where samples for culturing were taken at different time periods. The overall results demonstrated that the antimicrobial activity of all intracanal medicaments tested was slowed down in the presence of necrotic tissue. Calcium hydroxide pastes in glycerin or chlorhexidine were significantly affected by serum. Of the medicaments tested in this study, the least affected was the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste.
Assuntos
Anti-Infecciosos Locais/farmacologia , Candida albicans/efeitos dos fármacos , Cavidade Pulpar/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Irrigantes do Canal Radicular/farmacologia , Animais , Anti-Infecciosos Locais/química , Hidróxido de Cálcio/química , Hidróxido de Cálcio/farmacologia , Cânfora/química , Cânfora/farmacologia , Bovinos , Clorexidina/química , Clorexidina/farmacologia , Clorofenóis/química , Clorofenóis/farmacologia , Contagem de Colônia Microbiana , Combinação de Medicamentos , Glicerol/química , Glicerol/farmacologia , Testes de Sensibilidade Microbiana , Necrose/microbiologia , Irrigantes do Canal Radicular/química , Soro , Camada de Esfregaço , Óxido de Zinco/química , Óxido de Zinco/farmacologiaRESUMO
The purpose of this study was to investigate the influence of serum and necrotic soft tissue on the antimicrobial activity of intracanal medicaments. The medicaments tested were: calcium hydroxyde/glycerin paste, calcium hydroxide/chlorhexidine paste, calcium hydroxide/camphorated paramonochlorophenol/glycerin paste, and chlorhexidine/zinc oxide paste. Survival of Enterococcus faecalis and Candida albicans exposed to the medicaments tested in the presence or absence of serum or necrotic tissue was monitored in three in vitro experiments where samples for culturing were taken at different time periods. The overall results demonstrated that the antimicrobial activity of all intracanal medicaments tested was slowed down in the presence of necrotic tissue. Calcium hydroxide pastes in glycerin or chlorhexidine were significantly affected by serum. Of the medicaments tested in this study, the least affected was the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste.
O objetivo deste estudo foi avaliar a influência do soro e de tecido mole necrosado na atividade antimicrobiana de medicamentos intra-canais. Os medicamentos testados foram pastas de hidróxido de cálcio/glicerina, hidróxido de cálcio/clorexidina, hidróxido de cálcio/paramonoclorofenol canforado/glicerina e clorexidina/óxido de zinco. A sobrevivência de Enterococcus faecalis e Candida albicans expostos aos medicamentos na presença ou ausência de soro ou tecido necrosado foi monitorada em três experimentos in vitro nos quais amostras para cultura foram avaliadas em diferentes períodos de tempo. No geral, os resultados demonstraram que a atividade antimicrobiana de todos os medicamentos testados foi retardada na presença de soro ou de tecido necrosado. As pastas de hidróxido de cálcio em glicerina ou clorexidina foram significativamente afetadas pelo soro. Dos medicamentos testados, o menos afetado foi a pasta de hidróxido de cálcio/paramonoclorofenol canforado/glicerina.
Assuntos
Animais , Bovinos , Anti-Infecciosos Locais/farmacologia , Candida albicans/efeitos dos fármacos , Cavidade Pulpar/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Irrigantes do Canal Radicular/farmacologia , Anti-Infecciosos Locais/química , Contagem de Colônia Microbiana , Hidróxido de Cálcio/química , Hidróxido de Cálcio/farmacologia , Cânfora/química , Cânfora/farmacologia , Clorexidina/química , Clorexidina/farmacologia , Clorofenóis/química , Clorofenóis/farmacologia , Combinação de Medicamentos , Glicerol/química , Glicerol/farmacologia , Testes de Sensibilidade Microbiana , Necrose/microbiologia , Irrigantes do Canal Radicular/química , Soro , Camada de Esfregaço , Óxido de Zinco/química , Óxido de Zinco/farmacologiaRESUMO
Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.
Assuntos
Candida albicans/isolamento & purificação , Candidíase Bucal/prevenção & controle , Clorexidina/uso terapêutico , Antissépticos Bucais/uso terapêutico , Saliva/metabolismo , Xerostomia/microbiologia , Adulto , Idoso , Candida albicans/efeitos dos fármacos , Candidíase Bucal/microbiologia , Clorexidina/farmacologia , Contagem de Colônia Microbiana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/farmacologia , Estudos Prospectivos , Saliva/microbiologia , Taxa Secretória , Estatísticas não ParamétricasRESUMO
Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.
O fluxo salivar reduzido está associado a maior quantidade de Candida spp. na boca, predispondo a candidíase. O objetivo deste estudo foi comparar o efeito da estimulação salivar ao efeito do uso de bochechos de clorexidina sobre a intensidade de colonização por Candida em pacientes com fluxo salivar reduzido. Trinta e um pacientes de ambulatório foram aleatoriamente incluídos nos protocolos de estimulação salivar (grupo 1) ou de bochecho com clorexidina (grupo 2). As avaliações foram realizadas no dia inicial (T0), ao final do tratamento (T1) e 15 dias após o final do tratamento (T2). A cada consulta foram coletadas amostras de saliva total estimulada. O grupo 1 mostrou uma redução constante nas contagens medianas de UFC de Candida, embora a diferença estatística tenha sido apenas entre T0 e T2 (p = 0,004). O grupo 2 mostrou redução nas contagens de UFC de Candida entre T0 e T1 (p = 0,01), mas a contagem de UFC aumentou em T2 (p = 0,01), sendo a diferença entre T0 e T2 não significante (p = 0,8). Concluiu-se que os pacientes que realizaram procedimentos de estimulação salivar apresentaram a quantidade de UFC de Candida salivar reduzida, além de apresentarem tendência ao aumento do fluxo. O uso de bochechos de clorexidina reduziu drasticamente a quantidade de UFC de Candida salivar, mas após o final do tratamento houve novo aumento.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Candida albicans/isolamento & purificação , Candidíase Bucal/prevenção & controle , Clorexidina/uso terapêutico , Antissépticos Bucais/uso terapêutico , Saliva , Xerostomia/microbiologia , Contagem de Colônia Microbiana , Candida albicans/efeitos dos fármacos , Candidíase Bucal/microbiologia , Clorexidina/farmacologia , Antissépticos Bucais/farmacologia , Estudos Prospectivos , Taxa Secretória , Estatísticas não Paramétricas , Saliva/microbiologiaRESUMO
The oral cavity may act as a reservoir for several pathogens related to systemic infections. Therefore, the purpose of this study was to determine the prevalence and levels of pathogenic bacteria in the subgingival biofilm of chronic periodontitis lesions and healthy periodontal sites using the checkerboard DNA-DNA hybridization technique. 200 samples of subgingival biofilm from sites with periodontitis (probing pocket depth > 4 mm and /or clinical attachment level > 4 mm) and 200 samples from healthy sites of 14 patients with chronic periodontitis, as well as 200 samples from 3 periodontally healthy patients were obtained. The presence and levels of 11 pathogenic bacteria were determined using whole genomic DNA probes and the checkerboard method, computed for each site and then across sites within each subject group. Significance of differences in clinical and microbiological parameters among groups were examinated using the Mann-Whitney and Wilcoxon sign tests. The predominant species in all 600 samples included Corynebacterium diphtheriae, Enterococcus faecalis, Staphylococcus aureus,Acinetobacter baumannii and Escherichia coli. In general, most of the species were detected in greater prevalence and levels in sites with and without disease from patients with periodontitis in comparison to the periodontally healthy group. In particular, C. diphtheriae, E. coli, E. faecalis, P. aeruginosa and S. aureus were significantly more prevalent and detected in higher counts in diseased sites of patients with periodontal disease compared to healthy subjects (p < 0.05). Clinical signs of disease presented a positive correlation with the species A. baumannii, Streptococcus pyogenes, E. coli, S. aureus and P. aeruginosa. In conclusion, "non-oral" pathogenic bacteria are detected in high prevalence and levels in periodontal sites of chronic periodontitis patients.
Apesar da extensa literatura sobre a associação de bactérias orais e doenças sistêmicas, tem se dado pouca atenção à cavidade oral como um reservatório de bactérias patogênicas "não-orais". A microbiota oral é constituída de mais de 300 espécies bacterianas já caracterizadas, além de organismos não cultiváveis que vêm sendo descobertos através de técnicas moleculares. O objetivo do presente estudo foi determinar a prevalência e os níveis de 11 bactérias patogênicas "não-orais" em sítios periodontais de pacientes com periodontite e de pacientes saudáveis, utilizando a técnica do "Checkerboard DNA-DNA hybridization". 200 amostras de biofilme subgengival de sítios doentes (PBS > 4mm e/ou NCI > 4mm), 200 amostras de sítios saudáveis de 14 pacientes com periodontite e 200 amostras de sítios de 3 pacientes saudáveis foram selecionadas. A prevalência ( por cento de sítios colonizados) e os níveis de cada espécie bacteriana foram computados para cada sítio e dentro de cada grupo. Diferenças clínicas e microbiológicas entre os grupos foram avaliadas através dos testes de Mann-Whitney e Wilcoxon. As espécies que predominaram nas 600 amostras analisadas incluíram Corynebacterium diphtheriae, Enterococcus faecalis, Staphylococcus aureus, Acinetobacter baumannii e Escherichia coli. Em geral, a maioria das espécies estudadas foi detectada com maior freqüência e em níveis elevados nos sítios com e sem doença nos pacientes com periodontite em relação ao grupo com saúde periodontal. Em particular, C. diphtheriae, E. coli, E. faecalis, Pseudomonas. aeruginosa e S. aureus foram significantemente mais prevalentes e detectadas em maior número nos sítios doentes de pacientes com periodontite em relação aos sítios de indivíduos com saúde periodontal (p < 0,05). Sinais clínicos de doença periodontal apresentaram uma correlação positiva com as espécies A. baumannii, Streptococcus pyogenes, E. coli, S. aureus e P. aeruginosa. Além disso, as espécies S. pyogenes...
Assuntos
Adulto , Humanos , Bactérias/patogenicidade , Biofilmes , Técnicas In Vitro , Doenças Periodontais , Periodontite , Métodos , Prevalência , Estudos de AmostragemRESUMO
This investigation attempted to detect the proteolytic activity of Fusobacterium nucleatum in living cells, lysate cells, and supernatant of cultures. The reactions were optimized in their pH, temperature, reaction time, enzyme source, and substrate volume. Synthetic substrates beta-naphthylamides (Cys-Na, Ser-Na, Leu-Na, Glu-Na, Lys-Na and BANA), carbobenzoxy L-tirosine p-nitrophenylester (CTN), and natural substrate azoalbumin were used. Reaction occurred with Cys-Na, Ser-Na, and Glu-Na in living cells and with Glu-Na, Leu-Na, and CTN substrates in lysate cells. The supernatant reacted only with Glu-Na. Optimal pH ranged from 6.0 to 7.5, except for CTN (pH 13), and optimal temperature, between 30 and 40 degrees C. Optimal reaction time was 60 min, except for Glu-Na in living cells (40 min), lysate cells (20 min), and CTN substrate (80 min). There was no activity with Lys-Na, BANA, and azoalbumin. Proteolytic activity was assessed by several inhibitors and the presence of metallo, serine, cysteine, and aspartic proteases were detected.
Assuntos
Fusobacterium nucleatum/enzimologia , Periodontite/enzimologia , Animais , Bovinos , Peptídeo Hidrolases/análise , Peptídeo Hidrolases/efeitos dos fármacos , Inibidores de Proteases/metabolismo , Inibidores de Proteases/farmacologiaRESUMO
The oral cavity may act as a reservoir for several pathogens related to systemic infections. Therefore, the purpose of this study was to determine the prevalence and levels of pathogenic bacteria in the subgingival biofilm of chronic periodontitis lesions and healthy periodontal sites using the checkerboard DNA-DNA hybridization technique. 200 samples of subgingival biofilm from sites with periodontitis (probing pocket depth > 4 mm and /or clinical attachment level > 4 mm) and 200 samples from healthy sites of 14 patients with chronic periodontitis, as well as 200 samples from 3 periodontally healthy patients were obtained. The presence and levels of 11 pathogenic bacteria were determined using whole genomic DNA probes and the checkerboard method, computed for each site and then across sites within each subject group. Significance of differences in clinical and microbiological parameters among groups were examinated using the Mann-Whitney and Wilcoxon sign tests. The predominant species in all 600 samples included Corynebacterium diphtheriae, Enterococcus faecalis, Staphylococcus aureus,Acinetobacter baumannii and Escherichia coli. In general, most of the species were detected in greater prevalence and levels in sites with and without disease from patients with periodontitis in comparison to the periodontally healthy group. In particular, C. diphtheriae, E. coli, E. faecalis, P. aeruginosa and S. aureus were significantly more prevalent and detected in higher counts in diseased sites of patients with periodontal disease compared to healthy subjects (p 0.05). Clinical signs of disease presented a positive correlation with the species A. baumannii, Streptococcus pyogenes, E. coli, S. aureus and P. aeruginosa. In conclusion, "non-oral" pathogenic bacteria are detected in high prevalence and levels in periodontal sites of chronic periodontitis patients.
Apesar da extensa literatura sobre a associação de bactérias orais e doenças sistêmicas, tem se dado pouca atenção à cavidade oral como um reservatório de bactérias patogênicas "não-orais". A microbiota oral é constituída de mais de 300 espécies bacterianas já caracterizadas, além de organismos não cultiváveis que vêm sendo descobertos através de técnicas moleculares. O objetivo do presente estudo foi determinar a prevalência e os níveis de 11 bactérias patogênicas "não-orais" em sítios periodontais de pacientes com periodontite e de pacientes saudáveis, utilizando a técnica do "Checkerboard DNA-DNA hybridization". 200 amostras de biofilme subgengival de sítios doentes (PBS > 4mm e/ou NCI > 4mm), 200 amostras de sítios saudáveis de 14 pacientes com periodontite e 200 amostras de sítios de 3 pacientes saudáveis foram selecionadas. A prevalência (% de sítios colonizados) e os níveis de cada espécie bacteriana foram computados para cada sítio e dentro de cada grupo. Diferenças clínicas e microbiológicas entre os grupos foram avaliadas através dos testes de Mann-Whitney e Wilcoxon. As espécies que predominaram nas 600 amostras analisadas incluíram Corynebacterium diphtheriae, Enterococcus faecalis, Staphylococcus aureus, Acinetobacter baumannii e Escherichia coli. Em geral, a maioria das espécies estudadas foi detectada com maior freqüência e em níveis elevados nos sítios com e sem doença nos pacientes com periodontite em relação ao grupo com saúde periodontal. Em particular, C. diphtheriae, E. coli, E. faecalis, Pseudomonas. aeruginosa e S. aureus foram significantemente mais prevalentes e detectadas em maior número nos sítios doentes de pacientes com periodontite em relação aos sítios de indivíduos com saúde periodontal (p 0,05). Sinais clínicos de doença periodontal apresentaram uma correlação positiva com as espécies A. baumannii, Streptococcus pyogenes, E. coli, S. aureus e P. aeruginosa. Além disso, as espécies S. pyogenes e A. baumannii, C. diphteriae e E. faecalis,C. diphteriae e S. pyogenes, S. aureus e P. aeruginosa também demonstraram uma forte correlação positiva entre si. Bactérias patogênicas "não-orais" são detectadas em grande prevalência e altos níveis em sítios de pacientes com periodontite crônica.
RESUMO
BACKGROUND: Mechanical periodontal therapy is the most common treatment of periodontal infections. It is directed primarily towards removing biofilm and calculus from the root surfaces, leading to ecological changes in the subgingival environment. Thus, the purpose of this study was to evaluate the effects of scaling and root planing (SRP) on the subgingival microbiota of Brazilian subjects with untreated chronic periodontitis over a 9-month period. METHODS: Twenty-five untreated chronic periodontitis patients (mean age 43 +/- 5 years; 20% smokers; 45% males) were selected from a Brazilian population. At baseline, probing depth (PD), clinical attachment level (CAL), visible supragingival biofilm (SB), bleeding on probing (BOP), and suppuration (SUP) were measured at six sites/tooth. Subgingival plaque samples were obtained from 10 sites with the deepest PD (> or =5 mm) of each subject and tested for the presence of 25 oral species by DNA probes and the checkerboard technique. Patients received full mouth SRP and oral hygiene instructions. Clinical and microbiological assessments were repeated at 3, 6, and 9 months after therapy. During this period, all patients received maintenance therapy, including supragingival prophylaxis and reinforcement in home care procedures. The clinical and microbiological parameters examined were computed for each subject and at each visit. Differences over time were sought using the Friedman test. RESULTS: Significant reductions in mean CAL and PD (P <0.01), percent of sites with SB (P <0.01), BOP and SUP (P <0.05) were observed during the course of the study. In general, microbial changes were more pronounced for the mean counts than for the frequency of the microorganisms, particularly at 3 months post-therapy. Significant reductions in prevalence and levels were observed for certain periodontal pathogens including P. gingivalis (P <0.05; P <0.01), T. forsythensis (P <0.01), C. rectus (P <0.01), and A. actinomycetemcomitans (P <0.01; P <0.05). Nevertheless, the frequency of A. actinomycetemcomitans increased to baseline values at 9 months after therapy. Treponema ssp. and Prevotella spp. showed a modest decrease in prevalence, whereas marked reductions in their levels were observed. In contrast, the frequency and counts of the suspected pathogens P. micros and F. nucleatum increased after treatment. Species considered beneficial including Actinomyces spp., some oral streptococci, and V. parvula increased in prevalence, although these two last species tended to return to baseline levels at 9 months. CONCLUSION: In Brazilians with untreated chronic periodontitis, SRP led to clinical improvement associated with a decrease of certain periodontal pathogens, and an increase of beneficial species for up to 9 months after therapy.
Assuntos
Biofilmes , Raspagem Dentária , Periodontite/microbiologia , Aplainamento Radicular , Adulto , Brasil , Doença Crônica , Placa Dentária/microbiologia , Feminino , Humanos , Masculino , Periodontite/terapia , Estatísticas não ParamétricasRESUMO
The purpose of the present study was to investigate the efficacy of the decontamination protocol for bacterial removal in titanium surfaces with three different levels of roughness using a high-pressure sodium bicarbonate device for 1 minute under aseptic conditions. Group 1 was composed of 10 as-machined titanium sheets and Groups 2 and 3 of titanium sheets blasted with aluminum oxide (Al2O3, alumina) particles with different diameters: Group 2 was blasted with 65-microm particles and Group 3 with 250-microm particles. The titanium specimens were sterilized and incubated in tubes containing a suspension of Streptococcus sanguis. The colony-forming units were counted before and after the application of the decontamination protocol. The arithmetic mean roughness (R(a)) per group was: Group 1, 0.17 microm +/- 0.01; Group 2, 1.14 microm +/- 0.15; and Group 3, 3.17 microm +/- 0.23. After the contamination period, Group 1 remained with 49 x 10(3) bacterial cells, and the bacterial concentrations of Groups 2 and 3 were 11 x 10(4) and 35 x 10(5), respectively. After the application of the decontamination protocol, no viable bacteria were detected. With the increase of the surface roughness, an exponential increase in bacterial cells was observed. The results showed that the decontamination protocol treatment with a high-pressure sodium bicarbonate device efficiently removed all bacterial cells in all surfaces tested. This indicates that high-pressure sodium bicarbonate spray should be used in the maintenance phase of implant treatment.
Assuntos
Aderência Bacteriana , Implantes Dentários/microbiologia , Bicarbonato de Sódio/uso terapêutico , Streptococcus sanguis/fisiologia , Titânio/química , Contagem de Colônia Microbiana , Descontaminação/métodos , Pressão , Propriedades de SuperfícieRESUMO
BACKGROUND: Tetracyclines have been extensively used as adjunctives to conventional periodontal therapy. Emergence of resistant strains, however, has been reported. This study evaluated longitudinally the tetracycline resistance patterns of the subgingival microbiota of periodontitis subjects treated with systemic or local tetracycline therapy+scaling and root planing (SRP). METHODS: Thirty chronic periodontitis patients were randomly assigned to three groups: SRP+500 mg of systemic tetracycline twice/day for 14 days; SRP alone and SRP+tetracycline fibers (Actsite) at four selected sites for 10 days. Subgingival plaque samples were obtained from four sites with probing pocket depths (PPD)> or =6 mm in each patient at baseline, 1 week, 3, 6 and 12 months post-therapy. Samples were dispersed and diluted in pre-reduced anaerobically sterilized Ringer's solution, plated on Trypticase Soy Agar (TSA)+5% blood with or without 4 microg/ml of tetracycline and incubated anaerobically for 10 days. The percentage of resistant microorganisms were determined and the isolates identified by DNA probes and the checkerboard method. Significance of differences among and within groups over time was sought using the Kruskal-Wallis and Friedman tests, respectively. RESULTS: The percentage of resistant microorganisms increased significantly at 1 week in the tetracycline groups, but dropped to baseline levels over time. The SRP+Actsite group presented the lowest proportions of resistant species at 6 and 12 months. No significant changes were observed in the SRP group. The predominant tetracycline-resistant species included Streptococcus spp., Veillonela parvula, Peptostreptococcus micros, Prevotella intermedia, Gemella morbillorum and Actinobacillus actinomycetemcomitans (Aa). A high percentage of sites with resistant Aa, Porphyromonas gingivalis and Tanerella forsythensis was observed in all groups at baseline. However, T. forsythensis was not detected in any group and P. gingivalis was not present in the SRP+Actsite group at 1 year post-therapy. Aa was still frequently detected in all groups after therapy. However, the greatest reduction was observed in the SRP+Actsite group. CONCLUSION: Local or systemically administered tetracycline results in transitory selection of subgingival species intrinsically resistant to this drug. Although the percentage of sites harboring periodontal pathogens resistant to tetracycline were quite elevated in this population, both therapies were effective in reducing their prevalence over time.