RESUMO
The aim of this study was to identify the presence of superinfecting microorganisms (Gram-negative enteric rods and Candida sp.) in heart transplant patients and correlate this with gingival overgrowth. Thirty patients (10 females, 20 males--mean age 45 years) were examined. All were under cyclosporin-A (CsA) therapy. Patients who had taken any antibiotics 3 months prior the study or had been submitted to periodontal therapy were not enrolled. Patients were required to have at least 6 teeth. The plaque index (PI), gingival index (GI), pocket depth (PD) and clinical attachment level (CAL) were recorded. Microbiological samples were taken from sulcus/pocket (s/p) and from stimulated saliva (ss) and submitted to analysis. Patients were divided into two groups: the ones with gingival overgrowth (GO) and those without gingival overgrowth (WGO). After statistical analysis (chi-square test, Student's t-test, Fisher test, p < or = 0.05), we concluded that there was no statistical difference between groups in the parameters of gender, CsA dosage, time since transplantation, PI, GI, PD and CAL. Gram-negative rods from either the sulcus/pocket or saliva samples were not found. Candida sp. was detected (s/p-30% and ss-30%). Stimulated saliva samples analysis determined that the presence of Candida sp. was associated with patients without gingival overgrowth.
Assuntos
Ciclosporina/efeitos adversos , Hiperplasia Gengival/induzido quimicamente , Bactérias Gram-Negativas/isolamento & purificação , Transplante de Coração , Imunossupressores/efeitos adversos , Boca/microbiologia , Adolescente , Adulto , Idoso , Candida albicans/isolamento & purificação , Índice de Placa Dentária , Feminino , Gengiva/microbiologia , Hiperplasia Gengival/microbiologia , Bolsa Gengival/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/microbiologia , Complicações Pós-Operatórias/microbiologiaRESUMO
This study compared the clinical and microbiological status of periodontally diseased sites in 42 patients who had a renal transplant and were undergoing immunosuppressive therapy (21 taking azathioprin and corticosteroids [Az-C] and 21 taking cyclosporin-A [Cy-A] with those of 21 systemically healthy matched controls. Probing pocket depth (PPD), bleeding on probing (BOP) and gingival hyperplasia (GH) were measured at 339 sites. Subgingival plaque samples were analyzed for the presence of Porphyromonas gingivalis, Treponema denticola and/or Bacteroides forsythus using the BANA test. Our findings suggest that immunosuppressed patients showed significantly less inflammation and fewer putative anaerobic pathogens using the BANA test, and that patients undergoing therapy with cyclosporin-A have a higher frequency of sites with gingival hyperplasia when compared with patients medicated with azathioprin or corticosteroids.
Assuntos
Transplante de Rim , Doenças Periodontais/classificação , Corticosteroides/uso terapêutico , Adulto , Análise de Variância , Azatioprina/uso terapêutico , Bacteroides/isolamento & purificação , Benzoilarginina-2-Naftilamida , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Colorimetria , Ciclosporina/uso terapêutico , Placa Dentária/microbiologia , Feminino , Hemorragia Gengival/classificação , Hemorragia Gengival/microbiologia , Hiperplasia Gengival/classificação , Hiperplasia Gengival/microbiologia , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/microbiologia , Bolsa Periodontal/classificação , Bolsa Periodontal/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Treponema/isolamento & purificaçãoRESUMO
A wide spectrum of oral lesions has been associated with human immunodeficiency viral infection (HIV), or AIDS. This report describes the case of an HIV-infected patient who developed a case of disseminated sporotrichosis whose first clinical sign was the presence of orofacial lesions. A histopathological study of this patient's biopsy specimens taken from the oropharyngeal lesions revealed a number of rounded and/or oval free-spore forms of Sporothrix schenkii, the identification of which was corroborated by culturing skin lesion exudate on Sabouraud's glucose agar. To the best of our knowledge to date, this is the first time a case of the oral manifestation of sporotrichosis in association with HIV infection has been described in the dental literature.