RESUMO
Abstract The last decade provided significant advances in the understanding of microbiota and its role in human health. Probiotics are live microorganisms with proven benefits for the host and were mostly studied in the context of gut health, but they can also confer significant benefits for oral health, mainly in the treatment of gingivitis. Postbiotics are cell-free extracts and metabolites of microorganisms which can provide additional preventive and therapeutic value for human health. This opens opportunities for new preventive or therapeutic formulations for oral administration. The microorganisms that colonize the oral cavity, their role in oral health and disease, as well as the probiotics and postbiotics which could have beneficial effects in this complex environment were discussed. The aim of this study was to review, analyse and discuss novel probiotic and postbiotic formulations intended for oral administration that could be of great preventive and therapeutic importance. A special attention has been put on the formulation of the pharmaceutical dosage forms that are expected to provide new benefits for the patients and technological advantages relevant for industry. An adequate dosage form could significantly enhance the efficiency of these products.
Assuntos
Saúde Bucal/classificação , Probióticos/análise , Microbiota/imunologia , Preparações Farmacêuticas/administração & dosagem , Ligilactobacillus salivarius/classificação , Boca/lesõesRESUMO
Objetivo: Esta pesquisa analisou os aspectos biomédicos da doença de Alzheimer, considerando as condições gerais e bucais, conduta terapêutica, propriedades físico-químicas da saliva, presença de distúrbios do sono e capacidade funcional em relação aos cuidados pessoais e mobilidade. Metodologia: Trinta e nove (39) pacientes com doença de Alzheimer, entre 62 e 100 anos, sexo masculino e feminino, participaram deste estudo. As manifestações clínicas gerais e bucais foram investigadas. As propriedades físico-químicas da saliva, incluindo a taxa de fluxo salivar, valor de pH e a capacidade tampão, e a os níveis de cortisol salivar diurno foram determinadas. Em adição, a sonolência excessiva diurna, o risco de Apneia Obstrutiva do Sono (AOS) e o desempenho das atividades básicas da vida diária (ABVD) foram analisadas a partir da aplicação dos questionários Escala de Sonolência de Epworth (ESE), STOP-BANG e Índice de Barthel Modificado (IBM), respectivamente. Os resultados obtidos foram submetidos à uma análise exploratória, utilizando estatística descritiva e inferencial. O nível de significância adotado foi de 5%. Conclusão: os transtornos mentais e os distúrbios circulatórios foram as patologias sistêmicas mais encontradas nos pacientes com DA, sendo os homens mais comprometidos. A maioria dos pacientes eram dentados (com presença de doença periodontal, raízes residuais e cárie). Todos os pacientes com alto risco para AOS apresentaram distúrbios circulatórios. O uso de medicamentos não influenciou as propriedades físico-químicas de saliva. A perda da autonomia foi um fator determinante na institucionalização dos pacientes com DA(AU)
Objective: This study analyzed the biomedical aspects of Alzheimer's disease, considering general and oral conditions, therapeutic conduct, physical-chemical properties of saliva, presence of sleep disorders and functional capacity in relation to personal care and mobility. Methodology: Thirty-nine (39) patients with Alzheimer's disease, between 62 and 100 years old, male and female, participated in this study. General and oral clinical manifestations were investigated. The physicochemical properties of saliva, including salivary flow rate, pH value and buffer capacity, and daytime salivary cortisol levels were determined. In addition, excessive daytime sleepiness, the risk of obstructive sleep apnea (OSA) and the performance of the activities of daily living (ADL) were analyzed using the Epworth Sleepiness Scale (ESE), STOP-BANG and Modified Barthel Index (MBI), respectively. The results were submitted to an exploratory analysis using descriptive and inferential statistics. The level of significance was 5%. Conclusion: Mental disorders and circulatory disorders were the most common systemic pathologies in AD patients, and men were more compromised. Most of the patients were not edentulous (and had periodontal disease, residual roots and cavities). All patients at high risk for OSA had circulatory disorders. The use of drugs did not influence the physicochemical properties of saliva. The loss of autonomy was a determining factor in the institutionalization of patients with AD(AU)
Assuntos
Humanos , Doença de Alzheimer/diagnóstico , Saliva/imunologia , Atividades Cotidianas , Saúde Bucal/classificação , Apneia Obstrutiva do Sono/prevenção & controleRESUMO
O presente estudo teve o objetivo de avaliar o impacto de condições bucais na qualidade de vida de indivíduos portadores de Lupus Eritematoso Sistêmico (LES). Foi realizado um estudo transversal, através do qual foram avaliados 75 pacientes portadores de LES em tratamento no Serviço de Reumatologia do Hospital das Clínicas da UFMG. A amostra foi constituída também por um grupo controle composto por 78 indivíduos, que segundo o autorrelato, não apresentavam nenhuma doença sistêmica. A qualidade de vida relacionada à saúde bucal (QVRSB) destes indivíduos foi avaliada através da versão brasileira do questionário Oral Health Impact Profile (OHIP-49). Todos os participantes foram submetidos à exame odontológico, tendo sido obtidos índice CPO-D; parâmetros periodontais e medidas referentes à sialometria. Foram coletadas também variáveis sociodemográficas, hábitos de higiene bucal. Indivíduos do grupo LES foram avaliados com relação à atividade da doença (SLEDAI) e os danos (SLICC/SDI) causados pela mesma. Através do teste qui-quadrado, o grupo LES e o grupo controle foram comparados de acordo com as variáveis independentes avaliadas. O teste não paramétrico Mann-Whitney foi usado para comparar a QVRSB de indivíduos do grupo LES e indivíduos do grupo controle. Dentro do grupo LES, o teste Mann-Whitney também foi utilizado para avaliar a QVRSB de indivíduos entre as diferentes categorias de SLEDAI e SLICC/SDI. Para o escore total do OHIP, o nível de significância foi estabelecido em (p<0,05). Para as sub-escalas aplicou-se a correção de Bonferroni e o nível de significância foi estabelecido em (p<0,007). Finalmente, análise de regressão linear foi realizada para a comparação da QVRSB dos dois grupos. Valores de (p<0,05) foram considerados de significância estatística. Os resultados demonstraram que indivíduos do grupo LES apresentaram um maior impacto negativo das condições bucais na qualidade de vida quando comparados aos indivíduos do grupo controle (p=0,011). A condição bucal determinante do impacto negativo foi o uso de prótese (p<0,05). No grupo LES, também foi observado que indivíduos com um dano moderado apresentaram QVRSB deteriorada quando comparados a indivíduos sem dano (p=0,043). O conhecimento do impacto das condições bucais na qualidade de vida de indivíduos portadores de LES pode ser útil para aprimorar o tratamento multidisciplinar deste grupo de pacientes
The present cross sectional study aimed to evaluate the impact of oralconditions on the quality of life of individuals with Systemic Lupus Erythematosus (SLE). A sample of 75 patients with SLE under surveillance at the Department of Rheumatology of the Federal University of Minas Gerais was evaluated. The study also included a control group of 78 individuals, who, according to self-report, did not present any disease..Individuals' oral health-related quality of life (OHRQoL) wasevaluated through the Brazilian version of the questionnaire Oral Health Impact Profile (OHIP-49). All the participants were submitted to dental examination. Dental caries was assessed by means of the DMFT index and the periodontal condition was evaluated through criteria previously established that considered probing depth. Measures of sialometry, sociodemographic characteristics, and oral hygiene habits were also collected. Individuals of the SLE group were evaluated in terms of disease activity (SLEDAI) and disease damage (SLICC/SDI). The responses to categorical questions for each group were compared using the Chi-square test. The responses to continuous variables for each group were compared using Mann-Whitney test. The Mann-Whitney test was also used to evaluate differences in the subscale and overall OHIP scores between the SLE group and the Control group and between the different SLEDAI and SLICC/SDI categories in the SLE group. For the overall score, the level of significance was set at p<0.05. For the subscales, the Bonferroni correction was used and p values <0.007 were considered statistically significant. The results demonstrated that individuals of the SLE group presented a higher negative impact of the oral conditions on the quality of life when compared with the individuals of the control group (p=0,011). The determinant of the negative impact was prosthesis wearing (p<0,05). In the SLE group, it was also observed that individuals with a moderate damage presented worse OHRQoL when compared with individuals without damage (p=0,043). Awareness of the impact of oral conditions on the quality of life of individuals with SLE may be useful to improve the multidisciplinary treatment of this group of patients
Assuntos
Humanos , Masculino , Feminino , Diagnóstico Bucal/tendências , Lúpus Eritematoso Sistêmico/complicações , Saúde Bucal/classificação , Qualidade de VidaRESUMO
AIMS: The aims of the present study were to evaluate oral health status among Brazilian adults aged 35 to 44 years with regard to functional dentition based on four different definitions and classify dentition configurations using a dental functional status classification system. METHODS: The sample was composed of 9564 individuals who participated in the 2010 National Oral Health Survey. The definitions were "well-distributed teeth" concept (WDT), the World Health Organization functional dentition concept (FDWHO), functional dentition classified by esthetics and occlusion (FDClass5), and functional dentition classified by esthetics, occlusion, and periodontal status (FDClass6). Dentitions were classified on six sequential, accumulative levels (anyone reaching level VI necessarily met the criteria on all previous levels): I-≥one tooth in each arch; II-≥10 teeth in each arch (WDT) or ≥20 teeth present (FDWHO); III-all 12 anterior teeth present; IV-≥3 premolar posterior occluding pairs (POPs) present; V-≥one molar POP bilaterally (FDClass5); VI-all sextants with Community Periodontal Index <3 and/or loss of attachment ≤1 (FDClass6). RESULTS: The prevalence rates of the different definitions of functional dentition ranged from 42.6 % (FDClass5) and 40.3 % (FDClass6) to 72.9 % (WDT) and 77.9 % (FDWHO). CONCLUSIONS: The oral health status of Brazilian adults exhibited considerable variation due to the different definitions of functional dentition, and less than half of Brazilian adults met all the criteria of function. CLINICAL RELEVANCE: The indication and planning of prosthetic rehabilitation should not only be based on the absence of teeth but also the distribution and periodontal status of the teeth present.
Assuntos
Dentição Permanente , Saúde Bucal/classificação , Adulto , Brasil/epidemiologia , Inquéritos de Saúde Bucal , Estética Dentária/classificação , Feminino , Humanos , Masculino , Índice Periodontal , PrevalênciaRESUMO
Produtos derivados de plantas podem representar estratégia promissora na odontologia. Desse modo, o objetivo deste trabalho foi levantar na literatura os estudos sobre o uso popular de plantas em afecções orais, bem como os estudos de avaliação da atividade antimicrobiana in vitro de extratos vegetais e compostos isolados sobre patógenos orais, no período de 1996 a 2011. Quarenta e sete famílias botânicas foram referidas, com maior número de citações para Anacardiaceae, sendo Anacardium occidentale L., a espécie mais citada. O levantamento sobre estudos de avaliação antimicrobiana relacionou extratos de sessenta e seis espécies vegetais pertencentes a trinta e oito famílias botânicas, destacando-se Anacardiaceae, com pesquisas realizadas de forma predominante com as folhas, investigadas pelo método de difusão em ágar. Cinquenta e oito substâncias isoladas de plantas foram avaliadas, demonstrando que Terminalia chebula Retz (Combretaceae) representa a espécie vegetal com atividade antimicrobiana in vitro mais significativa, apresentando halo de inibição de 32,97 mm contra Staphylococcus aureus, microrganismo encontrado em infecções orais; enquanto ácido tetra iso-alfa isolada de Humulus lupulus L. (Canabinaceae) apresentou maior halo de inibição para Streptococcus mutans (26,0 mm). Os resultados apresentados devem estimular o desenvolvimento dos estudos de validação na garantia do uso seguro e eficaz de espécies vegetais em odontologia.
Products derived from plants may represent a promising strategy in dentistry. Thus, the objective of this paper is to review studies of the popular use of plants in oral diseases, as well as studies evaluating the in vitro antimicrobial activity of plant extracts and isolated compounds in oral pathogens from 1996 to 2011. Forty-seven botanical families were mentioned, with the highest number of referencesfor Anacardiaceae, and Anacardium occidentale L. was the most mentioned specie. The review of antimicrobial activity studies relatedextracts from sixty-six plant species belonging to thirty-eight botanical families, especially Anacardiaceae, being predominant tests with leaves, investigated by the agar diffusion method. Fifty-eight compounds isolated from plants have been evaluated, showing that Terminalia chebula Retz (Combretaceae) represents the plant species with more meaningful in vitro antimicrobial activity, with inhibition zone of 32.97 mm against Staphylococcus aureus, microorganism found in oral infections, while tetra iso-alpha acid isolated from Humulus lupulus L. (Canabinaceae) showed greater inhibition zone for Streptococcus mutans (26.0 mm). The presented results should encourage the development of validation studies, ensuring the safe and effective use of plant species in dentistry.
Assuntos
Saúde Bucal/classificação , Odontologia/classificação , Plantas Medicinais/metabolismo , Extratos Vegetais , NoxasRESUMO
The present study assesses the validity and reproducibility of two occlusal indices for epidemiological studies--the Dental Aesthetic Index (DAI) and the Dental Health Component of the Index of Orthodontic Treatment Need (DHC-IOTN) for the identification of orthodontic treatment needs. The total of 131 study models was examined by an examiner (orthodontic specialist) for the determination of the DAI and DHC-IOTN. Thirty days later, further assessment was performed to determine the reproducibility. The duration of each exam was measured in seconds with a stopwatch. The indices were compared by a panel of three experts in orthodontics to evaluate validity. The intra-examiner reliability evaluation resulted in an intraclass correlation coefficient of 0.89 for the DAI (95% CI = 0.64 to 1.0) and 0.87 for the DHC-IOTN (95% CI = 0.56 to 0.96). The time spent on the evaluation of the DHC-IOTN was less than the time spent on that of the DAI (P < 0.001). The accuracy of the indices, as reflected by the area under the receiver-operating characteristic curve, was 61% for the DAI (95% CI = 51 to 70; p = 0.037) and 67% for the DHC-IOTN (95% CI = 58 to 77; p = 0.001). Both indices presented good reproducibility and validity.
Assuntos
Estética Dentária/classificação , Índice de Necessidade de Tratamento Ortodôntico/métodos , Saúde Bucal/classificação , Ortodontia Corretiva/métodos , Adolescente , Brasil , Criança , Estudos Epidemiológicos , Estética Dentária/estatística & dados numéricos , Humanos , Índice de Necessidade de Tratamento Ortodôntico/estatística & dados numéricos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Estatísticas não ParamétricasRESUMO
Se realiza una revisión de la clasificación de las lesiones bucales relacionadas con el VIH debido a la importancia de que los profesionales de la salud (médicos y estomatólogos) dispongan de conocimientos suficientes sobre estas lesiones. Las manifestaciones orales por la infección del virus de la inmunodeficiencia humana (VIH) son, en ocasiones, el primer signo de la enfermedad, y en muchos casos un indicador de la progresión de la infección hacia el síndrome de inmunodeficiencia adquirida (SIDA). Actualmente, gracias a la mejoría de los tratamientos antirretrovirales, y en concreto, tras la aparición de los tratamientos antirretrovirales de gran actividad (TARGA), la prevalencia de las lesiones orales asociadas con el VIH está disminuyendo paulatinamente. Por otro lado, el aumento de la esperanza de vida de estos pacientes está condicionando una mayor presencia en nuestras consultas de pacientes infectados por el VIH, lo que implica una actualización continua en el diagnóstico y tratamiento de estos procesos(AU)
A review of the classification the oral injuries related to HIV was made taking into account that it is very important that health professionals (physicians and stomatologists) have enough knwoledge on these injuries. The oral manifestations due to the HIV infection are, on ocassions, the first sign of the disease and, in many cases, an indicator of the progression of the infection towards AIDS. At present, thanks to the improvement of the antiretroviral treatments and, basically, to the appearance of antiretroviral treatments of great activity, the prevalence of the oral injuries associated with HIV is gradually decreasing. On the other hand, the increase of the life expectancy of these patients is conditioning a higher presence in our offices of HIV-infected patients, which implies a continuous updating in the diagnosis and treatment of these processes(AU)