RESUMO
OBJECTIVE: This narrative review explores alternative non-antibiotic antimicrobial agents for CRS management in adults. METHODS: Alternative antimicrobial agents using EPOS 2020 guidelines as reference were selected, and articles dated from 2003 to 2022 in English, Portuguese, or Spanish using PubMed and EMBASE databases. The parameters analyzed included study design, evidence level, population characteristics, CRS characteristics, interventions, outcomes, sample size, randomization, blinding, and side effects. Reviews, unrelated contexts,in vitro experiments, and duplicates were excluded. RESULTS: 148 articles were screened; 19 articles were selected for analysis. Randomized controlled trials and cohort studies assessing non-antibiotic antimicrobial treatments for CRS were included. Xylitol demonstrated effectiveness in reducing CRS symptoms, particularly SNOT-22 scores, surpassing saline irrigation benefits. Manuka honey showed potential microbiological benefits in recalcitrant CRS, but symptomatic and endoscopic improvements remained inconclusive. Baby shampoo irrigation improved nasal mucociliary clearance and postoperative outcomes. Colloidal silver nasal irrigation showed limited efficacy in reducing CRS symptoms or endoscopic scores. Povidone-Iodine (PI) nasal irrigation yielded mixed results, with varying effects on culture negativity and SNOT-20 scores. Bacteriophage treatment exhibited promise in decreasing specific bacterial strains and cytokine levels. CONCLUSION: Non-antibiotic antimicrobial therapies, including xylitol, manuka honey, baby shampoo, colloidal silver, PI, bacteriophages, lactoferrin, and carrageenan offer potential alternatives for CRS in adult patients. Xylitol, baby shampoo, and PI presented benefits in improving symptoms and nasal endoscopic scores, however, the number of studies is limited for conclusive recommendations and safety assessments. CRS management should adopt a comprehensive approach, particularly for non-infectious or immune-related cases, moving beyond antibiotics. Antibiotics should be reserved for confirmed bacterial infections. Overall, this review shows the importance of exploring non-antibiotic therapies to enhance the management of CRS.
Assuntos
Rinite , Sinusite , Humanos , Rinite/tratamento farmacológico , Rinite/microbiologia , Doença Crônica , Sinusite/tratamento farmacológico , Sinusite/microbiologia , Anti-Infecciosos/uso terapêutico , Mel , Xilitol/uso terapêutico , RinossinusiteRESUMO
OBJECTIVE: Regular use of toothpaste with fluoride (F) concentrations of ≥ 1000 ppm has been shown to contribute to reducing caries increment. However, when used by children during the period of dental development, it can lead to dental fluorosis. In this study, we aimed to evaluate the in vitro effect of a toothpaste formulation with reduced fluoride (F) concentration (200 ppm) supplemented with sodium trimetaphosphate (TMP: 0.2%), Xylitol (X:16%), and Erythritol (E: 4%) on dental enamel demineralization. METHODOLOGY: Bovine enamel blocks were selected according to initial surface hardness (SHi) and then divided into seven experimental toothpaste groups (n=12). These groups included 1) no F-TMP-X-E (Placebo); 2) 16% Xylitol and 4% Erythritol (X-E); 3) 16% Xylitol, 4% Erythritol and 0.2%TMP (X-E-TMP); 4) 200 ppm F (no X-E-TMP: (200F)); 5) 200 ppm F and 0.2% TMP (200F-TMP); 200 ppm F, 16% Xylitol, 4% Erythritol, and 0.2% TMP (200F-X-E-TMP); and 7) 1,100 ppm F (1100F). Blocks were individually treated 2×/day with slurries of toothpastes and subjected to a pH cycling regimen for five days (DES: 6 hours and RE: 18 hours). Then, the percentage of surface hardness loss (%SH), integrated loss of subsurface hardness (ΔKHN), fluoride (F), calcium (Ca), and phosphorus (P) in enamel were determined. The data were analyzed by ANOVA (1-criterion) and the Student-Newman-Keuls test (p<0.001). RESULTS: We found that the 200F-X-E-TMP treatment reduced %SH by 43% compared to the 1100F treatments (p<0.001). The ΔKHN was ~ 65% higher with 200F-X-E-TMP compared to 1100F (p<0.001). The highest concentration of F in enamel was observed on the 1100F treatment (p<0.001). The 200F-X-E-TMP treatment promote higher increase of Ca and P concentration in the enamel (p<0.001). CONCLUSION: The association of 200F-X-E-TMP led to a significant increase of the protective effect on enamel demineralization compared to the 1100F toothpaste.
Assuntos
Fluoretos , Desmineralização do Dente , Criança , Animais , Bovinos , Humanos , Fluoretos/farmacologia , Cremes Dentais/uso terapêutico , Xilitol/farmacologia , Xilitol/uso terapêutico , Desmineralização do Dente/tratamento farmacológico , Esmalte Dentário , Dureza , Cálcio/farmacologia , Cariostáticos/farmacologia , Fluoreto de Sódio/farmacologiaRESUMO
ABSTRACT Objective To describe and evaluate the xylitol products' applicability and its effects in the health area worldwide utilizing a bibliometric analysis from randomized controlled trials (RCT) with humans. Material and Methods Electronic searches were carried out in Medline/PubMed, Scopus, Cochrane Library, Web of Science, and VHL databases. The main data extracted were: year, area of applicability, type of treatment, country, journal, xylitol posology and concentration, presentation form, outcomes, and effects. Results From 1476 studies, 257 were included. These studies were published between 1973-2021. The majority was carried out in dentistry (73.9%) and under preventive treatment (67.4%). These studies were developed in the USA (15.4%) and published in Caries Research (6.6%). The posology and concentration ranged between 0.004-67 g/day and 0.002-100%, respectively. The xylitol is usually used in the chewing gum form (44.0%), and for antimicrobial activity evaluation (38.5%). A positive effect was observed in 204 studies (79.3%) and was associated with xylitol concentration ≥ 15(p=0.007). Side effects were reported in 8.2and were associated with posology ≥ 5 g/day (p=0.03). Conclusion Most studies with xylitol were conducted to prevent diseases in the dentistry field. The chewing gum form and antimicrobial activity evaluation were more frequent. Most xylitol products have a positive effect, and few studies report side effects.
Assuntos
Terapêutica , Xilitol/uso terapêutico , Bibliometria , Ensaios Clínicos Controlados Aleatórios como Assunto , Goma de Mascar , Anti-Infecciosos , Brasil , Distribuição de Qui-Quadrado , Saúde Bucal/educação , Interpretação Estatística de DadosRESUMO
BACKGROUND: We evaluated the efficacy of xylitol varnishes on the remineralization of newly erupted permanent and deciduous teeth in vitro and in situ. Human enamel specimens were randomly allocated to 8 groups (n = 15/group). Artificial caries lesions were produced and enamel alterations were quantified by surface/subsurface hardness and transverse microradiography. The blocks were then treated with the following varnishes: DuraphatTM; 20 wt% xylitol (146 µm) varnish; 20 wt% milled xylitol (80 µm) varnish, and placebo varnish, and removed after 6 h of immersion in artificial saliva. The blocks were subjected to pH-cycles for 8 days. CONCLUSIONS: fifteen subjects wore palatal appliances containing four pre-demineralized and treated enamel specimens, for 5 days. Data were statistically analyzed by ANOVA/Tukey and Kruskal-Wallis/Tukey's test (p < 0.05). The %SHR in both studies was significantly increased by xylitol and Duraphat™ varnishes when compared to placebo. Considering subsurface remineralization, only the xylitol varnishes were able to significantly reduce the enamel lesion. Xylitol varnishes can be promising alternatives to promote enamel remineralization of newly erupted permanent and deciduous teeth.
Assuntos
Cárie Dentária , Xilitol , Cariostáticos/uso terapêutico , Cárie Dentária/tratamento farmacológico , Esmalte Dentário , Fluoretos Tópicos , Humanos , Fluoreto de Sódio , Remineralização Dentária , Xilitol/uso terapêuticoRESUMO
ABSTRACT The aim of this study was to explore the remineralizing effect of toothpastes based on Xilitol, Camellia Sinensis and Juniperus Communis. An in vitro experimental study was carried out in an 18 human premolars sample, which were treated with one of the 3 evaluated toothpastes and a control fluoride one. The atomic percentages of Ca and P were evaluated by Energy Dispersive X-ray Spectroscopy (EDS). In addition, the enamel surface of treated teeth was visualized by Scanning Electron Microscopy (SEM). The evaluations were carried out in three stages: pre-treatment, after an artificial demineralization process and after the treatment with the toothpastes. In the statistical analysis, the one-way ANOVA and Pearson correlation tests were used. Xilitol and Juniperus Communis showed the greatest gain of P ions compared to the control group (p<0.01). As for Ca, the group treated with xylitol-based toothpaste showed more ion gain compared with the control group (p<0.01). In the Pearson correlation test between Ca and P, statistically significant correlations were observed in all groups (p<0.01), ranging between r=0.7413 (Xylitol Group) and r=0.9510 (Control Group). We concluded that Xylitol paste showed the highest remineralizing property, both in the EDS analysis and in the SEM images.
RESUMEN El objetivo de este studio fue explorer el efecto remineralizante de las cremas dentales compuestas de Xilitol, Camelia Sinensis y Juniperus Communis. Se llevó a cabo un estudio experimental in vitro en una muestra de 18 premolares humanos, los cuales fueron tratados con una de las tres pastas dentales evaluadas y una fluorada. Los porcentajes atomicos de Ca y P fueron evaluados por Espectroscopia de rayos X de energía dispersive (EDS). Además, la superficie del esmalte de los dientes tratados fue examinada por Microscopia Electronica de Barrido (SEM). Las evaluaciones fueron llevadas a cabo en tres etapas: pre-tratamiento, despues de un proceso artificial de desmineralizacion y después del tratamiento con las pastas dentales. Se usaron ANOVA de una via y correlacion de Pearson para el analisis estadistico. Xilitol y Juniperus Communis mostraron la mayor ganancia de iones P comparados con el grupo control (p<0.01), con rangos entre r=0.7413 (Grupo con Xylitol) and r=0.9510 (Group Control). Se concluyó que la pasta con Xilitol mostró las mayores propiedades remineralizantes, tanto en el analisis EDS y las imágenes SEM.
Assuntos
Remineralização Dentária/métodos , Cremes Dentais , Xilitol/uso terapêutico , Técnicas In Vitro , Juniperus , CamelliaRESUMO
RESUMEN: El objetivo del presente trabajo fue determinar el efecto de una pasta dental comercial conteniendo xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes. El presente fue un ensayo clínico, a doble ciego, que se realizó en el Centro de Salud "José Olaya" (Chiclayo Perú), en enero de 2017. Se trabajó con una población muestral de 50 gestantes en el segundo trimestre que cumplieron con los criterios establecidos, distribuyéndolas en dos grupos: 25 gestantes usaron pasta dental con 10 % de xilitol y 25 gestantes usaron pasta dental sin xilitol. Se les tomó y procesó microbiológicamente una muestra de saliva antes del inicio del estudio y 14 días después del uso de las respectivas pastas. Se realizó el recuento de unidades formadoras de colonias (UFC) de Streptococcus mutans en saliva con una confiabilidad altamente significativa mediante el Coeficiente de Correlación Intraclase, calibración intra e interexaminador (1,000 y 0,999, respectivamente). El análisis de los datos se realizó mediante la prueba U de Mann-Whitney, considerando un nivel de significancia del 5 %. No se encontró diferencia entre las gestantes que emplearon pasta dental con xilitol en comparación con las que utilizaron pasta sin xilitol (p=0,062). Se concluyó que el efecto de la pasta dental comercial conteniendo xilitol es similar a una pasta sin xilitol sobre el recuento de Streptococcus mutans en saliva de gestantes.
ABSTRACT: The objective of the present study was to determine the effect of a commercial toothpaste containing xylitol on the counts of Streptococcus mutans in saliva of pregnant women. The present was a double-blind clinical trial performed at the "José Olaya" health Centre (Chiclayo Peru) in January 2017. We worked with a sample population of 50 pregnant in the second trimester that met the established criteria, distributing in two groups: 25 pregnant women used toothpaste with 10 % xylitol and 25 pregnant used toothpaste without xylitol. They were taken and microbiologically processed a sample of saliva before the start of the study and 14 days after the use of the respective toothpastes. The Colony-forming units (CFU) of Streptococcus mutans in saliva were counted with a highly significant reliability through the intraclass correlation coefficient, Intra-and Interexaminer calibration (1.000 and 0.999, respectively). Data analysis was performed using the Mann-Whitney U test, considering a 5 % significance level. No difference was found among the pregnant women who used xylitol toothpaste compared to those who used toothpaste without xylitol (p = 0,062). It was concluded that the effect of xylitol containing commercial toothpaste is similar to a toothpaste without xylitol on the count of Streptococcus mutans in the saliva of pregnant women.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Streptococcus mutans/patogenicidade , Cremes Dentais/efeitos adversos , Xilitol/administração & dosagem , Gestantes , Peru , Saliva/microbiologia , Xilitol/uso terapêutico , Saúde Bucal , Tamanho da AmostraRESUMO
OBJECTIVES: Analyse the effect of varnishes containing xylitol alone or combined with fluoride on the remineralization of artificial enamel caries lesions in vitro. METHODS: Bovine enamel specimens were randomly allocated to 7 groups (n=15/group). Artificial caries lesions were produced by immersion in 30 mL of lactic acid buffer containing 3mM CaCl2·2H2O, 3mM KH2PO4, 6 µM tetraetil metil diphosphanate (pH 5.0) for 6 days. The enamel blocks were treated with the following varnishes: 10% xylitol; 20% xylitol; 10% xylitol plus F (5% NaF); 20% xylitol plus F (5% NaF); Duofluorid™ (6% NaF, 2.71% F+6% CaF2), Duraphat™ (5% NaF, positive control) and placebo (no-F/xylitol, negative control). The varnishes were applied in a thin layer and removed after 6h. The blocks were subjected to pH-cycles (demineralization-2h/remineralization-22 h during 8 days) and enamel alterations were quantified by surface hardness and transversal microradiography. The percentage of surface hardness recovery (%SHR), the integrated mineral loss and lesion depth were statistically analysed by ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). RESULTS: Enamel surface remineralization was significantly increased by Duraphat™, 10% xylitol plus F and 20% xylitol plus F formulations, while significant subsurface mineral remineralization could be seen only for enamel treated with Duraphat™, Duofluorid™ and 20% xylitol formulations. CONCLUSIONS: 20% xylitol varnishes seem to be promising alternatives to increase remineralization of artificial caries lesions. CLINICAL SIGNIFICANCE: effective vehicles are desirable for caries control. Xylitol varnishes seem to be promising alternatives to increase enamel remineralization in vitro, which should be confirmed by in situ and clinical studies.
Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Esmalte Dentário/efeitos dos fármacos , Remineralização Dentária/métodos , Xilitol/uso terapêutico , Animais , Cariostáticos/administração & dosagem , Bovinos , Esmalte Dentário/química , Fluoretos Tópicos/uso terapêutico , Dureza , Concentração de Íons de Hidrogênio , Ácido Láctico/efeitos adversos , Microrradiografia , Minerais/análise , Placebos , Distribuição Aleatória , Saliva Artificial/química , Fluoreto de Sódio/uso terapêutico , Xilitol/administração & dosagemRESUMO
Prevention is the area of dentistry that should be given more emphasis to reduce further consequences on the oral cavity. The aim of this study was to assess the use of xylitol chewing gum on dental plaque, saliva flow and saliva buffer capacity in youngster. Fifteen dental students were randomly assigned to a study and control group, the first received a xylitol chewing gum while the second a placebo chewing gum, provided 4 times per day for 21 days. Dental plaque, saliva flow and saliva ph were measures at day 0, 7, 14 and 21st. Dental plaque concentration decreased in both groups (p >0,05), saliva flow increased (p>0,05) and saliva ph was incremented but no significant differences were found among groups (p>0,05). The use of xylitol chewing gum helps to reduce dental plaque, increase saliva flow and ph, like the placebo chewing gum, but a larger study is needed to properly assess if xylitol has an additional benefit on the studied variables.
La prevención es el área de la odontología a la que se le debe dar más énfasis para disminuir posteriores consecuencias sobre la cavidad oral. El objetivo de este estudio fue evaluar el efecto del uso de chicles con xilitol sobre placa bacteriana, flujo salival y capacidad buffer de la saliva en jóvenes. Participaron 15 alumnos de quinto año, se asignaron al azar en un grupo de estudio y un grupo control, consumiendo chicles con xilitol y un placebo respectivamente, 4 veces al día por 21 días. Se midió placa bacteriana, flujo salival y capacidad buffer de la saliva al día 0, 7, 14 y 21. La placa bacteriana se redujo en ambos grupos tras 21 días de tratamiento sin obtener valores significativos (p>0,05). Asimismo el flujo salival aumentó tanto en el grupo de estudio como en el grupo de control, pero sin encontrar resultados significativos (p>0,05). El pH salival aumentó en ambos grupos, sin obtener valores significativos (p>0,05). Los resultados sugieren quemasticar chicles con xilitol disminuye la placa bacteriana, aumenta el flujo salival y la capacidad buffer de la saliva, pero estudios con un mayor número de pacientes deberían realizarse para obtener valores significativos.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Adulto Jovem , Goma de Mascar , Edulcorantes/uso terapêutico , Placa Dentária/tratamento farmacológico , Saliva , Xilitol/uso terapêutico , Chile , Cariostáticos/uso terapêutico , Concentração de Íons de Hidrogênio , Saliva/microbiologia , Saliva , Fatores de Tempo , Taxa SecretóriaRESUMO
Aim: To assess the effect of the combination of cetylpyridinium chloride and xylitol on the formation of dental biofilm and development of experimental gingivitis. Methods: A crossover, double-blind, placebo-controlled study was conducted and divided into two phases of 21 days each with a time interval of 10 days between them. A modified experimental gingivitis model was used and 31 volunteers were randomly divided into 2 groups. The volunteers performed daily mouthwashes twice a day with the test solution containing cetylpyridinium combined with xylitol or a placebo solution. On day 0 and day 21 of each phase the Plaque Index (PI) and Gingival Index (GI) of each volunteer were measured. During this phase, the volunteers brushed their teeth with standard toothbrushes and dentifrice, protecting the third quadrant with a toothshield. After brushing, the toothshield was removed and the mouthwash was used. Results: The PI values observed in the Test Group at baseline and on day 21 were 0 (0.00 0.03) and 0 (0.22-0.48) respectively, and in Control Group 0 (0.00 0.03) and 1 (0.45 0.81) (inter-group analysis - McNemar test, p<0.05). For GI, the values obtained in the Test Group were 0 (0.00 0.03) and 1 (0.48 0.71), at baseline and day 21 and in Control Group 0 (0.00 0.03) and 1 (0.58 0.84) (inter-group analysis - McNemar test, p>0.05). Conclusions: The test solution had a positive effect on dental biofilm control. However, it was not capable of preventing the development of experimental gingivitis.
Assuntos
Humanos , Masculino , Feminino , Cetilpiridínio/uso terapêutico , Gengivite/microbiologia , Xilitol/uso terapêuticoRESUMO
La otitis media aguda (OMA) es una patología extraordinariamente frecuente en escolares y lactantes, siendo la primera causa de uso de antibióticos en este último grupo. Elprincipal agente involucrado es el S. pneumoniae. Se ha postulado la hipótesis de que el xilitol, un poliol presente en la corteza de abedules, podría tener efectos inhibitorios sobre ésta y otras bacterias otopatógenas en el momento en que se encuentran en la rinofaringe, lo que podría resultar efectivo a la hora de prevenir la invasión de la cavidad timpánica y por ende el desarrollo de OMA. En esta revisión se analizan los estudios realizados que respaldan el uso del xilitol como profilaxis de OMA.
Acute otitis media (AOM) is an extremely common disease in school children and infants, which is the first cause of antibiotic use in this latter group. The main agent involved is S pneumoniae. It has proposed the hypothesis thatxylitol, a polyol which is present in the bark of birch, may have inhibitory effects on this bacteria and another otopathogen at the time found in the nasopharynx, which may be effective in preventing the invasion of the tympanic cavity and thus the development of AOM. In this review, is it discussed the studies supporting the use of xylitol prophylaxisof AOM.
Assuntos
Humanos , Edulcorantes/uso terapêutico , Otite Média/prevenção & controle , Xilitol/uso terapêutico , Doença AgudaRESUMO
AIMS: To assess the effect of combining 1% chlorhexidine varnish (CHX) with xylitol chewing gum (XYL) on Streptococcus mutans and biofilm levels in 6-8-year-old children. DESIGN: Randomised controlled study. SUBJECTS AND METHODS: Eighty-two 6-8-year-old children were randomly divided into groups as follows: G1 (n = 20): xylitol chewing gum twice a day after breakfast and lunch; G2 (n = 20): xylitol gum as G1 plus chlorhexidine varnish application at the start of the study and after one and two months; G3 (n = 20): chlorhexidine varnish as G2; and G4 (n = 22): fluoride gel application at the start of the study and after one and two months. Microbiological tests were performed to assess Streptococcus mutans colony forming units (CFU) and the teeth of those children with moderate or higher CFU scores were examined for visible biofilm. CFU scores were categorised as follows: 0 = absence of S. mutans, 1 = low level (1-10 CFU), 2 = moderate level (11-100 CFU), 3 = high level (101-250 CFU), 4 = very high level (>250 CFU). Biofilm scores based on a scale from 0 (absence of biofilm) to 5 (thick biofilm firmly adhered to posterior and anterior teeth) were obtained. RESULTS: The biofilm reduction was greater in G2 and G3, with mean values of 3.38 and 3.17 to 1.79 and 1.88, respectively (p <0.05). All groups presented a reduction in the S. mutans levels. XYL + CHX showed the largest reduction throughout the study period, with 58.3% in the first month, 84.2% in the second and 92.9% at the end of the study. CONCLUSIONS: The XYL + CHX combination was efficient and superior to single treatments in controlling biofilm and suppressing S. mutans.
Assuntos
Anti-Infecciosos Locais/uso terapêutico , Biofilmes/efeitos dos fármacos , Cariostáticos/uso terapêutico , Goma de Mascar , Clorexidina/uso terapêutico , Streptococcus mutans/efeitos dos fármacos , Edulcorantes/uso terapêutico , Xilitol/uso terapêutico , Fluoreto de Fosfato Acidulado/uso terapêutico , Anti-Infecciosos Locais/administração & dosagem , Carga Bacteriana , Criança , Clorexidina/administração & dosagem , Placa Dentária/microbiologia , Combinação de Medicamentos , Feminino , Fluoretos Tópicos/uso terapêutico , Seguimentos , Géis , Humanos , Masculino , Saliva/microbiologia , Timol/administração & dosagem , Timol/uso terapêutico , Dente/microbiologiaRESUMO
This in vitro study aimed to analyze the effects of application of xylitol varnishes and solutions to protect against enamel erosion. Twelve bovine enamel specimens were pre-treated with 5% NaF-Duraphat varnish, 10% xylitol varnish, 20% xylitol varnish, placebo varnish, 5% NaF solution, 10% xylitol solution or 20% xylitol solution. The varnishes and solutions were applied for 6 h and 1 min, respectively. Controls remained untreated (n = 12). Specimens were then subjected to erosive demineralization (Coca-Cola, 4 × 90 s/d) and remineralization (artificial saliva, 2 h) cycling for 10 days. After 5 days, the varnishes and solutions were reapplied. After reapplication, two specimens per group were analyzed by SEM. Enamel loss was measured profilometrically after the 5th and 10th days. Data were then analyzed statistically by ANOVA and Tukey's post-hoc test (n = 10, P < 0.05). After the 5th day, all varnishes and 20% xylitol solution significantly reduced the enamel loss when compared to the placebo varnish/control. After 10 days of erosive pH cycling, both xylitol varnishes and solutions significantly reduced the enamel erosion when compared with the control. However, 10% xylitol solution produced a smooth layer on eroded enamel and significantly reduced the enamel erosion when compared to the placebo varnish/control. Xylitol thus appears to be a good option to partially reduce enamel erosion.
Assuntos
Erosão Dentária/prevenção & controle , Xilitol/uso terapêutico , Análise de Variância , Animais , Bebidas Gaseificadas/efeitos adversos , Bovinos , Cola/efeitos adversos , Esmalte Dentário/patologia , Fluoretos Tópicos/uso terapêutico , Concentração de Íons de Hidrogênio , Microscopia Eletrônica de Varredura , Pintura , Fluoreto de Sódio/uso terapêutico , Estatísticas não Paramétricas , Erosão Dentária/etiologia , Xilitol/administração & dosagemRESUMO
O presente estudo foi dividido em quatro etapas distintas. A primeira etapa teve por objetivo avaliar a liberação de xilitol na saliva de humanos ao longo do tempo após aplicação de verniz controle e contendo 10% e 20% de xilitol. Um estudo cruzado foi realizado pela aplicação de 32 mg de cada verniz sobre as superfícies vestibulares de todos os incisivos centrais de 10 voluntários. Amostras salivares foram coletadas no baseline e após 5 min, 10 min, 15 min, 30 min, 1 h, 1 h 30 min, 2 h, 4 h e 8 h da aplicação dos vernizes para posterior análise da concentração de xilitol na saliva. Um estudo clínico foi realizado na segunda etapa com o objetivo de verificar a influência do verniz contendo xilitol a 20% sobre a contagem de estreptococos do grupo mutans provenientes de biofilme dentário. Semanalmente, 32 mg de verniz controle (grupo G1) ou verniz contendo xilitol a 20% (grupo G2) foram aleatoriamente aplicados sobre as superfícies vestibulares dos incisivos centrais de 67 crianças. Após quatro semanas de procedimento, amostras de biofilme dentário foram coletadas do terço cervical de todos os dentes presentes na cavidade bucal e a contagem relativa e absoluta dos microrganismos foi determinada. A terceira etapa objetivou analisar a influência do xilitol sobre a ultra-estrutura de Streptococcus mutans ATCC 33478 e Streptococcus sobrinus ATCC 25175. Além disso, a capacidade do xilitol e do flúor em promover estresse celular em S. mutans UA 159 geneticamente modificados (deleção do gene vicK) foi determinada na quarta etapa. As concentrações de xilitol na saliva (F=5,228, p=0,024) em diferentes tempos de coleta (F=18,24, p<0,0001) foram estatisticamente diferentes após aplicação dos vernizes contendo 10% e 20% do açúcar (etapa 1). Na etapa 2, contagens absolutas inicial e final de estreptococos do grupo mutans (Teste-t, p=0,4192) e de estreptococos totais (Teste-t, p=0,3506) não foram significativamente diferentes nos indivíduos pertencentes ao grupo G2...
This study was divided in four distinct stages. The first one aimed to assess the xylitol release in human saliva along time after application of control, 10% or 20% xylitol varnishes. A cross-over design study was performed by application of 32 mg of each varnish on buccal surfaces of all incisors of 10 volunteers. Salivary samples were collected to analyze the xylitol concentration in baseline and after 5 min, 10 min, 15 min, 30 min, 1 h, 1 h 30 min, 2 h, 4 h and 8 h from varnishes application. A clinical study was executed in the second stage aiming observe the influence of 20% xylitol varnish on mutans streptococci counts from dental plaque. Weekly, 32 mg of control varnish (group G1) or 20% xylitol varnish (group G2) were randomly applied on buccal surfaces of central incisors of 67 children. After 4 weeks of procedures, dental plaque samples were collected from cervical of all teeth and relative and absolute counts of microorganisms were determined. The third stage aimed to analyze the effect of xylitol on the ultrastructure of Streptococcus mutans ATCC 33478 and Streptococcus sobrinus ATCC 25175. Moreover, the capacity of xylitol and fluoride to promote cellular stress in S. mutans UA 159 knockout vick gene was determined in the fourth stage. Salivary xylitol concentrations (F=5,228, p=0,024) in different collection times (F=18,24, p<0,0001) were statistically different after 10% and 20% varnishes application (stage 1). In stage 2, initial and final absolute mutans streptococci (Teste-t, p=0,4192) and total streptococci counts (Teste-t, p=0,3506) did not differ significantly in volunteers from group G2. However, a significant reduction of initial and final relative mutans streptococci counts was observed in relation to total streptococci (Teste-t, p= 0,0095). 20% xylitol promoted alterations in morphology of S. mutans ATCC 33478 and S. sobrinus, ATCC 25175, resulting in more diffuse and less...
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adulto Jovem , Adulto , Cariostáticos , Saliva/química , Streptococcus mutans/crescimento & desenvolvimento , Streptococcus mutans , Xilitol/uso terapêutico , Análise de Variância , Contagem de Colônia Microbiana , Meios de Cultura , Cárie Dentária/prevenção & controle , Placa Dentária/microbiologia , Placa Dentária/prevenção & controle , Estatísticas não Paramétricas , Streptococcus mutans/ultraestrutura , Fatores de Tempo , Xilitol/químicaRESUMO
O presente estudo foi dividido em quatro etapas distintas. A primeira etapa teve por objetivo avaliar a liberação de xilitol na saliva de humanos ao longo do tempo após aplicação de verniz controle e contendo 10% e 20% de xilitol. Um estudo cruzado foi realizado pela aplicação de 32 mg de cada verniz sobre as superfícies vestibulares de todos os incisivos centrais de 10 voluntários. Amostras salivares foram coletadas no baseline e após 5 min, 10 min, 15 min, 30 min, 1 h, 1 h 30 min, 2 h, 4 h e 8 h da aplicação dos vernizes para posterior análise da concentração de xilitol na saliva. Um estudo clínico foi realizado na segunda etapa com o objetivo de verificar a influência do verniz contendo xilitol a 20% sobre a contagem de estreptococos do grupo mutans provenientes de biofilme dentário. Semanalmente, 32 mg de verniz controle (grupo G1) ou verniz contendo xilitol a 20% (grupo G2) foram aleatoriamente aplicados sobre as superfícies vestibulares dos incisivos centrais de 67 crianças. Após quatro semanas de procedimento, amostras de biofilme dentário foram coletadas do terço cervical de todos os dentes presentes na cavidade bucal e a contagem relativa e absoluta dos microrganismos foi determinada. A terceira etapa objetivou analisar a influência do xilitol sobre a ultra-estrutura de Streptococcus mutans ATCC 33478 e Streptococcus sobrinus ATCC 25175. Além disso, a capacidade do xilitol e do flúor em promover estresse celular em S. mutans UA 159 geneticamente modificados (deleção do gene vicK) foi determinada na quarta etapa. As concentrações de xilitol na saliva (F=5,228, p=0,024) em diferentes tempos de coleta (F=18,24, p<0,0001) foram estatisticamente diferentes após aplicação dos vernizes contendo 10% e 20% do açúcar (etapa 1). Na etapa 2, contagens absolutas inicial e final de estreptococos do grupo mutans (Teste-t, p=0,4192) e de estreptococos totais (Teste-t, p=0,3506) não foram significativamente diferentes nos indivíduos pertencentes ao grupo G2...
This study was divided in four distinct stages. The first one aimed to assess the xylitol release in human saliva along time after application of control, 10% or 20% xylitol varnishes. A cross-over design study was performed by application of 32 mg of each varnish on buccal surfaces of all incisors of 10 volunteers. Salivary samples were collected to analyze the xylitol concentration in baseline and after 5 min, 10 min, 15 min, 30 min, 1 h, 1 h 30 min, 2 h, 4 h and 8 h from varnishes application. A clinical study was executed in the second stage aiming observe the influence of 20% xylitol varnish on mutans streptococci counts from dental plaque. Weekly, 32 mg of control varnish (group G1) or 20% xylitol varnish (group G2) were randomly applied on buccal surfaces of central incisors of 67 children. After 4 weeks of procedures, dental plaque samples were collected from cervical of all teeth and relative and absolute counts of microorganisms were determined. The third stage aimed to analyze the effect of xylitol on the ultrastructure of Streptococcus mutans ATCC 33478 and Streptococcus sobrinus ATCC 25175. Moreover, the capacity of xylitol and fluoride to promote cellular stress in S. mutans UA 159 knockout vick gene was determined in the fourth stage. Salivary xylitol concentrations (F=5,228, p=0,024) in different collection times (F=18,24, p<0,0001) were statistically different after 10% and 20% varnishes application (stage 1). In stage 2, initial and final absolute mutans streptococci (Teste-t, p=0,4192) and total streptococci counts (Teste-t, p=0,3506) did not differ significantly in volunteers from group G2. However, a significant reduction of initial and final relative mutans streptococci counts was observed in relation to total streptococci (Teste-t, p= 0,0095). 20% xylitol promoted alterations in morphology of S. mutans ATCC 33478 and S. sobrinus, ATCC 25175, resulting in more diffuse and less...
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adulto Jovem , Cariostáticos , Saliva/química , Streptococcus mutans/crescimento & desenvolvimento , Streptococcus mutans , Xilitol/uso terapêutico , Análise de Variância , Contagem de Colônia Microbiana , Meios de Cultura , Cárie Dentária/prevenção & controle , Placa Dentária/microbiologia , Placa Dentária/prevenção & controle , Estatísticas não Paramétricas , Streptococcus mutans/ultraestrutura , Fatores de Tempo , Xilitol/químicaRESUMO
Dental caries is a multifactorial disease, which depends on the fermentation of carbohydrates by microorganisms of the dental biofilm. Xylitol is a sugar-alcohol, which cannot be fermented by oral cariogenic bacteria. This article aimed to review the literature on the use of xylitol for prevention of dental caries. There is little conclusive scientific evidence about this subject, although several studies have been performed. The development of products and clinical protocols should be based on studies with sound experimental design, which will permit the understanding of clinical and laboratorial parameters, such as mecanisms of action, vehicles of delivery, dose-response effects, and frequency of use of the polyol. Clarification of the potential and limitations of the use of xylitol for prevention of dental caries would help clinicians to select preventive protocols more efficient and cost-effective for specific groups.
A cárie dentária é uma doença multifatorial, dependente da fermentação de carboidratos por microrganismos formadores do biofilme dentário. O xilitol é um açúcar-álcool que não pode ser fermentado por bactérias orais cariogênicas. Esta revisão da literatura teve por objetivo propiciar o maior entendimento sobre o uso do xilitol na prevenção da cárie dentária. Apesar de inúmeros trabalhos realizados na área, poucas são as evidências científicas sobre o tema. O desenvolvimento de produtos e protocolos capazes de tornar o xilitol mais eficiente e eficaz contra a cárie dentária só será possível através da realização de estudos mais bem delineados, pautados no entendimento de parâmetros clínicos e laboratoriais, como mecanismos de ação, veículo de administração, efeito dose-resposta e frequência de uso. O esclarecimento do potencial e das limitações de uso do xilitol para prevenção de cárie dentária auxiliaria o cirurgião dentista na seleção de protocolos preventivos mais eficientes e com melhor custobenefício para grupos específicos.
Assuntos
Cárie Dentária/prevenção & controle , Xilitol/uso terapêuticoRESUMO
Introdução: O xilitol é um carboidrato naturalmente encontrado em diversas frutas e vegetais. Estudos têm demonstrado o uso do xilitol como uma estratégia inovadora na prevenção de otite média aguda (OMA). Objetivo: Esclarecer os possíveis mecanismos de ação do xilitol sobre a inibição do crescimento de bactérias otopatogênicas e descrever estudos que contribuem para a discussão sobre a viabilidade deste carboidrato na prevenção de OMA. Método: Revisão de literatura baseado em artigos científicos selecionados por meio das bases médicas MEDLINE, Cochrane, PubMed (MeSH) e Web of Science. Resultados: Trabalhos demonstraram que o xilitol é eficaz na prevenção de OMA quando administrado em gomas de mascar cinco vezes ao dia. Porém, o carboidrato não é tão efetivo quando administrado durante infecções de vias aéreas superiores. Comentários Finais: O xilitol parece ser uma estratégia eficaz na prevenção de otite média aguda. No entanto, novos estudos são necessários para estabelecer doses, frequências e veículos ideais para a correta administração do açúcar, possibilitando sua utilização no sistema público de saúde.
Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM). Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles selected by means of the medical databases: MEDLINE, Cochrane, PubMed (MeSH) and Web of Science. Results: Studies have demonstrated the efficacy of xylitol to prevent the AOM, when it is administered five times a day in chewing gum. However, this sugar is not so effective in the prevention of AOM during upper airways infections. Final Comments: Xylitol seems to be an effective strategy in prevention of acute otitis media. However, new studies are necessary to establish ideal doses, frequencies and vehicles for the correct administration of the sugar, which allows for its utilization in the public health system.
Assuntos
Infecções Estreptocócicas/prevenção & controle , Infecções Pneumocócicas/prevenção & controle , Otite Média/prevenção & controle , Literatura de Revisão como Assunto , Doença Aguda , Xilitol/uso terapêuticoRESUMO
Growing evidence from clinical studies suggests that mothers using xylitol gums or lozenges have decreased levels of Streptococcus mutans (SM) and do not transmit these cariogenic bacteria as readily to their children. To begin to determine mechanisms for these clinical findings and to explore potential synergism of antimicrobial combinations, we studied the effect of multiple exposures of chlorhexidine (CHX) combined with copper gluconate (CG) or zinc gluconate (ZG) followed by xylitol (XYL) on the ability of SM to adhere and form biofilms. Cell suspensions of SM were exposed two times to CHX; CG; CHX plus CG; ZG; and CHX plus ZG, and then four times to XYL. Control cells were exposed six times to water or XYL or received no treatment. For biofilm assessment, glass slides were inoculated with treated cells, and numbers of bacteria were enumerated after 48 hours of incubation. To assess the ability of SM to adhere, microtiter plate wells coated with primary S. sanguinis biofilms grown in sucrose were inoculated with treated SM, and adhesion was determined. Cells exposed to CHX-XYL combinations exhibited significant but transient inhibition of growth. The multiple-exposure regimen groups showed significant decreases in the ability of SM to form biofilms (P < 0.05). However, the CHX-XYL group exhibited a much greater effect than the other treatment groups (P < 0.001). Adhesion studies revealed that none of the multiple-exposure regimens had a significant effect on adhesion of SM to primary biofilms of S. sanguinis. We concluded that significant inhibition of SM growth and subsequent inability to grow as biofilms in the presence of sucrose occurs after a staggered exposure regimen to CHX initially and then to XYL. This may help explain the clinical data showing the decreased levels of SM in mothers treated with CHX and XYL.
Assuntos
Anti-Infecciosos Locais/uso terapêutico , Biofilmes/crescimento & desenvolvimento , Clorexidina/uso terapêutico , Streptococcus mutans/efeitos dos fármacos , Edulcorantes/uso terapêutico , Xilitol/uso terapêutico , Aderência Bacteriana/efeitos dos fármacos , Aderência Bacteriana/fisiologia , Clorexidina/metabolismo , Combinação de Medicamentos , Gluconatos/farmacologia , Streptococcus mutans/fisiologia , Streptococcus sanguis/efeitos dos fármacos , Streptococcus sanguis/fisiologia , Xilitol/metabolismoRESUMO
OBJECTIVES: To evaluate if sugar alcohols would reduce enamel demineralization enhancing the fluoride (F) effect. METHODS: A crossover in situ study was conducted in four phases, during which 10 volunteers were submitted to one of the treatments: (I) Distilled and deionized water, as a negative control; (II) F (226 microg F/ml as NaF; concentration used in commercial mouthrinse); (III) X:S (xylitol:sorbitol 1:3; final concentration 1.6M; 28% of sugar alcohols) and (IV) F+X:S (same final concentration that groups II and III). The volunteers wore palatal appliances containing four bovine enamel blocks of known surface microhardness (SMH), covered with a 'test plaque' of mutans streptococci, which were immersed during 1 min in one of the allocated treatment solutions simultaneously that the volunteers rinsed their mouths with the same solution. After the rinsing the appliances were put in the mouth and after 20 min a cariogenic challenge was made with 20% sucrose solution during 1 min. After further 45 min the 'test plaque' was collected for F analysis, enamel SMH was again determined and the percentage of change in relation to baseline was calculated; F uptake in enamel was also determined. RESULTS: With respect to all the analyses made, the group F+X:S did not differ from the F treatment (p>0.05) and the groups treated with F and F+X:S differed from the negative control (p<0.05). CONCLUSIONS: The results suggest that xylitol:sorbitol may not enhance the effect of fluoride present in mouth rinse on the reduction of enamel demineralization.
Assuntos
Cariostáticos/uso terapêutico , Antissépticos Bucais/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Álcoois Açúcares/uso terapêutico , Desmineralização do Dente/prevenção & controle , Adulto , Análise de Variância , Animais , Cariostáticos/análise , Bovinos , Estudos Cross-Over , Esmalte Dentário/química , Combinação de Medicamentos , Dureza , Humanos , Análise de Regressão , Fluoreto de Sódio/análise , Sorbitol/uso terapêutico , Estatísticas não Paramétricas , Xilitol/uso terapêuticoRESUMO
O objetivo desse trabalho foi avaliar o xilitol contido em uma goma de mascar mediante a variação do pH salivar, comparando-o com a clorexidina. Foram selecionadas 19 crianças que não possuíam clinicamente atividade de cárie. Utilizou-se: xilitol (grupo teste). clorexidina (controle positivo) e sacarose (controle negativo). Coletou-se a saliva de cada criança e foram medidos os pH iniciais e após o uso de cada substância (pH final). Foi concluído que a ação do xilitol na elevação do pH salivar pode ser considerada um efeito anticariogênico, assim como a clorexidina.
Assuntos
Humanos , Masculino , Feminino , Criança , Goma de Mascar , Cárie Dentária/prevenção & controle , Concentração de Íons de Hidrogênio , Saliva , Xilitol/uso terapêutico , Clorexidina/uso terapêutico , Sacarose/uso terapêuticoRESUMO
PURPOSE: To compare the long-term caries increment associated with the use of two dentifrices: (1) a test dentifrice containing 0.836% sodium monofluorophosphate (1100 ppm F) in a dicalcium phosphate dihydrate base plus 10% xylitol; and (2) a positive control dentifrice containing 0.836% sodium monofluorophosphate (1100 ppm F) in a dicalcium phosphate dihydrate base. MATERIALS AND METHODS: Three thousand three hundred ninety four (3,394) school children aged 7-12 years were selected to participate in this double blind clinical caries study at 28 public schools in the central plateau of Costa Rica. Children accepted for participation were stratified into two balanced groups within the participating schools on the basis of age and sex, and assigned to one of the two dentifrices. The study was conducted in harmony with the guidelines for caries clinical studies published in 1988 by the Council on Dental Therapeutics of the American Dental Association, and employed clinical diagnostic criteria provided in 1991 guidelines published by the National Institute of Dental Research (NIH/NIDR). Dental radiographs were not employed. RESULTS: Of those subjects who met the initial inclusion/exclusion criteria for this study, 2,539 were available for the 30-month exam. DFS increments over the 30-month period of this clinical study were 1.30 for the test dentifrice containing 10% xylitol, and 1.51 for the positive control dentifrice without xylitol; for DFT, the corresponding increments were 0.69 for the test dentifrice containing 10% xylitol, and 0.81 for that which did not contain xylitol. For both DFS and DFT, the increments associated with the test dentifrice containing 10% xylitol were statistically significantly lower than those associated with the positive dentifrice without xylitol (P < 0.05), with the observed reductions in caries increment exceeding 10% in for both parameters.