Importancia de la apropiada selección de aditamentos protésicos sobre implantes para conservar el estado de salud gingival: reporte de caso / Importance of the appropriate selection of prosthetic attachments on implants to preserve the state of gingival health: case report

Introducción: La rehabilitación oral en pacientes edéntulos parciales que requieren implantes dentales ha incrementado su demanda en los últimos años, convirtiéndose en un tratamiento de rutina, donde procedimientos quirúrgicos y protésicos tienen un éxito considerable. En algunos casos estas complicaciones se resuelven de forma simple, en otros, se necesita de una mejor planificación. Objetivo: Modificar y complementar el plan de tratamiento del paciente como solución definitiva al posicionamiento equivocado de los implantes dentales oseo integrados. Presentación del Caso: Paciente de 64 años, hombre, asistió a Centro de Atención Odontológica de la Universidad de Las Américas (CAO/UDLA), para terminar tratamiento odontológico de especialidad, rehabilitación de cuatro implantes colocados en zona 1.6 (Mis: C1 4.20 x 13mm); 1.4 (Mis: C1 3.75x11.50 mm); 1.2 (Mis: C1 3.75 x 11.50 mm); 2.1 (Mis: C1 4.20 x 11.50 mm), a examen clínico se pudo observar prótesis acrílica transicional inmediata desadaptada e inestable oclusalmente como resultado de proceso de cicatrización de tejidos, pérdida de piezas dentales postero-inferiores (3.6; 3.7; 4.6 y 4.7).La angulación equivocada de los implantes anteriores obligó la necesidad de corregirla mediante el uso de aditamentos rotacionales Multi-unit rectos de 2 mm altura en implantes 1.6; 1.4, aditamentos anti rotacionales tipo Multi-unit angulados de 1 mm de altura a 30º para los implantes 1.2 y 2.1 con healingcaps para proteger el aditamento de la acumulación de placa bacteriana y facilitar la higienización e inserción de la prótesis múltiple. Conclusiones: Los aditamentos colocados modificaron y complementaron la rehabilitación de los implantes incluso en la zona anterior donde se encontró tejido mucoso insuficiente que cubra de forma completa el aditamento elegido. (AU)

Introduction: Oral rehabilitation in partial edentulous patients who require dental implants has increased its demand in recent years, becoming a routine treatment, where surgical and prosthetic procedures have considerable success In some cases these complications are resolved simply, in others. Aims: Better planning is needed modify and complement the patient’s treatment plan as a definitive solution to the wrong positioning of osseointegrated dental implants. Presentation of the Case: Patient of 64 years, man, attended the Dental Care Center of the University of the Americas (CAO / UDLA), to finish specialty dental treatment, rehabilitation of four implants placed in zone 1.6 (Mis: C1 4.20 x 13mm); 1.4 (Mis: C1 3.75x11.50 mm); 1.2 (Mis: C1 3.75 x 11.50 mm); 2.1 (Mis: C1 4.20 x 11.50 mm), On clinical examination, immediate transitional acrylic prosthesis could be observed maladapted and occlusally unstable as a result of tissue healing process, loss of postero-inferior teeth (3.6; 3.7; 4.6 and 4.7). The wrong angulation of the previous implants forced the need to correct it through the use of 2 mm high straight Multi-unit rotational attachments in implants 1.6; 1.4, angled Multi-unit anti-rotational attachments from 1 mm high to 30 mm for implants 1.2 and 2.1 with healing caps to protect the attachment from the accumulation of bacterial plaque and facilitate the sanitization and insertion of the multiple prosthesis. Conclusions: The attachments placed modified and complemented the rehabilitation of the implants even in the anterior area where insufficient mucous tissue was found to completely cover the chosen attachment. (AU)

Oral conditions and salivary analysis in HIV-uninfected subjects using preexposure prophylaxis

Background: New prevention strategies have been advocated to control the progression of HIV/AIDS, such as preexposure prophylaxis (PrEP). The aim of this study is to evaluate the potential changes in the oral and salivary conditions of HIV-uninfected subjects using PrEP. Material and Methods: Subjects were evaluated before beginning the medication (T0), at the first follow-up (T1), and at the second follow-up (T2). Xerostomia, presence of untreated cavitated caries, oral hygiene habits, taste, gingival and plaque index, stimulated salivary flow rate (SSFR), and salivary concentrations of calcium, glucose, urea, and total proteins were evaluated. Data obtained were analyzed using statistical tests (p<0.05). Results: Forty-seven participants (41 men; 6 women) were evaluated at T0. Thirty (28 men; 2 women) and 17 men were reassessed at T1 and T2, respectively. There was no difference between the SSFR and oral and salivary conditions between T0, T1, and T2 (p>0.05), except for the salivary calcium concentration, that increased at T2 compared to T1 (p=0.02). There was significant difference between taste and xerostomia at T1 (p=0.017), and the need to drink to swallow at T2 (p=0.015). There was significant correlation between the reported amount of saliva and taste (p=0.039, r=-0.378) at T1. Conclusions: The prolonged use of PrEP seems to be associated with reports of dry mouth and worsening of taste, possibly associated with increased salivary calcium concentration.(AU)

Evaluación de un protocolo de cepillado dental con aspiración en pacientes hospitalizados en la unidad de cuidados intensivos utilizando análisis de imagen y microbiología: estudio piloto / Evaluation of a dental brushing protocol with aspiration in patients hospitalized in an intensive care unit using image and microbiological analyzes: Pilot study

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Riesgos asociados al uso de Expansión Rápida del Maxilar / Risks associated with the use of Maxillary Rapid Expansion

INTRODUCCIÓN: Las anomalías dentomaxilares corresponden a un grupo de alteraciones que dificultan el desarrollo armónico de los maxilares, donde encontramos las anomalías transversales. La expansión rápida del maxilar (ERM) se utiliza como tratamiento de anomalías transversales, su objetivo es aumentar la distancia transversal por la separación de ambas hemiarcadas a nivel de la sutura palatina, utilizando un aparato expansor fijo y rígido. Los disyuntores más utilizados son los expansores Hass, Hyrax y de McNamara. OBJETIVO: El objetivo de la presente revisión es identificar los riesgos de la RME reportados en la literatura relacionados con disyuntores Hass, Hyrax y Mc Namara. METODOLOGÍA: Se realizó una búsqueda en PubMed, Scielo, Science Direct, Trip Database y Google Acadèmico utilizando los tèrminos: "Rapid Maxillary Expansion", "Risks", "Child", "Maxillary Expansion", "RME", "Palatal Expansion", "Hyrax", "Hass". Se incluyeron estudios en inglès y español, sin límites en el año de publicación o tipo de estudio. Como criterios de exclusión consideramos la expansión quirúrgica, expansión lenta u otro tratamiento simultáneo durante la fase de expansión activa. RESULTADOS: De los artículos encontrados, veinte cumplieron los criterios de inclusión. Dentro de los riesgos se encuentran: deglución accidental del dispositivo de activación del expansor, bacteremia transitoria, desviación del septum nasal, reabsorción radicular, compromiso periodontal, cambio posicional de los cóndilos, cambios faciales de tejido blando y cambios esqueletales. CONCLUSIÓN: La ERM es un procedimiento ortopèdico eficaz, sus indicaciones en el tratamiento precoz han aumentado debido a resultados positivos. De acuerdo con la bibliografía encontrada los beneficios superan considerablemente a los efectos negativos

INTRODUCTION: The dentomaxillary anomalies correspond to a group of alterations that hinder the harmonic development of the jaws, where we find the transversal anomalies. Rapid Maxillary Expansion (RME) is used as a treatment for transverse anomalies, its objective is to increase the transversal distance by separating both hemiarchies at the level of the palatal suture, using a fixed and rigid expander. The most used are the Hass, Hyrax and McNamara expanders. OBJECTIVE: The objective of this review is to identify the EMR risks reported in the literature related to Hass, Hyrax and Mc Namara expander. METHODOLOGY: A search was made in PubMed, Scielo, Science Direct, Trip Database and Google Scholar using the terms: "Rapid Maxillary Expansion", "Risks", "Child", "Maxillary Expansion", "RME", "Palatal Expansion", "Hyrax", "Hass". Studies in English and Spanish were included, without limits in the year of publication or type of study. As exclusion criteria, we consider surgical expansion, slow expansion or other simultaneous treatment during the active expansion phase. RESULTS: Of the articles found, twenty met the inclusion criteria. Among the risks are: accidental swallowing of the expander activation device, transient bacteremia, deviation of the nasal septum, root resorption, periodontal involvement, positional change of the condyles, soft tissue facial changes and skeletal changes. CONCLUSION: RME is an effective orthopedic procedure, its indications in early treatment have increased due to positive results. According to the bibliography found, the benefits considerably outweigh the negative effects

Metagenomic investigation of bacteria associated with dental lesions: a cross-sectional study

BACKGROUND: Dental caries is considered as one of the most significant global health problem over the world. Dental caries initiates from bacterial shifts within the supragingival biofilm, then a polymicrobial biofilm is formed on the surface of tooth, and finally various bacterial species aggregate in a complex-organized manner. The exploiting variability in 16S rRNA gene sequence has been considered as a cost-efficient high-throughput characterization approach in human oral microbiome investigations. The aim of this study is to characterize bacterial species associated with superficial dental biofilm, underlying carious dentine and root caries lesion by16S rRNA gene-based metagenomic analysis. MATERIAL AND METHODS: Herein, the bacterial communities in carious dentin lesion, biofilm and root canal samples of 30 subjects (aged 4-76 years) admitted to a clinic in Tehran during 2017 were investigated using a culture independent approach. Total genomic DNA of each tissue was subjected to metagenomic identification of bacteria using a nested PCR assay and 16S rRNA library construction method. RESULTS: 31 samples collected from 30 consenting patients (29 samples from 29 patients ant two biofilm samples from one patient). Bioinformatics analyses of a-800bp sequences of the second step of Nested-PCR revealed presence of 156 bacterial isolates in carious (n = 45), biofilm (n = 81) and root canal (n = 30) specimens. Prevotella spp., Lactobacillus vaginalis, and streptococcus spp. showed higher prevalence in carious dentin, root and biofilm samples, respectively. CONCLUSIONS: Exploring the dental microbiota and comparing them in health or diseased conditions is critical step in the determination of human general health. The method applied in this study could identify bacteria related to the three dental lesions. However, due to lack of data for comparison in Genbank or because of the sequence similarity lower than 98% for most identified bacteria, the use of more powerful approaches like NGS platforms or typing of multiple loci (MLST) in future studies is recommended

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Efecto del manejo de la obesidad clase I con metformina sobre actividad de metaloproteinasas en pacientes con periodontitis crónica / Effect of the management of class I obesity with metformin on metalloproteinase activity in patients with chronic periodontitis

Introducción: el principal problema de salud pública en México es la obesidad y sus enfermedades asociadas, incluyendo las bucales. Objetivo: evaluar el efecto del tratamiento con metformina en pacientes obesos de clase I sobre la actividad de las metaloproteinasas presentes en el periodonto con periodontitis crónica. Métodos: se realizó un estudio clínico con 68 pacientes mujeres con obesidad de clase I y enfermedad periodontal. Se dividieron en 4 grupos; a 2 de ellos, además del tratamiento periodontal, se les administro metformina de 850 mg al día durante seis semanas. Se tomaron 2 muestras por paciente de tejido periodontal antes y después de cada tratamiento y se midió el índice de masa corporal (IMC), el índice de placa dentobacteriana y de inflamación. Mediante zimografía en gel de acrilamida se midió la actividad de las metaloproteinasas en la muestra de tejido recolectada. Los datos obtenidos fueron analizados mediante estadística descriptiva t de student para muestras relacionadas y se realizó ANOVA de una vía considerando p < 0,01 como estadísticamente significativa. Resultados: en el grupo de pacientes a las que se les administro metformina al final del tratamiento se observó una disminución del índice de masa corporal, del grado de inflamación y menor actividad de metaloproteinasas respecto al grupo control (65% frente a 25%; p < 0,01). Conclusiones: el tratamiento con metformina en pacientes con obesidad de clase I y enfermedad periodontal disminuye el IMC, mejora los síntomas de la periodontitis crónica y disminuye la actividad de las metaloproteinasas 1, 3, 8 y V presentes en el periodonto de estos pacientes

Introduction: in Mexico the main problem in public health is obesity and other diseases that are associated whit this condition, including oral health. Objective: to evaluate the effect of metformin treatment in patients with class I obese on the activity of metalloproteinases present in periodontium with chronic periodontitis. Methods: a clinical study was conducted in 68 patients with class I obesity and periodontal disease. They were divided into 4 groups. 2 of them, in addition to the periodontal treatment, were administered metformin 850 mg per day for six weeks; 2 samples were taken per patient of periodontal tissue before and after each treatment, body mass index, plaque index and inflammation were measured. Acrylamide gel zymography was used to measure the activity of metalloproteinases in the sample of tissue collected. The data obtained were analyzed by descriptive statistics, student t for related samples and one-way ANOVA was performed considering p < 0.01 as statistically significant. Results: in the group of patients who were administered metformin at the end of the treatment, there was a decrease in the body mass index, the degree of inflammation and lower metalloproteinase activity, compared with the control group (65% vs 25%; < 0.01). Conclusions: treatment with metformin in patients with obesity class I and periodontal disease decreases BMI, improves the symptoms of chronic periodontitis and decreases the activity of metalloproteinases 1, 3, 8, V present in periodontium of these patients

Perfil bacteriano del biofilm dental supragingival en niños con dentición temporal y mixta temprana utilizando la técnica de secuenciación de próxima generación (HOMINGS) / Bacterial profile of the supragingival dental biofilm in children with deciduous and early mixed dentition using next generation sequencing (HOMINGS) technique

OBJETIVO: Describir el perfil bacteriano del biofilm supragingival de niños con dentición temporal (NDT) y dentición mixta temprana (NDMT), con la técnica de secuenciación de próxima generación HOMINGS. MÉTODO: Se realizó un estudio descriptivo comparativo con 30 niños de 5 a 7 años de edad sistémicamente sanos de escuelas públicas de Cartagena (Colombia). Todos los participantes estaban libres de caries, según los criterios del Sistema Internacional de Detección y Evaluación de Caries (ICDAS II) y sin experiencia de caries según el índice de dientes cariados, perdidos y obturados (DCPO). Se recolectaron muestras de biofilm supragingival. Se extrajo el ADN bacteriano y se usó para su análisis mediante HOMINGS (identificación de microorganismos orales humanos utilizando secuenciación de próxima generación) basado en la secuenciación de la región V3-V4 del gen 16S rRNA con la plataforma Illumina MiSeq. RESULTADOS: Se identificaron 360 especies específicas y 65 géneros específicos de las sondas: Streptococcus, Actinomyces, Veillonella y Fusobacterium (29,2% del total de ADN bacteriano presente), mientras que en el grupo de dentición mixta temprana se encontraban Streptococcus, Leptotrichia, TM7 y Porphyromonas (24,5% del ADN bacteriano presente). Las especies bacterianas con mayor abundancia relativa en el microbioma oral de biofilm de NDT fueron Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, mientras que en NDMT fueron S. sanguinis, Leptotrichia sp. HOT-417, Leptotrichia sp. HOT-498. El índice de diversidad de Shannon fue 2,77 (DE = 0,26) para NDT y 3,01 (DE = 0,39) para NDMT (p = 0,06). CONCLUSIONES: El análisis del perfil bacteriano del biofilm dental supragingival en niños con NDMT mediante HOMINGS mostró baja diversidad microbiológica tanto en presencia como en abundancia relativa a nivel de género y de especies bacterianas

OBJECTIVE: Tdescribe the bacterial profile of the supragingival biofilm of children with temporary dentition (CTD) and early mixed dentition (CEMD), with the next-generation sequencing (HOMINGS) technique. METHOD: A comparative descriptive study was carried out with 30 systemically healthy children aged between 5 and 7 years old from public schools in Cartagena-Colombia. All participants were caries-free applying the criteria of the International Caries Detection and Assessment System (ICDAS II) and had no caries experience according to the Decayed, Missing and Filled Teeth (DMFT) index. Supragingival biofilm samples were collected. Bacterial DNA was extracted and used for analysis using HOMINGS (Human Oral Microbe Identification using Next-Generation Sequencing) based on the sequencing of the V3-V4 region of the 16S rRNA gene using the Illumina MiSeq platform (V3-V4 primers). RESULTS: A total of 360 species-specific and 65 genus-specific probes were identified. The bacterial genus most predominant in CTD were Streptococcus, Actinomyces, Veillonella and Fusobacterium (29.2% of all bacterial DNA present), while in CEMD the most predominant were Streptococcus, Leptotrichia, TM7 and Porphyromonas (24.5% of all bacterial DNA present). The bacterial species with the highest relative abundance in the oral biofilm microbiome from CTD were Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, while in CEMD they were S. sanguinis, Leptotrichia spp. HOT-417 and Leptotrichia spp. HOT-498. The Shannon diversity index was 2.77 (SD = 0.26) for CTD and 3.01 (SD = 0.39) for CEMD (P = 0.06). CONCLUSIONS: The analysis of the bacterial profile of the supragingival dental biofilm in children with DMFT, by means of HOMINGS showed low microbiological diversity both in presence and in relative abundance in terms of genus as well as bacterial species

Oral mucosal peeling related to dentifrices and mouthwashes: A systematic review

Background: The aim of this systematic review was to summarise the clinical information available about oral mucosal peeling (OMP) and to explore its aetiopathogenic association with dentifrices and mouthwashes. Material and Methods: PICOS outline: Population: subjects diagnosed clinically and/or pathologically. Intervention: exposition to oral hygiene products. Comparisons: patients using products at different concentrations. Out-comes: clinicopathological outcomes (primary) and oral epithelial desquamation (secondary) after use. Study de-sign: any. Exclusion criteria: reports on secondary or unpublished data, in vitro studies. Data were independently extracted by two reviewers. Results: Fifteen reports were selected from 410 identified. Descriptive studies mainly showed low bias risk, ex-perimental studies mostly an "unclear risk". Dentifrices or mouthwashes were linked to OMP, with an unknown origin in 5 subjects. Sodium lauryl-sulphate (SLS) was behind this disorder in 21 subjects, tartar-control dentifrices in 2, and flavouring agents in 1 case. Desquamation extension was linked to SLS concentration. Most cases were painless, leaving normal mucosa after desquamation. Tartar-control dentifrices caused ulcerations more frequently. Conclusions: OMP management should consider differential diagnosis with oral desquamative lesions, particularly desquamative gingivitis, with a guided clinical interview together with pathological confirmation while discouraging the use of the product responsible for OMP

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Development and viability of biofilms grown on experimental abutments mimicking dental implants: An in vivo model

Background: To determine whether an experimental abutment mimicking the macro- and microstructure of a dental implant is a suitable method for recovering biofilm, and to describe the features of biofilms formed around such abutments on healthy implants. Material and Methods: Experimental abutments were used in 15 patients without peri-implant diseases. After 14 days' absence of dental hygiene in this area, the abutments were retrieved and analyzed through confocal laser scanning microscopy and scanning electron microscopy. The biofilm formation on the surface of the first 5 abut-ments was determined by a fluorescence-staining method using SYTO9 nucleic acid stain. In order to study the biofilm's coverage and vitality, 10 additional abutments were assessed using live & dead bacterial viability. Descriptive and bivariate analyses of the data were performed. Results: A global plaque coverage of the abutments was observed in all cases. The submucosal area of the abutment was mostly covered with biofilm (over 21%). Moreover, significant differences between supra- and subgingival locations were detected. Conclusions: This in vivo experimental model allows detailed observation of the extensive plaque growth found on exposed experimental abutments mimicking dental implants when hygiene measures are absent. The biofilm cover-age is significantly higher in the supragingival zone than in the subgingival portion

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Capacidad antiséptica del digluconato de clorhexidina 0.05% y cloruro de cetilpiridinio 0.05%. Estudio clínico prospectivo y microbiológico / Antiseptic capacity of 0.05% Chlorhexidine digluconate and 0.05% Cetylpyridinium chloride. A prospective and microbiological clinical study

Introducción: El objetivo de este estudio consiste en evaluar la eficacia clínica y microbiológica de un colutorio a base de digluconato de clorhexidina (CHX) 0,05% y cloruro de cetilpiridinio (CPC) 0,05%, y otro colutorio sin propiedades antisépticas, empleados como coadyuvantes de los métodos de higiene oral. Material y métodos: Se llevó a cabo un estudio microbiológico que evaluó la capacidad de los colutorios para inhibir la formación y adherencia de un biofilm bacteriano de Streptococcus oralis mediante espectrofotometría, y un ensayo clínico, aleatorizado y doble ciego sobre una muestra de 48 pacientes, los cuales fueron asignados aleatoriamente a cada colutorio. A: CHX 0,05%, CPC 0,05% y lactato de cinc 0,14% y B: permethol 0.10% y provitamina B5 0.50%. El índice de placa (IP), el índice gingival modificado (IGM) y el índice de sangrado (IS) fueron evaluados con periodicidad mensual y trimestral. Resultados: El colutorio a base de CHX 0,05% y CPC 0,05% evidenció una elevada capacidad para inhibir la formación (P=0,013) y adherencia (P=0,001) del biofilm bacteriano Se observaron diferencias estadísticamente significativas en el IP inter-grupos a los tres meses de observación (P<0,001). También se observaron diferencias en el IGM al mes (P=0,034) y a los tres meses de observación (P<0,001); y en el IS al mes (P=0,004) y a los tres meses de observación (P=0,002). Conclusiones: El colutorio a base de CHX 0,05% y CPC 0,05% posee una capacidad superior para reducir la placa bacteriana y la gingivitis

Introduction: The aim of this study was to evaluate the clinical and microbiological efficacy of a mouthrinse containing 0.05% chlorhexidine digluconate (CHX) and 0.05% cetylpyridinium chloride (CPC), and another mouthrinse without antiseptic properties, used as adjuvants to oral hygiene methods. Material and methods: First a microbiological study using spectrophotometry was done to assess the ability of both mouthrinses to inhibit the formation and adhesion of an Streptococcus oralis biofilm. Then, a randomised, double-blind clinical trial was performed on a sample of 48 patients, who were randomly assigned to each mouthrinse. A: 0.05% CHX and 0.05% CPC, and B: 0.10% permethol and 0.50% provitamin B5. Plaque index (PI), modified gingival index (MGI) and bleeding index (BI) were assessed at one and three months. Results: The 0.05% CHX and 0.05% CPC mouthrinse showed a high capacity to inhibit the formation (P=0.013) and adhesion (P=0.001) of the bacterial biofilm. Statistically significant differences were observed in the inter-group PI after three months of monitoring (P<0.001). Differences were also observed in MGI after one month (P=0,034) and after three months of monitoring (P<0,001); and in BI after one month (P=0,004) and after three months of monitoring (P=0,002). Conclusions: The 0.05% CHX and 0.05% CPC mouthrinse has a good capacity to reduce bacterial plaque and gingivitis

Primer caso de absceso renal por Parvimonas micra / First case of renal abscess by Parvimonas micra

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Proantocianidinas del arándano: cómo combatir de forma natural la gingivitis / Cranberry proanthocyanidins: How to fight gingivitis naturally

La periodontitis es una infección polimicrobiana caracterizada por un proceso inflamatorio destructivo que resulta en la pérdida de los tejidos que sostienen los dientes. uno de sus principales agentes etiológicos, Porphyromonas gingivalis, es capaz de adherirse y formar un biofilm o placa, contribuyendo a la colonización de la cavidad bucal. También sintetiza proteasas que pueden degradar proteínas tisulares y plasmáticas, que contribuyen a la invasión de los tejidos periodontales. Los procedimientos habituales para evitar el progreso de la enfermedad periodontal no siempre consiguen el resultado clínico deseado. Sin embargo, varios estudios indican que los polifenoles del arándano, concretamente las proantocianidinas (PAC), pueden inhibir la formación de placa dental, la producción de ácido y de enzimas proteolíticas derivadas de distintos patógenos periodontales, así como la respuesta inflamatoria del huésped. La combinación de estos efectos puede contribuir al manejo de enfermedades como la caries, la gingivitis y la periodontitis (AU)

Periodontitis is a polymicrobial infection characterized by a destructive inflammatory process that results in the loss of teeth-supporting tissues. One of its main etiological agents, Porphyromonas gingivalis, is able to adhere and form a biofilm, contributing to the colonization of the oral cavity. It also synthesizes proteases that can degrade tissue and plasma proteins and contribute to the invasion of periodontal tissues. The usual procedures to prevent the progression of periodontal disease do not always achieve the expected clinical outcome. however, several studies indicate that cranberry polyphenols, namely proanthocyanidins (PACs), may inhibit the formation of dental plaque, the production of acid and proteolytic enzymes derived from different periodontal pathogens, as well as the host inflammatory response. The combination of these effects may contribute to the management of diseases such as caries, gingivitis and periodontitis (AU)

Synergistic effect of persica mouthwash and Iranian ethanolic extract of propolis against biofilm formation of oral pathogens (in vitro study) / Efecto sinérgico del enjuague bucal persica y del extracto etanólico iraní de propolis contra la formación de biofilm de patógenos orales (estudio in vitro)

Aims: Several pathogens are responsible for oral diseases and dental plaque and their main mechanism is biofilm production. Natural products are point of interest for controlling these infections. persica mouthrinse, propolis and honey are some of these products with considerable antibacterial effects. In this study, we aimed to investigate synergy effect of these products on their antibiofilm and antibacterial effect. Material and Methods: Minimal Inhibitory effect and Minimial Biofilm inhibitory concentration of persica mouthrinse, propolis, honey solely and in combination was calculated against Streptococcus mutans ATCC35668, methicillin-resistant Staphylococcus aureus ATCC 33591, Staphylococcus aureus ATCC 29213, Staphylococcus epidermidis, Enterococcus faecalis ATCC 29212 , Escherichia coli ATCC 25922. Results: Combination of persica and propolis had a better profile in biofilm's inhibition than honey. None of herbal combinations had synergistic effect against studied bacteria; MIC of the persica mouth had the best effect against Streptococcus mutans, which causes caries. Conclusions: There was no synergistic effect of persica and propolis and the best antimicrobial effect was observed on subminimum inhibitory concentration of persica mouthwash. Findings of the present study suggest use of other combination than honey, propolis and persica for improving antimicrobial activity of these components

Objetivos: Varios patógenos son responsables de enfermedades orales y la placa dental y su mecanismo principal es la producción de biofilm. Los productos naturales son puntos de interés para controlar estas infecciones. persica mouthrinse, propolis y miel son algunos de estos productos con considerables efec­tos antibacterianos. En este estudio, se buscó investigar el efecto sinérgico de estos productos sobre su antibiótico y efecto antibacteriano. Material y Métodos: Se calculó el efecto inhibidor mínimo y la concentración inhibitoria mínima de bi­ofilm de enjuague bucal de persica, propóleos, miel únicamente y en combinación, contra Staphylococcus aureus ATCC 29213, S. epidermidis, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922. Resultados: La combinación de persica y propóleo tuvo un mejor perfil en la inhibición de la biopelícula que la miel. Ninguna de las combinaciones de hierbas tuvo efecto sinérgico contra las bacterias estudia­das; La Se calculó el efecto inhibidor mínimo de la boca de la persica tuvo el mejor efecto contra Strepto­coccus mutans, que causa la caries. Conclusiones: No hubo efectos sinérgicos de la persica y el propóleo y se observó el mejor efecto an­timicrobiano en la concentración mínima inhibitoria de enjuague bucal de persica. Los hallazgos del presente estudio sugieren el uso de otra combinación que la miel, el propóleo y la persica para mejorar la actividad antimicrobiana de estos componentes

Disbiosis como factor determinante de enfermedad oral y sistémica: importancia del microbioma / Dysbiosis as a determinant factor of systemic and oral pathology: importance of microbiome

Los avances en los estudios de genética y epigenética modifican algunos conceptos de salud y enfermedad que se habían mantenido intactos durante décadas. En este sentido, en los últimos años se está otorgando un protagonismo creciente a microorganismos que han acompañado durante millones de años de evolución a los seres vivos superiores. Los genes de estos y de su microbiota constituyen un microbioma que interviene en el mantenimiento de la salud. La boca es lugar de asiento de gran variedad de microorganismos, cuyo control ayuda a estabilizar la enfermedad oral y sistémica. El objetivo del presente artículo es actualizar algunos conceptos relativos al microbioma oral y de su vinculación con la salud oral y general (AU)

Advances in genetic and epigenetic studies modified some concepts of health and disease that had been kept intact for decades. In this respect, in the last few years, microorganisms that have evolved with superior life forms for millions of years have taken an increased prominence. The genes of organisms and their microbiota constitute a microbiome that intervenes in health maintenance. The oral cavity is inhabited by a variety of microorganisms, their control aids in stabilising oral and systemic disease. The objective of this article is to update some concepts related to oral microbiome and its correlation with general and oral health (AU)

Periodontal, salivary and IL-6 status in rheumatoid arthritis patients. A cross-sectional study

Background: The aim of this study was to determine whether saliva interleukin-6 (IL-6) levels are elevated in patients with rheumatoid arthritis versus a control group and examine the possible relationship between the oral condition and the risk of RA. Material and Methods: In 30 patients with RA and 30 healthy controls, different periodontal indices were recorded; sialometric measurements were taken to determine resting whole saliva, stimulated whole saliva and stimulated parotid saliva flow; and the saliva IL-6 levels were measured. Logistic regression analysis was performed, with the presence or absence of RA as dependent variable. Results: The patients with RA had a greater presence of bacterial plaque, a greater periodontal pocket depth, a larger percentage of medium-sized pockets, and greater periodontal attachment loss compared with the controls. Likewise, a decrease in resting and stimulated saliva flow was observed, together with an increase in saliva IL-6 levels. Logistic regression analysis reported that the plaque index is the principal differentiating factor of patients with RA. Stimulated parotid saliva flow was also significantly correlated to the presence of RA. Conclusions: The patients with RA showed a greater tendency to develop periodontal disease than the controls, with lower salivary flow and higher levels of IL-6 in saliva (AU)

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Salud e higiene oral en los adolescentes gallegos / Oral health and hygiene status in Galician schoolchildren

OBJETIVO: Conocer el estado de salud e higiene oral entre los escolares gallegos de 12 años. MÉTODO: Estudio transversal realizado en el curso 2010-2011 en una muestra de 1.267 escolares. La información sociodemográfica, sobre dieta y hábitos de higiene oral de los participantes se recogió con cuestionarios autocumplimentados. A los participantes se les realizó una exploración de la cavidad oral, de acuerdo con los criterios de la Organización Mundial de la Salud, para valorar la presencia de placa y de caries. Se estimaron medias y prevalencias acompañadas de intervalos de confianza del 95% y se ajustaron modelos de regresión logística. RESULTADOS: Participaron en el estudio 1.045 escolares; en el 35% la eliminación de la placa era incorrecta y el 39,3% tenían caries. La presencia de caries fue mayor entre los escolares de clases sociales más desfavorecidas y la frecuencia diaria de cepillado se asoció con una mejor salud oral. CONCLUSIONES: Es necesario diseñar e implantar programas educativos orientados a los escolares con el objetivo de mejorar su higiene y salud oral

OBJECTIVE: The aim of this study is to determine the oral health and hygiene status in 12 year-old Galician schoolchildren. METHOD: A cross-sectional study was conducted on a sample of 1267 schoolchildren. The fieldwork was carried out in the 2010-2011 academic year. Information regarding socio-demographic status, dietary habits, and oral hygiene practices was obtained through a structured self-report questionnaire given to the children at school. Dental examination to evaluate plaque and caries was carried out according to World Health Organization criteria. The prevalence and mean with 95% confidence intervals were calculated and logistic regression models were ajusted. RESULTS: Out of a total of 1045 pupils who participated in the study, 35% showed incorrect removal of dental plaque, and the prevalence of caries was 39.3%. Those who belonged to a lower socioeconomic group showed a higher prevalence of caries. Those who brushed their teeth daily had better oral hygiene. CONCLUSIONS: Educational programmes need to be designed and implemented in order to improve dental health and hygiene

Comparison of the detection of periodontal pathogens in bacteraemia after tooth brushing by culture and molecular techniques

BACKGROUND: The prevalence and amounts of periodontal pathogens detected in bacteraemia samples after tooth brushing-induced by means of four diagnostic technique, three based on culture and one in a molecular-based technique, have been compared in this study. MATERIAL AND METHODS: Blood samples were collected from thirty-six subjects with different periodontal status (17 were healthy, 10 with gingivitis and 9 with periodontitis) at baseline and 2 minutes after tooth brushing. Each sample was analyzed by three culture-based methods [direct anaerobic culturing (DAC), hemo-culture (BACTEC), and lysis-centrifugation (LC)] and one molecular-based technique [quantitative polymerase chain reaction (qPCR)]. With culture any bacterial isolate was detected and quantified, while with qPCR only Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were detected and quantified. Descriptive analyses, ANOVA and Chi-squared tests, were performed. RESULTS: Neither BACTEC nor qPCR detected any type of bacteria in the blood samples. Only LC (2.7%) and DAC (8.3%) detected bacteraemia, although not in the same patients. Fusobacterium nucleatum was the most frequently detected bacterial species. CONCLUSIONS: The disparity in the results when the same samples were analyzed with four different microbiological detection methods highlights the need for a proper validation of the methodology to detect periodontal pathogens in bacteraemia samples, mainly when the presence of periodontal pathogens in blood samples after tooth brushing was very seldom

Influencia de parámetros clínicos sobre la severidad de la recesión gingival localizada / Clinical parameters related to severity of localised gingival recession

INTRODUCCIÓN: La recesión gingival localizada es un problema de salud bucodental fundamental porque su progresión conduce a la pérdida dentaria. El propósito de este trabajo fue evaluar la influencia de distintos parámetros clínicos sobre la recesión gingival localizada. MATERIAL Y MÉTODOS: Se estudiaron 40 pacientes con recesión gingival localizada en los que se analizaron diversos parámetros clínicos relacionados con la recesión gingival. Para la comparación de variables cuantitativas se utilizó el test de Student (t-Student) y para la de variables cualitativas el test chi-cuadrado. RESULTADOS: En este estudio, según la clasificación de Miller, el 37,5% de los pacientes tenían recesiones de tipo I, el 60% de tipo II y el 2,5% restante, de tipo III. Los siguientes parámetros: edad, frecuencia de cepillado, tipo de cepillo, uso de colutorios y de seda dental, otros hábitos orales y el tratamiento de ortodoncia, no tienen influencia sobre la severidad de la recesión gingival (p > 0,05 en todos los casos). Presentan recesión gingival más severa, los varones (p = 0,03), los sujetos fumadores (p = 0,007) y los que tienen técnicas de cepillado horizontal (p = 0,02). En los cuatro momentos de seguimiento del estudio (inicial, 6, 12 y 18 meses), la profundidad de sondaje, la pérdida de inserción, el índice de placa y el índice de sangrado mejoraron a los 6 meses para luego empeorar en el resto de períodos. DISCUSIÓN: El sexo, el tabaco y la técnica de cepillado son los tres factores que tienen influencia sobre la severidad de la recesión gingival localizada en este estudio

INTRODUCTION: Localised gingival recession is a major problem of oral health because its progression leads to the dental loss. The aim of this study was to evaluate the possible influence of different clinical parameters in localised gingival recession. MATERIAL AND METHODS: Forty patients with localised gingival recession were studied. Data from several clinical parameters related to gingival recession were collected. RESULTS: In this study, 37.5% of patients had recessions of Miller's type I, 60% Miller's type II, and the remaining 2.5% of Miller's type III. Age, frequency of toothbrushing, toothbrushing technique, use of mouthwash and/or dental floss, other oral habits, and orthodontic therapy, have no influence on the severity of gingival recession (p > 0.05 in all cases). More severe gingival recession was observed in males (p = 0.03), smokers (p = 0.007) and those with horizontal toothbrushing techniques (p = 0.02). In the four follow-up periods of the study, probing depth, attachment loss, plaque index and bleeding index improved after 6 months and then got worse in the rest of the follow-up intervals. DISCUSSION: Gender, smoking and toothbrushing technique were the three factors that influenced the severity of localised gingival recession

Presencia de biofilm en la superficie radicular externa asociado a periodontitis apical persistente: a propósito de dos casos / Biofilm on external root surfaces associated with persistent apical periodontitis: report of two cases

Se presentan dos casos en los cuales fue identificado biofilm en la superficie radicular externa de los dientes con periodontitis apical persistente (PAP). En el primer caso presentado, dos incisivos centrales superiores derechos con tratamientos de conductos realizados previamente y con PAP, fueron retratados y después realizada una cirugía periapical. Los ápices radiculares resecados fueron examinados y se observaron sus superficies cubiertas con un material duro similar al cálculo. El análisis histológico del tejido blando apical indicó tejido de granulación y abundantes elementos granulomatosos. Examinados ambos ápices con microscopía electrónica de barrido (MEB), se pudieron observar gruesas capas de biofilm bacteriano, en su mayoría formado por cocos, sobre el material duro que se asemeja al cálculo. En el segundo caso presentado, un primer molar superior derecho con PAP, con un tratamiento incorrecto de conductos realizado anteriormente, fue retratado y posteriormente realizada una cirugía apical. Examinada la raíz palatina mediante MEB, se identificaron gruesas capas de biofilm bacteriano, compuestas por células del tipo actinomices con forma de bastoncillos irregulares, adheridos a la superficie del material duro que se asemeja al cálculo. Los casos que se exponen a continuación, apoyan el concepto de que las infecciones persistentes periapicales de origen pulpar, en especial los casos sintomáticos, pueden estar asociadas a la presencia de biofilms adheridos a la superficie externa de la raíz, interfiriendo con la reparación apical

Two cases in which biofim was identified on the external root surface of root-filled teeth with persistent apical periodontitis (PAP) are reported. In the first case, the root canals of two maxillary right incisors with PAP were retreated and the apices were surgically resected. The resected root ends were examined and the surfaces covered with a hard calculus-like material. Histological analysis of the apical soft tissue indicated both granulation and granulomatosus elements. Scanning electron microscopy (SEM) examination showed thick layers of bacterial biofilm, mostly cocciform bacteria, on the calculus-like material. In the second case, the root canals of a maxillary left first molar with PAP, were treated and the root end of the palatal root was resected. SEM examination of the palatal root tip indentified thick layers of bacterial biofilm composed of actinomyces-like cells and irregular rod-shaped bacteria attached to the surface of a calculus-like material. The cases reported here support the concept that persistent periapical infections of pulpal origin may be associated with the presence of biofilms on the external root surface infections, causing impaired healing of the, may be associated to bacterial biofilms on external root Surface

Changes in microflora in dental plaque from cancer patients undergoing chemotherapy and the relationship of these changes with mucositis: a pilot study

BACKGROUND: To assess changes in oral microflora in dental plaque from cancer patients within 7 days of the first course of chemotherapy, and the relationship of the changes with mucositis. MATERIAL AND METHODS: Thirty cancer patients, divided into a test group undergoing chemotherapy and a control group no undergoing chemotherapy, were enrolled in this pilot study. Oral microflora were cultured from three samples of dental plaque at t0 (before chemotherapy), t1 (1 day after chemotherapy) and t2 (7 days after chemotherapy). Single and crossed descriptive analyses were used to establish prevalence, and the χ2 test was used to establish the statistical significance of the differences observed in distributions (significance level: P<0.05). RESULTS: In most patients (57%), oral microflora consisted mainly of Gram-positive cocci, while the remaining 43% of the bacterial flora also had periodontal-pathogenic species. No Porphyromonas gingivalis appeared in the test group. Actinobacillus was the least frequently found bacterium among periodontal pathogens in the test group, while Fusobacterium nucleatum was the most frequently found. No significant differences were found in quantitative bacterial changes between t0, t1 and t2 in either the test or control groups, or between the two groups. According to World Health Organization scores, oral mucositis developed in 10 patients (66.6%) in the test group. CONCLUSIONS: The results of this pilot study indicate that there were no changes in microflora in dental plaque in cancer patients within 7 days of the first course of chemotherapy. No correlations between oral mucositis and specific microorganisms were assessed