Antifungal activity and mode of action of thymol and its synergism with nystatin against Candida species involved with infections in the oral cavity: an in vitro study.

BACKGROUND: Limitations of antifungal agents used in the treatment of oral candidiasis, as the development of resistant strains, are known by the scientific community. In this context, the aim of this study was to evaluate the antifungal activity of thymol against Candida albicans, Candida tropicalis and Candida krusei strains and to determine its mode of action and synergistic effect when combined with the synthetic antifungal nystatin. METHODS: The minimum inhibitory concentration (MIC) was determined using a microdilution technique, and the minimum fungicidal concentration (MFC) was determined via subculture sowing. The mode of action of thymol was established by verifying fungal growth in the presence of sorbitol or ergosterol. The fractional inhibitory concentration index (FIC) was determined using the checkerboard method. RESULTS: Thymol presented an antifungal effect, with MICs of 39 µg/mL for C. albicans and C. krusei and 78 µg/mL for C. tropicalis. The results of the antifungal test remained unchanged in the presence of sorbitol; however, the MIC value of thymol against C. albicans increased eight times (from 39.0 to 312.5 µg/mL) in presence of exogenous ergosterol. The combination of thymol and nystatin reduced the MIC values of both products by 87.4%, generating an FIC index of 0.25. CONCLUSIONS: Thymol was found to have a fungicidal effect on Candida species and a synergistic effect when combined with nystatin.

Luxação Intrusiva e Fratura Dental com Inserção do Fragmento no Lábio Inferior: Relato de Caso / Intrusive Luxation and Dental Fracture with Integration of Fragment on Lower Lip: A Case Report

O traumatismo dentário ocorre numa frequência relativamente alta, acometendo, especialmente, crianças e adolescentes. Os elementos dentários mais afetados são os incisivos centrais superiores, ocasionando impacto em vários aspectos da vida dos pacientes. O objetivo deste artigo foi relatar um caso clínico de traumatismo dentário, com fratura e intrusão dentária e inserção do fragmento no lábio inferior. Durante a anamnese e exame clínico, observou-se fratura de esmalte e dentina nos incisivos centrais superiores permanentes, com intrusão do elemento esquerdo, além de laceração do lábio inferior, que continha o fragmento em seu interior, constatado através de exame radiográfico. O paciente foi encaminhado para tratamento endodôntico do incisivo central superior esquerdo e cirurgia para remoção do fragmento dentário. Após análise, optou-se pela reerupção espontânea do elemento intruído e restauração com resina composta dos dentes fraturados. Durante a proservação do paciente, observou-se o total posicionamento na linha de oclusão do dente que sofreu intrusão e nenhuma reabsorção radicular após 2 anos de acompanhamento. Em casos de traumatismos dentários, é imprescindível que seja feito um exame minucioso nos tecidos duros e moles do paciente, para melhor diagnóstico e planejamento do tratamento, ademais de uma sistemática de monitoramento, para evitar consequências indesejadas oriundas do próprio traumatismo ou do tratamento executado.

The dental trauma occurs at a significant frequency, affecting especially children and adolescents. Dental elements most affected are the maxillary central incisors, causing impact on various aspects of life of patients. The aim of this article is to report a case of dental trauma with fracture and intrusive tooth and inserting the fragment in the lower lip. The history taking and clinical examination revealed a fracture of enamel and dentin in permanent maxillary central incisors, with intrusion of the element left, and laceration of the lower lip, which contained the fragment, within evidenced by radiographic examination. The patient was referred for endodontic treatment of the maxillary left central incisor and surgery to remove the tooth fragment. After analysis, spontaneous re-eruption of the intruded element and restoration of the fractured teeth with composite resin has been decided to perform. A total positioning of the occlusion line of the tooth that has undergone intrusion was observed, with no resorption after 2 years follow up. In cases of dental trauma, it is imperative that the examination is done in hard and soft tissues of the patient for better diagnosis and treatment planning, in addition to a systematic monitoring to avoid unintended consequences arising from both the trauma or treatment performed.

Atividade antibacteriana in vitro de fitoconstituintes sobre micorganismos do biofilme dentário / In vitro antibacterial activity of phytochemicals on dental biofilm microorganisms

Objetivo: Avaliar in vitro a atividade antimicrobiana docitronelol, linalol, timol e D-limoneno frente a Streptococcus mutans, S. salivarius e S. oralis. Materiale Métodos: Realizou-se um screening pela técnica de difusão em meio sólido. Discos de papel absorvente foram em bebidos com 30 μL da substância-teste e dispostos em placas dePetri contendo Ágar Müeller Hinton previamente semeadas com inóculo bacteriano. Após incubação por 24h a 37ºC, foi realizada a mensuração dos halos de inibição do crescimento bacteriano com auxílio de um paquímetro manual. A clorexidina2% foi utilizada como controle positivo. O estudo foi realizado em triplicata. Resultados: O citronelol obteve média do diâmetro dos halos, em milímetros (mm), para S. mutans, S.oralis e S. salivarius, respectivamente: 10.7, 10.0 e 9.8. Otimol, para a mesma sequência de microorganismos: 7.3, 7.3e 8.3 mm. O D-limoneno exibiu médias de 8.0, 6.7 e 6.0 mmpara S. mutans, S. oralis e S. salivarius, respectivamente.Mensurou-se médias dos halos de 8.0, 9.0 e 8.2 mm, para os mesmos microorganismos, quando testado o linalol. Aclorexidina, por sua vez, apresentou média dos diâmetros dos halos de 17 mm para S. mutans, 16.8 mm para S. oralis e19.7 mm para S. salivarius. Conclusão: Os produtos avaliados apresentaram atividade antibacteriana,representando possíveis substâncias com aplicabilidade na prevenção da cárie dentária.

Objective: To evaluate the in vitro antibacterial activity ofcitronellol, linalool, thymol, and D-limonene againstStreptococcus mutans, S. salivarius and S. oralis. Materialand Methods: It was performed a screening by the diffusiontechnique on solid medium. Absorbent paper discs weresoaked with 30 μl of the tested substance and then placedon petri dishes containing Mueller Hinton agar previously sownwith the bacterial inoculum. After incubation for 24 h at 37 °C,it was measured the halo of growth inhibition with the aid ofa manual caliper. Chlorhexidine (2%) was used as positivecontrol. Tests were performed in triplicate. Results: Forcitronellol, the means of the diameters of the halos, in millimeters (mm), were 10.7, 10.0, and 9.8 against S. mutans,S. salivarius and S. oralis respectively. The values foundfor thymol were 7.3, 7.3 and 8.3 mm, respectively. Thephytochemical D-limonene exhibited means of 8.0, 6.7 and6.0 mm, respectively. For linalool, the means of the haloswere 8.0 mm, 9.0 mm and 8.2 mm. Chlorhexidine was foundto show means of 17, 16.8 and 19.7 mm on S. mutans, S.oralis and S. salivarius respectively. Conclusion: The products under test showed antibacterial activity, being therefore potential substances to be applied for dental caries prevention.