Periodontal Pathogen Colonization in Young Children by PCR Quantification - A Longitudinal Survey.

INTRODUCTION: Periodontal diseases are among the leading causes of premature tooth loss in adults, but the microbiota associated with this problem is established over time in childhood. AIM: This longitudinal study aimed to verify the occurrence of periodontal pathogens in the oral cavity of children aged six, twelve, eighteen and twenty-four months through PCR quantification, correlating them with the oral microbiota of their mothers. STUDY DESIGN: Saliva and oral biofilm samples were collected from mothers and children by using sterilized paper points. Furthermore, a questionnaire was applied in all periods to evaluate hygiene and dietary habits. RESULTS: A positive correlation was found between mother-child pairs in all periods. No correlation was observed between hygiene and dietary habits and occurrence of periodontal pathogens. CONCLUSION: Early inclusion of children in preventive and biofilm control programs could contribute to preventing acquisition of aggressive pathogens.

Biochemical and microbiological characteristics of in situ biofilm formed on materials containing fluoride or amorphous calcium phosphate.

PURPOSE: To evaluate the biochemical and microbiological characteristics of in situ biofilm formed on materials that release fluoride (F-) or calcium (Ca++) and phosphate (Pi). METHODS: This study comprised an in situ and in vitro experiment, utilizing three materials [Auralay XF and Fuji IX GP, containing fluoride, and Aegis containing amorphous calcium phosphate (ACP)] and bovine dental enamel slabs. For the in situ: 10 volunteers wore palatal devices, each containing four material specimens or enamel slabs that were treated with 20% sucrose solution. The biofilm had pH measurements on Day 7 and the composition was analyzed on Day 8 by assessing the following: F-, Ca++, Pi and insoluble extracellular polysaccharides (EPS) concentrations, and then identification of the microbiota. For the in vitro: materials/enamel were subjected to a 7-day pH-cycling regimen to determine F, Ca++ and Pi release. RESULTS: The biofilm formed on F(-)-releasing materials was richer in F, Ca++ and Pi and had lower mutans streptococci counts than enamel biofilm. The biofilm on the ACP-containing material exhibited similar Ca++ and Pi concentrations to biofilm on F(-)-releasing materials. The materials showed buffering action compared with enamel. Biochemical and microbiological characteristics showed a less cariogenic biofilm on materials containing fluoride or amorphous calcium phosphate.

Dental implants in patients with osteoporosis: a clinical reality?

Osteoporosis is a systemic disorder characterized by generalized decrease in bone mineral density. Dental implantology is a specialty with high predictability when both quantity and quality of the bone are respected. Therefore, the diagnosis and the implant treatment in patients with osteoporosis are important. In the current study, a literature review about osteoporosis and dental implant therapy was conducted. PubMed, Cochrane, ISI, Dentistry Oral Science, SciELO, and Bireme databases were consulted over the last 20 years. English- and Portuguese-language articles were included in this revision. Some authors stated that the osteoporotic bone is similar to the proposed model of bone type IV. Randomized clinical studies reported implant failure in patients with osteoporosis after menopause. Studies that contraindicate the use of implants in patients with osteoporosis infer that the impaired bone metabolism led to reduction of bone healing around the implants. Nevertheless, other authors believe that the presence of osteoporosis is not a definitive condition to contraindicate the therapy with dental implants. In these cases, the dentist should perform a proper treatment planning, modifying the implant geometry, and use larger implant diameter and with surface treatment. Thus, osteoporosis is not a contraindication for implant surgery because an accurate analysis of bone quality by means tomography is performed.

Dental Caries Investigation in Children Controlled for an Educative and Preventive Oral Health Programme.

PURPOSE: To evaluate the association of dental caries with behavioural, socioeconomic and cultural factors; and Streptococcus mutans (SM) levels in the saliva and oral hygiene index of children aged 4 and 6 years old placed in an oral health programme. MATERIALS AND METHODS: This study was an analytic cross-sectional oral health survey conducted over a 9-month period. A total of 466 children aged 4 and 6 years old were included for evaluation of SM levels in saliva, simplified oral hygiene index and dental caries activity. RESULTS: High SM levels were associated with dmft index, toothbrushing without parental assistance, deficient oral hygiene and ingestion of sweet foods. Deficient oral hygiene was found in children aged 4 years old and with three or more siblings. Dental caries was associated with low family income, deficient oral hygiene, sucrose ingestion by children younger than three years old, bottle-feeding habit and low parental compliance. CONCLUSIONS: High SM levels in saliva, deficient oral hygiene and high frequency of sucrose ingestion had association with dental caries in children. Cultural, socioeconomic and behaviour factors indirectly influenced the onset of dental caries.

Tissue reaction to Aroeira (Myracrodruon urundeuva) extracts associated with microorganisms: an in vivo study.

Based on aroeira's (Myracrodruon urundeuva) antimicrobial activity and a future trend to compose intracanal medication, the aim of this study was to assess in vivo inflamatory tissue response to the extracts by edemogenic and histological analysis containing inactivated facultative and anaerobic microorganisms. For edema quantification, eighteen animals were divided into three groups (n = 3, periods: 3 and 6 hours) and 0.2 mL of 1% Evans blue per 100 g of body weight was injected into the penile vein under general anesthesia. After 30 min the animals received a subcutaneous injection in the dorsal region of aqueous or ethanolic extract of aroeira or saline (control) containing inactivated bacteria. Samples were collected, immersed in formamide for 72h, and evaluated by spectrophotometry (630 m). For histological analysis, polyethylene tubes with the extracts were implanted in the dorsal of 30 male rats. Analysis of the fibrous capsule and inflammatory infiltrate were performed after 7 and 30 days. The aqueous extract group induced less edema in both postoperative periods compared to the other groups, but the differences were not significant (p > 0.05). Tissue repair was significantly better after 30 days than after 7 days (p < 0.01). The aqueous solution showed less inflammatory response than the ethanolic solution (p < 0.05), with tendency for better results than control after 7 days. After 30 days, the response to both extracts was similar to control. The aqueous and ethanolic aroeira extracts containing inactivated microorganisms showed a trend for better results than saline, even when associated with microorganisms, and facilitated the tissue repair process.

Microorganisms related to early childhood caries in a sample of an oral preventive-educative program: a longitudinal study / Microorganismos relacionados a cárie precoce da infância em uma amostra de um programa preventivo de cárie dentária: um estudo longitudinal

Objetivo: Premature acquisition of cariogenic microorganisms seems to be related to higher prevalence and activity of caries lesions. The aim of the study was to evaluate the prevalence of Streptococcus mutans and Streptococcus sobrinus in infants enrolled in a dental preventive program and in their mothers, as well as to assess the influence of bacterial prevalence, diet and oral hygiene in dental caries prevalence. Material and methods: After clinical examinations (n = 50), saliva and oral biofilms were collected and stored prior to real-time PCR at 6, 12, 18 and 24 months of age. Results: No correlation was observed between the presence of cariogenic pathogens and diet or hygiene habits at all ages; however, association increased with number of erupted teeth. Salivary levels of bacteria were lower in children than in their mothers at all ages, and children with carious lesions had high ingestion of sugared food. Conclusion: As the levels of cariogenic pathogens were low in the patients that were enrolled in a preventive program, we can conclude that control of oral biofilm as eruption of infants' teeth occurs and sugar ingestion should be considered of great importance in preventive dentistry, because the association between them was highly positive. (AU)

Objetivo: A aquisição precoce de microorganismos cariogênicos está correlacionada a alta prevalência e atividade de lesões de cárie. O objetivo deste estudo foi avaliar a prevalência de Streptococcus mutans e Streptococcus sobrinus em bebês e pares de mães, matriculados no programa educativo e preventivo da Bebê Clínica da Faculdade de Odontologia de Araçatuba (UNESP), como também foi avaliada influência da prevalência bacteriana, dieta e higiene oral na prevalência de cárie dentária. Material e métodos: Após exame clínico (n=50), foram coletados saliva e biofilme e submetidos a real-time PCR aos 6, 12, 18 e 24 meses de idade. Resultados: Não foi observada correlação entre a presence de patógenos cariogênicos e hábitos de dieta e higiene em todas as idades avaliadas. Níveis salivares foram mais baixos nas crianças do que em suas mães em todas as idades, e as crianças portadoras de lesões cariosas tinham maior ingestão de alimentos açúcarados. Conclusão: Uma vez que os níveis de patógenos cariogênicos foram baixos nos pacientes que frequentam um programa preventivo, podemos concluir que o controle de biofilme durante a erupção dentária e da ingestão de açúcares pode ser considerada medida de grande relevância em prevenção odontológica, uma vez que a associação foi altamente positiva. (AU)

Tissue reaction to Aroeira (Myracrodruon urundeuva) extracts associated with microorganisms: an in vivo study

Abstract: Based on aroeira's (Myracrodruon urundeuva) antimicrobial activity and a future trend to compose intracanal medication, the aim of this study was to assess in vivo inflamatory tissue response to the extracts by edemogenic and histological analysis containing inactivated facultative and anaerobic microorganisms. For edema quantification, eighteen animals were divided into three groups (n = 3, periods: 3 and 6 hours) and 0.2 mL of 1% Evans blue per 100 g of body weight was injected into the penile vein under general anesthesia. After 30 min the animals received a subcutaneous injection in the dorsal region of aqueous or ethanolic extract of aroeira or saline (control) containing inactivated bacteria. Samples were collected, immersed in formamide for 72h, and evaluated by spectrophotometry (630 m). For histological analysis, polyethylene tubes with the extracts were implanted in the dorsal of 30 male rats. Analysis of the fibrous capsule and inflammatory infiltrate were performed after 7 and 30 days. The aqueous extract group induced less edema in both postoperative periods compared to the other groups, but the differences were not significant (p > 0.05). Tissue repair was significantly better after 30 days than after 7 days (p < 0.01). The aqueous solution showed less inflammatory response than the ethanolic solution (p < 0.05), with tendency for better results than control after 7 days. After 30 days, the response to both extracts was similar to control. The aqueous and ethanolic aroeira extracts containing inactivated microorganisms showed a trend for better results than saline, even when associated with microorganisms, and facilitated the tissue repair process.

Evaluation of tissue reaction to Aroeira (Myracrodruon urundeuva) extracts: a histologic and edemogenic study.

OBJECTIVES: This study evaluated subcutaneous tissue response to Aroeira (Myracrodruon urundeuva) extract employing edemogenic and histological analyses. MATERIAL AND METHODS: Test groups consisted of aqueous and ethanolic Aroeira extracts and saline (control). For edema quantification, 18 rats received an intravenous injection of Evan's Blue. After 30 min, the extracts and saline were injected on the dorsum of the rats, which were then sacrificed after 3 and 6 h. Readings were performed in a spectrophotometer. For subcutaneous implantation, 30 rats received a polyethylene tube containing the extracts on their dorsum and then they were killed after 7 and 28 days. The samples were processed for histological analysis and evaluated with a light microscope. The inflammatory infiltrate was quantified. RESULTS: There were no statistically significant differences between aqueous extract and saline groups in relation to edema quantification in the different periods (p>0.05). Ethanolic solution resulted in more edema independently of the experimental period (p<0.05). Histological analysis showed similar results on the 7-day period for the 3 groups. There was a notable reduction on inflammatory cell number for saline and aqueous extract groups at 28 days. CONCLUSION: The aqueous extract showed biocompatible properties similar to those of saline.

Influence of local tetracycline on the microbiota of alveolar osteitis in rats.

The aim of the present study was to evaluate the effects of local tetracycline on the occurrence of alveolar osteitis in rats, and on the microbiota associated to this infection. Forty Wistar rats were randomly assigned to 4 groups (n=10): I - the rats had the maxillary right incisor extracted and the alveolar wound did not receive any treatment; II - adrenaline and Ringer-PRAS were introduced into the alveolar wound; III - the alveolar wound was irrigated with sterile saline; and IV - the alveolar wound was irrigated with an aqueous solution of tetracycline. Microbial samples from the alveolar wounds were collected 2 days after surgery and inoculated on blood agar (with and without 8 microg/mL of tetracycline) and other selective media, and were incubated in either aerobiosis or anaerobiosis at 37 degrees C, for 2 to 14 days. It was verified that tetracycline reduced the occurrence of alveolar osteitis in the rats and caused significant changes in the microbiota of the surgical sites, decreasing the number of anaerobes and increasing the participation of tetracycline-resistant and multi-resistant microorganisms.

Condutas terapêuticas para caninos inclusos / Therapeutic behavior for impacted canines

Normalmente, os últimos dentes a erupcionar são os que permanecem inclusos ou semi-inclusos, como é o caso dos caninos. O estudo teve como objetivo relatar algumas opções de tratamento a fim da manutenção estética e funcional da área atuada diante de um canino incluso, discutindo as suas indicações, contra-indicações, vantagens e desvantagens. Este trabalho também busca enfatizar a acessibilidade que o paciente teria caso a sua opção ideal fosse uma das formas de tratamento abordadas. Para a identificação dos estudos incluídos ou considerados nesta revisão, foi realizada uma estratégia de busca detalhada para os bancos de dados pesquisados: Pubmed, Bireme, Scielo, Cochrane e Dentistry Oral Science até o ano de 2011. Foram utilizados como descritores: dente não-erupcionado, canino e terapêutica. Os critérios de inclusão foram: artigos clínicos e de revisão que abordavam o tema. Foi constatado mediante esta revisão que a falta do conhecimento técnico-científico por parte do cirurgião-dentista e a impossibilidade financeira da maioria da população são alguns dos empecilhos para o estabelecimento do correto planejamento para o canino incluso.

Normally, the last teeth to erupt are the ones which remain impacted or semi-impacted, and that is the case of the canines. This study aimed to report a few options of treatment, aiming at esthetic and functional maintenance of the affected area before a impacted canine, discussing its indications, contraindications, advantages and disadvantages. This study also aims to emphasize the accessibility the patient would have in case his/her option were one of the approached ways of treatment. In order to identify the studies included or analyzed in this review, a detailed search strategy was performed for the database used: Pubmed, Bireme, Scielo, Cochrane, and Dentistry Oral Science up to 2011. We used non-erupted teeth, canine, and therapeutics as descriptors. The criteria of inclusion were clinical and review articles that approached the theme. Through this review, it was found that the surgeon dentist?s lack of technical and scientific knowledge and the financial impossibility of most population are some hindrances for the establishment of the right planning for the impacted canine.

Evaluation of tissue reaction to Aroeira (Myracrodruon urundeuva) extracts: a histologic and edemogenic study

OBJECTIVES: This study evaluated subcutaneous tissue response to Aroeira (Myracrodruon urundeuva) extract employing edemogenic and histological analyses. MATERIAL AND METHODS: Test groups consisted of aqueous and ethanolic Aroeira extracts and saline (control). For edema quantification, 18 rats received an intravenous injection of Evan's Blue. After 30 min, the extracts and saline were injected on the dorsum of the rats, which were then sacrificed after 3 and 6 h. Readings were performed in a spectrophotometer. For subcutaneous implantation, 30 rats received a polyethylene tube containing the extracts on their dorsum and then they were killed after 7 and 28 days. The samples were processed for histological analysis and evaluated with a light microscope. The inflammatory infiltrate was quantified. RESULTS: There were no statistically significant differences between aqueous extract and saline groups in relation to edema quantification in the different periods (p>0.05). Ethanolic solution resulted in more edema independently of the experimental period (p<0.05). Histological analysis showed similar results on the 7-day period for the 3 groups. There was a notable reduction on inflammatory cell number for saline and aqueous extract groups at 28 days. CONCLUSION: The aqueous extract showed biocompatible properties similar to those of saline.

Contaminação Microbiana das Soluções de Processamento Radiográfico: Risco de Infecção Cruzada / Microbial Contamination of Radiographic Developing and Fixing Solutions: Risk of Cross Infection

Objetivo: Avaliar a contaminação microbiana em amostras de revelador e fixador radiográficos água de processamento radiográfico, água do equipo odontológico e da fonte externa de água do consultório. Método: Amostras de 50 consultórios particulares e de 20 consultórios da Faculdade de Odontologia de Araçatuba-UNESP foram coletadas. As amostras foram submetidas à neutralização dos agentes inibitórios residuais e submetidas à pré-enriquecimento em água peptonada e caldo EVA e inoculadas em meios de cultura seletivos e não seletivos. O DNA nas amostras foi extraído e a presença de microrganismos superinfectantes foi avaliada por PCR. As diferenças na prevalência dos microrganismos nas amostras de soluções foram submetidas ao teste análise de variância de medidas repetitivas para dados categóricos, enquanto os testes de Qui-Quadrado e de Mann-Whitney foram utilizados para avaliar a existência de possíveis associações entre o número total de microrganismos heterotróficos e os protocolos de controle de infecção. O nível de significância adotado foi de 5%.Resultados: Verificou-se que as amostras de fixador eram contaminadas em uma freqüência muito menor do que o revelador e água de processamento radiográfico, sendo que essa última mostrava microrganismos tipicamente originados da microbiota bucal e da pele humanas, bem como microrganismos freqüentemente encontrados na água do equipo odontológico. A contaminação da água de processamento foi menor em consultórios onde o invólucro da película radiográfica recebia desinfecção antes do processamento ou era recoberto com filme plástico. Adicionalmente, todas as amostras de água da fonte externa do consultório se mostraram potáveis.Conclusão: A utilização de barreiras filmes plásticos de proteção a película mostrou ser a melhor forma de reduzir a contaminação dessas soluções

Objective: To evaluate the microbial contamination in samples of radiographic developing and fixing solutions, radiographic processing water, dental unit waterlines and dental officeÆs external water supply. Methods: Samples of 50 private dental offices and 20 dental offices of the School of Dentistry de Araçatuba-UNESP were collected. The samples were subjected to neutralization of the residual inhibitory agents followed by pre-enrichment in peptone water and EVA broth and were inoculated in selective and non-selective culture media. The DNA of the samples was extracted and the presence of superinfectant microorganisms was evaluated by PCR. The differences in the prevalence of the microorganisms in the samples of the solutions were analyzed by repeated-measures analysis of variance for category data, while the Chi-Square and Mann-Whitney tests were used to evaluate the existence of associations between the total number of heterotrophic microorganisms and infection control protocols. The significance level was set at 5%.Results: Samples of radiographic fixing solution presented a remarkably less frequent contamination than radiographic developing solution and radiographic processing water. The latter exhibited microorganisms typically originated from the oral microbiota and human skin as well as microorganisms frequently found in dental unit waterlines. There was less contamination of radiographic processing water in the dental offices where the x-ray film packets were disinfected before processing or were covered by a plastic film. Additionally, all samples of dental officeÆs external water supply were drinkable.Conclusion: Covering the x-ray film packets with a plastic film protection barrier was proven the best manner to reduce the contamination of the evaluated solutions

Quarto molar retido: a importância do diagnóstico precoce / Fourth molar: the importance of early diagnosis

Dente supranumerário é aquele que excede a série normal, podendo ocorrer em ambos os arcos dentários. Sua etiologia não é completamente entendida. Em relação a sua prevalência, ocorre mais na dentição permanente e duas vezes mais nos homens que nas mulheres. Os dentes supranumerários são classificados de acordo com sua morfologia e localização. A presença desses dentes pode causar problemas, como falhas na erupção, deslocamento de dentes, apinhamentos, cistos e tumores odontogênicos. O diagnóstico é realizado geralmente por meio de radiografias de rotina, pois a maior parte desses dentes está inclusa e é assintomática. Objetivo e relato do caso: Este trabalho teve como objetivo realizar uma breve revisão de literatura e relatar um caso clínico de paciente do sexo femini-no, 23 anos, melanoderma, com três quartos molares. Considerações finais: O diagnóstico precoce mostrou ser importante para a resolução do caso minimizar ou prevenir o aparecimento de complicações e estabelecer um adequado plano de tratamento.

Occurrence of Actinobacillus actinomycetemcomitans in patients with chronic periodontitis, aggressive periodontitis, healthy subjects and children with gingivitis in two cities of the state of São Paulo, Brazil.

The aim of this study was to determine the frequency of isolation of Actinobacillus actinomycetemcomitans (Aa) in 100 patients with chronic periodontitis, 14 patients with aggressive periodontitis, 142 pre-school children with gingivitis and 134 periodontally healthy subjects. Samples of subgingival plaque were taken using sterilized paper points introduced into periodontal pockets or gingival crevice for 60 seconds and inoculated on TSBV agar, which was incubated under anaerobiosis at 37 degrees C, for 4 days. Microbial identification was performed through biochemical methods and morphocellular and morphocolonial analysis. Aa was detected in 40.3% of healthy subjects, 68% of patients with chronic periodontitis, 92.86% of patients with aggressive periodontitis and 40.14% of children with gingivitis. The rate of recovery of Aa in the tested human groups proved to be higher than previously reported and in agreement with participation of this facultative anaerobe as a member of native microbiota of the periodontium and its relation with aggressive and chronic periodontitis in Brazil.

Frequência de anquiloglossia em uma comunidade indígena brasileira / Frequency of ankyloglossia in a community of native Brazilians

Objetivo: Avaliar a prevalência de anquiloglossia na comunidade indígena Umutina, no município de Barra do Bugres (MT), em diversas faixas etárias. Métodos: A amostra foi constituída de 291 índios que se submeteram ao exame clínico. Resultados: A anquiloglossia foi observada em 108 (37,11%) índios. O sexo masculino apresentou maior prevalência, sendo 57 casos (43,8%), enquanto o sexo feminino apresentou 51(31,7%) dos casos. A distribuição da faixa etária foi feita após análise de agrupamento hierárquico, distribuídas em três grupos: 1-20 anos, 21-45 anos e 46-99 anos. Sendo que a anquiloglossia apresentou maior prevalência na faixa etária de 1- 20 anos, com 65 casos (40,6%). Conclusão: Verificou-se que, apesar da anquiloglossia se apresentar nas etnias da reserva indígena Umutina com frequência elevada, a mesma não parece ser responsável por alterações associadas à fonação, mastigação, presença de diastema e problemas periodontais, uma vez que essas alterações foram observadas em baixa frequência e não foram motivos de queixas da população.

Objective: This study aimed to assess the prevalence of ankyloglossia in people of different age groups living in the native Brazilian community of Umutina, in the municipality of Barra do Bugres/ Mato Grosso. Methods: The sample consisted of 291 native Brazilians who underwent clinical examination. Results: Ankyloglossia was observed in 108 (37.11%) individuals. There was a greater prevalence of ankyloglossia among males, with 57 cases (43.8%) against 51 cases (31.7%) in females. Age distribution was done after analyzing the hierarchical grouping, resulting in three age groups: 1- to 20-year-olds, 21- to 45-year-olds and 46- to 99-year-olds. Ankyloglossia was more prevalent in the youngest group, with 65 cases (40.6%). Conclusion: Although there is a high rate of ankyloglossia among the individuals who live in the Umutina Reservation, ankyloglossia does not seem responsible for the changes associated with phonation, mastication, presence of diastema and periodontal problems, since these changes were infrequent and generated no complaint.

Granuloma gravídico: relato de caso / Gravidarum granuloma: case report

Conhecido como "granuloma gravídico" quando presente em grávidas, o granuloma piogênico manifesta-se clinicamente como uma lesão lobulada ou plana, pediculada e, em alguns casos, de superfície ulcerada. Como características histológicas evidentes há presença de tecido de granulação em áreas de proliferação endotelial e de espaços vasculares e massas lobuladas de tecido hiperplásico. O presente relato objetiva apresentar um caso clínico em paciente de 23 anos, grávida de sete meses, portadora de granuloma gravídico em região de gengiva vestibular inferior. O caso foi tratado cirurgicamente com prognóstico favorável.

The pyogenic granuloma may be classified as “pregnancy tumor” when it occurs in pregnant women manifests itself clinically as an injury lobulada or flat, pedicled and, in some cases, surface ulcerated. As histological features are obvious to the presence of granulation tissue, in areas of proliferation of endothelial and vascular spaces and lobulated masses of hyperplastic tissue.The objective of this study is to present a 23 years old patient’s case, 7 months pregnancy, bearer of pyogenic granuloma in vestibular lower gingival region. The case was surgically treated with favorable prognosis.

Osteonecrose associada com o uso dos bifosfonatos / Osteonecrosis associated to the use of bisphosphonates

Introdução: Os bifosfonatos são análogos dos pirofosfatos endógenos e possuem alta afinidade pelos tecidos mineralizados, atuando em sítios de grande formação e reabsorção óssea, sendo utilizados no tratamento da osteoporose, osteogênese imperfeita, displasia fibrosa, doença de Paget, mieloma múltiplo e nas metástases ósseas das complicações de vários tipos de neoplasias malignas. Contudo, numerosas complicações de seu uso vêm sendo descritas, destacando-se o aparecimento de osteonecrose nos ossos gnáticos.Objetivo: Alertar o cirurgião-dentista sobre os possíveis efeitos colaterais dessa classe de drogas sobre o tecido ósseo, os quais podem se assemelhar à outras patologias, como a osteorradionecrose e osteomielites. Verificou-se que a osteonecrose por bifosfonatos é mais comum em pacientes com mieloma múltiplo e câncer de mama, embora também tenha sido relatada em pacientes sob tratamento para osteoporose. Com relação à etiologia, sugere-se uma relação com exodontias e alterações periodontais, embora casos aparentemente espontâneos tenham sido relatados. A despeito da severidade da patologia, não existem protocolos bem estabelecidos de tratamento, variando de conservadores, utilizando a antibioticoterapia e bochechos com clorexidina 0,12%, à radicais, como a mandibulectomia e maxilectomia. Tratamentos alternativos também podem ser realizados, utilizando-se o plasma rico em plaquetas associado às ressecções. Diante dos efeitos dos bifosfonatos aos ossos gnáticos, deve-se dar enfâse à prevenção realizando exames clínicos e radiográficos, a fim de detectar possíveis infecções dentais e realizar os procedimentos convenientes como extrações dentárias, tratamentos endodônticos e periodontais, além de remoção de torus mandibulares ou maxilares, uma das áreas anatômicas mais acometidas.Conclusão: A instituição de protocolos prévios odontológicos a terapia dos bifosfonatos deveria ser uma rotina no início do tratamento médico, promovendo assim à prevenção da osteonecrose.

Lipoma em mucosa bucal / Lipoma in the oral mucosa

Tido como neoplasia mesenquimal benigna rara na boca, o lipoma em geral apresenta algumas características que facilitam o diagnóstico, como o fato de apresentar menor densidade que o líquido fixador, permitindo à peça cirúrgica boiar quando inserida no frasco. O presente artigo relata um caso de lipoma intrabucal em paciente melanoderma de 59 anos, sexo feminino, que apresentava lesão nodular na mucosa jugal direita, cor escura, assintomática. A conduta adotada foi a realização de biópsia excisional, fixando-se a peça cirúrgica em formol, não se observando flutuação desta. Dentre outros dados diagnósticos, os autores reúnem dados microscópicos e discutem fatores prognósticos do caso.

Lipoma, a rare benign mesenchymal neoplasm in the mouth, generally presents some characteristics that facilitate the diagnosis, such as the fact that it presents a lower density than the fixative fluid, allowing the surgical device to float when inserted into the flask. This paper reports a case of oral lipoma in a 59-year-old black woman, presenting as a nodule with brown pigmentation on its surface. After the surgical excision, the anatomical specimen was conditioned in the fixing solution, no floating being observed. Among other diagnostic data, the authors present microscopic data and discuss prognostic factors of the case.

Influence of local tetracycline on the microbiota of alveolar osteitis in rats

The aim of the present study was to evaluate the effects of local tetracycline on the occurrence of alveolar osteitis in rats, and on the microbiota associated to this infection. Forty Wistar rats were randomly assigned to 4 groups (n=10): I - the rats had the maxillary right incisor extracted and the alveolar wound did not receive any treatment; II - adrenaline and Ringer-PRAS were introduced into the alveolar wound; III - the alveolar wound was irrigated with sterile saline; and IV - the alveolar wound was irrigated with an aqueous solution of tetracycline. Microbial samples from the alveolar wounds were collected 2 days after surgery and inoculated on blood agar (with and without 8 µg/mL of tetracycline) and other selective media, and were incubated in either aerobiosis or anaerobiosis at 37ºC, for 2 to 14 days. It was verified that tetracycline reduced the occurrence of alveolar osteitis in the rats and caused significant changes in the microbiota of the surgical sites, decreasing the number of anaerobes and increasing the participation of tetracycline-resistant and multi-resistant microorganisms.

O objetivo do presente estudo foi avaliar os efeitos do uso tópico de tetraciclina sobre a ocorrência de alveolite em ratos e sobre a microbiota a ela associada. Quarenta ratos foram divididos, ao acaso, em 4 grupos (n=10): grupo I, realizou-se somente a extração do incisivo superior direito e a ferida alveolar não recebeu nenhum tratamento; grupo II, além da extração dental, soluções de adrenalina e Ringer-PRAS foram introduzidas no interior do alvéolo; grupo III, a ferida alveolar foi irrigada com solução salina estéril; grupo IV, a ferida alveolar foi irrigada com solução aquosa de cloridrato de tetraciclina a 10 por cento. As amostras dos alvéolos para processamento microbiológico foram coletadas dois dias após a realização das cirurgias e foram inoculadas em ágar sangue com ou sem 8 µg/mL de tetraciclina e em outros meios de cultura seletivos, incubadas em aerobiose ou anaerobiose, a 37ºC, de 2 a 14 dias. Verificou-se que a tetraciclina reduziu a ocorrência de alveolite e provocou uma modificação significativa na microbiota do sítio cirúrgico, levando a uma redução nas proporções ocupadas pelos microrganismos anaeróbios e uma elevação da participação de microrganismos resistentes à tetraciclina e outros antimicrobianos.