Microbiota associated with chronic osteomyelitis of the jaws.

Chronic osteomyelitis of maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of mandible or maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37(o)C for 14 and 3 days, respectively. Bacteria were cultivated from twelve patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from sixteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.

Occurrence of yeasts, enterococci and other enteric bacteria in subgingival biofilm of HIV-positive patients with chronic gingivitis and necrotizing periodontitis.

The purpose of this study was to determine the prevalence of enteric bacteria and yeasts in biofilm of 80 HIV-positive patients with plaque-associated gingivitis or necrotizing periodontitis. Patients were subjected to extra, intra oral and radiographic examinations. The oral hygiene, bleeding on probing, gingival conditions, and attachment loss were evaluated. Clinical specimens were collected from gingival crevices or periodontal pockets, transferred to VMGA III, diluted and transferred to Sabouraud Dextrose agar with 100 µg/ml of chloramphenicol, peptone water, EVA broth, EMB agar, SS agar, Bile esculin agar and Brilliant green agar. Isolation of yeasts was carried out at room temperature, for 3-7 days; and for the isolation of enteric microorganisms plates were incubated at 37°C, for 24-48 h. The yeasts identification was performed according to the carbon and nitrogen assimilation, fermentation of carbohydrates and germ tube formation. Bacteria were identified according to their colonial and cellular morphologies and biochemical tests. Yeasts were identified as Candida albicans and its occurrence was more common in patients with CD4+ below 200/mm(3) and was affected by the extension of periodontal involvement (P = 0.0345). Enteric bacteria recovered from clinical specimens were identified as Enterobacter sakazakii, Enterobacter cloacae, Serratia liquefaciens, Klebsiella oxytoca and Enterococcus sp. Enterobacteriaceae and enterococci were detected in 32.5% of clinical samples from patients with necrotizing periodontitis. In conclusion, non-oral pathogenic bacteria and C. albicans were more prevalent in periodontal sites of HIV-positive patients with necrotizing periodontitis and chronic gingivitis.

Plasmid profile in oral Fusobacterium nucleatum from humans and Cebus apella monkeys.

Fusobacterium nucleatum is a strict anaerobe and is indigenous of the human oral cavity. This organism is commonly recovered from different monomicrobial and mixed infections in humans and animals. In this study, the plasmid profile, the plasmid stability and the penicillin-resistance association in oral F. nucleatum isolated from periodontal patients, healthy subjects and Cebus apella monkeys were evaluated. Forty-five F. nucleatum strains from patients, 38 from healthy subjects and seven from C. apella were identified and analyzed. Plasmid extraction was performed in all the isolated strains. These elements were found in 26.7% strains from patients and one strain from C. apella. Strains from healthy subjects did not show any plasmid. Most of strains showed two plasmid bands ranging from 4 to 16 Kb, but digestions with endonucleases showed that they belonged to a single plasmid. The plasmid profile was similar and stable in human and monkey strains. Also, plasmids were classified into three groups according to size. Two strains were positive to beta-lactamase production and no plasmid DNA-hybridization with a beta-lactamase gene probe was observed, suggesting a chromosomal resistance.

Treponema denticola in microflora of bovine periodontitis / Treponema denticola na microbiota da periodontite bovina

Periodontitis in cattle is an infectious purulent progressive disease associated with strict anaerobic subgingival biofilm and is epidemiologically related to soil management at several locations of Brazil. This study aimed to detect Treponema species in periodontal pockets of cattle with lesions deeper than 5mm in the gingival sulcus of 6 to 24-month-old animals considered periodontally healthy. We used paper cones to collect the materials, after removal of supragingival plaques, and kept frozen (at -80°C) up to DNA extraction and polymerase chain reaction (PCR) using T. amylovorum, T. denticola, T. maltophilum, T. medium and T. vincentii primers. In periodontal pocket, it was possible to identify by PCR directly, the presence of Treponema amylovorum in 73% of animals (19/26), T. denticola in 42.3% (11/26) and T. maltophilum in 54% (14/26). Among the 25 healthy sites, it was possible to identify T. amylovorum in 18 (72%), T. denticola in two (8%) and T. maltophilum in eight (32%). Treponema medium and T. vincentii were not detected over all 51 evaluated samples. The presence of Treponema amylovorum, T. maltophilum and, in particular, the widely recognized T. denticola in subgingival microflora brings an original and potencially important contribution in studies of the bovine periodontitis.

A periodontite bovina é um processo infeccioso purulento e progressivo associado à presença de biofilme subgengival anaeróbio estrito e epidemiologicamente relacionada ao manejo do solo em amplas áreas geográficas do Brasil. O trabalho teve por objetivo detectar espécies de Treponema presentes na bolsa periodontal de bovinos com lesões de profundidade maior que 5mm e do sulco gengival de animais com idade de 6 a 24 meses e considerados periodontalmente sadios. Os materiais foram colhidos por meio de cones de papel, após a remoção do biofilme supragengival, e mantidos sob congelamento (-80°C) até a extração do DNA e realização da reação em cadeia da polimerase (PCR) com o emprego de iniciadores de T. amylovorum, T. denticola, T. maltophilum, T. medium e T. vincentii. Na bolsa periodontal de 73% (19/26) dos animais foi possível detectar diretamente, pela PCR, a presença de Treponema amylovorum, de 42,3% (11/26) T. denticola e de 54% (14/26) T. maltophilum. Dos 25 sítios sadios, em 18 (72%) foi possível identificar T. amylovorum, em dois (8%) T. denticola e em oito (32%) T. maltophilum. Treponema medium e T. vincentii não foram detectados nas 51 amostras avaliadas. A presença de Treponema amylovorum, T. maltophilum na microbiota subgengival, e em especial do amplamente reconhecido periodontopatógeno T. denticola, traz uma contribuição original de importância potencial nos estudos da periodontite bovina.

Presence of Porphyromonas and Prevotella species in the oral microflora of cattle with periodontitis / Presença de espécies de Porphyromonas e Prevotella na microbiota oral de bovinos com periodontite

Bovine periodontitis is a progressive purulent infectious process associated with the presence of strictly and facultative anaerobic subgingival biofilm and epidemiologically related to soil management in large geographic areas of Brazil. This study aimed to detect species of the genera Porphyromonas and Prevotella, which occurr in periodontal pockets of cattle with lesions deeper than 5mm (n=26) and in gingival sulcus of animals considered periodontally healthy (n=25). Presence of the microorganisms was evaluated by independent-culture medium diagnostic method, using polymerase chain reaction (PCR) with specific primers of Porphyromonas asaccharolytica, P. endodontalis, P. gingivalis, P. gulae, Prevotella buccae, P. intermedia, P. loescheii, P. melaninogenica, P. nigrescens, P. oralis and P. tannerae. The species P. endodontalis (80.7%), P. melaninogenica (73.1%) and P. intermedia (61.5%) were the most predominant in samples of cattle with periodontitis. Regarding non-injured gingival sulcus of cattle, P. endodontalis (40%) and P. loeschei (40%) prevailed. Porphyromonas gingivalis, P. gulae and Prevotella tannerae were not detected in the 51 samples studied. Data evaluation by T test, enabled to verify that ocorrence of Porphyromonas asaccharolytica (p=0.000003), P. endodontalis (p=0.0023), Prevotella buccae (p=0.0017), P. intermedia (p=0.0020), P. melaninogenica (p=0.00006) and P. oralis (p=0.0028) is correlated with bovine periodontitis...

A periodontite bovina é um processo infeccioso purulento e progressivo associado à presença de biofilme subgengival anaeróbio estrito e facultativo e de incidência em extensas áreas geográficas do Brasil. O trabalho teve por objetivo detectar espécies dos gêneros Porphyromonas e Prevotella presentes na bolsa periodontal de bovinos com lesões de profundidade maior que 5mm (n=26) e do sulco gengival de animais com idade de 6 a 24 meses e considerados periodontalmente sadios (n=25). A presença dos microrganismos foi avaliada pelo método independente de cultivo bacteriano, por meio da reação em cadeia da polimerase (PCR) com iniciadores específicos para Porphyromonas asaccharolytica, P. endodontalis, P. gingivalis, P. gulae, Prevotella buccae, P. intermedia, P. loescheii, P. melalinogenica, P. nigrescens, P. oralis e P. tannerae. P. endodontalis (80,7%), P. melalinogenica (73,1%) e P. intermedia (61,5%) foram os mais prevalentes nas amostras de bovinos com periodontite. Já no sulco gengival de bovinos sem lesões prevaleceram P. endodontalis (40%) e P. loeschei (40%). Porphyromonas gingivalis, P. gulae e Prevotella tannerae não foram detectados nas 51 amostras pesquisadas. A partir da avaliação dos dados pelo teste T, verificou-se que a ocorrência de Porphyromonas asaccharolytica (p=0.000003), P. endodontalis (p=0.0023), Prevotella buccae (p=0.0017), P. intermedia (p=0.0020), P. melalinogenica (p=0.00006) e P. oralis (p=0.0028) está associada à periodontite bovina...

Resistance to tetracycline and ß-lactams and distribution of resistance markers in enteric microorganisms and pseudomonads isolated from the oral cavity.

This study evaluated the occurrence of enteric bacteria and pseudomonads resistant to tetracycline and ß-lactams in the oral cavity of patients exhibiting gingivitis (n=89), periodontitis (n=79), periodontally healthy (n=50) and wearing complete dentures (n=41). Microbial identification and presence of resistance markers associated with the production of ß-lactamases and tetracycline resistance were performed by using biochemical tests and PCR. Susceptibility tests were carried out in 201 isolates of enteric cocci and rods. Resistance to ampicillin, amoxicillin/clavulanic acid, imipenem, meropenem and tetracycline was detected in 57.4%, 34.6%, 2.4%, 1.9% and 36.5% of the isolates, respectively. ß-lactamase production was observed in 41.2% of tested microorganisms, while the most commonly found ß-lactamase genetic determinant was gene blaTEM. Tetracycline resistance was disseminated and a wide scope of tet genes were detected in all studied microbial genus.

Influence of preventive dental treatment on mutans streptococci counts in patients undergoing head and neck radiotherapy.

UNLABELLED: The aim of this study was to evaluate the influence of chlorhexidine gluconate, sodium fluoride and sodium iodine on mutans streptococci counts in saliva of irradiated patients. MATERIAL AND METHODS: Forty-five patients were separated into three experimental groups and received chlorhexidine (0.12%), sodium fluoride (0.5%) or sodium iodine (2%), which were used daily during radiotherapy and for 6 months after the conclusion of the treatment. In addition, a fourth group, composed by 15 additional oncologic patients, who did not receive the mouthwash or initial dental treatment, constituted the control group. Clinical evaluations were performed in the first visit to dental clinic, after initial dental treatment, immediately before radiotherapy, after radiotherapy and 30, 60, 90 days and 6 months after the conclusion of radiotherapy. After clinical examinations, samples of saliva were inoculated on SB20 selective agar and incubated under anaerobiosis, at 37ºC for 48 h. Total mutans streptococci counts were also evaluated by using real-time PCR, through TaqMan system, with specific primers and probes for S. mutans and S. sobrinus. RESULTS: All preventive protocols were able to reduce significantly mutans streptococci counts, but chlorhexidine gluconate was the most effective, and induced a significant amelioration of radiotherapy side effects, such as mucositis and candidosis. CONCLUSION: These results highlights the importance of the initial dental treatment for patients who will be subjected to radiotherapy for head and neck cancer treatment.

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilian Indians from Umutina Reservation, Mato Grosso, Brazil.

UNLABELLED: Aggregatibacter actinomycetemcomitans is associated with periodontal disease, especially localized aggressive periodontitis, produces a potent leukotoxin and its distribution is influenced by ethnic characteristics of the population. OBJECTIVE: Using culture and polymerase chain reaction (PCR) techniques, this study evaluated the occurrence of this microorganism and the distribution of leukotoxic strains isolated from Indians belonging to the Umutima Reservation, Mato Grosso, Brazil. MATERIAL AND METHODS: Forty-eight native Brazilians with gingivitis and 38 with chronic periodontitis, belonging to Umutina, Paresi, Bororo, Bakairi, Kayabi, Irantxe, Nambikwara and Terena ethnicities, were studied. Subgingival, supragingival and saliva samples of each patient were collected and transferred to VMGA III medium and to ultra pure Milli Q water. Bacteria were grown on TSBV agar and incubated in anaerobiosis (90% N2 + 10% CO2) at 37 degrees C for 72 h. The presence of the ltx promoter was determined by PCR, and a 530 bp deletion in the promoter was evaluated by using specific primers. RESULTS: A. actinomycetemcomitans was isolated from 8.33% of saliva, supragingival and subgingival samples from patients with gingivitis and from 18.42% of saliva and supragingival biofilm, and 26.32% subgingival biofilm from patients with chronic periodontitis. By PCR, the bacterial DNA was detected in 8.33% of saliva, supragingival and subgingival biofilms from patients with gingivitis and from 23.68% of saliva, 28.95% supragingival biofilm and 34.21% subgingival biofilm from patients with periodontitis. All strains were grouped as non-JP2 clones based on the absence of deletion in the leukotoxin promoter. Differences among the microbial and clinical parameters in patients were analyzed by using the Mann-Whitney, Chi-square or Fisher's exact tests. CONCLUSIONS: The present results suggest that A. actinomycetemcomitans can be related to the attachment loss in this population, but the presence of minimally leukotoxic strains, as well as its role in the pathogenesis of the periodontitis in these native Brazilians need to be further investigated.

Antimicrobial Susceptibility to ß-lactams and Metronidazole of Microorganisms Isolated from Chronic and Aggressive Periodontitis / Susceptibilidad Antimicrobiana a ß-lactámicos y Metronidazol de Microorganismos Aislados de Periodontitis Crónica y Agresiva

The objective of this study was to evaluate the microbial susceptibility to ß-lactams and metronidazole, and evaluate the production of ß-lactamases by microorganisms isolated from patients with chronic or aggressive periodontitis. The samples were obtained from 50 patients with periodontitis and microorganisms were isolated onto selective and nonselective culture media, identified by biochemical methods and tested for susceptibility to antimicrobial agents (amoxicillin, amoxicillin/clavulanate, cefoxitin, imipenem, metronidazole, penicillin G). The isolates were resistant to at least 1 mg/ml of any drug tested were evaluated to verify the production of ß-lactamases by the method of double layer (or biological) and chromogenic cephalosporin using nitrocefin. The results evidenced resistance to amoxicillin and penicillin G, while the susceptibility to association amoxicillin/clavulanate, imipenem and cefoxitin was widely disseminated among the organisms. Resistance to these drugs showed a clear correlation with the production of ß-lactamase in the majority of microbial groups.

El objetivo fue evaluar la susceptibilidad a ß-lactámicos y metronidazol, y evaluar la producción de ß-lactamasas por microorganismos aislados de pacientes con periodontitis crónica y agresivo. Las muestras fueron obtenido de 50 pacientes con periodontitis y microorganismos aislados en medios de cultivo selectivos y no selectivos, identificados por métodos bioquímicos y probados a la susceptibilidad a los antimicrobianos (amoxicilina, amoxicilina/clavulanato, cefoxitina, imipenem, metronidazol, penicilina G). Los aislados fueron resistentes a por lo menos 1 mg/ml de cualquier drogas analizadas fueron evaluados para verificar la producción de ß-lactamasas por el método de doble capa (o biológico) y nitrocefina. Los resultados mostraron resistencia a amoxicilina y penicilina G, mientras la susceptibilidad a la asociación amoxicilina/ clavulanate, cefoxitina y imipenem fue ampliamente difundido entre los microrganismos. Resistencia a estas drogas mostraron una clara correlación con la producción de ß-lactamasas en la mayoría de grupos microbianos.

Susceptibility of strict and facultative anaerobes Isolated from endodontic infections to metronidazole and beta-lactams.

Endodontic infections are mixed aerobic-anaerobic infections and several microbial groups associated to these pathologies are also involved in orofacial infections. The goal of this study was to evaluate the susceptibility of microorganisms isolated from endodontic infections to beta-lactams and metronidazole and verify the production of beta-lactamases. Clinical specimens were collected from 58 endodontic infections of 52 patients. The microorganisms were isolated in selective and non-selective culture media, under anaerobiosis and aerobiosis, and identified using biochemical methods. In the susceptibility tests, it was used an agar dilution method, and Wilkins-Chalgren agar enriched with blood, hemin and menadione for the anaerobes, while Mueller-Hinton agar was employed for the facultative anaerobes. The production of beta-lactamases was evaluated through the biological and chromogenic cephalosporin methods. All tested isolates were sensitive to imipenem and 99.3% to amoxicillin/clavulanate association, while 16.1% showed resistance to amoxicillin and penicillin G, and 4.89% to cefoxitin. Resistance to metronidazole was just found in facultative anaerobes. Production of beta-lactamases was detected in 18.2% of the isolates and presented a correlation with resistance to beta-lactams.

Occurrence of yeasts, pseudomonads and enteric bacteria in the oral cavity of patients undergoing head and neck radiotherapy

The aim of this study was to evaluate the occurrence of yeasts, pseudomonads and enteric bacteria in the oral cavity of patients undergoing radiotherapy (RT) for treatment of head and neck cancer. Fifty patients receiving RT were examined before, during and 30 days after RT. Saliva, mucosa, and biofilm samples were collected and microorganisms were detected by culture and polymerase chain reaction (PCR). The most prevalent yeasts in patients submitted to RT were Candida albicans, C. tropicalis, C. krusei, C. glabrata and C. parapsilosis. Citrobacter, Enterobacter, Enterococcus, Klebsiella, Proteus, and Pseudomonas were the most frequently cultivated bacteria. Before RT, targeted bacteria were cultivated from 22.2 percent of edentulous patients and 16.6 percent of dentate patients; 30 days after RT, these microorganisms were recovered from 77.8 percent edentulous and 46.8 percent dentate patients. By PCR, these microorganisms were detected from all edentulous patients, 78.1 percent of dentate patients. The presence of Gram-negative enteric roads and fungi was particularly frequent in patients presenting mucositis level III or IV. Modifications in the oral environment due to RT treatment seem to facilitate the colonization of oral cavity by members of family Enterobacteriaceae, genera Enterococcus and Candida.

Antimicrobial activity of six plant extracts from the Brazilian savanna on periodontal pathogens / Actividad antimicrobiana de seis extractos de plantas de la sabana brasileña en patógenos periodontales

The extracts of plants from Brazilian savanna are currently used in popular medicine. This study evaluated the inhibitory activity of the alcoholic and aqueous extracts from savanna plants on periodontal bacteria. The minimal inhibitory concentrations were evaluated by the agar dilution method, using Wilkins-Chalgren agar. Antimicrobial activity of plants extracts on microbial biofilms was determined in microplates. Psidium cattleianum and Myracrodruon urundeuva extracts demonstrated significant inhibitory activity on all bacterial strains tested; alcoholic and aqueous extracts showed similar results. The extracts from these two species were able to inhibit both planktonic cells and microbial biofilm.

Los extractos de las plantas de la sabana brasileña actualmente se utilizan en la medicina popular. Este estudio evaluó la actividad inhibitoria de los extractos alcohólicos y acuosos de plantas de la sabana en bacterias periodontales. Las concentraciones inhibitorias mínimas fueron evaluados por el método de dilución en agar, utilizando agar Wilkins-Chalgren. La actividad antimicrobiana de los extractos de plantas en las biopelículas microbianas se determinó en microplacas. Los extractos de Psidium cattleianum y Myracrodruon urundeuva demostraron una importante actividad inhibitoria sobre todas las cepas bacterianas probadas, extractos alcohólicos y acuosos mostraron resultados similares. Los extractos de estas dos especies fueron capaces de inhibir las células planctónicas y biofilm microbiano.

Evaluation of oral health in a community of native Brazilians of the Umutina Reservation, Mato Grosso State / Evaluación de la salud oral en una comunidad de Brasileños nativos de la Reserva Umutina, Estado de Mato Grosso

The occurrence of diseases and variations from normality is very common in the maxillofacial complex,and this phenomenon is closely associated to peculiar genetic determinants and influenced by genetic isolation. Studies on the distribution of oral diseases and variations from normality in South American natives are generally directed mainly to thestudy of dental caries in the children and periodontal diseases in the adults, disregarding a wide range of other oral diseases. The aim of this study was to evaluate the distribution of lesions and anatomical variations from normality in eight ethnic groups living in the Umutina Indian Reservation, State of Mato Grosso, Brazil, through physical and oral examinations besides cytological evaluation and assessment of diet and habits, such as tobacco and alcohol consumption. A total of 291 Indians, of both genders, with ages ranging from 1 to 96 years, were examined, being identified 132 variations from normality,evidencing a high occurrence of ankyloglossia, which was present in 108 cases (37.1 percent), followed by benign migratory glossitis in 5 cases (1.7 percent); mandibular torus and candidiasis in 3 cases (1.0 percent). No malignant lesion was identified in thepopulation.

La ocurrencia de enfermedades y variaciones de normalidad son muy comunes en el complejo maxilofacial. Este fenómeno se asocia estrechamente a determinantes genéticos peculiares y son influenciados a través del aislamiento genético. Estudios sobre la distribución de enfermedad oral y variaciones de la normalidad en nativos Sudamericanos son generalmente dirigidos al estudio de la caries dental en niños y enfermedad periodontal en adultos, dejando de lado una amplia gama de otras enfermedades orales. El objetivo de este estudio fue evaluar la distribución de lesiones y las variaciones anatómicas de normalidad en ocho grupos étnicos indígenas pertenecientes a la reserva Umutina, Estado de Mato Grosso, Brasil, a través del examen físico y oral, además de la evaluación citológica y valoración de dieta y hábitos como tabaco y consumo de alcohol. Un total de 291 indígenas de ambos sexos, con edades que van de 1 a 96 años fueron examinados, identificándose 132 variaciones de normalidad, evidenciando una alta ocurrencia de anquiloglosia, la cual se presentó en 108 casos (37,1 por ciento), seguido por glositis migratoria benigna en 5 casos (1,7 por ciento); torus mandibular y candidiasis en 3 casos (1,0 por ciento). Ninguna lesión maligna se identificó en la población.

Antimicrobial resistance of aerobes and facultative anaerobes isolated from the oral cavity

OBJECTIVES: This study evaluated the resistance to antimicrobials of aerobes and facultative anaerobes isolated from patients wearing complete dentures, patients with gingivitis and periodontitis, and periodontally health subjects. MATERIAL AND METHODS: Three hundred and four isolates were tested. The minimal inhibitory concentrations of the drugs were evaluated through the agar dilution method using Mueller-Hinton agar. RESULTS: The most active antimicrobial drugs were the carbapenems (meropenem and imipenem), and resistance to these drugs was restrict to 1.6-2.3 percent of the isolates, as well as ciprofloxacin and rifampin. Microbial resistance to ampicillin, amoxicillin/clavulanic acid, cefoxitin, cephalothin, amikacin, chloramphenicol and nalidixic acid was particularly high. In most cases, the resistance to β-lactams was mediated by the production of hydrolytic enzymes, especially in gram-negative enteric rods, while enterococci did not evidence production of these enzymes. The association amoxicillin/clavulanic acid was not effective in 28.3 percent of the tested isolates. CONCLUSIONS: The results of this investigation confirmed that the oral cavity of patients with periodontitis and gingivitis, and particularly edentulous patients wearing complete dentures could harbor microorganisms with several antimicrobial resistance markers, and these microorganisms are frequently implicated in multiresistant, systemic, oral or nosocomial infections.

Implicações clínicas da doença de Lyme em região facial: revisão da literatura / Clinical implications of the disease of Lyme in facial area: literature revision: literature review

Doença de Lyme (DL) é uma alteração inflamatória sistêmica resultante da ação direta e da resposta imune à espiroqueta Borrelia burgdoferi transmitida pela inoculação na corrente circulatória por carrapato do gênero Ixodes, sendo mais comumente encontrada na América do Norte, Europa e Ásia. Essa enfermidade pode levar a manifestações neurológicas periféricas e faciais, tais como paralisia de Bell, alterações oftalmológicas, desordens na articulação temporo-mandibular além de parestesia de nervos alveolares superiores e inferiores. No Brasil, o diagnóstico da DL é primeiramente baseado na apresentação clínica, com o eritema migrans cutâneo, e informações epidemiológicas do paciente. O reconhecimento das primeiras manifestações da DL por profissionais de saúde é essencial para o correto tratamento antibiótico impedindo a progressão da doença, sendo também relevante orientações preventivas para aqueles que vivem ou trabalham em áreas endêmicas.

Lyme disease (LD) is a systemic inflammatory changes resulting from direct action and the immune response to the spirochete Borrelia burgdoferi transmitted by inoculation of the flow of the genus Ixodes tick and is most commonly found in North America, Europe and Asia. This disease can lead to facial and peripheral neurological manifestations, such as Bell’s palsy, eye changes, disorders in the temporo-mandibular joint in addition to paresthesia of superior and inferior alveolar nerves. In Brazil, the diagnosis of LD is primarily based on clinical presentation, the erythema migrans skin, and epidemiological information of the patient. Recognition of the onset of the DL by health professionals is essential for the correct antibiotic treatment preventing the progression of the disease, and also relevant preventive guidelines for those living or working in endemic areas.

Estudo radiográfico de terceiros molares inferiores retidos e parcialmente irrompidos / Radiographic study of mandibular third molars partially erupted and retained

Introdução: Patologias associadas a dentes retidos ou parcialmente erupcionados são comuns na população em geral. Objetivo: pretendeu-se avaliar a mensuração do espaço pericoronário de terceiros molares inferiores retidos e parcialmente erupcionados em radiografias panorâmicas. Método: tratou-se de um estudo retrospectivo sobre a frequência da retenção dental e dos problemas que a mesma pode causa em 107 radiografias de pacientes onde foi medida a largura em sua maior dimensão a fim de verificar a presença ou não de patologias associadas aos dentes em questão. Resultado: Num totalde 107 ortopantomografias analisadas a mensuração mais encontrada foi a de 1,0 mm com 32,71 por cento dos casos seguido da de 2,0 mm com 29,91 por cento dos casos. Conclusão: a mensuração do espaço pericoronário de terceiros molares inferiores retidos e parcialmente retidos, através da sua maior largura, constitui-se em uma técnica prática e efetiva para aplicabilidade na rotina clínica, permitindo sugerir a presença ou não de patologias odontogênicas com precocidade.

Introduction: Pathology associated with retained or partially erupted teeth are common in the general population. Objective: the aim was to evaluate the measurement of pericoronal space of retained third molars and partially erupted teeth in panoramic radiographs. Method: a retrospective study was carried on on the frequency of tooth retention and the problems it can cause in 107 radiographs of patients where the width was measured to verify the presence or absence of diseases associated with the involved teeth. Results: in the 107 panoramic radiographs analyzed the most frequent measurement was of 1.0 mm with 32.71 per cent of cases followed by 2.0 mm with 29.91 per cent of cases. Conclusion: The measurement of the pericoronal sapce of retained third molars and partially retained through its greatest width is in a practical and effective technique for application in routine clinical practice, which suggests the presenceo r absence of eraly odontogenic pathology..

Microbiota associated with chronic osteomyelitis of the jaws

Chronic osteomyelitis of maxilla and mandible is rare in industrialized countries and its occurrence in developing countries is associated with trauma and surgery, and its microbial etiology has not been studied thoroughly. The aim of this investigation was to evaluate the microbiota associated with osteomyelitis of mandible or maxilla from some Brazilian patients. After clinical and radiographic evaluation, samples of bone sequestra, purulent secretion, and biopsies of granulomatous tissues from twenty-two patients with chronic osteomyelitis of mandible and maxilla were cultivated and submitted for pathogen detection by using a PCR method. Each patient harbored a single lesion. Bacterial isolation was performed on fastidious anaerobe agar supplemented with hemin, menadione and horse blood for anaerobes; and on tryptic soy agar supplemented with yeast extract and horse blood for facultative bacteria and aerobes. Plates were incubated in anaerobiosis and aerobiosis, at 37ºC for 14 and 3 days, respectively. Bacteria were cultivated from twelve patient samples; and genera Actinomyces, Fusobacterium, Parvimonas, and Staphylococcus were the most frequent. By PCR, bacterial DNA was detected from sixteen patient samples. The results suggest that cases of chronic osteomyelitis of the jaws are usually mixed anaerobic infections, reinforcing the concept that osteomyelitis of the jaws are mainly related to microorganisms from the oral environment, and periapical and periodontal infections may act as predisposing factors.

Chronic osteomyelitis of the maxilla and mandible: microbiological and clinical aspects / Osteomielitis crónica del maxilar y mandíbula: aspectos microbiológicos y clínicos

Osteomyelitis of the mandible and maxilla are common in developing countries and their treatment may belong-standing and difficult. Thus, the aim of this study was to discuss the main biological aspects of the chronic osteomyelitis of the jaws of especial interest for dental team. These infections are associated with a complex microbiota composed mainly by anaerobic bacteria, sometimes associated with microorganisms originated from the skin and digestive tract. These data suggest that chronic osteomyelitis of the mandible and maxilla should be treated as anaerobic infections in most cases. In addition, local surgical treatments are relevant in the therapy outcome, associated to the use of antimicrobial agents, and the failure to accomplish them is a major cause of treatment failure.

La osteomielitis maxilar y mandibular son comunes en países en desarrollo y su tratamiento puede ser difícil y de larga duración. Así, el objetivo del presente estudio fue discutir los principales aspectos biológicos de especial interés odontológico de la osteomielitis crónica del maxilar. Estas infecciones están asociadas a una microbiota compleja compuesta principalmente de bacterias anaerobias, algunas veces asociadas a microorganismos oriundos de la piel y del tracto digestivo. Estos datos sugieren que la osteomielitis crónica maxilar y mandibular deben ser tratadas como infecciones anaerobias en la mayoría de los casos. Además, tratamientos quirúrgicos locales son relevantes en el éxito de la terapia, asociados al uso de agentes anti-microbianos, e cuyos resultados no satisfactorios representan una de las principales causas de un tratamiento fallo o no adecuado.

Condições de saúde de pacientes do gênero feminino com dependência química / Health conditions of female patients with chemical dependency

O presente estudo avaliou as condições gerais e bucais de saúde de pacientes do gênero feminino mantidas em um programa para recuperação de dependentes químicos e de pacientes que não utilizaram esses compostos. Utilizando-se de anamnese, avaliações médicas e odontológicas, as condições de saúde de 160 pacientes foram examinadas, das quais 80 apresentavam dependência química e 80 não utilizavam drogas. As drogas mais consumidas foram o tabaco, álcool e crack, quase sempre em diferentes associações. As pacientes com dependência química apresentaram freqüência aumentada de alterações comportamentais, além de diferentes enfermidades envolvendo os sistemas imunológico e cardiovascular, com destaque para as de reações inflamatórias e infecciosas e retardo no processo de reparo tecidual. Na cavidade bucal, verificou-se maior ocorrência de periodontite e gengivite...

This study evaluated the general and oral health conditions of female patients included in a program for recovering drug addiction and patients who did not use drugs. By means of anamnesis and medical history, as well as medical and dental assessments, the health conditions of 160 patients were assessed; 80 presented drug dependence and 80 do not use drugs. The most frequently used drugs were tobacco, alcohol, and crack, usually in associations. The patients presenting chemical dependence had increased frequency of behavioral changes, as well as several diseases involving the immune and cardiovascular systems, de taching infectious and inflammatory reactions and delay in the process of tissue repair. In the oral cavity,it was verified a high occurrence of periodontitis and gingivitis...

Resistance to tetracycline and β-lactams and distribution of resistance markers in enteric microorganisms and pseudomonads isolated from the oral cavity

This study evaluated the occurrence of enteric bacteria and pseudomonads resistant to tetracycline and β-lactams in the oral cavity of patients exhibiting gingivitis (n=89), periodontitis (n=79), periodontally healthy (n=50) and wearing complete dentures (n=41). Microbial identification and presence of resistance markers associated with the production of β-lactamases and tetracycline resistance were performed by using biochemical tests and PCR. Susceptibility tests were carried out in 201 isolates of enteric cocci and rods. Resistance to ampicillin, amoxicillin/clavulanic acid, imipenem, meropenem and tetracycline was detected in 57.4 percent, 34.6 percent, 2.4 percent, 1.9 percent and 36.5 percent of the isolates, respectively. β-lactamase production was observed in 41.2 percent of tested microorganisms, while the most commonly found β-lactamase genetic determinant was gene blaTEM. Tetracycline resistance was disseminated and a wide scope of tet genes were detected in all studied microbial genus.