Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis.

Gingivitis and periodontitis are associated with a negative impact on Oral Health Related Quality of Life (OHRQoL), exerting a significant influence on aspects related to the patients' function and esthetics. Periodontitis has been associated with several systemic conditions, including adverse pregnancy outcomes, cardiovascular diseases, type 2 diabetes mellitus (DM), respiratory disorders, fatal pneumonia in hemodialysis patients, chronic renal disease and metabolic syndrome. The aim of this paper was to review the results of different periodontal treatments and their impacts on patients' OHRQoL and systemic health. Non-surgical and surgical periodontal treatments are predictable procedures in terms of controlling infection, reducing probing pocket depth and gaining clinical attachment. In addition, the treatment of periodontitis may significantly improve OHRQoL and promote a reduction in the levels of systemic markers of inflammation, including some cytokines associated with cardiovascular diseases. Studies have also suggested that periodontal treatment may improve glycemic control in patients with DM. Strategies and actions for preventing the onset and recurrence of periodontitis, and the challenges facing the field of periodontology in the XXI century are presented in this review.

Additive manufacturing of titanium alloy could modify the pathogenic microbial profile: an in vitro study.

Additive manufacturing (AM) is an emerging process for biomaterials and medical devices. Direct Laser Metal Sintering (DLMS) is an AM technique used to fabricate Ti-6Al-4V implant materials with enhanced surface-related properties compared with wrought samples; thus, this technique could influence microbial adsorption and colonization. Therefore, this in vitro study was conducted to evaluate the impact of different implant production processes on microbial adhesion of periodontal pathogens. Titanium discs produced using two different processes-conventional and AM-were divided into three groups: conventional titanium discs with machined surface (G1), AM titanium discs with chemical treatment (G2) and AM titanium discs without chemical treatment (G3). Subgingival biofilm composed of 32 species was formed on the titanium discs, and positioned vertically in 96-well plates, for 7 days. The proportions of microbial complexes and the microbial profiles were analyzed using a DNA-DNA hybridization technique, and data were evaluated using Kruskal-Wallis and Dunnett tests (p < 0.05). Lower proportions of the red complex species were observed in the biofilm formed in G2 compared with that in G1 (p < 0.05). Moreover, the proportions of the microbial complexes were similar between G2 and G3 (p > 0.05). Compared with G1, G2 showed reduced levels of Porphyromonas gingvalis , Actinomyces gerencseriae, and Streptococcus intermedius , and increased levels of Parvimonas micra , Actinomyces odontolyticus, and Eikenella corrodens (p < 0.05). The microbial profile of G3 did not differ from G1 and G2 (p > 0.05). The results of this in vitro study showed that titanium discs produced via AM could alter the microbial profile of the biofilm formed around them. Further clinical studies should be conducted to confirm these findings.

Microbiological and clinical effects of adjunctive systemic metronidazole and amoxicillin in the non-surgical treatment of peri-implantitis: 1 year follow-up.

The aim of this study was to evaluate the effects of adjunct systemic antibiotic treatment with metronidazole (MTZ) and amoxicillin (AMX) in patients receiving non-surgical subgingival debridement (NSD) for peri-implantitis. Forty subjects presenting with at least one implant with severe peri-implantitis were randomized into an experimental group [treated with NSD plus MTZ (400 mg) and AMX (500 mg) three times a day for 14 days] and a control group treated with NSD plus placebo. Clinical parameters and submucosal biofilm profiles were evaluated up to 1 year post-treatment. Overall, both treatments improved clinical parameters over time. At 1 year, mean probing depth (PD), mean clinical attachment (CA) level and proportions of red complex pathogens did not differ significantly between the two groups. In addition, mean PD and CA changes to 1-year posttreatment did not differ significantly between the two groups between baseline and 1-year post-treatment. These results suggest that the addition of MTZ and AMX to the treatment protocol of patients undergoing NSD for with severe peri-implantitis does not improve the clinical and microbiological outcomes of NSD. The fact that half of the implants in both groups did not achieve clinical success (PD < 5 mm, no BoP, no bone loss) suggest that neither of the tested protocols were effective for treating severe peri-implantitis.

Microbiological and clinical effects of adjunctive systemic metronidazole and amoxicillin in the non-surgical treatment of peri-implantitis: 1 year follow-up

Abstract The aim of this study was to evaluate the effects of adjunct systemic antibiotic treatment with metronidazole (MTZ) and amoxicillin (AMX) in patients receiving non-surgical subgingival debridement (NSD) for peri-implantitis. Forty subjects presenting with at least one implant with severe peri-implantitis were randomized into an experimental group [treated with NSD plus MTZ (400 mg) and AMX (500 mg) three times a day for 14 days] and a control group treated with NSD plus placebo. Clinical parameters and submucosal biofilm profiles were evaluated up to 1 year post-treatment. Overall, both treatments improved clinical parameters over time. At 1 year, mean probing depth (PD), mean clinical attachment (CA) level and proportions of red complex pathogens did not differ significantly between the two groups. In addition, mean PD and CA changes to 1-year posttreatment did not differ significantly between the two groups between baseline and 1-year post-treatment. These results suggest that the addition of MTZ and AMX to the treatment protocol of patients undergoing NSD for with severe peri-implantitis does not improve the clinical and microbiological outcomes of NSD. The fact that half of the implants in both groups did not achieve clinical success (PD < 5 mm, no BoP, no bone loss) suggest that neither of the tested protocols were effective for treating severe peri-implantitis.

Additive manufacturing of titanium alloy could modify the pathogenic microbial profile: an in vitro study

Abstract Additive manufacturing (AM) is an emerging process for biomaterials and medical devices. Direct Laser Metal Sintering (DLMS) is an AM technique used to fabricate Ti-6Al-4V implant materials with enhanced surface-related properties compared with wrought samples; thus, this technique could influence microbial adsorption and colonization. Therefore, this in vitro study was conducted to evaluate the impact of different implant production processes on microbial adhesion of periodontal pathogens. Titanium discs produced using two different processes—conventional and AM—were divided into three groups: conventional titanium discs with machined surface (G1), AM titanium discs with chemical treatment (G2) and AM titanium discs without chemical treatment (G3). Subgingival biofilm composed of 32 species was formed on the titanium discs, and positioned vertically in 96-well plates, for 7 days. The proportions of microbial complexes and the microbial profiles were analyzed using a DNA-DNA hybridization technique, and data were evaluated using Kruskal-Wallis and Dunnett tests (p < 0.05). Lower proportions of the red complex species were observed in the biofilm formed in G2 compared with that in G1 (p < 0.05). Moreover, the proportions of the microbial complexes were similar between G2 and G3 (p > 0.05). Compared with G1, G2 showed reduced levels of Porphyromonas gingvalis , Actinomyces gerencseriae, and Streptococcus intermedius , and increased levels of Parvimonas micra , Actinomyces odontolyticus, and Eikenella corrodens (p < 0.05). The microbial profile of G3 did not differ from G1 and G2 (p > 0.05). The results of this in vitro study showed that titanium discs produced via AM could alter the microbial profile of the biofilm formed around them. Further clinical studies should be conducted to confirm these findings.

Successful and failed mini-implants: microbiological evaluation and quantification of bacterial endotoxin.

OBJECTIVES: Using two groups of mini-implants (successful and failed) the objectives of this in vivo study were: to evaluate the microbial contamination by the checkerboard DNA-DNA hybridization technique and to quantify the bacterial endotoxin by the limulus amebocyte lysate assay. MATERIAL AND METHODS: The 15 successful and 10 failed mini-implants (1.6 mm diameter × 7.0 or 9.0 mm long), placed in the maxilla and/or mandible, were obtained from 15 patients undergoing orthodontic treatment. Data were analyzed statistically by the Wilcoxon rank-sum test using the SAS software (a=0.05). RESULTS: All 40 microbial species were detected in both groups of mini-implants, with different frequencies. No differences were observed between the groups with respect to microbial complexes (blue, purple, yellow, green, orange, red and other species) and endotoxin quantification (p>0.05). CONCLUSION: Neither microbial contamination nor endotoxin quantification was determinant for the early loss of stability of the mini-implants.

Successful and failed mini-implants: microbiological evaluation and quantification of bacterial endotoxin

Abstract Objectives Using two groups of mini-implants (successful and failed) the objectives of this in vivo study were: to evaluate the microbial contamination by the checkerboard DNA-DNA hybridization technique and to quantify the bacterial endotoxin by the limulus amebocyte lysate assay. Material and Methods The 15 successful and 10 failed mini-implants (1.6 mm diameter × 7.0 or 9.0 mm long), placed in the maxilla and/or mandible, were obtained from 15 patients undergoing orthodontic treatment. Data were analyzed statistically by the Wilcoxon rank-sum test using the SAS software (a=0.05). Results All 40 microbial species were detected in both groups of mini-implants, with different frequencies. No differences were observed between the groups with respect to microbial complexes (blue, purple, yellow, green, orange, red and other species) and endotoxin quantification (p>0.05). Conclusion Neither microbial contamination nor endotoxin quantification was determinant for the early loss of stability of the mini-implants.

Microbial Reduction by Two Chemical-Mechanical Protocols in Primary Teeth with Pulp Necrosis and Periradicular Lesion - An In Vivo Study

The objective of this study was to determine the efficacy of chemical-mechanical procedures of two endodontic protocols for septic content reduction of root canals from primary teeth with pulp necrosis and periradicular lesion. Twenty-four primary root canals with pulp necrosis and periradicular lesion were divided into two treatment groups (n=12): multiple-visit and single-visit protocols. Samples were collected using sterile paper points before and after endodontic cleaning followed by microbiological identification through checkerboard DNA-DNA hybridization. Statistical analysis was performed using Proportion Test for score=0 comparing the findings before and after treatment for each group (Wilcoxon's test) as well as the differences in scores between protocols (Mann-Whitney's test) (p<0.05). Data were expressed as prevalence (presence or absence) and estimate of the average count (x105 cells) of each species. Differences in proportions of score=0 prior to treatment were non-significant (p=0.415), demonstrating equivalence between groups. A significant increase in score=0 was detected after treatment for both groups (p<0.0001). Single-visit protocol achieved a significantly greater reduction in mean scoring following endodontic treatment (p=0.024). Both protocols were capable of significantly reducing septic content in root canals of primary teeth with periradicular lesion. Moreover, single-visit protocol showed greater efficacy in reducing endodontic infection.

O objetivo deste estudo foi determinar a eficácia das manobras químico-mecânicas de dois protocolos endodônticos, na redução do conteúdo séptico de canais radiculares de dentes decíduos com polpa necrosada e lesão perirradicular. Vinte e quatro canais radiculares decíduos com necrose pulpar e lesão perirradicular foram divididos em dois grupos de tratamento (n=12): multisessões e sessão única. Amostras foram coletadas usando pontas de papel estéreis, antes e após a limpeza endodôntica, seguido de identificação microbiológica por hibridização DNA-DNA checkerboard. A análise estatística foi realizada usando teste de proporções para escore=0, comparando os achados antes e após tratamento para cada grupo (teste de Wilcoxon) e as diferenças dos escores entre os protocolos (teste de Mann-Whitney) (p<0,05). Os dados foram expressos em prevalência (presença ou ausência) e contagem média (x105 células) de cada espécie. As diferenças nas proporções de escore=0 antes do tratamento não foram significativas (p=0,415), mostrando equivalência entre os grupos. Um aumento significativo de escore=0 foi detectado após o tratamento para ambos os grupos (p<0,0001). O protocolo de sessão única mostrou uma redução significativamente maior dos escores médios após o tratamento endodôntico (p=0,024). Ambos os protocolos são capazes de reduzir significativamente o conteúdo séptico de canais radiculares de dentes decíduos com lesão perirradicular. Entretanto, o protocolo de sessão única mostrou uma maior eficácia na redução da infecção endodôntica.

Changes in the subgingival biofilm composition after coronally positioned flap

OBJECTIVES: This study evaluated the effects of coronally positioned flap (CPF) on the subgingival biofilm composition. MATERIAL AND METHODS: Twenty-two subjects with gingival recessions were treated with CPF. Clinical parameters were assessed before and at 6 months after surgery. Subgingival biofilms were analyzed by checkerboard DNA-DNA hybridization technique for 40 bacterial species. RESULTS: Recession height, clinical attachment level and bleeding on probing improved significantly (p<0.05) at 6 months post-CPF. The proportions of 10 periodontal pathogens and the proportions of red and orange complexes decreased at 6 months. CONCLUSION: In conclusion, CPF can induce beneficial effects on the composition of the subgingival microbiota after 6 months.

Prevalência de Archaea em indivíduos com doença periodontal e saúde periodontal / Prevalence of Archaea in subjets with periodontal disease and periodontally healthy

Apesar de micro-organismos do domínio Archaea já terem sido detectados em amostras de biofilme subgengival de indivíduos com periodontite, nenhum estudo comparou diretamente a associação de Archaea com as periodontites crônica e agressiva. Assim sendo, o objetivo desse estudo foi avaliar a prevalência do domínio Archaea em indivíduos com periodontite crônica generalizada (PCrG), periodontite agressiva generalizada (PAgG) e indivíduos com saúde periodontal (SP), e correlacionar os achados microbiológicos com o aumento da profundidade de sondagem (PS). Foram selecionados 15 indivíduos com PCrG, 15 com PAgG e 15 com SP. Inicialmente, os indivíduos foram submetidos ao exame clínico-periodontal. Em seguida, amostras de biofilme subgengival foram coletadas de 9 sítios nos indivíduos do grupo SP e de 9 sítios (PS <3mm, 3 PS 4-6mm e 3 PS >7mm) nos indivíduos dos grupos PCrG e PAgG. Após a extração do DNA, as amostras foram submetidas à reação de amplificação do gene 16S rRNA de Archaea. A presença de Archaeafoi detectada em 11/15 indivíduos do grupo PCrG, em 9/15 indivíduos com PAgG e 12/15 indivíduos com SP (p>0,05). Em relação ao número de amostras positivas, foram 21 no grupo SP, 39 no PAgG e 43 no PCrG observados. Não foram observadas diferenças estatísticas entre os diferentes grupos experimentais (p>0,05) e também não houve correlação entre a presença de Archaea e as diferentes categorias de profundidade de sondagem. Em conclusão, sugere-se ausência de associação entre a detecção de Archaea e a periodontite.

Archaea has been detected in subgingival biofilm samples from individuals with periodontitis, however, no studies were found to enable a direct comparison of the association of Archaea with chronic and aggressive periodontitis. Therefore, the aim of the present study was to evaluate the prevalence of the Archaea domine in individuals with generalized chronic periodontitis (GCrP), generalized aggressive periodontitis (GAgP) and periodontal healthy (PH) and correlation these finding with the increase of probing depth (PD). Fifteen individuals with GCrP, fifteen individuals with GAgP and fifteen individuals with PH were selected. The individuals were submitted a clinical periodontal examination. Subgingival biofilm samples were collected from 9 sites in the PH group and 9 sites (3 PD ¡Ü3mm, 3 PD 4-6mm and 3 PD ¡Ý7mm) in the 30 individuals in the GAgP and GCrP groups. After the DNA extraction, the presence of Archaea was analyzed by polymerase chair reaction (PCR). The occurrence of Archaea was detected in 11/15 individuals in the GCrP group, 9/15 individuals with GAgP and 12/15 individuals with SP (p>0.05). Among the individuals of with SP, PAgG and PCrG, 21, 39 and 43 samples were positive for Archaea, respectively. However, there were no statistical differences observed among experimental groups (p>0.05). There was no correlation between the presence of Archaea and the different probing depth categories. In conclusion, these results suggest the absence of association between the detection of Archaeaand periodontitis.

Qual o antibiótico para periodontite agressiva? / What antibiotic to aggressive periodontitis?

As doenças periodontais são um grupo de infecções que possuem como fator etiológico primário as bactérias presentes na cavidade bucal, especialmente as que colonizam as superfícies dos dentes, supra e subgengivalmente, organizadas num biofilme cuja presença acomete as estruturas de proteção e sustentação dos dentes, levando à perda de inserção, de tecido ósseo e, eventualmente, do elemento dentário1. Muitos avanços tecnológicos nas áreas da imunologia e biologia molecular, ocorridos principalmente nas duas últimas décadas, facilitaram sobremaneira o entendimento da etiopatogenia das periodontites, incluindo a microbiota patogênica relacionada a cada tipo de doença e o perfil do hospedeiro. Esses conhecimentos têm facilitado o direcionamento de terapias mais específicas para cada paciente, que, sendo fundamentadas nos fatores etiológicos da infecção, podem trazer melhores resultados clínicos e microbiológicos em longo prazo.

The ability of the BANA Test to detect different levels of P. gingivalis, T. denticola and T. forsythia.

The aim of this study was to evaluate the ability of the BANA Test to detect different levels of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia or their combinations in subgingival samples at the initial diagnosis and after periodontal therapy. Periodontal sites with probing depths between 5-7 mm and clinical attachment level between 5-10 mm, from 53 subjects with chronic periodontitis, were sampled in four periods: initial diagnosis (T0), immediately (T1), 45 (T2) and 60 days (T3) after scaling and root planing. BANA Test and Checkerboard DNA-DNA hybridization identified red complex species in the subgingival biofilm. In all experimental periods, the highest frequencies of score 2 (Checkerboard DNA-DNA hybridization) for P. gingivalis, T. denticola and T. forsythia were observed when strong enzymatic activity (BANA) was present (p < 0.01). The best agreement was observed at initial diagnosis. The BANA Test sensitivity was 95.54% (T0), 65.18% (T1), 65.22% (T2) and 50.26% (T3). The specificity values were 12.24% (T0), 57.38% (T1), 46.27% (T2) and 53.48% (T3). The BANA Test is more effective for the detection of red complex pathogens when the bacterial levels are high, i.e. in the initial diagnosis of chronic periodontitis.

The ability of the BANA test to detect different levels of P. gingivalis, T. denticola and T. forsythia

The aim of this study was to evaluate the ability of the BANA Test to detect different levels of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia or their combinations in subgingival samples at the initial diagnosis and after periodontal therapy. Periodontal sites with probing depths between 5-7 mm and clinical attachment level between 5-10 mm, from 53 subjects with chronic periodontitis, were sampled in four periods: initial diagnosis (T0), immediately (T1), 45 (T2) and 60 days (T3) after scaling and root planing. BANA Test and Checkerboard DNA-DNA hybridization identified red complex species in the subgingival biofilm. In all experimental periods, the highest frequencies of score 2 (Checkerboard DNA-DNA hybridization) for P. gingivalis, T. denticola and T. forsythia were observed when strong enzymatic activity (BANA) was present (p < 0.01). The best agreement was observed at initial diagnosis. The BANA Test sensitivity was 95.54 percent (T0), 65.18 percent (T1), 65.22 percent (T2) and 50.26 percent (T3). The specificity values were 12.24 percent (T0), 57.38 percent (T1), 46.27 percent (T2) and 53.48 percent (T3). The BANA Test is more effective for the detection of red complex pathogens when the bacterial levels are high, i.e. in the initial diagnosis of chronic periodontitis.

Microbiological composition associated with vitamin D receptor gene polymorphism in chronic periodontitis.

The aim of this cross-sectional study was to examine the relationship between the composition of the subgingival microbiota and the vitamin D receptor (VDR) gene polymorphism in Brazilian adults with chronic periodontitis. The clinical parameters of probing depth, clinical attachment level, bleeding on probing, plaque accumulation and suppuration were measured in 60 Caucasian adults who were divided into two groups: 30 healthy individuals (control) and 30 with chronic periodontitis (ChP). Subgingival plaque samples were collected from 6 sites per subject and analyzed for 38 bacterial species using the Checkerboard DNA-DNA Hybridization. DNA was obtained from the subjects' epithelial cells by scraping the buccal mucosa and using a mouthwash containing 3% of glucose. Polymorphism in the VDR gene was analyzed by the polymerase chain reaction (PCR), followed by Taql digestion (RFLP). The healthy subjects presented significantly lower levels (0.3 x 10(7) +/- 0.7 x 10(7)) of total microbial counts in comparison with subjects with chronic periodontitis (4.5 x 10(7) +/- 2.9 x 10(7)). Regarding the occurrence of VDR polymorphism, it was observed that the Tt genotype was more prevalent in the Periodontitis group (60%) than in the Healthy group (30%), while the prevalences of the TT genotype were 23.3% and 53.3%, respectively (Chi-square test, p < 0.05). No difference was found in the composition of subgingival microbiota among the VDR genotypes evaluated for the Healthy and Periodontitis groups. In conclusion, the Tt genotype was associated with periodontal disease; however, no association with the subgingival microbiota was observed.

Microbiological composition associated with vitamin D receptor gene polymorphism in chronic periodontitis

The aim of this cross-sectional study was to examine the relationship between the composition of the subgingival microbiota and the vitamin D receptor (VDR) gene polymorphism in Brazilian adults with chronic periodontitis. The clinical parameters of probing depth, clinical attachment level, bleeding on probing, plaque accumulation and suppuration were measured in 60 Caucasian adults who were divided into two groups: 30 healthy individuals (control) and 30 with chronic periodontitis (ChP). Subgingival plaque samples were collected from 6 sites per subject and analyzed for 38 bacterial species using the Checkerboard DNA-DNA Hybridization. DNA was obtained from the subjects' epithelial cells by scraping the buccal mucosa and using a mouthwash containing 3 percent of glucose. Polymorphism in the VDR gene was analyzed by the polymerase chain reaction (PCR), followed by Taql digestion (RFLP). The healthy subjects presented significantly lower levels (0.3 × 10(7) ± 0.7 × 10(7)) of total microbial counts in comparison with subjects with chronic periodontitis (4.5 × 10(7) ± 2.9 × 10(7)). Regarding the occurrence of VDR polymorphism, it was observed that the Tt genotype was more prevalent in the Periodontitis group (60 percent) than in the Healthy group (30 percent), while the prevalences of the TT genotype were 23.3 percent and 53.3 percent, respectively (Chi-square test, p < 0.05). No difference was found in the composition of subgingival microbiota among the VDR genotypes evaluated for the Healthy and Periodontitis groups. In conclusion, the Tt genotype was associated with periodontal disease; however, no association with the subgingival microbiota was observed.

Da infecção focal à medicina periodontal / From focal infection to periodontal medicine

A participação de bactérias da cavidade oral na etiopatogenia de outras doenças no organismo pode ocorrer pela migração da própria bactéria para o foco de infecção extra-oral ou pelo estabelecimento de um quadro inflamatório sistêmico crônico a partir da infecção localizada na boca. Evidências científicas recentes sugerem que as doenças periodontais podem interferir na saúde sistêmica por meio desses dois mecanismos, principalmente pela liberação contínua de diversos mediadores químicos e subprodutos da inflamação. Concentrações plasmáticas elevadas dessas substâncias por períodos prolongados podem influenciar o início ou a progressão de outras enfermidades, como eventos adversos na gravidez e doenças cardiovasculares. Este artigo apresenta um breve histórico sobre a influência de bactérias orais na saúde sistêmica, desde a teoria da Infecção Focal até o atual conceito de Medicina Periodontal. Também são abordados os mecanismos de interação entre a microbiota periodonto patogência e a respostado hospedeiro.

Controle da placa bacteriana supragengival na terapia periodontal não-cirúrgica / Supragingival plaque control on non-surgery periodontal therapy

O tratamento periodontal está relacionado diretamente aos microrganismos envolvidos nos processos de saúde e doença, sendo assim, as terapias devem ser direcionadas para o controle desses microrganismos. A raspagem e o alisamento radicular (RAR) são uma terapia inespecífica que tem capacidade de alterar microbiologicamente o ambiente subgengival e proporcionar resultados clínicos positivos. Todavia, tais resultados não persistem a longo prazo devido à recolonização dos sítios tratados pelas bactérias remanescentes da região subgengival ou por agentes bacterianos provenientes da região supragengival. Nesse contexto, por meio de uma revisão de literatura, este estudo visa a esclarecer a importância da remoção mecânica da placa supragengival e a influência de tal procedimento nos resultados clínicos e microbiológicos da terapia periodontal. Diferentes metodologias clínicas e microbiológicas, tais como métodos de cultura, de microscopia de campo escuro e técnicas mais apuradas de biologia molecular foram utilizadas com o objetivo de avaliar o efeito do controle de placa supragengival associado ou não a RAR. Esses resultados têm demonstrado melhoras adicionais clínicas e microbiológicas quando é realizado um meticuloso controle da placa supragengival associado à RAR. O reconhecimento de novas metodologias microbiológicas faz do controle de placa supragengival um assunto em discussão e novos estudos precisam ser realizados na tentativa de aprimorar o conhecimento sobre a recolonização a longo prazo por periodontopatógenos nos sítios tratados

The periodontal treatment is relationship directly with the microorganism involved on the health and diseases status, and consequently, the therapies must focus the control of these microorganisms. The scaling and root planning (SRP) is an unspecific therapy that are able not only to change the microbial composition of the subgingival area but also to offer positive clinical results. Nevertheless, these positive results are not longer observed due to re-colonization of the treated periodontal sites by the pathogens remained either in the sub- or in the supragingival area. Therefore, by means of a review of literature this study aims to clarify the importance of both mechanic removal of the subgingival dental plaque and the influence of the SRP on the microbiological and clinical results. Different clinic and microbiologic methodologies such as cultivable techniques, dark-field electron microscopy, and molecular biology were used with the purpose to evaluate the effect of the supragingival plaque control associated or not with the SRP. These results have shown better clinical and microbiological additional results when there is and association between meticulous supragingival plaque control and SRP. The recognize of new microbiological methodologies demonstrate that the control of the supragingival plaque is a field in currently discussion and further investigations must be conducted to try arise the knowledge about the long term re-colonization of treated periodontal sites by periodontal pathogens

Cross-contamination in the dental laboratory through the polishing procedure of complete dentures.

Polishing of dental prostheses can cause a dangerous cycle of cross-contamination involving dentists, laboratory technicians, patients and auxiliary personnel. The aim of this study was to show the microbial contamination in the dental laboratory during the polishing procedure of complete dentures. For this purpose, 4 experiments were conducted. Experiment I -- Determination of the total colony-forming units (CFU) counts contaminating complete maxillary dentures. During the polishing procedure, determination of the CFU counts transferred to the operator (Experiment II) and of the total CFU counts transferred to previously sterilized complete dentures (Experiment III). Experiment IV -- The total counts of remaining CFU in the lathe spindle after Experiments II and III. Complete dentures were highly contaminated (mean = 1.4 x 10(7) CFU/mL). There was a elevated level of contamination by splatter and aerosols. There was high microbial transfer from the contaminated lathe spindle to the sterile prostheses (mean = 1.7 x 10(7) CFU/mL). The spindles were highly contaminated after polishing procedures (mean = 3.5 x 10(8) CFU/mL). The polishing of dental prostheses is a possible source of transmission of communicable diseases in the laboratory and requires improved techniques for infection control.

Cross-contamination in the dental laboratory through the polishing procedure of complete dentures

O polimento de próteses dentais pode causar um ciclo de contaminação cruzada envolvendo cirurgões-dentistas, técnicos de laboratório, pacientes e pessoal auxiliar. O objetivo deste estudo foi demonstrar a contaminação microbiana em laboratório dental durante os procedimentos de polimento de próteses totais. Com esse propósito, 4 experimentos foram idealizados: Experimento I - Determinação da contagem total de unidades formadoras de colônias (UFC) presentes em próteses totais superiores. Durante o procedimento de polimento, determinação da contagem de UFC transferidas para o operador (Experimento II) e contagem total transferida para próteses totais previamente esterilizadas (Experimento III). Experimento IV - Contagem total de UFC remanescentes no cone da politriz após a realização dos experimentos II e III. As próteses totais estavam altamente contaminadas (média = 1,4 x 107 UFC/mL). Observou-se um elevado nível de contaminação pelo aerosol. Houve transferência de microrganismos da politriz contaminada para as próteses esterilizadas (média = 1,7 x 107 UFC/mL). Os cones estavam altamente contaminados depois dos procedimentos de polimento (média = 3,5 x 108 UFC/mL). O polimento de próteses dentais é um possível veículo de transmissão de doenças no ambiente do laboratório e requer técnicas adequadas para o controle de infecção.

A aplicabilidade de teste de BANA no consultório odontológico / The BANA test applicability in dental office

Os autores apresentam uma revisão bibliográfica sobre o Teste de BANA, método enzimático de diagnóstico complementar, capaz de detectar uma infecção periodontal associada à presença de alguns microrganismos periodontopatogênicos anaeróbicos (Porphyromonas gingivalis, Bacteroides forsythus, Treponema denticola). Também relatam a aplicabilidade de sua fase sólida (ou do cartão) no consultório odontológico e a contribuição na Clínica de Periodontia para o diagnóstico e monitoramento de pacientes periodontalmente envolvidos.