Evaluation of a new oral health scale of infectious potential based on the salivary microbiota.

OBJECTIVES: The objective of this study is to analyse the correlation of our own design of oral health scale (grades 0 and 1-better oral health vs. grades 2 and 3-poorer oral health) with the salivary microbiota. PATIENTS AND METHODS: The oral health scale we elaborated was evaluated in 100 adults (25 patients from each global oral health grade). Saliva samples collected from these patients were analysed using microbiological culture techniques, determining the presence/absence and the concentrations of some odontopathogens and periodontopathogens. RESULTS: In comparison with the global oral health grades 0-1, the grades 2-3 presented significantly higher values for the presence of odontopathogens (78 vs. 38 %; Streptococcus mutans, Lactobacillus spp. and Actinomyces spp.) and periodontopathogens (100 vs. 90 %; Aggregatibacter actinomycetemcomitans, Campylobacter spp., Fusobacterium spp. and Prevotella gingivalis). In comparison with the grades 0-1, the grades 2-3 presented significantly higher values for the concentrations (CFU/mL log10) of facultative anaerobes, strict anaerobes, odontopathogens (S. mutans, Lactobacillus spp. and Actinomyces spp.) and periodontopathogens (A. actinomycetemcomitans, Capnocytophaga spp., Campylobacter spp. and Fusobacterium spp.). CONCLUSION: Our new global oral health scale shows a positive correlation with the detection and quantification of certain odontopathogens and periodontopathogens present in the saliva, confirming their possible infectious potential. CLINICAL RELEVANCE: Our own design of oral health scale could be particularly useful for the epidemiological study of different populations, the evaluation of the influence of oral health on the development of certain systemic diseases as well as the analysis of inter- and intra-individual variability of the oral microbiota in relation to the different grades of the oral health scale.

Reliability of partial-mouth recording systems to determine periodontal status: a pilot study in an adult Portuguese population.

BACKGROUND: The efficacy of various partial-mouth recording (PMR) systems is analyzed in the evaluation of periodontal status, using index teeth and different combinations of quadrants. METHODS: The study group was formed of 108 adults aged 25 to 65 years old. A full-mouth examination (FME) was performed in all participants to determine the periodontal probing depth (PD) and clinical attachment level (CAL) at six sites per tooth. The results of PMR using the Ramfjord teeth, the Community Periodontal Index of Treatment Needs teeth, and the four quadrants individually and combined in pairs were compared to the results obtained with FME. RESULTS: Concordance with FME in terms of the prevalence of patients with PD ≥4 mm, CAL ≥2 mm, and CAL ≥4 mm was lowest with examination of single quadrants and highest with combinations that included one superior and one inferior quadrant. CONCLUSIONS: PMR systems, particularly with combinations of a superior plus an inferior quadrant, could be useful to evaluate periodontal status based on PD and CAL. This tool could be useful for epidemiologic surveys on periodontal status.

Evaluation of an oral health scale of infectious potential using a telematic survey of visual diagnosis

Objective: To compare the results of a subjective estimation of oral health through review of a set of intraoral photographs with those of an objective oral health scale of infectious potential. Method: The pool of patients was made up of 100 adults. Using an infectious-potential scale based on dental and periodontal variables, we assigned 1 of the 4 grades of the scale (range, 0 to 3; 0 corresponds to an excellent oral health status and 3 to the poorest oral health status) to each subject. A total of 20 representative subjects were selected from the pool of patients, 5 subjects for each one of the grades of the scale, and a standardized photographic record was made. One thousand dentists practicing in Spain were sent the survey by e-mail and 174 completed forms were received. We then calculated the concordance of the oral health status indicated by the respondents after visualising the photographs on comparison with the results of the oral health scale of infectious potential; concordance was termed correct grade allocation (CGA). Results: The majority of respondents (69.1%) achieved a CGA in 8 to 12 cases and none achieved more than 15 CGAs. The poorest CGA rates were found with grades 1 and 2, with a mean of 1.74 ± 1.09 and 1.87 ± 1.18, respectively, out of a maximum of 5. The concordance in terms of CGA was high for grade 0 (70.5%), very low for grade 1 (10.8%), low for grade 2 (37.3%), and moderate for grade 3 (42.6%). Conclusion: In comparison with visual examination of the oral cavity, the use of objective scale that establishes a reliable diagnosis of oral health in terms of infectious potential was found to be advantageous (AU)

Evaluation of an oral health scale of infectious potential using a telematic survey of visual diagnosis.

OBJECTIVE: To compare the results of a subjective estimation of oral health through review of a set of intraoral photographs with those of an objective oral health scale of infectious potential. METHOD: The pool of patients was made up of 100 adults. Using an infectious-potential scale based on dental and periodontal variables, we assigned 1 of the 4 grades of the scale (range, 0 to 3; 0 corresponds to an excellent oral health status and 3 to the poorest oral health status) to each subject. A total of 20 representative subjects were selected from the pool of patients, 5 subjects for each one of the grades of the scale, and a standardized photographic record was made. One thousand dentists practicing in Spain were sent the survey by e-mail and 174 completed forms were received. We then calculated the concordance of the oral health status indicated by the respondents after visualising the photographs on comparison with the results of the oral health scale of infectious potential; concordance was termed correct grade allocation (CGA). RESULTS: The majority of respondents (69.1%) achieved a CGA in 8 to 12 cases and none achieved more than 15 CGAs. The poorest CGA rates were found with grades 1 and 2, with a mean of 1.74 ± 1.09 and 1.87 ± 1.18, respectively, out of a maximum of 5. The concordance in terms of CGA was high for grade 0 (70.5%), very low for grade 1 (10.8%), low for grade 2 (37.3%), and moderate for grade 3 (42.6%). CONCLUSION: In comparison with visual examination of the oral cavity, the use of objective scale that establishes a reliable diagnosis of oral health in terms of infectious potential was found to be advantageous.

Evaluation of partial-mouth recording systems of gingival parameters in a Portuguese adult population.

OBJECTIVE: To analyze the diagnostic reliability of various partial-mouth recording systems (PMRS) for the simultaneous assessment of supragingival plaque, calculus, and gingival inflammation in a population of Portuguese adults. METHODS: A single examiner determined the levels of plaque, calculus, and gingival inflammation in 108 subjects using quantitative and dichotomous indices. Half-mouth and ≤ 10-tooth PMRS were compared with full-mouth examination (FME). RESULTS: On comparison with FME, Q1+Q3, Q1+Q4, Q2+Q3, Q2+Q4 combinations and the Ramfjord teeth did not show statistically significant differences in the simultaneous assessment of plaque, calculus, and gingival inflammation using both quantitative and dichotomous indices. Comparison of the prevalence of subjects that presented discrepancy in the three clinical parameters between FME and PMRS, Q1+Q3 combination was associated with lower percentages of discrepancy (range of discrepancies=0.9-6.4 percent) and a higher specificity (≥ 0.90) and sensitivity (≥ 0.89). CONCLUSIONS: The Q1+Q3 combination could be particularly applicable in studies investigating relationships between the state of gingival health and environmental or patient-related systemic factors, as well as in the development of oral health scales that include gingival parameters.

Suscetibilidade de estafilococos coagulase-negativos de significado clínico aos agentes antimicrobianos / Antimicrobial susceptibility of coagulase-negative staphylococci of clinical significance

Os estafilococos coagulase-negativos são responsáveis por uma série de doenças humanas e a resitência de várias espécies aos antibióticos tem sido relatada. Determinamos a suscetibilidade de 141 cepas à novobiocina e a um painel de 17 agentes anti-microbianos pelo método de difusão em meio sólido. Uma percentagem elevada (71,6%) das cepas foram resistentes à penicilina e em menor grau à ampicilina (42,5%), tetraciclina (35,4%), cloranfenicol (30,4%, meticilina (29%) e oxacilina (26,9%). Um número de cepas mostraram-se resistentes à cefalotina, carbenicilina, clidamicina e aminoglicosideos. A co-resistência para pares de agentes antimicrobianos ocorreu para penicilina-ampicilina, oxacilina-meticilina e tetraciclina-cloranfenicol. Dezessete padrões de multiresistência foram observados e as espécies foram resistentes a 5 e até a 16 antibióticos.

Determinaçao de especies de estafilococos coagulase-negativos de significado clinico / Species identification of coagulase-negative staphylococci of clinical significance

Uma coleçao de 141 amostras de estafilococos coagulase-negativos, isoladas de especimes clinicos, assim como de portadores e ambiente hospitalar, foram analisadas quanto as caracteristicas fisiologicas e propriedades biologicas. Oito especies foram identificadas pelos metodos convencionais segundo Kloos & Schleifer, e corresponderam a S. saprophyticus, S. epidermis, S. cohnil, S. simulans, S. hominis, S. warneri, S. haemolyticus e S. xylosus. Quatorze amostras nao foram identificadas. Atraves da aplicaçao da tecnica de taxonomia numerica se observou uma tendencia para a separaçao em dois grandes grupos, compreendendo S. saprophyticus e S. epidermidis. A partir dai as amostras restantes se identificaram com as outras especies de referencia de diferentes graus de similaridade. O emprego do micrometodo API no estudo de 39 das amostras ja identificadas so permitiu a classificaçao de 17 cepas em especies.

Lisogenia e resistência à tetraciclina em estreptococos do grupo A / Lysogeny and resistance to tetracycline in streptococco group A

Lisogenia em amostras de estreptococos do grupo A foi examinada. Verificou-se que entre as lisogênicas a resistência a tetraciclina era mais comum

Production of ß-lactamase by coagulase-negative staphylococci and susceptibility to ß-lactam antimicrobial agents

A produçäo de ß-lactamase foi pesquisada em 119 amostras de estafilococos coagulase-negativos (107 isoladas de material clínico e 12 de ambiente hospitalar). Para tal, foram empregados dois diferentes métodos; o acidométrico e o da cefalosporina cromogênica. Os resultados foram comparados com os de testes de susceptibilidade a antimicrobianos ß-lactâmicos, executados pelo método de difusäo em agar. Entre as amostras estudadas, S. saprophyticus foi a espécie de maior prevalência, seguida, respectivamente, por S. epidermidis e S. cohnii. A maioria das amostras (85%) se apresentou resistente a penicilina, sendo a resistência a ampicilina também de elevada frequência (50,5%). As resistências a meticilina e a oxacilina foram observadas, respectivamente, em 40 (33,5%) e 36 (30,5%) amostras. Somente 2 amostras foram resistentes a cefalotina, assim como aos outros ß-lactâmicos testados. A produçäo de ß-lactamase foi detectada em 29 (24,5%) amostras, através dos dois métodos utilizados. Entretanto, pelo método da cefalosporina cromogênica (nitrocefin), foram obtidas reaçöes fracas e tardias com 13 (11%) amostras adicionais, as quais forneceram resultados negativos pelo método acidométrico, mas se apresentaram resistentes a penicilina nos testes de difusäo em agar. Embora todas as amostras produtoras de ß-lactamase tenham se apresentado resistentes a penicilina nos testes de difusäo em agar, näo foi encontrada uma forte correlaçäo entre resistência a agentes ß-lactâmicos e aproduçäo de ß-lactamase

Susceptibility of coagulase negative staphylococci to ciprofloxacin in vitro

A sensibilidade ao ciprofloxacin foi testada in vitro em 83 cepas de estafilococos coagulase-negativas isoladas de infecçöes humanas. De 83 cepas, 82 mostraram-se sensíveis ao antibiótico pelo método de difusäo com disco (5microng) e foram inibidas na concentraçäo de 1microng/ml da droga