Nystatin effect on chlorhexidine efficacy against Streptococcus mutans as planktonic cells and mixed biofilm with Candida albicans.

OBJECTIVE: The aim of this study was to evaluate the effect of nystatin on the efficacy of chlorhexidine against Streptococcus mutans in planktonic cells and mixed biofilm with Candida albicans. MATERIAL AND METHODS: S. mutans ATCC 25,175 in suspension and also combined with C. albicans ATCC 18,804 in biofilm were cultured. Minimum inhibitory concentration (MIC), crystal violet colorimetric assay, and colony-forming unit counting (CFUs/mL) were performed. RESULTS: An increased MIC of chlorhexidine against S. mutans was observed when the drugs were administered mixed in a single formulation and with time intervals in between, except for the 30-min interval. The biofilm optical density (OD) in treatments using chlorhexidine and nystatin combined did not significantly differ from chlorhexidine alone. Either in biofilm colorimetric assay or determination of CFUs, the combined treatments with nystatin administered before chlorhexidine had less effect on chlorhexidine efficacy. CONCLUSIONS: Nystatin interferes with the action of chlorhexidine against S. mutans. The antimicrobial effectiveness of the combined drugs depends on their concentration, time interval used, and the planktonic or biofilm behavior of the microorganisms. CLINICAL RELEVANCE: In view of the great number of patients that can receive a prescription of chlorhexidine and nystatin concomitantly, this study contributes to the knowledge about the effect of the combined drugs. Given the high prevalence of prescriptions of chlorhexidine and nystatin in dentistry, dental professionals should be aware of their possible antagonistic effect.

Alternativa de tratamento reabilitador para pacientes em uso de bisfosfonato intravenoso: relato de caso clínico / An alternative rehabilitation treatment for patients using intravenous bisphosphonate: clinical case report

O objetivo deste relato de caso clínico foi descrever a importância de planejar de maneira minuciosa uma alternativa de reabilitação conservadora de um paciente em uso de bisfosfonato intravenoso, bem como detalhar os procedimentos realizados. Paciente do gênero masculino, 78 anos, buscou atendimento odontológico relatando insatisfação com sua condição dentária atual, e o desejo de realizar novas próteses dentárias. Ao exame clínico, observou-se instabilidade da prótese parcial removível superior devido à fratura coronária do elemento 26. Ao exame radiográfico, observaram-se extensas lesões cariosas nos dentes 16 e 26. Após plano de tratamento realizado em equipe multidisciplinar, foi sugerida uma reabilitação sem nenhum procedimento cirúrgico, a fim de minimizar as complicações pós-operatórias e proporcionar saúde oral de maneira mais breve e minimamente invasiva. O tratamento incluiu a confecção de uma prótese parcial fixa dos elementos 13 ao 23 com encaixes de precisão associada à uma prótese parcial removível superior. Já para a arcada inferior, foi realizada uma prótese parcial fixa dos elementos 33 ao 41 e uma prótese parcial removível. Por meio deste caso clinico, foi possível concluir que uma abordagem conservadora possibilitou uma reabilitação que supriu as necessidades estéticas e funcionais do paciente que faz uso de medicamento antirreabsortivo(AU)

The aim of this study was to describe the importance of a carefully planning to conservative rehabilitation alternative for a patient using intravenous bisphosphonate, as well as to detail the procedures performed. A male patient, 78 years old, sought dental care reporting dissatisfaction with his current dental condition and the desire to perform new dental prostheses. At the clinical examination, instability of the superior removable partial denture was observed due to the coronary fracture of element 26. Radiographic examination revealed extensive carious lesions on teeth 16 and 26. After a multidisciplinary treatment planning, was suggested a rehabilitation without any surgical procedure, in order to minimize postoperative complications and provide oral health in a minor and minimally invasive manner. Treatment included a fixed partial denture of elements 13 to 23 with precision fittings attachments associated with a removable partial denture. To the jaw, a fixed partial prosthesis of elements 33 to 41 and a partial removable prosthesis were performed. Through this clinical case, it was possible to conclude that a conservative management provides an aesthetical and functional patient rehabilitation who take antiresorptive medication(AU)

Gardner syndrome with maxillofacial manifestation: A case report.

Gardner syndrome is a hereditary disease in which patients develop gastrointestinal polyps, osteomas, desmoid tumors, epidermoid cysts, fibromas, lipomas, and retinal lesions. Dental abnormalities such as supernumerary or impacted teeth, odontomas and dentigerous cysts are also reported. The most serious concern in this syndrome is the extremely high risk of gastrointestinal polyps undergoing malignant transformation. Since the maxillofacial findings usually precede gastrointestinal polyps, the dentist plays a crucial role in the diagnosis of Gardner syndrome, and panoramic radiography is an important tool in the diagnosis of the disease. We report here a case of Gardner syndrome in a patient showing mandibular osteomas and impacted teeth. Also, cases of Gardner syndrome with maxillofacial manifestations reported in the literature were reviewed and compared with ours. According to the findings, osteomas are important manifestations of this syndrome, and regardless of the absence of family history of intestinal polyposis, their occurrence should prompt diagnostic evaluation for this disease.