Development, characterization and antimicrobial activity of multilayer silica nanoparticles with chlorhexidine incorporated into dental composites.

OBJECTIVE: In this study a dentistry nanocomposite with prolonged antibacterial activity using silica nanoparticles (SNPs) loaded with chlorhexidine (CHX) was developed. METHODS: SNPs were coated with the Layer-by-Layer technique. Dental composites were prepared with organic matrix of BisGMA/TEGDMA and SNPs with or without CHX (0, 10, 20 or 30% w/w). The physicochemical properties of the developed material were evaluated and agar diffusion method was used to test the antibacterial. In addition, the biofilm inhibitory activity of the composites was evaluated against S. mutans. RESULTS: SNPs were rounded with diameters about 50 nm, the organic load increased with increasing deposited layers. Material samples with SNPs loaded with CHX (CHX-SNPs) showed the highest values of post-gel volumetric shrinkage, that ranged from 0.3% to 0.81%. Samples containing CHX-SNPs 30% w/w showed the highest values of flexural strength and modulus of elasticity. Only samples containing SNPs-CHX showed growth inhibition against S. mutans, S. mitis and S. gordonii in a concentration-dependent manner. The composites with CHX-SNPs reduced the biofilm formation of S. mutans biofilm at 24 h and 72 h. SIGNIFICANCE: The nanoparticle studied acted as fillers and did not interfere with the evaluated physicochemical properties while providing antimicrobial activity against streptococci. Therefore, this initial study is a step forward to the synthesis of experimental composites with improved performance using CHX-SNPs.

Antimicrobial Activity of Honey against Oral Microorganisms: Current Reality, Methodological Challenges and Solutions.

Honey has been shown to have antimicrobial activity against different microorganisms, but its effects on oral biofilms are largely unknown. In this review, we analyzed the currently available literature on the antimicrobial activity of honey against oral biofilms in order to determine its potential as a functional food in the treatment and/or prevention of oral diseases. Here, we compare studies reporting on the antimicrobial activity of honey against systemic and oral bacteria, discuss methodological strategies, and point out current gaps in the literature. To date, there are no consistent studies supporting the use of honey as a therapy for oral diseases of bacterial origin, but current evidence in the field is promising. The lack of studies examining the antibiofilm activity of honey against oral microorganisms reveals a need for additional research to better define aspects such as chemical composition, the mechanism(s) of action, and antimicrobial action.

Statins with potential to control periodontitis: From biological mechanisms to clinical studies.

BACKGROUND: Statins are widely used for the treatment of hyperlipidemia. However, these drugs have pleiotropic effects that can be promising for the prevention and treatment of oral diseases, such as periodontitis. HIGHLIGHT: This review aimed to identify preclinical, observational, and clinical studies that evaluate the effects and biological mechanisms of statins on oral cells and tissues and those using these drugs to treat periodontitis. A literature survey has been conducted in PubMed using combinations of the uniterms: "statins," "dentistry," "periodontal disease," and "periodontal treatment." In vitro findings showed positive statin results in cell lines related to alveolar bone metabolism by altering the signaling pathway Osteoprotegerin/Receptor Activator of Nuclear Factor Kappa B/Receptor Activator of Nuclear Factor Kappa B Ligand (OPG/RANK/RANKL), stimulating the production of alkaline phosphatase and osteocalcin, and reducing the production of matrix metalloproteinases (MMPs). Animal studies have shown a reduction in alveolar bone loss and osteoclastic activity, in addition to a reduction in inflammatory markers, such as IL-1, IL-6, and TNF-α, when statins were used prophylactically. Clinical trials showed a positive impact on clinical parameters, leading to a higher reduction in probing depth and gain in clinical attachment when a local statin was adjunctively associated with mechanical therapy. CONCLUSION: Statins were shown to be promising for regenerating and stimulating bone activity, with great potential for treating chronic periodontitis. However, further studies are required to confirm its effectiveness.

Os produtos naturais são uma alternativa para o tratamento da candidose oral? Uma revisão de ensaios clínicos / Are natural products an alternative for the treatment of oral candidosis? A review of clinical trials / ¿Los productos naturales son una alternativa para el tratamiento de la candidiasis oral? Una revisión de los ensayos clínicos

Introdução: a candidose oral é uma doença oportunista que acomete principalmente pacientes imunossuprimidos e usuários de prótese dentária total. Apesar da eficácia terapêutica dos antifúngicos utilizados atualmente para o tratamento desta doença, essas drogas apresentam muitos efeitos adversos relacionados à dose. Além disso, tem-se observado um aumento da resistência microbiana para esses agentes. Baseado nisso, uma fonte de busca promissora de princípios ativos alternativos para o tratamento da candidose oral são os produtos naturais. Objetivo: revisar a literatura sobre ensaios clínicos com produtos naturais para o tratamento da candidose oral, a fim de responder se existe evidência que os produtos naturais podem ser utilizados como tratamento alternativo para esta doença. Material e método: foi realizada uma síntese de todos os ensaios clínicos com produtos naturais para tratamento da candidose indexados banco de dados Pubmed. Resultado: seguindo os critérios de inclusão e exclusão entraram nesta revisão 6 estudos. Os estudos avaliaram a eficácia dos produtos naturais quanto aos parâmetros clínicos e micológicos e grau de satisfação do paciente. Conclusão: apesar da pouca quantidade de ensaios clínicos nesta temática, há evidência de que os produtos naturais podem ser usdos para tratar a candidose oral, especialmente alho, mamona, româ e melaleuca(AU)

Introduction: oral candidiasis is an opportunistic disease that mainly affects immunosuppressed patients and users of total dental prosthesis. Despite the therapeutic efficacy of currently used antifungals for the treatment of this disease, these drugs have many dose related adverse effects. In addition, an increase in microbial resistance has been observed for these agents. Based on this, a promising source of alternative active principles for the treatment of oral candidosis are the natural products. Objective: to review the literature on clinical trials with natural products for the treatment of oral candidosis in order to answer if there is evidence that natural products can be used as an alternative treatment for this disease. Material and method: a synthesis of all clinical trials with natural products for the treatment of candidiasis indexed Pubmed database was performed. Results: following the inclusion and exclusion criteria, 6 studies were included in this review. The studies evaluated the efficacy of the natural products regarding clinical and mycological parameters and degree of patient satisfaction. Conclusion: despite the limited amount of clinical trials on this subject, there is evidence that natural products can be used to treat oral candidosis, especially garlic, castor oil, pomegranate, and melaleuca(AU)

Introducción: la candidose oral es una enfermedad oportunista que afecta principalmente a los pacientes inmunosuprimidos ya los usuarios de prótesis dentales totales. A pesar de la eficacia terapéutica de los antifúngicos utilizados actualmente para el tratamiento de esta enfermedad, estos medicamentos presentan muchos efectos adversos relacionados con la dosis. Además, se ha observado un aumento de la resistencia microbiana para estos agentes. En base a esto, una fuente de búsqueda prometedora de principios activos alternativos para el tratamiento de la candidiasis oral son los productos naturales. Objetivo: revisar la literatura sobre ensayos clínicos con productos naturales para el tratamiento de la candidiasis oral, a fin de responder si existe evidencia que los productos naturales pueden ser utilizados como tratamiento alternativo para esta enfermedad. Material y método: se realizó una síntesis de todos los ensayos clínicos con productos naturales para el tratamiento de la candidose indexada base de datos Pubmed. Resultado: siguiendo los criterios de inclusión y exclusión entraron en esta revisión 6 estudios. Los estudios evaluaron la eficacia de los productos naturales en cuanto a los parámetros clínicos y micológicos y grado de satisfacción del paciente. Conclusión: a pesar de la poca cantidad de ensayos clínicos en esta temática, hay evidencia de que los productos naturales pueden ser utilizados para tratar la candidose oral, especialmente ajo, ricino, granada y melaleuca(AU)

Avaliação da profilaxia da trombose venosa profunda em um hospital geral / Evaluation of deep vein thrombosis prophylaxis in a general hospita

Contexto: O tromboembolismo venoso (TEV) representa uma preocupação crescente nas instituições hospitalares, tem grande impacto sobre a morbimortalidade em pacientes clínicos e cirúrgicos, e é a principal causa de morte evitável hospitalar. Embora existam modelos de avaliação de risco para pacientes hospitalizados, a profilaxia ainda é subutilizada ou é feita de forma incorreta. Objetivos: Avaliar o perfil de risco para TEV de pacientes clínicos e cirúrgicos recém-internados, bem como as medidas tromboprofiláticas aplicadas nas primeiras 24 horas de internação. Métodos: Este estudo transversal foi realizado em um hospital geral de grande porte do interior do estado de São Paulo entre março e julho de 2015. Os escores de Pádua e Caprini foram utilizados para estratificação de risco dos pacientes clínicos e cirúrgicos, respectivamente, enquanto a análise das medidas tromboprofiláticas baseou-se nas recomendações do 8º e 9º Consenso do American College of Chest Physicians. Resultados: Foram analisados 592 pacientes (62% clínicos e 38% cirúrgicos). A estratificação de risco revelou necessidade de quimioprofilaxia em 42% dos pacientes clínicos e 81% dos cirúrgicos (51% de alto risco e 30% de moderado risco). Por outro lado, receberam profilaxia adequada nas primeiras 24 horas de internação 54% dos pacientes clínicos de alto risco, 85% dos cirúrgicos de alto risco e 4% dos cirúrgicos de moderado risco, todos sem contraindicação. Conclusões: Há necessidade de aprimoramento da segurança do paciente em relação ao TEV já nas primeiras horas de internação. Existe uma subutilização da quimioprofilaxia especialmente nos pacientes clínicos de alto risco e cirúrgicos de moderado risco

Background: Venous thromboembolism (VTE) is a cause for growing concern in hospitals, has great impact on morbidity and mortality in clinical and surgical patients, and is the leading cause of preventable hospital deaths. Although there are risk assessment models for hospital inpatients, prophylaxis is still underused or is administered incorrectly. Objectives: To assess the risk profile for VTE in recently hospitalized clinical and surgical patients and evaluate the thromboprophylactic measures implemented in the first 24 hours of hospitalization. Methods: Cross-sectional study conducted in a large general hospital in the state of São Paulo, Brazil, between March and July 2015. Padua and Caprini scores were used for risk stratification of clinical and surgical patients, respectively, while thromboprophylactic measures were analyzed for compliance with the recommendations contained in the 8th and 9th Consensus of the American College of Chest Physicians. Results: A total of 592 patients (62% clinical and 38% surgical) were assessed. Risk stratification revealed a need for chemoprophylaxis in 42% of clinical patients and 81% of surgical patients (51% high risk and 30% moderate risk). However, 54% of high-risk clinical patients, 85% of high-risk surgical patients, and 4% of moderate-risk surgical patients, who were free from contraindications, were actually given the correct prophylaxis in the first 24 hours of hospitalization. Conclusions: There is a need to improve patient safety in relation to VTE in the first hours of hospitalization, since there is underutilization of chemoprophylaxis, especially in high-risk clinical patients and moderate-risk surgical patients

Evaluation of deep vein thrombosis prophylaxis in a general hospital.

BACKGROUND: Venous thromboembolism (VTE) is a cause for growing concern in hospitals, has great impact on morbidity and mortality in clinical and surgical patients, and is the leading cause of preventable hospital deaths. Although there are risk assessment models for hospital inpatients, prophylaxis is still underused or is administered incorrectly. OBJECTIVES: To assess the risk profile for VTE in recently hospitalized clinical and surgical patients and evaluate the thromboprophylactic measures implemented in the first 24 hours of hospitalization. METHODS: Cross-sectional study conducted in a large general hospital in the state of São Paulo, Brazil, between March and July 2015. Padua and Caprini scores were used for risk stratification of clinical and surgical patients, respectively, while thromboprophylactic measures were analyzed for compliance with the recommendations contained in the 8th and 9th Consensus of the American College of Chest Physicians. RESULTS: A total of 592 patients (62% clinical and 38% surgical) were assessed. Risk stratification revealed a need for chemoprophylaxis in 42% of clinical patients and 81% of surgical patients (51% high risk and 30% moderate risk). However, 54% of high-risk clinical patients, 85% of high-risk surgical patients, and 4% of moderate-risk surgical patients, who were free from contraindications, were actually given the correct prophylaxis in the first 24 hours of hospitalization. CONCLUSIONS: There is a need to improve patient safety in relation to VTE in the first hours of hospitalization, since there is underutilization of chemoprophylaxis, especially in high-risk clinical patients and moderate-risk surgical patients.