Periodontal Ehlers-Danlos syndrome in early childhood: A case report of loss of deciduous teeth.

The aim of the present study is to report a case of periodontal Ehlers-Danlos syndrome (pEDS) in early childhood. A 3-year-old child, complaining of severe tooth mobility, gingival bleeding, and early loss of deciduous teeth sought the dental clinics. The patient was diagnosed with pEDS, and no other systematic health impairments were diagnosed. It was implemented a strict supragingival biofilm control, using mechanical and chemical strategies. However, during the treatment, the patient had to receive multiple dental extractions. Scaling and root planing were performed in the remaining teeth, and the patient is included in the periodontal maintenance program to prevent recurrence of the disease. It was concluded that, although rare, severe cases of periodontitis may occur in deciduous teeth. Strict supragingival biofilm control and periodontal maintenance are strongly recommended in those patients, along with familial monitoring.

Peptídeos antimicrobianos como terapia complementar periodontal: uma análise da literatura / Antimicrobial peptides as periodontal complementary therapy: an analysis of literature

Objetivo: realizar um levantamento sistemático da literatura no que tange ao uso de peptídeos antimicrobianos contra periodontopatógenos e indicar quais os peptídeos e micro-organismos mais estudados, com o objetivo final de traçar um perfil das publicações na área. Material e métodos: a busca por artigos ocorreu na base de dados Pubmed, com os seguintes critérios de inclusão: publicação nos últimos dez anos; palavras-chave "Antimicrobial Peptide" and "Periodontal" and "Bacteria", publicados em inglês e disponíveis gratuitamente na íntegra para leitura. Um total de dez artigos foram selecionados após o refinamento dos dados. Resultados: apesar do pequeno número de estudos encontrados, evidencia-se o potencial uso de peptídeos antimicrobianos no controle das principais bactérias periodontopatogênicas. Além disso, os peptídeos produzidos por células da mucosa oral (Defensinas, LL-37 e Histatinas), bem como os micro-organismos Porphyromonas gingivalis e Fusobacterium nucleatum, foram os mais estudados. Conclusão: é possível concluir que o uso de peptídeos antimicrobianos como potencial ferramenta no controle microbiano tem uma importância crescente, provavelmente devido à sua ampla aplicabilidade, mecanismos de ação e baixos índices de resistência. Contudo, estudos relacionados à sua toxicidade sobre células humanas, modo de aplicação e ensaios clínicos precisam ser realizados.

Objectives: to perform a systematic review of the literature regarding the use of antimicrobial peptides against periodontopathogens and indicate the most studied peptides and microorganisms, with the final objective of outlining a profile of publications in the area. Material and methods: the search for articles occurred in Pubmed database with the following inclusion criteria: publication in the last 10 years; Keywords "Antimicrobial Peptide" and "Periodontal" and "Bacteria", published in English and freely available for reading. Results: a total of 10 articles were selected after refi ning the data. Despite the small number of studies found, it is evident the potential use of antimicrobial peptides in the control of the main periodontopathogenic bacteria. In addition, the peptides produced by oral mucosa cells (Defensins, LL-37 and Histatins) as well as the microorganisms Porphyromonas gingivalis and Fusobacterium nucleatum were the most studied. Conclusion: it is possible to conclude that the use of antimicrobial peptides as a tool in microbial control is of increasing importance, probably due to their wide applicability, mechanisms of action and low resistance indices. However, studies related to its toxicity on human cells, mode of application and clinical trials still need to be performed.

Use of antidepressive agents as a possibility in the management of periodontal diseases: A systematic review of experimental studies.

Antidepressant agents have anti-inflammatory functions that could be interesting as adjuvants in periodontal therapy. The aim of the present study was to analyze the effect of antidepressive drugs in the management of periodontal disease. The MEDLINE, Scopus, Embase, LILACS, and SciELO databases were searched. To be included, the studies had to be experimental studies; randomized, controlled; double-blinded; or blinded studies. A total of 565 articles were initially searched, of which five were selected for the systematic review. All studies used rats, and three different drugs were evaluated: tianeptine, venlafaxine, and fluoxetine. Two of these studies evaluated the effect of antidepressive agents in rats submitted to both ligature-induced periodontitis and depression models, showing that depressive rats had greater alveolar bone loss (ABL). Only the venlafaxine study was not able to find any significant ABL reduction in the group that used this antidepressive drug. The other four studies showed statistically-significant differences, favoring the group with the antidepressant agent. Treatments that are able to modulate the brain-neuroendocrine-immune system could be used as an adjuvant to periodontal disease management. However, studies on humans and animals are scarce, limiting the conclusion of a positive effect in the present systematic review.

Efficacy of an unwaxed dental floss impregnated with 2% chlorhexidine on control of supragingival biofilm: A randomized, clinical trial.

AIM: In the present study, we evaluated the antiplaque and antigingivitis efficacy of a dental floss impregnated with 2% chlorhexidine digluconate. METHODS: Thirty dental students were randomly divided into three groups (n=10): (a) negative control (NC) group, in which no interproximal cleaning was performed; (b) the positive control (PC) group, which used a standard unwaxed dental floss twice daily; and (c) and the test group, which used a unwaxed dental floss impregnated with 2% chlorhexidine twice daily. Six surfaces per tooth were evaluated by the Quigley-Hein plaque index (Turesky modification) at the last appointment (day 15), and testing for the presence of marginal bleeding was performed using the marginal bleeding index (MBI) at both the baseline and last appointments. RESULTS: At day 15, the test group had the lowest mean plaque index (1.04±0.67), showing a statistically-significant difference compared to the NC group (1.40±0.65, P<.001) and PC group (2.30±0.73, P<.001). The PC and test groups showed a mean reduction of 70.2% and 87.26%, respectively, with significant reduction compared to baseline (P<.05) for the MBI. No statistically-significant difference was found between the PC and test groups (P=.126). CONCLUSION: Unwaxed dental floss impregnated with 2% chlorhexidine showed additional reductions in supragingival interproximal biofilm compared with a conventional unwaxed dental floss, without additional improvement in marginal bleeding.

Percepção e nível de conhecimento sobre halitose entre estudantes e pacientes / Perception and level of knowledge about halitosis among students and patients

O presente estudo analisou a percepção e o nível de conhecimento de estudantes e pacientes sobre halitose. Dois grupos de voluntários de ambos os gêneros, entre 18 e 60 anos, totalizando 225 participantes, responderam a um questionário que continha oito questões relativas à percepção, às causas e ao tratamento da halitose. O grupo de pacientes (P) consistiu-se de 150 indivíduos que procuraram os serviços odontológicos da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará, Brasil, e o grupo de estudantes (S), de 75 alunos de Odontologia da mesma Universidade. No grupo P, 45,3% dos participantes acreditava ter halitose, já no grupo S, esse percentual foi de apenas 16,2%. Em relação às causas e aos tratamentos da halitose, encontrou-se que o grupo P assinalou mais opções relacionadas com o correto conhecimento sobre halitose quando comparados com o grupo S. É possível concluir que os pacientes relataram maior percepção da halitose do que os estudantes, bem como têm demonstrado maior conhecimento sobre a origem e tratamento da halitose.

This study aimed to assess individual perception and level of knowledge of students and patients about halitosis. Two groups of volunteers of both genders between 18 and 60 years old, totaling 225 subjects, answered a questionnaire containing eight questions relating to perception, causes, and treatment of halitosis. The group of patients (P) consisted of 150 individuals seeking dental services at the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Brazil, and the Group of students (S) consisted of 75 students of Dentistry at the same University. In Group P, 45.3% of participants believed they had halitosis, while in Group S, this percentage was only 16.2%. In matters relating to the causes and treatment of halitosis, it was found that the Group P marked more options related to the correct knowledge about halitosis when compared to Group S. It is possible to conclude that patients reported greater halitosis perception than students, and also that they showed a better knowledge about the halitosis etiology and treatment.

Pleiotropic effects of statins on the treatment of chronic periodontitis--a systematic review.

AIM: Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase and are an important group of hypolipidaemic drugs, widely used in the treatment of hypercholesterolaemia and cardiovascular disease. Some studies have shown that statins are able to modulate inflammation and alveolar bone loss. METHODS: In order to evaluate whether statins could influence periodontal treatment, improving the clinical and radiographic parameters in chronic periodontitis, a systematic review was conducted in the databases PUBMED and BIREME, searching for articles in English and Portuguese, published between the years 2004 and 2014, using the combined keywords statin, periodontal disease, periodontitis and alveolar bone. Studies regarding the treatment of chronic periodontitis in humans, blind or double-blind, retrospective cohort or randomized controlled trials that used statins topically or systemically were selected. RESULTS: Statins have important anti-inflammatory and immune effects, reducing levels of C-reactive protein and matrix metalloproteinases and their intermediate products, such as tumour necrosis factor-α, and are also able to inhibit the adhesion and extravasation of leukocytes, which block the co-stimulation of T cells. Statins reduce bone resorption by inhibiting osteoclast formation and lead to increased apoptosis of these cells. The effect of statins on bone formation is related to the increased gene expression of bone morphogenetic protein in osteoblasts. CONCLUSION: Although we found biological mechanisms and clinical results that show lower alveolar bone loss and reduction of clinical signs of inflammation, further studies are needed to evaluate the clinical applicability of statins in the routine treatment of chronic periodontitis.

Azithromycin: a new concept in adjuvant treatment of periodontitis.

In most patients periodontitis is successfully treated by scaling and root planing, but some studies have shown that certain sites continue to show periodontal tissue destruction despite conventional periodontal therapy. To solve this problem, antibiotics may be administered as an adjuvant treatment. This includes azithromycin (AZM), which is effective against Gram-negative aerobic and anaerobic bacteria and has a long half-life in periodontal tissues. The purpose of the present study was to determine the efficacy of azithromycin as an adjuvant treatment for periodontitis through a review of the literature in Medline, Lilacs and Scielo, combining the keywords "azithromycin", "periodontal treatment" and "periodontitis" in both Portuguese and English languages. To be included, articles had to be clinical trials, randomized, controlled, double-blind or blind, and published between 2001 and 2011. 70 articles were found, of which 12 were selected based on title and abstract. Most studies used AZM as an adjuvant treatment for chronic periodontitis, usually in a single daily dose of 500 mg over three days, and indicated that AZM significantly reduced probing depth and increased periodontal attachment when compared to controls. Furthermore, a reduction in red and orange complex and an increase in bacteria associated with healthy periodontal conditions were observed in subjects treated with AZM. It may be concluded that the use of AZM as an adjuvant treatment for periodontitis improves clinical and microbiological parameters when compared to conventional treatment alone.

Composição, princípios ativos e indicações clínicas dos dentifrícios: uma revisão da literatura entre 1989 e 2011 / Composition, active ingredients and clinical indications of dentifrices: a literature review between1989 and 2011

Apesar do controle mecânico ser tido como o melhor método para remoção do biofilme das superfícies dentárias, a utilização de agentes antimicrobianos presentes em soluções para bochechos e em dentifrícios é, muitas vezes, requerida. O presente estudo teve como objetivo revisar a literatura acerca da composição dos dentifrícios atuais, seus princípios ativos e suas indicações clínicas. Para tanto, revisou-se a literatura compreendida entre o período de 1989 a 2011, utilizando-se a combinação das seguintes palavras-chaves: dentifrícios, composição química e flúor, nas línguas inglesa e portuguesa, nas bases de dados Pubmed, BVS, Bireme, SciELO e Portal da Capes. Foram incluídos também livros-texto de referência. Observou-se que os dentifrícios são utilizados para levar várias substâncias à cavidade bucal, objetivando a redução da cárie, das doenças gengivais e periodontais, do cálculo dentário, da hipersensibilidade dentinária e da halitose. Atualmente, os dentifrícios são compostos por: sistemas abrasivos, detergentes, flavorizantes, solventes, umectantes, aglutinantes, edulcorantes, conservantes e princípio ativo. A variedade de substâncias presentes nos dentifrícios é muito grande, sendo essa uma das razões para a grande dificuldade em identificar o dentifrício mais apropriado para cada situação clínica. No intuito de facilitar a aquisição desses produtos, é de suma importância que a composição química e a sua indicação sejam informadas adequadamente.

Although mechanical control is considered the best method to remove dental surfaces biofilm, the use of antimicrobial agents contained in mouthwashes and toothpaste is required. This study aimed to review the literature about the current composition of dentifrices, their active ingredients and clinical indications. Thus the literature between 1989 and 2011 was reviewed, using the following keyword combinations: dentifrice, chemical composition and fluoride, in English and Portuguese languages, in Pubmed, BVS, Bireme, SciELO, and Portal Capes databases. It was also included reference textbooks. It was observed that dentifrices are used to carry out a lot of substances to oral cavity, aiming to reduce caries, gingival and periodontal diseases, dental calculus, dentin hypersensitivity and also halitosis. Nowadays, dentifrices are composed of: abrasive systems, detergents, flavorings, solvents, humectants, binders, sweeteners, preservatives and active ingredient.The variety of substances found in dentifrices is huge, and this is one of the reasons that makes harder to identify the most appropriate dentifrice for each clinical situation. In order to facilitate the acquisition of these products, is quite important that the chemical composition and its indication are informed properly.