Adjuvant effects of Saccharomyces cerevisiae in the treatment of experimental periodontitis in rats undergoing chemotherapy.

Surgical procedures, radiotherapy, and chemotherapy, individually or in association, are current oncological treatments. Among the most used chemotherapy drugs, 5-fluorouracil (5FU) is an antimetabolite with a broad spectrum of action. This study evaluated the effects of probiotics (PRO) as an adjuvant to the treatment of experimental periodontitis (EP) in rats immunosuppressed with 5FU.108 rats were randomly allocated to six different groups: EP; SS - systemic treatment with saline solution (SS); 5FU - systemic treatment with 5FU; 5FU+PRO - systemic treatment with 5FU, followed by the local administration of Saccharomyces cerevisiae ; 5FU+SRP - systemic treatment with 5-FU, followed by scaling and root planing (SRP); and 5FU+SRP+PRO - systemic treatment with 5FU followed by local treatments with SRP and PRO. Immunosuppression was obtained at two points: at the time of ligature installation and after 48 h. Six animals from each group were euthanized at seven, 15, and 30 d and hemimandibles were collected and processed for histopathological, histometric, and immunohistochemical analysis. Data were subjected to statistical analysis (α=5%). At 7 d, the 5FU+PRO group showed less bone resorption and better structured connective tissue compared with the EP, SS, 5FU+SRP, and 5FU+SRP+PRO groups. At 15 d, the 5FU+SRP group showed a greater intensity of the inflammatory response (p<0.05). At 30 d, the 5FU+SRP+PRO group showed better structured bone tissue and a higher percentage of bone tissue (PBT) than the EP, SS, 5FU, and 5FU+PRO groups (p<0.05). The use of Saccharomyces cerevisiae as monotherapy or as an adjuvant to periodontal therapy may have a positive effect on bone repair in immunosuppressed conditions.

Adjuvant effects of Saccharomyces cerevisiae in the treatment of experimental periodontitis in rats undergoing chemotherapy

Abstract Surgical procedures, radiotherapy, and chemotherapy, individually or in association, are current oncological treatments. Among the most used chemotherapy drugs, 5-fluorouracil (5FU) is an antimetabolite with a broad spectrum of action. This study evaluated the effects of probiotics (PRO) as an adjuvant to the treatment of experimental periodontitis (EP) in rats immunosuppressed with 5FU. Methodology 108 rats were randomly allocated to six different groups: EP; SS - systemic treatment with saline solution (SS); 5FU - systemic treatment with 5FU; 5FU+PRO - systemic treatment with 5FU, followed by the local administration of Saccharomyces cerevisiae ; 5FU+SRP - systemic treatment with 5-FU, followed by scaling and root planing (SRP); and 5FU+SRP+PRO - systemic treatment with 5FU followed by local treatments with SRP and PRO. Immunosuppression was obtained at two points: at the time of ligature installation and after 48 h. Six animals from each group were euthanized at seven, 15, and 30 d and hemimandibles were collected and processed for histopathological, histometric, and immunohistochemical analysis. Data were subjected to statistical analysis (α=5%). Results At 7 d, the 5FU+PRO group showed less bone resorption and better structured connective tissue compared with the EP, SS, 5FU+SRP, and 5FU+SRP+PRO groups. At 15 d, the 5FU+SRP group showed a greater intensity of the inflammatory response (p<0.05). At 30 d, the 5FU+SRP+PRO group showed better structured bone tissue and a higher percentage of bone tissue (PBT) than the EP, SS, 5FU, and 5FU+PRO groups (p<0.05). Conclusion The use of Saccharomyces cerevisiae as monotherapy or as an adjuvant to periodontal therapy may have a positive effect on bone repair in immunosuppressed conditions.

Effectiveness of antimicrobial photodynamic therapy mediated by butyl toluidine blue in preventing medication-related osteonecrosis of the jaws in rats.

BACKGROUND: Medication-related osteonecrosis of the jaws (MRONJ) is difficult to treat, therefore, prevention would be the ideal clinical approach. This study evaluated the effectiveness of antimicrobial photodynamic therapy (aPDT), mediated by butyl toluidine blue (BuTB) in the prevention of MRONJ-like lesions after tooth extraction in rats. METHODS: Twenty-eight senescent female rats were distributed in groups: VEH and VEH-aPDT, treated with vehicle, ZOL and ZOL-aPDT, treated with 100 µg/Kg of zoledronate, both treatments every three days over seven weeks. After three weeks from the commencement of treatment, the mandibular first molar was extracted. For the VEH and ZOL groups, no local treatment was performed, while with the VEH-aPDT and ZOL-aPDT groups, photodynamic treatment was carried out at 0, 2, and 4 days after extraction. For aPDT, 500µl of BuTB solution was deposited on the dental extraction site (0.5 mg/ml; 60 s), followed by irradiation with low-level laser (InGaAIP; 660 nm; 35 mW; 74.2 J/cm²; 60 s). After 28 postoperative days, euthanasia was performed. The hemimandibles were processed to: (1) histological analysis of tissue repair; (2) histometric analysis of the percentage of newly formed bone tissue (PNFBT) and percentage of non-vital bone tissue (PNVBT); (3) immunohistochemical analysis for tartrate-resistant acid phosphatase (TRAP). RESULTS: The ZOL and ZOL-aPDT groups showed less TRAP-positive cells when compared with VEH and VEH-aPDT. The ZOL group demonstrated great compromise in the tissue repair process, consistent with MRONJ-like lesions. VEH, VEH-aPDT and ZOL-aPDT presented a favorable tissue repair process. PNFBT in the ZOL group was lower than in the VEH, VEH-aPDT and ZOL-aPDT groups, whereas PNVBT in the ZOL group was higher than in the VEH, VEH-aPDT and ZOL-aPDT groups. CONCLUSION: aPDT mediated by BuTB prevented the occurrence of MRONJ-like lesions after tooth extraction in rats.

The effects of Lactobacillus reuteri on the inflammation and periodontal tissue repair in rats: A pilot study.

Objective: The aim of this study was to evaluate the effects of probiotic (PRO) Lactobacillus reuteri (DSM17938) as an adjuvant to the treatment of experimental periodontitis (EP). Material and methods: Fifty-four male adult Wistar rats were included. EP was induced and maintained for 7 days. Subsequently, the ligature was removed and the animals were allocated into three different experimental groups (n = 18/group): EP - no local treatment, the animals received four systemic saline solution (SS) administrations; SRP+SS, the animals underwent SRP treatment, followed by SS administration; and SRP+PRO, the animals received SRP treatment, followed by the systemic administration of PROs (Lactobacillus reuteri ; 0.16 ml/day). Six animals from each group were euthanised at 7, 15 and 30 days. Histological and histometric analyses of alveolar bone loss (BL) and immunohistochemical analyses for TRAP, RANKL, OPG, OCN, and PCNA were performed. Shapiro-Wilk, ANOVA, post-hoc Tukey, Kruskal-Wallis, Student-Newman Keuls were performed. Results: The SRP+PRO group presented a reduction in inflammation. At 15 days, a lower BL was observed in the SRP+SS and SRP+PRO groups. Greater immunolabeling was noticed for PCNA at 15 days in the SRP+PRO group than in the SRP +SS group. The SRP+PRO group demonstrated a higher OCN immunolabeling pattern than the EP group at 15 and 30 days. Conclusion: The use of Lactobacillus reuteri as an adjuvant to SRP for the treatment of EP showed promising results in the control of local inflammatory responses, and enhanced the periodontal tissue repair process according to the employed concentration.

Effects of multiple sessions of antimicrobial photodynamic therapy (aPDT) in the treatment of periodontitis in patients with uncompensated type 2 diabetes: A randomized controlled clinical study.

BACKGROUND: The aim of this study was to compare, through clinical and microbiological analysis, the use of multiple applications of aPDT as an adjuvant therapy to non-surgical periodontal treatment of stage III and IV grade C periodontitis in type 2 diabetic (DM2) patients. METHODS: Thirty-four patients with non-compensated DM2 and periodontitis were randomly divided into two groups: SRP Group (n = 17): scaling and root planing (SRP); and SRP+aPDT Group (n = 17): SRP followed by 3 consecutive aPDT applications, immediately, 48 and 96 h after in pockets with probing depth (PD) ≥5 mm. In SRP+aPDT, after 1 min of irrigation with methylene blue (10 mg/ml), the sites were irradiated with a 660 nm diode laser for 50 s (157 J/cm2, 4.7 J, 100 mW). Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) were quantified by real-time qPCR. Periodontal clinical and microbiological data (baseline, 90 and 180 days) were statistically analyzed (α = 5%). RESULTS: There was a significant reduction in PD and bleeding on probing at 90 and 180 days post-treatment in both groups (p<0.05). The SRP+aPDT group presented a significant reduction in the number of residual pockets at 90 and 180 days (p<0.05). The SRP+aPDT group presented reduced PD means in deep pockets 180 days post-treatment (p<0.05). No differences were observed in P. gingivalis and P. intermedia levels (p>0.05). CONCLUSION: The results of present study indicate that the use of multiples aPDT sessions as adjuvant therapy in the periodontal treatment of uncompensated diabetic patients with periodontitis promotes additional clinical benefits.

Comparative effects of different phenothiazine photosensitizers on experimental periodontitis treatment.

AIM: The aim of the present study was to compare the effects of the phenothiazine photosensitizers methylene blue (MB), toluidine blue-O (TBO) and butyl toluidine blue (BuTB) in antimicrobial photodynamic therapy (aPDT), as adjuvant therapy to scaling and root planing (SRP) in the treatment of experimental periodontitis (EP) in rats. MATERIAL AND METHODS: 120 Wistar rats underwent ligation around the lower left molar. After seven days, the ligature was removed. The animals were separated into the following groups (n = 15): EP, no treatment; SRP, SRP and irrigation with saline solution; MB, SRP and deposition of MB; TBO, SRP and deposition of TBO; BuTB, SRP and deposition of BuTB; MB-aPDT, SRP and aPDT with MB; TBO-aPDT, SRP and aPDT with TBO and; BuTB-aPDT, SRP and aPDT with BuTB. The aPDT session was performed after SRP, with deposition of the photosensitizer and irradiation with a diode laser (DL; InGaAlP, 660 nm, 40 mW, 60 s, 2.4 J). Histological and histometric analysis was performed. RESULTS: BuTB-aPDT group had a lesser extent of the inflammatory process compared to the EP, SRP, MB and TBO at all experimental periods (p < 0.05). At 15 days, the aPDT treated groups had a greater bone tissue structure than groups EP and SRP (p < 0.05) The BuTB showed lower Alveolar Bone Loss (ABL) compared to the TBO-aPDT group at 30 days (p < 0.05). CONCLUSION: aPDT using the photosensitizer BuTB proved to be the adjuvant therapy that most favored the reduction of inflammatory infiltrate in the furcation area and ABL.

Lactobacillus reuteri associated with scaling and root planing in the treatment of periodontitis in rats submitted to chemotherapy.

OBJECTIVE: The aim of this study was to evaluate the effects of Lactobacillus reuteri applied locally or systemically with scaling and root planing (SRP) to the treatment of experimental periodontitis (EP) in rats treated with 5-fluorouracil. METHODS: A cotton ligature was installed on the molars of rats. The animals (n = 54) underwent chemotherapy and were divided into groups: SRP (n = 18), scaling and root planing only; LP (n = 18), SRP and 4 sessions of local probiotic (PRO); SP, SRP and 4 sessions of systemic PRO. The molar furcation area was submitted to histopathological, histometric of alveolar bone loss (ABL) and immunolabeling analysis after euthanasia at 7, 15 and 30 days. The data were submitted to statistical analysis (α = 5%). RESULTS: At 15 days ABL was higher in LP compared to SP. At 30 days, ABL was higher in LP compared to SRP and SP. Higher immunolabeling of TGF-ß1 was observed in LP and SP at 7 days compared to SRP (p < 0.05). Lower immunolabeling of OCN and higher immunolabeling of RANKL were observed at all periods in SRP compared to SP (p < 0.05). At 30 days, SRP showed lower immunolabeling of OPG compared to SP and LP (p < 0.05). In SP, lower immunolabeling was observed at 15 days compared at 30 days (p < 0.05). CONCLUSION: The ABL was similar among the groups treated with SRP associated or not to probiotic therapeutic, although the systemic use of Lactobacillus reuteri considerably reduced inflammation and favored periodontal tissues repair.

Effects of butyl toluidine blue photosensitizer on antimicrobial photodynamic therapy for experimental periodontitis treatment in rats.

AIM: This study evaluated three concentrations of butyl toluidine blue (BuTB) for antimicrobial photodynamic therapy (aPDT) in experimental periodontitis (EP) in rats. MATERIAL AND METHODS: EP was ligature-induced at the first mandibular molar in 105 rats. Ligature was removed after 7 days and animals were distributed into the following treatments: SRP, scaling and root planing (SRP) plus saline solution; BuTB-0.1, SRP plus BuTB at 0.1 mg/mL; aPDT-0.1, SRP plus BuTB at 0.1 mg/mL and InGaAlP diode laser (DL) irradiation; BuTB-0.5, SRP plus BuTB at 0.5 mg/mL; aPDT-0.5, SRP plus BuTB at 0.5 mg/mL and DL irradiation; BuTB-2.0, SRP plus BuTB at 2 mg/mL; aPDT-2.0, SRP plus BuTB at 2 mg/mL and DL irradiation. Five animals from each group were submitted to euthanasia at 7, 15 and 30 days post-treatment. The furcation area was submitted to histological, histometric and immunohistochemical (TGF-ß1, OCN and TRAP) analyses. RESULTS: aPDT-0.5 group presented a better tissue remodeling in all periods, resolution of the inflammatory response and bone neoformation areas at 30 days. aPDT-0.5 also resulted in higher immunolabeling patterns of TGF-ß1 at all periods (p < 0.05) and of OCN at 30 days (p < 0.05). CONCLUSION: aPDT-0.5 showed the best benefits for inflammatory response and periodontal repair process.

Antimicrobial photodynamic therapy (aPDT) with curcumin and LED, as an enhancement to scaling and root planing in the treatment of residual pockets in diabetic patients: A randomized and controlled split-mouth clinical trial.

INTRODUCTION: Residual pockets represent a risk factor for periodontal disease progression. Diabetes Mellitus (DM) may impair prognosis after cause-related therapy, mainly due to the chronic hyperglycemia that negatively influences tissue repair. This study evaluated the clinical efficacy of antimicrobial photodynamic therapy (aPDT) with curcumin (CUR) solution (100 mg/L) and LED irradiation (465-485 nm), as an adjunctive therapy to scaling and root planing (SRP), in the treatment of residual pockets in type 2 diabetic patients. METHODS: Individuals with type 2 DM and chronic periodontitis presenting at least one residual pocket per quadrant were selected (n = 25). In each patient, all residual pockets with probing depth (PD) ≥5 mm and bleeding on probing (BOP) were allocated to receive, according to quadrant: 1) SRP (SRP group); 2) SRP and irrigation with CUR solution (100 mg/L) (CUR group); 3) SRP and LED irradiation (InGaN, 465-485 nm, 0.78 cm², 78 mW, 100 mW/cm², 60 s) (LED group); 4) SRP, irrigation with CUR solution (100 mg/L), one minute of pre-irradiation, and LED irradiation (InGaN, 465-485 nm, 60 s) (aPDT group). Clinical parameters of PD, gingival recession (GR), clinical attachment level (CAL), BOP and visible plaque index (PI) were evaluated at baseline, three and six months post-therapies. Differences between the examination periods in each group were analyzed by Friedman's test for non-parametric data, while parametric data were submitted to analysis of variance (One-way ANOVA), followed by Tukey's test. Intergroup comparisons were performed by Kruskal-Wallis test. RESULTS: In an intergroup comparison, the mean values for PD, GR, CAL, BOP and PI were not different at baseline, three and six months (p > 0.05). The intragroup comparison evidenced reduction in PD and BOP in all treatment groups at three and six months (p < 0.05). Significant CAL gain was notable only for the aPDT and LED groups at three months in comparison to baseline data (p < 0.05). CONCLUSION: Treatment of residual pockets in patients with type 2 DM through association of SRP with aPDT (CUR solution 100 mg/L and LED irradiation) or LED irradiation may yield short-term (three months) clinical benefits regarding CAL gain.

Efeito do fotossensibilizador butyl azul de toluidina na terapia fotodinâmica antimicrobiana para o tratamento da periodontite experimental em ratos / Effects of butyl toluidine blue photosensitizer on antimicrobial photodynamic therapy for experimental periodontitis treatment in rats

O presente estudo avaliou pela primeira vez "in vivo" os efeitos de três concentrações do butyl azul de toluidina (BuTB) como agente fotossensibilizador na terapia fotodinâmica antimicrobiana (aPDT), como terapia coadjuvante a raspagem e alisamento radicular (RAR), para o tratamento de periodontite experimental (PE) em ratos. A PE foi induzida por meio da instalação de um fio de algodão ao redor do primeiro molar inferior esquerdo. Posteriormente os animais foram aleatoriamente distribuídos em 7 grupos com 15 animais cada, através de uma tabela gerada por computador, de acordo com os seguintes tratamentos: RAR (n=15) - RAR seguido de irrigação local de solução salina fisiológica; BuTB-0,1 (n=15) - RAR seguido de aplicação local de BuTB na concentração de 0,1 mg/mL; aPDT-0,1 (n=15) - RAR seguido da aplicação local de BuTB na concentração de 0,1 mg/mL e irradiação com laser de diodo (LD) de InGaAlP (660 nm, 40 mW, 60 s, 2,4 J); BuTB-0,5 (n=15) ­ RAR seguido de aplicação local de BuTB na concentração de 0,5 mg/mL; aPDT-0,5 (n=15) ­ RAR seguido da aplicação local de BuTB na concentração de 0,5 mg/mL e irradiação com LD; BuTB-2,0 (n=15) - RAR seguido de aplicação local de BuTB na concentração de 2 mg/mL; aPDT-2,0 (n=15) - RAR seguido da aplicação local de BuTB na concentração de 2 mg/mL e irradiação com LD. Decorridos 7, 15 e 30 dias pós-tratamento, 5 animais de cada grupo foram submetidos à eutanásia. A área de furca dos molares foi submetida às análises histológica, histométrica e dos padrões de imunomarcação para TGF-ß1, OCN e TRAP. Os dados foram submetidos à análise estatística (α = 5%). De acordo com a análise histométrica na região de furca, todos os grupos experimentais apresentaram menor perda óssea comparado ao grupo controle. Histologicamente, os espécimes do aPDT-0,5 apresentaram uma resposta inflamatória local mais branda e menos extensa, com melhor reestruturação tecidual em todos os períodos. Aos 30 dias observou-se resolução total da resposta inflamatória local, com presença de tecido conjuntivo denso. Alguns espécimes apresentavam trabéculas ósseas com contorno regular revestido com osteoblastos ativos, incluindo áreas de neoformação óssea. O tratamento com aPDT na concentração de 0,5 mg/mL resultou em padrões mais altos de imunomarcação de TGF-ß1 em todos os períodos e de OCN aos 30 dias. Diante dos resultados obtidos, todas as concentrações do novo fotossensibilizador BuTB trouxeram resultados adicionais ao tratamento da PE em relação a RAR. No entanto, a aPDT realizada com a concentração de 0,5 mg/mL resultou em benefícios adicionais na resposta inflamatória local e melhor reestruturação tecidual(AU)

The present study evaluated for the first time the effects of three concentrations of butyl toluidine blue (BuTB) as a photosensitizing agent on antimicrobial photodynamic therapy (aPDT), as adjuvant therapy to scaling and root planing (SRP), for the treatment of experimental periodontitis (EP) in rats. EP was induced by placing a cotton thread around the lower left first molar. Subsequently, the animals were randomly distributed into seven groups with 15 animals each, through a computer generated table, according to the following treatments: SRP (n = 15), SRP followed by local irrigation of physiological saline solution; BuTB-0.1 (n = 15), SRP followed by local application of 0.1 mg/mL BuTB; aPDT-0.1 (n = 15), SRP followed by local application of BuTB at 0.1 mg/mL concentration and irradiation with InGaAlP diode laser (DL) (660 nm, 40 mW, 60 s, 4 J); BuTB-0.5 (n = 15), SRP followed by local application of BuTB at 0.5 mg/mL concentration; aPDT-0.5 (n = 15), SRP followed by local application of BuTB at 0.5 mg/mL concentration and DL irradiation; BuTB-2.0 (n = 15), SRP followed by local application of BuTB at 2 mg/mL concentration; aPDT-2.0 (n = 15), SRP followed by local application of BuTB at 2 mg/mL concentration and DL irradiation. The animals (n=5) from each group were submitted to euthanasia at 7, 15 and 30 days post-treatment. The furcation area of the first lower molar was submitted to histological, histometric and immunohistochemical analyses to identify TGF-ß1, OCN and TRAP. The data were submitted to statistical analysis (α = 5%). According to the histometric analysis in the furcation region, all experimental groups presented lower bone loss compared to the control group. Histologically, the aPDT -0.5 specimens presented a milder and less extensive local inflammatory response, with better tissue remodeling in all periods. Total resolution of the local inflammatory response was observed at 30 days with presence of mature connective tissue. Some specimens presented bone trabeculae with a regular contour and active osteoblasts, including areas of bone neoformation. Treatment with aPDT-0.5 also resulted in higher immunolabelling patterns of TGFß1 at all periods and of OCN at 30 days. All concentrations of the new photosensitizer BuTB resulted in significant improvement for EP treatment in relation to SRP. However, aPDT combined with BuTB at 0.5 mg / mL showed the best benefits for inflammatory response and periodontal repair process(AU)

aPDT como coadjuvante no tratamento da periodontite agressiva localizada / aPDT as an adjuvant in the treatment of localized aggressive periodontitis ­ report of two cases

A terapia fotodinâmica antimicrobiana (aPDT) tem demonstrado, em alguns estudos clínicos, ser efetiva como terapia coadjuvante à raspagem e alisamento radicular (RAR) na periodontite agressiva. Além dos efeitos antimicrobianos da aPDT, a irradiação com laser de baixa intensidade pode modular a resposta dos tecidos periodontais. O objetivo deste trabalho foi relatar o uso da aPDT como coadjuvante à RAR no tratamento de periodontite agressiva localizada. Duas pacientes do sexo feminino, com 31 e 23 anos de idade, sem envolvimento sistêmico, procuraram atendimento odontológico relatando desconforto ao mastigar. Clinicamente, observou-se presença de tecido gengival edemaciado e sinais de inflamação discretos. A média de sítios com profundidade a sondagem (PS) maior do que 4 mm foi de 15,43% e 4,93%, respectivamente. As duas pacientes foram submetidas à sessão única de RAR usando ultrassom e curetas manuais, seguida da aplicação da aPDT em todas as bolsas com PS  4 mm. O protocolo da aPDT seguiu os seguintes parâmetros: azul de metileno (10 mg/ml) seguido de irradiação com laser de baixa potência após um minuto da aplicação (AsGaAl, 660 nm, 100 mW, 48 segundos, 157 J/cm2). Na reavaliação, foi verificada diminuição média da PS de 1,16 mm (caso 1) e 1,13 mm (caso 2) nas bolsas tratadas com aPDT, com redução do número de sítios com sangramento em ambos os casos. De acordo com os resultados clínicos observados, sugere-se que a aPDT apresenta-se como uma terapia coadjuvante promissora no tratamento da periodontite agressiva localizada.

Antimicrobial photodynamic therapy (aPDT) has been shown, in some clinical studies, to be effective as an adjunct therapy to scaling and root planing (SRP) in aggressive periodontitis. In addition to the antimicrobial effects of aPDT, low intensity laser irradiation can modulate the response of periodontal tissues. The objective of this work is to report the use of aPDT as an adjuvant to SRP in the treatment of localized aggressive periodontitis. Two female patients, 31 and 23 years of age, without systemic involvement, sought dental care, reporting discomfort when chewing. Clinically, the presence of gingival swollen tissue and discrete signs of infl ammation were observed. The mean number of sites with probing depth (PD) greater than 4 mm was 15.43% and 4.93%, respectively. The two patients received a single SRP session using ultrasound and manual curettes, followed by the application of aPDT in all pockets with PS  4 mm. The aPDT protocol followed the parameters: methylene blue (10 mg/ml) followed by low-power laser irradiation after 1 minute of application (AsGaAl, 660 nm, 100 mW, 48 seconds, 157 J/cm2). The mean PD decrease of 1.16 mm (case 1) and 1.13 mm (case 2) in the pockets treated with aPDT were observed, with a reduction in the number of sites with bleeding in both cases. According to the clinical results observed, it is suggested that aPDT is a promising adjuvant therapy for the treatment of localized aggressive periodontitis.

Comparison of repeated applications of aPDT with amoxicillin and metronidazole in the treatment of chronic periodontitis: A short-term study.

AIM: The aim of this study was to compare the clinical effects of Metronidazole (MTZ) combined with Amoxicillin (AMX) and repeated applications of antimicrobial photodynamic therapy (aPDT) as an adjuvant for the treatment of chronic periodontitis. METHODS: A double-blind controlled and randomized clinical trial was conducted in 34 patients. All of the patients were treated with scaling and root planing (SRP) and separated into 2 groups: the MTZ+AMX Group (n=17), who received SRP and the systemic use of MTZ (400mg 3×per day for 7days) and AMX (500mg 3×per day for 7days), and the aPDT Group (n=17), who received SRP and three aPDT applications at all sites with a probing depth≥5mm immediately, at 48 and 96h after scaling and placebo pills over the span of 7days. Clinical examinations were performed at baseline and 90days post-therapy. The clinical parameters of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured. The aPDT was conducted using methylene blue and a low-level laser (GaAlAs 660nm, 100mW, 48s, and 160J/cm2) in all sites with a probing depth≥5mm. A statistical analysis was also performed (α=5%). RESULTS: There was a significant improvement in CAL only in the intermediate pocket in the aPDT group compared to the MTZ+AMX group between baseline and 90days post-treatment (p=0.01). There was a reduction of both BOP and the percentage of residual pockets at 90days after treatment compared with baseline in both groups (p<0.05). CONCLUSION: Both proposed adjuvant therapies associated with conventional mechanical treatment in patients with chronic periodontitis were equally effective in terms of the gain of clinical insertion, control of inflammation and elimination of residual pockets.

Curcumin photodynamic effect in the treatment of the induced periodontitis in rats.

This study assessed the effect of curcumin as a photosensitizer in antimicrobial photodynamic therapy (aPDT) for the treatment of induced periodontitis in rats. Periodontitis was induced via a ligature around the mandibular first molar on the left side of 96 rats. The ligature was removed 7 days later, and the animals were randomized into four groups: NT, no local treatment; CUR, irrigation with curcumin solution (40 µM); LED, irradiation with a light-emitting diode (LED, InGaN, 465-485 nm, 200 mW/cm2, 60 s); and aPDT, irrigation with curcumin solution (40 µM) followed by irradiation with LED. Eight animals from each group were euthanized at 7, 15, and 30 days post-treatment. Treatments were assessed using alveolar bone loss (ABL) in the furcation region using histological, histometric, and immunohistochemical analyses. Rats treated with aPDT exhibited less ABL at 7 days compared to the NT group, moderate pattern immunolabeling for osteoprotegerin at 30 days, and a pattern of immunolabeling for RANKL from moderate to low. Treatments resulted in smaller numbers of TRAP-positive cells compared to the NT group. aPDT as monotherapy using curcumin as a photosensitizer and LED as the light source was effective in the treatment of induced periodontitis in rats.

Periodontal status of candidates for allogeneic hematopoietic stem cell transplantation.

PURPOSE: The aim of this study was to describe the periodontal profile of -candidates for allogeneic hematopoietic stem cell transplantation. METHODS: This cross-sectional prospective study was performed from March 2014 to March 2015. After an initial interview, eligible individuals were evaluated by the following clinical parameters: visible plaque, bleeding on probing, probing depth, and clinical attachment level at six sites per tooth, excluding third molars. RESULTS: Thirty-six candidates for allogeneic hematopoietic stem cell transplantation (HSCT) were clinically assessed. Eight (22%) patients were diagnosed with gingivitis and 21 (58%) of them with periodontitis. The gingival bleeding was statistically correlated with the percentage of sites with visible plaque (p < 0.0001; r = 0.630) and did not correlate with the number of platelets (p = 0.643, r = -0.082). CONCLUSIONS: The candidates for allogeneic HSCT studied showed a high prevalence of periodontal diseases with unmonitored local infection before transplantation.

Consequências da doença de Parkinson na saúde periodontal / Consequences of Parkinson's disease in periodontal health ­ a literature review

A doença de Parkinson é uma desordem neurológica, crônica e progressiva que atinge o sistema nervoso central. Nela, ocorre a degeneração dos neurônios que sintetizam a dopamina, neurotransmissor presente na substância negra do cérebro e que é responsável por transmitir estímulos para a realização de movimentos voluntários automáticos. Os sintomas da doença de Parkinson, como o tremor e a rigidez muscular, têm sido associados ao aumento da incidência de problemas bucais, como doença periodontal, perdas dentais, dor orofacial e cárie. Essa revisão da literatura teve por objetivo apresentar e discutir as evidências científicas disponíveis sobre a prevalência e severidade da doença periodontal em pacientes portadores da doença de Parkinson. Alguns estudos voltados a este assunto mostram diferenças significativas em relação ao aumento de problemas bucais entre portadores da doença de Parkinson e indivíduos saudáveis. Diante da análise da literatura, pôde-se verificar que a incidência e severidade da doença periodontal aumentam conforme a doença de Parkinson progride, e a prevalência de complicações bucais também está relacionada à evolução da doença neurológica em questão, diretamente relacionada ao comprometimento da realização adequada das manobras de higienização bucal.

Parkinson's disease is a chronic progressive neurological disorder, which affects the central nervous system. It is a degeneration of neurons that synthesize dopamine, the neurotransmitter at the substantia nigra of the brain responsible for transmitting stimuli for performing automatic volunteers movements. The symptoms of Parkinson's disease such as tremors and stiffness, have been linked to increased incidence of oral problems such as periodontal disease, dental orofacial pain loss, caries disease. This literature review aims to present and discuss the scientific evidence available about the prevalence and severity of periodontal disease in patients with Parkinson's disease. Some studies focused on this subject show significant differences in relation to the increase of oral problems among people with Parkinson's disease and healthy individuals. On the analysis of the literature, one can verify that the symptoms of Parkinson's appear to increase the incidence and severity of periodontal disease, and the prevalence of oral complications are related to evolution of neurological disease in question, directly related to the commitment of carrying out appropriate oral hygiene.

Access to oral care before hematopoietic stem cell transplantation: understand to improve.

PURPOSE: Although the relevance of dental intervention before transplant is recognized, many patients are undergoing transplantation without receiving dental care. The objective of this study was to identify the searching profile, access, and use of dental services by candidates to hematopoietic stem cell transplantation (HSCT), and the difficulties faced by those candidates. METHODS: All candidates for an allogeneic HSCT from a bone marrow transplant unit were invited to take part in this research from March 2014 to March 2015. A questionnaire was developed consisting of five sections with questions about personal information, hematologic disease, access to dental services, and history of dental treatment, patient's preferences, and knowledge. RESULTS: One hundred and ten candidates for allogeneic HSCT participated in this study. Fifty-five participants received professional oral care in the previous year of interview. The majority of patients (64 %) went to a dentist not linked to transplant staff, and private dental service was the most visited (42 %). To visit a dentist during the previous year was statistically associated with the habit of going to a dentist outside the hospital (p < 0.001), which was statistically associated with the family income (p = 0.001). The main barriers to access to dental treatment were lack of guidance (66 %), apprehension (45 %), and lack of confidence (29 %) in an "external" dentist. CONCLUSIONS: Most of the barriers seem to be associated to lack of confidence and information among patients and professionals, as well as a lack of parameters for scheduling or referrals to dental care, especially for those with a low-socioeconomic background.