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1.
J Cosmet Dermatol ; 2020 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-32654409

RESUMO

BACKGROUND: Deoxycholic acid (DCA) was developed by the pharmaceutical industry for aesthetical use in submental fat reduction. It represents the first lipolytic substance approved by the Food and Drug Administration (FDA) for fat reduction in that area. AIMS: This study presents an update of properties and the use of DCA, as well as adverse events and possible complications. METHODS: A search in MEDLINE/PubMed, Cochrane, and Bireme/LILACS databases was performed using the terms: "deoxycholic acid" OR "ATX-101" AND "injection" NOT "amphotericin" NOT "biliary" NOT "bile." Experimental studies developed in animals, clinical trials, literature reviews, case reports, and letters to the editor that included the DCA mechanism of action, dose, manner of use, adverse effects, and complications were selected. RESULTS: The most frequent adverse events are edema, local pain, bruise, and numbness, which usually spontaneously regress. However, complications, including, skin necrosis, nerve injury, alopecia, and vascular events, can occur, demanding complex management without specific protocols. CONCLUSION: Although DCA is beneficial for lysis of adipose tissue, clinicians should be aware about the adverse effects and risks involved with the use of this substance. The knowledge of local anatomy, properties, and adverse effects are fundamental to treatment with DCA.

2.
J Photochem Photobiol B ; 209: 111933, 2020 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-32570059

RESUMO

Xerostomia and hyposalivation are frequent conditions in patients undergoing head and neck radiotherapy, which usually lead to a worsening of quality of life. This study aimed to assess whether photobiomodulation (PBM) can minimize hyposalivation, xerostomia and qualitative changes on saliva and improve quality of life in patients undergoing radiotherapy in short-term follow-up. Twenty-one patients were randomly divided into two groups: sham group (SG) and laser group (LG). A diode laser was used for intra- (660 nm, 10 J/cm2, 0.28 J per point, 40 mW) and extra-oral (810 nm, 25 J/cm2, 0.7 J per point, 40 mW) applications over the salivary glands, three times a week, during the entire radiotherapy period. In SG, the tip of the instrument was sealed with blue rubber to prevent the passage of light. Xerostomia and pH were evaluated and unstimulated and stimulated salivary flow was determined before the start of radiotherapy (T1), after the 15th session (T2), after the end of radiotherapy (T3) and 60 days after radiotherapy (T4). Concentrations of calcium, total proteins, chloride, sodium, potassium and amylase and catalase activities were evaluated in stimulated saliva samples. Quality of life was assessed at times T1 and T4. Generalized estimating equations were used to assess differences in the outcome between times and groups. All patients showed worsening in unstimulated (p = .003) and stimulated (p < .001) salivary flow, xerostomia (p < .05) and quality of life during radiotherapy (p = .001). An increase in chloride concentrations was observed at times T3 and T4 (p < 0,05), and a reduction in amylase activity at T3 (p < .05). Unstimulated saliva pH was higher in LG than SG at T3 (p = .037). No difference between groups was noted in relation to salivary flow and composition, xerostomia or quality of life. Our results suggest that PBM may help in preserving salivary pH during radiotherapy.

3.
Oral Dis ; 2020 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-32400905

RESUMO

PURPOSE: The aim of this study was to evaluate the clinical, histological, hematological, and oxidative stress effects of cannabidiol (CBD) in mice with induced oral mucositis. METHODS: We used 90 mice of the CF-1 strain in which oral mucositis was induced using a protocol with 5-fluorouracil (5-FU) chemotherapy. The animals were divided randomly into 10 study groups. Three groups were treated with different doses of CBD (3, 10, and 30 mg/kg), while 2 were control groups (positive control: 5-FU + mechanical trauma + placebo; and negative control: mechanical trauma + placebo), and 2 experimental times were studied (4 and 7 days). All treatments were by intraperitoneal administration. RESULTS: In the clinical evaluation, the groups treated with CBD showed less severity of oral lesions compared with the positive control at both experimental times. The intensity of the inflammatory response was also lower in the groups treated with this drug, but there was no statistically significant difference when compared with the positive control. With regard to erythrocyte, leukocyte, and platelet counts and anti-oxidant enzyme activity, the groups treated with CBD showed better results, but only some of these variables showed statistically significant differences. CONCLUSIONS: CBD seems to exert an anti-inflammatory and anti-oxidant activity favoring a faster resolution of oral mucositis in this animal model.

4.
Altern Ther Health Med ; 26(S1): 12-16, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31634872

RESUMO

The high frequency and painful profile of inflammatory oral lesions and the lack of an effective drug protocol for their management stimulate the search for pharmacological alternatives for the treatment of these conditions. Cannabidiol is the major non-psychotropic constituent of Cannabis sativa, receiving lately scientific interest because of its potential in the treatment of inflammatory disorders such as asthma, colitis and arthritis. There is little published in the current literature about the use of cannabidiol in oral health. Among its many protective functions, the ability to attenuate inflammation through the modulation of cytokines and its antiedema and analgesic effects may be important features in the treatment of oral lesions. In this review, we suggest that cannabidiol can be useful in the management of oral inflammatory disorders.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Canabidiol/uso terapêutico , Cannabis/química , Inflamação/tratamento farmacológico , Doenças da Boca/tratamento farmacológico , Citocinas , Humanos , Dor
5.
Med. oral patol. oral cir. bucal (Internet) ; 24(5): e577-e582, sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-185673

RESUMO

Background: The aim of this retrospective, cross-sectional and observational study was to perform a survey of the stomatological conditions of elderly patients seen in a period of 40 years at a Stomatology Service in Southern Brazil. Material and Methods: A total of 24,347 medical records were reviewed, of which 5,063 belonged to elderly pa-tients aged 60 to 97 years. The stomatological conditions, systemic conditions, and smoking and alcohol drinking habits as well were recorded. Results: The mean age of the patients was 69.29 years, 67.1% were female and 32.9% were male. Variations of normality accounted for 44.5% of the cases. The most prevalent disorders were fungal infections (26.1%), reac-tive inflammatory lesions (24.6%), burning mouth syndrome (14.9%), benign neoplasms (12.4%), autoimmune disorders (12.3%), premalignant lesions (10.2%) and malignant epithelial neoplasms (7.2%). Regarding biopsied lesions, squamous cell carcinoma was the most prevalent at 30.2%, followed by hyperplasic lesions (28.2%). Conclusions: Knowledge of these physiological and pathological conditions in the oral cavity of the older people is essential for early diagnosis and preventive and therapeutic measures when necessary


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Bucais , Medicina Bucal , Brasil , Estudos Transversais , Estudos Retrospectivos
6.
J Clin Pharm Ther ; 44(6): 838-843, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31400293

RESUMO

WHAT IS KNOWN AND OBJECTIVES: In addition to its antimicrobial effect, doxycycline has potent anti-inflammatory activity. In view of these pharmacological characteristics, its use in the management of inflammatory, autoimmune and granulomatous diseases has been proposed. The objective of this study was to investigate, through a systematic literature review, the effect of doxycycline on pain and healing of ulcerated lesions of the mouth. METHODS: An electronic search was performed in accordance with PRISMA guidelines in PubMed, Cochrane Central Register, Web of Science, Bireme/LILACS and Scopus databases. Controlled, randomized clinical trials were selected. The concentration of doxycycline, frequency of application, pain relief and clinical remission of the lesions were analysed. RESULTS AND DISCUSSION: According to the inclusion criteria, five articles were selected. In four of these studies, doxycycline was used in the treatment of aphthous stomatitis, and in one study, it was used in the treatment of herpes labialis. In all studies, the drug was used topically, both as a hydrogel and as a crushed tablet (along with a prosthetic adhesive). The groups treated with doxycycline showed faster healing of lesions and lower pain scores compared to placebo. WHAT IS NEW AND CONCLUSION: The present study suggests that topical doxycycline has a positive effect on the treatment of recurrent aphthous ulceration and herpes labialis. Experimental animal studies and double-blind randomized clinical trials should be performed on other oral lesions, such as traumatic ulcers and mucositis.


Assuntos
Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/uso terapêutico , Doxiciclina/farmacologia , Doxiciclina/uso terapêutico , Doenças da Boca/tratamento farmacológico , Animais , Humanos , Dor/tratamento farmacológico , Medição da Dor/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
RFO UPF ; 24;(2): 176-182, maio/ago. 2 2019.
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1049317

RESUMO

Objetivo: realizar um levantamento epidemiológico das doenças de glândulas salivares por meio de análise de prontuários registrados em um serviço de Estomatologia do sul do Brasil. Métodos: a amostra foi composta por aproximadamente 24.000 prontuários de pacientes do Serviço de Estomatologia do Hospital São Lucas, atendidos no período de 1977 a 2017. Foram selecionados os prontuários que apresentassem as seguintes enfermidades de glândulas salivares: mucocele, rânula, sialolitíase, sialoadenite infecciosa, síndrome de Sjögren, sialometaplasia necrosante e neoplasias benignas ou malignas. Os dados coletados foram analisados por meio de estatística descritiva e inferencial, utilizando o teste Qui-Quadrado. Resultados: das 817 enfermidades encontradas, 56,2% eram mucoceles, 11,1% sialoadenites infecciosas, 10,3% rânulas, 10,1% sialolitíases, 5,5% neoplasias benignas, 4,3% síndrome de Sjögren, 2,1% neoplasias malignas e 0,4% sialometaplasias necrosantes. O mucocele apresentou predileção pelo sexo masculino, enquanto a rânula e a síndrome de Sjögren foram mais associadas ao sexo feminino. As demais enfermidades não apresentaram predileção por sexo. A localização das lesões, as características clínicas e a idade dos pacientes acometidos foram também avaliadas. Conclusão: as doenças das glândulas salivares merecem destaque entre as enfermidades do sistema estomatognático devido à complexa anatomia dessas estruturas, à importância da saliva na homeostase bucal e ao comportamento clínico indolente das neoplasias malignas que acometem essas glândulas.


Objective: to perform an epidemiological survey of salivary gland diseases by analyzing medical records from a Stomatology Service in southern Brazil. Methods: the sample consisted of approximately 24,000 medical records of patients assisted at the Stomatology Service of the São Lucas Hospital between 1977 and 2017. The following salivary gland disorders were selected: mucocele, ranula, sialolithiasis, infectious sialadenitis, Sjögren's syndrome, necrotizing sialometaplasia, and benign or malignant neoplasms. The data collected were analyzed by descriptive and inferential statistics using the chi-squared test. Results: from the 817 disorders found, 56.2% were mucocele, 11.1% sialadenitis, 10.3% ranula, 10.1% sialolithiasis, 5.5% benign neoplasms, 4.3% Sjögren's syndrome, 2.1% malignant neoplasms, and 0.4% necrotizing sialometaplasia. Mucocele was more prevalent in men, while ranula and Sjögren's syndrome were more associated with women. The other diseases did not present gender preference. The location of the lesions, clinical characteristics, and age of the patients affected were also assessed. Conclusion: salivary gland diseases deserve special attention among stomatognathic system disorders due to the complex anatomy of such structures, the importance of saliva in the oral homeostasis, and the indolent clinical behavior of the malignant neoplasms affecting these glands.

8.
Spec Care Dentist ; 39(1): 65-71, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30417483

RESUMO

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.


Assuntos
Síndrome de Gardner/diagnóstico , Neoplasias Mandibulares/diagnóstico por imagem , Osteoma/diagnóstico por imagem , Adolescente , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias Mandibulares/patologia , Neoplasias Mandibulares/cirurgia , Osteoma/patologia , Osteoma/cirurgia , Radiografia Panorâmica
9.
Stomatologija ; 21(2): 35-41, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32108654

RESUMO

PURPOSE: The aim of this paper was to review the current literature with regard to the use of chlorhexidine and povidone-iodine in the treatment of oral wounds. BACKGROUND: Oral mucosa is continuously subjected to physical or chemical injuries, where it becomes a common site for the occurrence of ulcerated lesions. These lesions are susceptible to infections that may delay healing. MATERIALS AND METHODS: A search of the medical and dental literature was conducted in Medline/Pubmed and Scielo using a combination of the terms oral ulcer, oral wound, wound healing, povidone-iodine and chlorhexidine, to review their mechanism of action and their use in the healing of oral wounds. RESULTS AND CONCLUSION: The use of chlorhexidine and povidone-iodine is effective in the control of local infection in a concentration-dependent manner, exerting a positive influence on the tissue repair process. Oral antiseptics appear be a good alternative in the management of these lesions, since there is a low risk of systemic toxicity and allergies, and less clinical evidence of bacterial resistance.


Assuntos
Anti-Infecciosos Locais , Povidona-Iodo , Antibacterianos , Clorexidina , Humanos , Cicatrização
10.
Phytother Res ; 32(11): 2275-2281, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30088305

RESUMO

The effects of cannabidiol (CBD), the main non-psychotropic component of Cannabis sativa, were assessed on oral wound healing in an in vivo model. Standardized ulcers were induced in 60 Wistar rats using a 5-mm biopsy punch on the midline of the ventral tongue. Animals received intraperitoneal injections of CBD at doses of 0 (control), 5, and 10 mg/kg daily. Animals were weighed daily, and wound healing was clinically and histologically evaluated after 3 and 7 days of treatment. CBD treatment did not influence the wound area of ulcerative lesions at either observation time. Conversely, microscopic findings revealed that at Day 3 postwounding, CBD-treated lesions exhibited significantly lower inflammatory scores than those in the control group. However, this difference was not observed at Day 7. Collectively, these findings indicate that CBD exert an antiinflammatory effect in early phase of wound healing process although it was not sufficient promote clinical improvement of oral traumatic ulcerative lesions.


Assuntos
Canabidiol/farmacologia , Cannabis/química , Úlceras Orais/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Animais , Injeções Intraperitoneais , Masculino , Ratos , Ratos Wistar
11.
Gerodontology ; 35(4): 305-316, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29956369

RESUMO

OBJECTIVE: To perform a literature review addressing the therapeutic strategies for salivary hypofunction. BACKGROUND: Qualitative and quantitative salivary dysfunctions predispose to changes in the oral mucosa and teeth, cause impairment to oral functions and negative impact on quality of life. MATERIALS AND METHODS: A MEDLINE/PubMed search was conducted using the terms "Xerostomia" AND, "Saliva Artificial" OR, "Citric Acid," "Malic Acid," "Chewing Gum," "Acupuncture" OR, "Pilocarpine" OR, "Bethanechol" OR, "Cevimeline" OR, "Hyperbaric Oxygen Therapy" OR, "Stem Cell Therapy" OR "Genetic Therapy" and their Mesh Terms. RESULTS: We selected 25 clinical trials investigating the effects of salivary substitutes, chewing gum, malic and citric acids, pilocarpine, cevimeline, bethanechol, acupuncture, hyperbaric oxygen therapy and regenerative therapies on salivary hypofunction. In most studies, the number of participants was low and the follow-up times short. The therapeutic modalities were classified according to the level of evidence on salivary dysfunction. CONCLUSIONS: Pilocarpine and cevimeline had the strongest evidence of beneficial effect on salivary hypofunction. Citric and malic acids increase salivary flow but also increase the risk of erosion and dental caries. There are no controlled clinical trials supporting the efficacy of acupuncture, stem cell therapy and gene therapy on salivary dysfunction, although clinical observations suggest a promising effect. There is no evidence supporting salivary substitutes, chewing gum, bethanechol or hyperbaric oxygen on the treatment of salivary hypofunction.


Assuntos
Agonistas Muscarínicos/uso terapêutico , Pilocarpina/uso terapêutico , Quinuclidinas/uso terapêutico , Tiofenos/uso terapêutico , Xerostomia/terapia , Terapia por Acupuntura , Betanecol/uso terapêutico , Goma de Mascar , Humanos , Oxigenação Hiperbárica , Xerostomia/tratamento farmacológico
12.
Oral Dis ; 24(7): 1367-1378, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29782688

RESUMO

OBJECTIVE: The study aimed to investigate the pattern of oral yeast colonization of Sjögren's syndrome patients and its correlation to salivary flow rates, age, and time of the disease progression. MATERIALS AND METHODS: Saliva and swab specimens were obtained from 45 patients (primary Sjögren's syndrome = 15/ secondary Sjögren's syndrome = 15/ healthy controls = 15). Yeast species were identified using culture method through chromogenic medium followed by polymerase chain reaction and Sanger sequencing. RESULTS: Eleven species from six different genera were detected. The most prevalent species found was Candida albicans followed by Candida tropicalis, Candida glabrata, Candida parapsilosis, and Candida krusei. Both groups of Sjögren's syndrome showed higher counts of C. albicans (Total and CFU counts) when compared to control group. In contrast, a greater variety of yeast species was identified on samples of the control group. CONCLUSIONS: This study showed that C. albicans is the most prevalent yeast, but also that a variety of other yeast species can colonize the oral cavity of Sjogren's syndrome patients. The identification of most of the colonies was not obtained by culturing-PCR methods combined.


Assuntos
Candida/isolamento & purificação , Saliva/microbiologia , Síndrome de Sjogren/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Contagem de Colônia Microbiana , Feminino , Humanos , Pessoa de Meia-Idade
13.
Spec Care Dentist ; 38(3): 163-171, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29603323

RESUMO

Brown tumor of the jaws is a manifestation of hyperparathyroidism consisting of osteolytic lesions that show proliferation of multinucleated giant cells in the maxilla and/or mandible. Differential diagnosis of these lesions from local central giant-cell granuloma is mandatory for the correct treatment of the patient. Radiographic and histopathological exams of the jaw lesion are not sufficient to determine the diagnosis, which requires laboratory tests including serum levels of calcium, alkaline phosphatase, parathyroid hormone (PTH) and phosphate, and radiographic examination of other bones as well, such as hand-wrist, pelvis, and femur. We present here a brief literature review focusing on the clinical and radiographic features, diagnostic criteria and treatment of brown tumor and also report a case of the disease affecting the jaw.


Assuntos
Hiperparatireoidismo/diagnóstico , Doenças Mandibulares/diagnóstico , Osteíte Fibrosa Cística/diagnóstico , Corticosteroides/uso terapêutico , Adulto , Biópsia , Diagnóstico Diferencial , Humanos , Imageamento Tridimensional , Transplante de Rim , Masculino , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/patologia , Osteíte Fibrosa Cística/tratamento farmacológico , Osteíte Fibrosa Cística/patologia , Tomografia Computadorizada por Raios X
14.
Arch Oral Biol ; 89: 70-76, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29477025

RESUMO

OBJECTIVE: Nystatin and chlorhexidine are extensively used in oral medicine; however, there is some controversy about the possibility of these drugs showing antagonism. To clarify this issue, this study investigated the efficacy and stability of nystatin and chlorhexidine in combination. DESIGN: An in vitro study was conducted to analyze the effect of nystatin and chlorhexidine combined on Candida albicans ATCC 18804, using the drugs mixed as a single formulation and as independent formulations used sequentially with different time intervals between them. The minimum inhibitory concentration (MIC) and effects on C. albicans suspensions and biofilms were evaluated. Also, the stability of nystatin and chlorhexidine in a mixture was tested by high performance liquid chromatography (HPLC). RESULTS: When nystatin and chlorhexidine were mixed in a single formulation, there was no significant difference in MIC compared to that of the drugs used alone (as the only treatment). However, when these drugs were used as independent formulations, sequentially with time intervals in between, their MICs were higher than the respective MIC of the drug used alone, except for the MIC of chlorhexidine with a 10-min interval. Nystatin/chlorhexidine combinations showed lower activity against C. albicans biofilms, except for that with a 30-min interval. The drugs when combined showed high percentages of degradation at all the times evaluated. CONCLUSIONS: The combination of nystatin and chlorhexidine seems to interfere with the efficacy of the drugs and to increase their rate of degradation.


Assuntos
Antifúngicos/farmacologia , Biofilmes/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Clorexidina/farmacologia , Nistatina/farmacologia , Antifúngicos/química , Biofilmes/crescimento & desenvolvimento , Candida albicans/crescimento & desenvolvimento , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Clorexidina/química , Combinação de Medicamentos , Estabilidade de Medicamentos , Sinergismo Farmacológico , Testes de Sensibilidade Microbiana , Nistatina/administração & dosagem , Nistatina/química , Medicina Bucal , Suspensões
15.
Arch Oral Biol ; 87: 218-225, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29316457

RESUMO

OBJECTIVE: This study investigated the effect of topical application of 0.12% chlorhexidine, 10% povidone-iodine and 50% erythromycin on the optimization of healing process of traumatic ulcers made on ventral tongue of rats. DESIGN: Forty-Eight Wistar rats were randomly divided into four groups: control, chlorhexidine (Chx), povidone-iodine (PvI) and erythromycin (Er). An ulcer of 5 mm in diameter was made on the ventral tongue of the animals. After 24 h, a microbiological sample was taken and daily application of the substances started. Six animals each group were euthanized at 4 days and the others at 8 days postoperative, totaling three and seven days of treatment. Prior to euthanasia, a new microbiological collection was performed. RESULTS: The experimental groups showed less area of residual ulcer. A significant difference was seen between the PvI and Chx in relation to the control after three days of treatment (p < 0.05). Although the experimental groups displayed greater newly formed epithelial area, there was no significant difference compared to the control (p > 0.05). Er exhibed the lowest inflammation scores after seven days of treatment (p < 0.05). PvI showed reduction of microorganisms at both times and under aerobic (p < 0.01 at 3 days and p < 0.001 at 7 days) and microaerophilic (p < 0.05) conditions. Er significantly reduced the count of microorganisms in aerobic condition when compared to control group (p < 0.05 at 3 days and p < 0.01 at 7 days). CONCLUSIONS: All drugs promoted reduction of the microorganisms at the site of the injury, which may have a direct effect on the tissue repair process.


Assuntos
Antibacterianos/farmacologia , Anti-Infecciosos Locais/farmacologia , Clorexidina/farmacologia , Eritromicina/farmacologia , Úlceras Orais/tratamento farmacológico , Úlceras Orais/microbiologia , Povidona-Iodo/farmacologia , Língua , Cicatrização/efeitos dos fármacos , Administração Tópica , Animais , Antibacterianos/administração & dosagem , Anti-Infecciosos Locais/administração & dosagem , Clorexidina/administração & dosagem , Eritromicina/administração & dosagem , Povidona-Iodo/administração & dosagem , Distribuição Aleatória , Ratos , Ratos Wistar
16.
Gerodontology ; 34(3): 291-298, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28556195

RESUMO

OBJECTIVES: The aim of this work was to review the scientific literature on the properties, indications and pitfalls related to nystatin and chlorhexidine in oral medicine and also to compare these to other topical antifungal agents, considering the elderly population. BACKGROUND: Nystatin is a polyene antifungal widely used as a topical formulation to treat candidiasis, whereas chlorhexidine is a wide-spectrum antimicrobial, especially used against bacteria, but also effective in treating some fungal infections including those caused by Candida spp. These compounds have been prescribed for immunocompromised patients, hospitalized or not, some of them undergoing head and neck radiation therapy and/or chemotherapy, including elderly patients. MATERIALS AND METHODS: Dental and medical literature concerning the use of nystatin and chlorhexidine in oral medicine were selected and reviewed. RESULTS: Nystatin and chlorhexidine are gold-standard antimicrobial mouthrinses respectively for Candida spp. and bacteria. Although recognized as effective in cotrolling oral infections, both nystatin and chlorhexidine are just complementary to systemic therapy in cases of systemic infections already established. The prescriber should also take into account that some commercial nystatin and chlorhexidine formulations contain compounds such as sugar and ethanol, which can be associated with side effects. Meanwhile, alternative formulations in which these compounds are absent are available and should be considered. CONCLUSIONS: Further studies investigating new drugs and interactions of drug combinations are necessary to improve the therapeutic management of oral infections.


Assuntos
Anti-Infecciosos/uso terapêutico , Antifúngicos/uso terapêutico , Clorexidina/uso terapêutico , Nistatina/uso terapêutico , Idoso , Candidíase Bucal/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Doenças Periodontais/tratamento farmacológico
17.
Int J Dent ; 2017: 5269856, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28408928

RESUMO

Objective. The aim of this study was to evaluate stress, anxiety, and salivary alpha-amylase (SAA) activity in patients with recurrent aphthous stomatitis (RAS). The impact of this disease on the life quality was also evaluated. Design. Twenty-two patients with RAS and controls, matched by sex and age, were selected. Stress and anxiety were assessed using Lipp's Inventory of Stress Symptoms and Beck Anxiety Inventory. Life quality was assessed through the World Health Organization Quality of Life-bref (WHOQOL-BREF) and the Oral Health Impact Profile-14 (OHIP-14). Saliva samples were collected in the morning and afternoon and the SAA activity was analyzed by enzymatic kinetic method. Results. No significant difference was observed between the groups regarding the SAA activity (p = 0.306). Patients with RAS had higher scores of anxiety (p = 0.016). The scores of WHOQOL-BREF were significantly lower in patients with RAS. The values obtained through OHIP-14 were significantly higher in these patients (p = 0.002). Conclusion. RAS negatively affects the life quality. Patients with the disease have higher levels of anxiety, suggesting its association with the etiopathogenesis of RAS.

18.
Diagn Pathol ; 12(1): 32, 2017 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-28381274

RESUMO

BACKGROUND: Oral squamous cell carcinoma (OSCC) accounts over 90% of malignant neoplasms of the oral cavity. This pathological entity is associated to a high mortality rate that has remained unchanged over the past decades. Tumour-associated macrophages (TAMs) are believed to have potential involvement in OSCC progression. However, the molecular networks involved in communication between stroma and cancer cells have not yet been fully elucidated. MAIN BODY: The role of M2 polarized cells in oral carcinogenesis is supported by a correlation between TAMs accumulation into OSCC stroma and poor clinical outcome. Signalling pathways such as the NF-κB and cytokines released in the tumour microenvironment promote a bidirectional cross-talk between M2 and OSCC cells. These interactions consequently result in an increased proliferation of malignant cells and enhances aggressiveness, thus reducing patients' survival time. CONCLUSIONS: Here, we present a comprehensive review of the role of interleukin (IL)-1, IL-4, IL-6, IL-8, IL-10 and the receptor tyrosine kinase Axl in macrophage polarization to an M2 phenotype and OSCC progression. Understanding the molecular basis of oral carcinogenesis and metastatic spread of OSCC would promote the development of targeted treatment contributing to a more favourable prognosis.


Assuntos
Carcinoma de Células Escamosas/metabolismo , Neoplasias de Cabeça e Pescoço/metabolismo , Interleucinas/metabolismo , Ativação de Macrófagos , Macrófagos/metabolismo , Neoplasias Bucais/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Receptores Proteína Tirosina Quinases/metabolismo , Animais , Carcinoma de Células Escamosas/imunologia , Carcinoma de Células Escamosas/patologia , Diferenciação Celular , Progressão da Doença , Neoplasias de Cabeça e Pescoço/imunologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Macrófagos/imunologia , Macrófagos/patologia , Neoplasias Bucais/imunologia , Neoplasias Bucais/patologia , Fenótipo , Transdução de Sinais , Carcinoma de Células Escamosas de Cabeça e Pescoço , Microambiente Tumoral
19.
Dentomaxillofac Radiol ; 46(4): 20160260, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28107028

RESUMO

OBJECTIVES: To analyze the clinical, radiographic and haematological aspects of patients under bisphosphonate therapy. METHODS: A retrospective study was conducted where the records of patients taking bisphosphonates were analyzed considering the occurrence of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Evaluation included panoramic and periapical radiographies, haematological examinations and clinical features. Radiographies were analyzed determining the presence or absence of bone sclerosis, osteolysis, persisting alveolar socket, narrowing of the mandibular canal, widening of the periodontal ligament space, periradicular radiolucency, sequestrum and thickening of the lamina dura. Laboratory tests consisted of complete blood count, fasting serum glucose, erythrocyte sedimentation rate (ESR) and serum levels of calcium, phosphorus, alkaline phosphatase, parathormone (PTH) and C-terminal telopeptide of collagen I (CTX). RESULTS: Alkaline phosphatase and ESR were significantly higher in the BRONJ group, whereas fasting serum glucose, CTX, PTH, calcium and phosphorus did not significantly differ. BRONJ showed association with smoking, tooth extraction, anaemia and leukocytosis. On radiographic analysis, persisting alveolar socket, osteolysis, bone sclerosis and narrowing of the mandibular canal were significantly more prevalent in the BRONJ group. Thickening of the lamina dura, periapical radiolucencies, widening of the periodontal ligament space and sequestrum did not significantly differ between the groups. CONCLUSIONS: BRONJ is a multifactorial disease with high morbidity, which requires experimental studies to clarify the role of the reported risk factors and clinical radiographic signs to improve its diagnosis.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/sangue , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Radiografia Panorâmica , Estudos Retrospectivos , Fatores de Risco
20.
Clin Oral Investig ; 21(1): 199-210, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26955837

RESUMO

OBJECTIVE: This study aimed to investigate the effect of hyperbaric oxygen therapy (HBOT) on tooth extraction sites in rats treated with bisphosphonate. MATERIALS AND METHODS: Rats were treated with zoledronic acid, subjected to tooth extractions and allocated into groups: (1) 7 days of HBOT, (2) 14 days of HBOT, (3) 7-day control, and (4) 14-day control. The site of tooth extractions was analyzed by histomorphometry and immunohistochemistry. RESULTS: On macroscopic analysis, HBOT did not significantly affect bone exposure volume either at 7 or 14 days. On hematoxylin and eosin (H&E) analysis, the 14-day HBOT group showed less non-vital bone compared to both controls and 7-day HBOT group. HBOT significantly lowered expression of vascular endothelial growth factor (VEGF), receptor activator NF-kB ligand (RANKL), bone morphogenetic protein-2 (BMP-2), and osteoprotegerin (OPG) at 7 days, compared to control, whereas at 14 days, there was no significant difference for these variables. CONCLUSION: HBOT can reduce the amounts of non-vital bone microscopically detected in tooth extraction sites of rats subjected to bisphosphonate therapy. The effect seems to occur in a dose-dependent mode. Further studies are required to clarify the mechanisms accounting for this effect. CLINICAL RELEVANCE: Treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been a challenging task, where the effectiveness of HBOT is controversial. This study reports important effects of HBOT on the maxillae of rats subjected to bisphosphonate treatment, making an important contribution to the knowledge about the applicability of HBOT in BRONJ.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/prevenção & controle , Conservadores da Densidade Óssea/farmacologia , Difosfonatos/farmacologia , Oxigenação Hiperbárica , Imidazóis/farmacologia , Extração Dentária , Animais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/metabolismo , Proteína Morfogenética Óssea 2/metabolismo , Imuno-Histoquímica , Osteoprotegerina/metabolismo , Ligante RANK/metabolismo , Ratos , Fator A de Crescimento do Endotélio Vascular/metabolismo , Ácido Zoledrônico
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