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1.
Oral Health Prev Dent ; 19(1): 137-147, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33615769

RESUMO

PURPOSE: To compare clinical outcomes and oral fluid biomarkers in gingivitis subjects using an electric toothbrush/irrigator combination (test) or a manual toothbrush alone (control) over 8 weeks. MATERIALS AND METHODS: Subjects were randomly assigned to two groups of n = 30. In both groups, toothbrushing was performed twice daily at home and no additional interdental cleaning aids were allowed. Plaque Index (PLI), Gingival Index (GI), whole saliva (WS), and gingival crevicular fluid (GCF) samples were collected at weeks 2, 4, and 8. RESULTS: Subjects' mean age was 23 years and 52% were female. Overall baseline means were 1.31 for PLI, 1.07 for GI, and 34.9 for number of bleeding sites. At every follow-up visit, both groups differed statistically significantly (p < 0.001) from baseline for all clinical parameters. The test group demonstrated statistically significantly (p < 0.001) greater reductions in GI vs the control group by 18% at week 2, 17% at week 4 and 24% at week 8. The test group also demonstrated statistically significantly (p < 0.002) greater reductions in the number of bleeding sites vs the control group by 33% at week 2, 34% at week 4 and 43% at week 8. Between-group comparisons for both WS and GCF revealed numerical trends for decreased levels of interleukin (IL)-1ß in GCF after 4 and 8 weeks, but these were not statistically significant. CONCLUSION: In subjects using the electric toothbrush/irrigator combination, increased clinical improvements may be found accompanied by similarly improved trends for oral fluid biomarkers such as IL-1ß.


Assuntos
Placa Dentária , Gengivite , Adulto , Biomarcadores , Índice de Placa Dentária , Desenho de Equipamento , Feminino , Gengivite/terapia , Humanos , Masculino , Método Simples-Cego , Escovação Dentária , Adulto Jovem
2.
J Biol Chem ; 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33402424

RESUMO

The development of a targeted therapy would significantly improve the treatment of periodontitis and its associated diseases including Alzheimer Disease, rheumatoid arthritis, and cardiovascular diseases. Glutaminyl cyclases (QCs) from the oral pathogens Porphyromonas gingivalis, Tannerella forsythia and Prevotella intermedia represent attractive target enzymes for small-molecule inhibitor development, as their action is likely to stabilize essential periplasmic and outer membrane proteins by N-terminal pyroglutamination. In contrast to other microbial QCs that utilize so-called type I enzymes, these oral pathogens possess sequences corresponding to type II QCs, observed hitherto only in animals. However, whether differences between these bacteroidal QCs and animal QCs are sufficient to enable development of selective inhibitors is not clear. To learn more, we recombinantly expressed all three QCs. They exhibit comparable catalytic efficiencies and are inhibited by metal chelators. Crystal structures  of the enzymes from P. gingivalis (PgQC) and T. forsythia (TfQC) reveal a tertiary structure composed of an eight-stranded ß-sheet surrounded by seven α-helices, typical of animal type II QCs. In each case, an active site Zn ion is tetrahedrally coordinated by conserved residues. Nevertheless, significant differences to mammalian enzymes are found around the active site of the bacteroidal enzymes. Application of a PgQC-selective inhibitor described here for the first time results in growth inhibition of two P. gingivalis clinical isolates in a dose dependent manner. The insights gained by these studies will assist in the development of highly specific small-molecule bacteroidal QC inhibitors, paving the way for alternative therapies against periodontitis and associated diseases.

3.
Monogr Oral Sci ; 29: 19-29, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427214

RESUMO

The pH value of a biofilm influences the pathogenesis and therapy of oral diseases such as caries and periodontitis. This study aimed to investigate the influence of different initial pH values on the microbial composition, bacterial counts, metabolic activity, and quantity of three defined biofilms representing oral health, caries, and periodontal disease. Respective bacterial suspensions in the nutrient broth were initially adjusted to pH values between 5 and 8. Then biofilms were cultured on polystyrene surfaces coated with a proteinaceous solution for 2 h ("healthy" biofilm), 6 h ("healthy," and "cariogenic" biofilms), 24 h ("cariogenic," and "periodontitis" biofilms), and 48 h ("periodontitis" biofilm). In all biofilms, total bacterial counts were lower at an initial pH of 5 or 5.5 than at higher pH values. In the biofilm representing caries, the percentage of cariogenic bacteria (Streptococcus mutans, S. sobrinus, Lactobacillus acidophilus) was higher at a low pH, the metabolic activity was highest at pH 6-6.5, and biofilm mass was greatest at pH 7-7.5. In the biofilm representing periodontitis, the percentage of Porphyromonas gingivalis increased with the pH. Also, the metabolic activity was highest at pH 8, whereas mass had the highest value at pH 7. In conclusion, the initial pH value influences biofilm formation. In particular, metabolic activity and the amount of bacteria associated with disease correlated with the respective pH known to be of importance in the development of caries (relatively low pH) and periodontitis (higher pH). Modifying the pH level in oral biofilms might be an alternative concept in (primary) prevention and treatment, not only of caries but also of periodontitis.


Assuntos
Cárie Dentária , Streptococcus mutans , Biofilmes , Humanos , Concentração de Íons de Hidrogênio , Lactobacillus acidophilus
4.
Monogr Oral Sci ; 29: 214-226, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427221

RESUMO

The activity of mouthwash ingredients used in daily oral care (chlorhexidine digluconate, benzalkonium chloride, povidone iodine solution, tea tree oil) and of nystatin was evaluated not only on planktonic Candida albicans or C. glabrata, but also on the inhibition of biofilm formation. A microbroth dilution technique was used to determine the minimum inhibitory concentration of the substances against two laboratory strains and seven clinical isolates. Furthermore, a potential inhibition of biofilm formation of C. albicans or C. glabrata (single-species biofilm or mixed with two oral bacteria) was assessed. The results showed an activity of all tested substances against all C. albicans and C. glabratastrains. In the biofilm assays, a concentration-dependent effect of the substances was visible. However, a low concentration of povidone iodine solution and in particular of benzalkonium chloride seemed to increase the virulence of C. albicans. Most test substances affected both bacteria and yeasts in the mixed biofilms, only nystatin predominately reduced the yeasts. In conclusion, nystatin might be the drug of choice when exclusively preventing the colonization of Candida sp. in biofilms. The alternatives, benzalkonium chloride, povidone iodine solution, and tea tree oil, should be investigated further.


Assuntos
Antifúngicos , Candida , Antifúngicos/farmacologia , Biofilmes , Candida albicans , Assistência à Saúde , Humanos
5.
Monogr Oral Sci ; 29: 80-90, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427222

RESUMO

Untreated dental caries is the most prevalent disease worldwide. Development of caries is associated with the intake of sugar. The microorganisms utilize the sugar and create an acidic environment, which results in mineral loss. The appropriate use of fluoride is associated with a decline of caries. Another approach in preventing caries might be the increase of pH in dental plaque. During recent years, arginine has increasingly become the focus of interest. This is based on the fact that certain streptococci possess an arginine deiminase system (ADS) which metabolizes free arginine. In vivo, the incidence of caries was inversely correlated with ADS activity in saliva and dental plaque. ADS is highly active in Streptococcus gordonii and S. sanguinis, but is absent in S. sobrinus and S. mutans. In the presence of 1.5% L-arginine, S. gordonii and S. sanguinis, but not S. mutans and S. sobrinus, synthesize the metabolite citrulline and increase the pH of the environment.In defined multispecies biofilms consisting of ADS-positive and ADS-negative streptococci, supplementation with 1.5% arginine suppressed the growth of ADS-negative by favoring ADS-positive streptococci together with an increase in the pH of the environment. Evaluating the influence of daily manual removal of the biofilm in vitro by brushing with a commercial toothpaste containing fluoride and arginine resulted in less surface microhardness even when compared with a toothpaste with fluoride only. Recent studies clinically investigated the effect of using an arginine-containing dentifrice and reported a decrease of DMFS by about 10-20%.


Assuntos
Cárie Dentária , Arginina , Biofilmes , Cárie Dentária/prevenção & controle , Humanos , Streptococcus mutans , Streptococcus sanguis
6.
Monogr Oral Sci ; 29: 98-104, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427228

RESUMO

The present narrative review provides a summary of the temporal and spatial reactions of the oral microbiome to the placement of a dental implant into the oral cavity, depicting the most important interactions between the oral microbiota and the host response involved in the development of peri-implant infections in humans (i.e., peri-implant mucositis and peri-implantitis). Starting with the formation of a pellicle to acute and rampant peri-implant inflammation, a number of steps, including biofilm formation, aggressive bacterial invasion, and host defense mechanisms, are involved. Better understanding of the factors related to the host response and changes in the composition of microbiota has led to the development of novel treatment modalities. Finally, a short outlook into the future is provided.


Assuntos
Implantes Dentários , Microbiota , Peri-Implantite , Estomatite , Bactérias , Implantes Dentários/efeitos adversos , Humanos , Peri-Implantite/etiologia , Estomatite/etiologia
7.
Monogr Oral Sci ; 29: 1-11, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427230

RESUMO

In reality, most microorganisms are not free floating. They exist in biofilms, a community of many of them from the same species or from other genera and attached to surfaces.Microorganisms undergo a transition from free-floating, planktonic microorganisms to a sessile, surface-attached one. Contact with a surface induces changes in gene expression, and a strong attachment of microcolonies occurs only after a few hours. The maturation of a biofilm is associated with matrix formation. The matrix is of importance as it provides stability and protects against environmental insults, it consists of polysaccharides, water, lipids, proteins, and extracellular DNA. Biofilms can be found everywhere - in the environment, in water systems - and they play an important role in medicine and dentistry. In medicine, infections of chronic wounds, of the respiratory tract in cystic fibrosis infections, or when linked with incorporated biomaterial are mostly biofilm associated. In the oral cavity, the most prevalent oral diseases, dental caries, and periodontitis are multi-species biofilm-associated diseases. Although not acting alone, key pathogens drive the development of the microbial shift. Microorganisms metabolize sugar and create an acidic environment where aciduric bacteria (including mutans streptococci) become dominant, which leads to the demineralization of enamel and dentine. Porphyromonas gingivaliscauses biofilm dysbiosis in the development of periodontal disease. Biofilm-associated infections are extremely difficult to treat. The matrix serves as a barrier to antimicrobial agents and there are subpopulations of dormant bacteria resistant to antimicrobials requiring metabolically active cells. Approaches to treat biofilm-associated infections include the modification of the biofilm composition, inhibitors of quorum-sensing molecules, or interfering with matrix constituents.


Assuntos
Cárie Dentária , Biofilmes , Humanos , Boca , Percepção de Quorum , Streptococcus mutans
8.
Monogr Oral Sci ; 29: 38-52, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427232

RESUMO

When analyzing the activity of antimicrobial agents, it should be considered that microorganisms mainly occur in biofilms. Data obtained for planktonic bacteria cannot be transferred non-critically to biofilms. Biofilm models should consider both the relevant microorganisms and the conditions present in the environment. The selection of the model depends on the question to be answered. In dentistry, single species, multispecies, or microcosms originating from saliva or dental biofilm are used to culture biofilms. Microorganism selection depends on the focus of the study, for example caries biofilms mostly include Streptococcus mutans, an endodontic biofilm consists mostly of Enterococcus faecalis, and defined anaerobes are used in periodontal/peri-implant biofilms. In contrast to single-species biofilm models in medicine, where the lowest concentration of the antimicrobial that kills microorganisms is measured, the common analyzed variables are counts of colony-forming units or the percentage of dead bacteria determined by confocal laser scanning microscopy after applying a differentiating stain. All the models are helpful to evaluate new antimicrobial treatment options. Conclusions regarding the antimicrobial activity tendency of the therapeutics can be drawn. However, there are limitations of the model and ultimately a new therapy has to be proven in randomized controlled clinical trials.


Assuntos
Biofilmes , Cárie Dentária , Enterococcus faecalis , Humanos , Saliva , Streptococcus mutans
9.
Int J Mol Sci ; 22(3)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33513808

RESUMO

There is little known about the effect of the periodontopathogen Filifactor alocis on macrophages as key cells of the innate immune defense in the periodontium. Therefore, the aim of the present study was to investigate the effect of F. alocis and additionally of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNFα) on visfatin and other pro-inflammatory and proteolytic molecules associated with periodontitis in human macrophages. The presence of macrophage markers CD14, CD86, CD68, and CD163 was examined in gingival biopsies from healthy individuals and periodontitis patients. Human macrophages were incubated with F. alocis and TNFα for up to 2 d. The effects of both stimulants on macrophages were determined by real-time PCR, ELISA, immunocytochemistry, and immunofluorescence. F. alocis was able to significantly stimulate the synthesis of visfatin by human macrophages using TLR2 and MAPK pathways. In addition to visfatin, F. alocis was also able to increase the synthesis of cyclooxygenase 2, TNFα, and matrix metalloproteinase 1. Like F. alocis, TNFα was also able to stimulate the production of these proinflammatory and proteolytic molecules. Our results highlight the pathogenetic role of F. alocis in periodontal diseases and also underline the involvement of visfatin in the aetiopathogenesis of periodontitis.

10.
Int J Mol Sci ; 22(2)2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33435582

RESUMO

The aim of the study was to clarify whether orthodontic forces and periodontitis interact with respect to the anti-apoptotic molecules superoxide dismutase 2 (SOD2) and baculoviral IAP repeat-containing protein 3 (BIRC3). SOD2, BIRC3, and the apoptotic markers caspases 3 (CASP3) and 9 (CASP9) were analyzed in gingiva from periodontally healthy and periodontitis subjects by real-time PCR and immunohistochemistry. SOD2 and BIRC3 were also studied in gingiva from rats with experimental periodontitis and/or orthodontic tooth movement. Additionally, SOD2 and BIRC3 levels were examined in human periodontal fibroblasts incubated with Fusobacterium nucleatum and/or subjected to mechanical forces. Gingiva from periodontitis patients showed significantly higher SOD2, BIRC3, CASP3, and CASP9 levels than periodontally healthy gingiva. SOD2 and BIRC3 expressions were also significantly increased in the gingiva from rats with experimental periodontitis, but the upregulation of both molecules was significantly diminished in the concomitant presence of orthodontic tooth movement. In vitro, SOD2 and BIRC3 levels were significantly increased by F. nucleatum, but this stimulatory effect was also significantly inhibited by mechanical forces. Our study suggests that SOD2 and BIRC3 are produced in periodontal infection as a protective mechanism against exaggerated apoptosis. In the concomitant presence of orthodontic forces, this protective anti-apoptotic mechanism may get lost.

11.
Oral Health Prev Dent ; 19(1): 59-65, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33491379

RESUMO

PURPOSE: The topical fluoride treatment of teeth can lead to a formation of CaF2-like material, which is considered to play a significant role in caries prevention. Different types of fluoride sources are applied. The aim of this study was to analyse the in vitro fluoridation effect of the lesser known organic fluoride compound nicomethanol hydrofluoride (NH) regarding fluoride accumulation and morphological changes on dental enamel surfaces. Materials and Methods: The fluoridation effect was investigated by scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDX) after treatment with fluoride solutions at a concentration of 1350 ppm F - and a pH value of 5.5. NH was tested against inorganic sodium fluoride (NaF) as reference. Fluoridation was done on pellicle-free and pellicle-covered enamel. Results: Formation of globular CaF2-like material was observed for both fluoride types. However, NH led to considerably higher calcium fluoride accumulation on the enamel surface as shown by both EDX and SEM. The globule diameters varied between 0.2 and 0.8 µm. Cross-sectional analysis revealed that the globular precipitates lay directly on the enamel surface; only the very surface-near volume was affected. No statistically significant difference of the fluoridation effect was measured with vs without saliva pre-treatment. Conclusion: The experiments showed a 6 times greater F - surface uptake on dental enamel with NH compared to sodium fluoride, thus suggesting an important role of NH during remineralization phases, fostering equilibrium between de- and remineralization.


Assuntos
Fluoreto de Cálcio , Fluoretos , Esmalte Dentário , Fluoretos Tópicos , Humanos , Álcool Nicotinílico , Fluoreto de Sódio
13.
Clin Oral Investig ; 2020 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-33274409

RESUMO

OBJECTIVES: To investigate how scaling affects the penetration of microorganisms into dentinal tubules, how pulpal cells seeded into the pulp cavity respond to bacterial challenge, and how penetration and inflammatory response may depend on the bacterial composition. MATERIALS AND METHODS: Root canals of 102 extracted human teeth underwent shaping and cleaning. Half of the teeth were subjected to scaling and root planing, the other half remained untreated. Teeth were exposed to either Streptococcus gordonii and Actinomyces oris or S. gordonii and Porphyromonas gingivalis for 10 weeks. Bacterial invasion was assessed in a depth of 1 mm to the root surface. Human pulpal cells were seeded into the cavities to assess the expression of interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), and matrix metalloproteinase-3 (MMP-3) by real-time polymerase chain reaction and immunoassay. RESULTS: The percentage of teeth with bacteria detected in dentine was higher when teeth received scaling than when they were untreated: 66.6% versus 44.4% when exposed to A. oris/S. gordonii, and 50% versus 25% when exposed to P. gingivalis/S. gordonii (p = 0.043). Scaling had no impact on IL-8 and MMP-3 expression in pulpal cells. P. gingivalis/S. gordonii caused higher levels of IL-8, MCP-1, and MMP-3 than A. oris/S. gordonii (p = 0.003, p = 0.011, p = 0.037). CONCLUSION: Scaling supports the penetration of bacteria into the dentine of extracted human teeth. P. gingivalis may affect the immune response in pulpal cells. CLINICAL RELEVANCE: Root surface debridement with hand instruments may facilitate bacterial penetration. Other kinds of mechanical instrumentation in this experimental setting should be investigated.

14.
BMC Oral Health ; 20(1): 364, 2020 12 29.
Artigo em Inglês | MEDLINE | ID: mdl-33372602

RESUMO

BACKGROUND: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis. METHODS: Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons. RESULTS: In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group. CONCLUSIONS: Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only. CLINICAL RELEVANCE: The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL .


Assuntos
Eritritol , Periodontite , Raspagem Dentária , Humanos , Bolsa Periodontal/tratamento farmacológico , Periodontite/tratamento farmacológico , Pós
15.
Oral Health Prev Dent ; 18(1): 981-990, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33215489

RESUMO

PURPOSE: To analyze in vitro new formulations with Citrox and chlorhexidine digluconate (CHX) regarding their antibacterial activity against planktonic bacteria and their potential to inhibit biofilm formation or to act on existing biofilms. MATERIALS AND METHODS: Five oral health care products with 0.05%-0.5% CHX formulations (four rinses and one gel) were compared with Citrox preparations and additive-free CHX solutions. The minimal inhibitory concentrations (MIC) were determined against 13 oral bacteria associated with caries or periodontitis. Further, the activity on retarding biofilm formation and on existing biofilms was analyzed; both a 'cariogenic' (5 species) and a 'periodontal' (12 species) biofilm were included. RESULTS: The MIC values did not differ between the CHX mouthrinse/gel formulations and the respective additive-free CHX solutions. Citrox was active against selected periodontopathogens (e.g. Porphyromonas gingivalis). The CHX formulations more effectively retarded biofilm formation than did solutions with the same concentration of CHX but without additives. The anti-biofilm activities depended on the CHX concentration in the formulations. Both CHX solutions and formulations (rinse and gel) were only slightly active on an already formed biofilm. Citrox did not exert any anti-biofilm effect. CONCLUSION: The present in vitro data support the anti-biofilm activity of the novel CHX, Citrox, poly-L-lysine and xylitol oral health-care formulations. Further studies are warranted to confirm the present findings in various clinical settings.


Assuntos
Clorexidina , Saúde Bucal , Biofilmes , Clorexidina/análogos & derivados , Clorexidina/farmacologia , Antissépticos Bucais/farmacologia
16.
Ann Anat ; 234: 151648, 2020 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-33221386

RESUMO

OBJECTIVE: The aim of the present study was to evaluate the expressions of CXCL5, CXCL8, and CXCL10 in periodontal cells and tissues in response to microbial signals and/or biomechanical forces. METHODS: Human gingival biopsies from inflamed and healthy sites were used to examine the chemokine expressions and protein levels by real-time PCR and immunohistochemistry. The chemokines were also investigated in gingival biopsies from rats submitted to experimental periodontitis and/or tooth movement. Furthermore, chemokine levels were determined in human periodontal fibroblasts stimulated by the periodontopathogen Fusobacterium nucleatum and/or constant tensile forces (CTS) by real-time PCR and ELISA. Additionally, gene expressions were evaluated in periodontal fibroblasts exposed to F. nucleatum and/or CTS in the presence and absence of a MAPK inhibitor by real-time PCR. RESULTS: Increased CXCL5, CXCL8, and CXCL10 levels were observed in human and rat gingiva from sites of inflammation as compared with periodontal health. The rat experimental periodontitis caused a significant (p<0.05) increase in alveolar bone resorption, which was further enhanced when combined with tooth movement. In vitro, F. nucleatum caused a significant upregulation of CXCL5, CXCL8, and CXCL10 at 1 day. Once the cells were exposed simultaneously to F. nucleatum and CTS, the chemokines regulation was significantly enhanced. The transcriptional findings were also observed at protein level. Pre-incubation with the MEK1/2 inhibitor significantly (p<0.05) inhibited the stimulatory actions of F. nucleatum either alone or in combination with CTS on the expression levels of CXCL5, CXCL8, and CXCL10 at 1d. CONCLUSIONS: Our data provide original evidence that biomechanical strain further increases the stimulatory actions of periodontal bacteria on the expressions of these chemokines. Therefore, biomechanical loading in combination with periodontal infection may lead to stronger recruitment of immunoinflammatory cells to the periodontium, which might result in an aggravation of periodontal inflammation and destruction.

17.
Antibiotics (Basel) ; 9(10)2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33050325

RESUMO

BACKGROUND: The aim was to compare two different systemic antibiotics regimens adjunctive to non-surgical periodontal therapy when Aggregatibacter actinomycetemcomitans was not detected in the subgingival biofilm. METHODS: A total of 58 patients with periodontitis and with no A. actinomycetemcomitans in the subgingival biofilm were treated with full-mouth subgingival instrumentation and either metronidazole (MET; n = 29) or amoxicillin/metronidazole (AMX/MET; n = 29). Probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were recorded at baseline, as well as after three and six months. Subgingival biofilm and gingival crevicular fluid were collected and analyzed for major periodontopathogens and biomarkers. RESULTS: PD, CAL and BOP improved at 3 and 6 months (each p < 0.001 vs. baseline) with no difference between the groups. Sites with initial PD ≥ 6 mm also improved in both groups after 3 and 6 months (p < 0.001) with a higher reduction of PD in the AMX/MET group (p < 0.05). T. forsythia was lower in the AMX/MET group after 3 months (p < 0.05). MMP-8 and IL-1ß were without significant changes and differences between the groups. CONCLUSION: When A. actinomycetemcomitans was not detected in the subgingival biofilm, the adjunctive systemic use of amoxicillin/metronidazole results in better clinical and microbiological outcomes of non-surgical periodontal therapy when the application of systemic antibiotics is scheduled.

18.
J Periodontal Res ; 2020 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-32885473

RESUMO

OBJECTIVE: To evaluate microbial and host-derived biomarker changes during experimental peri-implantitis in the Beagle dog. BACKGROUND: Limited data exist on the microbial and biomarker changes during progressive bone loss as result of experimental peri-implantitis. METHODS: In total, 36 implants (ndogs  = 6) were assessed over 3 episodes of ligature-induced peri-implantitis followed by a period of spontaneous progression. Implants with hybrid (H) and completely rough (R) surface designs were used. Clinical and radiographic parameters were recorded at 4 timepoints. Peri-implant sulcus fluid was collected from the buccal and lingual aspects of the implants. The presence of 7 bacterial species and 2 host-derived biomarkers was assessed during the study period. RESULTS: Total bacterial counts were significantly correlated with marginal bone loss (MBL) (r = .21; P = .009). Further, Phorphyromonas gulae (Pg) and Tannerella forsythia (Tf) were commonly correlated with MBL, suppuration (SUP) and the sulcular bleeding index scores (mSBI) (P < .05). Other bacteria were further correlated with SUP, mSBI, and MBL. While the analyzed bacteria dropped, Prevotella intermedia (Pi) further increased during the spontaneous progressive phase (P < .05). Total bacterial load did not differ significantly between H and R implants. Host-derived IL-10 was undetected along the study period. IL-1ß positively correlated with probing pocket depth (r = .18; P = .03). During spontaneous progression, H implants displayed statistically significant lower levels of IL-1ß (P = .003). CONCLUSION: Experimental peri-implantitis is associated with an increase in bacterial counts. While Pg and Tf are associated with ligature-induced disease progression, Pi augmented its load during the spontaneous progressive phase. IL-1ß is associated with pocket probing depth and influenced by implant surface characteristics during the spontaneous progression phase.

19.
Photodiagnosis Photodyn Ther ; : 101971, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32835882

RESUMO

BACKGROUND: Recent data from preclinical studies and case series suggest that transgingival irradiation with diode lasers may represent a novel modality for antimicrobial photodynamic therapy (aPDT). However, at present, there is lack of data from controlled clinical studies on the use of transgingival antimicrobial photodynamic therapy (tg-aPDT) in the treatment of periodontitis. OBJECTIVE: To evaluate the clinical effects of tg-aPDT used in conjunction with nonsurgical mechanical instrumentation during supportive periodontal therapy (SPT). MATERIALS AND METHODS: Forty stage II and III periodontitis patients enrolled in SPT were randomly assigned to two groups of equal size. At baseline, study sites had to show sites with pocket probing depth (PPD) of ≥ 5 mm and Bleeding on Probing (BOP). Full mouth and site-specific Plaque-Index scores (PI), BOP, PPD, and Clinical Attachment Level (CAL) were recorded at baseline (BL), three months (3 M), and 6 months (6 M), respectively. The primary outcome variable was the change in the number of sites with BOP. Treatment was performed under local anaesthesia after random allocation to one of the following groups 1) Subgingival scaling and root planing (SRP) + tg-aPDT (test) or 2) SRP alone (control). RESULTS: Thirty-nine patients completed the study. Full mouth PI and BOP improved over six month, however without statistically significant difference between the groups. At 6 M, BOP-levels were statistically significantly lower in test sites (25.0%) compared to the control sites (65.0%), (p < 0.025). PPD improved in both groups with comparable mean values at 3 M (PPD test: 5.21 ± 0.92 mm; PPD control: 4.45 ± 1.36 mm) and 6 M (PPD test: 5.11 ± 1.10 mm; PPD control: 4.35 ± 1.14 mm). Additionally, CAL slightly improved in both groups with comparable mean values at 3 M (CAL test: 6.79 ± 1.72 mm; CAL control: 5.30 ± 2.43 mm) and 6 M (CAL test: 6.26 ± 1.70 mm; CAL control: 5.50 ± 2.33 mm). CONCLUSIONS: Within its limits, the present results appear to indicate that the use of tg-aPDT adjunctive to SRP may represent a new modality for controlling inflammation and further bleeding in residual periodontal pockets.

20.
Clin Oral Investig ; 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32839833

RESUMO

AIM: To evaluate the outcomes following surgical periodontal treatment and root surface decontamination by means of air polishing using an erythritol powder or conventional mechanical root debridement. MATERIAL AND METHODS: Thirty systemically healthy patients (44.38 ± 8.2 years old, 11 smokers, 19 women) diagnosed with periodontitis stages III-IV were included. Each patient, with one single-rooted tooth, with one probing pocket depth (PD) ≥ 6 mm associated with horizontal bone loss, was treated by means of simplified papilla preservation flap (SPPF) and randomized to either test treatment (careful removal of the calculus with the tip of a blade, air polishing of the root surfaces with erythritol) or to the control group (scaling and root planing with hand curettes, ultrasonic instruments). PD, clinical attachment (CAL), bone sounding (BS), and radiographic bone level (BL) were evaluated at baseline and 12 months postsurgically. RESULTS: Twenty-seven patients completed the 12-month follow-up (test: n = 14, control: n = 13). In both groups, statistically significant improvements were obtained (p < 0.05, mean CAL gain/PD reduction: test, 2.50 ± 1.60 mm/3.00 ± 0.96 mm; control, 2.85 ± 1.21 mm/3.38 ± 1.12 mm). No statistically significant differences were observed between the groups for any of the investigated parameters (p < 0.05). CONCLUSION: Within their limits, the present results indicate that the use of air polishing with an erythritol powder during periodontal surgery may represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus. CLINICAL RELEVANCE: The use of air polishing with an erythritol powder during periodontal surgery appears to represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.

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