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1.
Oral Health Prev Dent ; 19(1): 441-448, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34505498

RESUMO

PURPOSE: During the past 20 years, a plethora of research reports has been published showing a statistical association between poor oral health and cardiovascular diseases. The aim of this narrative review was to focus on associations between oral infections and non-atherosclerosis-related systemic diseases. MATERIALS AND METHODS: An open literature search and evaluation of articles were conducted on Medline and Cochrane databases with the key words 'oral infection', 'periodontitis', 'pneumonia', 'osteoarthritis', 'rheumatic diseases', 'inflammatory bowel disease', 'kidney disease', 'liver diseases', 'metabolic syndrome', 'diabetes', 'cancer', 'Alzheimer's disease'. Cardiovascular diseases were excluded from the analysis. RESULTS: The scarcity of controlled studies did not allow conducting a systematic review with meta-analysis on the topics, but dental infections have been shown be associated with several general diseases also beyond the atherosclerosis paradigm. However, there is no causal evidence of the role of dental infections in this regard. Poor oral health has nevertheless often been observed to be associated with worsening of the diseases and may also affect treatments. CONCLUSIONS: Maintaining good oral health is imperative regarding many diseases, and its importance in the daily life of any patient group cannot be over emphasised.


Assuntos
Doenças Cardiovasculares , Periodontite , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Saúde Bucal , Periodontite/complicações , Periodontite/epidemiologia
3.
Tumour Biol ; 43(1): 1-9, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33935124

RESUMO

BACKGROUND: Oral infections associate statistically with cancer. OBJECTIVE: We hypothesized that certain periodontal microorganisms might specifically link to malignancies in general and set out to investigate this in our ongoing cohort study. METHODS: A sample of 99 clinically examined patients from our cohort of 1676 subjects was used to statistically investigate the associations between harboring periodontal microorganisms Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g), Prevotella intermedia (P.i), Tannerella forsythia (T.f) and Treponema denticola (T.d). We used oral infection indexes and the incidence figures of malignancies as registered in 2008-2016 in the Swedish National Cancer Register. RESULTS: The pathogen A.a showed strong association with malignancy in 32 out of the 99 patients while P.g and P.i were more prevalent among patients without malignancy. In principal component analyses, A.a appeared in the strongest component while the second strongest component consisted of a combination of T.f and T.d. The third component consisted of a combination of P.g and P.i, respectively. Of basic and oral health variables, gingival index appeared to be the strongest expression of inflammation (Eigen value 4.11 and Explained Variance 68.44 percent). CONCLUSIONS: The results partly confirmed our hypothesis by showing that harboring certain periodontal bacteria might link to malignancy. However, the associations are statistical and no conclusions can be drawn about causality.


Assuntos
Neoplasias/epidemiologia , Periodontite/epidemiologia , Periodontite/microbiologia , Bactérias/classificação , Bactérias/isolamento & purificação , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Índice Periodontal , Prevalência , Suécia/epidemiologia
4.
Surgeon ; 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33608227

RESUMO

BACKGROUND: Previous studies have shown an increased prevalence of candidiasis in patients receiving radiotherapy for head and neck cancer. However, little is known of the effect the different cancer treatment modalities have on the oral Candida status. OBJECTIVE AND HYPOTHESIS: The objective of this study was to investigate the change in salivary Candida status of oral squamous cell carcinoma (OSCC) patients undergoing cancer treatment. The hypothesis was that cancer treatments change the oral microbial environment favouring an increase in the prevalence of more pathogenic non-albicans Candida (NAC). METHODS: We collected paraffin-stimulated saliva from 44 OSCC patients before surgery and after a minimum of 19 months of follow-up. Chromagar, Bichro-Dupli-test and API ID 32 C were used for identification of different Candida species and results were analysed statistically. RESULTS: At both timepoints, 75% of samples were Candida positive with C. albicans being the most common yeast. NAC strains were present in 16% of the pre-operative samples and 14% of the follow-up samples. The NAC species found were C. dubliniensis, C. krusei, C. guilliermondii (preoperatively only) and C. glabrata (at follow-up only). In 73% of the cases, the salivary Candida status remained unchanged. There was an 18% increase in the prevalence of candidiasis. However, the different treatment modalities did not statistically significantly affect the Candida status of the patients. CONCLUSION: The intraindividual prevalence of salivary Candida among OSCC patients seems to be stable and different treatment modalities have little to no effect on the salivary Candida status.

6.
Dent J (Basel) ; 8(3)2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32882798

RESUMO

In order to investigate the effects of mouthwashes on oral biofilms with probiotics, we compared in biofilms the susceptibility to mouthwashes of probiotic Lactobacillus rhamnosus GG (LGG) and oral pathogens Streptococcus mutans, Streptococcus sanguinis, and Candida albicans. We also evaluated these pathogens' susceptibility to the mouthwashes and their recovery after mouthwash-rinsing in biofilms with/without LGG. First, 1-day-/3-day-old LGG-integrated multi-species biofilms were exposed for 1 min to mouthwashes containing chlorhexidine, essential oils, or amine fluoride/stannous fluoride. Cells were plate-counted and relative survival rates (RSRs) of LGG and pathogens calculated. Second, 1-day-/3-day-old multispecies biofilms with and without LGG were exposed for 1 min to mouthwashes; cells were plate-counted and the pathogens' RSRs were calculated. Third, 1-day-old biofilms were treated for 1 min with mouthwashes. Cells were plate-counted immediately and after 2-day cultivation. Recovery rates of pathogens were calculated and compared between biofilms with/without LGG. Live/Dead® staining served for structural analyses. Our results showed that RSRs of LGG were insignificantly smaller than those of pathogens in both 1-day and 3-day biofilms. No significant differences appeared in pathogens' RSRs and recovery rates after treatment between biofilms with/without LGG. To conclude, biofilm LGG was susceptible to the mouthwashes; but biofilm LGG altered neither the mouthwash effects on oral pathogens nor affected their recovery.

7.
Transplant Proc ; 52(10): 3231-3235, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32768288

RESUMO

BACKGROUND: Triggering receptors expressed on myeloid cells (TREMs) and their ligand, peptidoglycan recognition protein 1 (PGLYRP-1), have been detected in secretions from patients with inflammatory diseases, which may lead to the formation of atherosclerotic plaques. Here, we aimed to analyze the association between salivary concentrations of soluble (s)TREM-1 and PGLYRP-1 with death and cardiovascular disease before and after kidney transplantation. MATERIALS AND METHODS: Saliva samples from 53 patients on dialysis were collected during their regular dental evaluation before treatment and after kidney transplantation. Oral inflammatory burden was assessed from panoramic radiographs and full-mouth dental examination. Demographic data, graft function, patient survival, and history of major cardiovascular events (MACEs) were retrieved from hospital records. RESULTS: Salivary sTREM-1 before transplantation increased the odds for death and MACE. In addition, PGLYRP-1 increased the odds for MACE before transplantation. After transplantation, neither salivary sTREM-1 nor PGLYRP-1 increased the odds for death or MACE, probably because of the previous eradication of oral inflammatory foci. None of the studied biomarkers correlated with kidney transplant function. CONCLUSIONS: Salivary sTREM-1 and PGLYRP-1 before transplantation were associated with MACE and death. The utility of salivary proinflammatory biomarkers for risk stratification in kidney transplant candidates requires further investigation.


Assuntos
Biomarcadores/metabolismo , Doenças Cardiovasculares , Transplante de Rim , Saliva/química , Receptor Gatilho 1 Expresso em Células Mieloides/metabolismo , Adulto , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/mortalidade , Feminino , Humanos , Inflamação/complicações , Inflamação/metabolismo , Transplante de Rim/efeitos adversos , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Periodontite/complicações , Periodontite/metabolismo , Receptor Gatilho 1 Expresso em Células Mieloides/análise
8.
Dent J (Basel) ; 8(3)2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32785107

RESUMO

BACKGROUND: The aim of this study is to investigate if using tobacco products (including snuff, smoking tobacco and dual-using) associates with periodontal health, education level and mortality in a Swedish cohort, hypothesizing that tobacco products affect periodontal health, associate with lower education and increase the risk of death. METHOD: Study cohort of 1080 subjects aged 31-40 years (528 men, 552 women) was clinically examined and interviewed in 1985 and followed for mortality until 2015. Subjects were classified into two groups: "tobacco users" and "non-users". Associations between periodontal health parameters, tobacco products, education level and age of death were analysed. SPSS was used for analyses. RESULTS: Tobacco products, as well as education level associated, with poor periodontal health. Tobacco users and lower education was linked to higher plaque-, calculus- and gingival-index scores than non-users (p < 0.001). They also had significantly higher prevalence of deep periodontal pockets (≥5 mm) (p < 0.001 and 0.010, respectively), missing teeth (p = 0.010 and 0.003, respectively) and lower education level (p < 0.001) compared with non-users. However, tobacco product users did not die significantly earlier than non-users. CONCLUSION: Tobacco products had a negative impact on periodontal health. Tobacco product users were less educated. However, using tobacco products may not cause premature death.

9.
Oral Dis ; 26(5): 1045-1052, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32026534

RESUMO

OBJECTIVES: Association was investigated between oral health before dialysis and the incidence of systemic infections during dialysis. We hypothesized that low-grade systemic inflammation caused by poor oral health associates with infectious episodes in patients on dialysis, despite earlier eradication of oral infection foci. SUBJECTS AND METHODS: A total of 117 patients (46 with peritoneal and 71 with hemodialysis) were examined and treated at predialysis stage and followed up during dialysis. Number of infection episodes and microorganisms cultured from blood and peritoneal fluid were analyzed. Number of teeth, periodontal inflammatory burden, and total dental index scores were assessed, and salivary matrix metalloproteinase 8, triggering receptor on myeloid cells 1, peptidoglycan recognition protein 1 (PGLYRP1), and interleukin-1ß were measured. RESULTS: In hemodialysis, 134 infection episodes were recorded, while peritoneal dialysis group had 77 peritonitis episodes. Culture-negative samples were 69% in hemodialysis and 23% in peritoneal dialysis group. Staphylococci were the most frequently associated microorganisms. Infections during dialysis did neither associate with oral health parameters nor associate with salivary inflammatory biomarkers, except for PGLYRP1, which associated with number of infection episodes during hemodialysis (p = .046). CONCLUSIONS: A number of infection episodes during hemodialysis were associated with salivary PGLYRP1 but not the other salivary markers or oral infection markers.


Assuntos
Doenças da Boca , Saúde Bucal , Diálise Renal , Biomarcadores , Humanos , Infecções/complicações , Inflamação , Doenças da Boca/complicações , Doenças da Boca/epidemiologia , Doenças da Boca/etiologia , Diálise Renal/efeitos adversos
10.
Dent J (Basel) ; 7(3)2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31484379

RESUMO

We studied oral health in 115 women with and without a history of gestational diabetes (GDM), expecting poorer oral health in the GDM group. Full-mouth examinations were performed 5 years postpartum and the number of teeth, total dental index (TDI) and decayed, missing, filled teeth (DMFT) index were calculated. Bleeding on probing (BOP), probing depth (PD), visible plaque index (VPI), and clinical attachment level (CAL) were recorded. The periodontal inflammatory burden index (PIBI) was calculated. Panoramic radiographs were taken and signs of infections recorded. Oral health habits, symptoms and participants' own opinion of oral health were recorded with questionnaires. At the time of examination, 45% of the women had a history of GDM in the index pregnancy. Mild periodontitis (62%) and bleeding on probing (46%) were common. VPI (13% and 17%, p = 0.009) and PIBI (13.1 and 17.5, p = 0.041) were lower among women with a history of GDM compared with those with no history of GDM. There was no difference between groups in DMFT scores. All women reported good subjective oral health. Thus, contrary to our hypothesis, women with a history of GDM showed better oral health parameters than women without a history of GDM.

11.
Caries Res ; 53(5): 491-501, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31060040

RESUMO

Recent results of randomized trials testing the efficacy of xylitol in caries prevention have been conflicting. This narrative review reveals the sources of discrepancy. The following databases were searched for the terms "xylitol" or "artificial sweeteners" restricted to the English language: PubMed, Web of Science, Evidenced-Based Medicine, Scopus, and the Cochrane database. In a separate search, the terms "dental caries" or "cariogenicity" or "glucosyltransferase" or "low glycemic" or "low insulinemic" or "dysbiosis" or "gut microbiome" were used and then combined. In section I, findings regarding the role of xylitol in dental caries prevention, the appropriateness of research methods, and the causes for potential biases are summarized. In section II, the systemic effects of xylitol on gut microbiota as well as low-glycemic/insulinogenic systemic effects are evaluated and summarized. The substitution of a carbonyl group with an alcohol radical in xylitol hinders its absorption and slowly releases sugar into the bloodstream. This quality of xylitol is beneficial for diabetic patients to maintain a constant glucose level. Although this quality of xylitol has been proven in in vitro and animal studies, it has yet to be proven in humans. Paradoxically, recent animal studies reported hyperglycemia and intestinal dysbiosis with artificial sweetener consumption. Upon careful inspection of evidence, it was revealed that these reports may be due to misinterpretation of original references or flaws in study methodology. Any systemic benefits of xylitol intake must be weighed in consideration with the well-established adverse gastrointestinal consequences. The contribution of xylitol to gut dysbiosis that may affect systemic immunity warrants further research.


Assuntos
Cárie Dentária/prevenção & controle , Adoçantes não Calóricos/administração & dosagem , Xilitol/administração & dosagem , Animais , Disbiose , Microbioma Gastrointestinal , Humanos , Adoçantes não Calóricos/uso terapêutico , Xilitol/uso terapêutico
12.
Clin Oral Investig ; 23(5): 2207-2213, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30276517

RESUMO

OBJECTIVE: This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist. MATERIAL AND METHODS: Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics. RESULTS: OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = - 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage. CONCLUSION: OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis. CLINICAL RELEVANCE: Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.


Assuntos
Transplante de Rim , Saúde Bucal , Qualidade de Vida , Diálise Renal , Insuficiência Renal Crônica/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Insuficiência Renal Crônica/cirurgia , Adulto Jovem
13.
Liver Int ; 39(3): 583-591, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30300961

RESUMO

BACKGROUND & AIMS: Chronic liver disease is a major health concern worldwide and the identification of novel modifiable risk factors may benefit subjects at risk. Few studies have analyzed periodontitis as a risk factor for liver complications. We studied whether periodontitis is associated with incident severe liver disease. METHODS: The study comprised 6165 individuals without baseline liver disease who participated in the Finnish population-based Health 2000 Survey (BRIF8901) during 2000-2001, a nationally representative cohort. Follow-up was until 2013 for liver-related admissions, liver cancer and mortality from National Hospital Discharge, Finnish Cancer Registry and Causes of Death Register, Statistics Finland. Mild to moderate periodontitis was defined as ≥1 tooth with periodontal pocket ≥4 mm deep, and advanced periodontitis as ≥5 teeth with such pockets. Multiple confounders were considered. RESULTS: A total of 79 subjects experienced a severe liver event during follow-up. When adjusted for age, sex and number of teeth, hazards ratios by Cox regression regarding incident severe liver disease were, for mild to moderate periodontitis, 2.12 (95% CI 0.98-4.58), and, for advanced periodontitis, 3.69 (95% CI 1.79-7.60). These risk estimates remained stable after additionally adjusting for alcohol use, smoking, metabolic risk, serum gamma-glutamyltransferase, dental-care habits, lifestyle and socioeconomic status. Periodontal disease-associated liver risk was accentuated among subjects with non-alcoholic fatty liver disease or heavy alcohol use at baseline. CONCLUSIONS: Periodontitis was associated with incident liver disease in the general population independently of various confounders. As a preventable disease, periodontal disease might present a modifiable risk factor for chronic liver disease.


Assuntos
Hepatopatias/epidemiologia , Periodontite/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Finlândia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Incidência , Hepatopatias/diagnóstico , Hepatopatias/mortalidade , Masculino , Pessoa de Meia-Idade , Periodontite/diagnóstico , Periodontite/mortalidade , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
14.
J Oral Maxillofac Surg ; 76(12): 2564-2571, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30509395

RESUMO

PURPOSE: This study examined the prevalence of Candida species in the saliva of oral squamous cell carcinoma patients and its effect on the mortality rate. MATERIALS AND METHODS: One hundred patients with oral cavity squamous cell carcinoma undergoing protocol treatment at Helsinki University Hospital were recruited into the study from March 2011 through 2014. For comparison, 75 age-matched controls with no current or previously treated oral cancer were recruited. Paraffin-stimulated whole saliva samples were collected and cultivated on CHROMagar Candida medium (CHROMagar, Paris, France) to establish possible Candida growth. The API ID 32C yeast identification kit (bioMérieux, Lyon, France) and Bichro-Dubli Fumouze latex agglutination test (Fumouze Diagnostics, Levallois-Perret, France) were used for further identification of different Candida species. Patients' medical records were studied for information on their health habits and general health status, as well as tumor-related data. The patients' status regarding being alive and cancer free was checked at a follow-up point in December 2017. Descriptive statistics and cross tabulation were carried out, and the P value was set at .05. RESULTS: Candida species were detected in 74% of the oral cancer patients' samples, with C. albicans being the most common species (84%). Other species identified were C. dubliniensis (8%), C. tropicalis (4%), C. glabrata (3%), C. parapsilosis (3%), C. sake (3%), C. krusei (1%), and C. guilliermondii (1%). After the follow-up period, 63% of the patients were alive and 86% of them were cancer free. Harboring Candida species in the saliva was not associated with any increase in the mortality rate. CONCLUSIONS: C. albicans was common in the oral cavity of the oral squamous cell carcinoma patients. However, in this patient population, we did not observe a statistically significant effect of the yeast on the mortality rate.


Assuntos
Candida/isolamento & purificação , Candidíase/complicações , Carcinoma de Células Escamosas/microbiologia , Neoplasias Bucais/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida albicans/isolamento & purificação , Candidíase/diagnóstico , Candidíase/epidemiologia , Carcinoma de Células Escamosas/mortalidade , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Prevalência , Prognóstico , Saliva/microbiologia , Taxa de Sobrevida
15.
New Microbiol ; 41(4): 296-301, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30311625

RESUMO

Oral Candida infections can be life-threatening in medically compromised patients. In particular non-albicans Candida strains are virulent. However, our knowledge is sparse on how proteolytic these strains are in patients with oral cancer. Our study aimed to investigate differences in proteolytic activity of non-albicans Candida and Candida albicans isolated from oral cancer patients. The hypothesis was based on anticipated different invasive capacity of the strains. Clinical and reference yeast samples from our laboratory were used for analyses. Candida strains were grown in yeast peptone glucose and the activity of Candida proteinases of broken cell fractions were analysed by MDPF-gelatin zymography. Fluorometric assay was used to compare activities of proteolytic enzymes and degradation assays were performed using CLDN 4 and plasma fibronectin. Clear differences were seen in the proteolytic activity between the studied non-albicans Candida and C. albicans strains. C. tropicalis had the highest proteolytic activity followed by strains of C. krusei and C. glabrata. The results confirmed our study hypothesis by showing differences between the non-albicans Candida and Candida albicans strains studied. Higher proteolytic activity may thus have an effect on the virulence of non-albicans Candida strains in oral cancer patients.


Assuntos
Candida albicans/enzimologia , Candida/enzimologia , Candidíase Bucal , Neoplasias Bucais/microbiologia , Peptídeo Hidrolases/metabolismo , Candida/patogenicidade , Candida albicans/patogenicidade , Candidíase Bucal/microbiologia , Glucose/metabolismo , Humanos , Peptonas/metabolismo , Virulência
16.
Oral Dis ; 24(8): 1562-1571, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29969841

RESUMO

OBJECTIVE: To investigate the impact of anti-rheumatic medications on salivary matrix metalloproteinase (MMP)-8 levels and MMP-8/TIMP (tissue inhibitor of MMPs)-1 ratio in patients with rheumatoid arthritis (RA) and periodontal findings during a 1-year follow-up. MATERIALS AND METHODS: Salivary MMP-8 was measured by an immunofluorometric assay and TIMP-1 by an enzyme-linked immunosorbent assay of 53 patients with early untreated RA (ERA), naïve to synthetic disease modifying anti-rheumatic drugs (DMARDs), of 28 patients with chronic RA (CRA), candidates for biologic DMARDs and of 43 age- and sex-matched controls. Periodontal health was evaluated by bleeding on probing (BOP), pocket depth (PD), and periodontal inflammatory burden index (PIBI). Examinations were conducted twice for RA patients and once for controls. RESULTS: Salivary MMP-8 level and MMP-8/TIMP-1 ratio associated positively with PIBI in patients with chronic RA (MMP-8: p < 0.001 at baseline, p = 0.002 after follow-up; MMP-8/TIMP-1 ratio p < 0.001, p = 0.003, respectively) and in controls (MMP-8: p = 0.010, MMP-8/TIMP-1 ratio: p = 0.010). Salivary MMP-8 levels were highest at the early stage of RA. The used DMARDs, synthetic or biologic, did not affect salivary MMP-8 concentrations. CONCLUSIONS: The use of synthetic or biologic DMARDs did not affect salivary MMP-8 levels in RA patients regardless the duration of RA.


Assuntos
Antirreumáticos/farmacologia , Metaloproteinase 8 da Matriz/metabolismo , Doenças Periodontais/metabolismo , Saliva/metabolismo , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Adulto , Idoso , Antirreumáticos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Biomarcadores/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Saliva/efeitos dos fármacos
17.
Rheumatol Int ; 38(9): 1661-1669, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30043237

RESUMO

To study oral health in patients with rheumatoid arthritis (RA) with emphasis on disease activity and treatment of RA. In this prospective cohort study 81 RA patients [53 early untreated RA (EURA) and 28 chronic RA (CRA) patients with inadequate response to synthetic disease modifying antirheumatic drugs (DMARDs)], underwent rheumatological [Disease Activity Score (28-joint) DAS28] and dental examinations [Total Dental Index (TDI), Decayed Missing Filled Teeth (DMFT) and Decayed Missing Filled Surfaces (DMFS)]. For controls, 43 volunteers were examined. After the examinations, EURA patients started treatment with synthetic DMARDs, oral and intra-articular glucocorticoids. CRA patients were candidates for biological DMARDs. The patients were re-examined mean 16 months later. Results were analyzed with descriptive statistics and logistic regression. TDI was higher in both RA groups at baseline compared to controls [EURA: 2 (2-3); CRA: 2 (1-3); controls 1 (1-3), p = 0.045]. DMFT [rs 0.561 (p = 0.002)] and DMFS [rs 0.581 (p = 0.001)] associated with DAS28 at baseline in CRA patients. After follow-up, DAS28 associated positively with DMFT [rs 0.384 (p = 0.016)] and DMFS [rs 0.334 (p = 0.038)] in EURA patients; as well as in CRA patients DMFT [rs 0.672 (p = 0.001)], DMFS [rs 0.650 (p = 0.001)]. RA patients already in the early phase of the disease had poorer oral health compared to controls. The caries indices associated with the activity of RA in both patient groups. Oral status may thus contribute to the development and further relate to the activity of RA.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Saúde Bucal , Adulto , Idoso , Idoso de 80 Anos ou mais , Produtos Biológicos/uso terapêutico , Cárie Dentária/epidemiologia , Feminino , Finlândia , Glucocorticoides , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Adulto Jovem
18.
Folia Med (Plovdiv) ; 60(1): 21-29, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29668457

RESUMO

The prevalence of common oral diseases, such as dental caries, periodontal diseases and oral candidiasis remains high in the general population. Various preventive strategies have been proposed and included in national health programs promoting oral health. Interest in probiotics in light of oral health has gradually evolved as attractive means in prevention of oral infectious diseases. The aim of the present review is to outline the current evidence on the role of probiotic species on oral health parameters and their beneficial role in contributing to healthier oral environment.


Assuntos
Saúde Bucal , Probióticos , Halitose , Humanos , Lactobacillus , Doenças da Boca , Iogurte
19.
Ann Med ; 50(4): 333-344, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29683364

RESUMO

OBJECTIVE: To study prospectively the association of salivary and serum matrix metalloproteinase (MMP)-8, tissue inhibitor of MMPs (TIMP)-1 and interleukin (IL)-6 with periodontal and systemic inflammation in rheumatoid arthritis (RA). We hypothesized that biomarker concentrations reflect inflammation. METHODS: Fifty three early untreated RA (ERA) and 28 chronic RA (CRA) patients, underwent rheumatological and dental examinations at baseline and one year later after starting first conventional or biological disease modifying antirheumatic drug. We included 43 control subjects. Saliva and serum samples were analyzed for MMP-8, TIMP-1 and IL-6. Periodontal health was assessed by bleeding on probing (BOP), pocket depth (PD) and periodontal inflammatory burden index (PIBI); RA disease activity was assessed by disease activity score DAS28. Joint destruction was analyzed by the modified Sharp-van der Heijde (SHS) method. RESULTS: Serum MMP-8 (p < .001; p < .001) and IL-6 (p < .001; p = .002) were significantly higher in CRA vs. other study groups during the study. Salivary MMP-8 (p = .010) and IL-6 (p = .010) were significantly higher in ERA vs. other study groups at baseline. Salivary MMP-8 was associated with periodontal parameters. CONCLUSION: Elevated serum concentrations of MMP-8 and IL-6 in CRA patients reflected chronic RA, while elevated salivary concentrations of MMP-8 levels in ERA patients reflected increased periodontal inflammation. Key messages Concentrations of inflammatory biomarkers in serum and saliva were different between patients with RA and healthy controls. Concentrations of MMP-8 and of IL-6 in serum were elevated in patients with chronic RA reflecting joint inflammation and the burden of established RA. Concentrations of MMP-8 in saliva was elevated already at the early stage of RA and the level of salivary MMP-8 was associated with poor periodontal health both in patients with early and in those with chronic RA.


Assuntos
Artrite Reumatoide/sangue , Periodontite/diagnóstico , Saliva/química , Adulto , Idoso , Artrite Reumatoide/imunologia , Biomarcadores/sangue , Doença Crônica , Feminino , Seguimentos , Humanos , Interleucina-6/sangue , Masculino , Metaloproteinase 8 da Matriz/sangue , Pessoa de Meia-Idade , Índice Periodontal , Periodontite/sangue , Periodontite/imunologia , Estudos Prospectivos , Índice de Gravidade de Doença , Inibidor Tecidual de Metaloproteinase-1/sangue
20.
Caries Res ; 52(3): 220-229, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29353279

RESUMO

Probiotic administration may favour caries prevention, as recent research has shown. This in vitro study aimed to investigate the growth of Lactobacillus rhamnosus GG (LGG) in experimental biofilms exposed to various carbohydrates, and also to assess its cariogenic potential. Multispecies experimental oral biofilms with or without LGG were grown with a sole-carbohydrate source (fructose/glucose/lactose/sorbitol/sucrose). The viable cells of LGG and structure of the biofilms were examined after 64.5 h of incubation, and pH values of spent media were measured at 16.5, 40.5, and 64.5 h. Fermentation profiles of LGG in biofilm media were assessed with study carbohydrate as the sole energy source. Our results showed that LGG reached higher viable cell numbers with glucose and sucrose in 64.5-h multispecies experimental oral biofilms compared to other carbohydrates. When LGG was incorporated in biofilms, no distinct pH changes at any time points were observed under any of the carbohydrates used; the pH values of spent media at each time point were lower when lactose was used, compared to other carbohydrates. The fermentation profiles of LGG in biofilm media were similar to its growth in MRS (no obvious growth with lactose or sucrose). In conclusion, LGG in our in vitro multispecies experimental oral biofilms was capable of surviving and growing well in each carbohydrate source. LGG might not have harmful effects on dental hard tissues. Another finding from our study was that the lowest pH values were observed in the presence of lactose, and the thickest biofilms were in sucrose.


Assuntos
Biofilmes/crescimento & desenvolvimento , Carboidratos/farmacologia , Lactobacillus rhamnosus/crescimento & desenvolvimento , Adulto , Carga Bacteriana , Biofilmes/efeitos dos fármacos , Meios de Cultura , Humanos , Concentração de Íons de Hidrogênio , Hibridização in Situ Fluorescente , Técnicas In Vitro , Lactobacillus rhamnosus/efeitos dos fármacos , Masculino , Saliva/metabolismo
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