RESUMO
It is urgently necessary to clarify the effect of extraction of impacted mandibular third molar (IMTM) on the periodontal tissue of adjacent second molars (ASMs). In this study, the ASM periodontal condition and pathogenic microbes were assessed before IMTM extraction and at 1, 4, 8 and 12 weeks postoperatively. Based on the inclusion and exclusion criteria, our study revealed that IMTM extractions adversely affected distal ï¼ periodontal probing depth (dPPD), attachment loss (dAL), plaque index (dPLI) and bleeding on probing (dBOP) within 8 weeks, but these indices gradually normalize after 12 weeks. The subgingival pathogens near the ASMs distal surface, Porphyromonas and Pseudomonas, were significantly increased postoperatively. Moreover, relevance of ASMs clinical indices and subgingival microbes after IMTM extractions was found. In contrast to the situation in chronic periodontitis, the effects of IMTM extraction on dPPD, dAL, dPLI and dBOP of ASMs were mainly correlated with Pseudomonas. Additionally, while the IMTM extractions have adverse distal periodontal indices of ASMs within 8 weeks and increase subgingival pathogens, the modified triangular flap (MTF) had fewer distal periodontal indices and less Pseudomonas. Compared to the traditional envelope flap and triangular flap, the MTF benefits the periodontal health, which could be considered as the priority option for IMTM extractions.
Assuntos
Mandíbula , Microbiota , Dente Serotino , Extração Dentária , Dente Impactado , Humanos , Dente Serotino/cirurgia , Masculino , Dente Impactado/cirurgia , Adulto , Feminino , Mandíbula/cirurgia , Mandíbula/microbiologia , Índice Periodontal , Periodonto/microbiologia , Periodonto/cirurgia , Adulto Jovem , Retalhos CirúrgicosRESUMO
BACKGROUND: Actinomyces species are commensal oral cavity flora that can cause jaw osteomyelitis. Osteomyelitis of the jaw by Actinomyces is rare, and its presentation can be confused with many different pathologies. CASE PRESENTATION: This is the case of a 61-year-old female with breast cancer and on chemotherapy as well as non-invasive carcinoma of the tongue who initially presented to the dentist with white spots in the right mandible near the incisors associated with right mandible pain and swelling. Actinomyces-induced osteomyelitis of the mandible was diagnosed. The patient was treated with penicillin V for 6 weeks along with a course of hyperbaric oxygen therapy, which resulted in the complete resolution of the infection. CONCLUSION: In summary, jaw osteomyelitis caused by Actinomyces should always be part of the differential diagnosis; as these organisms are commensal flora. The symptoms manifested are non-specific, and such a diagnosis could be easily missed, resulting in delay of care and disease progression.
Assuntos
Actinomyces , Actinomicose , Osteomielite , Humanos , Osteomielite/microbiologia , Osteomielite/diagnóstico , Osteomielite/tratamento farmacológico , Feminino , Pessoa de Meia-Idade , Actinomicose/diagnóstico , Actinomicose/microbiologia , Actinomicose/tratamento farmacológico , Actinomicose/complicações , Actinomyces/isolamento & purificação , Antibacterianos/uso terapêutico , Mandíbula/microbiologia , Oxigenoterapia Hiperbárica , Diagnóstico Diferencial , Doenças Mandibulares/microbiologia , Doenças Mandibulares/tratamento farmacológico , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológicoRESUMO
In recent years, several studies have examined the gut microbiome of lepidopteran larvae and how factors such as host plant affect it, and in turn, how gut bacteria affect host plant responses to herbivory. In addition, other studies have detailed how secretions of the labial (salivary) glands can alter host plant defense responses. We examined the gut microbiome of the cabbage looper (Trichoplusia ni) feeding on collards (Brassica oleracea) and separately analyzed the microbiomes of various organs that open directly into the alimentary canal, including the labial glands, mandibular glands, and the Malpighian tubules. In this study, the gut microbiome of T. ni was found to be generally consistent with those of other lepidopteran larvae in prior studies. The greatest diversity of bacteria appeared in the Firmicutes, Actinobacteria, Proteobacteria, and Bacteriodetes. Well-represented genera included Staphylococcus, Streptococcus, Corynebacterium, Pseudomonas, Diaphorobacter, Methylobacterium, Flavobacterium, and Cloacibacterium. Across all organs, two amplicon sequence variants (ASVs) associated with the genera Diaphorobacter and Cloacibacterium appeared to be most abundant. In terms of the most prevalent ASVs, the alimentary canal, Malpighian tubules, and mandibular glands appeared to have similar complements of bacteria, with relatively few significant differences evident. However, aside from the Diaphorobacter and Cloacibacterium ASVs common to all the organs, the labial glands appeared to possess a distinctive complement of bacteria which was absent or poorly represented in the other organs. Among these were representatives of the Pseudomonas, Flavobacterium, Caulobacterium, Anaerococcus, and Methylobacterium. These results suggest that the labial glands present bacteria with different selective pressures than those occurring in the mandibular gland, Malpighian tubules and the alimentary canal. Given the documented effects that labial gland secretions and the gut microbiome can exert on host plant defenses, the effects exerted by the bacteria inhabiting the labial glands themselves deserve further study.
Assuntos
Bactérias/classificação , Sistema Digestório/microbiologia , Mariposas/microbiologia , Glândulas Salivares/microbiologia , Animais , Bactérias/isolamento & purificação , Microbioma Gastrointestinal , Túbulos de Malpighi/microbiologia , Mandíbula/microbiologiaRESUMO
Hypoxia and limited vascularization inhibit bone growth and recovery after surgical debridement to treat osteomyelitis. Similarly, despite significant efforts to create functional tissue-engineered organs, clinical success is often hindered by insufficient oxygen diffusion and poor vascularization. To overcome these shortcomings, we previously used the oxygen carrier perfluorooctane (PFO) to develop PFO emulsion-loaded hollow microparticles (PFO-HPs). PFO-HPs act as a local oxygen source that increase cell viability and maintains the osteogenic differentiation potency of human periosteum-derived cells (hPDCs) under hypoxic conditions. In the present study, we used a miniature pig model of mandibular osteomyelitis to investigate bone regeneration using hPDCs seeded on PFO-HPs (hPDCs/PFO-HP) or hPDCs seeded on phosphate-buffered saline (PBS)-HPs (hPDCs/PBS-HP). Osteomyelitis is characterized by a series of microbial invasion, vascular disruption, bony necrosis, and sequestrum formation due to impaired host defense response. Sequential plain radiography, computed tomography (CT), and 3D reconstructed CT images revealed new bone formation was more advanced in defects that had been implanted with the hPDCs/PFO-HPs than in defects implanted with the hPDCs/PBS-HP. Thus, PFO-HPs are a promising tissue engineering approach to repair challenging bone defects and regenerate structurally organized bone tissue with 3D architecture.
Assuntos
Regeneração Óssea/fisiologia , Mandíbula/patologia , Microesferas , Osteoblastos/citologia , Osteomielite/terapia , Oxigênio/farmacologia , Periósteo/citologia , Animais , Regeneração Óssea/efeitos dos fármacos , Soluções Tampão , Modelos Animais de Doenças , Fluorocarbonos/química , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/efeitos dos fármacos , Mandíbula/microbiologia , Osteoblastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Osteomielite/diagnóstico por imagem , Osteomielite/microbiologia , Osteomielite/patologia , Implantação de Prótese , Staphylococcus aureus/efeitos dos fármacos , Suínos , Porco MiniaturaRESUMO
We report a pediatric case aged 10 years with Granulicatella adiacens-associated chronic mandibular osteomyelitis. The causative pathogen was uncertain because polymicrobial species were detected from the bacterial culture in bone marrow fluid. In contrast, G. adiacens was predominantly identified in the clone library analysis of the bacterial 16S rRNA gene sequence. Vancomycin to which G. adiacens was reported to be susceptible was not administrated sufficiently to this patient because of its adverse event, whereas linezolid and ciprofloxacin was alternatively effective for the treatment of chronic mandibular osteomyelitis.
Assuntos
Antibacterianos/uso terapêutico , Carnobacteriaceae/patogenicidade , Mandíbula/microbiologia , Osteomielite/microbiologia , Carnobacteriaceae/genética , Carnobacteriaceae/isolamento & purificação , Criança , Doença Crônica/terapia , Curetagem , Quimioterapia Combinada , Feminino , Humanos , Oxigenoterapia Hiperbárica , Mandíbula/diagnóstico por imagem , Osteomielite/diagnóstico , Osteomielite/patologia , Osteomielite/terapia , RNA Ribossômico 16S/isolamento & purificação , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
CLINICAL INTRODUCTION: A 77-year-old man presented to the ED with a history of fevers, purulent drainage and right mandibular pain. He had been diagnosed with multiple myeloma 2 years previously and was receiving treatment with pamidronate. On presentation, the lower right lip and chin were anaesthetic, tooth number 31 had grade 2 mobility and a 15 mm long ulceration was present on the lingual aspect of the mandible (figure 1). Antibiotics were administered, and a maxillofacial CT without contrast was performed (figure 2).emermed;36/1/17/F1F1F1Figure 1Clinical examination revealing a 15 mm long ulceration (arrow mark) associated with the lingual aspect of tooth number 31.emermed;36/1/17/F2F2F2Figure 2CT maxillofacial (coronal) demonstrating osseous destruction (arrow mark) of the right mandibular body. QUESTION: What is your diagnosis?Odontogenic abscessBenign fibro-osseous lesionMedication-related osteonecrosis of the jaw (MRONJ)Metastatic malignancy.
Assuntos
Osteonecrose/cirurgia , Pamidronato/efeitos adversos , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Idoso , Antibacterianos/uso terapêutico , Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/uso terapêutico , Drenagem/métodos , Febre/etiologia , Humanos , Masculino , Mandíbula/microbiologia , Mandíbula/fisiopatologia , Osteonecrose/tratamento farmacológico , Dor/etiologia , Pamidronato/uso terapêutico , Tomografia Computadorizada por Raios X/métodosRESUMO
Osteomyelitis of mandible, if it affects the neonate presents as a diagnostic and therapeutic challenge to the clinician. Symptoms and signs are often non-specific, and the consequences of a missed diagnosis could lead to long-lasting functional limitations. A rare case of a 52 days old infant with osteomyelitis of the mandible following natal tooth extraction is presented in this report. The diagnosis, pathogenesis and management have been explained. The accompanying review briefly summarizes the main clinical, pathophysiological and radiological aspects of the condition and gives an update on the treatment.
Assuntos
Mandíbula/microbiologia , Dentes Natais/cirurgia , Osteomielite/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Infecções Estafilocócicas/diagnóstico , Extração Dentária/efeitos adversos , Antibacterianos/uso terapêutico , Feminino , Humanos , Lactente , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Complicações Pós-Operatórias/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Vancomicina/uso terapêuticoRESUMO
Some microbes possess the ability to adaptively manipulate host behavior. To better understand how such microbial parasites control animal behavior, we examine the cell-level interactions between the species-specific fungal parasite Ophiocordyceps unilateralis sensu lato and its carpenter ant host (Camponotus castaneus) at a crucial moment in the parasite's lifecycle: when the manipulated host fixes itself permanently to a substrate by its mandibles. The fungus is known to secrete tissue-specific metabolites and cause changes in host gene expression as well as atrophy in the mandible muscles of its ant host, but it is unknown how the fungus coordinates these effects to manipulate its host's behavior. In this study, we combine techniques in serial block-face scanning-electron microscopy and deep-learning-based image segmentation algorithms to visualize the distribution, abundance, and interactions of this fungus inside the body of its manipulated host. Fungal cells were found throughout the host body but not in the brain, implying that behavioral control of the animal body by this microbe occurs peripherally. Additionally, fungal cells invaded host muscle fibers and joined together to form networks that encircled the muscles. These networks may represent a collective foraging behavior of this parasite, which may in turn facilitate host manipulation.
Assuntos
Formigas/microbiologia , Interações Hospedeiro-Patógeno , Hypocreales/ultraestrutura , Aprendizado de Máquina , Músculos/microbiologia , Animais , Formigas/anatomia & histologia , Formigas/citologia , Comportamento Animal , Hypocreales/patogenicidade , Hypocreales/fisiologia , Processamento de Imagem Assistida por Computador/estatística & dados numéricos , Imageamento Tridimensional , Mandíbula/microbiologia , Músculos/ultraestruturaRESUMO
INTRODUCTION: The purpose of this study is to compare a group of patients with Primary Chronic Osteomyelitis of the mandible (PCO) and a group with Secondary Chronic Osteomyelitis of the mandible (SCO) to support the classification of osteomyelitis of the jaws defined by Eyrich et al. MATERIAL AND METHODS: Medical records of patients with chronic osteomyelitis of the mandible were screened and relevant clinical data was recorded retrospectively. The patients were divided into two groups according the criteria proposed by Eyrich et al.: one group with PCO and one with SCO. Comparison was made between these two groups. RESULTS: Twenty-two patients were included, 10 in the PCO group, and 12 in the SCO group. The main differences between the two groups concerned the duration of the symptoms (100% of the cases in the PCO group lasted more than 2years, versus 8.3% in the SCO group, P<0.05), computed tomography images of bone sclerosis and bone hypertrophy (present in respectively 100% and 50% of the patients in the PCO group, vs. 36.4% and 0% in the SCO group, P<0.05), and the treatment (100% of surgical decortication and 80% of Nonsteroidal Anti-Inflammatory Drug or steroids use in the PCO group vs. 25% and 0% in the SCO group, P<0.05). DISCUSSION: The classification proposed by Eyrich et al. seems relevant according to the results of our study, PCO and SCO differing especially on the duration of the symptoms, the radiologic findings and the treatment and its outcomes.
Assuntos
Doenças Mandibulares/epidemiologia , Doenças Mandibulares/etiologia , Osteomielite/epidemiologia , Osteomielite/etiologia , Adolescente , Adulto , Antibacterianos/uso terapêutico , Criança , Doença Crônica , Comorbidade , Feminino , Humanos , Masculino , Mandíbula/microbiologia , Mandíbula/patologia , Doenças Mandibulares/diagnóstico , Doenças Mandibulares/terapia , Pessoa de Meia-Idade , Osteomielite/diagnóstico , Osteomielite/terapia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Although enamel matrix derivative (EMD) has been used to promote periodontal regeneration, little is known of its effect on the microbiome. Therefore, this investigation aims to identify changes in periodontal microbiome after treatment with EMD using a deep-sequencing approach. METHODS: Thirty-nine patients with mandibular Class II buccal furcation defects were randomized to beta-tricalcium-phosphate/hydroxyapatite graft (BONE group), EMD+BONE, or EMD alone. Plaque was collected from furcation defects at baseline and 3 and 6 months post-treatment. Bacterial DNA was analyzed using terminal restriction fragment length polymorphism and 16S pyrotag sequencing, resulting in 169,000 classifiable sequences being compared with the Human Oral Microbiome Database. Statistical comparisons were made using parametric tests. RESULTS: At baseline, a total of 422 species were identified from the 39 defects, belonging to Fusobacterium, Pseudomonas, Streptococcus, Filifactor, and Parvimonas. All three regenerative procedures predictably altered the disease-associated microbiome, with a restitution of health-compatible species. However, EMD and BONE+EMD groups demonstrated more long-term reductions in a higher number of species than the BONE group (P <0.05), especially disease-associated species, e.g., Selenomonas noxia, F. alocis, and Fusobacterium. CONCLUSIONS: EMD treatment predictably alters a dysbiotic subgingival microbiome, decreasing pathogen richness and increasing commensal abundance. Further investigations are needed to investigate how this impacts regenerative outcomes.
Assuntos
Substitutos Ósseos/farmacologia , Proteínas do Esmalte Dentário/farmacologia , Defeitos da Furca/microbiologia , Gengiva/microbiologia , Microbiota/efeitos dos fármacos , Substitutos Ósseos/uso terapêutico , DNA Bacteriano/isolamento & purificação , Proteínas do Esmalte Dentário/uso terapêutico , Índice de Placa Dentária , Feminino , Defeitos da Furca/terapia , Humanos , Hidroxiapatitas/farmacologia , Hidroxiapatitas/uso terapêutico , Masculino , Mandíbula/microbiologia , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Our aims were to analyze adhesion of periodontopathogens to self-ligating brackets (Clarity-SL [CSL], Clippy-C [CC] and Damon Q [DQ]) and to identify the relationships between bacterial adhesion and oral hygiene indexes. METHODS: Central incisor brackets from the maxilla and mandible were collected from 60 patients at debonding after the plaque and gingival indexes were measured. Adhesions of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), and Tannerella forsythia (Tf) were quantitatively determined using real-time polymerase chain reactions. Factorial analysis of variance was used to analyze bacterial adhesion in relation to bracket type and jaw position. Correlation coefficients were calculated to determine the relationships between bacterial adhesion and the oral hygiene indexes. RESULTS: Total bacteria showed greater adhesion to CSL than to DQ brackets, whereas Aa, Pg, and Pi adhered more to DQ than to CSL brackets. CC brackets showed an intermediate adhesion pattern between CSL and DQ brackets, but it did not differ significantly from either bracket type. Adhesion of Fn and Tf did not differ significantly among the 3 brackets. Most bacteria were detected in greater quantities in the mandibular than in the maxillary brackets. The plaque and gingival indexes were not strongly correlated with bacterial adhesion to the brackets. CONCLUSIONS: Because Aa, Pg, and Pi adhered more to the DQ brackets in the mandibular area, orthodontic patients with periodontal problems should be carefully monitored in the mandibular incisors where the distance between the bracket and the gingiva is small, especially when DQ brackets are used.
Assuntos
Aderência Bacteriana , Braquetes Ortodônticos/microbiologia , Periodonto/microbiologia , Adulto , Carga Bacteriana , Placa Dentária/microbiologia , Feminino , Humanos , Incisivo/microbiologia , Masculino , Mandíbula/microbiologia , Maxila/microbiologia , Índice de Higiene Oral , Estatística como AssuntoRESUMO
Actinomycosis is an infection of filamentous, gram-positive anaerobic bacteria. Actinomycosis of jaw bone is rare and the diagnosis is often difficult. The aim of this patient report is to present an actinomycotic osteomyelitis of mandible in a 30-year-old male patient. The patient presented with a chief complaint of pain and unhealed dental socket after mandibular teeth extractions. Radiographs showed ill-defined radiolucencies and perforation of buccal and lingual cortical plate; several biopsies and different therapy could not improve the lesion because of fault diagnosis and improper treatment. Finally, the authors' histopathological examination revealed granulation tissue surrounded bacterial colonies compatible with actinomycotic colonies. Follow-up examinations showed that the patient was well 6 months after prolonged treatment without any pain and discharge from dental socket.
Assuntos
Actinomicose/diagnóstico , Mandíbula/microbiologia , Osteomielite/diagnóstico , Actinomyces/isolamento & purificação , Actinomicose/microbiologia , Actinomicose/terapia , Adulto , Antibacterianos/uso terapêutico , Biópsia , Humanos , Masculino , Mandíbula/patologia , Mandíbula/cirurgia , Osteomielite/microbiologia , Osteomielite/terapia , Osteotomia/métodosRESUMO
Changes in bacteriological indices through the square of the wound of chemical origin under local impact of the silver nanoparticles (NP), stabilized by 2-ethyl-6-methyl-3-hydroxypyridine succinate (mexidol) and polyvinylpyrrolidone were studied. The wounds of submandibular region were simulated in white rats, using injection of 10% solution of calcium chloride with further opening of necrotic foci and open management of the wound. Beginning from the fifth day, every day the wound was irrigated with liquid, which have contented the stabilized NP of the silver, 0.05% water solution of chlorhexidine or isotonic solution of the the sodium chloride (control). There was established, that the silver NP impact antiseptically and regenerative while the wound treatment, and reduce during 10 days microbial contamination of exudate in 24 times, the wound square--in three times in comparison with original indices. These changes were identical to those while application of chlorhexidine.
Assuntos
Anti-Infecciosos Locais/farmacologia , Nanopartículas Metálicas/uso terapêutico , Prata/farmacologia , Infecções dos Tecidos Moles/tratamento farmacológico , Infecção dos Ferimentos/tratamento farmacológico , Animais , Carga Bacteriana , Cloreto de Cálcio , Clorexidina/farmacologia , Masculino , Mandíbula/efeitos dos fármacos , Mandíbula/microbiologia , Mandíbula/patologia , Picolinas/química , Povidona/química , Ratos , Ratos Wistar , Infecções dos Tecidos Moles/induzido quimicamente , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Resultado do Tratamento , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/induzido quimicamente , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/patologiaRESUMO
Own experience of treatment of a narcotic dependence patients, suffering osteomyelitis of jaws, was analyzed. In those patients, who have had exposed themselves towards toxic impact of narcotic substances (even after arrest of the consumption) for a long period of time, the inflammation spreading on the bones of facial middle zone and the skull base with occurrence of a life3threatening purulent3septic, including intracerebral, complications (cerebral аbscess, meningitis, sepsis) were observed. Additional division of cerebral abscess on open and closed forms for optimization of diagnosis of Ñntracranial complications was proposed.
Assuntos
Mandíbula/cirurgia , Maxila/cirurgia , Osteomielite/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Base do Crânio/cirurgia , Transtornos Relacionados ao Uso de Substâncias/cirurgia , Adulto , Antibacterianos/uso terapêutico , Abscesso Encefálico/etiologia , Abscesso Encefálico/microbiologia , Abscesso Encefálico/patologia , Abscesso Encefálico/cirurgia , Doença Crônica , Face/microbiologia , Face/patologia , Face/cirurgia , Feminino , Humanos , Masculino , Mandíbula/microbiologia , Mandíbula/patologia , Maxila/microbiologia , Maxila/patologia , Meningite/etiologia , Meningite/microbiologia , Meningite/patologia , Meningite/cirurgia , Entorpecentes/administração & dosagem , Osteomielite/complicações , Osteomielite/microbiologia , Osteomielite/patologia , Estudos Retrospectivos , Sepse/etiologia , Sepse/microbiologia , Sepse/patologia , Sepse/cirurgia , Base do Crânio/microbiologia , Base do Crânio/patologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/microbiologia , Transtornos Relacionados ao Uso de Substâncias/patologiaRESUMO
PURPOSE: To determine the level of bacterial contamination in immediate implantation or augmentation sites vs pristine bone, before and after saline rinses. MATERIALS AND METHODS: Bacterial samples were taken from fresh extraction sites (17 patients) and pristine bone (15 patients) before performing implant dentistry surgical procedures. Levels of bacterial contamination were estimated before and after saline rinses. Samples from the socket were placed on an agar plate for total bacterial account and on selective plates for Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis counts. RESULTS: The level of bacterial contamination before saline rinse was 1.2 × 10(4) units of bacterial colony (CFU)/mL in fresh extraction sites (study group) and 5 × 10(2) CFU/mL in pristine bone sites (control group). After a saline rinse, the bacterial level was lowered significantly to 5.2 × 10(3) CFU/mL in the study group and to zero in the control group (P < .05). Levels of bacterial contamination were higher in the mandibular sockets (7.5 × 10(3) CFU/ml) than in the maxillary sockets (5.6 × 10(3) CFU/mL), and the difference was statistically significant (P = .034). All implanted/augmented fresh or pristine sites survived in the follow-up period. CONCLUSION: Fresh extraction sockets with clinical signs of infection show bacterial presence. Pristine bone shows a lower bacterial level. Saline rinse in addition to a decontamination protocol may reduce the level of bacterial contamination significantly both in fresh extraction sites and pristine bone.
Assuntos
Bactérias/isolamento & purificação , Antissépticos Bucais/uso terapêutico , Cloreto de Sódio/uso terapêutico , Extração Dentária , Alvéolo Dental/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Aumento do Rebordo Alveolar , Carga Bacteriana , Estudos de Coortes , Implantação Dentária Endóssea/métodos , Implantes Dentários , Feminino , Humanos , Masculino , Mandíbula/microbiologia , Mandíbula/cirurgia , Maxila/microbiologia , Maxila/cirurgia , Pessoa de Meia-Idade , Porphyromonas gingivalis/isolamento & purificação , Estudos Prospectivos , Alvéolo Dental/cirurgia , Adulto JovemRESUMO
Methicillin-resistant Staphylococcus aureus (MRSA) is an established nosocomial pathogen with frequent multidrug resistance. The immaturity of the immune system along with intravascular lines and empirical antibiotic treatments place hospitalized preterm infants at major risk of MRSA infection.We report a case of MRSA mandibular osteomyelitis complicating a persistent S. aureus bacteremia in a 23-week preterm infant. From the first weeks of life, the infant showed recurrent C-reactive protein (CRP) elevation, associated with S. aureus bacteremia. Antibiotic courses, including vancomycin and linezolid, were performed with transitory normalization of blood parameters. On day 74, the infant suddenly deteriorated and showed a significant increase of both CRP and procalcitonin. Empiric vancomycin and piperacillin-tazobactam treatment was started; nevertheless, she developed a progressive hard swelling of neck and mandible. Radiological evaluation revealed a mandibular osteomyelitis complicated by an abscess, whose culture grew MRSA. Vancomycin was thus changed to teicoplanin and complete clinical and radiological healing was gradually achieved.In the presence of major risk factors, persistent bacteremia and nonspecific symptoms, a localized focus of infection should be suspected. Microbiological diagnosis should always be attempted and antibiotic treatment should be guided by both susceptibility results and clinical response.
Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Mandíbula/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Osteomielite/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Infecção Hospitalar/microbiologia , Feminino , Humanos , Recém-Nascido , Osteomielite/microbiologia , Infecções Estafilocócicas/microbiologiaRESUMO
PURPOSE: The aim of this study was to compare levels of bacterial contamination of autogenous bone collected when using low-speed drilling, a back-action chisel, and a bone filter. MATERIALS AND METHODS: Bone tissue samples were taken from 31 patients who underwent surgical extraction of their third lower molars. Before surgical removal of the molar, bone particles were collected by a low-speed drill or a back-action chisel. Then, a stringent aspiration protocol was applied during the ostectomy to collect particulate bone by a bone filter. Processing of samples commenced immediately by incubation in an anaerobic or a CO2-rich atmosphere. The number of colony-forming units (CFUs) was determined at 48 hours of culture. RESULTS: No significant difference in the number of CFUs per milliliter was observed between the low-speed drilling group and the back-action chisel group in the anaerobic or CO2-rich condition (P = .34). However, significantly more micro-organisms were found in the bone filter group than in the low-speed drilling group or the back-action chisel group in the anaerobic and CO2-rich conditions (P < .001). CONCLUSIONS: Particulate bone harvested with low-speed drilling or a back-action chisel is safer for use as an autograft than are bone particles collected with a bone filter. These results suggest that bone obtained from low-speed drilling is safe and straightforward to harvest and could be the method of choice for collecting particulate bone. Further research is needed to lower the bacterial contamination levels of autogenous bone particles used as graft material.
Assuntos
Autoenxertos/microbiologia , Bactérias/isolamento & purificação , Transplante Ósseo , Osso e Ossos/microbiologia , Coleta de Tecidos e Órgãos/métodos , Adulto , Anaerobiose , Carga Bacteriana , Técnicas Bacteriológicas , Dióxido de Carbono/metabolismo , Feminino , Filtração/instrumentação , Humanos , Masculino , Mandíbula/microbiologia , Mandíbula/cirurgia , Dente Serotino/cirurgia , Osteotomia/instrumentação , Osteotomia/métodos , Fatores de Tempo , Coleta de Tecidos e Órgãos/instrumentação , Dente Impactado/cirurgia , Sítio Doador de Transplante/cirurgia , Adulto JovemRESUMO
OBJECTIVE: To analyze in vivo mutans streptococci (MS) adhesion to self-ligating ceramic brackets [Clarity-SL (CSL) and Clippy-C (CC)] and the relationships between bacterial adhesion and oral hygiene indices. MATERIALS AND METHODS: Four central incisor brackets from the maxilla and mandible were collected from 40 patients (20 patients per each bracket type) at debonding immediately after plaque and gingival indices were measured. Adhesions of Streptococcus mutans, S. sobrinus, and total bacteria were quantitatively determined using real-time polymerase chain reaction after genomic DNA was extracted. Factorial analysis of variance was used to analyze bacterial adhesion to the brackets with respect to the bracket type and jaw position. Correlation coefficients were calculated to determine the relationships of bacterial adhesion to oral hygiene indices. RESULTS: Adhesion of total bacteria and S. mutans to CSL was higher than that to CC (P < 0.001). Adhesion of total bacteria to the mandibular brackets was higher than that to the maxillary ones (P < 0.001), while adhesion of S. mutans to the maxillary brackets were higher than that in the mandibular ones (P < 0.001). In particular, the proportion of S. mutans to total bacteria in CSL was higher than CC (P < 0.05) in the maxillary anterior teeth (P < 0.001). There were no significant differences in adhesion of S. sobrinus between the brackets and jaw positions. Interestingly, no significant relationships were found between bacterial adhesions and oral hygiene indices. LIMITATIONS: Complex bracket configurations may significantly influence bacterial adhesion to orthodontic brackets. Further in vivo study using bracket raw materials will help to define the relationships between bacteria adhesion and enamel demineralization. CONCLUSIONS: Because oral hygiene indices were not significantly correlated with adhesions of MS to self-ligating ceramic brackets, careful examinations around the brackets should be needed to prevent enamel demineralization, regardless of oral hygiene status.
Assuntos
Aderência Bacteriana/fisiologia , Braquetes Ortodônticos/microbiologia , Streptococcus mutans/fisiologia , Adolescente , Carga Bacteriana , Cerâmica/química , DNA Bacteriano/análise , Materiais Dentários/química , Placa Dentária/microbiologia , Índice de Placa Dentária , Feminino , Humanos , Masculino , Mandíbula/microbiologia , Maxila/microbiologia , Índice de Higiene Oral , Índice Periodontal , Estudos Prospectivos , Reação em Cadeia da Polimerase em Tempo Real , Streptococcus mutans/isolamento & purificação , Streptococcus sobrinus/isolamento & purificação , Streptococcus sobrinus/fisiologia , Propriedades de Superfície , Adulto JovemRESUMO
Periodontal diseases are multifactorial, caused by polymicrobial subgingival pathogens, including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia. Chronic periodontal infection results in inflammation, destruction of connective tissues, periodontal ligament, and alveolar bone resorption, and ultimately tooth loss. Enoxacin and a bisphosphonate derivative of enoxacin (bis-enoxacin) inhibit osteoclast formation and bone resorption and also contain antibiotic properties. Our study proposes that enoxacin and/or bis-enoxacin may be useful in reducing alveolar bone resorption and possibly bacterial colonization. Rats were infected with 10(9) cells of polymicrobial inoculum consisting of P. gingivalis, T. denticola, and T. forsythia, as an oral lavage every other week for twelve weeks. Daily subcutaneous injections of enoxacin (5 mg/kg/day), bis-enoxacin (5, 25 mg/kg/day), alendronate (1, 10 mg/kg/day), or doxycycline (5 mg/day) were administered after 6 weeks of polymicrobial infection. Periodontal disease parameters, including bacterial colonization/infection, immune response, inflammation, alveolar bone resorption, and systemic spread, were assessed post-euthanasia. All three periodontal pathogens colonized the rat oral cavity during polymicrobial infection. Polymicrobial infection induced an increase in total alveolar bone resorption, intrabony defects, and gingival inflammation. Treatment with bis-enoxacin significantly decreased alveolar bone resorption more effectively than either alendronate or doxycycline. Histologic examination revealed that treatment with bis-enoxacin and enoxacin reduced gingival inflammation and decreased apical migration of junctional epithelium. These data support the hypothesis that bis-enoxacin and enoxacin may be useful for the treatment of periodontal disease.