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1.
Trials ; 20(1): 603, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651364

RESUMO

BACKGROUND: Routine application of chlorhexidine oral rinse is recommended to reduce risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Recent reappraisal of the evidence from two meta-analyses suggests chlorhexidine may cause excess mortality in non-cardiac surgery patients and does not reduce VAP. Mechanisms for possible excess mortality are unclear. The CHORAL study will evaluate the impact of de-adopting chlorhexidine and implementing an oral care bundle (excluding chlorhexidine) on mortality, infection-related ventilator-associated complications (IVACs), and oral health status. METHODS: The CHORAL study is a stepped wedge, cluster randomized controlled trial in six academic intensive care units (ICUs) in Toronto, Canada. Clusters (ICU) will be randomly allocated to six sequential steps over a 14-month period to de-adopt oral chlorhexidine and implement a standardized oral care bundle (oral assessment, tooth brushing, moisturization, and secretion removal). On study commencement, all clusters begin with a control period in which the standard of care is oral chlorhexidine. Clusters then begin crossover from control to intervention every 2 months according to the randomization schedule. Participants include all mechanically ventilated adults eligible to receive the standardized oral care bundle. The primary outcome is ICU mortality; secondary outcomes are IVACs and oral health status. We will determine demographics, antibiotic usage, mortality, and IVAC rates from a validated local ICU clinical registry. With six clusters and 50 ventilated patients on average each month per cluster, we estimate that 4200 patients provide 80% power after accounting for intracluster correlation to detect an absolute reduction in mortality of 5.5%. We will analyze our primary outcome of mortality using a generalized linear mixed model adjusting for time to account for secular trends. We will conduct a process evaluation to determine intervention fidelity and to inform interpretation of the trial results. DISCUSSION: The CHORAL study will inform understanding of the effectiveness of de-adoption of oral chlorhexidine and implementation of a standardized oral care bundle for decreasing ICU mortality and IVAC rates while improving oral health status. Our process evaluation will inform clinicians and decision makers about intervention delivery to support future de-adoption if justified by trial results. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03382730 . Registered on December 26, 2017.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Clorexidina/administração & dosagem , Antissépticos Bucais/administração & dosagem , Higiene Bucal , Pacotes de Assistência ao Paciente , Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Respiração Artificial/efeitos adversos , Anti-Infecciosos Locais/efeitos adversos , Clorexidina/efeitos adversos , Estado Terminal , Estudos Cross-Over , Drenagem , Humanos , Antissépticos Bucais/efeitos adversos , Estudos Multicêntricos como Assunto , Ontário , Higiene Bucal/efeitos adversos , Pacotes de Assistência ao Paciente/efeitos adversos , Pneumonia Associada à Ventilação Mecânica/diagnóstico , Pneumonia Associada à Ventilação Mecânica/etiologia , Pneumonia Associada à Ventilação Mecânica/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Respiração Artificial/mortalidade , Fatores de Tempo , Escovação Dentária , Resultado do Tratamento
2.
Anticancer Res ; 39(4): 1935-1942, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30952736

RESUMO

BACKGROUND: Oropharyngeal mucositis occurs in virtually all patients with head and neck cancer receiving radiochemotherapy. The manipulation of the oral cavity microbiota represents an intriguing and challenging target. PATIENTS AND METHODS: A total of 75 patients were enrolled to receive Lactobacillus brevis CD2 lozenges or oral care regimen with sodium bicarbonate mouthwashes. The primary endpoint was the incidence of grade 3 or 4 oropharyngeal mucositis during radiotherapy treatment. RESULTS: There was no statistical difference in the incidence of grade 3-4 oropharyngeal mucositis between the intervention and control groups (40.6% vs. 41.6% respectively, p=0.974). The incidence of pain, dysphagia, body weight loss and quality of life were not different between the experimental and standard arm. CONCLUSION: Our study was not able to demonstrate the efficacy of L. brevis CD2 lozenges in preventing radiation-induced mucositis in patients with head and neck cancer. Although modulating homeostasis of the salivary microbiota in the oral cavity seems attractive, it clearly needs further study.


Assuntos
Quimiorradioterapia/efeitos adversos , Neoplasias de Cabeça e Pescoço/terapia , Lactobacillus brevis/fisiologia , Boca/microbiologia , Antissépticos Bucais/administração & dosagem , Probióticos/administração & dosagem , Bicarbonato de Sódio/administração & dosagem , Estomatite/prevenção & controle , Administração Oral , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/efeitos adversos , Estudos Prospectivos , Saliva/microbiologia , Bicarbonato de Sódio/efeitos adversos , Estomatite/diagnóstico , Estomatite/microbiologia , Fatores de Tempo , Resultado do Tratamento
3.
J Thorac Cardiovasc Surg ; 158(4): 1094-1100, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30826096

RESUMO

OBJECTIVE: Postoperative pneumonia is one of the most common complications after cardiac surgery, entailing increased patient morbidity, mortality, and health care burden. The primary aim of this study was to assess whether preoperative chlorhexidine mouthwash is associated with reduced postoperative pneumonia after cardiac surgery. METHODS: A comprehensive systematic search of NLM Pubmed, Embase, Scopus, and Cumulative Index of Nursing and Allied Health was executed to include the studies since inception to June 27, 2017, which assessed the effects of preoperative chlorhexidine gluconate mouthwash on postoperative pneumonia. Studies were identified by 2 independent reviewers, and data were extracted using a predefined protocol. Random effects models were run to obtain risk ratios with 95% confidence intervals. Quality of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation criteria. Postoperative pneumonia after cardiac surgery was the primary outcome of the study. RESULTS: Five studies including a cumulative of 2284 patients were included. A total of 1125 patients received preoperative chlorhexidine. Use of chlorhexidine gluconate was associated with reduced risk of postoperative pneumonia compared with the patients who did not receive it (risk ratio, 0.52; 95% confidence interval, 0.39-0.70; P < .001). No adverse effects from chlorhexidine gluconate mouthwash were reported by any of these studies. CONCLUSIONS: Among the patients receiving preoperative chlorhexidine mouthwash, the risk of postoperative pneumonia is reduced by approximately one-half; its adoption in preoperative protocols could help improve patient outcomes.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Procedimentos Cirúrgicos Cardíacos , Clorexidina/análogos & derivados , Infecção Hospitalar/prevenção & controle , Boca/microbiologia , Antissépticos Bucais/administração & dosagem , Saúde Bucal , Higiene Bucal/métodos , Pneumonia Bacteriana/prevenção & controle , Cuidados Pré-Operatórios/métodos , Administração Oral , Anti-Infecciosos Locais/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Clorexidina/administração & dosagem , Clorexidina/efeitos adversos , Infecção Hospitalar/microbiologia , Humanos , Antissépticos Bucais/efeitos adversos , Higiene Bucal/efeitos adversos , Pneumonia Bacteriana/microbiologia , Cuidados Pré-Operatórios/efeitos adversos , Período Pré-Operatório , Fatores de Proteção , Fatores de Risco , Resultado do Tratamento
4.
J Altern Complement Med ; 25(5): 552-558, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30758216

RESUMO

Objective: An alcohol-free mouthwash of curcuminoids purified from the turmeric (Curcuma longa Linn.) rhizome was formulated using a cosolvent system, comprising chitosan and polyethylene glycol (PEG) 400, and determined for its efficacy and safety in management of denture stomatitis (DS) in comparison with a chlorhexidine (CHX) mouthwash. Design: A single-center, randomized, controlled parallel-arm trial was conducted. Setting: The study took place at the Faculty of Dentistry, Prince of Songkla University, Hat-Yai, Thailand, between June 2016 and June 2017. Subjects: Participants were 20 years old or older adults of both genders, using removable dentures, and with a confirmed diagnosis of DS from an oral medicine specialist. Interventions: A total of 30 patients were randomly assigned to 3 different interventions, including the chitosan-curcuminoid (CHI-CUR) mouthwash, CHX mouthwash, and a vehicle formulation comprising chitosan and PEG 400. Ten milliliters of each intervention was given to the patient to be used for 30 sec, three times a day at 8 am, 12 pm, and 4 pm, for 2 weeks. Outcome measures: Outcome measures included complete relief of erythematous lesions under the denture and reduction in the number of candida colonies present in the denture-fitting surface. Results: Eight of 10 patients (80%) using the CHI-CUR mouthwash had a complete response after the 2-week treatment course compared with 30% of patients using the CHX mouthwash (p < 0.05). Both interventions exerted comparable anticandida efficacy. No oral or systemic adverse events that could possibly be related to the use of mouthwash were documented. Conclusions: The finding indicated that an alcohol-free CHI-CUR mouthwash may serve as a safe and potential topical therapeutic alternative in treating generalized or candida-associated DS.


Assuntos
Quitosana/uso terapêutico , Clorexidina/uso terapêutico , Curcumina/uso terapêutico , Antissépticos Bucais , Estomatite sob Prótese/tratamento farmacológico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/efeitos adversos , Antissépticos Bucais/química , Antissépticos Bucais/uso terapêutico , Satisfação do Paciente , Resultado do Tratamento
5.
Enferm. intensiva (Ed. impr.) ; 29(4): 187-188, oct.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-182236

RESUMO

Propósito: La clorhexidina oral es un antiséptico ampliamente utilizada en pacientes hospitalizados y ambulatorios para mantener la salud oral. El objetivo del estudio es analizar el efecto de los cuidados orales con clorhexidina sobre la mortalidad en la población general hospitalizada de un centro sanitario. Método: Es un estudio de cohortes, observacional de un único centro, retrospectivo, que incluye pacientes adultos entre 2012 y 2014. La mortalidad asociada a los cuidados orales con clorhexidina se evaluó mediante análisis de regresión logística. Se consideró una dosis acumulativa de clorhexidina de 300mg como proxy dicotómico para la exposición al antiséptico. Se ajustan los resultados según datos demográficos, categorías de diagnóstico y riesgo de mortalidad expresados en cuatro categorías (menor, moderado, mayor y extremo). Resultados: La cohorte de estudio incluyó a 82.274 pacientes, de los cuales un 14% recibieron cuidados orales con clorhexidina. Un nivel bajo de exposición a la clorhexidina (≤300mg) se asoció a un mayor riesgo de muerte [odds ratio (OR) 2.61; IC del 95% 2,32-2,92]. Esta asociación fue más fuerte en pacientes con un menor riesgo de muerte: [odds ratio (OR) 5.50; IC del 95% 4.51-6.71] para riesgo menor/moderado, [odds ratio (OR) 2.33; IC del 95% 1.96-2.78] para riesgo mayor y [odds ratio (OR) 1.13;IC del 95% 0.90-1.41] no significativo para riesgo extremo. El estudio analiza también el riesgo alto para la exposición a clorhexidina (≤300mg) y no se observan diferencias en la mortalidad entre pacientes críticos ventilados y no ventilados pero sí se observa un incremento del riesgo de muerte en aquellos pacientes que no habían estado ventilados mecánicamente y que no habían estado ingresados en UCI. El número de pacientes que debían estar expuestos para tener un caso de letalidad adicional fue de 47.1 (IC del 95%; 45.2-49,1). Discusión/Conclusión: Los datos obtenidos argumentan la necesidad de replantear el uso indiscriminado y generalizado de los cuidados orales con clorhexidina en los pacientes hospitalizados en ausencia de beneficios comprobados en poblaciones específicas


No disponible


Assuntos
Pneumonia Associada à Ventilação Mecânica/prevenção & controle , Respiração Artificial/efeitos adversos , Clorexidina/toxicidade , Pneumonia Associada à Ventilação Mecânica/complicações , Pneumonia Associada à Ventilação Mecânica/mortalidade , Clorexidina/administração & dosagem , Antissépticos Bucais/efeitos adversos , Estudos de Coortes
6.
Indian J Dent Res ; 29(5): 672-677, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30409952

RESUMO

Denture stomatitis, periodontitis, and peri-implantitis are the growing problems in restorative dentistry. Chemicals play an important role as an adjuvant to mechanical cleaning of teeth, implants, surrounding tissues, and prostheses. Current mouth rinses are reported to affect the tissues and prostheses if used on a long-term basis. Sodium bicarbonate, the common baking soda, has been reported to be versatile. A search of the resources through Medline and Google Scholar was made to understand the current status of the mouth rinses and the use of sodium bicarbonate. Different MeSH and search criteria were used for the different search engines. Baking soda, being a common household item, with its ready availability, safety, minimal abrasivity, and bactericidal property makes it a patient-friendly mouthwash, component in the dentifrice, or chewing gum, which can be used on a long-term basis as an adjunct virtually free of any side effects.


Assuntos
Antissépticos Bucais , Bicarbonato de Sódio , Antibacterianos , Goma de Mascar , Cárie Dentária/prevenção & controle , Dentifrícios , Higienizadores de Dentadura , Humanos , Antissépticos Bucais/efeitos adversos , Higiene Bucal , Peri-Implantite/prevenção & controle , Segurança , Bicarbonato de Sódio/administração & dosagem , Bicarbonato de Sódio/farmacologia , Estomatite/prevenção & controle , Estomatite sob Prótese/prevenção & controle , Abrasão Dentária/induzido quimicamente , Abrasão Dentária/prevenção & controle , Clareadores Dentários
7.
Regul Toxicol Pharmacol ; 99: 249-250, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30267827

RESUMO

The SCCS has estimated that exposure to water-soluble zinc salts via toothpaste and mouthwash at the concentrations of 1 and 0.1%, respectively, may lead to a daily intake level of 3.54 mg for adults and children aged 6-17 years. This exposure constitutes between 14 and 35% of the Upper Limit (UL) for these age groups. Therefore, the SCCS considers that the use of zinc in toothpaste and mouthwash per se is safe for adults and children aged 6-17 years. The SCCS has estimated that exposure to water-soluble zinc salts via toothpaste at the concentrations of 1% may lead to a daily intake level of 1.0-2.00 mg for children aged 0.5-5 years. This exposure constitutes between 10 and 29% of the UL for this age group. Therefore, the SCCS considers that the use of zinc in toothpaste per se is safe for children aged 0.5-5 years. Exposure to zinc may also occur from sources other than oral hygiene products. An important source of zinc in the population is the diet. This assessment has not taken into account the daily dietary intake of zinc. The dietary zinc intake (estimated by EFSA in 2014) ranges from 6.8 to 14.5 mg/day in adolescents aged 10 to < 18 years, from 5.5 to 9.3 mg/day in children aged 3 to < 10 years and from 4.6 to 6.2 mg/day in children aged 1 to <3 years. Therefore, exposure to zinc via the diet may already exceed or be close to exceeding the upper limits of 18, 13, 10 and 7 mg/day for the age groups 11-14, 7-10, 3-7 and 1-3 years, respectively. Any additional source of exposure, including cosmetics, may lead to exceeding the upper limits for children. The SCCS cannot advise which portion of the upper limit should be allocated to exposure from cosmetic products. When assessing exposure to chemicals, allocation factors that reflect a reasonable level of exposure while still being protective may be applied. For exposure via toys or drinking water, for example, allocation factors of 10% or 20% of the reference value may be considered as safe. In the case of zinc, the use of 1% in toothpaste and 0.1% in mouthwash constitutes between 10 and 35% of the upper limit depending on the age group. The SCCS is aware that upper limits may be exceeded in some cases because the default values used in this Opinion are based on conservative estimates.


Assuntos
Sais/efeitos adversos , Água/química , Zinco/efeitos adversos , Adolescente , Atitude , Criança , Pré-Escolar , Qualidade de Produtos para o Consumidor , Cosméticos/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Antissépticos Bucais/efeitos adversos , Higiene Bucal/métodos , Conservantes Farmacêuticos/efeitos adversos , Medição de Risco , Fatores de Risco , Cremes Dentais/efeitos adversos
8.
Am J Dent ; 31(4): 211-214, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30106538

RESUMO

PURPOSE: To evaluate the tooth discoloration effect of the daily use protocol of six different mouthrinses. METHODS: 70 extracted caries-free central incisors were divided into seven groups (n=10/per group) : Group 1: Curasept Anti Discoloration System; Group 2: CB12; Group 3: Listerine Zero; Group 4: Listerine Cool Mint; Group 5: Colgate Plax; Group 6: Kloroben. The teeth were exposed to the mouthrinse for 2 minutes daily for 3 weeks. Color measurement was performed four times: at the beginning of the study, and after 1, 2 and 3 weeks, with a digital spectrophotometer (Vita Easyshade Advanced). Color changes (ΔE) were calculated and ANOVA and post hoc Tukey's test were used for statistical analysis. RESULTS: Although there was no statistically significant difference between the Colgate Plax and control groups, both groups had a significant difference from the other groups within all ΔE1, ΔE2 and ΔE3 values. CLINICAL SIGNIFICANCE: Among the mouthrinses tested, Listerine Cool Mint group exhibited the most tooth discoloration, while Colgate Plax demonstrated the least noticeable color change.


Assuntos
Antissépticos Bucais , Clareadores Dentários , Descoloração de Dente , Placa Dentária , Humanos , Antissépticos Bucais/efeitos adversos , Dente , Descoloração de Dente/induzido quimicamente
9.
J Contemp Dent Pract ; 19(7): 862-866, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30066692

RESUMO

AIMS: The aim of the study was to evaluate the shear bond strength (SBS) of orthodontic brackets after mouth rinsing. MATERIALS AND METHODS: Sixty orthodontically extracted maxillary premolar teeth were used in the present study. Buccal surfaces of all the teeth were bonded with orthodontic bracket. Later, each tooth was embedded into acrylic resin and stored in distilled water. All the teeth were randomly divided into four groups (group I: Artificial saliva, group II: Alcohol mouth rinse- Listerine, group III: Chlorhexidine (CHX) mouth rinse-Hexidine, and group IV: Herbal mouth rinse-Befresh) and stored in each solution for 12 hours. Later, each tooth was subjected to SBS testing using universal testing machine. Brackets and enamel surfaces were examined under a stereomicroscope at 10* magnification for modified adhesive remnant index (ARI). The data were statistically evaluated using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows, version 20.0 (IBM Corp., Armonk, New York, USA) and using one-way analysis of variance (ANOVA) and Chi-square test with significance of p < 0.05. RESULTS: Highest mean SBS was observed in artificial saliva control group (14.27 ± 0.52 MPa), followed by herbal Befresh group (11.14 ± 0.72 MPa) and CHX, and least was found in alcohol-Listerine group of 8.48 ± 0.52 MPa (p < 0.001). The ARI score showed highest bond failure for group I (ARI 14) compared to group II (ARI 11) (p < 0.001). CONCLUSION: Alcohol-containing mouth rinses should be avoided in patients during fixed orthodontic treatment because it affects the bond strength. CLINICAL SIGNIFICANCE: Shear bond strength is affected with the use of alcohol-based mouth rinse compared with herbal or CHX mouth rinses.


Assuntos
Álcoois/efeitos adversos , Colagem Dentária , Antissépticos Bucais/efeitos adversos , Antissépticos Bucais/química , Braquetes Ortodônticos , Resistência ao Cisalhamento , Resinas Acrílicas , Dente Pré-Molar , Análise do Estresse Dentário , Humanos , Técnicas In Vitro
10.
Gen Dent ; 66(3): 75-79, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29714705

RESUMO

This in vitro study measured the pH values, titratable acidity (TA), and erosive potential of commercially available mouthrinses. A pH analysis of 6 mouthrinses (Listerine Total Care, Listerine Ultraclean, Listerine Original, Crest Pro-Health, Scope Classic, and ACT Total Care) was performed using a calibrated pH meter, and the neutralizable acidity was measured by titrating the mouthwashes against 0.1 M of sodium hydroxide. A gravimetric analysis was performed by submerging human enamel and dentin specimens in 5 mL of each mouthrinse for a total of 2 weeks. Specimens were weighed on a calibrated analytical balance at baseline, 24 hours, 48 hours, 96 hours, 1 week, and 2 weeks, and finally the loss of mass was calculated. The differences in erosive potential among the 6 mouthrinses were verified using nonparametric tests (Kruskal-Wallis and Mann- Whitney). The level of significance was set at 0.05. The mouthrinses were found to have the following mean pH/ TA values: Crest Pro-Health, 7.05/0.00; ACT Total Care, 6.31/5.44; Scope Classic, 5.18/0.42; Listerine Original, 3.98/9.26; Listerine Total Care, 3.43/5.88; and Listerine Ultraclean, 3.87/10.36. A significant correlation between pH and TA was observed for this dataset (P > 0.0001). No statistically significant difference in enamel loss among the groups was observed (P = 0.0631). However, a significant difference in dentin loss was observed among the 6 mouthrinses (P = 0.0011). Within the limitations of this in vitro study, it can be concluded that some mouthrinses have a pH lower than the critical pH of enamel and dentin. There is a significant association between acidic pH values and higher TA. Some of the tested mouthrinses presented an erosive potential on dentin.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Dentina/efeitos dos fármacos , Antissépticos Bucais/efeitos adversos , Erosão Dentária/induzido quimicamente , Cetilpiridínio/efeitos adversos , Combinação de Medicamentos , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Compostos de Amônio Quaternário/efeitos adversos , Salicilatos/efeitos adversos , Terpenos/efeitos adversos
12.
Eur Arch Paediatr Dent ; 19(3): 147-153, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29770926

RESUMO

AIM: This was to investigate the effects of Klorhex, Tantum Verde, Kloroben, and Listerine on the discolouration of composite resin, compomer, giomer, and resin-modified glass ionomer. METHODS: Fifty disc-shaped specimens from each restorative material (n = 50) were prepared; initial colour values were measured with a spectrophotometer. Forty specimens from each group were placed in the four different types of mouthwashes (n = 10), while the remaining 10 specimens were immersed in distilled water for 2 min, twice a day for a period of 3 weeks. Colour change (ΔE*) values were obtained and the results were evaluated statistically. RESULTS: The ΔE* of composite resin in Klorhex (0.84 ± 0.37) was significantly lower than that of the other mouthwash groups. Moreover, composite resin showed the least colour change when compared with the other materials in all four mouthwashes. Resin-modified glass ionomer values were significantly higher in Tantum Verde (6.36 ± 2.82) when compared with the other mouthwashes (p < 0.05). Clinically appreciable discolourations were observed in the resin-modified glass ionomer specimens placed in Tantum Verde and Listerine. CONCLUSIONS: Nano-filling composite resins are the most successful aesthetic restorative materials, whereas the commonly used resin-modified glass ionomers exhibit more aesthetically divergent results following the use of mouthwashes.


Assuntos
Cor , Resinas Compostas , Restauração Dentária Permanente , Cimentos de Ionômeros de Vidro , Antissépticos Bucais/efeitos adversos , Odontopediatria , Resinas Acrílicas , Análise de Variância , Materiais Dentários , Humanos , Teste de Materiais , Dióxido de Silício , Espectrofotometria
14.
J Oral Pathol Med ; 47(5): 511-518, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29504154

RESUMO

BACKGROUND: The role of alcohol-containing mouthwash as a risk factor for the development of oral cancer is a subject of conflicting epidemiological evidence in the literature despite alcohol being a recognised carcinogen. The aim of this study was to use in vitro models to investigate mechanistic and global gene expression effects of exposure to alcohol-containing mouthwash. METHODS: Two brands of alcohol-containing mouthwash and their alcohol-free counterparts were used to treat two oral cell lines derived from normal (OKF6-TERT) and dysplastic (DOK) tissues. Genotoxicity was determined by Comet assay. RNA-seq was performed using the Ion Torrent platform. Bioinformatics analysis used R/Bioconductor packages with differential expression using DEseq2. Pathway enrichment analysis used EnrichR with the WikiPathways and Kegg databases. RESULTS: Both cell lines displayed dose-dependent DNA damage in response to acute exposure to ethanol and alcohol-containing mouthwashes as well as alcohol-free mouthwashes reconstituted with ethanol as shown by Comet assay. The transcriptomic effects of alcohol-containing mouthwash exposure were more complex with significant differential gene expression ranging from >2000 genes in dysplastic (DOK) cells to <100 genes in normal (OKF6-TERT) cells. Pathway enrichment analysis in DOK cells revealed alcohol-containing mouthwashes showed common features between the two brands used including DNA damage response as well as cancer-associated pathways. In OKF6-TERT cells, the most significantly enriched pathways involved inflammatory signalling. CONCLUSIONS: Alcohol-containing mouthwashes are genotoxic in vitro to normal and dysplastic oral keratinocytes and induce widespread changes in gene expression. Dysplastic cells are more susceptible to the transcriptomic effects of mouthwash.


Assuntos
Álcoois/efeitos adversos , Expressão Gênica/efeitos dos fármacos , Queratinócitos/efeitos dos fármacos , Queratinócitos/metabolismo , Antissépticos Bucais/efeitos adversos , Transcriptoma/efeitos dos fármacos , Linhagem Celular , Dano ao DNA/efeitos dos fármacos , Etanol/efeitos adversos , Humanos , Técnicas In Vitro , Inflamação/genética , Mucosa Bucal/citologia , Mucosa Bucal/efeitos dos fármacos , Neoplasias Bucais/induzido quimicamente , Neoplasias Bucais/genética , Antissépticos Bucais/química , Fatores de Risco
15.
J Pak Med Assoc ; 68(3): 437-443, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29540881

RESUMO

Numerous substances may have an adverse influence on the oral region by virtue of their potentially harmful effects. Dental practitioners are often the first to see these effects in the head and neck region. Knowledge of the damaging consequences of agents such as alcohol, tobacco, areca nut, medications, alcohol-containing mouthwashes, dental devices and materials can assist the practitioners in clinical decision-making and accurate diagnosis of associated lesions. More importantly, timely diagnosis and prompt reporting of such harmful effects improve the quality of care. Such knowledge may also help in patient's education for the avoidance of associated adverse effects (AEs). Consequently, a thorough acquaintance of AEs will consolidate the distinct role of medical and oral health practitioners in safeguarding the patients' oral and systemic well-being. This article was planned to review the harmful consequences of specific substances on the oral health. Traditionally, the emphasis of review articles has been on reviewing the harmful effects of a single entity on oral health. This review is unique in the sense that it comprehensively and collectively focussed on the harmful effects on the oral health of addictive and illicit substances (alcohol, betel nut), medications, alcohol-containing mouthwashes, medications and dental materials.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Areca/efeitos adversos , Materiais Dentários/efeitos adversos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Doenças da Boca/etiologia , Antissépticos Bucais/efeitos adversos , Uso de Tabaco/efeitos adversos , Candidíase Bucal/etiologia , Fibrose/etiologia , Crescimento Excessivo da Gengiva/etiologia , Humanos , Ceratose/etiologia , Leucoplasia Oral/etiologia , Mucosa Bucal , Úlceras Orais/etiologia , Distúrbios do Paladar/etiologia
16.
Int J Pharm Compd ; 22(1): 60-65, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29385386

RESUMO

Several oral rinses are commercially available to alleviate the symptoms of oral mucositis. Prolonged retention of active pharmaceutical ingredients in the oral cavity is a major problem. In this study, we modified the Stanford oral rinse by including a proprietary mucoadhesive polymer called MucoLox, which we hypothesized would improve active pharmaceutical ingredient mucoadhesion. Characterization of this newly compounded oral rinse showed absence of cytotoxicity in human oral keratinocyte and fibroblast cell lines. The compounded formulation significantly stimulated the migration of these two cell lines in Oris Cell Migration Assay plates, better than the reference commercial product Magic mouthwash. Based on this in vitro study, the new Stanford modified oral rinse with MucoLox is safe and may promote healing of oral mucositis.


Assuntos
Movimento Celular/efeitos dos fármacos , Composição de Medicamentos/métodos , Fibroblastos/efeitos dos fármacos , Queratinócitos/efeitos dos fármacos , Antissépticos Bucais/farmacologia , Cicatrização/efeitos dos fármacos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Humanos , Antissépticos Bucais/administração & dosagem , Antissépticos Bucais/efeitos adversos , Antissépticos Bucais/química , Polímeros/química , Estomatite/prevenção & controle , Adesivos Teciduais/química
17.
Food Chem Toxicol ; 111: 511-524, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29198857

RESUMO

Cosmetic exposure data for face and mouth are limited in Europe. The aim of the study was to assess the exposure to face cosmetics using recent French consumption data (Ficheux et al., 2016b, 2015). Exposure was assessed using a probabilistic method for thirty one face products from four lines of products: cleanser, care, make-up and make-up remover products and two oral care products. Probabilistic exposure was assessed for different subpopulation according to sex and age in adults and children. Pregnant women were also studied. The levels of exposure to moisturizing cream, lip balm, mascara, eyeliner, cream foundation, toothpaste and mouthwash were higher than the values currently used by the Scientific Committee on Consumer Safety (SCCS). Exposure values found for eye shadow, lipstick, lotion and milk (make-up remover) were lower than SCCS values. These new French exposure values will be useful for safety assessors and for safety agencies in order to protect the general population and the at risk populations.


Assuntos
Cosméticos/efeitos adversos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Qualidade de Produtos para o Consumidor , Cosméticos/análise , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/efeitos adversos , Antissépticos Bucais/análise , Medição de Risco , Adulto Jovem
18.
J Oral Rehabil ; 45(2): 140-146, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29164661

RESUMO

This study aimed to assess the short-term effect of alcohol-containing mouthrinse versus mouthrinse without alcohol on xerostomia scores reported by Xerostomia Inventory (XI) scores and short version of the Xerostomia Inventory (SXI). This study was a two-group parallel-arm randomised controlled trial where participants were randomly allocated to twice a day for 7 days use of either alcohol-containing or alcohol-free mouthrinse. Allocation was concealed. The participants, the outcome assessors and the statistician were blinded to the allocation status. A total of 163 participants completed the pre-and post-intervention data collection. There were no statistically significant differences between the study groups with respect to demographics or other measured independent variables. After adjusting for age and gender, regression coefficient (95% CI) for XI was 0.02 (-1.72-2.29) and that for SXI was 0.03 (-0.54-0.83). Both adjusted and unadjusted models showed no significant differences in change in XI or SXI. The mean difference in scores between the groups for XI was -0.45 (-2.45-1.55) and for SXI was 0.05 (-0.65-0.75). There was no significant difference in the change in xerostomia levels as a result of short-term exposure to alcohol-containing mouthrinse, when compared to those exposed to alcohol-free mouthrinse. Short-term use of alcohol-containing mouthrinse does not result in worsening xerostomia.


Assuntos
Clorexidina/efeitos adversos , Placa Dentária/prevenção & controle , Mucosa Bucal/efeitos dos fármacos , Antissépticos Bucais/efeitos adversos , Higiene Bucal , Xerostomia/terapia , Idoso , Idoso de 80 Anos ou mais , Clorexidina/farmacologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antissépticos Bucais/farmacologia , Fatores de Tempo
19.
Nitric Oxide ; 71: 14-20, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28939409

RESUMO

AIMS: Over-the-counter mouthwash comprises part of routine oral care for many; however, potential adverse effects of the long-term daily use have not been evaluated. Most mouthwash contain antibacterial ingredients, which could impact oral microbes critical for nitric oxide formation, and in turn predispose to metabolic disorders including diabetes. Our aim was to evaluate longitudinally the association between baseline over-the-counter mouthwash use and development of pre-diabetes/diabetes over a 3-year follow-up. MATERIALS AND METHODS: The San Juan Overweight Adults Longitudinal Study (SOALS) recruited 1206 overweight/obese individuals, aged 40-65, and free of diabetes and major cardiovascular diseases; 945 with complete follow-up data were included in the analyses. We used Poisson regression models adjusting for baseline age, sex, smoking, physical activity, waist circumference, alcohol consumption, pre-hypertension/hypertension status; time between visits was included in the models as an offset. RESULTS: Many participants (43%) used mouthwash at least once daily and 22% at least twice daily. Participants using mouthwash ≥ twice daily at baseline, had a significantly elevated risk of pre-diabetes/diabetes compared to less frequent users (multivariate IRR = 1.55, 95% CI: 1.21-1.99), or non-users of mouthwash (multivariate IRR = 1.49; 95% CI: 1.13-1.95). The effect estimates were similar after adding income, education, oral hygiene, oral conditions, sleep breathing disorders, diet (processed meat, fruit, and vegetable intake), medications, HOMA-IR, fasting glucose, 2hr post load glucose or CRP to the multivariate models. Both associations were also significant among never-smokers and obese individuals. Mouthwash use lower than twice daily showed no association, suggesting a threshold effect at twice or more daily. CONCLUSIONS: Frequent regular use of over-the-counter mouthwash was associated with increased risk of developing pre-diabetes/diabetes in this population.


Assuntos
Diabetes Mellitus/etiologia , Antissépticos Bucais/efeitos adversos , Estado Pré-Diabético/etiologia , Adulto , Feminino , Humanos , Masculino , Microbiota/efeitos dos fármacos , Pessoa de Meia-Idade , Boca/microbiologia , Antissépticos Bucais/administração & dosagem , Fatores de Risco , Fatores de Tempo
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