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1.
Cochrane Database Syst Rev ; 12: CD003864, 2020 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-33314046

RESUMO

BACKGROUND: For people with physical, sensory and cognitive limitations due to stroke, the routine practice of oral health care (OHC) may become a challenge. Evidence-based supported oral care intervention is essential for this patient group. OBJECTIVES: To compare the effectiveness of OHC interventions with usual care or other treatment options for ensuring oral health in people after a stroke. SEARCH METHODS: We searched the Cochrane Stroke Group and Cochrane Oral Health Group trials registers, CENTRAL, MEDLINE, Embase, and six other databases in February 2019. We scanned reference lists from relevant papers and contacted authors and researchers in the field. We handsearched the reference lists of relevant articles and contacted other researchers. There were no language restrictions. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that evaluated one or more interventions designed to improve the cleanliness and health of the mouth, tongue and teeth in people with a stroke who received assisted OHC led by healthcare staff. We included trials with a mixed population provided we could extract the stroke-specific data. The primary outcomes were dental plaque or denture plaque. Secondary outcomes included presence of oral disease, presence of related infection and oral opportunistic pathogens related to OHC and pneumonia, stroke survivor and providers' knowledge and attitudes to OHC, and patient satisfaction and quality of life. DATA COLLECTION AND ANALYSIS: Two review authors independently screened abstracts and full-text articles according to prespecified selection criteria, extracted data and assessed the methodological quality using the Cochrane 'Risk of bias' tool. We sought clarification from investigators when required. Where suitable statistical data were available, we combined the selected outcome data in pooled meta-analyses. We used GRADE to assess the quality of evidence for each outcome. MAIN RESULTS: Fifteen RCTs (22 randomised comparisons) involving 3631 participants with data for 1546 people with stroke met the selection criteria. OHC interventions compared with usual care Seven trials (2865 participants, with data for 903 participants with stroke, 1028 healthcare providers, 94 informal carers) investigated OHC interventions compared with usual care. Multi-component OHC interventions showed no evidence of a difference in the mean score (DMS) of dental plaque one month after the intervention was delivered (DMS -0.66, 95% CI -1.40 to 0.09; 2 trials, 83 participants; I2 = 83%; P = 0.08; very low-quality evidence). Stroke survivors had less plaque on their dentures when staff had access to the multi-component OHC intervention (DMS -1.31, 95% CI -1.96 to -0.66; 1 trial, 38 participants; P < 0.0001; low-quality evidence). There was no evidence of a difference in gingivitis (DMS -0.60, 95% CI -1.66 to 0.45; 2 trials, 83 participants; I2 = 93%; P = 0.26: very low-quality evidence) or denture-induced stomatitis (DMS -0.33, 95% CI -0.92 to 0.26; 1 trial, 38 participants; P = 0.69; low-quality evidence) among participants receiving the multi-component OHC protocol compared with usual care one month after the intervention. There was no difference in the incidence of pneumonia in participants receiving a multi-component OHC intervention (99 participants; 5 incidents of pneumonia) compared with those receiving usual care (105 participants; 1 incident of pneumonia) (OR 4.17, CI 95% 0.82 to 21.11; 1 trial, 204 participants; P = 0.08; low-quality evidence). OHC training for stroke survivors and healthcare providers significantly improved their OHC knowledge at one month after training (SMD 0.70, 95% CI 0.06 to 1.35; 3 trials, 728 participants; I2 = 94%; P = 0.03; very low-quality evidence). Pooled data one month after training also showed evidence of a difference between stroke survivor and providers' oral health attitudes (SMD 0.28, 95% CI 0.01 to 0.54; 3 trials, 728 participants; I2 = 65%; P = 0.06; very low-quality evidence). OHC interventions compared with placebo Three trials (394 participants, with data for 271 participants with stroke) compared an OHC intervention with placebo. There were no data for primary outcomes. There was no evidence of a difference in the incidence of pneumonia in participants receiving an OHC intervention compared with placebo (OR 0.39, CI 95% 0.14 to 1.09; 2 trials, 242 participants; I2 = 42%; P = 0.07; low-quality evidence). However, decontamination gel reduced the incidence of pneumonia among the intervention group compared with placebo gel group (OR 0.20, 95% CI 0.05 to 0.84; 1 trial, 203 participants; P = 0.028). There was no difference in the incidence of pneumonia in participants treated with povidone-iodine compared with a placebo (OR 0.81, 95% CI 0.18 to 3.51; 1 trial, 39 participants; P = 0.77). One OHC intervention compared with another OHC intervention Twelve trials (372 participants with stroke) compared one OHC intervention with another OHC intervention. There was no difference in dental plaque scores between those participants that received an enhanced multi-component OHC intervention compared with conventional OHC interventions at three months (MD -0.04, 95% CI -0.33 to 0.25; 1 trial, 61 participants; P = 0.78; low-quality evidence). There were no data for denture plaque. AUTHORS' CONCLUSIONS: We found low- to very low-quality evidence suggesting that OHC interventions can improve the cleanliness of patient's dentures and stroke survivor and providers' knowledge and attitudes. There is limited low-quality evidence that selective decontamination gel may be more beneficial than placebo at reducing the incidence of pneumonia. Improvements in the cleanliness of a patient's own teeth was limited. We judged the quality of the evidence included within meta-analyses to be low or very low quality, and this limits our confidence in the results. We still lack high-quality evidence of the optimal approach to providing OHC to people after stroke.


Assuntos
Cuidadores , Educação em Saúde Bucal , Higiene Bucal/métodos , Acidente Vascular Cerebral/enfermagem , Atitude Frente a Saúde , Placa Dentária/diagnóstico , Gengivite/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Casas de Saúde , Pneumonia/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estomatite sob Prótese/epidemiologia
2.
PLoS One ; 15(7): e0236692, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32730310

RESUMO

AIMS: To assess feasibility, acceptability, and early efficacy of monetary incentive-based interventions on fostering oral hygiene in young children measured with a Bluetooth-enabled toothbrush and smartphone application. DESIGN: A stratified, parallel-group, three-arm individually randomized controlled pilot trial. SETTING: Two Los Angeles area Early Head Start (EHS) sites. PARTICIPANTS: 36 parent-child dyads enrolled in an EHS home visit program for 0-3 year olds. INTERVENTIONS: Eligible dyads, within strata and permuted blocks, were randomized in equal allocation to one of three groups: waitlist (delayed monetary incentive) control group, fixed monetary incentive package, or lottery monetary incentive package. The intervention lasted 8 weeks. OUTCOMES: Primary outcomes were a) toothbrushing performance: mean number of Bluetooth-recorded half-day episodes per week when the child's teeth were brushed, and b) dental visit by the 2-month follow-up among children with no prior dental visit. The a priori milestone of 20% more frequent toothbrushing identified the intervention for a subsequent trial. Feasibility and acceptability measures were also assessed, including frequency of parents syncing the Bluetooth-enabled toothbrush to the smartphone application and plaque measurement from digital photographs. FINDINGS: Digital monitoring of toothbrushing was feasible. Mean number of weekly toothbrushing episodes over 8 weeks was 3.9 in the control group, 4.1 in the fixed incentive group, and 6.0 in the lottery incentive group. The lottery group had 53% more frequent toothbrushing than the control group and 47% more frequent toothbrushing than the fixed group. Exploratory analyses showed effects concentrated among children ≤24 months. Follow-up dental visit attendance was similar across groups. iPhone 7 more reliably captured evaluable images than Photomed Cannon G16. CONCLUSIONS: Trial protocol and outcome measures were deemed feasible and acceptable. Results informed the study protocol for a fully powered trial of lottery incentives versus a delayed control using the smart toothbrush and remote digital incentive program administration. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT03862443.


Assuntos
Assistência Odontológica para Crianças , Recompensa , Escovação Dentária , Pré-Escolar , Placa Dentária/diagnóstico , Placa Dentária/patologia , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Feminino , Humanos , Lactente , Masculino , Aplicativos Móveis , Pais/psicologia , Projetos Piloto , Escovação Dentária/instrumentação , Escovação Dentária/métodos
3.
BMC Oral Health ; 20(1): 141, 2020 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404094

RESUMO

BACKGROUND: Dental plaque causes many common oral diseases (e.g., caries, gingivitis, and periodontitis). Therefore, plaque detection and control are extremely important for children's oral health. The objectives of this study were to design a deep learning-based artificial intelligence (AI) model to detect plaque on primary teeth and to evaluate the diagnostic accuracy of the model. METHODS: A conventional neural network (CNN) framework was adopted, and 886 intraoral photos of primary teeth were used for training. To validate clinical feasibility, 98 intraoral photos of primary teeth were assessed by the AI model. Additionally, tooth photos were acquired using a digital camera. One experienced pediatric dentist examined the photos and marked the regions containing plaque. Then, a plaque-disclosing agent was applied, and the areas with plaque were identified. After 1 week, the dentist drew the plaque area on the 98 photos taken by the digital camera again to evaluate the consistency of manual diagnosis. Additionally, 102 intraoral photos of primary teeth were marked to denote the plaque areas obtained by the AI model and the dentist to evaluate the diagnostic capacity of each approach based on lower-resolution photos. The mean intersection-over-union (MIoU) metric was employed to indicate detection accuracy. RESULTS: The MIoU for detecting plaque on the tested tooth photos was 0.726 ± 0.165. The dentist's MIoU was 0.695 ± 0.269 when first diagnosing the 98 photos taken by the digital camera and 0.689 ± 0.253 after 1 week. Compared to the dentist, the AI model demonstrated a higher MIoU (0.736 ± 0.174), and the results did not change after 1 week. When the dentist and the AI model assessed the 102 intraoral photos, the MIoU was 0.652 ± 0.195 for the dentist and 0.724 ± 0.159 for the model. The results of a paired t-test found no significant difference between the AI model and human specialist (P > .05) in diagnosing dental plaque on primary teeth. CONCLUSIONS: The AI model showed clinically acceptable performance in detecting dental plaque on primary teeth compared with an experienced pediatric dentist. This finding illustrates the potential of such AI technology to help improve pediatric oral health.


Assuntos
Aprendizado Profundo , Cárie Dentária , Placa Dentária , Gengivite , Criança , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Gengivite/diagnóstico , Humanos , Dente Decíduo
4.
Sci Rep ; 10(1): 4478, 2020 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-32161288

RESUMO

The purpose of the present cross-sectional clinical study was to check the ability of plaque detection and quantification by QLF-D against conventional digital photographs of disclosed plaque in multibracket appliance (MB) patients. 20 patients were included according to the following criteria: (1) upper and lower jaw treated by MB appliance, (2) patients being 16 years of age or older, (3) all central and lateral incisors as well as canines in situ, (4) absence of developmental defects, carious lesions, surface fillings, prosthetic restorations or recessions greater than 1/3 of root length in central/lateral incisors and canines as well as (5) declaration of consent. QLF-D and conventional photographs were analyzed planimetrically regarding plaque coverage on buccal and oral surfaces of central/lateral incisors and canines. The conventional photographs of stained plaque served as gold standard. On average, in QLF-D pictures 20.7% ± 17.4 of the tooth surfaces were covered with plaque, while the conventional photographs of disclosed plaque presented a mean plaque-covered area of 36.2% ± 23.5. The Bland-Altman plot for both imaging modalities showed a very large inconsistent scattering with both negative and positive deviations. The method discrepancy increased with increasing plaque coverage, thus indicating a systematic method error. On average, the deviation of the methods from the optimal line of accordance was -15.5%. In patients wearing MB appliances, there was no clinical significant agreement regarding the plaque-covered tooth surface depicted by QLF-D respectively conventional images of disclosed plaque. Due to the large method discrepancy, QLF-D is currently not reliable for precise plaque quantification in MB patients.


Assuntos
Placa Dentária/diagnóstico , Imagem Óptica , Braquetes Ortodônticos , Fluorescência Quantitativa Induzida por Luz , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Imagem Óptica/métodos , Adulto Jovem
5.
Clin Ter ; 170(5): e373-e381, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31612196

RESUMO

Among the various pathologies of the oral cavity, the formation of "unsightly black spots" on the surface of the tooth, universally known as Black Stain (BS) has recently been acquiring more interest. Usually BS is typically found in individuals in prepubertal age, even though it has been identified in adults associated with microbial exchange and / or with iron metabolism disorders. Microbial exchange concerns the possible exchange of bacteria between family members which can take place directly, through effusions, or indirectly, through brushes, cutlery or glasses. For this reason, it is recommended that toothbrushes of family members not be left damp and in contact with each other. The bathroom, being a warm-humid environment, is in fact an optimal habitat for microbial proliferation. Of specific importance in BS is the accumulation of iron in tissues and secretions which, together with chromogenic bacteria, are the primary cause of this pathology. In fact, among the metabolic products synthesized by bacteria in the oral cavity, hydrogen sulfide is of considerable interest, since upon reacting with iron available in saliva, in pathological conditions (iron metabolism disorders), it forms black precipitates consisting of ferric sulfide. These precipitates bind to the surface of the teeth, tending to form a stria that usually follows the contour of the gingiva, with an unsightly and variable chromatic intensity. In physiological situations, iron homeostasis is defined as the state of equilibrium between iron present in tissues and in secretions and that which is present in the circulation. Instead, in pathological conditions, defined as iron metabolism disorders, there is an accumulation of iron in tissues and secretions and a lack of it in the circulation. It is also important to remember that subjects affected by BS are more protected from carious processes than healthy subjects, probably due to a significant predominance of chromogenic bacteria compared to those responsible for caries. It should also be remembered that in young subjects BS tends to regress with pubertal development and the transition to adult life. In any case, using common professional hygiene procedures, it is possible to remove BS as well as plaque and tartar deposits. In particular, with ultrasonic scalers, polishing pastes and powders carried by air and water jets, the surfaces of the teeth can be restored to their natural healthy state. All the techniques for removing the precipitates, are not enough however, to fix and permanently eradicate their appearance, as these precipitates last only for short periods and recur very frequently. Due to the frequent recurrences, new oral microbiota control therapies are emerging; among these the use of lactoferrin (Lf) in the dental field and particularly in the treatment of BS appears to be very promising. Taken togheter, here the effect of Lf in subjects affected by BS has been investigated.


Assuntos
Anti-Infecciosos/administração & dosagem , Cárie Dentária/dietoterapia , Distúrbios do Metabolismo do Ferro/tratamento farmacológico , Lactoferrina/administração & dosagem , Descoloração de Dente/diagnóstico , Adulto , Criança , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Feminino , Humanos , Distúrbios do Metabolismo do Ferro/diagnóstico , Masculino , Gravidez , Saliva/metabolismo , Descoloração de Dente/tratamento farmacológico
6.
Nutr. hosp ; 36(5): 1095-1100, sept.-oct. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-184632

RESUMO

Introducción: el principal problema de salud pública en México es la obesidad y sus enfermedades asociadas, incluyendo las bucales. Objetivo: evaluar el efecto del tratamiento con metformina en pacientes obesos de clase I sobre la actividad de las metaloproteinasas presentes en el periodonto con periodontitis crónica. Métodos: se realizó un estudio clínico con 68 pacientes mujeres con obesidad de clase I y enfermedad periodontal. Se dividieron en 4 grupos; a 2 de ellos, además del tratamiento periodontal, se les administro metformina de 850 mg al día durante seis semanas. Se tomaron 2 muestras por paciente de tejido periodontal antes y después de cada tratamiento y se midió el índice de masa corporal (IMC), el índice de placa dentobacteriana y de inflamación. Mediante zimografía en gel de acrilamida se midió la actividad de las metaloproteinasas en la muestra de tejido recolectada. Los datos obtenidos fueron analizados mediante estadística descriptiva t de student para muestras relacionadas y se realizó ANOVA de una vía considerando p < 0,01 como estadísticamente significativa. Resultados: en el grupo de pacientes a las que se les administro metformina al final del tratamiento se observó una disminución del índice de masa corporal, del grado de inflamación y menor actividad de metaloproteinasas respecto al grupo control (65% frente a 25%; p < 0,01). Conclusiones: el tratamiento con metformina en pacientes con obesidad de clase I y enfermedad periodontal disminuye el IMC, mejora los síntomas de la periodontitis crónica y disminuye la actividad de las metaloproteinasas 1, 3, 8 y V presentes en el periodonto de estos pacientes


Introduction: in Mexico the main problem in public health is obesity and other diseases that are associated whit this condition, including oral health. Objective: to evaluate the effect of metformin treatment in patients with class I obese on the activity of metalloproteinases present in periodontium with chronic periodontitis. Methods: a clinical study was conducted in 68 patients with class I obesity and periodontal disease. They were divided into 4 groups. 2 of them, in addition to the periodontal treatment, were administered metformin 850 mg per day for six weeks; 2 samples were taken per patient of periodontal tissue before and after each treatment, body mass index, plaque index and inflammation were measured. Acrylamide gel zymography was used to measure the activity of metalloproteinases in the sample of tissue collected. The data obtained were analyzed by descriptive statistics, student t for related samples and one-way ANOVA was performed considering p < 0.01 as statistically significant. Results: in the group of patients who were administered metformin at the end of the treatment, there was a decrease in the body mass index, the degree of inflammation and lower metalloproteinase activity, compared with the control group (65% vs 25%; < 0.01). Conclusions: treatment with metformin in patients with obesity class I and periodontal disease decreases BMI, improves the symptoms of chronic periodontitis and decreases the activity of metalloproteinases 1, 3, 8, V present in periodontium of these patients


Assuntos
Humanos , Feminino , Adulto , Obesidade/tratamento farmacológico , Obesidade/enzimologia , Metformina/administração & dosagem , Metaloproteases/metabolismo , Periodontite/complicações , Periodontite/diagnóstico , Metformina/metabolismo , Periodontite/terapia , Análise de Variância , Placa Dentária/diagnóstico , Índice de Placa Dentária
7.
BMJ Open ; 9(9): e030638, 2019 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-31501124

RESUMO

BACKGROUND: There is limited data on the beneficial effects of probiotics on the gingival health of patients undergoing treatment with fixed orthodontic appliances. This study aims to compare the effect of probiotic tablets combined with regular oral hygiene versus regular oral hygiene alone on gingival status in these patients. The effect of probiotic intake on plaque formation and salivary microbiome composition will be also assessed. METHODS AND ANALYSIS: This is a 3 month single-centre, single blind (clinical and laboratory examiners), parallel group randomised controlled two arm superiority trial. Fifty paediatric patients attending the Postgraduate Orthodontic Clinic at the Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates, who meet the eligibility criteria will be recruited. Block randomisation with 1:1 allocation and concealment of allocation will be carried out. The treatment group will receive probiotic tablets containing Streptococcus salivarius M18 and Lactobacillus acidophilus together with regular oral hygiene versus the control group on regular oral hygiene alone. Clinical examination and collection of saliva for microbiome assay will be carried out at baseline and end of study. Self-reporting by patients will be used to document acceptability and adverse effects. Statistically significant decrease in gingival bleeding on probing in the treatment group will be classified as primary outcome of treatment success. Statistically significant reduction in Plaque Index, Gingival Index and shift in the composition of the oral microbiome in favour of beneficial bacteria are secondary outcomes indicative of efficacy of probiotic intake. ETHICS AND DISSEMINATION: Ethical approval for the study has been granted by the HBMCDM, MBRU, Institutional Review Board (Reference #: MBRU-IRB-2018-015). Study findings will be disseminated via publication in peer-reviewed journal. TRIAL REGISTRATION NUMBER: ISRCTN95085398.


Assuntos
Placa Dentária , Lactobacillus acidophilus/fisiologia , Aparelhos Ortodônticos Fixos , Probióticos , Saliva , Streptococcus salivarius/fisiologia , Criança , Placa Dentária/diagnóstico , Placa Dentária/prevenção & controle , Suplementos Nutricionais , Feminino , Humanos , Masculino , Saúde Bucal , Higiene Bucal/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Probióticos/administração & dosagem , Probióticos/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Saliva/efeitos dos fármacos , Saliva/microbiologia
8.
BMC Res Notes ; 12(1): 328, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182149

RESUMO

OBJECTIVE: The aim of the present study is to compare and assess the risk of periodontitis due to the presence of four putative periodontopathic bacteria viz., Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens. To fulfil the above objective, polymerase Chain reaction using the primers targeting 16S rRNA gene of the bacterial species was performed with the subgingival plaque collected from the permanent first molars of type 1 diabetic children and age matched healthy children. RESULTS: The prevalence of periodontal pathogens in diabetic and healthy children was 6% and 16% for E. corrodens, 18% and 36% for C. rectus, 2% and 2% for P. intermedia, 4% and 0%, for P. nigrescens respectively. Statistically, significant difference was not observed for the prevalence of all the four periodontal pathogens between type 1 diabetic and healthy children (P = 1.00). The results of the present study thus reveal a negative correlation of type I diabetes to periodontitis in association to Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens.


Assuntos
Campylobacter rectus/genética , Placa Dentária/microbiologia , Diabetes Mellitus Tipo 1/microbiologia , Eikenella corrodens/genética , Periodontite/microbiologia , Prevotella intermedia/genética , Prevotella nigrescens/genética , Adolescente , Técnicas de Tipagem Bacteriana , Campylobacter rectus/classificação , Campylobacter rectus/isolamento & purificação , Estudos de Casos e Controles , Criança , Placa Dentária/complicações , Placa Dentária/diagnóstico , Placa Dentária/patologia , Índice de Placa Dentária , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/patologia , Eikenella corrodens/classificação , Eikenella corrodens/isolamento & purificação , Feminino , Humanos , Masculino , Periodontite/complicações , Periodontite/diagnóstico , Periodontite/patologia , Prevotella intermedia/classificação , Prevotella intermedia/isolamento & purificação , Prevotella nigrescens/classificação , Prevotella nigrescens/isolamento & purificação , RNA Ribossômico 16S/genética
9.
PLoS One ; 14(6): e0218266, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31216300

RESUMO

BACKGROUND: Periodontitis is a common inflammatory disease, leading to bone destruction and tooth loss. Screening for periodontitis is important in preventing the progress of this disease. Various types of bacteria have been examined as potential screening targets, but only culturable pathogenic bacteria have been considered candidates. Recently, the various uncultivable bacteria have been identified in microbiome studies, but the value of these bacteria in periodontitis screening remains unknown. OBJECTIVES: The aim of this study was to evaluate the diagnostic use of uncultivable bacteria Fretibacterium sp. HOT 360 and TM7 sp. HOT 356 for periodontitis screening in the Japanese population. MATERIAL AND METHODS: Stimulated saliva samples were collected from 217 participants (periodontitis group, n = 157; healthy group, n = 60). The two uncultivable bacterial species selected were: Fretibacterium sp. human oral taxon 360 (Fretibacterium sp. HOT 360) and TM7 sp. human oral taxon 356 (TM7 sp. HOT 356). The levels of these two bacterial species were compared with those of Porphyromonas gingivalis (P. gingivalis), a keystone pathogen in periodontitis. These three species of bacteria were then quantified using qualitative real-time polymerase chain reaction (qPCR) with specific primers and Taqman probes. Statistical analysis was performed by SPSS 20.0 software. P value was statistically significant at .05. RESULTS: The populations of uncultivable bacterial species TM7 sp. HOT 356 and Fretibacterium sp. HOT 360 were significantly higher in periodontitis group than in healthy group. Only Fretibacterium sp. HOT 360 showed a significantly positive correlation with such periodontal parameters as probing pocket depth (PPD) and bleeding on probing (BOP). CONCLUSION: These findings indicate that uncultivable bacteria Fretibacterium sp. HOT 360 can be used as a saliva-based diagnostic bacterial biomarker for periodontitis screening.


Assuntos
Biomarcadores/análise , Placa Dentária/diagnóstico , Periodontite/diagnóstico , Saliva/microbiologia , Idoso , Bacteroides/genética , Biofilmes/crescimento & desenvolvimento , Placa Dentária/microbiologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Microbiota/genética , Pessoa de Meia-Idade , Periodontite/microbiologia , Porphyromonas gingivalis/patogenicidade
10.
Qual Life Res ; 28(9): 2481-2489, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31123881

RESUMO

PURPOSE: The aim of this study was to evaluate if health and oral health status of children and adolescents with different stages of CKD are associated with their health-related quality of life (HRQoL), oral health-related quality of life (OHRQoL) and socioeconomic and demographic conditions. METHODS: One hundred children and adolescents with CKD were age and gender matched to 100 individuals without CKD (mean age ± SD = 13.04 ± 2.57). Oral health was characterised by means of gingival bleeding index (GBI), plaque index (PI), the decayed, missing, and filled teeth (DMFT) index and the developmental enamel defect (DED) index. All children and adolescents answered two Peds QL® instruments (general and oral health scales). RESULTS: Comparing the mean scores of HRQoL and OHRQoL between groups, we observed that CKD group demonstrated worse perceptions when compared to non-CKD group. Multiple linear regression analysis with bootstrap estimation of variance (1000 replications) showed association between dental caries experience (p < 0.001), gingival inflammation (p < 0.001) and diagnosis of CKD (p = 0.027) with the OHRQoL and between physical and the emotional domain of HRQoL, when moderate/severe gingival inflammation and hypoplasia were present. CONCLUSION: The implementation of public policies that contemplate the early dental preventive intervention in CKD children and adolescents should occur aiming to improve their oral health, once oral manifestations can directly affect the aspects of the HRQoL and OHRQoL of these individuals.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Nível de Saúde , Saúde Bucal/estatística & dados numéricos , Qualidade de Vida/psicologia , Insuficiência Renal Crônica/psicologia , Adolescente , Criança , Estudos Transversais , Demografia , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Feminino , Humanos , Masculino , Índice Periodontal
11.
J Biophotonics ; 12(7): e201800414, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30834691

RESUMO

Quantitative light-induced fluorescence (QLF) technology can detect some dental plaque as red fluorescence. This in vivo study aimed to identify the microbial characteristics of red fluorescent (RF) dental plaque using 16S rRNA gene sequencing and evaluate the correlations between RF plaque and the clinical symptoms of dental diseases. Paired supragingival plaque samples collected from each 10 subjects and consisted of RF and non-RF dental plaques as observed by QLF technology using a 405 nm blue light source for excitation. The characteristics of the bacterial communities in the RF and non-RF plaque samples were compared by sequencing analysis. An increase in microbial diversity was observed in RF plaque compared with the non-RF plaque. There were significant differences in the community compositions between the 2 types of dental plaque. Periodontopathic bacteria were significantly more abundant in the RF plaque than non-RF plaque. The fluorescence intensity of RF plaque was significantly related to the proportion of the periodontopathic bacterial community and the presence of gingival inflammation. In conclusion, the plaque red fluorescence is associated with changes in the microbial composition and enrichment of periodontopathic pathogens, which suggests that RF plaque detected by QLF technology could be used as a risk indicator for gingival inflammation.


Assuntos
Placa Dentária/diagnóstico , Placa Dentária/etiologia , Fluorescência , Adulto , Bactérias/isolamento & purificação , Biodiversidade , Estudos Transversais , Placa Dentária/microbiologia , Feminino , Humanos , Masculino
12.
J Breath Res ; 13(2): 026005, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30523908

RESUMO

AIM: This randomized controlled cross-over-design-study investigated short-term effects on oral malodour of a zinc-lactate-containing mouthwash. MATERIALS AND METHODS: Sixteen subjects (18-65 years) with an organoleptic score (OLS) ≥2 were included. Following rinses were used: (A) a zinc-lactate-containing mouthwash (10 ml/30 s); (B) a zinc-lactate-containing mouthwash (15 ml/60 s); (C) a rinse without zinc-lactate (3 droplets/10 ml tap water/30 s) and (D) tap water (10 ml/30 s). Each formulation was evaluated by two blinded examiners comparing OLS and three volatile-sulphur-compounds (VSC; H2S (hydrogen sulphide), CH3SH (methyl mercaptan) and (CH3)2S (dimethyl sulphide)) before, 1 and 3 h after rinsing. Subject's perception was investigated with a visual-analogue-scale. Linear mixed models were used to compare all parameters simultaneously with respect to the four treatment groups with a significance level α < 0.05. RESULTS: OLS was significantly reduced by A and B compared to C and D after 3 h (p < 0.006). The sum of the 3 VSCs as well as H2S alone were significantly reduced by rinses A and B after 1 and 3 h compared to rinses C and D (p < 0.05). Significant differences were found between the four rinses for 'Taste' (p = 0.003), for 'Change of mouth feeling' (p = 0.001), for 'Feeling of freshness' (p = 0.002) and for 'Effectiveness' (p = 0.002) in favour of A & B. CONCLUSION: A zinc-lactate-containing mouthwash reduced OLS and VSC over a period of 3 h with favourable patient reported outcomes.


Assuntos
Halitose/tratamento farmacológico , Lactatos/farmacologia , Boca/patologia , Antissépticos Bucais/química , Antissépticos Bucais/uso terapêutico , Zinco/farmacologia , Adulto , Estudos Cross-Over , Placa Dentária/diagnóstico , Método Duplo-Cego , Feminino , Humanos , Sulfeto de Hidrogênio/análise , Masculino , Pessoa de Meia-Idade , Sensação/efeitos dos fármacos , Compostos de Sulfidrila/análise , Sulfetos/análise , Inquéritos e Questionários , Fatores de Tempo , Volatilização , Adulto Jovem
13.
Int J Dent Hyg ; 17(1): 16-26, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29405627

RESUMO

OBJECTIVES: To review the effectiveness of antiseptic oral sprays on oral health. METHODS AND MATERIALS: Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included. RESULTS: Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores. CONCLUSIONS: Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Clorexidina/administração & dosagem , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Sprays Orais , Adolescente , Adulto , Idoso , Criança , Bases de Dados Bibliográficas , Placa Dentária/diagnóstico , Índice de Placa Dentária , Feminino , Gengivite/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Índice Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
14.
BMC Oral Health ; 18(1): 187, 2018 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458753

RESUMO

BACKGROUND: The aim of this study was to analyze the correlation between the dental plaque indices measured using quantitative light-induced fluorescence-digital (QLF-D) and conventional clinical indices that assess gingival status. METHODS: From among the patients who visited Ewha Womans University Mokdong Hospital, 33 adults in their 20s who had relatively even teeth were selected for full-mouth QLF-D imaging. The images were used to analyze the QLF-D score and the QLF-D ΔR score. As clinical indices, the gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), and patient hygiene performance (PHP) index were measured. The correlations between the QLF-D score and QLF-D ΔR score and each clinical index were analyzed. Analyses were performed comparing the indices of maxillary and mandibular teeth, the teeth on right and left sides of the mouth, anterior and posterior teeth, and buccal and lingual surfaces of each tooth. Pearson's correlation analysis was conducted (p < 0.05). RESULTS: The mean full-mouth QLF-D score was highly correlated with the GI, BOP, PPD, PHP index (p < 0.01). The mean full-mouth QLF-D score showed the highest correlation with GI (r = 0.749) and the lowest correlation with PPD (r = 0.683). The correlations between the QLF-D score were higher in the mandible than in the maxilla and in the anterior teeth than in the posterior teeth, while no significant differences were seen between the buccal and lingual surfaces of tooth. CONCLUSIONS: This study concluded that the correlations between the plaque indices measured for each tooth surface area using QLF-D and the clinical indices assessed were significantly high, and it allowed objective determination of the gingival status. Therefore, the plaque index measured using QLF-D may be used as an alternative to supplement the shortcomings of conventional clinical indices for educating patients about plaque control and continued patient oral care.


Assuntos
Índice de Placa Dentária , Placa Dentária/diagnóstico , Fluorescência Quantitativa Induzida por Luz , Adulto , Estudos Transversais , Placa Dentária/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Fotografação , Reprodutibilidade dos Testes , Autorrelato , Inquéritos e Questionários , Adulto Jovem
15.
Psychiatry Res Neuroimaging ; 282: 132-133, 2018 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-30291038

RESUMO

We investigated a possible link between bacterial infestation of the oral cavity, dental health and Alzheimer's dementia (AD). Resistant germs on the surface of the maxillary molars are the cause of a complex biofilm of bacteria with the effect of a colonization of germs between oral cavity and maxillary sinus. Bacterial toxins may lead to subsequent inflammatory processes transgressing to neighboring central nervous system structures that are suspected to be crucial in the inception of AD, such as the entorhinal cortex and the hippocampus.


Assuntos
Envelhecimento/patologia , Doença de Alzheimer/microbiologia , Toxinas Bacterianas/isolamento & purificação , Encéfalo/microbiologia , Placa Dentária/microbiologia , Periodontite/microbiologia , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/tratamento farmacológico , Antibacterianos/uso terapêutico , Encéfalo/patologia , Placa Dentária/diagnóstico , Placa Dentária/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/diagnóstico
16.
Rev Esp Salud Publica ; 922018 Aug 31.
Artigo em Espanhol | MEDLINE | ID: mdl-30168507

RESUMO

OBJECTIVE: Given the high prevalence of caries and periodontal disease globally, and its cumulative process from an early age, effective strategies are required to influence healthy habits that are formed in a sustainable manner, taking advantage of common spaces such as school. The objective was to evaluate for 72 months an oral health prevention strategy in schoolchildren. METHODS: This quasi-experimental study considered an initial sample of 350 students with similar cultural and socioeconomic conditions, which was later reduced to 220, after the 72 months. The tooth brushing practice was carried out at school daily; with teacher motivation and leader in oral health formation. Intervention was supervised all time long. to At the beginning and end of the 72 months, the following epidemiological indexes were taken: Silness-Loe plaque index, Loe-Silness Gingival index, brushing skill index by Simmons Smith & Gelbie (ISSG), and the MEDI-MED index that dichotomically considered: healthy permanent teeth, health of the gums and good attitude towards dental health. The statistical analysis included measures of central tendencies. The difference in averages of the indices was determined by the Mann-Whitney U test. RESULTS: The average of the indices: initial (II) and final (IF) registered as follows: gingival (II: 0.63-IF: 0.27) and bacterial plaque (II: 0.99-IF: 0.41) with a difference p <0.05. The index (ISSG) indicated a dental plaque removal of 82.18%.MEDI-MED index "healthy permanent teeth" (II: 91% - IF: 59%); Gum (II: 14% - IF: at 85%) and the "Mind" component (II: 96% - IF: 87%). CONCLUSIONS: The preventive strategy evaluated significantly reduced the rates of bacterial and gingival plaque. The MEDI-MED index indicated decreased in healthy permanent teeth and a positive attitude towards dentistry.


Assuntos
Cárie Dentária/prevenção & controle , Placa Dentária/prevenção & controle , Promoção da Saúde/métodos , Saúde Bucal/estatística & dados numéricos , Serviços de Saúde Escolar , Escovação Dentária/métodos , Criança , Colômbia , Cárie Dentária/epidemiologia , Placa Dentária/diagnóstico , Placa Dentária/epidemiologia , Índice de Placa Dentária , Feminino , Humanos , Estudos Longitudinais , Masculino , Resultado do Tratamento
17.
BMC Oral Health ; 17(1): 162, 2017 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-29284461

RESUMO

BACKGROUND: Significant numbers of adults and children have untreated plaque due to poor oral hygiene and consequently suffer from associate dental and systemic diseases. METHODS: A handheld device equipped with 405 nm light-emitting diodes was constructed to examine the prevalence of red fluorescence signatures associated with dental plaque. This device was used for in vivo imaging of all four incisors and all four canines of twenty-eight consenting human subjects. The same areas were further imaged under white light illumination with a commercial image-processing based plaque-imaging device, and evaluated by a hygienist and dentist. A custom computer vision algorithm using pixel information was developed to calculate plaque coverage ratios ranging from 0 (no plaque) to 1 (complete plaque coverage) for images captured by both devices. RESULTS: The algorithm calculated red fluorescence-based plaque coverage ratios ranging from 0.011 to 0.211 for the subjects imaged. Clinical assessment and statistical analyses of associated plaque ratios of the 405 nm device images indicated high sensitivity and specificity in detecting dental plaque by the experimental device compared to the commercial reference device. CONCLUSIONS: The low-cost and open source 405 nm device and the associated computer vision algorithm successfully captured red fluorescence signatures associated with dental plaque and demonstrated comparable performance to a commercially available device. Therefore, a proof of concept validation was provided for the construction and application of a sensitive cost-effective plaque-detecting device. A miniaturized mobile adaptable version of the device was also provided, together with and a step-by-step guide for device assembly and webhost the associated software, to facilitate open-source access to a cost-effective at-home, in-clinic oral care technology. TRIAL REGISTRATION: ClinicalTrials.gov NCT03379337, December 19 2017. Retrospectively registered.


Assuntos
Placa Dentária/diagnóstico por imagem , Imagem Óptica/métodos , Adulto , Idoso , Algoritmos , Placa Dentária/diagnóstico , Placa Dentária/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Imagem Óptica/instrumentação , Reprodutibilidade dos Testes , Software
18.
J Pediatr Endocrinol Metab ; 30(11): 1155-1159, 2017 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-28988224

RESUMO

BACKGROUND: The aim of this study was to compare the oral health status of children with type 1 diabetes and healthy controls. METHODS: This comparative study involved 64 children, 32 children with type 1 diabetes and 32 age- and gender-matched controls. Oral health examination was conducted using WHO criteria. Dental caries experience was recorded using DMFT/dmft index and periodontal parameters were assessed using plaque, gingivitis, gingival bleeding and calculus indexes. Dental caries and periodontal parameters between the two groups were compared using the Mann-Whitney U-test. RESULTS: Children with diabetes exhibited significantly greater plaque deposits (p=0.01) and a higher mean plaque index (p<0.01), when compared to healthy subjects. No significant difference in DMFT and dmft scores, mean bleeding index, calculus index and gingival index was found between the two groups. CONCLUSIONS: Children with type 1 diabetes had a poor oral health status with greater plaque accumulation than children without diabetes.


Assuntos
Placa Dentária/epidemiologia , Complicações do Diabetes/epidemiologia , Diabetes Mellitus Tipo 1/fisiopatologia , Gengivite/epidemiologia , Saúde Bucal , Estudos de Casos e Controles , Criança , China/epidemiologia , Placa Dentária/diagnóstico , Complicações do Diabetes/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Feminino , Seguimentos , Gengivite/diagnóstico , Nível de Saúde , Humanos , Incidência , Masculino , Prognóstico
19.
PLoS One ; 12(8): e0182992, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28800622

RESUMO

OBJECTIVES: The purpose of this study was to compare microbial profiles of saliva, pooled and site-specific subgingival samples in patients with periodontitis. We tested the hypotheses that saliva can be an alternative to pooled subgingival samples, when screening for presence of periopathogens. DESIGN: Site specific subgingival plaque samples (n = 54), pooled subgingival plaque samples (n = 18) and stimulated saliva samples (n = 18) were collected from 18 patients with generalized chronic periodontitis. Subgingival and salivary microbiotas were characterized by means of HOMINGS (Human Oral Microbe Identification using Next Generation Sequencing) and microbial community profiles were compared using Spearman rank correlation coefficient. RESULTS: Pronounced intraindividual differences were recorded in site-specific microbial profiles, and site-specific information was in general not reflected by pooled subgingival samples. Presence of Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia, Filifactor alocis, Tannerella forsythia and Parvimona micra in site-specific subgingival samples were detected in saliva with an AUC of 0.79 (sensitivity: 0.61, specificity: 0.94), compared to an AUC of 0.76 (sensitivity: 0.56, specificity: 0.94) in pooled subgingival samples. CONCLUSIONS: Site-specific presence of periodontal pathogens was detected with comparable accuracy in stimulated saliva samples and pooled subgingival plaque samples. Consequently, saliva may be a reasonable surrogate for pooled subgingival samples when screening for presence of periopathogens. Future large-scale studies are needed to confirm findings from this study.


Assuntos
DNA Bacteriano/genética , Filogenia , Porphyromonas gingivalis/genética , Prevotella intermedia/genética , Tannerella forsythia/genética , Treponema denticola/genética , Adulto , Idoso , Periodontite Crônica/diagnóstico , Periodontite Crônica/microbiologia , Placa Dentária/diagnóstico , Placa Dentária/microbiologia , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Bolsa Periodontal/diagnóstico , Bolsa Periodontal/microbiologia , Porphyromonas gingivalis/classificação , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/classificação , Prevotella intermedia/isolamento & purificação , Saliva/química , Saliva/microbiologia , Tannerella forsythia/classificação , Tannerella forsythia/isolamento & purificação , Treponema denticola/classificação , Treponema denticola/isolamento & purificação
20.
Int J Prosthodont ; 30(4): 377-383, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28697210

RESUMO

PURPOSE: The aim of this study was to evaluate the reliability and agreement of a new computerized planimetric method (CPM) for the measurement and assessment of plaque on all types of removable dental prostheses (RDPs). MATERIALS AND METHODS: From a database containing 780 images taken following a standardized method for 65 RDPs, 55 images were randomly selected for image analysis. Adobe Photoshop software was used according to standard operating procedure (SOP) by one main examiner two times in different sessions, and one time by three additional examiners. To estimate the intra- and interexaminer reliability, intraclass correlation coefficient ICC(2,1) were used. Three parameters were used to estimate agreement: standard error of measurement (SEM), smallest detectable change at the 95% confidence level (SDC95%), and limits of agreement (LoA) according to the Bland-Altman method. RESULTS: In all steps of the image analysis, both intra- and interexaminer reliability were excellent, with ICC(2,1) values > 0.85 at the 95% confidence level. The intra- and interexaminer values for both the SEMagreement and SDC95% were ≤ 6% and ≤ 17%, respectively. The Bland-Altman analysis revealed a satisfactory level of agreement. CONCLUSION: This study shows excellent inter- and intraexaminer reproducibility, a satisfactory level of examiner agreement, and acceptable measurement error. Furthermore, the method can be used with all types of RDPs. The CPM is more suitable for clinical research because of its objectivity, reliability, high level of standardization, and ability to detect and quantify small changes in plaque.


Assuntos
Placa Dentária/diagnóstico , Prótese Dentária , Diagnóstico por Computador , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Placa Dentária , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Software
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