Levels of HIV-1 in subgingival biofilm of HIV-infected patients.

AIM: The aims of the current study were to compare the levels of HIV-1 in the subgingival biofilm (SHVL) between detectable and undetectable plasmatic HIV-1 viral load (PHVL) in HIV-infected patients as well as to determine the association of SHVL with PHVL and clinical periodontal parameters. MATERIAL AND METHODS: Forty-one HIV-infected individuals were divided into two groups: detectable (21) and undetectable (20) PHVL. Subgingival biofilm samples were obtained for detection and quantification of HIV-1 by real-time RT-PCR. To estimate the effect of co-variables on the outcome undetectable SHVL, the Generalized Estimation Equation (GEE) was employed. RESULTS: Detectable SHVL was observed only in the detectable PHVL group and the detection of the HIV-1 was observed in 40% of these individuals. In the bivariate analysis between co-variables from the individual level and the outcome SHVL, significant difference was observed only for the CD4+ T lymphocytes levels (p = 0.017). The multiple logistic model demonstrated that only CD4+ T lymphocytes levels had a significant effect on the outcome undetectable SHVL [OR 8.85 (CI 3.6-9.2), p = 0.002]. CONCLUSION: HIV-1 can be detected and quantified in the subgingival biofilm of HIV-infected individuals, but these findings are not associated with PHVL and periodontal clinical parameters.

Characterization of proteolytic activities of Fusobacterium nucleatum.

This investigation attempted to detect the proteolytic activity of Fusobacterium nucleatum in living cells, lysate cells, and supernatant of cultures. The reactions were optimized in their pH, temperature, reaction time, enzyme source, and substrate volume. Synthetic substrates beta-naphthylamides (Cys-Na, Ser-Na, Leu-Na, Glu-Na, Lys-Na and BANA), carbobenzoxy L-tirosine p-nitrophenylester (CTN), and natural substrate azoalbumin were used. Reaction occurred with Cys-Na, Ser-Na, and Glu-Na in living cells and with Glu-Na, Leu-Na, and CTN substrates in lysate cells. The supernatant reacted only with Glu-Na. Optimal pH ranged from 6.0 to 7.5, except for CTN (pH 13), and optimal temperature, between 30 and 40 degrees C. Optimal reaction time was 60 min, except for Glu-Na in living cells (40 min), lysate cells (20 min), and CTN substrate (80 min). There was no activity with Lys-Na, BANA, and azoalbumin. Proteolytic activity was assessed by several inhibitors and the presence of metallo, serine, cysteine, and aspartic proteases were detected.

Bacteremia after Endodontic Procedures in Patients with Heart Disease: Culture and Molecular Analyses.

INTRODUCTION: Infective endocarditis (IE) is still associated with high mortality, and antibiotic prophylaxis strategies are under intense debate. We evaluated the incidence of bacteremia after root canal preparation in teeth with necrotic pulps and apical periodontitis. METHODS: Blood samples were taken before and 5 and 30 minutes after endodontic treatment in teeth with apical periodontitis from individuals at high (n = 21) or no risk (n = 11) for IE. The former received prophylactic antibiotic therapy. Bacteriologic samples were taken from root canals before chemomechanical preparation to confirm pulp infection. Samples were subjected to aerobic and anaerobic culture and quantitative real-time polymerase chain reaction (qPCR), the latter to determine the total bacterial and streptococcal levels. RESULTS: Culture revealed no bacteremia in all individuals. Analysis by qPCR showed that bacterial DNA occurred in all root canal samples. qPCR showed a similar incidence of bacteremia between patients who received or did not receive prophylactic antibiotic therapy (P > .05). In blood samples taken 5 minutes after endodontic procedures, bacteria were detected in 2 of 11 (18%) individuals not taking antibiotics and in 4 of 21 (19%) patients under prophylaxis. After 30 minutes, the incidence of bacteremia decreased to 2 of 21 (10%) in patients taking antibiotics and was undetectable in patients at no risk of IE. The incidence of bacteremia by streptococci was identical as that for total bacteria. CONCLUSIONS: No detectable bacteremia was evident by culture after treatment of infected root canals. Molecular analysis revealed bacterial DNA and streptococci in blood from some patients without a significant difference between individuals receiving or not receiving antibiotic prophylaxis.

Effects of non-surgical mechanical therapy on the subgingival microbiota of Brazilians with untreated chronic periodontitis: 9-month results.

BACKGROUND: Mechanical periodontal therapy is the most common treatment of periodontal infections. It is directed primarily towards removing biofilm and calculus from the root surfaces, leading to ecological changes in the subgingival environment. Thus, the purpose of this study was to evaluate the effects of scaling and root planing (SRP) on the subgingival microbiota of Brazilian subjects with untreated chronic periodontitis over a 9-month period. METHODS: Twenty-five untreated chronic periodontitis patients (mean age 43 +/- 5 years; 20% smokers; 45% males) were selected from a Brazilian population. At baseline, probing depth (PD), clinical attachment level (CAL), visible supragingival biofilm (SB), bleeding on probing (BOP), and suppuration (SUP) were measured at six sites/tooth. Subgingival plaque samples were obtained from 10 sites with the deepest PD (> or =5 mm) of each subject and tested for the presence of 25 oral species by DNA probes and the checkerboard technique. Patients received full mouth SRP and oral hygiene instructions. Clinical and microbiological assessments were repeated at 3, 6, and 9 months after therapy. During this period, all patients received maintenance therapy, including supragingival prophylaxis and reinforcement in home care procedures. The clinical and microbiological parameters examined were computed for each subject and at each visit. Differences over time were sought using the Friedman test. RESULTS: Significant reductions in mean CAL and PD (P <0.01), percent of sites with SB (P <0.01), BOP and SUP (P <0.05) were observed during the course of the study. In general, microbial changes were more pronounced for the mean counts than for the frequency of the microorganisms, particularly at 3 months post-therapy. Significant reductions in prevalence and levels were observed for certain periodontal pathogens including P. gingivalis (P <0.05; P <0.01), T. forsythensis (P <0.01), C. rectus (P <0.01), and A. actinomycetemcomitans (P <0.01; P <0.05). Nevertheless, the frequency of A. actinomycetemcomitans increased to baseline values at 9 months after therapy. Treponema ssp. and Prevotella spp. showed a modest decrease in prevalence, whereas marked reductions in their levels were observed. In contrast, the frequency and counts of the suspected pathogens P. micros and F. nucleatum increased after treatment. Species considered beneficial including Actinomyces spp., some oral streptococci, and V. parvula increased in prevalence, although these two last species tended to return to baseline levels at 9 months. CONCLUSION: In Brazilians with untreated chronic periodontitis, SRP led to clinical improvement associated with a decrease of certain periodontal pathogens, and an increase of beneficial species for up to 9 months after therapy.

Antimicrobial activity of a temporary sealant used in endodontic treatment: An in vitro study.

OBJECTIVE: The present study is aimed to evaluate the antimicrobial action of Coltosol(®) in direct contact with human saliva. MATERIALS AND METHODS: Twelve different individuals were selected. Saliva samples were evaluated at four different time periods: Baseline 1 (T1-initial control), T2 (2 h), T4 (24 h after contact with a standardized sample of a coronary sealer) and baseline 2 (T3-final control). Seeded plates were incubated at 37°C in a bacterial incubator for a period of 48-72 h. After the incubation period, the colony forming units were counted, and the results compared. RESULTS: Differences were statistically significant. There was an inhibition of bacterial growth after the first 2 h of contact and an increase in the number of bacteria after 24 h of direct contact between the material and the saliva. Coltosol(®) presented bacterial growth inhibition in direct contact with saliva. This inhibitory effect tended to decrease over time, as shown by the two periods when the material was in contact with different samples of saliva. CONCLUSIONS: The antimicrobial activity of the material is an important feature; however, other physical and chemical properties of the coronary temporary sealer should be considered.

Comparison of 16S rDNA-based PCR and checkerboard DNA-DNA hybridisation for detection of selected endodontic pathogens.

Molecular methods have been used recently to investigate the bacteria encountered in human endodontic infections. The aim of the present study was to compare the ability of a 16S rDNA-based PCR assay and checkerboard DNA-DNA hybridisation in detecting Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Peptostreptococcus micros, Porphyromonas endodontalis, Por. gingivalis and Treponema denticola directly from clinical samples. Specimens were obtained from 50 cases of endodontic infections and the presence of the target species was investigated by whole genomic DNA probes and checkerboard DNA-DNA hybridisation or taxon-specific oligonucleotides with PCR assay. Prevalence of the target species was based on data obtained by each method. The sensitivity and specificity of each molecular method was compared with the data generated by the other method as the reference--a value of 1.0 representing total agreement with the chosen standard. The methods were also compared with regard to the prevalence values for each target species. Regardless of the detection method used, T. denticola, Por. gingivalis, Por. endodontalis and B. forsythus were the most prevalent species. If the checkerboard data for these four species were used as the reference, PCR detection sensitivities ranged from 0.53 to 1.0, and specificities from 0.5 to 0.88, depending on the target bacterial species. When PCR data for the same species were used as the reference, the detection sensitivities for the checkerboard method ranged from 0.17 to 0.73, and specificities from 0.75 to 1.0. Accuracy values ranged from 0.6 to 0.74. On the whole, matching results between the two molecular methods ranged from 60% to 97.5%, depending on the target species. The major discrepancies between the methods comprised a number of PCR-positive but checkerboard-negative results. Significantly higher prevalence figures for Por. endodontalis and T. denticola were observed after PCR assessment. There was no further significant difference between the methods with regard to detection of the other target species.

Subgingival microbiota of Brazilian subjects with untreated chronic periodontitis.

BACKGROUND: Different periodontopathogenic microbiota have been associated with periodontal diseases in several populations. The present investigation determined the subgingival microbiota of untreated chronic periodontitis Brazilians using the checkerboard DNA-DNA hybridization technique. METHODS: Twenty-five periodontitis patients (mean age, 41 +/- 2; mean probing depth [PD], 3.3 +/- 0.2; mean attachment level [AL], 3.6 +/- 0.2) with no history of previous periodontal therapy and a control group of 14 healthy subjects (mean age, 34 +/- 0.6; mean PD, 1.8 +/- 0.2; mean AL, 1.7 +/- 0.1) were selected. Measurements of PD, AL, bleeding on probing, plaque accumulation, and suppuration were recorded at 6 sites/tooth. Subgingival plaque samples were obtained from 4 sites in each tooth/subject in both groups. The presence and levels of 41 subgingival species were determined in 4,032 plaque samples using whole genomic DNA probes and the checkerboard method. RESULTS: Periodontal pathogens, as well as some unusual species (E. faecalis, E. coli and Bartonella sp.), were detected significantly more often and/or in higher levels in the periodontitis group (P < 0.05). Most species were more frequently detected in interproximal sites. B. forsythus, P. gingivalis, E. nodatum, and F. nucleatum ss vincentii showed a significant positive correlation with mean PD and AL (P < 0.05). CONCLUSIONS: The subgingival microbiota of Brazilians with untreated chronic periodontitis were complex, including high proportions of periodontopathogens commonly found in other populations, as well as some unusual species.

Peptostreptococcus micros in primary endodontic infections as detected by 16S rDNA-based polymerase chain reaction.

A 16S rDNA-based polymerase chain reaction (PCR) method was used to detect Peptostreptococcus micros in primary root canal infections. Samples were collected from 50 teeth having carious lesions, necrotic pulps, and different forms of periradicular diseases. DNA extracted from the samples was amplified using the PCR assay, which yielded a specific fragment of P. micros 16S rDNA. P. micros was detected in 6 of 22 root canals associated with asymptomatic chronic periradicular lesions (27.3%), 2 of 8 teeth with acute apical periodontitis (25%), and 6 of 20 cases of acute periradicular abscess (30%). In general, P. micros was found in 14 of 50 cases (28%). There was no correlation between the presence of P. micros and the occurrence of symptoms. Findings suggested that P. micros can be involved in the pathogenesis of different forms of periradicular lesions.

Elimination of Candida albicans infection of the radicular dentin by intracanal medications.

Fungi have been associated with cases of secondary or persistent root canal infections. The purpose of this study was to evaluate the effectiveness of four intracanal medications in disinfecting the root dentin of bovine teeth experimentally infected with Candida albicans. Infected dentin cylinders were exposed to four different medications: calcium hydroxide/glycerin; calcium hydroxide/0.12% chlorhexidine digluconate; calcium hydroxide/camphorated paramonochlorophenol/glycerin; and 0.12% chlorhexidine digluconate/zinc oxide. Specimens were in contact with the medications for 1 h, 2 days, and 7 days. The viability of C. albicans after exposure was evaluated by specimen incubation in culture medium to compare the effectiveness of the medications in disinfecting dentin. Results showed that the specimens treated with calcium hydroxide/camphorated paramonochlorophenol/ glycerin paste or with chlorhexidine/zinc oxide paste were completely disinfected after 1 h of exposure. Calcium hydroxide/glycerin paste only consistently eliminated C. albicans infection after 7 days of exposure. Calcium hydroxide mixed with chlorhexidine was ineffective in disinfecting dentin even after 1 week of medication exposure. Among the medications tested, the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste and chlorhexidine digluconate mixed with zinc oxide were the most effective in eliminating C. albicans cells from dentinal specimens.

Fungal infection of the radicular dentin.

Although fungi have been detected in infected root canals, their precise role as endodontic pathogens has not yet been elucidated. The purpose of this study was to investigate the pattern of radicular dentin colonization by five fungal species. Bovine root sections were infected with each of the following fungal species: Candida albicans, Candida glabrata, Candida guilliermondii, Candida parapsilosis, and Saccharomyces cerevisiae. After 14 days, the sections were fixed in glutaraldehyde, split into two halves, critical point-dried in CO2, sputter-coated with gold, and examined under scanning electron microscopy. Regardless of the species, single or budding yeast cells were the only fungal forms observed. C. albicans colonized most of the specimens. On the other hand, the other four fungal species presented discrete or no colonization of the radicular dentin. C. albicans showed different patterns of dentin infection. In some specimens, colonization of the dentinal surface was slight and no penetration within dentinal tubules was observed. In the other specimens, some areas of the root canal walls were covered with large colonies of yeast cells and some dentinal tubules were heavily infected. The results suggested that whereas C. albicans showed the ability to colonize dentin, the other four fungal species did not. This can help to explain why C. albicans is the fungal species most often found in endodontic infections.

Efficacy of instrumentation techniques and irrigation regimens in reducing the bacterial population within root canals.

The purpose of this study was to compare the in vitro intracanal bacterial reduction produced by using two instrumentation techniques and different irrigation methods. Root canals inoculated with Enterococcus faecalis were prepared by using the following techniques and irrigants: alternated rotary motions (ARM) technique, hand nickel-titanium files and 2.5% sodium hypochlorite (NaOCl) as irrigant; ARM technique and combined irrigation with 2.5% NaOCl and citric acid; ARM technique and combined irrigation with 2.5% NaOCl and 2% chlorhexidine gluconate; and Greater Taper rotary files, using 2.5% NaOCl as irrigant. Controls were instrumented by using the ARM technique and irrigated with sterile saline. Canals were sampled before and after preparation. After serial dilution, samples were plated onto Mitis-Salivarius agar, and the colony forming units that were grown were counted. All test techniques and solutions significantly reduced the number of bacterial cells within the root canal (p < 0.05). There was no significant difference between the experimental groups (p > 0.05). Nonetheless, all of them were significantly more effective than the control group (p < 0.05). These findings support the importance of using antimicrobial irrigants during the chemomechanical preparation, regardless of the solutions or instrumentation techniques used.

Association of T CD4 lymphocyte levels and subgingival microbiota of chronic periodontitis in HIV-infected Brazilians under HAART.

OBJECTIVE: The aim of this study was to determine the subgingival microbiota of HIV-infected patients with chronic periodontitis and different T CD4 lymphocyte levels under HAART. STUDY DESIGN: 64 HIV+ patients (mean age 34.5 +/- 7.3; 75% males) were distributed into Group I: chronic periodontitis (> or = 3 sites with probing pocket depth (PPD) and/or clinical attachment level (CAL) > or = 5 mm); and Group II: periodontal health (no sites with PPD > 3 mm and/or CAL > 4 mm). All subjects received conventional periodontal therapy. Periodontal clinical parameters were evaluated at 6 sites/tooth in all teeth at baseline and 4 months after therapy. The levels of T CD4 were obtained from the patient's medical record. Subgingival plaque samples were taken from the 6 sites with the largest pocket depth in each subject of Group I, and 6 randomly selected sites in subjects of Group II. The presence of 22 subgingival species was determined using the checkerboard DNA-DNA hybridization method. Significant microbiological differences within and among groups were sought using Wilcoxon signed-rank and Mann-Whitney tests, respectively. Relationships between T CD4 levels and microbiological parameters were determined using Kruskal-Wallis test. RESULTS: Sixty-one percent of the HIV-infected patients represented AIDS cases, although 69% of them were periodontally healthy. The T CD4 lymphocyte mean level was 333 cells/mm3 and viral load was 12,815 +/- 24,607 copies/mm3. Yet, the prevalence of chronic periodontitis was relatively low (36%). Several periodontal pathogens, in particular T. forsythensis (P < .05), were more prevalent in HIV-positive patients with periodontitis than in HIV-positive subjects with periodontal health. Most of the species decreased in frequency after therapy, particularly P. gingivalis (P < .05). E. faecalis and F. nucleatum were significantly more prevalent in the subgingival microbiota of patients with chronic periodontitis and lower levels of T CD4 (P < .05), while beneficial species tended to be more frequently detected in individuals with T CD4 counts over 500 cells/mm3. CONCLUSION: The subgingival microbiota of HIV-infected patients with chronic periodontitis include a high prevalence of classical periodontal pathogens observed in non-infected individuals. Furthermore, the severe immunosuppression seems to favor the colonization by these species, as well as by species not commonly found in the subgingival microbiota.

Relationship between salivary flow rates and Candida counts in subjects with xerostomia.

OBJECTIVE: This study evaluated the relationship between salivary flow and Candida colony counts in the saliva of patients with xerostomia. STUDY DESIGN: Sialometry and Candida colony-forming unit (CFU) counts were taken from 112 subjects who reported xerostomia in a questionnaire. Chewing-stimulated whole saliva was collected and streaked in Candida plates and counted in 72 hours. Species identification was accomplished under standard methods. RESULTS: There was a significant inverse relationship between salivary flow and Candida CFU counts (P =.007) when subjects with high colony counts were analyzed (cutoff point of 400 or greater CFU/mL). In addition, the median sialometry of men was significantly greater than that of women (P =.003), even after controlling for confounding variables like underlying disease and medications. Sjögren's syndrome was associated with low salivary flow rate (P =.007). There was no relationship between the median Candida CFU counts and gender or age. There was a high frequency (28%) of mixed colonization. Candida albicans was the most frequent species, followed by C parapsilosis, C tropicalis, and C krusei. CONCLUSIONS: In subjects with high Candida CFU counts there was an inverse relationship between salivary flow and Candida CFU counts.

The association between detectable plasmatic human immunodeficiency virus (HIV) viral load and different subgingival microorganisms in Brazilian adults with HIV: a multilevel analysis.

BACKGROUND: This study investigates the association between detectable plasmatic human immunodeficiency virus (HIV) viral load (HVL) and high levels of periodontal- and non-periodontal-related microorganisms in the subgingival microbiota of individuals with HIV. METHODS: Thirty-seven individuals with HIV were divided into two groups: 1) detectable HVL (n = 15); and 2) undetectable HVL (n = 22). Subgingival biofilm samples were obtained, and the levels of 35 microbial species were determined by the checkerboard DNA-DNA hybridization method. Periodontal clinical measures and laboratory and sociodemographic data were also registered. χ(2) test, Fisher exact test, and Mann-Whitney U test were used to compare groups. Multilevel ordinal regression models were used to test the association between HVL and the levels of 35 microbial species in subgingival biofilm, adjusted for confounders. RESULTS: Of the 35 species studied, 11 (31.4%) showed higher mean levels in the detectable HVL group than undetectable HVL group (P <0.001). These species included Actinomyces naeslundii II, Actinomyces israelii, Actinomyces odontolyticus, Veillonella parvula, Capnocytophaga gingivalis, Eikenella corrodens, Campylobacter concisus, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Candida albicans. Significant associations between detectable HVL and high levels of microorganisms, adjusted for confounders, were observed for A. naeslundii I, Actinomyces gerencseriae, C. gingivalis, E. corrodens, C. concisus, Prevotella nigrescens, T. forsythia, and Dialister pneumosintes. CONCLUSION: Detectable plasmatic HVL in individuals with HIV was associated with elevated levels of known periodontal pathogens, such as P. nigrescens, T. forsythia, and E. corrodens, as well as C. concisus, C. gingivalis, and D. pneumosintes in the subgingival biofilm.

Influence of serum and necrotic soft tissue on the antimicrobial effects of intracanal medicaments.

The purpose of this study was to investigate the influence of serum and necrotic soft tissue on the antimicrobial activity of intracanal medicaments. The medicaments tested were: calcium hydroxyde/glycerin paste, calcium hydroxide/chlorhexidine paste, calcium hydroxide/camphorated paramonochlorophenol/glycerin paste, and chlorhexidine/zinc oxide paste. Survival of Enterococcus faecalis and Candida albicans exposed to the medicaments tested in the presence or absence of serum or necrotic tissue was monitored in three in vitro experiments where samples for culturing were taken at different time periods. The overall results demonstrated that the antimicrobial activity of all intracanal medicaments tested was slowed down in the presence of necrotic tissue. Calcium hydroxide pastes in glycerin or chlorhexidine were significantly affected by serum. Of the medicaments tested in this study, the least affected was the calcium hydroxide/camphorated paramonochlorophenol/glycerin paste.

Estudo comparativo da atividade antimicrobiana "in vivo" de seis antissépticos bucais sobre a microbiota da saliva / A comparative in vitro study of antimicrobial activity of six commercial mouthwashes against salivary bacteria

Introdução: Soluções de antissépticos bucais podem desempenhar importante papel no controle químico do biofilme dentário. No entanto, os procedimentos de controle de qualidade relacionados com a atividade antimicrobiana destes enxaguatórios contra bactérias da cavidade oral não são bem divulgados. Objetivo: Avaliar a atividade antimicrobiana in vivo de seis soluções de antissépticos bucais disponíveis no mercado brasileiro, empregadas como enxaguatórios contra bactérias da saliva humana. Material e métodos: Um estudo in vivo foi desenvolvido com indivíduos voluntários (8 do sexo masculino e 7 do sexo feminino, variando de 18 a 63 anos de idade ), independente do estado de saúde bucal. Os seguintes produtos comerciais foram testados durante 2 horas após um único procedimento de bochecho: 1) Plax®, 2) Listerine®, 3) Periogard®, 4) Cepacol®, 5) Sanifill Premium® e 6) Oral B®.Os resultados foram analisados pelo teste de ANOVA de medidas repetidas e ANOVA one-way com um nível de significância de 5%. Resultados: Houve diferença significativa (p <0,05) observada na diminuição da carga microbiana para Plax® entre o início (antes anti-séptico bucal) e imediatamente após o bochecho (T0); para Periogard® entre os valores iniciais e T60 (60 minutos após o bochecho), na linha de base e T120 (120 minutos após o bochecho) e B® Oral entre os valores iniciais e T-30 (30 minutos após o bochecho). Periogard® apresentou a maior redução da carga microbiana salivares. Conclusão: Dos seis bochechos testados, Plax®, Oral B® e Periogard ® apresentou atividade antibacteriana imediata. Periogard® foi o anti-séptico bucal que mostrou a atividade mais prolongada contra bactérias anaeróbias salivares (AU).

Introduction: Mouthwashes solutions can play an important role in the chemical control of dental biofilm. However, quality control procedures related to antimicrobial activity of these solutions against oral bacteria are not well known. Objective: To evaluate in vivo antimicrobial activity of six mouthwashes solutions available in the Brazilian market against anaerobic salivary bacteria. Material and methods: An in vivo study was developed in human volunteers (8 male and 7 female, ranging from 18 to 63 years old), despite their oral health status. The following commercial products were tested after 2 hours of a single mouthwash procedure: 1) Plax®, 2) Listerine®, 3) Periogard®, 4) Cepacol®, 5) Sanifill Premium® and 6)Oral B®. Data were analyzed by ANOVA to repeated measures and ANOVA one-way with a significance level of 5%. Results: Statistically significant difference (p<0.05) was observed in the decrease of microbial counts to Plax® between baseline (before mouthwash) and immediately after mouthwash (T0); to Periogard® between baseline and T60 (60 minutes after mouthwash), baseline and T120 (120 minutes after mouthwash) and to Oral B® between baseline and T-30 (30 minutes after mouthwash). Periogard® showed the highest and delayed reduction of salivary microbial counts. Conclusion: Out of six tested mouthwashes, Plax®, Oral B® and Periogard ® showed immediate antibacterial activity. Periogard® was the oral anti-septic that showed the best delayed activity against salivary anaerobic bacteria (AU).

Antibióticos no tratamento de abscessos perirradiculares agudos / Antibiotics in the treatment of acute periradicular abscesses

O abscesso perirradicular agudo pode resultar em complicações sistêmicas, sendo necessária a antibioticoterapia coadjuvante ao tratamento clínico. No entanto, os antibióticos são frequentemente prescritos pelos cirurgiões-dentistas no tratamento destas infecções em algumas situações questionáveis. É importante destacar que o uso incorreto destes agentes terapêuticos pode levar ao surgimento de micro- -organismos resistentes. O objetivo da presente revisão de literatura é descrever a antibioticoterapia no tratamento de abscessos perirradiculares agudos, abordando suas indicações e drogas utilizadas, e discutir a resistência bacteriana a alguns antibióticos.

The acute periradicular abscess can result in systemic complications, being necessary a complementary antibiotic therapy to clinical treatment. However, antibiotics are often prescribed by dentists to treat these infections, but its use is questionable in some situations. Misuse of antibiotics can lead to the emergence of resistant micro-organisms. The aim of this present literature review is to describe the antibiotic treatment in acute periradicular abscesses by addressing its indications and drug use, and discuss about bacterial resistance to some antibiotics.

Os cistos radiculares poem curar após tratamento endodôntico / Radicular cysts may heal after endodontic treatment

A etiologia das lesões perirradiculares e suas diferentes manifestações clínicas já estão bastante esclarecidas, porém o tratamento dos cistos radiculares ainda é um assunto controverso na Odontologia. O objetivo deste trabalho é realizar uma análise crítica, baseada na literatura, sobre o tratamento de cistos radiculares, buscando evidências que demonstrem que os cistos radiculares podem ser eliminados após tratamento endodôntico. Os cistos podem ser divididos em: cistos em bolsa e cistos verdadeiros, sendo que os cistos em bolsa respondem ao tratamento endodôntico, enquanto os cistos verdadeiros somente podem ser tratados através da cirurgia perirradicular. Pode-se concluir que sendo o agente microbiano o responsável pelas lesões perirradiculares, a maioria destas lesões, incluindo os cistos, regridem após a intervenção endodôntica não cirúrgica.

The etiology of apical periodontitis and its different clinical manifestations are already well versed, but the treatment of radicular cysts is still a controversial subject in Dentistry. The e aim of this study is to perform a critical analysis based on literature regarding treatment of radicular cysts, seeking evidence demonstrating that the radicular cysts can be eliminated after endodontic treatment. The cysts can be divided in: Apical Pocket Cysts and true cysts. Apical pocket cysts respond to endodontic treatment, while true cysts can only be treated by periradicular surgery. It can be concluded that since the microbial agent is responsible for the apical periodontitis, the majority of these lesions, including cysts regress after nonsurgical endodontic therapy.

A prospective randomized trial to reduce oral Candida spp. colonization in patients with hyposalivation.

Low salivary flow rates are associated with higher oral Candida spp. counts, which may predispose to oral candidiasis. The aim of this study was to compare the effect of stimulating salivary flow rates with that of a regimen of chlorhexidine mouth rinse on the intensity of Candida colonization in patients with reduced salivary flow rates. Thirty-one outpatients were randomized to stimulate salivary output (group 1) or to receive chlorhexidine mouth rinses (group 2). Evaluations were performed at baseline (T0), at end of treatment (T1), and 15 days after last day of treatment (T2). Chewing-stimulated whole saliva samples were collected at each visit. Group 1 showed a constant reduction in median cfu counts, although the difference was significant only between T0 and T2 (p = 0.004). Group 2 showed a reduction in median Candida cfu counts between T0 and T1 (p = 0.01), but the counts increased at T2 (p = 0.01), and the difference between T0 and T2 was not significant (p = 0.8). In conclusion, patients who received salivary stimulation showed reductions of Candida cfu counts in saliva and a trend for increasing salivary flow rates between baseline and end of study evaluations. The use of chlorhexidine mouth rinses dramatically reduced Candida cfu counts, but when patients discontinued treatment, intensity of colonization rose again.

Efeitos do consumo diário de probiótico sobre a microbiota cariogênica / Effects of daily consumption of probiotic on the cariogenic microbiota

Probióticos são definidos como micro-organismos vivos que, quando administrados em quantidade adequada, podem trazer benefícios ao hospedeiro melhorando seu equilíbrio intestinal. Estudos recentes têm sugerido que alguns probióticos funcionam como um método auxiliar no controle da doença cárie, pois podem diminuir os níveis salivares de Streptococcusmutans. Muitas bactérias, incluindo os gêneros Lactobacillus e Bifidobacterium possuem propriedades probióticas. Diversos veículos podem ser utilizados para administrá-los, entretanto o mais comum é o iogurte. Porém mais estudos sobre probióticos são necessários para comprovar seus reais benefícios na cavidade oral, permitindo aos dentistas indicarem seu consumo com segurança.