Comparison of two methods for sialometry: weighing and volume techniques

A composição da saliva é essencial para homeostase da cavidade oral. Assim sendo, a diminuição do fluxo salivar pode levar ao aumento da incidência de cáries, boca seca, alteração no paladar, alteração na deglutição, gengivite, halitose, problemas mastigatórios, mucosites, candidíases, problemas no sono, fala e lesões orais traumáticas. O objetivo deste estudo foi avaliar a técnica de sialometria por peso em comparação com a técnica tradicional de sialometria por volume, com coleta de saliva estimulada e não estimulada. Cinquenta pacientes com ou sem queixa prévia de xerostomia ou hipossalivação foram selecionados na clínica de Estomatologia da Faculdade de Odontologia da Universidade de São Paulo, Brasil. Todas as coletas foram realizadas entre 9 e 10 horas da manhã. Seis rolos de algodão foram separados e divididos em três pares e colocados em três diferentes coletores plásticos universais, sendo cada conjunto pesado previamente em balança analítica calibrada. O teste de sialometria foi realizado em três etapas: fluxo salivar sem estimulação; estimulado com 1% de ácido cítrico em aplicação única; e estimulado com aplicação de 1% de ácido cítrico a cada 30 segundos até completar 2 minutos. Esses resultados por peso foram comparados com o método de sialometria por volume tradicional. Não houve diferença estatística observada entre os dois métodos de coleta e 100% dos pacientes preferiram a coleta realizada com roletes de algodão.The composition of saliva is essential for the oral cavity homeostasis, therefore, the decrease in salivary flow leads to consequences, such as an increase of dental caries, dry mouth and lips, dysgeusia, dysphagia, gingivitis, halitosis, mastication problems, oral mucositis, oral pharyngeal candidiasis, sleeping and speaking difficulties and traumatic oral lesions. The objective of this study was to evaluate the efficacy of the sialometry technique by weighing in comparison to the sialometry technique by volume. Fifty patients without previous complaint of xerostomia and/or hyposalivation were selected at the Oral Medicine Clinic, Dentistry School, University of São Paulo, Brazil. All samples were collected between 9 am and 10 am and the whole saliva was collect stimulated and unstimulated. Six cotton rolls were prepared, divided into three pairs and placed in different universal dispensers of a random brand, they were weighed in a previously calibrated analytical balance (FA-2104N CELTAC). The sialometry test was performed in three steps: unstimulated salivary flow, salivary flow with stimulation of 1% citric acid solution and stimulation of 1% citric acid solution every 30 seconds. The results of the weighing method were compared to the standard method. There was no significant statistical difference between the two types of collection and 100% of the participants expressed their preference for the weighing method

Effect of a 0.5% chlorhexidine gel on dental plaque superinfecting microorganisms in mentally handicapped patients

Foi conduzido um ensaio clínico aleatório com objetivo de investigar o efeito do gel de clorexidina (CHX) a 0,5% sobre microorganismos superinfectantes da placa bacteriana de pacientes especiais. Trinta internos da instituição "Casas André Luiz" foram aleatoriamente divididos em grupo teste (gel de CHX, n = 15) e controle (gel placebo, n = 15). O gel foi utilizado por oito semanas. Amostras de placa supragengival foram coletadas no início do estudo, após o uso do gel (oito semanas) e 16 semanas após o início do estudo. Foi avaliada a presença de bacilos entéricos Gram-negativos, Staphylococcus e leveduras. Não houve diferença entre os grupos quanto à presença desses microorganismos em qualquer momento do estudo. Os resultados indicam que o gel de CHX não provocou mudanças significativas na composição desses microorganismos.A randomized clinical trial was conducted to investigate the effect of a 0.5% chlorhexidine (CHX) gel on dental plaque superinfecting microorganisms in mentally handicapped patients. Thirty inmates from the institution "Casas André Luiz" were assigned to either test group (CHX gel, n = 15) or control group (placebo gel, n = 15). The gel was administered over a period of 8 weeks. Supragingival plaque samples were collected at baseline, after gel use (8 weeks) and 16 weeks after baseline. The presence of Gram-negative Enterobacteriaceae, Staphylococcus and yeasts was evaluated. No significant growth of any superinfecting microorganism was observed in the CHX group, when compared to the placebo group. The results indicated that the 0.5% chlorhexidine gel did not produce an undesirable shift in these bacterial populations

Compliance improvement in periodontal maintenance

OBJECTIVES: The aim of this study was to assess the infuence of efforts applied to modify the patients' behavior towards periodontal maintenance. MATERIAL AND METHODS: Patients were classifed into three groups: Complete Compliance (participation in all visits), Irregular Compliance (irregular participation, one or more missing appointments), and Noncompliance (abandoned or never returned to the program). Complete compliers received usual procedures of the maintenance visit. The irregular compliers and non-compliers received usual procedures and strategies such as reminding next visit, informing patients on both periodontal disease and importance of maintenance, motivating the patient who showed an improvement in compliance. Thus, 137 patients were observed for 12 months. RESULTS: The degree of compliance has increased signifcantly during this period (p=0.001). No association was detected between age or gender and compliance degree. CONCLUSIONS: The results have shown that the intervention applied had a favorable infuence on the patients' compliance

Compliance improvement in periodontal maintenance

OBJECTIVES: The aim of this study was to assess the infuence of efforts applied to modify the patients' behavior towards periodontal maintenance. MATERIAL AND METHODS: Patients were classifed into three groups: Complete Compliance (participation in all visits), Irregular Compliance (irregular participation, one or more missing appointments), and Noncompliance (abandoned or never returned to the program). Complete compliers received usual procedures of the maintenance visit. The irregular compliers and non-compliers received usual procedures and strategies such as reminding next visit, informing patients on both periodontal disease and importance of maintenance, motivating the patient who showed an improvement in compliance. Thus, 137 patients were observed for 12 months. RESULTS: The degree of compliance has increased signifcantly during this period (p=0.001). No association was detected between age or gender and compliance degree. CONCLUSIONS: The results have shown that the intervention applied had a favorable infuence on the patients' compliance

Impact of Cytomegalovirus and Grafts versus Host Disease on the Dynamics of CD57+CD28−CD8+ T Cells After Bone Marrow Transplant

OBJECTIVES: The present study aimed to evaluate the dynamics of CD28 and CD57 expression in CD8+ T lymphocytes during cytomegalovirus viremia in bone marrow transplant recipients. METHODS: In a prospective study, blood samples were obtained once weekly once from 33 healthy volunteers and weekly from 33 patients. To evaluate the expression of CD57 and CD28 on CD8+ T lymphocytes, flow cytometry analysis was performed on blood samples for four months after bone marrow transplant, together with cytomegalovirus antigenemia assays. RESULTS: Compared to cytomegalovirus-seronegative healthy subjects, seropositive healthy subjects demonstrated a higher percentage of CD57+ and a lower percentage of CD28+ cells (p<0.05). A linear regression model demonstrated a continuous decrease in CD28+ expression and a continuous increase in CD57+ expression after bone marrow transplant. The occurrence of cytomegalovirus antigenemia was associated with a steep drop in the percentage of CD28+ cells (5.94%, p<0.01) and an increase in CD57+ lymphocytes (5.60%, p<0.01). This cytomegalovirus-dependent effect was for the most part concentrated in the allogeneic bone marrow transplant patients. The development of acute graft versus host disease, which occurred at an earlier time than antigenemia (day 26 vs. day 56 post- bone marrow transplant), also had an impact on the CD57+ subset, triggering an increase of 4.9% in CD57+ lymphocytes (p<0.05). CONCLUSION: We found continuous relative changes in the CD28+ and CD57+ subsets during the first 120 days post- bone marrow transplant, as part of immune system reconstitution and maturation. A clear correlation was observed between the expansion of the CD57+CD28-CD8+ T lymphocyte subpopulation and the occurrence of graft versus host disease and cytomegalovirus viremia

Effect of systemic antibiotic and probiotic therapies as adjuvant treatments of subgingival instrumentation for periodontitis: a randomized controlled clinical study

Objective: This study assessed the efficacy of two adjunct therapies (antibiotic and probiotic) for periodontal treatment based on clinical and immunological parameters in patients with Stage II and III Grade B periodontitis. Methodology: 45 patients were randomly allocated into three groups: control group (CG); antibiotic group (GAtb), in which 500 mg amoxicillin + 400 mg metronidazole were used; and probiotic group (GProb), for which Lactobacillus reuteri was used. Patients received medications after undergoing periodontal debridement. Clinical and immunological parameters were assessed at baseline, 30 days, and 90 days. Results: All therapies reduced bleeding on probing (BoP) in the evaluated periods, and the GAtb had a greater reduction at 90 days (p=0.03). The GProb group showed better results for plaque index (PI) and gingival recession (GR) compared to the GAtb at 90 days (p=0.0014; p=0.006). The area of inflammation (PISA Index) significantly decreased in all therapies in the evaluated periods. Therapies had no significant differences regarding moderate pockets. The GAtb had a greater reduction in probing depth (PD) for deep pockets (p=0.03) at 90 days and in the number of deep pocket sites at 30 days (p=0.04). The occurrence of adverse effects was commonly reported in the GAtb as a percentage per patient. The GAtb had a significant reduction in the concentration of interleukins IL-1β and IL-8 and an increase in IL-10 and TNF-α. The CG had a reduction in IL-6 and IL-1 β, whereas in the GProb there was no difference. Conclusion: After three months, none of the adjuvant therapies provided any additional benefit for subgingival instrumentation

Hantavirus Infection in Anajatuba, Maranhão, Brazil

In 2000, the first outbreak of hantavirus pulmonary syndrome was recognized in the Brazilian Amazon (Maranhão State). An epidemiologic study identified a 13.3% prevalence of hantavirus-specific immunoglobulin G. The analysis of risk factors suggests that persons are occupationally exposed to infected rodents in the crop fields