Saliva and tongue coating pH before and after use of mouthwashes and relationship with parameters of halitosis

OBJECTIVES: The aim of this work was to evaluate saliva and tongue coating pH in oral healthy patients with morning bad breath before and after use of different oral mouthrinses. MATERIAL AND METHODS: Saliva and tongue coating pH of 50 patients allocated in 5 groups were measured respectively by a digital pHmeter and color pH indicators, before, immediately after and 30 min after rinsing 5 different mouthrinses: cetilpiridine chloride associated with sodium chloride, triclosan, enzymatic solution, essential oil and distilled water. RESULTS: Only triclosan and essential oil increased salivary pH immediately after rising. The enzymatic solution decreased salivary and tongue coating pH immediately after rinsing. CONCLUSIONS: Salivary pH tended to be acidic while tongue coating pH tended to be alkaline, even after rising. Triclosan and essential oil mouthrinses increased salivary pH immediately after rinsing. Enzymatic solution decreased saliva and tongue coating pH immediately after rising.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES

Phenotype and cell proliferation activity of duct-like structures in human sublingual glands: a histological and immunohistochemical study

There are several age-related microscopic changes in the salivary glands, including the increase in the number of duct-like structures (DLS). However, the true origin and the phenotype of the DLS are not known. Objective To evaluate the phenotype and the cell proliferation index of the DLS of human sublingual glands. Material and Methods Sixty sublingual glands obtained from human cadavers were divided into two groups - 0-30 and 61-90 years old. The phenotype was estimated by immunostaining for cytokeratin 19 (CK 19) and the S-100 protein as well as by the presence of mucin and glycogen. The cell proliferation index was determined by the Ki-67 antibody. The histochemical techniques used periodic acid-Schiff (PAS) and Alcian Blue. In each captured microscopic field, the DLS were counted to establish a percentage for the staining profile. The statistical analysis was accomplished using Student's t-test, the Mann-Whitney test and Pearson's correlation coefficient (

Acinar autolysis and mucous extravasation in human sublingual glands: a microscopic postmortem study

Although some morphological investigations on aged human sublingual glands (HSG) found eventual phenomena identified as autolysis and mucous extravasation, the exact meaning of these findings has not been elucidated.Objective The aim of this work is to investigate whether acinar autolysis and mucous extravasation are related to the aging process in human sublingual glands. We also speculate if autolytic changes may assist forensic pathologists in determining time of death.Material and Methods 186 cadavers’ glands were allocated to age groups: I (0–30 years); II (31–60), and III (61–90). Time and mode of death were also recorded. Acinar autolysis and mucous extravasation were classified as present or absent. Ultrastructural analysis was performed using transmission electron microscopy (TEM). Data were compared using Mann-Whitney U, Spearman’s correlation coefficient, Kruskal-Wallis, and Dunn tests (

CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus : importance to sagittal split osteotomy

Mandibular Sagittal Split Osteotomy (MSSO) is a popular technique in orthognathic surgery used both to advance and to retreat the mandible. However, MSSO may incur in important complications, such as bad splits and sensorineural injuries. Knowing the location of the fusion between the buccal and lingual cortical (FBLC) in the mandibular ramus and the bone thickness in the region where osteotomies will be performed is determinant in MSSO planning to avoid complications. The aim of this study was to document and evaluate possible differences between sexes regarding the location of the FBLC in relation to the superior cortical of mandibular foramen (MF) and bone thickness in the region of interest for MSSO in a Brazilian population. Eighty five cone-beam Computed Tomography (CBCT) scans were used to perform linear measurements to determine the location of the FBLC. Bone thickness from the mandibular canal (MC) to the cortical external surfaces and the diameter of the MC were measured at three different points: mandibular ramus (A), mandibular angle (B) and mesial of the second molar (C). The FBLC was located at a mean distance of 8.3 mm from the superior cortical of the MF in males and 8.1 mm in females. There was no difference between males and females regarding the mean bone thickness from the MC to the buccal external surface at all the points investigated (p >>0.05). Bone thickness from the lingual external surface to the MC was bigger among females than males in regions B and C (p<0.05). The diameter of the MC was bigger among males in regions B and C. Sexual dimorphism regarding mandibular bone thickness but not regarding the location of FBLC was present. This fundamental knowledge may assist to the panning of MSSO

Projeto Pequenos gestos, grandes sorrisos

O projeto de extensão “Pequenos Gestos, Grandes Sorrisos” desenvolve suas atividades na região da cidade de Maringá, localizada no estado do Paraná - Brasil; e atualmente integra um grupo de onze acadêmicos do curso de Odontologia, três docentes e uma assistente social da Universidade Estadual de Maringá. O foco principal do projeto é promover saúde bucal em crianças, adolescente e suas famílias, por meio de técnicas de educação em saúde com a utilização de diferentes recursos lúdicos e pedagógicos junto às comunidades e instituições contempladas com esse serviço. O presente trabalho objetivou mostrar as atividades extensionistas desenvolvidas pelo projeto  nas cidades de Maringá, Paiçandu e Sarandi. Em Sarandi, também foram realizados levantamentos epidemiológicos em crianças e adolescentes e tratamentos curativos, com a técnica de tratamento restaurador atraumático (ART). Os resultados, como a melhoria na autonomia de higiene bucal e maior conhecimento sobre saúde, mostraram a importância no aumento da qualidade de vida nas comunidades, por meio da promoção de saúde bucal e a colaboração para a formação científica, social, cultural e humana dos acadêmicos de odontologia que o integram

Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment

Evaluation of the phenotype and the proliferation capacity of duct-like structures in the aging process of human sublingual glands

São várias as alterações microscópicas decorrentes do processo de envelhecimento das glândulas salivares, dentre elas o aumento no número de estruturas ductiformes. O objetivo deste trabalho é estudar o fenótipo e o índice de proliferação celular das mesmas. Sessenta glândulas sublinguais de cadáveres humanos foram divididas em dois grupos segundo a aixa etária dos indivíduos (0-30 anos e 61-90 anos). O fenótipo foi estimado pela imunomarcação da citoqueratina 19 (CK 19), da proteína S-100 e pela evidenciação dos polissacarídeos mucina e glicogênio. A avaliação do índice de proliferação de células epiteliais das estruturas ductiformes se deu por meio da imunomarcação do Ki-67. As técnicas histoquímicas consistiram no ácido periódico de Schiff (PAS) e Azul de Alcian pH 2,5. Em cada campo microscópico capturado foram contadas as estruturas ductiformes para estabelecer o perfil de marcação em percentual. A análise estatística foi realizada por meio dos testes t de Student, Mann-Whitney e correlação de Pearson (p < 0,05). Comparando os dois grupos, apenas a imunomarcação para CK 19 mostrou diferença estatisticamente significante (p = 0,033), sendo sua expressão mais forte no grupo de idosos. Não houve diferença significante entre os marcadores PAS e Azul de Alcian (p = 0,270). Nos dois grupos a imunomarcação para CK 19 foi mais forte do que para S-100 (p = 0,004; p < 0,001), sendo a correlação entre os dois imunomarcadores ausente (&#x3C1; = -0,163; p = 0,315). Não houve imunomarcação para o Ki-67 em nenhuma estrutura ductiforme. Concluiu-se que as estruturas ductiformes demonstram um perfil fenotípico ductal e não apresentam atividade proliferativa celular. Elas podem representar um processo regressivo com origem nos ácinos ou resultarem de metaplasia.There are several age-related microscopic changes in the salivary glands, including the increase in the number of duct-like structures. The aim of this study is to evaluate the phenotype and the cell proliferation index of these structures. Sixty sublingual glands obtained from human cadavers were divided into two groups according to the individuals age (0-30 and 61-90 years old). The phenotype was estimated by the immunostaining for cytokeratin 19 (CK 19), S-100 protein and by the disclosure of the polysaccharides mucin and glycogen. The cell proliferation index was determined by Ki-67 immunostaining. The histochemical techniques consisted of periodic acid-Schiff (PAS) and Alcian Blue pH 2.5. Ineach captured microscopic field, the duct-like structures were counted to establish the staining profile in percentage. Statistical analysis was done by Students t-test, Mann-Whitney test and Pearsons correlation coefficient (p < 0.05). Comparing the two groups, only the immunostaining for CK 19 showed significant statistical difference (p = 0.033), with strongest expression in the elderly group. There was no significant difference between the markers PAS and Alcian Blue (p = 0.270). In both groups the immunostaining for CK 19 was stronger than for S-100 (p = 0.004; p < 0.001), but there was no correlation between the two immunomarkers (&#x3C1; = -0.163; p = 0.315). There was no immunostaining for Ki-67 in any ductlike structure. We concluded that the duct-like structures demonstrate a ductal phenotypic profile and do not present cell proliferation activity. They may represent a regressive process arising from acini or a result of a metaplasia

Evaluation of saliva and tongue coat pH before and after use of mouthwashes and relationship with parameters of halitosis

A relação entre halitose, pH da saliva e da saburra lingual frente ao uso de enxaguantes orais ainda não é totalmente conhecido. O objetivo deste estudo foi avaliar o pH da saliva e da saburra lingual em pacientes com saúde oral íntegra e halitose fisiológica através de um pHmetro analógico e um digital e de fitas indicadoras de pH, antes e imediatamente após utilização de diferentes enxaguantes orais e 30 minutos após o bochecho; avaliar o pH dos diferentes anti-sépticos; avaliar se há diferença nas medições do pH entre os pHmetros analógico e digital; avaliar as opiniões dos pacientes em relação ao enxaguante utilizado e relacionar as possíveis alterações do pH a parâmetros de halitose. Foram avaliados 50 pacientes divididos em 5 grupos, com bochechos de 5 diferentes soluções clorito de cetilpiridínio associado ao cloreto de sódio (Saúde Bucal®), Triclosan (Colgate Total Plax®), solução enzimática (Biotène Mouthwash®), óleo essencial (Listerine®) e água destilada (placebo). Os pacientes foram submetidos a duas consultas, sendo que a segunda ocorreu no período da manhã, em jejum. Na primeira, foi realizado exame clínico; na segunda a coleta da saliva, análise do pH e aplicação do questionário. Os resultados foram analisados utilizando-se o teste de análise de variância a dois critérios, teste t pareado e teste de Tukey (p<0,05), onde se observou que os enxaguantes Colgate Total Plax® e Listerine® aumentaram o pH da saliva imediatamente após o bochecho e o Biotène Mouthwash® diminuiu o pH da saliva e da saburra lingual. Pôde-se observar também que as quatro marcas comerciais de soluções para bochecho testadas apresentaram pH ácido e que o pHmetro analógico forneceu uma média de valores maiores que o pHmetro digital. Os enxaguantes de maior aceitação pela população estudada foram o Saúde Bucal® e o Biotène Mouthwash®.The relationship between halitosis, saliva and tongue coat pH front by use of mouthwashes is not yet totally known. The aim of this work was to evaluate saliva and tongue coat pH in oral healthy patients with morning breath through an analog and a digital pHmeter and color pH indicators, before and immediately after use of different mouthwashes and 30 minutes after rinsing; verify different mouthwashes pH; evaluate if there is difference in pH measurements between analog and digital pHmeters; evaluate the patients opinions about the mouthwashes and relate the possible pH alterations to parameters of halitosis. 50 patients were allocated in 5 groups, with 5 different solutions rinses - Cetilpiridine chloride associated with sodium chloride (Saúde Bucal®), Triclosan (Colgate Total Plax®), enzymatic solution (Biotène Mouthwash®), essential oil (Listerine®) and distilled water (control). The patients had been submitted to two exams; the second one occurred in the morning period, without food and drink. In the first exam, the patients were submitted to clinical examination; in the second one, saliva collection, pH analysis and questionnaire application were performed. The data was analyzed by means of the ANOVA two criteria test, paired t-test and Tukey test (p<0,05), which showed that Colgate Total Plax® and Listerine® had increased saliva pH immediately after rinsing and Biotène Mouthwash® reduced saliva and tongue coat pH. We also observed that the four commercial marks of mouthwashes tested had presented acid pH and that analog pHmeter has offered bigger average values that digital pHmeter. The mouthwashes with best acceptance for the studied population had been Saúde Bucal® and Biotène Mouthwash®