Antimicrobial effect of human serum on oral Fusobacterium nucleatum isolates from humans and monkeys

Foi avaliada a susceptibilidade de oitenta isolados de F. nucleatum obtidos de pacientes com doença periodontal, indivíduos sadios e Cebus apella (macaco-prego) frente ao soro humano. A resistência à atividade bactericida do soro foi observada em 46,9% das fusobactérias isoladas de pacientes com doença periodontal, 28,6% das obtidas de indivíduos sadios e em 40% das fusobactérias de primatas não humanos. Esses resultados suportam o conceito de que o soro possui um papel ecológico em controlar a população microbiana no interior do sulco gengival ou bolsa periodontal.The susceptibility of eighty F. nucleatum isolates from periodontal patients, healthy subjects and Cebus apella monkeys to human pooled sera was tested. The resistance to serum bactericidal effects was observed in 46.9% of the isolates from periodontal patients, 28.6% of the healthy subjects and 40% of the monkeys. These results support the hypothesis that serum plays an ecological role by controlling the microbial population inside either the gingival crevice or periodontal pocket.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

O tabagismo como fator de risco para as doenças periodontais: aspectos microbiológicos

O fumo é considerado importante fator predisponente para muitas doenças, incluindo-se as periodontopatias. Desde que as doenças periodontais representam a inter-relação entre os fatores de virulência da microbiota subgengival sobre um hospedeiro susceptível, foi objetivo avaliar a freqüência de isolamento de três periodontopatógenos em indivíduos sadios e pacientes com doença periodontal, fumantes ou não, com níveis variados de higiene bucal; verificar a relação entre o número de microrganismos produtores de sulfeto de hidrogênio na placa subgengival de fumantes e não fumantes e sua condição clínica. Foram examinados 189 pacientes e indivíduos sadios, dos quais 60 foram selecionados para análise microbiológica. O índice de placa foi registrado de acordo com o índice de O'Leary e os espécimes de placa subgengival coletados e processados de acordo com SLOTS35 (1982). A identificação dos isolados foi obtida pelas suas características morfocelulares, morfocoloniais e bioquímico-fisiológicas. Verificou-se que a freqüência de isolamento dos bastonetes anaeróbios produtores de pigmento negro, Fusobacterium nucleatum e bactérias produtoras de sulfeto de hidrogênio foi similar entre fumantes e não fumantes, sendo mais elevada nos pacientes com doença periodontal. Já Actinobacillus actinomycetemcomitans foi isolado mais freqüentemente em sadios fumantes do que sadios não fumantes.Smoking is one of the most relevant risk factors for many diseases, including periodontal diseases. These periodontal pathologies result from the action of host defenses and from microbial virulence factors on a susceptible host. Thus, the aim of this study was to evaluate the frequency of periodontopathogens in healthy individuals and in patients with periodontal disease. Both smoking and non-smoking patients were included. The number of bacteria that produce sulfur compounds in subgengival plaque samples of smokers and non smokers with different clinical conditions was also assessed. One hundred and eighty-nine patients were clinically and radiographically examined. The sample included patients with periodontal disease and healthy individuals. Sixty subjects were selected for microbiological evaluation. The isolation of periodontopathogens was carried out according to the methodology described by SLOTS35 (1982). The identification of the isolates was performed through biochemical tests. The isolation of black pigmented Bacteroides, Fusobacterium nucleatum and hydrogen sulfide producing bacteria was similar in smokers and non-smokers and higher among periodontal patients than among healthy subjects. However, the frequency of isolation of Actinobacillus actinomycetemcomitans in smokers with no periodontal pathologies was higher than in healthy individuals who do not use tobacco

Influência da aplicação de flúor sobre a rugosidade superficial do ionômero de vidro Vitremer e adesão microbiana a este material

Os cimentos ionoméricos representam importante opção de material restaurador em Odontologia e sua adesão à estrutura dental, diminuindo a infiltração marginal, somada à liberação de flúor, inibindo o metabolismo de microrganismos acidogênicos e favorecendo a remineralização dental, podem diminuir a ocorrência de cárie secundária. A aplicação tópica de géis acidulados ou neutros contendo flúor tem sido largamente utilizada em Odontologia. No entanto, este procedimento pode afetar a integridade dos materiais restauradores, aumentando sua rugosidade e a retenção de placa bacteriana. Dessa forma, o presente estudo avaliou o período de tempo no qual o cimento ionomérico Vitremer mantém sua capacidade inibitória sobre Streptococcus mutans ATCC 25175 e a adesão dos mesmos sobre a superfície do material, bem como a influência da aplicação tópica de flúor acidulado e neutro sobre esses parâmetros microbiológicos e as características superficiais daquele material. Verificou-se que a atividade antimicrobiana do cimento ionomérico Vitremer se mantém por aproximadamente quatro dias e não é recuperada com o uso de flúor gel acidulado ou neutro. Observou-se, também, que Streptococcus mutans ATCC 25175 adere ao material restaurador testado sendo que a aplicação tópica de flúor não influenciou esta adesão. As características superficiais desses materiais não se alteraram com a aplicação dos géis.Glass ionomer cements are important options in restorative and preventive dentistry due to their adhesion to the tooth surface and to fluoride release, which can decrease the risk of recurrent caries. The topical use of acidulated and neutral fluoride gels has been frequent in dentistry. However, this procedure can adversely affect the surface of restorative materials, increasing their roughness and the retention of dental plaque. Thus, this study evaluated the period in which Vitremer glass ionomer cement maintains its antimicrobial activity over Streptococcus mutans ATCC 25175, as well as the effects of topical application of acidulated and neutral fluoride gels on these microbiological parameters and on the superficial characteristics of the restorative material. It was verified that the antimicrobial activity of Vitremer is very transient, decreasing to an undetectable level after four days, and the topical application of fluoride gel did not restore this activity. It was observed that S. mutans ATCC 25175 adheres to this restorative material, and the topical fluorides did not affect this event. The surface of Vitremer was not altered by the application of fluoride gels

Antimicrobial resistance of aerobes and facultative anaerobes isolated from the oral cavity

Objectives: This study evaluated the resistance to antimicrobials of aerobes and facultative anaerobes isolated from patients wearing complete dentures, patients with gingivitis and periodontitis, and periodontally health subjects. Material and Methods: Three hundred and four isolates were tested. The minimal inhibitory concentrations of the drugs were evaluated through the agar dilution method using Mueller-Hinton agar. Results: The most active antimicrobial drugs were the carbapenems (meropenem and imipenem), and resistance to these drugs was restrict to 1.6-2.3% of the isolates, as well as ciproflaxacin and rifampin. Microbial resistance to ampicillin, amoxicillin/clavulanic acid, cefoxitin, cephalothin, amikacin, chloramphenicol and nalidixic acid was particularly high. In most cases, the resistance to beta-lactams was mediated by the production of hydrolytic enzymes, especially in gram-negative enteric rods, while enterococci did not evidence production of these enzymes. The association amoxicillin/clavulanic acid was not effective in 28.3% of the tested isolates. Conclusions: The results of this investigation confirmed that the oral cavity of patients with periodontitis and gingivitis, and particularly edentulous patients wearing complete dentures, could harbor microorganisms with several antimicrobial resistance markers, and these microorganisms are frequently implicated in multiresistant, systemic, oral or nosocomial infections.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Retention of oral microorganisms on conventional and resin-modified glass-ionomer cements

A cárie secundária representa problema de saúde pública e socioeconômico no mundo. A restauração de dentes acometidos por cárie pode criar condições favoráveis à proliferação microbiana na superfície do material restaurador ou na interface dente/restauração, criando ambiente propício para o estabelecimento de cárie secundária. O objetivo deste estudo foi avaliar a capacidade de retenção de placa bacteriana em cimentos de ionômero de vidro convencionais (Chelon-Fil e Vidrion R) e modificados por resina (Vitremer e Fuji II LC) e de resina composta híbrida (Z100), utilizada como controle. Nos testes de retenção de microrganismos, in situ, 12 voluntários utilizaram, por 7 dias, placa de Hawley contendo corpos-de-prova de todos os materiais. A seguir, os corpos-de-prova foram transferidos para tubos contendo 2,0 ml de Ringer-PRAS e os microrganismos presentes em sua superfície foram cultivados em placa com ágar-sangue e ágar Mitis Salivarius Bacitracina, os quais foram incubados, a 37ºC, em anaerobiose (90% N2, 10% CO2), por 10 e 2 dias, respectivamente. Os ionômeros modificados por resina retiveram quantidade de bactérias similar àquela mostrada pela resina testada. Os ionômeros modificados por resina também apresentaram menor número de estreptococos do grupo mutans do que a resina e os cimentos ionoméricos convencionais. Os ionômeros de vidro convencionais apresentaram menor número de estreptococos do grupo mutans que a resina, sendo que essa diferença não foi estatisticamente significativa.Secondary caries are a worldwide public and socioeconomic problem. The placement of restorations can lead to the development of environmental conditions favorable to microbial colonization, especially on the tooth/restoration interface, which is a predisposing factor for secondary caries. The aim of this study was to evaluate microbial retention on conventional (Chelon-Fil and Vidrion R) and resin-modified (Vitremer and Fuji II LC) glass-ionomer cements, in situ, using a hybrid composite resin (Z100) as a control. Twelve volunteers wore Hawley appliances with specimens made of all tested filling materials for 7 days. The specimens were then removed from the appliances and transferred to tubes containing 2.0 ml of Ringer-PRAS. Microorganisms from the samples were inoculated onto blood agar and Mitis Salivarius Bacitracin agar and incubated under anaerobiosis (90% N2, 10% CO2), at 37°C, for 10 and 2 days, respectively. The resin-modified glass-ionomer cements and the composite resin retained the same levels of microorganisms on their surfaces. The resin-modified glass-ionomers retained less mutans streptococci than the composite resin and conventional glass-ionomer cements. The conventional glass-ionomer cements retained less mutans streptococci than the composite resin, but that difference was not statistically significant

Contaminação microbiana das soluções de processamento radiográfico: Risco de infecção cruzada

Objective: To evaluate the microbial contamination in samples of radiographic developing and fixing solutions, radiographic processing water, dental unit waterlines and dental office's external water supply. Methods: Samples of 50 private dental offices and 20 dental offices of the School of Dentistry de Araçatuba-UNESP were collected. The samples were subjected to neutralization of the residual inhibitory agents followed by pre-enrichment in peptone water and EVA broth and were inoculated in selective and non-selective culture media. The DNA of the samples was extracted and the presence of superinfectant microorganisms was evaluated by PCR. The differences in the prevalence of the microorganisms in the samples of the solutions were analyzed by repeated-measures analysis of variance for category data, while the Chi-Square and Mann-Whitney tests were used to evaluate the existence of associations between the total number of heterotrophic microorganisms and infection control protocols. The significance level was set at 5%. Results: Samples of radiographic fixing solution presented a remarkably less frequent contamination than radiographic developing solution and radiographic processing water. The latter exhibited microorganisms typically originated from the oral microbiota and human skin as well as microorganisms frequently found in dental unit waterlines. There was less contamination of radiographic processing water in the dental offices where the x-ray film packets were disinfected before processing or were covered by a plastic film. Additionally, all samples of dental office's external water supply were drinkable. Conclusion: Covering the x-ray film packets with a plastic film protection barrier was proven the best manner to reduce the contamination of the evaluated solutions

Dental Implants in Patients With Osteoporosis: A Clinical Reality?

Osteoporosis is a systemic disorder characterized by generalized decrease in bone mineral density. Dental implantology is a specialty with high predictability when both quantity and quality of the bone are respected. Therefore, the diagnosis and the implant treatment in patients with osteoporosis are important. In the current study, a literature review about osteoporosis and dental implant therapy was conducted. PubMed, Cochrane, ISI, Dentistry Oral Science, SciELO, and Bireme databases were consulted over the last 20 years. English- and Portuguese-language articles were included in this revision. Some authors stated that the osteoporotic bone is similar to the proposed model of bone type IV. Randomized clinical studies reported implant failure in patients with osteoporosis after menopause. Studies that contraindicate the use of implants in patients with osteoporosis infer that the impaired bone metabolism led to reduction of bone healing around the implants. Nevertheless, other authors believe that the presence of osteoporosis is not a definitive condition to contraindicate the therapy with dental implants. In these cases, the dentist should perform a proper treatment planning, modifying the implant geometry, and use larger implant diameter and with surface treatment. Thus, osteoporosis is not a contraindication for implant surgery because an accurate analysis of bone quality by means tomography is performed

O cuidador de paciente com neoplasia cerebral maligna primária: os desafios do cuidado

Patients with primary malignant brain tumor endure several motor and cognitive dysfunctions, demanding the presence of a caregiver even more because the time necessary for their assistance increases considerably. Usually this task is performed by a family relative, whose activities include taking care of the patient’s personal hygiene, escorting them to medical appointments, managing their money and performing their housework. All of this overwhelms the caregiver both physical and psychologically. This bibliographic research intends to analyze the role in which a caregiver plays in the quality of life of those kinds of patients, the complications of such task, the caregivers’ needs and the daily life of those terminal patients. It was used CAPES, PubMed and Google Academic databases for researching articles related to family caregivers who assisted adult patients with primary malignant brain tumor. The study concluded that being a caregiver of patients in such conditions harms one’s quality of life, with consequences such as stress, insomnia, financial problems and lack of social support. Theirs needs include: having someone to talk to about the matter, attending programs for reducing stress and increasing their knowledge about the disease. In advanced phases of the condition, the patient shows great mobility problems, aphasia and regular seizures, which end up overwhelming the caregiver. The level of quality of life found was above other types of cancer’s caregivers. Therefore, they represent a group with special needs, which should be especially handled by health professionals.Los pacientes con neoplasias cerebrales malignos primarios sufren varias pérdidas de las funciones cognitivas y motoras, es necesaria la presencia de un cuidador que cada vez más tiene que dedicar su tiempo para ser capaz de dar el apoyo necesario. Por lo general, esta función es asumida por un miembro de la familia, con actividades que incluyen la higiene personal del paciente, el acompañamiento a las citas médicas y manejar las finanzas, lo que causa la sobrecarga física y psicológica. Por lo tanto, esta revisión de la literatura tiene como objetivo examinar el impacto que el papel de cuidador de pacientes adultos con tumores cerebrales malignos primarios puede causar a la calidad de vida de la persona que toma las complicaciones de las demandas de atención de los cuidadores y el contacto con el paciente que está en la fase terminal de la enfermedad. Através del estudio se concluyó que el cuidador de esos pacientes tiene consecuencias en la calidad de vida de la persona que se encarga de esta función con el estrés, pérdida de sueño, problemas financieros y la falta de apoyo social. Sus necesidades son: tener alguien con quien hablar sobre ello, participar en programas de reducción de estrés y tener información acerca de la enfermedad. En fases avanzadas de la enfermedad, el paciente tiene dificultad motora severa, afasia y convulsiones frecuentes, en última instancia conduce al agotamiento del cuidador. Se observa que el nivel de calidad de vida es por lo general menor que la encontrada en los cuidadores de otros tipos de cáncer, por lo que es un grupo que necesita más atención, especialmente de los profesionales de la salud.Pacientes com neoplasias cerebrais malignas primárias sofrem várias perdas de funções cognitivas e motoras, sendo necessária a presença de um cuidador que cada vez mais tenha de dedicar seu tempo para conseguir dar o suporte necessário. Geralmente, esta função é assumida por membro da família, com atividades que incluem higiene pessoal do paciente, acompanhá-lo nas consultas médicas e lidar com finanças, o que acaba sobrecarregando-o física e psicologicamente. Assim sendo, esta revisão de literatura pretende analisar os impactos que o papel de cuidador de paciente adulto com neoplasia cerebral maligna primária pode causar na qualidade de vida daquele que o assume, as complicações do cuidado, demandas dos cuidadores e convívio com paciente que está na fase terminal da doença. Foram pesquisados em bases de dados artigos que tratassem de cuidadores familiares de pacientes adultos com neoplasia cerebral maligna primária. O estudo permitiu concluir que ser cuidador deste tipo de paciente tem consequências na qualidade de vida daquele que se encarrega desta função, com estresse, perdas de sono e problemas financeiros. Suas necessidades incluem: ter alguém para conversar sobre o assunto, participar de programas de redução do estresse e ter informações sobre a doença. Em fases avançadas da doença, o paciente tem sério comprometimento motor, afasia e convulsões frequentes, o que acaba levando o cuidador ao esgotamento. Observa-se que o nível de qualidade de vida costuma ser abaixo do encontrado em cuidadores de outros tipos de cânceres, portanto é um grupo que precisa de maior atenção, principalmente dos profissionais de saúde