Effects of triclosan on host response and microbial biomarkers during experimental gingivitis

AimThis exploratory randomized, controlled clinical trial sought to evaluate anti‐inflammatory and ‐microbial effects of triclosan during experimental gingivitis as assessed by host response biomarkers and biofilm microbial pathogens.Materials and MethodsThirty participants were randomized to triclosan or control dentifrice groups who ceased homecare for 21 days in an experimental gingivitis (EG) protocol. Plaque and gingival indices and saliva, plaque, and gingival crevicular fluid (GCF) were assessed/collected at days 0, 14, 21 and 35. Levels and proportions of 40 bacterial species from plaque samples were determined using checkerboard DNA‐DNA hybridization. Ten biomarkers associated with inflammation, matrix degradation, and host protection were measured from GCF and saliva and analysed using a multiplex array. Participants were stratified as “high” or “low” responders based on gingival index and GCF biomarkers and bacterial biofilm were combined to generate receiver operating characteristic curves and predict gingivitis susceptibility.ResultsNo differences in mean PI and GI values were observed between groups and non‐significant trends of reduction of host response biomarkers with triclosan treatment. Triclosan significantly reduced levels of A. actinomycetemcomitans and P. gingivalis during induction of gingivitis.ConclusionsTriclosan reduced microbial levels during gingivitis development (ClinicalTrials.gov NCT01799226).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/134115/1/jcpe12519.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/134115/2/jcpe12519_am.pd

A new treatment alternative for sensitive teeth: A desensitizing oral rinse

AbstractObjectiveTooth sensitivity is a common, painful dental condition. Consumer dental products, mostly dentifrices, play an important role in sensitivity treatment. The objective of this review is to describe a new mouthwash-based desensitizing technology.DataBackground literature concerning desensitizing products is reviewed. Potassium salts are the most commonly used active ingredients in desensitizing dentifrices. Clinical studies show that while potassium salt dentifrices are generally effective; most formulations require several weeks to exert their desensitizing effect. Recently, a new desensitizing dentifrice containing the amino acid arginine was introduced. This dentifrice acts to occlude the dentinal tubules, and has been shown to be highly effective in multiple clinical studies. This arginine-containing dentifrice has also been shown to provide instant relief of sensitivity pain when applied directly to the sensitive tooth surface.In contrast to dentifrices, there are few desensitizing mouthwashes available. Building on the success of the arginine-based dentifrice, an arginine-based mouthwash formula was developed and tested.SourcesPublished studies in peer-reviewed publications.Study selectionControlled and blinded clinical studies to provide evidence of efficacy. In vitro studies are included to indicate the mechanism of action. This review includes studies testing the new arginine-based desensitizing mouthwash.ConclusionClinical findings indicate that this new desensitizing mouthwash, based on the Pro-Argin™ mouthwash technology effectively reduces sensitivity symptoms and can be used alone or as a adjunct to the use of the arginine-containing dentifrice in the home treatment of tooth sensitivity

Hereditariedade na periodontite agressiva generalizada : aspectos microbiológicos, imunológicos e preventivos

Orientador: Renato Corrêa Viana CasarinTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: Periodontite agressiva generalizada (PAG) é uma doença multifatorial causado por um desequilíbrio entre a resposta do hospedeiro e as agressões do biofilme. Ela é caracterizada pela agregação familiar dos casos, provavelmente associada ao compartilhamento de fatores de susceptibilidade entre membros de uma mesma família, o que poderia aumentar o risco de descendentes de indivíduos PAG também desenvolverem a doença. Neste contexto, o presente trabalho descreve dois estudos diferentes, um com o objetivo de caracterizar o microbioma, assim como a sua associação com a resposta do hospedeiro, em indivíduos PAG e seus filhos e o segundo estudo objetivando avaliar a pasta de dente contendo Triclosan como uma terapia adjunta no controle das alterações precoces demonstradas em descendentes PAG. No primeiro estudo 15 pais PAG com pelo menos um filho com idade entre 6 e 12 anos e 15 pais periodontalmente saudáveis com pelo menos uma criança entre 6 e 12 anos foram selecionadas. O exame clínico e a coleta de biofilme subgengival e fluido gengival (GCF) foram realizados para todos os participantes. O DNA bacteriano do biofilme subgengival foi extraído, a região 16S do rRNA foi sequenciado utilizando a plataforma Illumina MiSeq e ferramentas de bioinformática foram utilizadas para analisar os dados. O fluido crevicular gengival foi analisado com a tecnologia Luminex MAGPIX para a identificação das citocinas interferon (IFN) -?, fator de necrose tumoral (TNF-?) e interleucinas (IL) -10, IL-17, IL-1?, IL-4, IL-6, IL-8. Crianças de pais PAG apresentaram piores condições clínicas, bem como um microbioma mais patogênico do que crianças de pais saudáveis. Uma forte correlação foi observada entre o microbioma do pai e o microbioma de seu filho. Diferenças nos níveis de citocinas foram observadas apenas em pais PAG que apresentaram níveis menores de IFN-?, IL-10 e IL-17. Apesar de não haver diferenças nos níveis de citocinas, as crianças dos pais PAG apresentaram alteração nas interações entre bactérias e o hospedeiro e demonstraram um padrão similar ao apresentado por seus pais. No segundo estudo, 18 crianças (entre 6 e 12 anos) filhas de indivíduos PAG e 18 criança filhas de ambos os pais periodontalmente saudáveis foram incluídas em um programa de controle de placa por 3 meses. Todos os indivíduos foram periodontalmente avaliados e submetidos a coleta de biofilme subgengival e GCF no início do estudo e após 3 meses de controle de placa. Sequenciamento de nova geração e ferramentas de bioinformática foram utilizadas para a avaliação do biofilme subgengival enquanto a plataforma Luminex/MAGPIX foi usada para aas análises inflamatórias no GCF. Análise de discriminantes lineares do índice Morisita-Horn demonstrou dois aglomerados maciços separando filhos de pais PAG de filhos de pais saudáveis (teste Adonis, p=0.014), demonstrando um impacto significativo da doença periodontal parental no microbioma de dos seus descendentes. Um microbioma mais patogênico associado com maior interrelação bactéria-hospedeiro e piores condições clínicas foram identificadas em crianças PAG. O microbioma disbiótico de descendentes PAG mostrou uma forte resiliência a mudança depois do controle de placa, mantendo a diversidade e a riqueza de espécies associadas a doença periodontal mesmo depois que benefícios clínicos forma atingidos. Além disso, o controle de placa não foi suficiente para alterar o padrão de interações entre o microbioma e o hospedeiro. No terceiro estudo, 15 crianças de pais PAG e 15 crianças de pais periodontalmente saudáveis foram incluídas neste estudo placebo cruzado. As crianças foram alocadas aleatoriamente nos grupos Triclosan ou Placebo para participar da primeira fase do estudo. Inicialmente, todas as crianças participaram de um período de wash-out de 15 dias usando apenas o creme dental placebo para posteriormente começaram a usar o creme dental selecionado por 45 dias. Após a primeira fase, eles repetiram o período de 15 dias de wash-out usando apenas o creme dental placebo. Os grupos foram cruzados e as crianças usaram a outra pasta por mais 45 dias. Em cada fase, foram realizados exame clínico e coleta de saliva, GCF e biofilme subgengival no exame inicial e aos 45 dias de estudo. Os níveis de IFN-?, IL-17, IL-4, IL-1?, IL-10 e TNF-? foram analisados pela plataforma Luminex / MAGpix e os níveis de patógenos periodontais salivares e subgengivais por qPCR. No início do estudo, as crianças dos pais PAG apresentaram maiores índice de placa (IP), índice gengival (IG) e sangramento à sondagem (SS), além de maiores concentrações de Aggregatibacter actinomycetemcomitans (Aa) na saliva e no biofilme subgengival e menores níveis de INF-?, IL-4, IL-17 no GCF. A terapia com placebo apenas reduziu o IP, em ambos os grupos. O creme dental com Triclosan reduziu o IP, assim como o IG, em ambos os grupos. Além disso, o Triclosan promoveu redução adicional do SS, da profundidade de sondagem (PS), dos níveis salivares Aa e IL-1? no grupo PAG. No grupo de saúde, Triclosan promoveu uma redução de INF-? e IL-4. Em conclusão, o microbioma e as interações hospedeiro-biofilme foram alterados nos indivíduos PAG e seus descendentes e uma forte correlação entre o estado periodontal dos pais e de seus filhos foi demonstrada. A disbiose foi relaciona com correlações mais intensas entre as bactérias e o hospedeiro e maior inflamação clínica. O controle de placa não foi suficiente para mudar o ambiente subgengival mais patogênico em descendentes PAG, que demonstrou uma alta resiliência para as mudanças microbiológicas e destacou o maior risco para o desenvolvimento de doença periodontal. Além disso, o creme dental com Triclosan demonstrou-se mais eficiente do que o creme dental placebo em controlar o perfil mais patogênico observado em PAG, uma vez que reduziu os níveis de sangramento a sondagem, sondagem periodontal, Aa salivar e IL-1?, em crianças de pais PAGAbstract: Generalized aggressive periodontitis (GAgP) is a multifactorial disease caused by an unbalance between the host response e the biofilm aggression. It is characterized by the familial aggregation of cases, probably associated with the sharing of susceptibility aspects between family member, what could increase the risk to GAgP descendants to develop GAgP. In this context, the present report describes three different studies: the first aiming to characterize the microbiome, as well its association to the host response, in GAgP subjects and their children; the second study aiming to evaluate the effective of plaque control in altering the pathogenic subgingival condition identified in GAgP descendants; the third aiming to evaluate the efficiency of Triclosan-containing toothpaste as an adjunctive therapy to control the precocious alteration demonstrated in GAgP descendants. In the first study, 15 GAgP parents with at least a child between 6-12 years old and 15 health parents with at least one child between 6-12 years old were selected. The clinical examination and the collection of subgingival biofilm and gingival crevicular fluid (GCF) were performed for all subjects. The bacterial DNA of the subgingival biofilm was extracted, the 16S rRNA was sequenced using the Illumina MiSeq platform and bioinformatic tools were used to analyze the data. The gingival crevicular fluid was analyzed with the Luminex MAGPIX technology for the identification of interferon (IFN)-?, and tumor necrosis factor (TNF)-?, interleukin (IL)-10, IL-4, IL-1?, IL-17, IL-6, IL-8 levels. Children from GAgP parents presented the worst clinical condition as well as a more pathogenic and dysbiotic microbiome than children from healthy parents. A strong correlation was observed between the parent microbiome and his child microbiome. Differences in the cytokines¿ levels were only observed in parents with GAgP parent presenting lower levels of IFN-?, IL-10, and IL-17. Despite no differences in the cytokine levels, children from GAgP parents presented alteration in the host-bacterial interactions and demonstrated a similar pattern to their parents. In the second study, 18 children (6-12 years old) from GAgP parents and 18 children from periodontally healthy parents were included in a plaque control program for 3 months. All subjects were periodontally examined and subgingival biofilm and gingival crevicular fluid (GCF) were collected at baseline and after 3 months of strict plaque control. Next-generation sequencing and bioinformatic tools were used to evaluate the subgingival microbiome and the Luminex/MAGPIX platform was used for the inflammatory analysis in GCF. The Linear Discriminant Analysis of Morisita-Horn index demonstrated two massive clusters separating children from AgP parents from children from healthy parents (Adonis test, p=0.014), demonstrating a significant impact of parental periodontitis on the microbiome of their descendants. A more pathogenic microbiome associated with more intense host-bacterial interactions and worst clinical condition was identified in children from GAgP parents. The dysbiotic microbiome of GAgP descendants showed a strong resilience against shifting after plaque control, maintaining the diversity and the richness of disease-associated species even after the clinical benefits achieved. In addition, plaque control was not sufficient to alter the pattern of host-bacterial interaction in the subgingival environment. In the third study, 15 children from GAgP parents and 15 children from periodontally healthy parents were included in this cross-over placebo study. Children were randomly allocated into Triclosan or Placebo groups to participate in the first phase of the study. Initially, all children participate in a wash-out period of 15 days using only the placebo toothpaste and posteriorly they started to use the elected toothpaste for 45 days. After the first phase, they repeated the period of 15 days of wash-out using only the placebo toothpaste. The groups were crossed, and the children used the other paste for more 45 days. In each phase, clinical examination and saliva, GCF and subgingival biofilm collection were performed at baseline and 45 days. The levels of IFN-?, IL-4, IL-10, IL-1?, IL-17, and TNF-? were analyzed by Luminex/MAGpix platform and subgingival and salivary periodontal pathogens¿ levels by qPCR. At baseline, children from AgP parents presented higher levels of the gingival index (GI), plaque index (PI), and bleeding on probing (BoP), a higher concentration of Aggregatibacter actinomycetemcomitans (Aa) in saliva and subgingival biofilm, and lower levels of INF-?, IL-4, IL-17 in the GCF. Placebo therapy only reduced PI, in both groups. Triclosan toothpaste reduced PI, as well as GI, in both groups. Moreover, Triclosan promoted the reduction of BoP and PPD, Aa salivary levels and IL-1? in GAgP group. In Health group, Triclosan promoted a reduction of INF-? and IL-4. In conclusion, the microbiome and the host-bacterial interaction were altered in GAgP parent and their descendants and a strong impact of the parents¿ periodontal condition in their children periodontal status was demonstrated. The dysbiosis was associated with more intense species cytokines correlations and higher clinical inflammation. The plaque control was not able to change the more pathogenic subgingival environment of GAgP descendants, that demonstrated a strong resilience to subgingival microbial shifting after strict plaque control, highlighting the higher risk for disease development. Furthermore, Triclosan dentifrice demonstrated to be more efficient than placebo toothpaste to control the more pathogenic profile demonstrate in GAgP, by reducing the bleeding on probing, probing depth, salivary Aa and IL-1?, in children from GAgP parentsDoutoradoPeriodontiaDoutora em Clínica Odontológica2015/50264-0; 2016/03704-7; 2016/19970-8FAPES

Efficacy in reducing dentine hypersensitivity of a regimen using a toothpaste containing 8% arginine and calcium carbonate, a mouthwash containing 0.8% arginine, pyrophosphate and PVM/MA copolymer and a toothbrush compared to potassium and negative control regimens: An eight-week randomized clinical trial

Objective Evaluate the efficacy of three regimens integrating toothpaste, toothbrush and mouthwash in reducing dentine hypersensitivity. Methods Eight-week single-centre, three-cell, double-blind, randomized study was conducted in the Dominican Republic. Subjects entered one of the three regimens: (1) toothpaste containing 8% arginine and 1450 ppm mono-fluorophosphate, in a calcium carbonate base, a soft-bristle toothbrush followed by a mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride; (2) toothpaste containing 5% potassium nitrate and 1450 ppm sodium fluoride, a soft-bristle toothbrush, followed by a mouthwash containing 0.51% potassium chloride and 230 ppm sodium fluoride; and (3) toothpaste containing 1450 ppm mono-fluorophosphate, a soft-bristle toothbrush followed by a fluoride/arginine free mouthwash. Tactile and Air-Blast dentine hypersensitivity measurements were performed at baseline, two, four, and eight weeks. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise (α = 0.05) were used. Kaplan–Meier survival analysis was performed to evaluate Time to Treatment Improvement. Results 120 subjects were enrolled, 118 completed the study. The Tactile hypersensitivity mean scores showed statistically significant improvement at two, four and eight (p ≤ 0.001) weeks in the arginine regime; the potassium regime did not show significant (p ≥ 0.05) improvement. Air-Blast Hypersensitivity scores had a statistically significant decrease at two (p = 0.006), four (p = 0.006) and eight (p = 0.002) weeks in arginine and potassium regimes (p ≤ 0.05). The most effective treatment proved to be arginine (p ≤ 0.05) compared to the potassium regime. Conclusion Arginine regimen provided the greatest reduction in Tactile and Air-Blast dentine hypersensitivity compared to potassium and negative control regimens; and provides faster dentine hypersensitivity relief than potassium regimen.Colgate-Palmolive Company///Estados UnidosUCR::Vicerrectoría de Docencia::Salud::Facultad de Odontologí

Influencia de polimorfismos geneticos sobre a perda precoce de implantes dentais endoosseos

Orientador: Sergio Roberto Peres LineDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaMestrad

Multiplex measurement of proinflammatory cytokines around miniscrews during orthodontic treatment

Objective: To determine the levels of proinflammatory cytokines around miniscrews with and without loading, used during orthodontic treatment. Material and Methods: A descriptive longitudinal study was executed with a sample of ten miniscrews inserted in patients that attended a dental clinic. Saliva and peri-implant crevicular fluid samples were taken: at baseline (T0), 24 hours after insertion (T1), 1 week after insertion (T2), 24 hours after loading (T3). The samples obtained were processed by immunoassay and read with a flow cytometer. Results: Data analysis was performed using the SPSS program version 21.0. To verify normal distribution, Kolmogorov-Smirnov test was used, followed by ANOVA to compare and determine statistical significance. Levels of inflammatory mediators in the peri-implant crevicular fluid at T1 had the following order of average values: IL-8>IL-1β >IL-6>TNF-α>IL-10>IL-12p70. Higher values were found 24 hours post-insertion. Salivary levels found were lower but the previously mentioned order was maintained. Statistically significant intergroup differences were found for IL-1β and IL-8 in the peri-implant crevicular fluid. The Scheffe post hoc test showed that there were no statistically significant differences when making an intragroup pair comparison of each mediator level in a given evaluation time. No statistically significant differences were found in saliva inter and intra-group for all the evaluated inflammatory mediators. Conclusions: The miniscrew loading did not generate an increase of the concentrations of the cytokines greater than the effect caused by the insertion per se. The highest levels of inflammatory mediators were found 24 hours post-insertion of the miniscrew.Objetivo: Determinar los niveles de citocinas inflamatorias alrededor de mini-implantes con y sin carga, durante el tratamiento ortodóntico. Material y métodos: Se realizó un estudio descriptivo longitudinal con una muestra de diez mini-implantes. La toma de muestras de saliva y líquido crevicular peri-implantario fue realizada en cuatro tiempos: basal (T0), 24 horas post-inserción (T1), 1 semana post-inserción (T2), 24 horas post-carga (T3). Fueron procesadas mediante una técnica de inmunoensayo y citometría de flujo. Resultados: El análisis de los datos se realizó con el programa SPSS versión 21.0. Para verificar la distribución normal se utilizó la prueba de Kolmogorov-Smirnov, seguida de la prueba ANOVA para comparar y determinar la significancia estadística. Los niveles de mediadores inflamatorios en el líquido crevicular peri-implantario en T1 tuvieron el siguiente orden de valores promedio: IL-8> IL-1β> IL-6> TNF-α> IL-10> IL-12p70. Los valores más altos se encontraron 24 horas post-inserción. Los niveles en saliva fueron menores pero se mantuvo el orden mencionado. Se hallaron diferencias estadísticamente significativas entre grupos para IL-1β e IL-8 en el líquido crevicular peri-implantario. Posteriormente, la prueba post hoc de Scheffe demostró la ausencia de diferencias estadísticamente significativas en la comparación de pares intragrupo de cada mediador. No se encontraron diferencias estadísticamente significativas inter e intragrupo para todos los mediadores inflamatorios evaluados en saliva. Conclusiones: La carga del mini-implante no generó un aumento en la concentración de citocinas mayor que el provocado por la inserción per se. Los niveles más altos se encontraron 24 horas después de la inserción

Desquamative Gingivitis: Early Sign of Mucous Membrane Pemphigoid and Pemphigus Vulgaris

Early signs and symptoms of autoimmune bullous diseases such as mucous membrane pemphigoid (MMP) or pemphigus vulgaris (PV) develop in the oral cavity in almost all cases. Desquamative gingivitis (DG) is a clinical manifestation common to several diseases or disorders and is frequently associated with autoimmune bullous diseases. This is a retrospective study of 37 patients with MMP (24 cases) or PV (13 cases) including 10 males and 27 females with a mean age of 58.4 years. The study indicates that DG is an early sign of autoimmune bullous diseases such as MMP or PV. About 70.3% of the oral lesions were confined only to the gingiva, and DG was the only manifestation of the diseases. Since some lesions remain limited to the oral cavity for a long period of time, patients diagnosed with MMP or PV should be closely followed because they must be immediately referred to other experts when they develop lesions on parts of their body other than the oral cavity. The oral healthcare provider should collaborate with other healthcare experts including dermatologists, ophthalmologists, and otolaryngologists to evaluate and manage patients with autoimmune bullous diseases in the oral cavity