A new technique for tongue brushing and halitosis reduction: the X technique

The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor. Objective: To evaluate a new tongue hygiene technique hereby referred to as “the X technique” and its effects on both halitosis and the number of microorganisms based on microbiological parameters and diagnostic features of the breath. Material and Methods: The study included thirty patients divided into a control group (patients without systematized guidelines of lingual hygiene, but who performed the mechanical cleaning of tongue dorsum, each in its own way), the 3R group (instructed to perform the movements of the X technique for 3 repetitions at each brushing), and the 6R group (instructed to perform 6 repetitions of the technique at each brushing). After two weeks, a new data collection was performed. Results: Patients in the 6R group presented the lowest score on the organoleptic assessment scale at the second consultation, followed by the 3R group and the controls. Regarding the self-perception of breath by the method of Visual Analog Scale (VAS), the control group did not perceive improvements in oral malodor; the results of the 3R group and the 6R group were similar. Conclusion: These results indicate that the X technique improves both measurements and perceptions of halitosis. Microbiological analyses revealed greatest reduction in the 6R group. The findings show that the X technique reduces both organoleptic scores and the number of bacterial colonies, and improves users’ perceptions of their breath

O efeito do tratamento da gengivite sobre o hálito de pacientes portadores de periodontite crônica

A presente dissertação objetivou correlacionar diferentes recursos de diagnóstico do hálito e analisar os efeitos do controle de placa supragengival sobre as medições do hálito. Para tanto, medições organolépticas (ORL), de compostos sulfurados voláteis (CSV) e de auto-percepção (EVA) foram realizadas em 27 pacientes (14 mulheres e 13 homens) portadores de periodontite crônica. O tratamento da gengivite foi realizado através de controle de placa supragengival. Análises do hálito foram realizadas ao exame inicial, 30, 90 e 180 dias após início do programa. Correlações significativas foram observadas entre ORL-CSV, ORL-EVA e EVA-CSV, sendo a última fraca. Em relação aos períodos experimentais, houve uma clara diminuição em todas as medições do hálito ao longo do tempo. Em análise post-hoc, subdividiu-se a amostra em dois grupos (relacionados ao hábito de limpar ou não a língua). Não foram observadas diferenças entre esses grupos. Pôde-se concluir que embora existam correlações significativas entre os recursos de diagnóstico do hálito, a medição organoléptica (padrão-ouro) deve ser sempre realizada. Além disso, um programa de controle de placa supragengival é eficaz em reduzir medidas relacionadas ao hálito, independentemente da limpeza da língua

Mechanisms involved in immune and inflammatory response to implantation of bovine bone cortical membrane in subcutaneous tissue of mice: characterization histomorphometric, imunoenzimatic and molecular

Os avanços relacionados à ciência dos biomateriais e engenharia tecidual buscam esclarecer os mecanismos envolvidos na resposta biológica associada ao uso desses dispositivos e sua interação com o sistema imune. Neste estudo, avaliou-se a resposta imune e inflamatória desenvolvida em camundongos frente à implantação de membrana de cortical óssea bovina no tecido subcutâneo, em implantação única e sequencial de duas membranas, assim como os possíveis mecanismos envolvidos no processo de reconhecimento e reabsorção desse biomaterial, de acordo com análise histomorfométrica, enzimática e molecular. Após a implantação da membrana, sinais de reabsorção que antes eram notados em pontos isolados, aos poucos se unem até sua completa degradação, observada somente após 15 dias. Todo o processo de reabsorção da membrana é acompanhado por uma reação inflamatória de magnitude moderada, seguida pelo declínio do número de leucócitos, surgimento de células gigantes multinucleadas e formação de uma cápsula de tecido conjuntivo fibroso. A cinética de TNF- e MMP-2, MMP-8, MMP-9 e MMP-13 apresentou um padrão de produção decrescente, entretanto os níveis dos inibidores de metaloproteinases (TIMPs) e TGF- parecem atuar de forma inversa. A velocidade de reabsorção após duas implantações consecutivas da membrana foi maior quando comparada ao grupo de animais que sofreu apenas uma implantação, porém os resultados do teste de hipersensibilidade do tipo tardia (DTH) demonstraram que a membrana é biocompatível, pois não elicitou resposta imunológica exacerbada após uma segunda implantação, confirmando então a natureza não imunogênica desse biomaterial. Finalmente, os animais CD14KO e MyD88KO apresentaram uma reabsorção mais lenta da membrana implantada, quando comparados aos animais C57Bl/6 (WT), demonstrando que as moléculas CD14 e MyD88 estão envolvidas no reconhecimento do biomaterial e desempenham importante papel no processo de reabsorção da membrana de cortical óssea bovina, indicando a participação de PAMPs e/ou DAMPs na resposta biológica gerada por esse biomaterial.Advances related to the biomaterials science and tissue engineering seek to clarify the mechanisms involved in the biological response associated with the use of those devices and their interaction with the immune system. This study evaluated the inflammatory and immune response developed in mice after implantation bovine bone cortical membrane in subcutaneous tissue, in both, unique and sequential implantation of 2 membranes, as the mechanisms involved in this biomaterial recognition and resorption process, on regards to histomorphometric, enzymatic and molecular analysis. After membrane implantation, previously observed signs of resorption in isolated spots, gradually unite until their complete degradation after 15 days. The whole membrane resorption process is accompanied by a moderate inflammatory reaction, followed by a decline in the leukocytes number, appearance of multinucleated giant cells and formation of a capsule of fibrous connective tissue. The kinetics of TNF-, MMP-2, MMP-8, MMP-9 e MMP-13 showed a pattern of decreasing production, however, levels of metalloproteinases inhibitors (TIMPs) and TGF- seem to act in reverse way. The resorption rate after two successive membrane implantations was higher when compared to the group which suffered only one implantation, however, the results of delayed test hypersensity (DTH) demonstrated that the membrane is biocompatible, that is, it does not elicited too high immune response after a second position, confirming the non immunogenic nature of this biomaterial. Eventually, CD14KO and MyD88KO strains showed a slower membrane resorption when compared to animals C57Bl/6, demonstrating that the CD14 and MyD88 molecules are involved in biomaterial recognition and play an important role in bovine cortical bone membrane resorption process, indicating that PAMPs and/or DAMPs are involved in biological response generated by this biomaterial

O efeito do tratamento da gengivite sobre o hálito de pacientes portadores de periodontite crônica

A presente dissertação objetivou correlacionar diferentes recursos de diagnóstico do hálito e analisar os efeitos do controle de placa supragengival sobre as medições do hálito. Para tanto, medições organolépticas (ORL), de compostos sulfurados voláteis (CSV) e de auto-percepção (EVA) foram realizadas em 27 pacientes (14 mulheres e 13 homens) portadores de periodontite crônica. O tratamento da gengivite foi realizado através de controle de placa supragengival. Análises do hálito foram realizadas ao exame inicial, 30, 90 e 180 dias após início do programa. Correlações significativas foram observadas entre ORL-CSV, ORL-EVA e EVA-CSV, sendo a última fraca. Em relação aos períodos experimentais, houve uma clara diminuição em todas as medições do hálito ao longo do tempo. Em análise post-hoc, subdividiu-se a amostra em dois grupos (relacionados ao hábito de limpar ou não a língua). Não foram observadas diferenças entre esses grupos. Pôde-se concluir que embora existam correlações significativas entre os recursos de diagnóstico do hálito, a medição organoléptica (padrão-ouro) deve ser sempre realizada. Além disso, um programa de controle de placa supragengival é eficaz em reduzir medidas relacionadas ao hálito, independentemente da limpeza da língua

Incidence, morphology and morphometry of the foramen of Vesalius: complementary study for a safer planning and execution of the trigeminal rhizotomy technique

The foramen of Vesalius (FV) is located in the greater wing of the sphenoid bone between the foramen ovale (FO) and the foramen rotundum in an intracranial view. The FO allows the passage of the mandibular branch of trigeminal nerve, which is the target of the trigeminal radiofrequency rhizotomy. We analyzed its location, morphology, morphometry and interrelation among other foramina. 400 macerated adult human skulls were examined. A digital microscope (Dino-Lite plus(A (R))) was used to capture images from the FV. A digital caliper was used to perform the measurements of the distance between the FV and other foramina (FO, foramen spinosum and the carotid canal) in an extracranial view of the skull base. In the 400 analyzed skulls, the FV was identified in 135 skulls (33.75%) and absent on both sides in 265 skulls (66.25%). The FV was observed present bilaterally in 15.5% of the skulls. The incidence of unilateral foramen was 18.25% of the skulls of which 7.75% on right side and 10.5% on left side. The diameter of the FV was measured and we found an average value of 0.65 mm, on right side 0.63 mm and on the left side 0.67 mm. We verified that positive correlations were statistically significant among the three analyzed distances. This study intends to offer specific anatomical data with morphological patterns (macroscopic and mesoscopic) to increase the understanding of the FV features as frequency, incidence and important distances among adjacent foramina

TBX21-1993T/C (rs4794067) polymorphism is associated with increased risk of chronic periodontitis and increased T-bet expression in periodontal lesions, but does not significantly impact the IFN-g transcriptional level or the pattern of periodontophatic bacterial infection

Th1-polarized host response, mediated by IFN-γ, has been associated with increased severity of periodontal disease as well as control of periodontal infection. The functional polymorphism TBX21-1993T/C (rs4794067) increases the transcriptional activity of the TBX21 gene (essential for Th1 polarization) resulting in a predisposition to a Th-1 biased immune response. Thus, we conducted a case-control study, including a population of healthy controls (H, n = 218), chronic periodontitis (CP, n = 197), and chronic gingivitis patients (CG, n = 193), to investigate if genetic variations in TBX21 could impact the development of Th1 responses, and consequently influence the pattern of bacterial infection and periodontitis outcome. We observed that the polymorphic allele T was significantly enriched in the CP patients compared to CG subjects, while the H controls demonstrated and intermediate genotype. Also, investigating the putative functionality TBX21-1993T/C in the modulation of local response, we observed that the transcripts levels of T-bet, but not of IFN-γ, were upregulated in homozygote and heterozygote polymorphic subjects. In addition, TBX21-1993T/C did not influence the pattern of bacterial infection or the clinical parameters of disease severity, being the presence/absence of red complex bacteria the main factor associated with the disease status and the subrogate variable probing depth (PD) in the logistic regression analysis

Expression Analysis of Wound Healing Genes in Human Periapical Granulomas of Progressive and Stable Nature

Introduction: Wound healing process involves the activation of extracellular matrix components, remodeling enzymes, cellular adhesion molecules, growth factors, cytokines and chemokines genes. However, the molecular patterns underlying the healing process periapical environment remain unclear. Here we hypothesized that endodontic infection might result in an imbalance in the expression of wound healing genes involved in the pathogenesis of periapical lesions. Furthermore, we suggest that differential expression of wound healing markers in active and latent granulomas could account for different clinical outcomes for such lesions. Methods: Study samples consisted of 93 periapical granulomas collected after endodontic surgeries and 24 healthy periodontal ligament tissues collected from premolars extracted for orthodontic purposes as control samples. Of these, 10 periapical granulomas and 5 healthy periapical tissues were used for expression analysis of 84 wound healing genes by using a pathway-specific real-time polymerase chain reaction array. The remaining 83 granulomas and all 24 control specimens were used to validate the obtained array data by real-time polymerase chain reaction. Observed variations in expression of wound healing genes were analyzed according to the classification of periapical granulomas as active/progressive versus inactive/stable (as determined by receptor activator for nuclear factor kappa B ligand/osteoprotegerin expression ratio). Results: We observed a marked increase of 5-fold or greater in SERPINE1, TIMP1, COL1A1, COL5A1, VTN, CTGF, FGF7, TGFB1, TNF, CXCL11, ITGA4, and ITGA5 genes in the periapical granulomas when compared with control samples. SERPINE1, TIMP1, COL1A1, TGFB1, and ITGA4 mRNA expression was significantly higher in inactive compared with active periapical granulomas (P < .001), whereas TNF and CXCL11 mRNA expression was higher in active lesions (P < .001). Conclusions: The identification of novel gene targets that curb the progression status of periapical lesions might contribute to a more accurate diagnosis and lead to treatment modalities more conducive to endodontic success. (J Endod 2012;38:185-190