Sexo e idade como fatores modificadores na remoção do biofilme supragengival

Objective: The present study aimed to evaluate the biofilm removal capacity according to sex and age. Material and methods: Seventy individuals aged between 21 and 70 years were included. Modified Navy Board Index (MNBI) was performed by a calibrated examiner. Individuals brushed their teeth with a brush for a minute, and the MNBI was applied again. The volunteers were asked to use the brush for seven days, twice a day, with standardized toothpaste. On day 7, the same procedures of the first visit were made. The percentages of removal of supragingival biofilm (whole-mouth, interproximal and gingival margin line) were calculated for each of the experimental periods. Comparisons were performed between genders and age using the t-test for independent samples. The significance level adopted was 5%. Results: At baseline and after 7 days, women presented more dental plaque in whole mouth than men (p 37 years or older (pObjetivo: Este trabalho objetivou avaliar a capacidade de remoção do biofilme de acordo com o sexo e a idade. Materiais e métodos: Setenta indivíduos com idades entre 21 e 70 anos foram incluídos. Índice de Placa Modificado da Marinha (IPMM) foi realizado por um examinador calibrado. Em seguida, eles escovaram seus dentes com uma escova macia por um minuto, e o IPMM foi novamente aplicado. Os voluntários utilizaram a escova durante sete dias, duas vezes ao dia, com dentifrício padronizado. Após sete dias, os mesmos procedimentos da primeira visita foram realizados. Os percentuais de remoção de biofilme supragengival (boca inteira, interproximal e da linha gengival) foram calculados em cada um dos períodos experimentais. Comparações foram realizadas entre os sexos e idade com o uso de teste-t para amostras independentes. O nível de significância adotado foi de 5%. Resultados: Na consulta inicial e após 7 dias, mulheres apresentaram maior quantidade de placa na boca toda do que homens (p 37 anos (

Ruxolitinib for Glucocorticoid-Refractory Acute Graft-versus-Host Disease

BACKGROUND: Acute graft-versus-host disease (GVHD) remains a major limitation of allogeneic stem-cell transplantation; not all patients have a response to standard glucocorticoid treatment. In a phase 2 trial, ruxolitinib, a selective Janus kinase (JAK1 and JAK2) inhibitor, showed potential efficacy in patients with glucocorticoid-refractory acute GVHD. METHODS: We conducted a multicenter, randomized, open-label, phase 3 trial comparing the efficacy and safety of oral ruxolitinib (10 mg twice daily) with the investigator's choice of therapy from a list of nine commonly used options (control) in patients 12 years of age or older who had glucocorticoid-refractory acute GVHD after allogeneic stem-cell transplantation. The primary end point was overall response (complete response or partial response) at day 28. The key secondary end point was durable overall response at day 56. RESULTS: A total of 309 patients underwent randomization; 154 patients were assigned to the ruxolitinib group and 155 to the control group. Overall response at day 28 was higher in the ruxolitinib group than in the control group (62% [96 patients] vs. 39% [61]; odds ratio, 2.64; 95% confidence interval [CI], 1.65 to 4.22; P<0.001). Durable overall response at day 56 was higher in the ruxolitinib group than in the control group (40% [61 patients] vs. 22% [34]; odds ratio, 2.38; 95% CI, 1.43 to 3.94; P<0.001). The estimated cumulative incidence of loss of response at 6 months was 10% in the ruxolitinib group and 39% in the control group. The median failure-free survival was considerably longer with ruxolitinib than with control (5.0 months vs. 1.0 month; hazard ratio for relapse or progression of hematologic disease, non-relapse-related death, or addition of new systemic therapy for acute GVHD, 0.46; 95% CI, 0.35 to 0.60). The median overall survival was 11.1 months in the ruxolitinib group and 6.5 months in the control group (hazard ratio for death, 0.83; 95% CI, 0.60 to 1.15). The most common adverse events up to day 28 were thrombocytopenia (in 50 of 152 patients [33%] in the ruxolitinib group and 27 of 150 [18%] in the control group), anemia (in 46 [30%] and 42 [28%], respectively), and cytomegalovirus infection (in 39 [26%] and 31 [21%]). CONCLUSIONS: Ruxolitinib therapy led to significant improvements in efficacy outcomes, with a higher incidence of thrombocytopenia, the most frequent toxic effect, than that observed with control therapy

Effect of periodontal treatment on C-reactive protein, glycated hemoglobin and lipid profile in patients with coronary artery disease : results of 12 month of a randoized clinical trial

Objetivo: Avaliar o impacto do tratamento periodontal na concentração sérica de proteína C-reativa (PCR), perfil lipídico e hemoglobina glicada em pacientes cardiopatas participantes de um ensaio clínico randomizado com análise de 12 meses de acompanhamento. Métodos: Trata-se de um ensaio clínico randomizado em hospital terciário com pacientes com doença arterial coronariana (DAC) estável e periodontite crônica grave. Foram realizados exames periodontais (seis sítios por dente em toda a boca) para registro de profundidade de sondagem (PS) e perda de inserção (PI), além de índice de placa visível (IPV) e índice de sangramento gengival (ISG). O grupo teste recebeu tratamento periodontal intensivo, sendo inicialmente realizada uma sessão de raspagem, alisamento e polimento supragengival (RAP) com orientação personalizada de higiene bucal. Em seguida, foram realizadas até quatro sessões de raspagem e alisamento radicular subgengival (RASUB) por quadrante, sob anestesia local. O grupo controle recebeu uma única sessão de RAP e orientação de higiene bucal. Foram coletadas amostras para mensuração dos níveis sistêmicos de PCR de alta sensibilidade, perfil lipídico e hemoglobina glicada. Resultados: 60 pacientes foram analisados após 12 meses, 28 no grupo teste e 32 no grupo controle, com idade média de 59 e 61 anos, respectivamente. Não foram observadas diferenças significativas ao longo do tempo, e entre os grupos nos dois tempos experimentais em relação a PCR. Assim como não foram encontradas diferenças significativas entre perfil lipídico e hemoglobina glicada. Conclusão: O tratamento periodontal não adicionou benefício sobre os níveis de PCR, hemoglobina glicada e perfil lipídico em indivíduos cardíacos crônicos tratados em uma unidade terciária. No entanto, foi observada uma tendência de benefício em pacientes cardíacos com níveis basais controlados de PCR.Objective: To evaluate the impact of periodontal therapy on serum concentration of CRP, lipid profile and glycated hemoglobin in patients with heart disease participating in a randomized clinical trial with 12 months of follow-up. Methods: A randomized clinical trial in a tertiary hospital with patients with stable coronary artery disease (CAD) and severe chronic periodontitis. Whole mouth periodontal examination (six sites per tooth) was performed and comprised probing depth (PD) and attachment loss, in addition to visible plaque (VPI) and gingival bleeding index (GBI) The test group received intensive periodontal treatment. Initially, supragingival scaling with oral hygiene instruction were performed. In sequence, up to four sessions of subgingival scaling root planing per quadrant, under local anesthesia were performed. The control group had supragingival scaling and oral hygiene instruction. Blood samples were collected to assess the serum levels of high sensitivity CRP, lipid profile and glycated hemoglobin. Results: A total of 60 patients were analyzed after twelve moths, 28 (test group) and 32 (control group), with a mean age of 59 and 61 years. No statistically significant differences were observed along the study between groups in CRP. Also, no statistically significant diferences were detected in glycated hemoblobin and lipid profile. Conclusion: Periodontal treatment did not add benefit on CRP and glycated hemoglobina levels as well as in lipid profile in chronic cardiac individuals treated in a tertiary unit. However, a positive trend was observed in cardiac patients with controlled RCP basal levels

Effect of periodontal treatment on C-reactive protein, glycated hemoglobin and lipid profile in patients with coronary artery disease : results of 12 month of a randoized clinical trial

Objetivo: Avaliar o impacto do tratamento periodontal na concentração sérica de proteína C-reativa (PCR), perfil lipídico e hemoglobina glicada em pacientes cardiopatas participantes de um ensaio clínico randomizado com análise de 12 meses de acompanhamento. Métodos: Trata-se de um ensaio clínico randomizado em hospital terciário com pacientes com doença arterial coronariana (DAC) estável e periodontite crônica grave. Foram realizados exames periodontais (seis sítios por dente em toda a boca) para registro de profundidade de sondagem (PS) e perda de inserção (PI), além de índice de placa visível (IPV) e índice de sangramento gengival (ISG). O grupo teste recebeu tratamento periodontal intensivo, sendo inicialmente realizada uma sessão de raspagem, alisamento e polimento supragengival (RAP) com orientação personalizada de higiene bucal. Em seguida, foram realizadas até quatro sessões de raspagem e alisamento radicular subgengival (RASUB) por quadrante, sob anestesia local. O grupo controle recebeu uma única sessão de RAP e orientação de higiene bucal. Foram coletadas amostras para mensuração dos níveis sistêmicos de PCR de alta sensibilidade, perfil lipídico e hemoglobina glicada. Resultados: 60 pacientes foram analisados após 12 meses, 28 no grupo teste e 32 no grupo controle, com idade média de 59 e 61 anos, respectivamente. Não foram observadas diferenças significativas ao longo do tempo, e entre os grupos nos dois tempos experimentais em relação a PCR. Assim como não foram encontradas diferenças significativas entre perfil lipídico e hemoglobina glicada. Conclusão: O tratamento periodontal não adicionou benefício sobre os níveis de PCR, hemoglobina glicada e perfil lipídico em indivíduos cardíacos crônicos tratados em uma unidade terciária. No entanto, foi observada uma tendência de benefício em pacientes cardíacos com níveis basais controlados de PCR.Objective: To evaluate the impact of periodontal therapy on serum concentration of CRP, lipid profile and glycated hemoglobin in patients with heart disease participating in a randomized clinical trial with 12 months of follow-up. Methods: A randomized clinical trial in a tertiary hospital with patients with stable coronary artery disease (CAD) and severe chronic periodontitis. Whole mouth periodontal examination (six sites per tooth) was performed and comprised probing depth (PD) and attachment loss, in addition to visible plaque (VPI) and gingival bleeding index (GBI) The test group received intensive periodontal treatment. Initially, supragingival scaling with oral hygiene instruction were performed. In sequence, up to four sessions of subgingival scaling root planing per quadrant, under local anesthesia were performed. The control group had supragingival scaling and oral hygiene instruction. Blood samples were collected to assess the serum levels of high sensitivity CRP, lipid profile and glycated hemoglobin. Results: A total of 60 patients were analyzed after twelve moths, 28 (test group) and 32 (control group), with a mean age of 59 and 61 years. No statistically significant differences were observed along the study between groups in CRP. Also, no statistically significant diferences were detected in glycated hemoblobin and lipid profile. Conclusion: Periodontal treatment did not add benefit on CRP and glycated hemoglobina levels as well as in lipid profile in chronic cardiac individuals treated in a tertiary unit. However, a positive trend was observed in cardiac patients with controlled RCP basal levels

Efficacy of two mouthwashes with cetylpyridinium chloride : a controlled randomized clinical trial

This study aimed to evaluate the anti-plaque and antigingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Lõe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival índices, by ANOVA, paired t-test and ANCOVA (a < 0.05). After 4 and 6 weeks, ali mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For Gl, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes

Efficacy of two mouthwashes with cetylpyridinium chloride : a controlled randomized clinical trial

This study aimed to evaluate the anti-plaque and antigingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Lõe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival índices, by ANOVA, paired t-test and ANCOVA (a < 0.05). After 4 and 6 weeks, ali mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For Gl, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes

Efficacy of two soft-bristle toothbrushes in plaque removal : a randomized controlled trial

The aim of this study was to compare the efficacy in supragingival plaque removal of two soft-bristle toothbrushes. Seventy volunteers were allocated randomly to the Colgate SlimSoft or Curaprox CS5460 toothbrush grourps. At baseline appointment, volunteers underwent plaque examination using the Rustogi Modification of the Navy Plaque Index. Under supervision, they then brushed their teeth for 1minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers performed daily oral hygiene with their assigned toothbrush and a regular dentifrice provided by the researchers for 7 days. The baseline experimental procedures were then repeated. Separate analyses of variance were performed for the whole-mouth, interproximal, and gumline plaque scores (p < 0.05). No difference in baseline pre-brushing scores was found between groups. After a single toothbrushing, the mean plaque score was significantly reduced in both groups (p < 0.05), with greater reduction of whole-mouth and interproximal plaque scores observed in the SlimSoft group compared with the Curaprox group (p < 0.05). After 7 days, the SlimSoft group showed greater reduction of the whole-mouth and interproximal plaque scores compared with the Curaprox group (p < 0.05). In conclusion, the SlimSoft toothbrush presented greater efficacy in supragingival plaque removal than did the Curaprox CS5460 toothbrush, as reflected by whole-mouth and interproximal plaque scores

Efficacy of two soft-bristle toothbrushes in plaque removal: a randomized controlled trial

Abstract The aim of this study was to compare the efficacy in supragingival plaque removal of two soft-bristle toothbrushes. Seventy volunteers were allocated randomly to the Colgate Slim Soft or Curaprox CS5460 toothbrush grourps. At baseline appointment, volunteers underwent plaque examination using the Rustogi Modification of the Navy Plaque Index. Under supervision, they then brushed their teeth for 1minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers performed daily oral hygiene with their assigned toothbrush and a regular dentifrice provided by the researchers for 7 days. The baseline experimental procedures were then repeated. Separate analyses of variance were performed for the whole-mouth, interproximal, and gumline plaque scores (p < 0.05). No difference in baseline pre-brushing scores was found between groups. After a single toothbrushing, the mean plaque score was significantly reduced in both groups (p < 0.05), with greater reduction of whole-mouth and interproximal plaque scores observed in the SlimSoft group compared with the Curaprox group (p < 0.05). After 7 days, the SlimSoft group showed greater reduction of the whole-mouth and interproximal plaque scores compared with the Curaprox group (p < 0.05). In conclusion, the SlimSoft toothbrush presented greater efficacy in supragingival plaque removal than did the Curaprox CS5460 toothbrush, as reflected by whole-mouth and interproximal plaque scores

Efficacy of two soft-bristle toothbrushes in plaque removal: a randomized controlled trial

Abstract The aim of this study was to compare the efficacy in supragingival plaque removal of two soft-bristle toothbrushes. Seventy volunteers were allocated randomly to the Colgate Slim Soft or Curaprox CS5460 toothbrush grourps. At baseline appointment, volunteers underwent plaque examination using the Rustogi Modification of the Navy Plaque Index. Under supervision, they then brushed their teeth for 1minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers performed daily oral hygiene with their assigned toothbrush and a regular dentifrice provided by the researchers for 7 days. The baseline experimental procedures were then repeated. Separate analyses of variance were performed for the whole-mouth, interproximal, and gumline plaque scores (p < 0.05). No difference in baseline pre-brushing scores was found between groups. After a single toothbrushing, the mean plaque score was significantly reduced in both groups (p < 0.05), with greater reduction of whole-mouth and interproximal plaque scores observed in the SlimSoft group compared with the Curaprox group (p < 0.05). After 7 days, the SlimSoft group showed greater reduction of the whole-mouth and interproximal plaque scores compared with the Curaprox group (p < 0.05). In conclusion, the SlimSoft toothbrush presented greater efficacy in supragingival plaque removal than did the Curaprox CS5460 toothbrush, as reflected by whole-mouth and interproximal plaque scores