Oral antibacterial effect of chlorhexidine treatments and professional prophylaxis in children

Aim: The primary aim of this longitudinal study was to evaluate additional effects of 4-week chlorhexidine digluconate (CHX) gel treatments to control Aggregatibacter actinomycetemcomitans counts in children after professional dental prophylaxis. Porphyromonas gingivalis and Streptococcus mutans counts were also determined to evaluate the secondary effects of anti-plaque treatments on microbial shifts. Methods: Twenty-six children with A. actinomycetemcomitans counts >4 log10/ mL of saliva and/or Quigley-Hein plaque index >3.0 were enrolled in this study. Patients were randomly assigned to groups GI (placebo gel), GII (0.5% CHX gel), GIII (1% CHX gel), and GIV (2% CHX gel). Four sessions of treatment were performed during 4 weeks after a session of professional dental prophylaxis. Real-Time polymerase chain reaction (PCR) was used to determine viable microorganism counts in non-stimulated whole saliva samples collected at baseline, one week, one month and three months after interruption of treatments. Results: A reduction of all bacterial counts was detected after the 3-month follow-up in all groups. Lower counts of P. gingivalis were achieved from 1 week on after treatments. The 2% CHX concentration seemed to contribute to lower A. actinomycetemcomitans levels and increase S. mutans levels. Conclusions: Professional dental prophylaxis was effective to control salivary levels of A. actinomycetemcomitans, P. gingivalis and S. mutans. Additional antimicrobial effects, however, were not observed by the combination of professional dental prophylaxis and 4-week chlorhexidine gel treatments

The action of photodynamic therapy on human dental plaque

Entre os métodos de prevenção da cárie dentária, os controles mecânico e químico do biofilme dentário são de grande relevância neste processo. O controle mecânico é eficaz desde que executado diariamente e sistematicamente envolver todas as superfícies dentárias expostas ao meio bucal. Ele pode ser realizado pelo odontólogo por meio da profilaxia profissional e pelo próprio paciente pela escovação dentária. O controle químico do biofilme dentário deve ser empregado de forma suplementar, quando o controle mecânico não puder ser realizado diariamente ou se for realizado de forma inadequada acarretando o risco do acúmulo do biofilme dentário e como consequência, a ocorrência de lesões de cárie dentária e/ou da doença periodontal. O ideal seria associar ambos os métodos, para que um compense a deficiência do outro. É nesta direção que inúmeros estudos são feitos nos últimos anos. Para o controle químico, são relatadas na literatura inúmeras substâncias antimicrobianas. Dentre os agentes químicos recomendados, a clorexidina (CLX) tem se mostrado eficiente para esta finalidade, porém, sua aplicação apresenta limitações como: manchamento de áreas desmineralizadas dos dentes e perda do paladar, condições estas que limitam seu uso por tempo prolongado. Sendo assim, a busca de alternativas para o controle microbiano do biofilme dentário é de grande relevância para se somar aos esforços ora empreendidos neste sentido. Nas últimas décadas o emprego da luz associada a corantes surgiu como um tratamento alternativo ao uso de agentes antimicrobianos tradicionais. Este tratamento é chamado terapia fotodinâmica (TFD), sendo recentemente também chamado de Terapia Fotodinâmica Antimicrobiana (TFDA). Na TFDA, a luz interage com o corante que está associado ao microorganismo, sendo capaz de inibir sua proliferação ou eliminá-lo completamente. Poucos são os estudos que avaliam a ação antimicrobiana da TFD sobre biofilmes cariogênicos. A comprovação da eficácia dessa terapia sobre o biofilme dentário humano poderá ter um impacto positivo para a Odontologia, favorecendo a implantação de novos protocolos de controle químico do mesmo. Este estudo teve como objetivo analisar comparativamente o efeito da clorexidina e da TFDA (com dois tipos de fotossensibilizadores: Azul de Toluidina O (TBO) e Clorofila Líquida (CL)) sobre biofilmes dentários humanos formados in situ. Voluntários utilizaram um dispositivo intrapalatino contendo espécimes de esmalte dental, sobre os quais biofilme dentário foi formado. Após 48 horas, diferentes terapias foram aplicadas sobre o biofilme: (1) água destilada: controle negativo; (2)CLX; (3) irradiação por laser; (4) TBO; (5) TBO +laser; (6) CL; (7) CL + laser. O biofilme então foi coletado e solubilizado. Em seguida, amostras foram semeadas em placas de Petri com diferentes meios de cultura, para contagem do número de microrganismos totais, estreptococos totais, Streptococcos mutans, Lactobacilos e Candida albicans. Amostras também foram coradas com Laranja de Acridina e visualizadas em microscopia de fluorescência, para análise da viabilidade das células presentes. Os resultados dos plaqueamentos apenas nos deram informações sobre os microrganismos totais e estreptococos totais, mostrando que a única redução significante dos microorganismos em relação ao grupo (1) ocorreu no grupo tratado por CLX (2). As outras terapias mostraram uma sensível redução. A viabilidade por microscopia por fluorescência se mostrou semelhante em todos os grupos. A clorexidina, portanto, comprovou seu efeito antimicrobiano, porém mais estudos precisam ser realizados para verificar o real papel da TFD sobre biofilme dentário humano.The mechanical and chemical controls of dental plaque are important methods of caries prevention. The mechanical control is efficient if its run properly and daily. It can be made by a dentist (professional cleaning) or by patients themselves (toothbrushing). The chemical control should be used additionally, when the mechanical control cant be performed properly, them the biofilm can accumulate and in consequence, there are risks of dental caries or periodontal disease. For chemical control, many antimicrobial substances are related in literature. Several studies have shown that chlorexidine (CLX) is an effective antimicrobial substance against dental plaque. However, it presents some limitations like: tooth staining, loss of taste, conditions that limit its use by prolonged periods. Therefore, the search by new alternatives in microbial control of plaque is very important for improvement the treatment. In last decades, the use of light for activation of a photosensitizer appears like an alternative treatment with antimicrobial function. This treatment is called Photodynamic Therapy (PDT), recently Photochemotherapy (PACT). In PACT, the light activates a photosensitizer that is bond in microorganism and it can kill it or inhibit its growing. If this treatment is effective on human dental plaque, it will have positive impact for Dentistry and new protocols of chemical control will be developed. The present study aim was analyze the chlorexidine effect and the PDT effect (using Toluidine blue (TBO) and Liquid Chlorophyll (LC) like photosensitizer) in human natural dental plaque formed in situ. Volunteers wore a palatal appliance containing bovine enamel blocks, where the biofilm was formed. After 48 hours, different therapies were performed on plaque: (1) distilled water: negative control; (2) CLX; (3) Laser irradiation; (4) TBO; (5) TBO + Laser; (6) CL; (7) CL + Laser. The plaque samples were collected and dispersed. Next, serial dilutions were prepared and seeded onto different culture broth for the determination of the number of colony-forming units per gram (CFU/g) of total microorganisms, total Streptococcus, Streptococcus mutans, Lactobacillus and C. albicans. Samples were stained with acridine orange to analyze cells viability. The results can reveal only information about total microorganism and total Streptococcus. When the groups (2-7) were compared with the group (1), significant microbial reduction was observed only in group treated with CLX (3). The other therapies showed only a discrete reduction in relation of group (1). The cell viability showed similar results in all groups. Therefore, the CLX proved its antimicrobial effect. More studies are necessary for exact evaluation of effect of TFD on dental plaque human

Oral antibacterial effect of chlorhexidine treatments and professional prophylaxis in children

e primary aim of this longitudinal study was to evaluate additional effects of 4-week chlorhexidine digluconate (CHX) gel treatments to control Aggregatibacter actinomycetemcomitans counts in children after professional dental prophylaxis. Porphyromonas gingivalis and Streptococcus mutans counts were also determined to evaluate the secondary effects of anti-plaque treatments on microbial shifts. Methods: Twenty-six children with A. actinomycetemcomitans counts >4 log10/mL of saliva and/or Quigley-Hein plaque index >3.0 were enrolled in this study. Patients were randomly assigned to groups GI (placebo gel), GII (0.5% CHX gel), GIII (1% CHX gel), and GIV (2% CHX gel). Four sessions of treatment were performed during 4 weeks after a session of professional dental prophylaxis. Real-Time polymerase chain reaction (PCR) was used to determine viable microorganism counts in non-stimulated whole saliva samples collected atbaseline, one week, one month and three months after interruption of treatments. Results: A reduction of all bacterial counts was detected after the 3-month follow-up in all groups. Lower counts of P. gingivalis were achieved from 1 week on after treatments. The 2% CHX concentration seemed to contribute to lower A. actinomycetemcomitans levels and increase S. mutans levels. Conclusions: Professional dental prophylaxis was effective to control salivary levels of A. actinomycetemcomitans, P. gingivalis and S. mutans. Additional antimicrobial effects, however, were not observed by the combination of professional dental prophylaxis and 4-week chlorhexidine gel treatments

Absence of functional TLR4 impairs response of macrophages after Candida albicans infection

Candida albicans is recognized by phagocytic cells through a set of recognition receptors patterns. Recently, we showed the importance of TLR2 in the regulation of neutrophil survival after C. albicans infection. In the present work, we analyzed the involvement of TLR4 in the recognition of C. albicans by neutrophils and macrophages. Our results show that the absence of functional TLR4 resulted in lower chemotaxis of neutrophils to the site of infection, lower levels of TNF-alpha, CXCL1 and nitric oxide, and dissemination and persistence of the pathogen in lymph nodes and spleen. In vitro, the phagocytic activity, nitric oxide production and myeloperoxidase activity, CXCL1, IL-1 beta production by neutrophils from TLR4-defective mice were not changed. In contrast, macrophages from TLR4-defective mice demonstrated lower phagocytosis and lower levels of CXCL1, IL-1 beta and TNF-alpha. Together, these data demonstrate that TLR4 signals are important for the recognition of C. albicans by macrophages and their absence allows persistence of the infection.</

Efeito do gel de clorexidina em diferentes concentrações no controle do biofilme bacteriano e da inflamação gengival em crianças

O presente estudo teve como objetivo avaliar a efetividade da utilização de géis de clorexidina nas concentrações de 0,5%, 1% e 2% para o controle do biofilme dentário e da inflamação gengival em crianças na faixa etária de 7 a 11 anos de idade. A amostra foi composta por 40 crianças, aleatoriamente divididas em quatro grupos: G1 (grupo controle - não utilização de agente químico), G2 (utilização de gel de clorexidina a 0,5%), G3 (utilização de gel de clorexidina a 1%) e G4 (utilização de gel de clorexidina a 2%) para determinação dos índices de placa e gengival. O gel de clorexidina foi aplicado com a utilização de moldeiras descartáveis pré-fabricadas (5 mL), por 1 minuto, uma vez por semana, durante 4 semanas. As avaliações clínicas foram feitas após 1 semana, 1 mês, 3 e 6 meses da última aplicação do gel. Os resultados obtidos foram analisados pela análise de variância a dois critérios, sendo adotado nível de significância igual a 5%. Os índices de placa e gengival reduziram durante o período experimental em todos os grupos. Não houve diferença significante (

An efficient similarity-based approach for comparing XML documents.

XML documents are widely used to interchange information among heterogeneous systems, ranging from office applications to scientific experiments. Independently of the domain, XML documents may evolve, so identifying and understanding the changes they undergo becomes crucial. Some syntactic diffapproaches have been proposed to address this problem. They are mainly designed to compare revisions of XML doc- uments using explicit IDs to match elements. However, elements in different revisions may not share IDs due to tool incompatibility or even divergent or missing schemas. In this paper, we present Phoenix, a similarity-based approach for comparing revisions of XML documents that does not rely on explicit IDs. Phoenix uses dynamic programming and optimization algorithms to compare different features (e.g., ele- ment name, content, attributes, and sub-elements) of XML documents and calculate the similarity degree between them. We compared Phoenix with X-Diffand XyDiff, two state-of-the-art XML diffalgorithms. XyDiffwas the fastest approach but failed in providing precise matching results. X-Diffpresented higher efficacy in 30 of the 56 scenarios but was slow. Phoenix executed in a fraction of the running time re- quired by X-Diffand achieved the best results in terms of efficacy in 26 of 56 tested scenarios. In our evaluations, Phoenix was by far the most efficient approach to match elements across revisions of the same XML document

Factors influencing fluoride ingestion from dentifrice by children

Objective: This study assessed the percentage of the amount of dentifrice loaded onto the toothbrush that is ingested by children, taking into account age, the amount of dentifrice used during toothbrushing, and the dentifrice flavor. Methods: The sample consisted of 155 children of both genders attending public kindergartens and schools in Bauru, Brazil, divided into 5 groups (n = 30-32) of children aged 2, 3, 4, 5 and 6 years old. The dentifrices used were Sorriso(TM) (1219 ppm F, peppermint-flavored) and Tandy(TM) (959 ppm F, tutti-frutti-flavored). The assessment of fluoride intake from dentifrices was carried out six times for each child, using 0.3, 0.6, and 1.2 g of each dentifrice, following a random, crossover distribution. Brushing was performed by the children or their parents/caregivers according to the home habits and under the observation of the examiner. Fluoride present in the expectorant and on toothbrush was analyzed with an ion-specific electrode after HMDS-facilitated diffusion. Fluoride ingestion was indirectly derived. Results were analyzed by 3-way repeated-measures anova and Tukey`s tests (P < 0.05) using the percent dentifrice ingested as response variable. Results: Age and percent dentifrice ingested for both dentifrices, and the three amounts used were inversely related (P < 0.0001). Percent dentifrice ingested was significantly higher after the use of Tandy(TM) under all conditions of the study when compared with Sorriso(TM) (P < 0.0001). Significant differences were observed when brushing with 0.3 g when compared with 1.2 g, for both dentifrices tested (P < 0.05). Conclusions: The results indicate that all variables tested must be considered in preventive measures aiming to reduce the amount of fluoride ingested by young children.FAPESP (The State of Sao Paulo Research Foundation)[2008/09059-0]FAPESP (The State of Sao Paulo Research Foundation)[2009/06336-5