Terapia fotodinâmica na Endodontia: emprego de uma estratégia coadjuvante frente à infecção endodôntica

O tratamento endodôntico é de fundamental importância para abolir a infecção nos dentes com necrose pulpar. O sucesso desse tratamento depende: da eliminação eficiente da infecção no sistema de canais radiculares (SCR) e do correto selamento pela obturação dos canais radiculares. Devido à complexidade anatômica do SCR, certas áreas podem ser inacessíveis ao preparo biomecânico (PBM), portanto, o emprego de uma medicação intracanal potencializa a redução dos microrganismos (MO) e seus produtos tóxicos no SCR. Mesmo com o avanço técnico e científico da Endodontia, há MO que ainda sobrevivem ao PBM, sendo os principais responsáveis pela manutenção infecção endodôntica. Assim, novos tratamentos devem ser pesquisados. Com o advento dos aparelhos de laser e LED, surgiram alternativas de tratamentos na área da saúde, como a terapia fotodinâmica (TFD), que é um conjunto de procedimentos físicos, químicos e biológicos, que ocorrem após a administração de um agente fotossensibilizador (FS) ativado por meio de uma luz visível de comprimento de onda específico (laser ou LED) para destruir a célula-alvo, ou auxiliar no combate das infecções. Na Endodontia, foram demonstrados em estudos in vitro e in vivo que o emprego da TFD atua como um coadjuvante e potencializa a desinfecção do SCR, além de ser de fácil aplicação e não promover resistência microbiana. O objetivo da presente revisão é apresentar o estado atual da terapia fotodinâmica em Endodontia.

Antimicrobial susceptibility to b-lactams and metronidazole of microorganisms isolated from chronic and aggressive periodontitis

The objective of this study was to evaluate the microbial susceptibility to ß-lactams and metronidazole, and evaluate the production of ß-lactamases by microorganisms isolated from patients with chronic or aggressive periodontitis. The samples were obtained from 50 patients with periodontitis and microorganisms were isolated onto selective and nonselective culture media, identified by biochemical methods and tested for susceptibility to antimicrobial agents (amoxicillin, amoxicillin/clavulanate, cefoxitin, imipenem, metronidazole, penicillin G). The isolates were resistant to at least 1 mg/ml of any drug tested were evaluated to verify the production of ß-lactamases by the method of double layer (or biological) and chromogenic cephalosporin using nitrocefin. The results evidenced resistance to amoxicillin and penicillin G, while the susceptibility to association amoxicillin/clavulanate, imipenem and cefoxitin was widely disseminated among the organisms. Resistance to these drugs showed a clear correlation with the production of ß-lactamase in the majority of microbial groups.

Severidade da mucosite bucal em pacientes com câncer de cabeça e pescoço submetidos à raditoerapia

Radioterapia é uma das modalidades terapêuticas mais utilizadas no tratamento de neoplasias de cabeça e pescoço. Contudo apresenta severos efeitos colaterais, dentre os quais a mucosite é uma das mais prevalentes e sérias, ocasionando áreas ulceradas com extremo desconforto para alimentação e possibilidades de infecções secundárias, muitas delas por microrganismos oportunistas. Esse estudo objetivou investigar a ocorrência e grau de severidade da mucosite oral em pacientes com lesões malignas de cabeça e pescoço submetidos à radioterapia, bem como relacionar com a interrupção do tratamento. 50 pacientes foram avaliados clinicamente e por meio de questionário, durante e após o tratamento, no Centro de Radioterapia de Megavoltagem em São José do Rio Preto-SP utilizando-se os critérios de mucosite da OMS. Pode-se verificar que a maioria dos pacientes apresentou algum grau de mucosite durante o tratamento e persiste em alguns pacientes mesmo após a interrupção da radioterapia. A má higiene bucal e tratamentos odontológicos prévios são fatores associados aos graus mais severos das lesões.

Anaeróbios do complexo vermelho de Socransky e infecções bucais em pacientes com imunocomprometimento: características clínicas e prognóstico do tratamento

Os anaeróbios obrigatórios que compõem o complexo vermelho de Socransky são reconhecidos pelo seu envolvimento nas doenças periodontais humanas, mas em pacientes imunocomprometidos os mesmos parecem estar associados a quadros sépticos mais graves e de tratamento mais complexo. Esse estudo objetivou avaliar a ocorrência de Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf) e Treponema denticola (Td) no biofilme, mucosas e saliva de 160 pacientes HIV+, 5 pacientes leucêmicos, 50 pacientes submetidos à radioterapia para tratamento de câncer de cabeça e pescoço e sua correlação com sintomatologia clínica. Amostras de biofilme sub e supragengival, saliva e mucosas foram coletadas após a realização do exame clínico intrabucal. Após a extração do DNA, a detecção desses microrganismos era realizada por PCR. Esses patógenos foram detectados de todos os espécimes clínicos de pacientes com necrose de tecidos moles bucais. Nos pacientes HIV+, a frequência de detecção de Pg e Tf entre pacientes com periodontite foi 2,8 e 2,1 vezes mais elevada do que a observada nos indivíduos periodontalmente saudáveis. T. denticola foi detectado apenas nos sítios com necrose, supuração e perda óssea pronunciada. Pg e Tf se mostraram associados com perda óssea e sangramento gengival. A presença desses microrganismos esteve associada a odor fétido e dor, o que pode auxiliar o clínico na escolha de antimicrobianos como auxiliares do tratamento, devendo-se evitar o emprego de β-lactâmicos, podendo-se associar essas drogas ao metronidazol.

Protocolo de biossegurança e gerenciamento de resíduos no ensino de radiologia odontológica da Faculdade de Odontologia de Araçatuba-UNESP

In dentistry, the technic and radiographic processing incur the possibility of cross infection and environmental contamination. The dentist is responsible for the patient and dental team. For this reason he needs to take a protocol to prevent the spread of microorganisms and environmental exposure to risk factors. The protocols are introduced in the dentistry school as an important teaching tool, whose learning and application reinforce the importance of continuity of these actions in the professional activity. The objective of this paper is to present the biosafety and waste management protocol used in the dental radiology clinic of Araçatuba Dental School, including procedures for the prevention of biological and environmental contamination.

Família Enterobacteriaceae, Acinetobacter baumannii e Pseudomonados na microbiota bucal de pacientes mantidos em unidades de terapia intensiva

Enteric organisms, pseudomonads and other opportunistic microorganisms in the oral microbiota have been linked to serious infections in patients hospitalized in intensive care units (ICU). The present study evaluated the presence of family Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii in the mouth of patients in ICU, correlating it with oral and systemic conditions. Data on health, socioeconomic status, medication use, drug addiction, medical and family histories of patients held for more than 72 hours in the ICU with a diagnosis of severe infection or that developed this condition after entry in said unit were obtained. Fifty patients provided clinical samples of supragingival and subgingival biofilms, saliva and oral mucous membranes were collected, as well as respiratory secretions from patients with pneumonia, blood and urine for sepsis. The presence of target microorganisms was carried out by polymerase chain reaction (PCR) and by culture using selective media. The Chi-square and Mann-Whitney tests were used for statistical analysis, and the significance level was 5%. The intraoral clinical conditions of the patients were poor. The family Enterobacteriaceae was the most prevalent, affecting 39.5% of the supragingival biofilm samples of patients attended in ICU and 18.6% of patients in the control group, besides the rods were the only group found in extraoral samples.

Classe mollicutes na boca de pacientes com dependência química

Drug addiction is one of the biggest public health problems worldwide, not only by the dimensions of the problem, but also by the severity of the damage, creating favorable conditions for opportunistic microorganisms such as class Mollicutes. This study aims to evaluate the presence of the main species and genera of this group in the subgingival biofilm of drug addiction patients, comparing them with non-dependent subjects. For this purpose, data on systemic health conditions, socioeconomic characteristics, drug addiction from 72 patients with drug addiction kept in rehab clinics and 100 non-dependent patients who formed the control group were obtained. Intra and extraoral clinical examinations were performed and samples of subgingival plaque were collected through sterile absorbent paper cones. The presence of different genera and species of the class Mollicutes was evaluated by PCR using the specific primers and conditions for each microorganism. The statistical analysis was performed using the Chi-square test for comparisons of three or more variables and the Mann-Whitney test, with significance level of 5%. Out of species and genera evaluated, Mycoplasma salivarium showed correlation with gingival inflammation in both patient groups and was more frequently detected among drug addiction patients

Enterococcus spp. em espécimes clínicos de pacientes atendidos em unidades de terapia intensiva

The relationship between the occurrence of enterococci in the oral microbiota and serious infections in patients hospitalized in intensive care units (ICU) has been established. This study evaluated the presence of Enterococcus faecalis and other species of this genus in the mouths of patients on ICU, correlating it with oral and systemic conditions. Data on health and socioeconomic, medication use, medical and family history of patients maintained for 72 hours in the ICU, diagnosed with severe infection or who have developed this condition after the entry to the unit were obtained. Fifty patients provided intraoral and extraoral clinical samples for analysis (above and subgingival biofilm, saliva and buccal mucosa, followed by obtaining samples of respiratory secretions for patients with pneumonia, and blood and urine for sepsis). The presence of target microorganisms was performed by polymerase chain reaction (PCR) and culture using selective media. The chi-square and Mann-Whitney tests were used for statistical analysis, and the significance level was 5%. The intraoral clinical conditions of the patients showed poor. E. faecalis was significantly more frequent microorganism, followed by E. faecium. The use of broadspectrum antimicrobial action was associated with the presence of these opportunistic microorganisms. These bacteria were more frequent in patients with periodontitis or gingivitis. The results showed that enterococci associated with serious infectious processes may originate from resident microbiota of patients and its prevalence is not elevated in healthy individuals.

Opportunistic microorganisms in patients with head and neck trauma

The use of antimicrobial agents has facilitated the dissemination of multi-resistant microorganisms, compromising dental and medical treatment. The aim of this study was to evaluate the distribution of different opportunistic microbial species in patients who suffered head and neck trauma, under temporary maintenance in nosocomial environment, particularly intensive care units, on the occurrence of such microorganisms in the oral cavity of the patients. It was selected 38 patients subjected to head and neck traumas. After emergency surgical procedures, clinical samples of saliva, sub and supragingival biofilms and mucosal surfaces were collected at two different moments: just after stabilization of the patient and soon after patients’ release from medical units. The presence of opportunistic and superinfecting microorganisms was evaluated by culture on selective and non-selective media, and the presence of the family Enterobacteriaceae, as well as genera Enterococcus, Pseudomonas, and Staphylococcus was assessed by PCR. It was found that the use of antimicrobials, even for short periods of time was sufficient to facilitate colonization by microorganisms of the families Enterobacteriaceae and Pseudomonadaceae, as well as yeasts and enterococci. These results support the concept that medical and dental teams should make a periodically change of antimicrobials used in treatment protocols in hospital for head and neck trauma patients, in order to minimize dissemination of opportunistic or superinfecting microorganisms.

Saliva contamination by opportunistic microorganisms in drug addiction females

In recent decades there has been a significant increase in the consumption of legal and illegal drugs, and most of such compounds are able to induce dependence and this increase was observed mainly in females. This drug addiction increases susceptibility to several infectious agents, especially opportunistic microorganisms. The objective of this study was to evaluate the occurrence of opportunistic bacteria and yeasts in the mouth of drug addiction patients and non-addicted patients with different periodontal conditions. The study included 50 addiction patients and 200 non-addiction subjects. Intra and extraoral clinical examinations were performed and saliva samples were transferred to saline solution and the presence of members of the family Enterobacteriaceae, genera Enterococcus and Pseudomonas, as well fungi of the genus Candida was evaluated by culture. Samples were cultivated onto selective and non-selective media under aerobic conditions, at 37oC, for 24 -48 h. Identification of selected microorganisms were carried out through biochemical tests. Chi-square test was used to evaluate the data when three or more categories were involved. Higher detection frequencies of Candida species, family Enterobacteriaceae, E. faecalis, Pseudomonas sp. and P. aeruginosa in addiction patients were verified. It was found that patients addicted to both genders showed a higher occurrence of members of the Enterobacteriaceae, which were also associated with bone loss only in patients with drug addiction.

Isoflavones supplementation of a probiotic soy product: effects on quality characteristics and isoflavones profile

The aim of the present study was to investigate the effect of isofl avones supplementation of a fermented soy product on its sensory acceptance, physicochemical properties and probiotic cell viable count. Additionally we also investigated the ability of the mixed starter cultures (Enterococcus faecium CRL 183 and Lactobacillus helveticus 416) to modify the isofl avones profi le of soy product during the fermentation process. Three products were analysed: soy product fermented with E. faecium CRL 183 and L. helveticus 416, isofl avonessupplemented soy product (fermented with E. faecium CRL 183 and L. helveticus 416; 50mg/100g, Isofl avin®, Galena, Brazil) and unfermented soy product. A panel of judges evaluated the acceptability of the samples on a nine point structured hedonic scale. The chemical composition namely fat, protein, ash and total carbohydrate contents, pH, enumeration of viable Lactobacillus spp. and Enterococcus spp. and quantifi cation of isofl avones using HPLC were investigated. All determinations were conducted after 7 days storage at 10°C. The sensorial acceptance was reduced in the isofl avones-supplemented soy product, but this effect was not signifi cant compared to the sample without isofl avones addition. Chemical composition did not differ (p<0.05) among the samples. Cell viable counts were reduced and total fermentation time was longer in the isofl avonessupplemented soy product, suggesting that the isofl avone addition could inhibit the starter cultures. However, all the products may be considered probiotic since they exhibited lactic acid bacterial populations varying from 2.3 x 109 up to 1.22 x 1010 CFU/mL. Fermentation of soymilk did not change the isofl avones profi le. In conclusion, it was possible to obtain a fermented soy product containing a high isofl avones concentration, adequate sensory and chemical characteristics and lactic acid bacterial viability suffi ciently high to characterize the product as a probiotic. The mixed starter culture was not able to convert the glycoside isofl avones into aglycone or produce equol during the fermented soy product processing.

Adição de plasma bovino em salmouras para injeção de coxão duro bovino (m. Biceps femoris) e seus efeitos no pH e na carga microbiana de bifes cozidos embalados à vácuo e mantidos sob refrigeração

The physical (pH) and microbiological (psychotrofi c microorganisms and lactic bacteria) characteristics of beef outside round (m. Biceps femoris) injected (15%) with brines free of polyphosphates containing and sodium lactate or sodium lactate and sodium diacetate and liquid bovine plasma (PLL and PLO) or dehydrated bovine plasma (PDL, PDO) were evaluated along with beef cuts injected with brines free from plasma, but containing polyphosphates and bacteriostatic agents (CL and CO) and non injected beef cuts (IN), comprising seven treatments of cooked and vacuum packaged beef steaks stored under refrigeration (6ºC) during 43 days. No differences in pH were detected among raw or cooked injected treatments, although IN showed lower pH value in raw beef cuts. The addition of liquid or dehydrated bovine plasma did not affect the microbial load after whole muscles pasteurization, but increased the bacterial counts in cooked beef steaks during refrigerated storage, comparing to treatments with no plasma addition (CL and CO). The storage temperature (6ºC), usually found during commercialization of meat increased the microorganisms growth rate affecting the microbiological quality, especially when plasma was added to the brine.

Percepção e atitudes de pedagogos sobre aspectos relevantes do uso de escovas dentárias

Objective: To evaluate the perception and attitude of kindergarten teachers in relation to the storage of toothbrushes. Methodology: The analysis instrument used was a structured and previously validated questionnaire. The sample universe of this study was composed of all states and municipals kindergarten school teachers who taught in school year of 2010 at the town of Araçatuba / SP (n = 232). The criteria used to integrate the study were: to have a college degree and agree to participate. Results: 164 teachers participated of the study. The results were analyzed using Epi Info 6.04 and showed that 55% of the teachers had received some information about the proper storage of toothbrushes, and only 35% believed that the toothbrushes were storaged improperly. Most teachers, 97% reported being possible the transmission of microorganisms through the brush, however, there was observed difficulty in identifying which diseases could be transmitted. About the question related to the execute of supervised toothbrushing, 93% of the educators said that they realize supervised toothbrushing and the same percentage was observed for the identification of preschoolers at the toothbrushes. Conclusions: The perception and attitude of the teachers ahead the storage of toothbrushes are weak and limited, so there is a need for educational programs targeted to this group, so that they would have more information and knowledge related to the correct storage of toothbrushes and would continue to perform oral health preventive methods.

Estrutura e funcionamento da alça microbiana nos sedimentos da Baía do Araçá, São Sebastião - SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análise da qualidade microbiológica do peixe (Eugerres brasilianus, Curvier 1830) e das águas do Estuário do Rio Itanhaém, SP, Brasil

Pós-graduação em Ciências Biológicas (Microbiologia Aplicada) - IBRC