Diretrizes para o tratamento e acompanhamento periodontal durante o tratamento ortodôntico

The aim of this paper was to search though a revision of the literature the cares before, during and after the orthodontic treatment in patients with a periodontal disease. The literature shows that the orthodontical treatment in healthy patients brings no risk to the periodontium, although the presence of an active periodontal disease counter indicates the dental movement. Thus, it is extremely important to execute a correct diagnosis of any periodontal alteration and treat them before the beginning of the orthodontical treatment. Besides, during the whole orthodontical treatment is also important to have a periodontal control with periodic reevaluations and at the end of the orthodontical treatment, a new oral hygiene orientation may be needed to finally establish the follow-up of the patient according to the risk of periodontal disease.

Detecção de Periodontopatógenos, Glicoproteína Emmprin (Cd-147) e sua correlação com MMP-2 e MMP-9

Periodontitis is an infectious disease characterized by the secretion of a variety of inflammatory mediators that lead to destruction of tooth supporting tissues, including the possible loss of alveolar bone, in association with infection with multiple species of bacteria. It is estimated that more than 400 species colonize the biofilm and some oral species related to periodontal disease is present in the subgingival including P. gingivalis, T. forsythia and T. denticola. However, other organisms may be related of this disease, as Filifactor allocis and Prevotella tannerae. These microorganisms and subproducts such as endotoxins released into the extracellular lead to the stimulation of metalloproteinase inducer glycoprotein (EMMPRIN, CD-147), which stimulates the release of MMPs by host cells, like fibroblasts and endothelial cells, thus leading to tissue destruction. The objective of this study was to detect F. allocis, P. tannerae, T. denticola and the glycoprotein EMMPRIN (CD-147) and its correlation with MMP-2 and MMP-9 in subgingival fluid samples of patients with chronic periodontitis. Fluids were collected from healthy and disease subgingival sites of 20 healthy individuals before basic periodontal treatment and after of 60 days of treatment. Their DNAs were extracted and portions of the 16S gene were amplified and performed conventional PCR. For immunological analysis and quantification of EMMPRIN (CD-147), MMP-2 and MMP-9 was used ELISA-Sandwich. Results demonstrated that the disease group showed significantly high amounts of T. denticola, F. alocis and P. tannerae when compared with health sites. MMP-2 and MMP-9 were detected in high concentrations with statistically significantly reduction after periodontal treatment to MMP-2, but without correlation with EMMPRIN.

Efeitos de drogas antiplaquetárias na doença periodontal

The association between platelets, angiogenesis and progression or repair of periodontal disease has been little explored and, consequently, the results are inconclusive. The pathogenic bacteria present in the periodontal pocket release endotoxins that affect the endothelial integrity and are able to induce the production of chemical mediators derived from plasma proteins and blood clotting while altering platelet function. There is great interest in the modulation of platelet activity in vascular disorders, especially cardiovascular diseases. For this reason, antiplatelet drugs, that are commonly used in the prevention of thromboembolic diseases, such as myocardial infarction, ischemic stroke and peripheral arterial disease, have been used. Aspirin is the only non-steroidal antiinflammatory agent with antiplatelet activity. In the periodontium, instead of only reduces levels of inflammatory cytokines, also significantly affects bleeding on probing, suggesting a dose-dependent modulation of periodontitis. In contrast, clopidogrel and ticlopidine are thienopyridine drugs with no known antiinflammatory action, suggesting that this benefit is related to an antiinflammatory effect indirectly correlated to their antiplatelet activity already established. In the literature there is limited information about the effect of these drugs on periodontium and periodontal disease development. Antiplatelet drugs hypothetically can change both the pathogenesis of periodontitis and subsequent periodontal tissue repair by blocking the secretion of chemical mediators which in general are important in modulating inflammation and tissue repair.

Patógenos periodontais: comparação entre cultura bacteriana e PCR em tempo real para teste diagnóstico

The correct distinguishment of microorganisms involved in the periodontal disease pathogen, it is important in the understanding of its progression and adequate treatment planning. Considering this fact, some molecular methods of identification and quantification were developed and are extremely sensitive and precise in the characterization of different bacteria species. The present study aimed to realize a literature review, including studies that realized a comparative analysis between bacterial culture and real time PCR methods in the identification of pathogens. The bacterial culture method can possibly identify new microorganisms and realize antibiotics sensitivity tests. The real time PCR is a microbiologic test that identifies and quantifies bacterial species, through gene amplification of predetermined DNA fragments, with high sensitivity and specificity, and need a shorter operation time of the operator when compared to the bacterial culture method. In this way, to determine a specific diagnostic test, should be considered not only its precision in the identification of microorganisms, but the cost-benefit relationship as well.

Aspectos atuais do tratamento da infecção endodôntica

Endodontics is a science that embodies etiology, diagnosis, prevention, and treatment of apical periodontitis and its repercussion in the organism. Technological resources in diagnosis and root canal negotiation, and new strategies , associated to mainly cleaning and eliminating the infection of the root canal system, shaping, and filling the endodontic space, according to biological bases, will allow us to reach higher standards of post-treatment success.

Efeito do fumo sobre os tecidos periodontais: uma revisão de literatura

Smoking is one of the most important risk factors for periodontal disease. Increased destruction of periodontal tissues has been observed in smokers. Studies show changes caused by different cigarette components, morphological, microbiological and immunological alterations which could lead to clinical changes. However, the pathophysiology of smoking on periodontal tissues are not completely understood. Therefore, this article aims to present a review of the literature addressing the changes on the periodontal tissues caused by the main components of the smoke observed in recent studies.

Prevalence of Candida spp. during radiographic examination in Diabetes mellitus patients

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Desenvolvimento, caracterização e ação anti-biofilme oralde sistemas nanoestruturados bioadesivos contendo o peptídeo KSL-W

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Condições de saúde bucal de crianças e adolescentes portadores de síndrome de Down

Patients with Down syndrome have shown different conditions of oral health, and there is a low occurrence of dental caries and a higher susceptibility to periodontal diseases. Thus, this study aimed to evaluate the prevalence of dental caries and periodontal diseases in subjects with Down syndrome. The population was composed of 40 patients with the syndrome, aged 6 to 18 years, of both genders, and an equal number of non-syndromic patients. The periodontal conditions were evaluated by mean of the criteria of PSR and dental conditions were registered following indexes dmft and DMFT. It was found that in children with Down syndrome, the dmft index was 1.17 and DMFT 3.53 while the control group was verified dmft 1.97 and DMFT 2.77. The results of PSR evidenced that 32.5% of children with Down syndrome were periodontally healthy, 65% were gingivitis patients and 2.5% were periodontitis patients, while in the control group, 50% healthy and 50% were gingivitis patients. The results evidenced similar populations of cariogenic cocci between patients with Down syndrome and non-syndromic subjects. It was concluded that the incidence of caries in children with Down syndrome was higher in permanent teeth compared with the control group, while in the occurrence of deciduous teeth caries was slightly higher in the control group, so when children with Down syndrome are subjected to periodic examinations, they present themselves periodontally healthy.

Procedimentos básicos em periodontia: método lógico para estabilizar a doença periodontal avançada

To treat periodontal disease is essential to establish a control in all etiological factors that cause destructive activity in periodontal tissues. Basic periodontal therapy may be applied to eliminate or/and to control all etiologic factors involved in disease development. In this paper, some aspects to stabilize advanced periodontal disease using basic periodontal therapy are analyzed and discussed.

Doença periodontal, diabete mellitus e hipertensão em gestantes usuárias do Sistema Único de Saúde (SUS)

Purpose: To evaluate the association among periodontal disease, diabetes mellitus and arterial hypertension in pregnant women users of the Brazilian Health System (SUS). Methods: The sample consisted of 86 women, with pregnant age between the 4th and 7 th month, submitted to pre-natal attendance in Health Basic Unities (HBUs). Periodontal condition was evaluated by 2 calibrated researchers (Kappa = 0.91) through the Community Periodontal Index (CPI). A sphygmomanometer was used to check the arterial pressure, what was accomplished by the professionals from the HBUs; glycemia test was accomplished through a blood sample collected from the middle finger with a disposable lancet adapted to a lance device (Accu-Chek Softclix Pro; Roche, USA), and for checking the glycemia level, a glycemia monitor was used (Accu-Chek Advantage II, Roche, USA). Data were written on a numbered register form, avoiding patient identification. After, the same data were statistically analyzed through the Fisher Exact Test, in order to evaluate the existence of association between the variables blood glucose and periodontal disease. In this test, a significance level of 0,05 was adopted. Results – Most of the pregnant woman presented periodontal health (58,1%); 41,9% of the research subjects showed at least one sign of periodontal disease, with 31,4% presenting gingivitis and 10,5% periodontitis. Hyperglycemia was detected in 51,2% and it was not found a value of arterial pressure higher than what is considered to be normal. Conclusion: it was not verified a significant association among the presence of periodontal disease, glycemia alteration and arterial hypertension in pregnant women who comprised this research.

Influência da menopausa no tratamento endodôntico

A menopausa é uma das mudanças fisiológicas caracterizadas pelo encerramento dos ciclos menstrual e ovulatório, ocorrendo nas mulheres entre a quarta e a quinta década de vida. Com ela, ocorre uma diminuição na produção de estrógeno, um importante hormônio que atua em muitos processos fisiológicos do indivíduo, como a regulação do sistema esquelético. O declínio nos níveis de estrógeno resulta em perda de densidade mineral óssea, aumento do risco de fratura, bem como no aparecimento de doenças ósseas, como a osteoporose, um processo patológico onde há o aumento na reabsorção de cavidades que não são completamente preenchidas por osso neoformado. Além disso, a deficiência de estrógeno pode causar muitas mudanças na saúde bucal do indivíduo. Na presença de uma infecção bacteriana no tecido pulpar, essa deficiência pode agravar a periodontite apical. Vários medicamentos têm sido estudados como potenciais agentes terapêuticos para suprir a deficiência de estrógeno. Essas drogas têm como objetivo reduzir o risco de fraturas e prevenir a perda óssea e distúrbios cardiovasculares e mentais resultantes de deficiência hormonal pós-menopausa. O raloxifeno (RLX), é uma das drogas terapêuticas mais estudadas, demonstrando prevenir a perda óssea. Mesmo com a indicação e benefícios do raloxifeno no metabolismo ósseo e na manutenção da densidade óssea, estudos sobre o seu papel na infecção endodôntica em organismos osteopênicos precisam ser realizados.

Antimicrobial activity of plants infusions on oral fusobacteria and their adherence to human erythrocytes

Periodontal disease is the result of the interrelationship between microbiotic aggression and the host’s organic defence. Amongst the microorganisms involved in periodontopathies, Fusobacterium nucleatum is conspicuous by establishing a link between the initial and final colonizers, besides producing toxic compounds and adhering to the host’s cells. Control of bacterial biofilm can be achieved by use of chemical agents, many of which extracted from plants. Thus the object of this study was to evaluate the inhibitory activity in vitro of some teas, generally taken in a normal diet, on Fusobacterium nucleatum and your adherence to host’s cells. Minimum inhibitory and bactericidal concentrations were established and haemagglutinative test in microplaques was effected. It was ascertained that all plant extracts have inhibitory activity and that infusions of Camellia sinensis (black tea and green tea), Mentha piperita (mint) and Pimpinella anixem (aniseed) added to the bacteria/erythrocyte compound reduced significantly the adherence of microorganisms.

Condições bucais de crianças e adolescentes portadores de síndrome de down

Os pacientes com síndrome de Down têm mostrado diferentes condições de saúde bucal, destacando-se uma baixa ocorrência de cárie e maior suscetibilidade às doenças periodontais. Assim, o presente estudo objetivou avaliar a prevalência de cárie, patologias periodontais e níveis de cocos cariogênicos em portadores de Síndrome de Down. A população foi constituída de 40 pacientes portadores da síndrome, com idade de 6 a 18 anos, de ambos os gêneros, e igual número de pacientes do grupo controle, os quais foram submetidos ao exame clínico periodontal segundo os critérios do PSR e para determinação do índice de cárie empregando-se os índices ceo-d e CPOD, e avaliação dos níveis de cocos cariogênicos através do real-time PCR. Verificou-se que nas crianças com síndrome de Down o índice médio ceo-d foi 1,17 e o CPO-D 3,53 enquanto que no grupo controle foi observado ceo-d 1,97 e o CPO-D 2,77. Verificou-se que 32,5% das crianças com síndrome de Down eram saudáveis, 65% com gengivite e 2,5% com periodontite e, no grupo controle, 50% foram saudáveis e 50% mostraram gengivite. Os resultados evidenciaram que a população de cocos cariogênicos foi similar entre pacientes portadores ou não de síndrome de Down. Concluiu-se que a ocorrência de cárie em crianças com síndrome de Down foi maior nos dentes permanentes comparadas com o grupo controle, enquanto que na dentição decídua a ocorrência de cárie foi maior no grupo controle, enquanto que as condições periodontais foram semelhantes entre os dois grupos.

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.