Staphylococcus spp. Na cavidade bucal e na bolsa periodontal de indivíduos com periodontite crônica: presença e sensibilidade aos antibióticos

Staphylococcus are not usually studied in the oral cavity, when this happens, they are considered to belong to transitory microflora. Individuals that present periodontal disease represent possibles reservoirs of these opportunist bacteria in the oral cavity. The use of antibiotics whether for treatment of periodontal disease or due to hospital infections, may predispose the increase of the Staphylococcus spp. in the oral cavity because they easily become resistant to antibiotics, resulting in superinfection. The study was made with 88 patients, minimum age- 25 years old, presenting chronical periodontitis, with, at least, two sites having a probing pocket bigger or equal to 5mm. After anamnese and clinical periodontal examination samples were taken from the periodontal pocket using paper cones and from the oral cavity using mouth rinse. Of the total patients 37,50% presented Staphylococcus spp. in the periodontal pocket and 61,36% in lhe oral cavity; 27,27% presented bacteria in the two sites, not necessarily of the same specie. S. epidermidis was the most prevailing specie in periodontal pocket (15,9%) and oral cavity (27,27%). Positive for S. aureus in the periodontal pocket were 4,5% and for the oral cavity 25%, and 3,4% were positive for the two sites. There was not found significative statistical difference referring to the presence of the microorganisms as to age, smoking habit and increase of the probing depth. The majority of the isolated Staphylococcus samples showed resistance to the tested antibiotics, indicating that the drugs as an adjunct to periodontal therapy, must be seen with caution

Microbiota bucal de pacientes HIV positivos: relação com o uso de drogas antirretrovirais e condições de saúde

Pós-graduação em Odontologia - FOA

Desenvolvimento da microbiota oral de bebês: análise longitudinal por pirosequenciamento da microbiota de bebês e suas mães dentro de um Programa de Saúde Bucal para Primeira Infância

Pós-graduação em Biopatologia Bucal - ICT

The effect of conventional mechanical periodontal treatment on red complex microorganisms and clinical parameters in Down syndrome periodontitis patients: a pilot study

Periodontal disease (PD) is induced by a complex microbiota, such as Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola (together called the red complex), which triggers intense inflammatory reaction. Down syndrome (DS) individuals demonstrate a high prevalence of PD compared with those who are otherwise chromosomally normal (euploids). This pilot study aimed to evaluate the effect of non-surgical periodontal treatment in DS chronic periodontitis patients on clinical and microbiological parameters. Patients with chronic periodontitis, 23 DS and 12 euploids (control group), were submitted to non-surgical mechanical periodontal treatment, followed by maintenance for 45 days. Clinical parameters after periodontal treatment were similar in diseased and healthy sites, independent of the genetic background. Diseased sites of DS and control patients harbored similar levels of P. gingivalis and T. forsythia at baseline, but significantly higher levels of T. denticola were found in DS patients. Increased levels of P. gingivalis at healthy sites were found in DS individuals. Non-surgical periodontal therapy decreased the levels of red complex microorganisms and improved the tested clinical parameters of diseased sites in both groups. However, the levels of red complex bacteria were higher in diseased sites of DS patients after the periodontal treatment. We conclude in this pilot study that, although the mechanical periodontal treatment seemed to be effective in DS subjects over a short-term period, the red complex bacteria levels did not decrease significantly in diseased sites, as occurred in controls. Therefore, for DS patients, it seems that the conventional non-surgical periodontal therapy should be improved by utilizing adjuvants to reduce the presence of periodontopathogens.

Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Occurrence of periodontal pathogens in ethnic groups from a native Brazilian reservation

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microbiota bucal e sua relação com infecções oportunistas em pacientes edêntulos mantidos em unidades de terapia intensiva

Pós-graduação em Odontologia - FOA

Inflamassomos NLRC4 E NLRP3 na Doença Periodontal Experimental Induzida por Aggregatibacter Actinomycetemcomitans

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Inflamassomos NLRC4 E NLRP3 na Doença Periodontal Experimental Induzida por Aggregatibacter Actinomycetemcomitans

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Periodontal Manifestations and Ambulatorial Management in a Patient With Sturge Weber Syndrome

Sturge-Weber syndrome is a nonhereditary congenital condition characterized by leptomeningeal and facial skin angiomatous malformation following the trigeminal nerve path. The intraoral angiomatosis are presented in 40% of cases and results in an important periodontal alteration, increasing the risk of bleeding during dental procedures. A 43-year-old male patient presented with port wine stain on the right side of the face, the entire hard and soft palates, the alveolar ridge, and buccal mucosa, and had an excessive accumulation of calcified masses in both supragingival and subgingival sites, with swelling and generalized inflammation throughout the gingiva and alveolar mucosa. He reported not having sanitized the area for years for fear of bleeding. Periodontal management, to remove calculus and to control gingivitis initiated in the supragingival region and gradually reaching the subgingival region to control oral microbiota, was performed with mild bleeding. The redness of the staining greatly diminished with time and the extreme halitosis of the patient also improved sharply leading to a dramatic improvement in quality of life. Ambulatory care is a feasible alternative for periodontal management that within safety limits for bleeding risks reduces the operational cost.

Phenotypic and genotypic features of Aggregatibacter actinomycetemcomitans isolated from patients with periodontal disease

Aggregatibacter actinomycetemcomitans is strongly implicated in the pathogenesis of periodontitis. In this study, the phenotypic and genotypic features of A. actinomycetemcomitans and the presence of genes involved in toxicity were determined. Sixty-five patients with periodontal pocket and 48 healthy subjects were evaluated. Biotyping, adherence and invasion, neuraminidase and biofilm production, presence of capsule and fimbria, as well as the presence of flp-1, apaH, ltx, and cdt genes were determined. Biotype II was the most prevalent. Sixty-six strains were adherent and 33 of them were able to invade KB cells. Sixty strains produced neuraminidase, and 55 strains biofilms. Strains showed capsule but not fimbriae. Forty-six strains were cytotoxic, and most strains harbored the apaH and flp-1 genes. LTX promoter and the ltxA gene were observed in all strains from periodontal patients. The cdtA gene was observed in 50 (71.4%) strains, cdtB in 48 (68.6%) strains, cdtC in 60 (85.7%), and cdtABC in 40 (57.1%) strains. The presence of A. actinomycetemcomitans harboring the cdtC gene from healthy subjects may represent a transitory microorganism in the oral microbiota. More studies are necessary to understand the real role of this microorganism in the pathogenesis of periodontal disease

Quantitative detection of Staphylococcus aureus, Enterococcus faecalis and Pseudomonas aeruginosa in human oral epithelial cells from subjects with periodontitis and periodontal health

Epithelial cells in oral cavities can be considered reservoirs for a variety of bacterial species. A polymicrobial intracellular flora associated with periodontal disease has been demonstrated in buccal cells. Important aetiological agents of systemic and nosocomial infections have been detected in the microbiota of subgingival biofilm, especially in individuals with periodontal disease. However, non-oral pathogens internalized in oral epithelial cells and their relationship with periodontal status are poorly understood. The purpose of this study was to detect opportunistic species within buccal and gingival crevice epithelial cells collected from subjects with periodontitis or individuals with good periodontal health, and to associate their prevalence with periodontal clinical status. Quantitative detection of total bacteria and Staphylococcus aureus, Pseudomonas aeruginosa and Enterococcus faecalis in oral epithelial cells was determined by quantitative real-time PCR using universal and species-specific primer sets. Intracellular bacteria were visualized by confocal microscopy and fluorescence in situ hybridization. Overall, 33 % of cell samples from patients with periodontitis contained at least one opportunistic species, compared with 15 % of samples from healthy individuals. E. faecalis was the most prevalent species found in oral epithelial cells (detected in 20.6 % of patients with periodontitis, P = 0.03 versus healthy individuals) and was detected only in cells from patients with periodontitis. Quantitative real-time PCR showed that high levels of P. aeruginosa and S. aureus were present in both the periodontitis and healthy groups. However, the proportion of these species was significantly higher in epithelial cells of subjects with periodontitis compared with healthy individuals (P = 0.016 for P. aeruginosa and P = 0.047 for S. aureus). Although E. faecalis and P. aeruginosa were detected in 57 % and 50 % of patients, respectively, with probing depth and clinical attachment level ≥6 mm, no correlation was found with age, sex, bleeding on probing or the presence of supragingival biofilm. The prevalence of these pathogens in epithelial cells is correlated with the state of periodontal disease.

Caratterizzazione microbiologica ed epidemiologica del microbiota del cavo orale mediante metodiche colturali e molecolari

La ricerca si è focalizzata su due degli aspetti di interesse odontoiatrico più diffusi: la carie dentaria e la parodontite cronica. Il problema della carie dentaria è stato studiato in una popolazione di 39 soggetti affetti da cardiopatia congenita in cui la scarsa igiene orale è fattore di rischio per problematiche di salute generale e soprattutto per lo sviluppo di endocardite infettiva. I dati osservati e confrontati con quelli di un omogeneo gruppo di controllo dimostrano che nella dentatura decidua questi bambini hanno più denti cariati, come dimostrato dalla significativa differenza dell'indice dmft. Nella dentatura permanente non si osservano differenze tra i due gruppi. La carica microbica totale rilevata nella saliva e la presenza di Streptococcus mutans non mostrano differenze tra i due gruppi. I problemi di parodontite cronica sono stati studiati in un gruppo di 352 soggetti italiani adulti in cui si è definita la prevalenza dei 6 più importanti patogeni parodontali e la possibile correlazione con parametri clinici (pus, sanguinamento al sondaggio - BOP, profondità di sondaggio della tasca parodontale – PPD). Tra le 6 specie batteriche ricercate, quello di più frequente riscontro è stato Fusobacterium nucleatum (95%), mentre quello con carica batterica più alta è stato Tannerella forsythia. La carica batterica di Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia e Fusobacterium nucleatum ha mostrato una correlazione diretta con il BOP e la presenza di pus. Inoltre, si è riscontrato che la carica batterica di tutte le specie (tranne Aggregatibacterium actinomycetemcomitans) aumenta all'aumentare del PPD. Tra le variabili studiate, PPD rappresenta il più importante fattore di rischio per la presenza di parodontopatogeni, mentre BOP è un indicatore di rischio per la ricerca del complesso rosso.

Short-term effects of systemic antibiotics during periodontal healing

OBJECTIVES: To investigate the short-term effects of nonsurgical therapy (scaling and root planing, SRP) on the subgingival microbiota in chronic (CP) and aggressive (AP) periodontal disease. METHOD AND MATERIALS: Ninety-seven CP and AP subjects underwent full-mouth SRP on 2 consecutive days. AP patients were randomly assigned to either receive systemic metronidazole plus amoxicillin (AP+AB) or were treated mechanically alone (AP). Pathogens were identified with 16S rRNA oligodeoxynucleotide probes and dot-blot hybridization before and at days 2, 3, 4, 7, 10, and 21 of healing. CP subjects were treated by scaling and root planing along with placebo tablets. RESULTS: Initially, AP cell counts were 69.9- (Porphyromonas gingivalis), 10.2- (Aggregatibacter actinomycetemcomitans), 5.7- (Tannerella forsythia), and 3.3-fold (Prevotella intermedia) enhanced compared to CP cell counts. Following SRP, immediate elimination occurred in single individuals of all three treatment groups at day 2. After SRP plus antibiotic therapy (AP+AB), the prevalence scores dropped beyond the levels of AP and CP, beginning at day 7, and remained low until day 21 (P =or< .05). Clinical healing statistically benefited from SRP with no differences among the three treatment groups. CONCLUSION: Nonsurgical therapy resulted in both a suppression and early elimination of single taxa immediately after completion of active treatment. Systemic antibiotics significantly accelerate the suppression of the periodontal microflora, but have limited effect on the elimination of target isolates during healing.

Oral microbiota in Swiss adolescents

OBJECTIVES: The purpose of the study was to determine the prevalence of different oral microbes in gingival plaque samples and in samples from the dorsum of the tongue in a Swiss adolescent population. MATERIALS AND METHODS: Ninety-nine adolescents between 15 and 18 years were enrolled. Plaque index, bleeding on probing (BOP), the periodontal screening index, and decayed missed filled tooth (DMFT) index were recorded. Samples from subgingival plaque and swabs from the tongue were analyzed by the Checkerboard DNA-DNA hybridization method. Additionally, counts of Streptococus mutans and Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were determined by real-time PCR. RESULTS: Periodontitis was not diagnosed in any of the subjects but all of them presented signs of gingival inflammation displaying a mean BOP of 28%. Ten (10.1%) subjects were tested positive for P. gingivalis, each 22 (22.2%) for A. actinomycetemcomitans and T. forsythia, (47.5%) for T. denticola. T. denticola and S. mutans showed a high affinity to the gingival plaque, whereas T. forsythia was often detected from the dorsum of the tongue. DMFT was associated with S. mutans counts, and BOP correlated with counts of P. gingivalis and T. denticola. CONCLUSIONS: The present data indicate that: (a) gingivitis but not periodontitis is a common finding among Swiss adolescents, and (b) bacteria associated with periodontitis were frequently detected in the subgingival dental plaque and on the dorsum of the tongue in Swiss adolescents with gingivitis. CLINICAL RELEVANCE: Although gingivitis was a frequent finding in Swiss adolescents, periodontitis was not detected in this population. The dorsum of the tongue appears to represent an important reservoir for periodontopathic bacteria.