Synergistic antimicrobial potential of EGCG and fosfomycin against biofilms associated with endodontic infections

Abstract Objective This study aimed to evaluate the cytotoxicity and synergistic effect of epigallocatechin gallate (EGCG) and fosfomycin (FOSFO) on biofilms of oral bacteria associated with endodontic infections. Methodology This study determined minimum inhibitory and bactericidal concentration (MIC/MBC) and fractionated inhibitory concentration (FIC) of EGCG and FOSFO against Enterococcus faecalis, Actinomyces israelii, Streptococcus mutans, and Fusobacterium nucleatum. Monospecies and multispecies biofilms with those bacteria formed in polystyrene microplates and in radicular dentin blocks of bovine teeth were treated with the compounds and control chlorhexidine (CHX) and evaluated by bacterial counts and microscopy analysis. Toxicity effect of the compounds was determined on fibroblasts culture by methyl tetrazolium assays. Results The combination of EGCG + FOSFO demonstrated synergism against all bacterial species, with an FIC index ranging from 0.35 to 0.5. At the MIC/FIC concentrations, EGCG, FOSFO, and EGCG+FOSFO were not toxic to fibroblasts. EGCG+FOSFO significantly reduced monospecies biofilms of E. faecalis and A. israelli, whereas S. mutans and F. nucleatum biofilms were eliminated by all compounds. Scanning electron microscopy of multispecies biofilms treated with EGCG, EGCG+FOSFO, and CHX at 100x MIC showed evident biofilm disorganization and substantial reduction of extracellular matrix. Confocal microscopy observed a significant reduction of multispecies biofilms formed in dentin tubules with 84.85%, 78.49%, and 50.6% of dead cells for EGCG+FOSFO, EGCG, and CHX at 100x MIC, respectively. Conclusion EGCG and fosfomycin showed a synergistic effect against biofilms of oral pathogens related to root canal infections without causing cytotoxicity.

Oral Condition of Adolescents who Participated in an Oral Health Program During the First Decade of Life

ABSTRACT Objective: To evaluate the oral health of adolescents who participated in an oral health preventive program during the first decade of life. Material and Methods: For the evaluation of dental caries and gingival condition, DMFT and Community Periodontal Index were used, both recommended by the World Health Organization. To verify the occurrence of dental fluorosis, the Dean index was used. Results: Data collection was obtained from 252 patients aged 12 to 16 years. The average DMFT index was 1.14; in relation to the gingival condition, the index of healthy gingival tissue prevailed and the average of this value was 84%, with code 0 being more registered in tooth 11, code 1, more frequently in teeth 16/17 and 36/37 and for last, code 2, in tooth 31 most frequently. Dean's index showed a percentage of 89% of patients without clinical signs of dental fluorosis. Conclusion: Adolescents participating in an oral health preventive program in the first decade of life exhibited very satisfactory results regarding the prevention of caries disease, healthy periodontal condition and reduced prevalence of dental fluorosis.

Impact of parental care on oral health of children with Intellectual Disabilities from zero to six years of age / Impacto dos cuidados parentais na saúde bucal de crianças com Deficiência Intelectual de zero a seis anos de idade

Introduction: the birth of a child with an intellectual disability requires the definition of the parents' roles in relation to the care of the child. Objective: evaluate how much parental care practices, sociodemographic and behavioral characteristics and family knowledge can have an impact on the oral health of children with intellectual disabilities in the age group from zero to six years of age. Material and method: the level of help given to the child in the practice of oral hygiene was evaluated according to the adapted functional independence scale. The Parental Beliefs and Care Practices Scale assessed primary care and stimulation offered to the child. The presence of dental plaque and the decay-missing-filled teeth (DMFT) index were analyzed. The significance level was 5%. Result: the relative percentage of dental plaque was 11.4%. The DMFT was 2. The prevalence of teeth with indicated extraction is higher in children who receive full assistance for cleaning, when compared to those who receive maximum, moderate help or supervision. Higher levels of dental plaque and decayed teeth were found in children whose parents rated their dental health as poor, hygiene as deficient, and when they believed their children might feel discomfort due to their oral health. Low stimulation frequency resulted in a higher plaque index and number of decayed teeth. Conclusion: the frequency of parental care stimulation influenced the percentage of plaque index and the number of decayed teeth in children with intellectual disabilities.

Introdução: o nascimento de uma criança com deficiência intelectual exige dos pais a definição de suas funções em relação aos cuidados com a criança. Objetivo: investigar o quanto as práticas de cuidados parentais, características sociodemográficas, comportamentais e o conhecimento familiar podem ter impacto na saúde bucal de crianças com deficiência intelectual na faixa etária de zero a seis anos de idade. Material e método: foi avaliado o nível de ajuda cedida à criança na prática de higiene bucal de acordo com a escala de independência funcional adaptada. A Escala de Crenças Parentais e Práticas de Cuidado avaliou os cuidados primários e a estimulação oferecida à criança. Foram analisados a presença de placa dentária e o índice ceo-d. O nível de significância foi de 5%. Resultado: a porcentagem relativa de placa dentária foi de 11,4%. O índice ceo-d foi de 2. A prevalência de dentes com extração indicada é maior em crianças que recebem ajuda total para higienização, quando comparadas as que recebem ajuda máxima, moderada ou supervisão. Níveis mais elevados de placa dentária e dentes cariados foram encontrados nas crianças cujos pais avaliaram a saúde dental como ruim, a higiene como deficiente e quando acreditavam que os filhos podem sentir desconforto em razão de seu estado de saúde bucal. Baixa frequência de estimulação resultou em maior índice de placa e número de dentes cariados. Conclusão: a frequência de estimulação dos cuidados parentais influenciou na porcentagem do índice de placa e no número de dentes cariados nas crianças com deficiência intelectual.

Effect of S. mutans combinations with bifidobacteria/lactobacilli on biofilm and enamel demineralization

Abstract The present study evaluated the ability of Bifidobacterium and Lactobacillus species associated with streptococci to increase insoluble extracellular polysaccharide (EPS) production and initial caries lesion progression. Bovine enamel blocks (n = 190; 4 mm x 4 mm) were prepared, selected according to initial surface hardness (SH), and divided into two groups: a) double combinations: S. mutans with Bifidobacterium or Lactobacillus, and b) triple combinations: S. mutans and S. sobrinus with Bifidobacterium or Lactobacillus species. The blocks were exposed to the bacterial associations for 7 days. Subsequently, quantity of EPS from biofilms and caries lesion depth were determined by means of colorimetric and cross-sectional enamel hardness (ΔKHN) analysis. The data were submitted to one-way analysis of variance, followed by the Bonferroni test (p < 0.05). S. mutans with B. animalis or B. dentium produced a higher quantity of EPS; S. mutans + B. animalis led to the highest ∆KHN. S. mutans + S. sobrinus + B. longum induced greater EPS and ∆KHN values. In conclusion, associations of B. animalis and B. longum with streptococci promoted EPS production and caries lesion progression.

Reabilitação estética e funcional em paciente com cárie na primeira infância: relato de caso / Aesthetic and functional rehabilitation in a patient with caries in early childhood: case report

Introdução: Cárie na Primeira Infância (CPI) é o termo utilizado para descrever a cárie dentária em crianças menores de 6 anos de idade. Objetivo: Relatar o tratamento reabilitador estético e funcional de uma criança com CPI. Relato do caso: Paciente do sexo masculino, 5 anos de idade, compareceu à clínica de Odontopediatria da Faculdade de Odontologia de Araçatuba (FOA/UNESP), acompanhado pela mãe, que relatou como queixa principal dor e presença de cárie. Ao exame clínico intrabucal, constatou-se na arcada superior lesões de cárie em todos os dentes, exceto nos dentes 55, já restaurado, e dente 65, hígido. Na arcada inferior, lesões de cárie foram observadas nos dentes 74 e 84. Após diagnóstico clínico e radiográfico, optou-se por realizar a confecção de coroa de aço para os dentes 74 e 84, exodontia dos dentes 51, 52, 61 e 64, instalação de aparelho mantenedor de espaço funcional removível e restaurações dos demais dentes afetados com compósito resinoso. Conclusão: Foi possível recuperar as funções estéticas, fonéticas e mastigatórias do paciente, colaborando para a melhora da autoestima da criança, o que gerou satisfação dos familiares. A educação em saúde bucal realizada com a criança e os responsáveis foi essencial para o sucesso do tratamento e a manutenção da saúde bucal.

Introduction: Early Childhood Caries (ECC) is the term used to describe dental caries in children under 6 years of age. Objective: Report the aesthetic and functional rehabilitation treatment of a child with ECC. Case report: A 5-year-old male patient was attended at the to the Pediatric Dentistry Clinic of the Araçatuba Dental School (FOA/UNESP), accompanied by his mother, who reported pain and dental caries as the main complaint. On intraoral clinical examination, caries lesions were found in all upper teeth, except for tooth 55, already restored, and tooth 65, healthy. In the lower arch, caries lesions were observed in teeth 74 and 84. After clinical and radiographic diagnosis, it was decided for the manufacture of steel crown for teeth 74 and 84, extraction of teeth 51, 52, 61 and 64, installation of removable functional space maintenance device and restorations of the other affected teeth with composite resin. Conclusion: In view of the treatment performed, it was possible to recover the aesthetic, phonetic and masticatory functions, contributing to the improvement of the child's self-esteem as well assatisfaction of family members. Oral health education carried out with the child and his parents was essential for the success of the treatment and the maintenance of oral health.

Inhibitory activity of Varronia curassavica and Mikania laevigatafractions against pathogens associated with persistent dental infections

Herbal medicines have been studied as potential antimicrobial agents, emerging as treatments against oral diseases. The current study evaluated the antimicrobial activity of the crude extract and fractions of Mikania laevigata SchultzBip. ex Baker (ML) and Varronia curassavicaJacq (VC) against oral pathogens associated with persistent dental root infections, under planktonic and biofilm conditions. Minimal inhibitory concentrations and minimal bactericidal/fungicidal concentrations were determined for the ML and VC fractions/extracts against Enterococcus faecalis, Actinomyces israelii, Pseudomonas aeruginosa, and Candida albicans using the microdilution method. The best results were chosen for subsequent biofilm assays. All tested ML and VC extracts/fractions demonstrated inhibitory activity against E. faecalis and A. israelii. The ML ethyl acetate fraction affected the growth of all microorganisms tested. C. albicans and P. aeruginosawere not affected by any VC extract/fractions. The ML ethyl acetate fraction eliminated E. faecalis, A.israelii, and P. aeruginosa biofilms after 24h. A similar result was observed for ML crude hydroethanolic extract and its hexane fraction for A. israelii. The VC hexane fraction was able to eliminate A. israelli biofilms. None of the tested extracts or fractions eliminated C. albicans biofilm. The Mikania laevigata ethyl acetate fraction is an efficient antimicrobial agent against oral pathogens and could be indicated for the treatment of persistent dental infections.

Frequency of Porphyromonas gingivalis fimA in smokers and nonsmokers after periodontal therapy

Abstract Porphyromonas gingivalis is one of the most important Gram-negative anaerobe bacteria involved in the pathogenesis of periodontitis. P. gingivalis has an arsenal of specialized virulence factors that contribute to its pathogenicity. Among them, fimbriae play a role in the initial attachment and organization of biofilms. Different genotypes of fimA have been related to length of fimbriae and pathogenicity of the bacterium. Objectives The aim of this study was to identify 5 types of fimA genotype strains in smokers and nonsmokers with periodontitis, before and after periodontal therapy. Material and Methods Thirty-one patients with periodontitis harboring P. gingivalis were selected: 16 nonsmokers (NS) and 15 smokers (SM). Clinical and microbiological parameters were evaluated at baseline and 3 months after periodontal treatment, namely: plaque index, bleeding on probe, probing depth, gingival recession and clinical attachment level. The frequency of P. gingivalis and fimA genotype strains were determined by polymerase chain reaction. Results Type I fimA was detected in the majority of SM and NS at baseline, and the frequency did not diminish after 3 months of treatment. The frequency of type II genotype was higher in SM than NS at baseline. After 3 months, statistical reduction was observed only for types II and V fimA genotypes in SM. The highest association was found between types I and II at baseline for NS (37.5%) and SM (53.3%). Conclusion The most prevalent P. gingivalis fimA genotypes detected in periodontal and smoker patients were genotypes I and II. However, the presence of fimA genotype II was higher in SM. Periodontal treatment was effective in controlling periodontal disease and reducing type II and V P. gingivalis fimA.

Doxycycline-containing glass ionomer cement for arresting residual caries: an in vitro study and a pilot trial

Abstract In a previous study, we demonstrated that the incorporation of doxycycline hyclate (DOX) into resin-modified glass ionomer cement (RMGIC) inhibited important cariogenic microorganisms, without modifying its biological and mechanical characteristics. In this study, we keep focused on the effect of that experimental material as a potential therapy for arresting residual caries by analyzing other in vitro properties and conducting a pilot clinical trial assessing the in vivo effect of DOX-containing RMGIC on residual mutans streptococci after partial carious removal in primary molars. Specimens of the groups RMGIC (control); RMGIC + 1.5% DOX; RMGIC + 3% DOX; and RMGIC + 4.5% DOX were made to evaluate the effect of DOX incorporation on surface microhardness and fluoride release of RMGIC and against biofilm of Streptococcus mutans. Clinical intervention consisted of partial caries removal comparing RMGIC and RMGIC + 4.5% DOX as lining materials. After 3 months, clinical and microbiologic evaluations were performed. Data were submitted to ANOVA/Tukey or Wilcoxon/Mann-Whitney set as α=0.05. Fluoride release and surface microhardness was not influenced by the incorporation of DOX (p>0.05). There was a significant reduction of S. mutans biofilm over the material surface with the increase of DOX concentration. After clinical trial, the remaining dentin was hard and dry. Additionally, mutans streptococci were completely eliminated after 3 months of treatment with RMGIC + 4.5% DOX. The incorporation of DOX provided better antibiofilm effect, without jeopardizing fluoride release and surface microhardness of RMGIC. This combination also improved the in vivo shortterm microbiological effect of RMGIC after partial caries removal.

Effect of storage time and chlorhexidine addition on the mechanical properties of glass ionomer cements

Aims: To evaluate the effect of the chlorhexidine (CHX) incorporation and the storage time on the mechanical properties of glass ionomer cements (GICs). Methods: The following GICs were evaluated: Ketac Molar Easymix (KM), Vidrion R (VR) and Vitromolar (VM), containing or not CHX. GIC liquid was modified by adding 1.25 % CHX digluconate and then manipulated with the power and placed into the stainless steel cylindrical or bar-shaped molds. GICs specimens were stored into water for 1, 7 and 28 days. After these periods, specimens were submitted to flexural, diametral tensile and compressive strength tests, according to ISO standards. Data from mechanical tests were statistically analyzed using 2-way ANOVA and Tukey tests. Results: Overall, the storage time did not influence any of the mechanical properties of the GICs tested. In contrast, the inclusion of CHX reduced significantly these properties for all GICs tested. KM presented the highest values of compressive strength for all storage times. KM + 1.25% CHX had lower compressive strength results than KM, however, it showed similar results when compared to another GICs without CHX. Conclusions: The presence of chlorhexidine, independent of the storage time, interfered on the mechanical characteristics of GIC (AU)

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment

Abstract Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Results: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. Conclusions: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

Antimicrobial Activity and Biocompatibility of the Psidium cattleianum Extracts for Endodontic Purposes

Abstract Psidium cattleianum (PC) has been displaying inhibitory effect against a variety of microorganisms, but this effect has not yet been tested against endodontic pathogens. The aim of this study was to evaluate the antimicrobial activity and biocompatibility of the aqueous (PCAE) and hydroethanolic (PCHE) extracts from Psidium cattleianum (PC) leaves. Minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) were determined using the microdilution broth method in order to analyze the antimicrobial effect against Enterococcus faecalis, Pseudomonas aeruginosa, Actinomyces israelii and Candida albicans in planktonic conditions. Biofilm assays were conducted only with the extracts that were able to determine the MLC for microorganisms in planktonic conditions. Immediate and late tissue reactions against PC extracts were evaluated using edemogenic test and histological analysis of subcutaneous implants in Wistar rats. The results showed that the MIC and MLC values ranged between 0.25 and 4 mg/mL. The MLC obtained for PCHE inhibited 100% growth of all the tested strains, except for C. albicans. PCAE had the same effect for E. faecalis and P. aeruginosa. Both PC extracts were able to eliminate E. faecalis biofilms and only the PCHE eliminated P. aeruginosa biofilms. The positive controls inhibited the growth of all tested strains in MIC and MLC essays, but no CHX tested concentrations were able to eliminate A. israelii biofilm. PCAE caused a discrete increase in the edema over time, while PCHE caused a higher initial edema, which decreased progressively. Both PCAE and PCHE extracts were biocompatible, but PCHE showed better results with slight levels of inflammation at 28 days. In conclusion, PCHE was biocompatible and presented better antimicrobial effect against important pathogens associated with persistent endodontic infections

Resumo Psidium cattleianum (PC) tem apresentado atividade inibitória frente diversos microrganismos, entretanto esse efeito ainda não foi testado contra microrganismos de interesse endodôntico. O objetivo desse estudo foi avaliar a atividade antimicrobiana e a biocompatibilidade dos extratos aquoso (EAPC) e hidroetanólico (EHPC) das folhas de Psidium cattleianum. As concentrações inibitória mínima (CIM) e letal mínima (CLM) foram determinadas pelo método de microdiluição em caldo, com o objetivo de analisar o efeito antimicrobiano frente Enterococcus faecalis, Pseudomonas aeruginosa, Actinomyces israelii e Candida albicans em condições planctônicas. Os ensaios de biofilme foram realizados somente com os extratos em que se determinou a CLM frente os microrganismos em condições planctônicas. Respostas teciduais imediata e tardia frente aos extratos de Psidium cattleianum foram avaliadas por teste edemogênico e análise histológica de implantes subcutâneos em ratos Wistar. Os resultados mostraram que CIM e CLM variaram entre 0,25 e 4 mg/mL. As CLMs determinadas pelo EHPC inibiram 100% do crescimento de todas as cepas testadas, exceto Candida albicans. EAPC apresentou o mesmo efeito para E. faecalis e P. aeruginosa. Ambos os extratos de PC conseguiram eliminar o biofilme de E. faecalis, e somente o EHPC eliminou o biofilme de P. aeruginosa. Os controles positivos inibiram o crescimento de todos os microrganismos testados nos ensaios de CIM e CLM, mas nenhuma das concentrações de clorexidina testadas foi capaz de eliminar o biofilme de A. israelii. O EAPC provocou um discreto aumento de edema com o tempo, enquanto EHPC provocou um edema inicial severo, que diminuiu progressivamente. Ambos os extratos EAPC e EHPC foram biocompatíveis, entretanto, EHPC apresentou melhores resultados com baixos níveis de inflamação em 28 dias. Pode-se concluir que EHPC foi biocompatível e apresentou melhor efeito antimicrobiano frente importantes patógenos associados a infecções endodônticas persistentes.

Microbiological, lipid and immunological profiles in children with gingivitis and type 1 diabetes mellitus

Abstract Objective The aim of this study was to compare the prevalence of periodontal pathogens, systemic inflammatory mediators and lipid profiles in type 1 diabetes children (DM) with those observed in children without diabetes (NDM), both with gingivitis. Material and methods Twenty-four DM children and twenty-seven NDM controls were evaluated. The periodontal status, glycemic and lipid profiles were determined for both groups. Subgingival samples of periodontal sites were collected to determine the prevalence of periodontal microorganisms by PCR. Blood samples were collected for IL-1-β, TNF-α and IL-6 analysis using ELISA kits. Results Periodontal conditions of DM and NDM patients were similar, without statistical differences in periodontal indices. When considering patients with gingivitis, all lipid parameters evaluated were highest in the DM group; Capnocytophaga sputigena and Capnocytophaga ochracea were more prevalent in the periodontal sites of DM children. “Red complex” bacteria were detected in few sites of DM and NDM groups. Fusobacterium nucleatum and Campylobacter rectus were frequently found in both groups. Similar levels of IL-1-β, TNF-α and IL-6 were detected in DM and NDM children. Conclusion Clinical and immunological profiles are similar between DM and NDM children. The presence of Capnocytophaga sputigena and Capnocytophaga ochracea were associated with gingivitis in DM children.

Streptococcus Mutans Biofilm Influences on the Antimicrobial Properties of Glass Ionomer Cements

Abstract The aim of this study was to evaluate the in vitro antibacterial and biofilm inhibition properties of glass ionomer restorative cements. Ketac Nano, Vitremer, Ketac Molar Easymix and Fuji IX were analyzed using the following tests: a) agar plate diffusion test to evaluate the inhibitory activity of cements against S. mutans (n=8); b) S. mutans adherence test by counting colony-forming units after 2 h of material/bacteria exposure (n=10); c) biofilm wet weight after seven days of bacterial accumulation on material disks, with growth medium renewed every 48 h (n=10); d) pH and fluoride measurements from the medium aspired at 48 h intervals during the 7-day biofilm development (n=10). Data from the a, b and c tests were submitted to Kruskal-Wallis and Mann-Whitney tests and the fluoride-release and pH data were submitted to two-way ANOVA and Tukey tests (a=5%). Vitremer followed by Ketac Nano showed the greatest inhibitory zone against S. mutans than the conventional ionomers. Vitremer also showed higher pH values than Ketac Nano and Fuji IX in the first 48 h and released higher fluoride amount than Ketac Nano e Ketac Molar Easymix throughout the experimental period. The chemical composition of restorative glass ionomer materials influenced the antibacterial properties. The resin modified glass ionomer (Vitremer) was more effective for inhibition of S. mutans and allowed greater neutralization of the pH in the first 48 h. However, the type of glass ionomer (resin modified or conventional) did not influence the weight and adherence of the biofilm and fluoride release.

Resumo O objetivo neste estudo foi avaliar in vitro as propriedades antibacterianas e a inibição do biofilme de cimentos de ionômero de vidro restauradores. Ketac Nano, Vitremer, Ketac Molar Easymix and Fuji IX foram avaliados através dos seguintes testes: a) teste de difusão em ágar para avaliar a inibição de S. mutans nos cimentos (n=8); b) adesão de S. mutans pela contagem de unidades formadoras de colônia após 2h de exposição material/bactéria (n=10); c) peso do biofilme úmido após sete dias de acúmulo bacteriano nos discos do material, com meio de cultura renovado após 48 h (n=10); d) mensuração do pH e liberação de flúor do meio aspirado nos intervalos de 48 h durante 7 dias de crescimento do biofilme (n=10). Os dados dos testes a, b e c foram submetidos aos testes Kruskal-Wallis e Mann-Whitney e os dados de liberação de flúor e pH a ANOVA dois fatores e Tukey (a = 5%). Vitremer seguido pelo Ketac Nano mostrou maior zona de inibição contra S. mutans quando comparados aos ionômeros convencionais. Vitremer também apresentou valores de pH mais elevados do que Ketac Nano e Fuji IX nas primeiras 48 h e liberou maior quantidade de flúor do que Ketac Nano e Ketac Molar Easymix durante todo o período experimental. A composição química dos ionômeros de vidro restauradores influenciou nas propriedades antibacterianas. O ionômero de vidro modificado por resina (Vitremer) foi mais eficaz na inibição de S. mutans e permitiu maior neutralização do pH nas primeiras 48 h. No entanto, o tipo de ionômero de vidro (modificado por resina ou convencional) não influenciou no peso e adesão do biofilme e na liberação de flúor.

Periodontopathogens, Candida spp. and immunological aspects in type 2 diabetes mellitus patients with chronic periodontitis

This study aimed to evaluate clinical, microbiological and immunological parameters in type 2 diabetes mellitus (DM) in comparison with normoglycemic patients (NDM). Glycemic and lipid profiles and periodontal clinical status were determined for thirty-three patients (17 DM and 16 NDM). The presence of periodontopathogens and species of Candida in subgingival sites were determined by polymerase chain reaction and immunological parameters by ELISA assays. All glycemic and clinical parameters evaluated were higher in the DM group, with statistical difference for fasting glucose, glycated-hemoglobin, and periodontal parameters. Lipid profile (except triglycerides), levels of TNF-α and myeloperoxidase and the prevalence of the tested microorganisms were similar between the groups, except for Candida albicans and Candida glabrata, which was higher in the DM group. In conclusion, although microbiological and immunological parameters were similar in the DM and NDM groups, periodontitis and the levels of some species of Candida were more severe in DM patients. (AU)

Prevalence of periodontopathogens and Candida spp. in smokers after nonsurgical periodontal therapy - a pilot study

Abstract This pilot study aimed to evaluate the influence of smoking on clinical and microbiological parameters after nonsurgical periodontal therapy. Forty-eight subjects were grouped into smokers (SM, n = 24) and nonsmokers (NS, n = 24) and paired according to gender, age, ethnicity, and periodontal status. Both groups received oral hygiene education and scaling and root planing. Clinical evaluation was performed using plaque index (PI), bleeding on probing (BOP), pocket probing depth (PPD), gingival recession (GR), and clinical attachment level (CAL) before instrumentation (baseline) and at 3 and 6 months. The prevalence of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Candida albicans, Candida glabrata, Candida tropicalis, and Candida dubliniensis in subgingival biofilm was determined by polymerase chain reaction. The data were statistically analyzed considering p < 0.05. Clinical conditions improved between baseline and 3 months after periodontal treatment. However, NS had a better clinical response, presenting greater PPD reduction and CAL increase in comparison to SM. Periodontal treatment reduced the levels of P. gingivalis, A. actinomycetemcomitans, and T. forsythia individually after 3 months for the NS group and after 6 months for both groups. The prevalence of Candida species was markedly higher in SM than in NS at all time points evaluated. Periodontopathogens associated or not with C. albicans or C. dubliniensis were more prevalent in SM than in NS at baseline and after 3 months. It was concluded that smoking impairs clinical and microbiological responses to periodontal therapy. Periodontopathogens combined or not with some Candida species are resistant to short-term periodontal therapy in SM.

Atividade antimicrobiana de cimentos endodônticos / Antimicrobial activity of root-canal sealers

A atividade antimicrobiana é uma propriedade fundamental dos cimentos endodônticos devido à permanência de microrganismos residuais no canal radicular, mesmo após o preparo químico-mecânico e o emprego do curativo de demora. O objetivo deste trabalho é realizar uma revisão de literatura a respeito das propriedades antimicrobianas de alguns dos principais cimentos endodônticos. Embora haja controvérsias em relação a essa propriedade, possivelmente devido a diferenças nas metodologias empregadas nos estudos, pode-se concluir que os cimentos com melhor atividade antimicrobiana foram (em ordem crescente): Endofill, Ketac Endo, Sealapex, AH Plus, Endo CPM Sealer, Sealer 26 e Epiphany. Activ GP ainda necessita de pesquisas científicas que avaliem essa propriedade

The antimicrobial activity is a fundamental property of root-canal sealers due to persistence of residual microorganisms in the root canal system, even after the chemo-mechanical preparation and using of intracanal dressing. The aim of this study is to review the literature about the antimicrobial properties of some of the main root-canal sealers. Although there is controversy regarding this property, probably due to differences in the methodologies used in the studies, it was concluded that the sealers with the best antimicrobial activity were (in ascending order): Endofill, Ketac Endo, Sealapex, AH Plus, Endo CPM Sealer, Sealer 26 and Epiphany. Activ GP still needs scientific research to evaluate this property

Métodos de avaliação da resistência à infiltração em obturações endodônticas / Methods for evaluating the resistance to infiltration of root-canal fillings

O adequado selamento do sistema de canais radiculares, obtido através da obturação, evita a infiltração de micro-organismos entre as paredes do canal radicular e o material obturador, reduzindo a possibilidade de insucesso do tratamento endodôntico. O objetivo deste trabalho foi realizar uma revisão de literatura a respeito das diferentes metodologias de avaliação da resistência à infiltração em obturações endodônticas.

The adequate sealing of the root canal system obtained by the obturation prevents microbial infiltration between the root canal walls and filling material, reducing the possibility of failure of the endodontic treatment. The aim of this study was to review the literature about different methods for evaluating infiltration resistance of root-canal obturation.

The role of immune system in the development of periodontal disease: a brief review / O papel do sistema imune no desenvolvimento da doença periodontal: uma breve revisão

Periodontitis is a highly complex and multi-factorial disease. This review summarizes some immunological factors involved in the development and control of this oral disease, such as: the participation of inflammatory cells in local inflammation, the synthesis of chemotaxis proteins with activation of the complement system and a range of antimicrobial peptides, such as defensins, cathelicidin and saposins. The integration of pathogen-associated molecular patterns (PAMPs) from microorganisms with their surface receptors in the immune cells, induces the production of several cytokines and chemokines that presents either a pro- and/or anti-inflammatory role by stimulating the secretion of a great variety of antibody subtypes and the activation of mechanisms of controlling the disease, such as the regulatory T cells. Although several studies have tried to clarify some of the immune mechanisms involved in periodontal disease, more studies must be conducted to understand its development and progression and consequently to discover new alternatives for the prevention and treatment of this severe inflammatory disease.

A periodontite é uma doença altamente complexa e multifatorial. Esta breve revisão reúne alguns fatores imunológicos envolvidos no desenvolvimento e controle desta doença oral, tais como: a participação de células inflamatórias no local da inflamação, a síntese de proteínas quimiotáticas através da ativação do sistema complemento e a presença de alguns dos peptídeos antimicrobianos, como defensinas, catelicidinas e saposinas. A interação de padrões moleculares associados à patógenos (PAMPs) de microrganismos com seus receptores de superfície, em células imunológicas, induz a produção de várias citocinas e quimiocinas que apresentam função pró- e/ou anti-inflamatória estimulando a secreção de uma grande variedade de subtipos de anticorpos e a ativação de mecanismos de controle da doença, como as células T reguladoras. Embora vários trabalhos tentem esclarecer alguns dos mecanismos imunológicos envolvidos na doença periodontal, estudos adicionais são necessários para ampliar conhecimentos sobre o desenvolvimento, a progressão e, consequentemente, para se descobrir novas alternativas de prevenção e tratamento desta grave doença inflamatória.

Effect of light-activation on the antibacterial activity of dentin bonding agents

Aim: This study evaluated the effect of light-activation on the antibacterial activity of dentin bonding systems. Methods: Inocula of Streptococcus mutans and Lactobacillus casei cultures were spread on the surface of BHI agar and the materials were applied and subjected or not to light-activation. Zones of bacterial growth inhibition around the discs were measured. Results: Excite, Single Bond and the bond of Clearfil SE Bond (SE) and Clearfil Protect Bond (CP) did not show any antibacterial activity. The strongest inhibitory activity was observed for the primers of CP and Prompt (PR) against S. mutans and the primers of SE andPB against L. casei. Conclusion: Light-activation significantly reduced or suppressed the antibacterial activity of the initially active uncured dentin bonding systems.

Fundamental mechanisms of immune response to oral bacteria and the main perspectives of a vaccine against dental caries: a brief review / Mecanismos fundamentais de resposta imune contra bactérias bucais e as principais perspectivas para uma vacina anticárie: uma breve revisão

Dental caries may be defined as a complex multifatorial disease in that a broad group of biological, socio-economic and cultural factors interact directly or indirectly in the establishment and colonization of cariogenic microorganisms within the microbial community of the dental biofilm. Innate and adaptative immunity are two fundamental aspects of the immune system response against infections, such as dental caries. Besides, the majority of pathogenic infectious agents enter the organisms by the oral route. Consequently, the mucosal tissue, associated exocrine glands and saliva contributes to the protection of the oral cavity because contain cells responsible for antigen internalization and antibodies specific to oral bacteria. Macrophages are phagocytic cells that can internalize and kill bacteria by several mechanisms of internalization, including endocytosis, macropinocytosis and phagocytosis. Streptococcus mutans is the major pathogen of dental caries due to its ability to adhere and accumulate on tooth surfaces, using different virulence factors (AgI/II, Gtf, Gbps). Recent studies demonstrated protection against experimentally induced dental caries for vaccines containing intact or peptides from antigen I/II, Gtf or Gbp and vaccines containing a combination of antigens. The present review summarizes the fundamental mechanisms of host immune responses to oral bacteria and the main perspectives of a vaccine against dental caries.

A cárie dentária pode ser definida como uma doença complexa multifatorial causada por fatores biológicos, socioeconômicos e culturais que interagem direta ou indiretamente na colonização e estabelecimento de microrganismos cariogênicos na comunidade microbiana do biofilme dentário. As imunidades inata e adaptativa são os dois aspectos fundamentais de resposta do sistema imune contra infecções, como a cárie dentária. Além disso, a maioria dos agentes infecciosos patogênicos entra no organismo por via oral. Consequentemente, o tecido mucoso, associado com as glândulas exócrinas e a saliva contribuem para a proteção da cavidade bucal por conterem células responsáveis pela internalização de antígenos ou anticorpos contra as bactérias bucais. Os macrófagos são células fagocíticas que podem internalizar e eliminar bactérias por diversos mecanismos de internalização, como a endocitose, macropinocitose e fagocitose. Streptococcus mutans é o principal patógeno da cárie dentária por sua habilidade em aderir e acumular nas superfícies dentárias, usando diferentes fatores de virulência (AgI/II, Gtf e Gbps). Estudos recentes têm demonstrado proteção contra cárie induzida experimentalmente utilizando vacinas contendo antígenos intactos ou peptídeos a partir de AgI/II, Gtf ou Gbps ou uma combinação de antígenos. A presente revisão sumariza os mecanismos fundamentais de resposta imune contra bactérias bucais e as principais perspectivas de uma vacina anticárie.