Effect of whitening mouthrinses on color change of stained resin composites / Efeito de enxaguatórios clareadores na alteração de cor de resinas compostas previamente manchadas

Objective: The present study compared the effect of whitening mouthrinses (WM) on the color change of stained resin composites (RC). Material and Methods: Cylindrical specimens (6mm-diameter and 1mm-thickness) were prepared with the following RC (n=60/group): Filtek Z350XT (Z350- methacrylate-based), Admira Fusion (AD- ormocer-based), TPH3 (TPH- methacrylate-based), and Beautifil II (BII- giomer/methacrylate-based). The initial color was assessed with reflectance spectrophotometer using CIE L*a*b* system. The specimens were immersed in staining broth during 14 days, submitted to color evaluation (ΔE1) and randomly allocated in 4 subgroups (n=15), according to WM adopted: Listerine Whitening (LW-2% hydrogen peroxide), Plax Whitening (PW-1.5% hydrogen peroxide), Bromelain/papain (BP-experimental solution), and Deionized water (DW-negative control). The whitening cycle consisted of RC immersion in WM for 1 min and in artificial saliva for 30 min, simulating 12 weeks, and final color assessment was performed (ΔE2). Color change data were analysed by ANOVA and Tukey's tests (α=5%). Results: After staining, TPH showed the lowest ΔE1 values and Z350 showed the highest color change (p=0.001). The whitening effect promoted by LW was significantly higher than color alteration obtained with PW (ΔE2), and BII showed the highest color change values (ΔE2) after whitening cycle. Conclusion: LW exhibited the greatest whitening potential on stained RC, mainly with the Giomer (Beautifill II) and the Ormocer-based (Admira Fusion) materials. Bromelain/papain solution showed no whitening effect on stained RC. (AU)

Objetivo: O presente estudo comparou o efeito de enxaguatórios clareadores (EC) na alteração de cor de resinas compostas (RC) previamente manchadas. Material e Métodos: Espécimes cilíndricos (6mm de diâmetro e 1mm de espessura) foram preparados com as seguintes RC (n=60/grupo): Filtek Z350XT (Z350- metacrilato), Admira Fusion (AD- ormocer), TPH3 (TPH- metacrilato), e Beautifil II (BII- giomer/metacrilato). A cor inicial foi mensurada com espectrofotômetro de reflectância utilizando o sistema CIE L*a*b*. Os espécimes foram imersos em um caldo de manchamento durante 14 dias, submetidos a avaliação de cor (ΔE1) e alocados aleatoriamente em 4 subgrupos (n=15), de acordo com EC adotado: Listerine Whitening (LW-peróxido de hidrogênio a 2%), Plax Whitening (PW- peróxido de hidrogênio a 1,5%), Bromelina/papaína (BP-solução experimental), e Água deionizada (AD- controle negativo). O ciclo clareador consistiu na imersão da RC no EC por 1 min e na saliva artificial por 30 min, simulando 12 semanas, e a cor final foi mensurada (ΔE2). Os dados de alteração de cor foram analisados pelos testes ANOVA e Tukey (α=5%). Resultados: Após o manchamento, TPH apresentou o menor valor de ΔE1 e Z350 apresentou a maior alteração de cor (p=0,001). O efeito clareador promovido pelo LW foi significativamente maior que o obtido com o PW (ΔE2) e BII teve a maior alteração de cor (ΔE2) após o ciclo clareador. Conclusão: LW exibiu maior potencial clareador nas RC manchadas. BII apresentou maior alteração de cor em resposta à ação clareadora de ambos enxaguatórios à base de peróxido de hidrogênio testados.(AU)

In vitro microbiological analysis on antibacterial, anti-inflammatory, and inhibitory action on matrix metalloproteinases-8 of commercially available chlorhexidine digluconate mouth rinses

Chlorhexidine (CHX) mouthrinses are known to have a beneficial effect in the management of periodontal disease. The present study was designed to investigate the antibacterial, anti-inflammatory, and matrix metalloproteinases-8 (MMP-8) inhibition efficacy of eight commercially available CHX mouthrinses from the Dominican Republic. Methods: The study samples are categorized into two categories, eight commercially available CHX mouthrinses were case sample group, and positive and negative controls used in the study are categorized as control sample group. Antibacterial activity of the samples was evaluated on bacterial strains obtained from American Type Culture Collection (ATCC, Rockville, MD USA) which were Porphyromonas gingivalis, Fusobacterium nucleatum, Eikenella corrodens, and Aggregatibacter actinomycetemcomitans. Results: The study samples 1, 2, 3, 5, 6, and 8 showed significant higher antibacterial efficacy and sample 4 and 7 were less effective. Samples 1, 2, 3, 5, and 6 showed higher antibacterial efficacy with no bacterial colonies formation in dilution assay method, whereas sample 8 showed smaller colonies of bacterial growth. The halo diameter found to be average in sample 8 with 13 mm, whereas sample 9 showed 12.5 + 3.48 mm, sample 1 was with a mean of 11.79 + 3.51 mm. The smaller halo diameter and minimal antibacterial activity were observed in samples 4 (mean of 3.5 + 5.95 mm) and 7 (3.5 + 7.70 mm). All eight samples showed statistically significant higher MMP-8 inhibition activity with P < 0.0001. Conclusion: Commercially available CHX digluconate mouthrinses showed the difference in plaque inhibition with 0.12 and 0.15% concentration.

A comparative evaluation of the anticaries efficacy of herbal extracts (Tulsi and Black myrobalans) and sodium fluoride as mouthrinses in children: A randomized controlled trial

Dental caries is a multifactorial disease in which microorganisms play an important role. Recently, herbs have been tried as mouthrinses to combat the side effects of chemical mouthrinses. The anticaries efficacy of Sodium fluoride, Tulsi leaf, and Black myrobalans fruit extracts on Streptococcus mutans (S. mutans) have been reported in the literature, but no comparative study has been done yet. Aim: This study aims to observe the change in the pH of saliva and to assess the efficacy of the herbal rinses-Tulsi and Black myrobalans on S. mutans count while comparing it with Sodium fluoride mouthrinse. Methods: Herbal ethanolic extracts of Tulsi (4%) and Black myrobalans (2.5%) were prepared as mouthrinses and compared with sodium fluoride mouthrinse (0.05%). Sixty high caries risk patients were selected and allocated randomly into three groups [n = 20], categorized as Group A-Sodium fluoride mouthrinse, Group B-Tulsi mouthrinse, and Group C-Black myrobalans mouthrinse. They were instructed to rinse their mouth with their assigned mouthrinses for 7 days. Salivary samples were collected and sent to the laboratory at baseline, 1 h postrinsing and after 7th day of rinsing for determining the salivary pH and S. mutans count. The increase in pH and reduction of S. mutans were determined. The values obtained were tabulated and statistically analyzed. Results: There was a significant increase in the salivary pH and reduction in S. mutans count after rinsing in all the three groups. Increase in salivary pH was more in the Sodium fluoride mouthrinse when compared to the experimental herbal groups (Group B and Group C). While S. mutans counts reduced more with Tulsi mouthrinse at 1 h postrinsing and after the 7th day of rinsing more reduction was seen in Black myrobalans mouthrinse group. Conclusion: The results of the study suggest that herbal mouthrinses could be tried as an adjunctive anticaries agent against dental caries causing microorganisms.

Effect of Ocimum gratissimum in Mouthrinses on De Novo Plaque Formation. A Randomized Clinical Trial

Resumo O objetivo do presente estudo foi avaliar clinicamente em humanos o efeito antiplaca de Ocimum gratissimum (Og). Quinze adultos saudáveis participaram deste estudo cruzado, duplo-cego, por meio de um modelo de acúmulo de placa parcial de 3 dias. Os voluntários aboliram qualquer método mecânico de higiene oral e foram inicialmente designados para usar os seguintes enxaguatórios bucais: água destilada (solução AD), digluconato de clorexidina a 0,12% (solução CLX) ou 10% Og (solução Og). O índice de placa (IPL) foi registrado em todos os dentes inferiores no final do experimento e os testes estatísticos Kruskal-Wallis (α=0,05) e Mann-Whitney (α=0,05) foram utilizados para estimar a diferença entre os grupos. Os resultados clínicos demonstraram diferença estatisticamente significante entre os três grupos (p<0,05), favorecendo os grupos CLX e Og; entretanto o grupo CLX foi mais efetivo que o grupo Og (p<0,05). Os enxaguatórios bucais contendo digluconato de clorexidina e Og a 10% foram capazes de reduzir a formação de nova placa bacteriana, mas Og mostrou resultados mais limitados em comparação ao digluconato de clorexidina.

Abstract The aim of this study was to evaluate the antiplaque effect of Ocimum gratissimum (Og) by in vivo investigation. Fifteen healthy volunteers participated in a crossover, double-blind clinical study, using a 3-day partial-mouth plaque accumulation model. The participants abolished any method of mechanical oral hygiene and they were randomly assigned to initially use just the following mouthrinses: distilled water (DW solution), 0.12% chlorhexidine digluconate (CLX solution) or 10% Og (Og solution). The plaque index (PLI) was recorded in all mandibular teeth at the end of the trial and the Kruskal-Wallis (α=0.05) and Mann-Whitney (α=0.05) tests were used to estimate the difference among groups. The clinical results showed statistically significant difference among the groups (p<0.05), favoring the CLX solution and Og solution, but the first was more effective (p<0.05). The mouthrinses containing 0.12% chlorhexidine digluconate and 10% Og were able to inhibit plaque re-growth, however Og showed more limited results in comparison to CLX.

Efficacy of commercially available chlorhexidine mouthrinses against specific oral microflora.

Context: This study evaluates the antimicrobial efficacy of commercially available chlorhexidine (CHX) mouthrinses of different concentrations. Aims: To evaluate and compare the antimicrobial efficacy of commercially available CHX mouthrinses of different concentrations (0.2%, 0.12%, and 0.1%) against specific standard strains of oral microflora at full strength (FS) and 1:1 dilution at 24 h. Settings and Design: Ten commercially available 0.2% (Rexidine, Hexidine, Smilehex, Chlorhex, Hexidale, Hex, Everfresh, and Gargwell), 0.12% (Periogard), and 0.1% (Eludril) CHX mouthrinses were selected to evaluate the efficacy against specific oral microflora using agar well diffusion Method. Materials and Methods: The standard strains of Streptococcus mutans American Type Culture Collection (ATCC 21293), Streptococcus sanguis Microbial Type Culture Collection (MTCC 442), Actinomyces viscosus (ATCC 3268), Staphylococcus aureus (ATCC 25923), Streptococcus pyogenes (MTCC 442), and Candida albicans (MTCC 183) were selected. The antimicrobial efficacy was calculated by measuring mean inhibitory zones formed on agar media. Statistical Analysis Used: Independent t‑test, one‑way ANOVA, Kruskal–Wallis tests, and Tukey’s Post hoc analysis were used. Results: Among 0.2% of CHX mouthrinses at FS and 1:1 dilution, hexidine was effective against most of the microorganisms except with S. pyogenes and C. albicans, where Hex and Hexidale were effective, respectively. When the concentration of 0.1% and 0.12% CHX was considered, Eludril was more effective at FS against all except with S. aureus and S. pyogenes which were more sensitive to Periogard at both FS and 1:1 dilution. Conclusions: 0.12% and 0.1% of CHX mouthrinses showed comparable efficacy with 0.2% CHX mouthrinses irrespective of their formulations.

In-vitro antimicrobial effectiveness of herbal-based mouthrinses against oral microorganisms

OBJECTIVE: To evaluate the in vitro antimicrobial effectiveness of commercial herbal-based mouthrinses against oral microorganisms. METHODS: A total of three mouthrinses (OX, Pesona and Watsons) were tested for their antimicrobial activity against six oral organisms, Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus), Lactobacillus salivarius (L. salivarius), Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa) and Candida albicans (C. albicans) by standard agar-disk diffusion assay. Oradex mouthrinse containing 0.12% chlorhexidine gluconate and sterile distilled water was served as positive and negative controls, respectively. RESULTS: All mouthrinse formulations were effective in inhibiting the growth of S. mutans, S. sobrinus, L. salivarius and C. albicans. Among the tested mouthrinses, Pesona was the only effective mouthrinse against S. aureus and P. aeruginosa, similar to Oradex mouthrinse. Pesona mouthrinse formulation appears to be as effective as Oradex mouthrinse formulation to kill S. aureus and P. aeruginosa. Statistical analysis showed no significant difference among the tested formulations regarding their antimicrobial activities (P > 0.05). CONCLUSIONS: Pesona was not the only herbal mouthrinse effective in inhibiting the growth of S. mutans, S. sobrinus, L. salivarius and C. albicans in vitro. All tested formulations were effective against those strains. Our findings may serve as a guide for selecting a kind of herbal mouthrinses as well as providing information to the dental professionals about the efficacy of these products.

Enjuagues de Calendula officinalis como alternativa de los antisépticos orales / Calendula officinalis mouthrinses as an alternative to oral antiseptics

En la progresión de la enfermedad periodontal intervienen múltiples factores, incluyendo los diversos microorganismos orales que conforman la placa bacteriana o patógenos libres en cavidad oral que logran desencadenar una respuesta inmunológica e inflamatoria en el huésped. Existen herramientas químicas que combaten cualquier posibilidad de colonización e infección por parte de algún microorganismo. Los antisépticos orales son de gran utilidad especialmente luego de cirugías periodontales. Es allí donde su importancia se hace casi imprescindible, para controlar la noxa, pero a su vez deben facilitar el proceso de cicatrización de los tejidos involucrados. El objetivo del presente manuscrito consistió en reportar y describir un caso clínico donde el empleo de clorhexidina al 0,12 por ciento como antiséptico oral postoperatorio no favoreció la cicatrización adecuada de los tejidos mucosos luego de realizarse un injerto gingival libre. Como alternativa antiséptica se prescribieron enjuagues a base de Caléndula, observándose cicatrización de los tejidos afectados a los pocos días de uso. Se discute que posterior a todo proceso operatorio de carácter quirúrgico se debe colocar en una balanza riesgo-beneficio, donde se escoge la posibilidad de evitar la infección posoperatoria o la cicatrización oportuna de esta. Los enjuagues orales de caléndula permitieron la cicatrización oportuna; los colutorios de caléndula contemplan una pequeña proporción de capacidad antimicrobiana y una alta habilidad inductora de la cicatrización tisular(AU)

Periodontal disease progression involves multiple factors, including several oral microorganisms of the bacterial biofilm or commensal pathogens in oral cavity, which trigger inflammatory immune response in the host. There are chemical tools that fight any possibility of colonization and infection by a microorganism. Oral antiseptics are useful especially after periodontal surgery where they are almost indispensable to control the noxa, but at in the same time, they should facilitate the healing process of the cut tissues. The objective of this paper was to describe a case in which the use of 0.12 percent chlorhexidine as an oral antiseptic postoperatively favored no proper healing of mucosal tissues after free gingival grafting. As an alternative, mouthrinse with Calendula was prescribed, observing affected tissue healing within a few days. It is argued that in all post-operative surgical process, one should analyze risks and benefits and choose avoiding the possibility of postoperative infection or timely scarring. As an alternative, the calendula mouthrinse allowed timely cicatrization and it should be noticed that they have some antimicrobial properties and high-inductive ability for the tissue healing(AU)

Avaliação da rugosidade superficial da resina composta filtek Z350 3M/ espe de baixa viscosidade exposta a enxaguatórios com e sem álcool / Assessment surface roughness of the flwable resin filtek Z350 3M/ espe exposed to mouthrinses with and without alcohol

O propósito deste trabalho foi o de verificar, in vitro, se existe alteração da rugosidade superficial provocada pela utilização de enxaguatórios com e sem álcool sobre a resina composta Filtek Z350 3M/ESPE de baixa viscosidade. A medida de rugosidade média RA foi obtida através da leitura em um rugosímetro. Foram utilizados 3 colutórios atualmente comercializados: Listerine, Plax Classic e Plax Kids, além da água destilada e álcool etílico. Foram preparados 51 corpos de prova, divididos em 6 grupos: água destilada, álcool etílico, listerine, plax classic e plax kids (com 10 amostras cada), e o grupo sem tratamento (composto de apenas 1 amostra). Os controles (negativo e positivo) foram realizados pela amostra sem tratamento e etanol, respectivamente. A lisura supertificial foi obtida com uma tira de poliéster, evitando qualquer influência do processo de polimento. As amostras ficaram imersas por um período total de 12 horas, o equivalente a 1 ano de utilização do enxaguatório. Foi possível observar um aumento significante da rugosidade em todos os grupos, com exceção do Plax Classic, quando comparada ao valor fixo obtido com a amostra sem ataque; entretanto, não houve diferença significante entre as soluções testadas.

The purpose of this study was to verify, in vitro, if there is a change of surface roughness caused by the use of mouthrinses with and without alcohol on the composite resin Filtek Z350 3M/ESPE flow. The measure of average roughness Ra was assessed by profilometry. Three mouthrinses currently marketed were used: Listerine, Plax Classic and Plax Kids, in addition to distilled water and alcohol. Fifty one disc specimes were prepared, divided into six groups: distilled water, ethyl alcohol, Listerine, Plax Classic and Plax Kids (with 10 specimens each), and the group without treatment (consisting of only 1 specimen). The negative and positive controls were carried out by the sample without treatment and ethanol, respectively. The surface smoothness was obtained with a polyester strip, avoiding any influence of the process of polishing. The specimens were immersed for a total period of 12 hours, equivalent to 1 year of use of mouthrinses. It was possible to see a significant increase of roughness in all groups, except the Plax Classic, as compared to the fixed value from the specimen without attack, but there was no significant difference between the solutions tested.

Comparison of mouthrinses containing chlorhexidine and other active agents with chlorhexidine mouthrinse-gel: effects on de novo plaque formation / Comparação de enxaguatórios de clorexidina e outros agentes ativos com enxaguatório-gel de clorexidina sobre a formação de biofilme

Purpose: Antiseptic mouthrinses containing chlorhexidine (CHX) seem to be the most effective chemical agents for plaque control. The CHX concentration is usually 0.12% or 0.20%, but formulations with lower concentrations of CHX (0.05%) in combination with other active agents such as sodium fluoride (0.05%) or cetyl pyridinium chloride (0.05%) (Cpc) are available. The aim of this study was to compare plaque formation at 24 hours after the use of 0.1% CHX mouthrinse-gel and mouthrinses containing 0.12% and 0.05% CHX plus other active agents. Methods: A controlled, randomized, double-blind, crossover clinical trial was designed. Thirty subjects underwent four consecutive experimental phases with four treatments: CHX 0.1% + hydroxymethylcellulose 2.5% (HMC), CHX 0.12% + alcohol, CHX 0.12% + 0.05% sodium fluoride, and CHX 0.05% + 0.05% Cpc. On the day of study, the subjects discontinued all other oral hygiene habits and were randomly assigned for treatment with the experimental mouthwash. Each experimental phase was preceded by a 28-day washout period. Plaque formation was recorded after one undisturbed day. Results: Formulations of CHX 0.12% with alcohol and sodium fluoride and CHX 0.1% + HMC 2.5% reduced de novo plaque formation to a greater extent than the mouthwash with CHX 0.05% + Cpc (P < 0.05). Conclusion: The 0.1% CHX gel presents an anti-plaque efficacy similar to that of mouthwashes containing 0.12% CHX and other active agents, and was more effective at inhibiting plaque formation than the mouthwash containing 0.05% CHX with Cpc.

Objetivo: Enxaguatórios contendo clorexidina (CHX) parecem ser os mais eficazes agentes químicos para controle de placa. A concentração de CHX geralmente é de 0.12% ou 0.20%, mas formulações de clorexidina em concentrações mais baixas (0.05%) com outros agentes ativos, tais como fluoreto de sódio (0.05%), cloreto de cetilpiridínio (0.05%) estão disponíveis atualmente. Este estudo teve por objetivo comparar a eficácia de gel de clorexidina a 0.1% com enxaguatórios contendo 0.12% e 0.05% CHX e outros agentes ativos, em relação ao crescimento de placa bacteriana em 24 horas. Metodologia: Um ensaio clínico com delineamento cruzado, randomizado, controlado e duplo-cego foi concebido. Trinta sujeitos foram submetidos a quatro fases experimentais consecutivas com quatro tratamentos (bochechos): CHX 0.1% + HMC 2.5%, 0.12% CHX + álcool, CHX 0.12% + 0.05% de fluoreto de sódio e CHX 0.05% + 0.05% cloreto de cetilpiridínio. No dia de estudo, os indivíduos interromperam todas as medidas de higiene oral e foram tratados os bochechos experimentais aleatoriamente. Cada fase experimental foi precedida por um período de 28 dias de washout. A formação de placa foi registrada depois de um dia sem disturbio de formação. Resultados: As formulações de CHX 0.12% com álcool e fluoreto de sódio e gel foram eficientes em retardar a formação de placa e foram superiores (P < 0,05) para a CHX 0.05% com cloreto de cetilpiridínio. Conclusão: O gel de clorexidina 0,1% para bochechos apresenta uma eficácia antiplaca semelhante aos bochechos de 0.12% CHX com outros agentes ativos, sendo superior aos bochechos de clorexidina a 0.05% com cloreto de cetilpiridínio.

Influência de colutórios bucais na dureza de resinas compostas / Influence of mouthrinses on the hardness of composite resin materials

O objetivo deste trabalho foi avaliar o efeito de colutórios bucais na dureza de três resinas compostas (Filtek Supreme® A2B – nanoparticulada [SUP], Filtek Z250® A2 – híbrida [Z25], Filtek Flow® A2 – híbrida de consistência fluida [FLO]). Três colutórios foram selecionados (Listerine® [LIS], PerioGard® [PER] e Cepacol® [CEP]) e a água destilada [AD] foi utilizada como solução de controle. Setenta e duas matrizes de um polímero de náilon, com 3 mm de diâmetro e 3 mm de espessura, foramconfeccionadas. As resinas foram inseridas nas matrizes em dois incrementos, os quais foram fotoativados por 20s cada. Os corpos-de-prova (cps) foram aplainados em lixas d’água e armazenados em água destilada por 24h. Cada tipo de resina composta foi dividido em quatro grupos (n = 6) de acordo com as soluções estudadas, as quais foram utilizadas sob o seguinte regime: três imersões por dia de 10min cada, durante trinta dias.Durante o período do estudo, os cps foram individualmente armazenados em água destilada. Cinco leiturasde dureza foram realizadas em cada cp e a média do número de dureza Knoop (KHN) dessas leituras foi utilizadapara a realização da análise estatística. Os resultados e desvios-padrão (DP) foram: SUP + LIS = 63,3(5,2) Bb; SUP + PER = 70,0(3,6)Ab; SUP + CEP = 67,8(3,6)ABb; SUP + AD = 64,3(3,8)Bb; Z25 + LIS = (2,4)88,4Aa; Z25 + PER = 77,1(5,4)Ba; Z25 + CEP = 83,8(3,9)Aa; Z25 + AD = 83,7(4,1)Aa; FLO + LIS = 44,3(4,1)Ac; FLO + PER = 46,5(1,6)Ac; FLO + CEP = 48,7(2,0)Ac; FLO + AD = 44,2(0,8)Ac. Após a análise de variância e o teste de Tukey (5 por cento), observou-se diferença estatística significativa entre a dureza Knoop das resinas testadas, sendoZ25 > SUP > FLO. Conclui-se que as resinas compostas comportaram-se de maneira diferente para cada tipo desolução utilizada

The biofilm concept and its role in prevention of periodontal disease: [review] / O conceito de biofilme e seu papel na prevenção da doença periodontal: [revisão]

OBJECTIVE: To provide an overview of the history of oral microbiology, a discussion of dental plaque as both a microbial community and a biofilm, and a review of the measures available to control the oral microflora. METHODOLOGY: The author reviewed the literature related to oral microbiology and associated infectious diseases. He also examined articles that detailed the structure and physiology of biofilms, including dental plaque biofilms. RESULTS and DISCUSSION: Biofilms cannot be eliminated. The pathogenic nature of the dental plaque biofilm can be diminished in the oral cavity by reducing the bioburden and effectively maintaining a normal oral flora via oral hygiene procedures that include daily toothbrushing, flossing and rinsing with an antimicrobial mouthrinse. An oral hygiene regimen that includes rinsing with an antimicrobial mouthrinse is a practical approach to the prevention and management of periodontal diseases.This strategy may have wider benefits when the link between periodontal disease and certain systemic diseases is considered. CONCLUSION: An effective oral hygiene regimen can help control dental plaque biofilm and associated periodontal diseases.

OBJETIVOS: Apresentar uma visão panorâmica da história da microbiologia bucal, uma discussão sobre a placa dental como uma comunidade microbiana e como biofilme, e uma revisão das medidas disponíveis para controle da microflora bucal. METODOLOGIA: O autor revisou a literatura relacionada com microbiologia bucal e doenças infecciosas associadas. Igualmente examinou artigos que detalharam a estrutura e a fisiologia dos biofilmes, incluindo biofilme da placa dental. RESULTADOS E DISCUSSÃO: Biofilmes não podem ser eliminados. A natureza patogênica do biofilme placa dental pode ser diminuída pela redução da carga biolótica e mantendo efetivamente a flora normal por meio de procedimentos de higiene bucal, que incluem escovação diária, uso de fio dental e colutórios com antimicrobianos. Essa estratégia pode ter benefícios amplos quando a ligação entre doença periodontal e certas doenças sistêmicas é considerada. CONCLUSÃO: O regime efetivo de higiene bucal pode ajudar no controle do biofilme placa dental e doenças periodontais associadas.

Halitosis: a review of associated factors and therapeutic approach

Halitosis or bad breath is an oral health condition characterized by unpleasant odors emanating consistently from the oral cavity. The origin of halitosis may be related both to systemic and oral conditions, but a large percentage of cases, about 85 percent, are generally related to an oral cause. Causes include certain foods, poor oral health care, improper cleaning of dentures, dry mouth, tobacco products and medical conditions. Oral causes are related to deep carious lesions, periodontal disease, oral infections, peri-implant disease, pericoronitis, mucosal ulcerations, impacted food or debris and, mainly, tongue coating. Thus, the aim of the present review was to describe the etiological factors, prevalence data and the therapeutic mechanical and chemical approaches related to halitosis. In general, halitosis most often results from the microbial degradation of oral organic substrates including volatile sulfur compounds (VSC). So far, there are few studies evaluating the prevalence of oral malodor in the world population. These studies reported rates ranging from 22 percent to more than 50 percent. The mechanical and chemical treatment of halitosis has been addressed by several studies in the past four decades. Many authors agree that the solution of halitosis problems must include the reduction of the intraoral bacterial load and/or the conversion of VSC to nonvolatile substrates. This could be achieved by therapy procedures that reduce the amount of microorganisms and substrates, especially on the tongue.