Antimicrobianos locales en periodoncia: revisión de la literatura / Local antimicrobials in periodontics: a review of the literature

Un creciente interés en el tratamiento antimicrobiano como adjunto a la terapia periodontal ha surgido posterior a 1970 debido a la asociación de ciertas especies bacterianas frecuentemente encontradas en procesos periodontales. El propósito de esta revisión fue establecer el estado de los antimicrobianos locales y su empleo en el tratamiento de la periodontitis. La información utilizada para esta revisión se encuentra en publicaciones internacionales desde 1985 a la fecha, utilizándose medline y pubmed como fuentes de recolección. Diferentes estudios han demostrado que el uso adjunto de antimicrobianos en la terapia periodontal mejoraría los resultados clínicos y microbiológicos frente a una terapia tradicional. El uso de la terapia antimicrobiana local se ha evaluado en diferentes tipos de estudios y con diferentes protocolos. En todos los casos ha demostrado favorecer positivamente la resolución de la periodontitis aunque con algunos protocolos de manejo ha mejorado significativamente al ser comparado con otros. Debemos señalar que esta terapia se debe implementar en casos que lo requieran y no como una medida para todos los pacientes. Así, al utilizar terapia antimicrobiana en pacientes con periodontitis se deben evaluar criterios como el surgimiento de resistencia a los antimicrobianos por parte de los microorganismos involucrados, el número de sitios afectados por la enfermedad, la profundidad del saco periodontal, el tiempo que se requiere y el costo de su uso. Finalmente, podemos señalar que la mejor forma para el uso de antimicrobianos locales es como adjunto a la terapia convencional de tartrectomía y pulido radicular.

An increasing interest in the antimicrobial treatment as attached to the periodontal therapy has arisen later 1970 due to the association of certain bacterial kinds frequently found in periodontal processes. The objective of this review is to identify the state of the local antimicrobial and his use in the treatment of periodontitis. The information used for this review is in international publications from 1985 to the date, with the use of medline and pubmed as sources of compilation. A great number of studies has demonstrated that the use of local antimicrobial in the periodontal therapy would improve the clinical and microbiological results front to a traditional therapy. The use of antimicrobial local therapy has been evaluated in different types of studies, being applied with different protocols. In all the cases it has demonstrated resolution of the periodontitis though of some protocols of managing and it has improved significantly. We must indicate that this therapy must be implemented in cases that need and not for all the patients. So that, the use of the antimicrobial therapy in patients with periodontitis, diferent criteria must be evaluated like the formation of antimicrobial resistance, the number of sites affected by the disease, the depth of the periodontal sack, the time needed and the cost of use. Finally, we can indicate that the best form for the use of antimicrobial places is like an enclosure to the conventional therapy of scaling and root planning.

Effect of dental adhesives on the exudative phase of the inflammatory process in subcutaneous tissue of rats

The vascular changes in the subcutaneous connective tissue of rats induced by dentin bonding systems (one step) was studied and compared to those induced by saline solution (negative control) and Furacin (positive control), during the exudative phase of the inflammatory process. Twenty mg/kg of Evan's blue were injected intravenously in the vein of the rats' penises; 0.1 ml of each substance tested was inoculated in the subcutaneous tissue. After a 3 hour period the animals were sacrificed and their skins were excised and punched out with a standard steel 2.5 cm in diameter. The specimens were immediately immersed in 8 ml of formamide and taken to a double boiler for 72 hours at 37ºC, to remove the dye. The liquid containing the overflowed dye was filtered, analyzed in the spectrophotometer (620 nm) and classified according to the criteria established by Nagem-Filho, Pereira (1976). After statistical analysis, the irritative potential of the substances was ranked as follows: Furacin (severe) > Single Bond and Bond 1 (moderate - no significant differences between the dentin bonding systems tested) > saline solution (not significant as regards the irritation degree)