Efectividad del uso transoperatorio de solución electrolizada de superoxidación para la prevención de infecciones postoperatorias en cirugía de terceros molares / Effectiveness of the trans-operative use of electrolyzed superoxidation solution for the prevention of post-operative infections in third molar surgery

La cirugía de terceros molares es uno de los procedimientos más realizados dentro de la práctica odontológica, generalmente conlleva la prescripción de fármacos, incluidos antibióticos indicados para prevenir la aparición de procesos infecciosos. La resistencia antimicrobiana es considerada como un problema de salud pública a nivel mundial, por lo que el uso de antibióticos debe ser cauteloso. La solución electrolizada de súperoxidación ha demostrado tener efectos bactericidas, virucidas y ha sido utilizada para la prevención y el tratamiento de procesos infecciosos. El objetivo del presente estudio fue demostrar la efectividad de dicha solución en la prevención de infecciones posteriores a la cirugía de terceros molares. Se realizó un estudio aleatorizado, ciego, prospectivo en 20 pacientes utilizando un diseño split mouth, en donde cada paciente fue sujeto control y experimental, en el grupo control se irrigó durante el procedimiento con solución de súperoxidación y no se prescribió antibiótico posterior, mientras que en el grupo control se irrigó con solución fisiológica y se prescribió antibiótico posterior. Se realizaron 40 cirugías en 20 pacientes utilizando en cada paciente ambas terapéuticas. Se analizó el dolor postoperatorio, inflamación y presencia de infección. El dolor y la inflamación fueron ligeramente superiores en el grupo experimental al tercer día; sin embargo, al séptimo día los resultados fueron similares. No se presentó ningún caso de infección postoperatoria. El uso de solución de súperoxidación transoperatoria puede ser una herramienta muy útil en la prevención de infecciones postoperatorias posterior a cirugía de terceros molares en pacientes sanos en cirugías con dificultad leve a moderada (AU)

Third molar surgery is one of the most performed procedures in dental practice, generally involving the prescription of drugs including antibiotics indicated to prevent the onset of infectious processes. Antimicrobial resistance is considered a public health problem worldwide, so the use of antibiotics should be cautious. The electrolyzed super oxidation solution has been shown to have bactericidal and virucidal effects and has been used for the prevention and treatment of infectious processes. The objective of the present study was to demonstrate the effectiveness of said solution in the prevention of infections after third molar surgery. A randomized, blind, prospective study was conducted in 20 patients using a split mouth design where each patient was a control and experimental subject, in the control group they were irrigated during the procedure with super oxidation solution and no subsequent antibiotic was prescribed. while the control group was irrigated with physiological solution and a subsequent antibiotic was prescribed. Forty surgeries were performed on 20 patients using both therapies in each patient. Postoperative pain, inflammation and presence of infection were analyzed. Pain and inflammation were slightly higher in the experimental group on third day, however on seventh day the results were similar. There were no cases of postoperative infection. The use of trans operative super oxidation solution can be a very useful tool in the prevention of postoperative infections after third molar surgery in healthy patients undergoing surgeries with mild to moderate difficulty.(AU)

Antibacterial and antifungal capacity of three commercially available mouthwashes with different concentrations of chlorhexidine / Efecto antibacteriano y antifúngico de tres enjuagues bucales comerciales con diferentes concentraciones de clorhexidina

Abstract Chlorhexidine was introduced almost seven decades ago and has a myriad of applications in dentistry. Few studies have evaluated the antimicrobial and antifungal capacity of different concentrations of chlorhexidine mouthwashes. Therefore, the aim of this study, was to evaluate in vitro, the antibacterial and antifungal capacity of three commercially available mouthwashes in Costa Rica, with different concentrations of chlorhexidine, 0.12%, 0.06%, and 0.03%. The experimental method selected was the Kirby-Bauer method to evaluate the antibacterial and antifungal effect of each compound by measuring the inhibitory effect on Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Candida albicans strains, exposed to the antiseptic solutions. All samples showed some degree of antibacterial and antifungal effect. Even though we provide in vitro results, our findings are of relevance since all the species used in our experiment are microorganisms that may be present in dental plaque. Our results further support evidence that oral hygiene regimens may include mouthwashes with low doses of chlorhexidine and maintain reasonable antibacterial and antifungal efficacy.

Resumen La clorhexidina se introdujo hace casi siete décadas y tiene una gran variedad de aplicaciones en odontología. Pocos estudios han evaluado la capacidad antimicrobiana y antifúngica de diferentes concentraciones de enjuagues bucales con clorhexidina. Por lo tanto, el objetivo de este estudio fue evaluar in vitro, la capacidad antibacteriana y antifúngica de tres enjuagues bucales disponibles comercialmente en Costa Rica, con diferentes concentraciones de clorhexidina, 0.12%, 0.06% y 0.03%. El método experimental seleccionado fue el método Kirby-Bauer para evaluar el efecto antibacteriano y antifúngico de cada compuesto midiendo el efecto inhibidor sobre Staphylococcus aureus, Enterococcus faecalis, Escherichia coli y Candida albicans, expuestos a la solución antiséptica. Todas las muestras mostraron algún grado de efecto antibacteriano y antifúngico. Aunque proporcionamos resultados in vitro, nuestros hallazgos son de relevancia, ya que todas las especies utilizadas en nuestro experimento son microorganismos que pueden estar presentes en la placa dental. Nuestros resultados respaldan aún más la evidencia de que los regímenes de higiene bucal pueden incluir enjuagues bucales con dosis bajas de clorhexidina y mantener una eficacia antibacteriana y antifúngica razonable.

Effectiveness of chlorhexidine oral rinse in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment- a systematic review and meta analysis / Eficacia del enjuague oral de clorhexidina en la prevención de la acumulación de placa y la gingivitis en pacientes en tratamiento de ortodoncia: una revisión sistemática y metaanálisis

Aim: The aim of this review was to systematically assess and report the effectiveness of chlorhexidine (CHX) mouthwash in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment. Material and Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and registered under PROSPERO database (CRD42020170776). Four electronic databases were systematically searched along with a complimentary manual search of orthodontic journals until June 2022. Only Randomized Control Trials (RCTs) reporting on antiplaque and antigingivitis efficacy of Chlorhexidine mouthwash compared with placebo or control in orthodontic patients were included. Risk of bias assessment was done using Cochrane ROB-2. Quantitative analysis (Random-Effects Model and Standard Mean Difference (SMD)) with 95 % confidence interval was used. Results: Six RCTs were included for qualitative analysis and four were included for quantitative analysis with a total of 211 participants. Out of six studies, 3 were judged to have a low risk of bias, two had some concerns and one of them had high risk of bias. Random effects meta-analysis performed for anti-plaque effect reported a significant reduction of -1.2 SMD for CHX at 4 to 6 weeks with low heterogeneity (I2-35%). The anti-gingivitis effect at 4 to 6 weeks was significant for CHX with a SMD of -1.03 and a moderate heterogeneity (I2-65%). Conclusion: On analyzing the available evidence a moderate level of certainty supports a short-term reduction in plaque accumulation and gingivitis in orthodontic patients subjected to rinsing with chlorhexidine oral rinse.

Objetivo: El objetivo de esta revisión fue evaluar e informar sistemáticamente la efectividad del enjuague bucal con clorhexidina (CHX) para prevenir la acumulación de placa y la gingivitis en pacientes que reciben tratamiento de ortodoncia. Material y Métodos: La revisión se preparó de acuerdo con las pautas de Preferred Reporting Items for Systematic Reviews (PRISMA) y se registró en la base de datos PROSPERO (CRD42020170776). Se realizaron búsquedas sistemáticas en cuatro bases de datos electrónicas junto con una búsqueda manual gratuita de revistas de ortodoncia hasta junio de 2022. Solo se incluyeron ensayos controlados aleatorios (ECA) que informaron sobre la eficacia antiplaca y antigingivitis del enjuague bucal con clorhexidina en comparación con placebo o control en pacientes de ortodoncia. La evaluación del riesgo de sesgo se realizó mediante Cochrane ROB-2. Se utilizó un análisis cuantitativo (modelo de efectos aleatorios y diferencia de medias estándar (SMD)) con un intervalo de confianza del 95 %. Resultados: Se incluyeron seis ECA para el análisis cualitativo y cuatro para el análisis cuantitativo con un total de 211 participantes. De los seis estudios, se consideró que tres tenían un bajo riesgo de sesgo, dos tenían algunas preocupaciones y uno de ellos tenía un alto riesgo de sesgo. El metanálisis de efectos aleatorios realizado para el efecto antiplaca informó una reducción significativa de -1,2 SMD para CHX a las 4 a 6 semanas con baja heterogeneidad (I2-35%). El efecto antigingivitis a las 4 a 6 semanas fue significativo para CHX con una SMD de -1,03 y una heterogeneidad moderada (I2-65%). Conclusión: Al analizar la evidencia disponible, un nivel de certeza moderado apoya una reducción a corto plazo en la acumulación de placa y gingivitis en pacientes ortodóncicos sometidos a enjuague con enjuague bucal con clorhexidina.

Eficácia de óleos vegetais no controle do biofilme dental: revisão integrativa / Efficacy of vegetable oils in control of dental biofilm: integrative review / Eficacia de los aceites vegetales en el control de biofilm dental: revision integrativa

Introdução:A terapia de bochecho com óleos vegetais é uma cultura tradicional na Índia com intuito de prevenir afecções bucais, como cárie e doença periodontal. Atualmente, com as mudanças nos padrões alimentares da sociedade, tem-se empregado com maior valor o uso de óleos naturais, já que estudos demonstram sua importância para saúde.Objetivo:Esta revisão integrativa teve como objetivo selecionar evidências que mostrassem a utilização de óleos vegetais, com ação antimicrobiana, no controle do biofilme dental. Metodologia:O levantamento bibliográfico foi realizado nos meses de julho e agosto de 2020, por meio de pesquisa por via eletrônica, consultando-se o banco de dados Pubmed e SciELO (Scientific Electronic Library Online). Foram utilizados os descritores: Óleos vegetais, agentes antimicrobianos, Placa dental, Odontologia preventiva e Odontologia, os descritores foram usados separadamente e em cruzamento com o operador boleano AND. Utilizou-se os seguintes critérios de inclusão: Estudos clínicos, artigos completos e disponíveis gratuitamente, publicados no período de 2010 a 2020 em português e/ou inglês, e indexados nas bases de dados já citadas. Foram excluídos os trabalhos de conclusão de curso, dissertações, teses, livros e capítulos de livros, além de artigos duplicados e que não abordaram o tema do estudo.Resultados:Atenderam os critérios da pesquisa 04 estudos do tipo clínico randomizado, os quais mostraram eficiência dos óleos vegetais utilizados no controle do biofilme dental. A realização de pesquisas envolvendo e motivando a industrialização de produtos naturaiscontribui para a Política Nacional de Práticas Integrativas e Complementares.Conclusões:Os artigos analisados mostraram eficácia na utilização de óleos vegetais no controle do biofilme dental, sendo esses aplicados clinicamente,não mostrando prejuízo aos participantes e indicados como coadjuvante na manutenção da saúde bucal (AU).

Introduction:Mouthwash therapy with vegetable oils is a traditional culture in India with the aim of preventing oral diseases, such as caries and periodontal disease. Currently, with the changes in the dietary patterns of society, the use of natural oils has been used with greater value, since studies demonstrate its importance for health.Objective:This integrative review aimed to select evidence that showed the use of vegetable oils, with antimicrobial action, in the control of dental biofilm. Methodology:Thebibliographic survey was carried out in July and August 2020, through electronic research, consulting the Pubmed and SciELO database (Scientific Electronic Library Online). The descriptors were used: Vegetable oils, antimicrobial agents, dental plaque, preventive dentistry and dentistry, the descriptors were used separately and in cross-section with the Boolean operator AND. The following inclusion criteria were used: Clinical studies, complete and freely available articles, published between 2010 and 2020in Portuguese and / or English, and indexed in the databases already cited. Course completion papers, dissertations, theses, books and book chapters were excluded, as well as duplicate articles that did not address the subject of the study. Results:Four studies of randomized clinical type met the research criteria, which showed efficiency of vegetable oils used in the control of dental biofilm. Conducting research involving and motivating the industrialization of natural products contributes to the National Policy on Integrative and Complementary Practices.Conclusions:The analyzed articles showed efficacy in the use of vegetable oils in the control of dental biofilm, which were applied clinically without showing any harm to the participants and indicatedas an adjunct in maintaining oral health (AU).

Introducción: La terapia de enjuague bucal con aceites vegetales es una cultura tradicional en India con el objetivo de prevenir enfermedades bucales, como caries y enfermedad periodontal. Actualmente, con los cambios en los patrones dietéticos de la sociedad, se ha utilizado con mayor valor el uso de aceites naturales, ya que los estudios demuestran su importancia para la salud. Objetivo: Esta revisión integradora tuvo como objetivo seleccionar evidencias que mostraran el uso de aceites vegetales, con acción antimicrobiana, en el control del biofilm dental.Metodología: El relevamiento bibliográfico se realizó en julio y agosto de 2020, mediante investigación electrónica, consultando la base de datos Pubmed y SciELO (Scientific Electronic Library Online). Se utilizaron los descriptores: Aceites vegetales, agentes antimicrobianos, placa dental, odontología preventiva y odontología, los descriptores se utilizaron por separado y en corte transversal con el operador booleano AND. Se utilizaron los siguientes criterios de inclusión: Estudios clínicos, artículos completos y de libre acceso, publicados entre 2010 y 2020 en portugués y / o inglés, e indexados en las bases de datos ya citadas. Se excluyeron trabajos de finalización de curso, disertaciones, tesis, libros y capítulosde libros, así como artículos duplicados que no abordaran el tema de estudio. Resultados: Cuatro estudios de tipo clínico aleatorizado cumplieron con los criterios de investigación, los cuales mostraron la eficiencia de los aceites vegetales utilizados enel control del biofilm dental. Realizar investigaciones que involucren y motiven la industrialización de productos naturales contribuye a la Política Nacional de Prácticas Integrativas y Complementarias.Conclusiones: Los artículos analizados mostraron eficacia en el uso de aceites vegetales en el control del biofilm dental, los cuales fueron aplicados clínicamente sin mostrar daño a los participantes e indicados como coadyuvante en el mantenimiento de la salud bucal (AU).

Uso de Peróxido de Hidrógeno como Enjuague Bucal Previo a la Consulta Dental para Disminuir la Carga Viral de COVID-19. Revisión de la Literatura / Use of Hydrogen Peroxide as a Dental Pre-consultation Mouthwash to Decrease the Viral Load of COVID-19. Literature Review

RESUMEN: La utilización de enjuagues antisépticos previo a la atención odontológica favorecería la disminución del virus en la cavidad oral. Se ha planteado el uso de peróxido de hidrógeno preconsulta dental. Se revisaron las bases de datos PubMed, Cochrane y Elsevier publicados desde Enero 2019 a junio 2020. Los estudios que cumplieron los criterios de inclusión fueron revisados por 2 autores individualmente. Se realizó una revisión cualitativa de los datos. No existen ensayos controlados aleatorios o estudios de observación clínica sobre el efecto curativo o preventivo del peróxido de hidrógeno contra el COVID-19, pero si protocolos de ensayos clínicos que están en proceso de reclutamiento. El enjuague bucal con peróxido de hidrógeno podría ser una solución viable pre consulta dental que debe ser estudiada para reducir la carga viral del COVID-19.

ABSTRACT: The use of antiseptic rinses prior to dental care would favor the reduction of the virus in the oral cavity. The use of hydrogen peroxide prior to dental consultation has been proposed. PubMed, Cochrane and Elsevier databases published from January 2019 to June 2020 were reviewed. Studies that met the inclusion criteria were reviewed by 2 authors individually. A qualitative review of the data was performed. There are no randomized controlled trials or clinical observation studies on the curative or preventive effect of hydrogen peroxide against COVID-19, but there are clinical trial protocols that are in the process of recruitment. Hydrogen peroxide mouthwash could be a viable solution prior to dental consultation that should be studied, to reduce COVID-19 viral load.

Fundamentos de elección terapéutica: osteonecrosis maxilar asociada a drogas antirresortivas (MRONJ) / Fundamentals of therapeutic choice: anti-resorptive drug-related maxillary osteonecrosis (MRONJ)

La acción terapéutica favorable que los antirresortivos (bifosfonatos BPs, denosumab DS) y drogas antiangiogénicas ocasionan en el tejido óseo en aquellos pacientes que presentan como causa etiológica cáncer o discrasias óseas incluyen hipercalcemias malignas o ­si requieren el consumo de dicha droga a baja concentración­ como ser: osteoporosis, osteopenia, enfermedad de Paget, displasia fibrosa, Osteogénesis Imperfecta. (1) La presente actualización pretende relacionar el tratamiento odontológico con prescripción crónica y drogas antirresortivas, para lo cual American Association of Oral and Maxillofacial Surgeons AAOMS: define el concepto de Osteonecrosis Maxilar Asociada a drogas Antirresortivas (MRONJ) como: «Área ósea necrótica expuesta al medio bucal con más de ocho semanas de permanencia, en presencia de tratamiento crónico con bifosfonatos en ausencia de radioterapia en cabeza y cuello¼. La AAOMS estableció los siguientes grupos de acuerdo con sus características clínicas en 4 estadios (0, 1 ,2 y 3) de acuerdo con el aspecto clínico y radiológico de la lesión osteonecrótica. Estadío 0: lesión osteonecrótica sin evidencia de hueso necrótico en pacientes bajo consumo de drogas antirresortivas. Estadío 1: lesión osteonecrótica con signos clínicos y ausencia de sintomatología clínica. Estadío 2: lesión osteonecrótica con signo y sintomatología clínica evidente. Estadío 3: lesión osteonecrótica con signo y sintomatología evidente que compromete a estructuras nobles: fracturas patológicas, anestesia del nervio dentario inferior, comunicación buco-nasal, comunicación buco-sinusal, fístulas cutáneas (2) (AU)

It is known the favourable action which antiresorptive (Bisphosphonates BPs, Denosumab: DS) and Antiangiogenic drugs produce in bone tissue. High concentrations are primarily used as an effective treatment in the management of cancer-related disorders, including hypercalcemia of malignant. Besides, low concentrations are used for other metabolic bone diseases including Osteoporosis, Osteopenia, Paget's Disease, Fibrous Dysplasia, Imperfect Osteogenesis. (1) The update relate relationship between dentistry and chronic treatment with antiresorptive drugs. According to the American Association of Oral and Maxillofacial Surgeons (AAOMS), MRONJ is defined as exposed or necrotic bone in the maxillofacial region that has persisted for more than 8 weeks in association with current or previous BPs or DS therapy and with a lack of head and neck radiotherapy. AAOMS divided the MRONJ into 4 stages (0,1, 2 and 3) according to the clinical and radiological aspect of the osteonecrotic lesion: Stage 0: osteonecrotic lesion without sign-pathognomonic evidence of osteonecrosis. Stage 1: osteonecrotic lesion with clinical signs and absence of clinical symptoms. Stage 2: osteonecrotic lesion with sign and evident clinical symptoms. Stage 3: osteonecrotic lesion with signs and evident symptoms that involve noble structures: pathological fractures, anaesthesia of the lower dental nerve, oral-nasal communication, oral-sinus communication, skin fistulas (2) (AU)

Eficacia del uso de un enjuague con aceites esenciales para el control del biofilm dental / Efficacy of the use of a rinse with essential oils for the control of dental biofilm

Introducción: Se ha documentado que, para tener mejores resultados en el control del biofilm oral, es necesario el uso de controles químicos, antes o después del cepillado dental. Entre éstos, encontramos los enjuagues de aceites esenciales. Objetivo: Determinar la actividad del enjuague con aceites esenciales antes o después del cepillado, en el control del biofilm dental. Material y métodos: El estudio se realizó con 27 voluntarios. Los participantes fueron seleccionados y agrupados. El grupo 1 fue el control, que empleó su técnica de cepillado habitual y dos grupos experimentales que, además del cepillado con dentífrico, usaron un enjuague de aceites esenciales durante ocho días, ya sea antes (grupo 2) o después del cepillado dental (grupo 3). La cuantificación del número de superficies teñidas en los tres grupos, tanto el estado inicial como posterior al uso de los enjuagues, se hizo con el índice de O'Leary y un revelador de placa tritonal, el cual permitió la observación del biofilm de forma clínica, así como su grado de patogenicidad. Resultados y conclusión: El análisis estadístico estableció que no existe diferencia significativa entre no usar y usar el enjuague con aceites esenciales antes o después del cepillado (AU)

Introduction: It has been documented that, to have better results in the control of oral biofilm, it is necessary to use chemical control, before or after tooth brushing. Among these, we find the essential oil rinses. Objective: To determine the activity of the rinse with essential oils before or after brushing, in the control of the dental biofilm. Material and methods: The study was conducted with 27 volunteers. The participants were selected and grouped. Group 1 was the control, which used its usual brushing technique and two experimental groups that, in addition to brushing with toothpaste, used a mouthwash of essential oils, for eight days, either before (group 2) or after tooth brushing (group number 3). For the quantification of the number of stained surfaces in the three groups, to record both the initial and subsequent state of the use of the rinses, it was done with the O'Leary index and a tritonal developer, which allowed the observation of the biofilm of clinical form, as well as its degree of pathogenicity. Results and conclusion: The statistical analysis established that there is no significant difference between not using and using the rinse with essential oils before or after brushing (AU)

Impact of oral hygiene in patients undergoing mechanical ventilation in the COVID-19 pandemic

SUMMARY COVID-19, caused by SARS-CoV-2, can present respiratory complications that often lead patients to depend on mechanical ventilation (MV) for several days. It is known that Pneumonia Associated with Mechanical Ventilation (PAMV) is frequent in patients who use this equipment for a long time. As a consequence of COVID-19, its prolonged use can lead to a worse prognosis for the patients. For this reason, in addition to the insufficiency of devices for mechanical ventilation to meet the current demand, it is necessary to adopt measures aimed at preventing complications that may aggravate the patient's clinical condition and, consequently, increase the average hospital stay and the respective hospital care costs. Therefore, the objective of this study was to discuss, in a concise and practical way, and based on the available literature, the importance of adopting adequate oral hygiene protocols for patients on mechanical ventilation. Based on the data obtained, it was identified that the adoption of effective oral hygiene measures, especially under the supervision of dental professionals, can contribute to the reduction of morbidity and mortality associated with MV, resulting in greater availability of mechanical ventilation equipment. Since such equipment is in great demand during the COVID-19 pandemic, the knowledge and implementation of effective oral hygiene measures will undoubtedly have an impact on improving the quality of care offered to patients, therefore benefiting all those in critical health conditions and assisted in ICUs.

RESUMO A COVID-19, causada pelo Sars-CoV-2, pode apresentar complicações respiratórias que, muitas vezes, levam o paciente a depender da ventilação mecânica por vários dias. Sabe-se que a Pneumonia Associada à Ventilação Mecânica (PAVM) é frequente nos pacientes que utilizam esse equipamento por um longo período de tempo e que sua ocorrência, consequente à COVID-19, pode cursar com um pior prognóstico para o paciente. Por esse motivo, e somado à insuficiência de aparelhos para atendimento da demanda atual, faz-se necessária a adoção de medidas que visem à prevenção de complicações que possam agravar o quadro clínico do paciente e, consequentemente, aumentar o tempo médio de internação e os respectivos custos da assistência. Sendo assim, o objetivo deste estudo foi discorrer de forma concisa e prática, com base na literatura disponível, sobre a importância da adoção de protocolos adequados de higiene oral nos pacientes em ventilação mecânica. Com base nos dados obtidos, identificou-se que a adoção de medidas efetivas de higiene oral, principalmente sob a supervisão do profissional dentista, pode contribuir para a redução da morbimortalidade associada à PAVM, resultando em maior disponibilidade de equipamentos de ventilação mecânica. Desde que tais equipamentos estão sendo muito demandados durante a pandemia da COVID-19, o conhecimento e a implantação de medidas efetivas de higiene oral, indubitavelmente, repercutirão na melhoria da qualidade da assistência oferecida aos pacientes, portanto, beneficiando todos aqueles em situação crítica de saúde e assistidos em UTIs.

Instant and freshness effect of mouth rinses on type 1 (oral) halitosis / Efecto anti-halitosis instantáneo y efecto de frescura de los enjuagues bucales sobre la halitosis (oral) tipo I

Hygiene deficiency causes type 1 (oral) halitosis. There are short and long-term studies on the anti-halitosis effect of mouth rinses but less knowledge on their instant effects. The aim of this study was to compare instant and freshness effects of 8 mouth rinses on type 1 halitosis. Ninety self-reported halitosis patients (19-58 y.o., median 31) were randomly divided into 9 groups. Cysteine (20 mM) challenge test was applied to obtain maximum halitosis level in the mouth of each patient. Single use of 8 different mouth rinses (R1-R8) and tap water (R0) were tested on each group (n=10). Afterward, patients were requested to score oral freshness effect of the mouth rinse on a 5-point scale (0, bad; 5, fresh). Minimum halitosis level was obtained by rinsing with 20 mMol ZnCL2. In each step, oral gas (organic, NH3, SO2, H2S, H2) concentrations were quantified by using a portable multi-gas detector (MX6, IndSci, US). The ANOVA or Kruskal Wallis tests were used to compare the quantitative measurements. R3 (Halitosil Zn) mouth rinse was found to be have the highest instant anti-halitosis effect while the R2 (Colgate plax) had the lowest. The sensation of freshness was highest in R7 (Oxyfresh power mouth rinse lemon-mint) and lowest in R8 (Signal expert protection). The freshness effect was not associated with the anti-halitosis effect (r= 0.185, p=0.608). Mouth rinses containing ZnCl2 without alcohol are instantly effective on halitosis. Mouth rinses containing ethyl and other alcohols (including glycol, sorbitol, menthol, eucalyptol, thymol, xylitol and eugenol) were found to be less effective on halitosis.

La deficiencia de higiene causa halitosis tipo 1 (oral). Se han reportado efectos anti-halitosis a corto o largo plazo de los enjuagatorios bucales, pero se desconocen sus efectos instantáneos. El objetivo de este estudio fue comparar el efecto instantáneo y de frescura de 8 enjuagues bucales en la halitosis tipo 1. Noventa pacientes (19-58 años, mediana 31) que reportaron sufrir halitosis se dividieron aleatoriamente en 9 grupos. Se aplicó la prueba de provocación con cisterna (20 mM) para obtener el máximo nivel de halitosis en la boca de cada paciente. El uso individual de 8 enjuagues bucales diferentes (R1-R8) y agua del grifo (R0) se probó en cada grupo (n = 10). Posteriormente, se pidió a los pacientes que puntuaran el efecto de la frescura oral del enjuague bucal en una escala de 5puntos (0, malo; 5, fresco). El nivel mínimo de halitosis se obtuvo con 20 mMol de ZnCL2 enjuague. En cada paso, se cuantificaron las concentraciones de gases orales (orgánicos, NH3, SO2, H2S, H2) mediante el uso de un detector portátil de múltiples gases (MX6, IndSci, EE. UU.)Se encontró que el enjuague bucal R3 (Halitosil Zn) tiene un mayor efecto antihalitosis instantáneo, mientras que el R2 (Colgate plax) fue el más bajo. El sentido de frescura fue mayor en el enjuague bucal R7 (enjuague bucal Oxyfresh power lemon-mint) mientras que fue bajo en R8 (protección experta de Signal). El efecto de frescura no se asoció con el efecto anti-halitosis (r = 0.185, p=0.608). Los enjuagues bucales que contienen ZnCl2 sin alcohol son instantáneamente efectivos en la halitosis. Se encontró que los enjuagues bucales que contenían etil y otros alcoholes (incluidos glicol, sorbitol, mentol, eucaliptol, timol, xilitol y eugenol) son menos efectivos para el control de la halitosis.

Aclaramiento Dental con Enjuagues de Libre Venta que Contienen Peróxido de Hidrógeno / Toothbleaching with over the Counter Mouthwashes Containing Hydrogen Peroxide

RESUMEN: El objetivo de este estudio in vitro fue evaluar la eficacia en el aclaramiento dental de tres enjuagues orales que contienen peróxido de hidrógeno en diferentes períodos de inmersión en comparación con el peróxido de carbamida al 10 %. Cuarenta muestras de premolares humanos se dividieron aleatoriamente en cuatro grupos según el agente al que se expuso: G1: Colgate Plax®Whitening, G2: Listerine®Whitening Extreme y G3: Oral B® 3D White™ se sumergieron dos minutos al día durante 28 días y G4: Peróxido de carbamida al 10 %, ocho horas al día durante 14 días. La medición de color se realizó con un espectrofotómetro Vita Easyshade usando la escala CIELab inicialmente, a los 14, 28 y 35 días de evaluación. Las comparaciones entre los grupos se realizaron utilizando las pruebas Kruskal-Wallis y U Mann-Whitney, mientras que entre los tiempos las pruebas Friedman y Signo-Rango de Wilcoxon. Los resultados revelaron que a los 14 días, los cuatro grupos mostraron cambios de color, pero no se evidenció mayor eficacia de alguno sobre el otro (p>0,05). Sin embargo, a los 28 y 35 días se observó una clara eficacia del peróxido de carbamida sobre los enjuagues (p<0,05). Los enjuagatorios orales aclaran los dientes a partir de los 28 días, con los protocolos indicados; sin embargo no llegan a tener resultados similares a un aclaramiento profesional con gel de peróxido de carbamida al 10 %.

ABSTRACT: The objective of this in vitro study was to evaluate the efficacy in dental toothbleaching of three mouthwashes containing hydrogen peroxide in different periods of immersion compared to 10 % carbamide peroxide. Forty samples of human premolars were randomly divided into four groups according to the agent to which they were exposed: G1: Colgate Plax®Whitening, G2: Listerine®Whitening Extreme and G3: Oral B® 3D White ™ were immersed two minutes a day during 28 days and G4: 10 % carbamide peroxide, eight hours a day for 14 days. The color measurement was performed with a Vita Easyshade spectrophotometer using the CIELab scale initially, at 14, 28 and 35 days of evaluation. The comparisons between the groups were made using the Kruskal-Wallis and U Mann-Whitney tests. While between the times the tests Friedman and Sign-Range of Wilcoxon. The results revealed that at 14 days, the four groups showed color changes, but no greater effectiveness was shown of one over the other (p>0,05). However, at 28 and 35 days a clear efficacy of carbamide peroxide was observed on the rinses (p<0,05). Mouthwashes clear the teeth after 28 days, with the indicated protocols; however, they do not reach similar results to a professional clarification with 10 % carbamide peroxide gel.

Comparison of full-mouth scaling and quadrant-wise scaling in the treatment of adult chronic periodontitis

Abstract In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student's t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.

Resumo Na busca do tratamento ideal da doença periodontal varias são técnicas não-cirúrgicas que podem ser consideradas. O objetivo deste estudo foi avaliar a eficácia da técnica de desinfecção total de boca (FMD, na sigla em Inglês) por parâmetros clínicos e microbiológicos. Foram avaliados 670 indivíduos com 230 indivíduos atendendo aos critérios de seleção e divididos em dois grupos; 115 indivíduos tratados com FMD e 115 tratados com sessões semanais de raspagem e alisamento corono radicular (SRP, na sigla em Inglês). A população avaliada tinha idade média de 51,67 anos, com periodontite crônica moderada. Os sujeitos foram avaliados antes do tratamento (T1) e 90 dias após a execução da terapia (T2), quanto à profundidade de sondagem (PS), nível de inserção clínica (NIC), índice de placa (IP), índice gengival (IG) e detecção microbiana da presença de Porphyromonas gingivalis (P.g.) e Prevotella intermedia (P.i.) por método de cultura e confirmada por testes bioquímicos. Os indivíduos tratados no grupo FMD também realizaram bochechos com clorexidina 0,12% durante sete dias após o tratamento. Os resultados foram analisados ​​utilizando o teste estatístico t de Student e o teste de qui-quadrado. Não foram observadas diferenças estatisticamente significativas para PS e NIC entre T1 e T2 em ambos os grupos. Para IG e IP observou-se diferença significativa entre os grupos. Para os parâmetros microbianos avaliados foi observada redução de P.g. e P.i., mas apenas para P.g. com uma redução significativa em ambos os grupos. A técnica FMD com a metodologia utilizada neste estudo proporcionou condições clínicas melhoradas e redução da P.g. Em indivíduos com periodontite moderada, otimizando o tempo gasto na execução terapêutica.

Evaluation of the clinical effect of a probiotic mouthwash in the treatment of generalized marginal chronic gingivitis: randomized pilot study

Objective. to evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. methodology. four-week study conducted in San Luis Potosí, Mexico, from january to march 2017. participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. subjects were randomized and divided into three groups: group A: mouthwash based on 0.05 percent cetylpyridinium chloride (CPC) (positive control); group B: mouthwash based on probiotics (experimental); group C: placebo mouthwash (negative control). no oral hygiene practices or routines were modified; subjects were followed for 4 weeks. the primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. results. of the 45 patients included, 19 (42.2 percent) were men and 26 (57.7 percent) women, mean age was 22.8±2.07. each group consisted of 15 subjects; all subjects completed the study. there was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). however, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). conclusions. the use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. there were no statistically significant differences between the study groups.

Effect of Sequential Use of 0. 2% Chlorhexidine Mouthwash and Listerine on Microbial Plaque Control

Objective: To evaluate the effects of combined and sequential consumption of chlorhexidine and listerine mouthwashes on plaque indices. Material and Methods: Sixteen dental students, both genders, were selected. After prophylaxis, four mouthwash regimens were used, such that in each period, mouthwash was used for 5 days and after each period there was 4 days of washing out. During the mouthwash period, the participants did not use any mechanical plaque control tool. The four regimens included: first regimen, first chlorhexidine then listerine; second regimen, listerine then chlorhexidine; third regimen, only listerine; fourth regimen, chlorhexidine alone. At the end of the period, individuals were evaluated for plaque indices and investigated for bleeding during probing using ANOVA variance analysis and post-hoc Tukey test. The level of significance was set at 5%. Results: Regimen 1 with a plaque mean of 0.55 ± 0.25 had significantly lower plaque than other regimens. The maximum rate of plaque was observed in regimen 3. Probing did not cause bleeding in any of the individuals who used the four mouthwash regimens. Conclusion: The use of 0.2% chlorhexidine and listerine has the highest effect on plaque reduction.

Chlorhexidine for prevention of alveolar osteitis: a randomised clinical trial

Abstract Objective To determine the effectiveness of chlorhexidine 0.12% mouthwash (CHX) after tooth extraction for the prevention of alveolar osteitis (AO). Material and methods We conducted a double-blind randomised clinical trial stratified by risk factors. We enrolled a cohort of 822 patients who underwent dental extractions, and were considered to be at risk of developing AO (previous surgical site infection, traumatic extraction, and tobacco smoking). After extraction, patients were randomly allocated for CHX group or placebo group, matched by risk factors. The primary outcome was clinical diagnosis of AO: increasing postoperative pain for 4 d within and around the socket, and total or partial breakdown of the blood clot in the socket with or without bone exposure. Results Follow-up was completed by 744 participants (372 chlorhexidine and 372 placebo). We detected no significant differences between the two groups at baseline. After completed follow-up, risk factors were equally distributed between the two groups. Overall incidence of OA was 4.97%, in which 27 participants treated with placebo (7.26%) and 10 participants treated with CHX (2.69%) developed AO. CHX reduced the incidence of AO by 63% [Absolute Risk Reduction: 4.57 (95% CI 1.5-7.7), Number Needed to Treat: 21.88 (95% CI 13.0-69.3), Fisher's exact test: p=0.006]. No adverse effects were reported. Conclusion The use of chlorhexidine 0.12% mouthwash after tooth extraction is safe and effective in reducing the incidence of AO in high-risk patients.

Estudio del Efecto de un Enjuagatorio de Rosmarinus officinalis (Romero) en la Cicatrización de Heridas de Mucosa / Oral Study of the Effect of Rosmarinus officinalis (Rosemary) Mouthrinse on Healing Wounds of the Oral Mucosa

RESUMEN: El objetivo de este estudio fue evaluar el efecto de un enjuague oral de extracto acuoso de Rosmarinus Officinalis (romero) sobre la cicatrización de heridas de mucosa oral en sujetos sanos. Veintiocho estudiantes, de sexo masculino, edad promedio de 22 años, fueron reclutados para un estudio de doble ciego en la Facultad de Odontología de la Universidad de Concepción, Chile. Se creó una herida estándar de 3 mm de diámetro en la mucosa palatina, que fue fotografiada durante un período de 21 días para determinar su tamaño por fotoplanimetría. Los voluntarios recibieron enjuagues orales para ser utilizados a diario desde el día de creación de la herida, 3 veces al día, y fueron divididos en grupo control (enjuague placebo) y grupo experimental (enjuague de extracto de romero). El extracto acuoso de Romero fue analizado por HPLC, mostrando un alto contenido de carnosol (83 %) y ácido rosmarínico (65 %). Se observó una disminución significativa en el tamaño de la herida del grupo tratado con enjuague de romero comparado con el tratado con enjuague placebo al día 3 de cicatrización (20 %, p=0,046, Mann-Whitney). Posteriormente no se encontraron diferencias, completándose la cicatrización antes del día 21 para ambos grupos. Los resultados sugieren que el enjuagatorio de extracto acuoso de romero favorece la cicatrización temprana de las heridas, lo que puede deberse a su alto contenido de carnosol y ácido rosmarínico que han demostrado estimular la cicatrización y poseer actividad antimicrobiana.

ABSTRACT: The objective of the study was to evaluate the effect of a mouthrinse containing an aqueous extract of Rosmarinus officinalis (rosemary) on healing wounds of the oral mucosa in healthy subjects. Twenty Eight healthy, non-smoking male students, mean age 22 years, were recruited for a double-blind study at the School of Dentistry of the University of Concepción, Chile. A standard 3mm wound was created on the palate with a punch biopsy. The wounds were photographed to assess healing for 21 days. The subjects were instructed to use a mouthrinse 3 times daily for 21 days, starting the day of wounding, and were divided into a control group (placebo) and an experimental group (rosemary extract). The aqueous rosemary extract used for the mouthrinse had a high content of carnosol (83 %) and rosmarinic acid (65 %) as determined by HPLC. We observed a 20 % reduction in wound size by day 3 in the rosemary mouthrinse group as compared to the placebo mouthrinse group (p=0.04, Mann Whitney). Thereafter, no significant differences in wound closure were observed. Healing was completed by day 21 in both groups. The results suggest that the mouthrinse containing the aqueous rosemary extract stimulates early healing of mucosal wounds. This could be due to the high content of carnosol and rosmarinic acid, which are known for their healing and antimicrobial properties.

Non-invasive treatment of an acute sinusitis after open maxillary sinus floor augmentation with simultaneous bone graft and implant placement: case report

Currently, the maxillary sinus floor augmentation technique is one of the most common procedures used in implantology. Despite being a straightforward techn istula, epistaxis, perforation of the Schneiderian membrane and acute sinusitis. Although many theories have been proposed as to the etiology of sinusitis, the majority of cases are due to idiopathic causes. Its treatment can often be very complex and traumatic for the patient. It normally involves antibiotic treatment combined with surgical or endoscopic procedures. The following case describes the full resolution of this disorder with abundant sinus rinsing with salt water and combined treatment of antibiotics and mucolytics without the need for removal of the implant or bone graft. Despite the disorder in this case being eradicated with a different approach combining antibiotics, mucolytics and sinus rinses, it is concluded that more studies are necessary before it is established as a definitive treatment procedure.

Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Abstract The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. Sixty systemically healthy volunteers receiving dental prophylaxis were randomly assigned to one of the following experimental groups (15 per group): (i) rinsing with 0.075% CPC, 0.28% Zn and 0.05% F (CPC+Zn+F), (ii) water or (iii) 0.12% chlorhexidine digluconate (CHX), and (iv) no rinsing. Viable bacteria were collected from different locations in the dental office on enriched TSA plates and anaerobically incubated for 72 hours. The colonies were counted and species were then identified by Checkerboard DNA–DNA Hybridization. The total number of colony-forming units (CFUs) detected in the aerosols from volunteers who rinsed with CPC+Zn+F or CHX was statistically significantly (p<0.05) lower than of those subjects who did not rinse or who rinsed with water. When all locations were considered together, the aerosols from the CPC+Zn+F and CHX groups showed, respectively, 70% and 77% fewer CFUs than those from the No Rinsing group and 61% and 70% than those from the Water group. The mean proportions of bacterial species from the orange complex were statistically significantly (p<0.05) lower in aerosols from the CPC+Zn+F and CHX groups compared with the others two groups. In conclusion, the mouthwash containing CPC+Zn+F, is effective in reducing viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler.