Tratamento de lesão periradicular, de origem endodôntica, com auxílio de laserterapia: uma revisão sistemática da literatura e apresentação se caso clínico / Treatment of periradicular injury, of endodontic origin, with the aid of laser therapy: a systematic review of the literature and presentation if clinical case

É sabido que a cavidade oral é a porta de entrada para muitos microrganismos e que possui alguns gêneros de bactérias que quando se associam ou proliferam em excesso, com a falta de higienização correta, fatores ambientais e imunológicos podem causar danos em algumas partes dos dentes como no tecido pulpar e canais radiculares. Neste sentido, a endodontia tem sido capaz de tratar pessoas com problemas dentários em fases muito precoces como as medidas profiláticas até casos infeciosos que afetam a polpa dos dentes causando as lesões perirradiculares que são infecções causadas por microrganismos, Para tanto, é necessário que a odontologia ofereça transformações positivas por meio de técnicas que sejam mais previsíveis para os tratamentos. A literatura tem indicado o uso da laserterapia como técnica auxiliar para o tratamento endodôntico pelo seu potencial mínimo invasivo, preciso e eficaz em menor tempo de cura de patologias orais como as lesões perirradiculares. Este estudo pretendeu abordar a importância da laserterapia sobre as variáveis patológicas de pacientes com lesão perirradiculares. Para realiza-lo foi necessário buscar na literatura estudos que associem este tipo de tratamento e sua eficiência no tratamento desta patologia. Para realizar esta pesquisa foi necessário buscar dados na literatura que tratam sobre o tema para investigar o tempo indicado ao tratamento com a laserterapia bem como o estágio em que as lesões podem ser tratadas com auxílio deste método. Corroborando com o estudo apresentamos um caso clínico(AU)

It is known that the oral cavity is the gateway to many microorganisms and that it has some genera of bacteria that when they associate or proliferate in excess, with the lack of correct hygiene, environmental and immunological factors can cause damage in some parts of the teeth such as in pulp tissue and root canals. In this sense, endodontics has been able to treat people with dental problems at very early stages such as prophylactic measures to infectious cases that affect the pulp of teeth causing perirradicular lesions that are infections caused by microorganisms, therefore, it is necessary that dentistry offer positive transformations through techniques that are more predictable for treatments. The literature has indicated the use of laser therapy as an auxiliary technique for endodontic treatment for its minimal invasive, precise and effective potential in shorter time of cure of oral pathologies such as perirradicular lesions. This study aimed to address the importance of laser therapy on the pathological variables of patients with perirradicular lesions. To accomplish this, it was necessary to seek studies in the literature that associate this type of treatment and its efficiency in the treatment of this pathology. To carry out this research it was necessary to seek data in the literature that deal with the subject to investigate the time indicated for treatment with laser therapy as well as the stage at which lesions can be treated with the aid of this method. Corroborating the study, we present a clinical case(AU)

Traceability of Geographic Origin Using Human Skin and Oral Microbiota / 法医学杂志

OBJECTIVES@#To explore the possibility of using human skin and oral microorganisms to estimate the geographic origin of an individual through the sequencing analysis of bacterial 16S rRNA gene.@*METHODS@#Microbial DNA was extracted from the palm and oral microorganisms of the Han population in Shanghai and Chifeng, Inner Mongolia, and the composition and diversity of the microbiota were analyzed by full-length 16S rRNA gene sequencing. Then, differential species were screened and a geographic location prediction model was constructed.@*RESULTS@#The compositions of palm and oral microorganisms between Shanghai and Chifeng samples were both different. The abundance and uniformity of palm side skin microorganisms were higher in Chifeng samples than in Shanghai samples, while there was no significant difference in oral microorganisms. Permutational multivariate analysis of variance (PERMANOVA) confirmed that the β-diversity between the samples from the two places were statistically significant, and the coefficients of determination (R2) for skin and oral samples were 0.129 and 0.102, respectively. Through principal co-ordinates analysis (PCoA), the samples from the two places could be preliminarily distinguished. The predictive model had the accuracies of 0.90 and 0.83 for the geographic origin using the skin and oral samples, respectively.@*CONCLUSIONS@#There are differences in the compositions of palm and oral microbiota between Han populations in Shanghai and Chifeng. The prediction model constructed by the random forest algorithm can trace the unknown individuals from the above two places.

Mecanismos de Acción de la Microbiota Oral en el Desarrollo del Cáncer: revisión Sistemática Exploratoria / Action Mechanisms of the Oral Microbiota in the Development of Cancer: scoping Review

En esta revisión sistemática exploratoria, presentamos la evidencia registrada en la literatura, de que la microbiota oral puede generar una acción carcinogénica, actuando a través de tres mecanismos principales: sobre el medio extracelular, activando vías de señalización intracelular y/o generando acción directa sobre el DNA, y que las principales bacterias estudiadas corresponden a Fusobacterium nucleatum y Porphyromona gingivalis. En la actualidad hay evidencia suficiente acerca de la asociación entre microbiota oral y distintos tipos de cáncer, sin embargo, no hay gran conocimiento de los mecanismos por los cuales esta microbiota participa en su desarrollo. Presentamos una recopilación de los diversos mecanismos de acción que utilizan las bacterias de la cavidad oral en el proceso de carcinogénesis en cuatro tipos diferentes de cáncer. Es de gran importancia aumentar el conocimiento acerca del rol etiológico de la microbiota oral en el desarrollo de la enfermedad de cáncer debido a que se establecería como un nuevo agente carcinogénico y su conocimiento podría ser utilizado como una herramienta valiosa en la detección y tratamiento de esta enfermedad.

In this Scoping Review, we present the evidence recorded in the literature about that oral microbiota can generate a carcinogenic action, acting through three main mechanisms: on the extracellular space, activating intracellular signaling pathways and/or generating direct action on DNA, and that the principal pathogens studied are Fusobacterium nucleatum and Porphyromona gingivalis. Nowadays, there is sufficient evidence about the association between oral microbiota and several types of cancer, however, there is not much knowledge about the mechanisms by which this microbiota participates in its development. We present a compilation of different mechanisms of action used by oral cavity bacteria in the process of carcinogenesis in four different types of cancer. It is of great importance to increase the knowledge about the etiological role of the oral microbiota in the development of cancer disease because it would be established as a new carcinogenic agent and its knowledge could be used as a valuable tool in the detection and treatment of this disease.

Disbiosis bacteriana y su efecto en enfermedades bucales: una revisión bibliográfica / Bacterial dysbiosis and its effect on oral diseases: a review bibliographic

Objetivo: actualizar la información sobre la disbiosis bacteriana oral y su efecto en enfermedades bucales. Material y métodos: se realizó una revisión bibliográfica detallada, donde la búsqueda de artículos comenzó desde el 2014 con trabajos de investigación relacionados con el tema. Se aplicaron palabras clave para facilitar y delimitar el tema. En los resultados obtenidos se observa información específica de disbiosis bacteriana y los problemas y enfermedades que causan en la cavidad bucal. Conclusión: la cavidad oral es un ecosistema muy complejo e interactivo donde se desarrollan variedades de hábitats que establecen relaciones entre los microorganismos en los distintos medios bucales. Por lo general, el cuerpo humano vive en simbiosis con dichas bacterias, esta relación hospedador-huésped es producto de años de evolución y convivencia para poder tolerar a dichas especies y por medio de años de investigación, determinar a los agentes patógenos y a los simbióticos, lo que permitirá en un futuro tener enfoques terapéuticos y científicos, para así solucionar, mejorar y evitar problemas relacionados con la salud (AU)

Objective: this review aimed to update the information on oral bacterial dysbiosis and its effect on oral diseases. Material and methods: a detailed literature review was performed, where the search for articles began in 2014 with research papers related to the topic. Keywords were applied to facilitate and delimit the topic. The results obtained show specific information on bacterial dysbiosis and the problems and diseases they cause in the oral cavity. Conclusion: the oral cavity is a very complex and interactive ecosystem where a variety of habitats develop and establish relationships between microorganisms in different oral environments. Generally, the human body lives in symbiosis with these bacteria, this host-guest relationship is the product of years of evolution and coexistence to be able to tolerate these species and through years of research to determine the pathogens and symbiotics, which will allow in the future to have therapeutic and scientific approaches, to solve, improve and avoid health-related problems (AU)

Oral microbiota in human systematic diseases / 国际口腔科学杂志·英文版

Oral bacteria directly affect the disease status of dental caries and periodontal diseases. The dynamic oral microbiota cooperates with the host to reflect the information and status of immunity and metabolism through two-way communication along the oral cavity and the systemic organs. The oral cavity is one of the most important interaction windows between the human body and the environment. The microenvironment at different sites in the oral cavity has different microbial compositions and is regulated by complex signaling, hosts, and external environmental factors. These processes may affect or reflect human health because certain health states seem to be related to the composition of oral bacteria, and the destruction of the microbial community is related to systemic diseases. In this review, we discussed emerging and exciting evidence of complex and important connections between the oral microbes and multiple human systemic diseases, and the possible contribution of the oral microorganisms to systemic diseases. This review aims to enhance the interest to oral microbes on the whole human body, and also improve clinician's understanding of the role of oral microbes in systemic diseases. Microbial research in dentistry potentially enhances our knowledge of the pathogenic mechanisms of oral diseases, and at the same time, continuous advances in this frontier field may lead to a tangible impact on human health.

Oral carriage of staphylococcus aureus in people with different body mass index / Colonización oral por staphylococcus aureus en personas con diferente índice de masa corporal

Background: The association between obesity and the oral microbiome has received great attention. Objective: This study aimed to determine the association of oral Staphylococcus aureus with different body mass index people. Material and Methods: A total of 155 saliva samples were collected. The individuals were grouped into three categories according to their BMI, normal weight, overweight and obese individuals. A loopful of saliva sample was cultured and incubated at 37°C for 24. Staphylococcus aureus isolates were diagnosed by colony characteristics, morphology, and biochemical tests. Results: The oral carriage rate of Staphylococcus aureus was 61.3% (65.1% females and 56.5% males). The Staphylococcus aureus rate was 68% in married and 60% in single people. The differences of oral carriage rates of Staphylococcus aureus in obese (73.6%) and overweight (85.4%) populations was statistically significant (p<0.0001) compared to the rate in normal weight group (34%). Among males, the highest oral carriage rate of Staphylococcus aureus was in overweight individuals (82.6%). Likewise, in females, the highest rate of salivary Staphylococcus aureus was among the overweight group (88.9%). Regarding marital status, in single people, the differences of Staphylococcus aureus in obese (p=0.0003) and overweight (p<0.0001) people was significantly compared to normal weight people. But, in married people, the differences in Staphylococcus aureus rates among all groups were statistically not significant (p=0.0935). Conclusion: Staphylococcus aureus was significantly related to overweight and obese individuals. The human oral Staphylococcus aureus may play a key role in the manifestation of obesity. The oral microbiota could provide a new target for improving the physical well being of humans.

Antecedentes: la asociación entre la obesidad y el microbioma oral ha recibido gran atención. Objetivo: Este estudio tuvo como objetivo determinar la asociación de Staphylococcus aureus oral en personas con diferentes índices de masa corporal. Material y Métodos: Se recolectaron un total de 155 muestras de saliva. Los individuos fueron agrupados en tres categorías según su indice de masa corporal: normopeso, sobrepeso y obesos. Se cultivó un asa de muestra de saliva y se incubó a 37°C durante 24 horas. Los aislamientos de Staphylococcus aureus se identificaron mediante las características de la colonia, la morfología y las pruebas bioquímicas. Resultados:La tasa de colonización oral por Staphylococcus aureus fue del 61,3% (65,1% mujeres y 56,5% hombres). La tasa de colonización por Staphylococcus aureus fue del 68% en casados y del 60% en solteros. Las diferencias de las tasas de portación oral de Staphylococcus aureus en las poblaciones obesas (73,6%) y con sobrepeso (85,4%) fueron estadísticamente significativas (p<0,0001) en comparación con la tasa en el grupo de peso normal (34.0%). Entre los hombres, la tasa más alta de portadores orales de Staphylococcus aureus fue en individuos con sobrepeso (82,6%). En las mujeres, la tasa más alta de Staphylococcus aureus salival se también se presentó en el grupo con sobrepeso (88,9 %). En cuantal estado civil, en solteros, las diferencias de Staphylococcus aureus en obesos (p=0,0003) y con sobrepeso (p<0,0001) fueron significativas compararadas con normopeso. Pero, en personas casadas, las diferencias en las tasas de Staphylococcus aureus entre todos los grupos no fueron estadísticamente significativas (p=0,0935). Conclusion: Staphylococcus aureus salival se relacionó significativamente en individuos con sobrepeso y obesidad. El Staphylococcus aureus oral humano puede jugar un papel clave en la manifestación de la obesidad. La microbiota oral podría proporcionar una nueva diana para mejorar el estado físico de los humanos

Resistencia de Cepas de Staphylococcus aureus Aisladas de la Mucosa Oral de una Población Joven Peruana / Resistance of Staphylococcus aureus Strains Isolated from the Oral Mucosa in a Young Peruvian Population

Staphylococcus aureus es un patógeno importante responsable de una variedad de enfermedades infecciosas. La emergencia de cepas resistentes a la meticilina es un tema preocupante. Existen escasos estudios que hayan reportado la resistencia de cepas aisladas de la cavidad bucal. Determinar la sensibilidad antimicrobiana de cepas de Staphylococcus aureus aisladas de mucosa bucal de portadores asintomáticos jóvenes peruanos. Se incluyeron 64 individuos a quienes se tomaron muestras de mucosa oral, mucosa nasal y de manos. Las muestras fueron cultivadas en agar manitol salado. La prueba coagulasa fue empleada para confirmar la presencia de Staphylococcus aureus. Luego se realizó el antibiograma usando el método de Kirby-Bauer. La prevalencia de colonias positivas de S. aureus provenientes de la mucosa oral, mucosa nasal y de la palma de la mano fue 7,8 %, 15,6 % y 50,0 %, respectivamente. En todas las muestras, se observaron una prevalencia de sensibilidad menor de 40 % y 11 % a la eritromicina y penicilina, respectivamente. Las colonias de la mucosa oral mostraron resistencia a la penicilina. En todas las muestras, se observó una prevalencia de sensibilidad ³ 60% en amoxicilina/ácido clavulánico, co-trimoxazol, gentamicina, oxacilina, ciprofloxacino, vancomicina y ampicilina/sulbactam. Se encontró resistencia a vancomicina en un 10 - 20 % de todas las muestras. Se encontró una alta prevalencia en la sensibilidad a amoxicilina/ácido clavulánico, gentamicina, cotrimoxazol, oxacilina, ciprofloxacino y ampicilina/sulbactam. Se encontró un elevado porcentaje de resistencia a la vancomicina en muestras de mucosa oral en comparación a otros estudios.

Staphylococcus aureus is an important pathogen responsible for a variety of infectious diseases. The increase of resistant strains is an issue of concern. There are very few studies reporting the resistant strains isolated from oral cavity. Aim: To determine the antimicrobial susceptibility of Staphylococcus aureus isolated from oral mucosa of Peruvian young healthy carriers. The study included 64 healthy individuals whose oral mucosa, nasal mucosa and hand swabs were collected and seeded in salt mannitol agar for primary isolation. Then, coagulase test was performed to confirm the presence of Staphylococcus aureus. After that, colonies of Staphylococcus aureus underwent antibiogram by using the Kirby Bauer method. The prevalence of Staphylococcus aureus positive strains isolated from oral mucosa, nasal mucosa, and hand, was 7.8 %, 15.6 %, 50.0 %, respectively. There was less than 40 % and 11 % of prevalence of susceptibility to erythromycin and penicillin, respectively, in the three studied samples. There was equal or more than 60% of prevalence of susceptibility to amoxicillin/clavulanic acid, cotrimoxazole, gentamicin, oxacillin, ciprofloxacin, vancomycin and ampicillin/sulbactam in all the studied samples. Vancomycin resistance was found in 10 - 20 % of all samples. A high prevalence in susceptibility to amoxicillin/ clavulanic acid, gentamicin, co-trimoxazole, oxacillin, ciprofloxacin, vancomycin and ampicillin /sulbactam in healthy carriers was found. Vancomycin resistance percentage is higher than previous reports.

Does Oral Hygiene Influence Salivary pH, Lactate, and IL-1β of Basketball Players During Intense Exercise? / La Higiene Oral Influye en el pH Salival, el Lactato y la IL-1β de los Jugadores de Baloncesto Durante el Ejercicio Intenso?

ABSTRACT: This study examined the salivary pH, salivary lactate, and salivary IL-1 β responses from a high-intensity intermittent running test, and the influence of hygiene oral status on these biomarkers in elite adolescent basketball players. Forty-six adolescent players participated. Saliva sampling was taken before and 3 min after a high-intensity exercise (Yo-Yo Intermittent Recovery Test Level 1; Yo-Yo IR1). In order to quantify and classify the oral hygiene level, the athletes were submitted to a dental examination, and an adapted Simplified Oral Hygiene Index was applied. After the dental examination, the whole group was divided into good oral hygiene group (GHG) and poor oral hygiene group (PHG). The results of a two- way analysis of variance showed a significant interaction effect (P = 0.0003), group effect (P < 0.0001), and time effect (pre to post Yo-yo IR1; P < 0.0001) for salivary pH and for salivary lactate (interaction effect, P = 0.008; group effect, P < 0.000 1; time effect, P < 0.0001) with a lower salivary pH and a higher salivary lactate at pre and post-Yo-Yo IR1 for PHG, but no difference was observed for IL-1β. The data demonstrated that the high-intensity exercise led to a significant change in salivary pH and salivary lactate concentration of the basketball players, and that the oral hygiene status influenced these responses, with a greater change for those players showing a poor oral hygiene.

RESUMEN: Este estudio examinó las respuestas de pH salival, lactato salival e IL-1β salival de una prueba de carrera intermitente de alta intensidad, y la influencia del estado de higiene oral en los biomarcadores en jugadores adolescentes de baloncesto de élite. En el análisis participaron 46 jugadores adolescentes. Se tomó una muestra de saliva antes y 3 minutos después de un ejercicio de alta intensidad (Prueba de recuperación intermitente Yo-Yo Nivel 1; Yo-Yo IR1). Para cuantificar y clasificar el nivel de higiene oral, los atletas fueron sometidos a un examen dental y se aplicó un índice adaptado de higiene oral simplificado. Después del examen dental, el grupo se dividió en un grupo de buena higiene oral (GHG) y un grupo de mala higiene oral (PHG). Los resultados de un análisis de varianza mostraron un efecto de interacción significativo (P = 0.0003), efecto de grupo (P<0.0001) y efecto de tiempo (antes y después de Yo-yo IR1; P <0.0001) para el pH salival y para lactato salival (efecto de interacción, P = 0.008; efecto de grupo, P <0.0001; efecto de tiempo, P <0.0001) con pH salival más bajo y lactato salival más alto en IR1 pre y post YoY para PHG, pero no se observó una diferencia para IL-1β. Los datos demostraron que el ejercicio de alta intensidad genera un cambio significativo en el pH salival y el lactato de los jugadores de baloncesto, y que el estado de higiene oral influyó en estas respuestas, con un cambio mayor para aquellos jugadores que mostraron una mala higiene oral.

Microbiota oral e retal de calitriquídeos (Callithrix sp) em área antropizada de Mata Atlântica, Rio de Janeiro, Brasil / [Oral and rectal microbiota of callitrichids (Callithrix sp) in an anthropized area of the Atlantic Forest in Rio de Janeiro, Brazil]

A proximidade dos primatas não humanos (PNH) com o ser humano pode ser considerada um fator de risco para transmissão de bactérias entre essas duas populações. Neste estudo, foi investigada a microbiota anfibiôntica aeróbica oral e retal de calitriquídeos em um fragmento de Mata Atlântica localizado no Rio de Janeiro, Brasil, e foram realizados testes fenotípicos para detecção de bactérias multirresistentes nos isolados encontrados. Foram capturados 14 calitriquídeos e coletadas 21 amostras (14 de cavidade oral e sete de cavidade retal) em dois pontos da mata próximos às habitações humanas. As espécies mais frequentes, na cavidade oral, foram Klebsiella oxytoca (50,0%), K. pneumoniae (28,6%), Kluyvera ascorbata (21,4%) e Stenotrophomonas maltophilia (21,4%) e, na cavidade retal, K. pneumoniae (85,7%), Escherichia coli (28,6%) e Enterobacter spp. (42,9%). Todos os 48 isolados da família Enterobacteriaceae foram negativos para ESBL (betalactamase de espectro ampliado), mostrando-se não produtores da enzima nos dois métodos utilizados: disco-aproximação e método de detecção automatizado. Na pesquisa de ERC (enterobactérias resistentes a carbapenêmicos), esses mesmos isolados não apresentaram resistência aos antibióticos imipenem, meropenem e ertapenem. Todas as bactérias isoladas apresentam um potencial zoonótico, o que representa um risco à saúde pública e à conservação das espécies.(AU)

Proximity of nonhuman primates (NHP) to humans can be considered a risk factor for transmission of pathogens between these two populations. This study investigated the oral and rectal aerobic bacterial microbiota of marmosets in an anthropized area of the Atlantic Forest located in Rio de Janeiro, Brazil, and performed phenotypic tests for detection of multidrug-resistant bacteria. Twenty-one samples (14 from the oral cavity and seven from the rectum) were collected from 14 Callithrix sp. captured in two sites of the forest near human dwellings. The most frequent species identified from the oral cavity swabs were Klebsiella oxytoca (50.0%), K. pneumoniae (28.6%), Kluyvera ascorbata (21.4%) and Stenotrophomonas maltophilia (21.4%), whereas the species most commonly identified from the rectum swabs were K. pneumoniae (85.7%), Enterobacter spp. (42.9%) and Escherichia coli (28.6%). All isolates of family Enterobacteriaceae showed no extended spectrum ß-lactamase production by disk-diffusion and automated detection tests. In the search for carbapenem-resistant enterobacteriaceae these isolates presented no resistance to the imipenem, meropenem and ertapenem antibiotics. The isolate of Staphylococcus aureus was susceptible to oxacillin and the isolate of Enterococcus was susceptible to vancomycin. All isolated bacteria showed zoonotic potential, thus posing a risk to species conservation and public health.(AU)

Impacto do uso de probióticos sobre o biofilme bucal / Impact of the use of probiotics on oral biofilme

Objetivo: o objetivo desse estudo foi realizar uma revisão integrativa sobre o impacto do uso de probióticos sobre o biofilme bucal. Revisão de literatura: a busca foi feita nas bases de dados Scielo, Science Direct, PubMed e LILACS, utilizando-se como descritores os termos probióticos, biofilme, cárie e periodontite, nos idiomas português e inglês. Foram selecionados os estudos que delimitavam o assunto em relação ao biofilme bucal. Foram encontrados 1689 artigos e selecionados 48. Os resultados demonstraram empregabilidade otimista dos probióticos, visto que apenas 2 artigos selecionados não obtiveram resultados positivos. Dentre as bactérias probióticas, a Lactobacillus salivarius e a Lactobacillus casei foram as mais utilizadas. Sugerem-se produtos viscosos como meio de utilização, por sua boa substantividade. Considerações finais: Recomenda-se que sejam realizados mais estudos com metodologias comparáveis, para melhor compreensão do efeito dos probióticos no biofilme bucal e para que sejam padronizadas doses, modo de administração, tempo da duração do seu efeito, bem como as cepas e as espécies bacterianas mais eficazes para cada objetivo. Principalmente, compreender melhor o seu mecanismo de ação para que assim possa ser protocolada uma técnica eficiente, fundamentada e segura para sua aplicação.

Objectives: to carry out an integrative review on the impact of the use of probiotics on oral biofilm. Materials and method: the search was done in the databases SciELO, Science Direct, PubMed and LILACS, using the terms probiotics, biofilm, caries and periodontitis, in Portuguese and English. The studies selected were those that delimited the subject in relation to the oral biofilm. Results: a total of 1.689 articles were found and 48 were selected. The results demonstrated optimum employability of probiotics, since only two of the selected articles did not obtain positive results. Among the probiotic bacteria, Lactobacillus salivarius and Lactobacillus casei were the most used. Viscous products are suggested as a means of use because of their good substantivity. Final considerations: it is recommended that further studies be conducted with comparable methodologies to better understand the effect of probiotics on oral biofilm and to standardize doses, mode of administration, duration of their effect, as well as the most effective strains and bacterial species for each objective. Mainly, it is necessary a better understanding of the mechanism of action, so that an efficient, reasoned and safe technique can be defined for its application.(AU)

Probable Association Between Oral Lichen Planus and presence of Helicobacter Pylori: a Preliminary Study in a Chilean Population / Probable Asociación entre Liquen plano Oral y la presencia de Helicobacter pylori: estudio Preliminar en Chile

ABSTRACT: Oral Lichen planus (OLP) is one of the main inflammatory diseases of the oral mucosa that is considered as a potentially malignant disorder. The exact pathogenesis of OLP remains to be completely understood. However, presence of bacteria has been associated to the inflammatory response observed in OLP. Particularly, Helicobacter pylori a major etiological agent of gastrointestinal inflammatory diseases and risk factor for gastric cancer, has been associated to Lichen planus. Here we studied a group of Chilean patients if there is any association between the presence of Helicobacter pylori and the clinical manifestation of OLP. We found a significant difference between the patients positive for H. pylori and the age of OLP diagnosis, suggesting that oral H. pylori might induce the disease at an earlier age. However, we could not confirm a statistically significance between the presence of the bacteria and OLP.

RESUMEN: Liquen Plano Oral (LPO) es una enfermedad inflamatoria de la mucosa oral considerada como desorden potencialmente maligno. La patogénesis exacta de LPO es desconocida. Sin embargo, se ha asociado la presencia de bacterias como responsables de la inflamación observada en LPO. Particularmente, Helicobacter pylori (H. pylori), agente etiológico principal de enfermedades inflamatorias gastrointestinales y factor de riesgo de cáncer gástrico, ha sido asociado con LPO. Se estudió la posible asociación entre H. pylori y manifestaciones clínicas de LPO en un grupo de pacientes Chilenos. Se encontró diferencia significativa entre los pacientes positivos para H. pylori y la edad de diagnóstico de LPO, sugiriendo que H. pylori podría inducir la enfermedad a temprana edad. Sin embargo, no se pudo confirmar significancia estadística entre la presencia de esta bacteria y la presencia de displasia en LPO.

Aleitamento natural e artificial: relações com a ocorrência de bactérias cariogênicas e saúde do bebê / Natural and artificial breastfeeding: relationships with the occurrence of cariogenic bacteria and baby's health

A Organização Mundial de Saúde recomenda o aleitamento materno exclusivo durante os primeiros 6 meses de vida do bebê, e sabe-se que hábitos alimentares inadequados estão associados a várias doenças, como cárie dentária e obesidade. A cárie dentária está relacionada a microrganismos como Streptococcus mutans que, por sua vez, facilitam a colonização por Candida. O objetivo nesta pesquisa foi analisar a ocorrência de S. mutans, Candida, uso de antibiótico, internação hospitalar e hábitos alimentares da criança e relacionar esses aspectos com a modalidade de aleitamento, no binômio mãe-filho, bem como com o índice de higiene bucal. Trata-se de um recorte de um estudo longitudinal, com 42 pares de mães e crianças aos 30 meses de vida. O exame clínico, para averiguação de presença de cárie e Índice de Higiene Oral Simplificado (IHOS), foi realizado nos pares em visitas domiciliares, além de aplicação de questionário sobre hábitos alimentares, uso de antibiótico e internação da criança, e coleta de saliva de mãe e filho, para análise de cultura de S. mutans e Candida. Como principais resultados, verificou-se que 64,28% das mães interromperam o aleitamento materno antes dos 06 meses de idade do bebê, 100,00% de bebês apresentaram S. mutans, 51,28% apresentaram Candida, 57,14% dos bebês foram submetidos à antibioticoterapia, 21,42% foram internados, 73,80% tinham hábitos alimentares inadequados, 71,43% fizeram uso de aleitamento artificial e 100,00% apresentaram (IHOS) baixo, e 11,90% das crianças apresentaram lesão de cárie. Portanto, com base nos resultados obtidos e respeitando-se os limites do estudo, concluiu-se que não houve relação da variável desmame precoce com a presença de S. mutans e Candida, uso de antibióticos e a internação hospitalar da criança, porém, houve a associação de presença de cárie com as variáveis desmame precoce-hábito alimentar (p=0,046) e uso de mamadeira-aleitamento artificial (p=0,018)(AU)

The World Health Organization recommends exclusive breastfeeding during the first 6 months of the baby's life, and inadequate eating habits are associated with several diseases, such as tooth decay and obesity. Dental caries is related to microorganisms such as Streptococcus mutans that facilitate colonization by Candida. The objective of this research was to analyze the occurrence of S. mutans, Candida, use of antibiotics, hospitalization and children's eating habits and to relate these aspects with the type of breastfeeding, in the mother-child binomial, as well as with the oral hygiene index. This is an excerpt from a longitudinal study, with 42 pairs of mothers and children at 30 months of age. The clinical examination, to check for the presence of caries and Simplified Oral Hygiene Index (IHOS), was carried out in pairs in home visits, in addition to the application of a questionnaire on eating habits, use of antibiotics and hospitalization of the child, and collection of saliva from mother and son, for culture analysis of S. mutans and Candida. As main results, it was found that 64.28% of mothers stopped breastfeeding before the baby was 6 months old, 100.00% of babies had S. mutans, 51.28% had Candida, 57.14% babies were submitted to antibiotic therapy, 21.42% were hospitalized, 73.80% had inadequate eating habits, 71.43% used artificial breastfeeding and 100.00% had low (IHOS), and 11.90% of the children had caries injury. Therefore, based on the results obtained and respecting the limits of the study, it was concluded that there was no relationship between the variable early weaning with the presence of S. mutans and Candida, use of antibiotics and the child's hospitalization, however, there was the association of the presence of caries with the variables early weaning-eating habits (p = 0.046) and use of bottle-feeding (p = 0.018)(AU)

Atividade antimicrobiana de plantas medicinais indicadas para uso no Sistema Único de Saúde / Actividad antimicrobiana de las plantas medicinales para su uso en el Sistema Único de Salud / Antimicrobial activity of medicinal plants for their potential use in the Brazilian Unified Health System

RESUMO Introdução: No Brasil, uma lista contendo 71 ervas medicinais foi divulgada pelo Ministério da Saúde com intuito de conduzir pesquisas e desenvolvimento de fitoterápicos para uso no Sistema Único de Saúde. Objetivo: Avaliar in vitro a atividade antimicrobiana de extratos de ervas medicinais sugeridos pelo Ministério da Saúde para utilização no Sistema Único de Saúde frente a bactérias orais. Métodos: Os extratos vegetais selecionados estavam na forma de óleo essencial (Eucalyptus globulus, Mentha piperita e Schinus terebinthifolius) ou tintura (Erythrina mulungu, Casearia sylvestris e Maytenus ilicifolia) e foram avaliados sobre Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) e S. salivarius (ATCC 7073). Realizou-se o teste de difusão em ágar com confecção de poços e adição de 50 µL dos extratos. Após 48 h em estufa bacteriológica, os halos de inibição foram medidos através de paquímetro. Para determinação da concentração inibitória mínima e da concentração bactericida mínima, realizou-se a técnica de microdiluição em microplacas e de esgotamento, respectivamente. A concentração inibitória mínima correspondeu a menor diluição na qual se verificou ausência de crescimento bacteriano visível. O controle positivo utilizado foi Clorexidina 0,12 porcento. Todos os testes foram realizados em triplicata e analisados descritivamente. Resultados: O extrato de Maytenus ilicifolia apresentou halos de inibição discretamente maiores aos demais produtos. Erythrina mulungu apresentou a menor da concentração inibitória mínima frente S. mutans (2,81 mg/mL) entre as tinturas e Mentha piperita (9,00), entre os óleos essenciais. Erythrina mulungu e Mentha piperita foram os únicos extratos que apresentaram concentração bactericida mínima frente às cepas utilizadas. Conclusão: Os extratos vegetais apresentaram atividade antimicrobiana frente a microrganismos orais destacando Mentha piperita e Erythrina mulungu(AU)

RESUMEN Introducción: En Brasil, una lista de 71 hierbas medicinales fue divulgada por el Ministerio de Salud con la meta de llevar a cabo la investigación y desarrollo de medicinas basadas en hierbas para su uso en el Sistema Único de Salud. Objetivo: Evaluar la actividad antimicrobiana in vitro de extractos de hierbas medicinales sugeridas por el Ministerio de Salud para su uso en el Sistema Único de Salud contra las bacterias bucales. Métodos: Los extractos de plantas seleccionadas fueron en forma de aceite essencial (Eucalyptus globulus, Mentha piperita e Schinus terebinthifolius) o tintura (Erythrina mulungu, Casearia sylvestris e Maytenus ilicifolia) y se evaluaron en Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) y S. salivarius (ATCC 7073). Se llevó a cabo la prueba de difusión en agar con la producción de los pozos y la adición de 50 µL de extractos. Después de 48 h en una incubadora bacteriológica, los halos de inhibición se midieron usando calibradores. Para determinar la concentración inhibitoria mínima y la concentración bactericida mínima, se empleó la técnica de microdilución en microplaca y el agotamiento, respectivamente. La concentración inhibitoria mínima correspondió a la dilución más baja en la que no hubo ningún crecimiento bacteriano visible. El control positivo usado fue de clorhexidina 0,12 por ciento. Todas las pruebas se realizaron por triplicado y se analizaron de manera descriptiva. Resultados: Los extractos de Maytenus ilicifolia presentaron los halos de inhibición ligeramente superior a otros productos. Erythrina mulungu mostró la más baja concentración inhibitoria mínima frente a S. mutans (2,81 mg/mL) entre lãs tinturas y Mentha piperita (9,00) entre los aceites esenciales. Los extractos de Erythrina y Mentha piperita fueron los únicos que mostraron concentración bactericida mínima frente a las cepas utilizadas. Conclusiones: Los extractos de plantas mostraron actividad antimicrobiana contra microorganismos bucales, entre los que se destacan Mentha piperita y Erythrina mulungu(AU)

ABSTRACT Introduction: A list of 71 medicinal herbs has been published by the Brazilian Ministry of Health with the purpose of studying and developing medicines obtained from herbs for their potential use in the Unified Health System. Objective: Evaluate the in vitro antimicrobial activity of extracts from medicinal herbs proposed by the Ministry of Health with a view to their possible use in the Unified Health System to combat oral bacteria. Methods: Extracts were obtained from the plants selected in the form of essential oil (Eucalyptus globulus, Mentha piperita and Schinus terebinthifolius) or tincture (Erythrina mulungu, Casearia sylvestris and Maytenus ilicifolia), and were tested against Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) and S. salivarius (ATCC 7073). The agar diffusion test was performed by making wells and adding 50 µL of the extracts. After 48 h in a bacteriological incubator, the inhibition haloes were measured with calipers. Minimum inhibitory concentration and minimum bactericidal concentration were determined by microplate microdilution and depletion technique, respectively. The minimum inhibitory concentration corresponded to the lowest dilution, at which there was no visible bacterial growth. The positive control used was 0.12 percent chlorhexidine. All the tests were performed in triplicate and analyzed descriptively. Results: Maytenus ilicifolia extracts exhibited slightly higher inhibition haloes than the other products. Erythrina mulungu had the lowest minimum inhibitory concentration against S. mutans (2.81 mg/mL) among tinctures, and Mentha piperita (9.00) among essential oils. Erythrina and Mentha piperita extracts were the only two displaying minimum bactericidal concentration against the strains used. Conclusions: The study plant extracts displayed antimicrobial activity against oral microorganisms, particularly against Mentha piperita and Erythrina mulungu(AU)

Chemical composition of essential oils from the apiaceae family, cytotoxicity, and their antifungal activity in vitro against candida species from oral cavity / Composição química de óleos essenciais da família apiaceae, citotoxicidade e sua atividade antifúngica in vitro contra espécies de candida da cavidade oral

Abstract The aims of this research were: evaluate the chemical composition and the cytotoxicity of the Cuminum cyminum (cumin), Anethum graveolens (dill), Pimpinella anisum (anise) and Foeniculum vulgare (fennel) essential oils, as well as their antifungal activity in vitro against ten Candida spp. isolates. The chemical composition of the oils was analyzed by means of gas chromatography coupled with mass spectrometry (GC/MS). The cytotoxicity assays were performed, using the cell proliferation reagent WST-1 in L929 mouse fibroblasts (20x103 well-1). The determinate the Minimum Inhibitory Concentration (MIC), was performed through the Broth Microdilution technique (CLSI). The chemical main components were the cuminaldehyde (32.66%) for cumin, carvone (34.89%) for the dill, trans-anethole (94.01%) for the anise and anethole (79.62%) for the fennel. Anise and fennel did not were cytotoxic in all the tested concentrations, however the cumin oil was cytotoxic in the concentration of 20 mg.mL-1 and the dill in the concentrations of 20 and 8 mg.mL-1. All yeasts were susceptible against the evaluated essential oils. Cumin presented the lowest MIC against yeasts. We concluded that all the essential oils presented inhibitory action against Candida spp., and C . cyminum, P. anisum and F. vulgare were not cytotoxic in the same minimum inhibitory concentrations for the fungi.

Resumo Os objetivos desta pesquisa foram: avaliar a composição química e a citotoxicidade dos óleos essenciais de Cuminum cyminum (cominho), Anethum graveolens (endro), Pimpinella anisum (erva-doce) e Foeniculum vulgare (funcho), bem como sua atividade antifúngica in vitro contra dez isolados de Candida spp.. A composição química dos óleos foi analisada por meio de cromatografia gasosa acoplada à espectrometria de massa (GC / MS). Os ensaios de citotoxicidade foram realizados, utilizando o reagente de proliferação celular WST-1 em fibroblastos de ratinho L929 (20x103 poço-1). A determinação da Concentração Inibitória Mínima (MIC) foi realizada através da técnica de microdiluição em caldo (CLSI). Os principais componentes químicos foram o cuminaldeído (32.66%) para cominho, carvona (34.89%) para o endro, trans-anetol (94.01%) para erva-doce e anetol (79.62%) para a funcho. O endro e a erva-doce não foram citotóxicos em todas as concentrações testadas, no entanto, o óleo de cominho foi citotóxico na concentração de 20 mg.mL-1 e o endro nas concentrações de 20 e 8 mg.mL-1. Todas as leveduras foram suscetíveis aos óleos essenciais avaliados. O cominho apresentou a menor CIM contra as leveduras. Concluímos que todos os óleos essenciais apresentaram ação inibidora contra Candida spp., e C. cyminum, P. anisum e F. vulgare não foram citotóxicos nas mesmas concentrações inibitórias mínimas para os fungos.

Prevalence of methicillin resistant staphylococcus aureus isolated from saliva samples of patients with oral squamous cell carcinoma / revalencia de Staphylococcus aureus resistente a la meticilina en muestras de saliva de pacientes con carcinoma oral de células escamosas

Objectives: To study the prevalence of methicillin resistant Staphylococcus aureus (MRSA) in saliva samples of pre-surgical oral squamous cell carcinoma (OSCC) patients along with their resistance pattern to other antibiotics. Methods: Saliva samples of OSCC patients were collected and processed for isolation of MRSA. Staphylococcus aureus isolates were primarily identified using standard microbiological methods like biochemical assays, specialized media and latex agglutination test. Confirmation of MRSA strains was done by growing the isolates on MRSA agar and by using PCR to amplify two MRSA specific genes. All the isolated Staphylococcus aureus strains were subjected to antibiotic sensitivity tests. Results: A total of 17 Staphylococcus aureus strains were isolated from 50 saliva samples of pre-surgical OSCC patients of which 13 were confirmed to be MRSA. These MRSA strains were also found to be mostly resistant to other commonly used antibiotics. Univariate analysis revealed that most patients with MRSA infections had a prior history of hospitalization and surgery. Also, it was confirmed that patients with other comorbidities and infections were more prone to having MRSA present in the saliva. Conclusion: The majority of Staphylococcus aureus isolates from the saliva of OSCC patients were MRSA, and were resistant to several other commonly used antibiotics.

Objetivos: Estudiar la prevalencia de Staphylococcus aureus resistente a la meticilina (MRSA) en muestras de saliva prequirúrgicas de pacientes con carcinoma oral de células escamosas (COCE) junto con su patrón de resistencia a otros antibióticos. Métodos: Se recolectaron muestras de saliva de pacientes con COCE y se procesaron para el aislamiento de SARM. Los aislamientos de Staphylococcus aureus se identificaron principalmente mediante métodos microbiológicos estándar, como los análisis bioquímicos, los medios especializados y la prueba de aglutinación con látex. La confirmación de las cepas de SARM se realizó cultivando los aislados en agar SARM y utilizando PCR para amplificar dos genes específicos de SARM. Todas las cepas aisladas de Staphylococcus aureus se sometieron a pruebas de sensibilidad a los antibióticos. Resultados: Se aislaron un total de 17 cepas de Staphylococcus aureus a partir de 50 muestras de saliva de pacientes prequirúrgicos con COCE, de los cuales solo se confirmó que 13 eran SARM. También se encontró que estas cepas de SARM son resistentes a otros antibióticos de uso común. El análisis univariado reveló que la mayoría de los pacientes con infecciones por SARM tenían antecedentes previos de hospitalización y cirugía. Además, se confirmó que los pacientes con otras comorbilidades e infecciones eran más propensos a las infecciones por SARM. Conclusión: la mayoría de los aislamientos de Staphylococcus aureusde la saliva de los pacientes con OSCC fueron MRSA y fueron resistentes a varios otros antibióticos de uso común.

Oral microbiota and their antibiotic susceptibility in free-living monkeys in Goiás State, Brazil: Repercussions for injuries in humans

Abstract INTRODUCTION: Goiás State, which is in the midwest region of Brazil, has several urban forests. This fact, along with the expansion of urban areas within the limits of Forest Conservation Units, increases the contact between humans and wildlife, such as capuchin monkeys. The impulsive behavior of these animals and the scarcity of food cause them to vigorously search for food, leading to direct encounters with Park visitors, which can result in scratches and bites and making them potential disseminators of pathogenic microorganisms. METHODS: Ten specimens of bearded capuchin monkey (Sapajus libidinosus) were captured at the Onofre Quinan Environmental Park in Anápolis, Goiás, Brazil. Samples were collected from the monkeys, and the bacteria and fungi present in the samples were isolated and identified. Then, the identified microorganisms were subjected to antibiotic susceptibility testing. RESULTS: A total of 111 bacteria and 12 fungi were isolated, including two strict anaerobic bacteria of the genus Peptostreptococcus, 109 facultative anaerobic bacteria, and 12 yeasts. Among the facultative bacteria, enterobacteria and Staphylococcus were common. Resistance to tetracycline and ampicillin antibiotics was detected in the enterobacteria, and resistance to tetracycline, erythromycin, and clindamycin was detected in the Staphylococci. The other strains were sensitive to all tested antimicrobials. Cefoxitin showed 100% efficacy in all isolated bacteria. CONCLUSIONS: For bites from capuchin monkeys, we recommend performing complete hygiene and antibiotic therapy, according to medical recommendations. Given the 100% effectiveness of cefoxitin, it should be considered for this type of injury, especially in the study region.

Evaluation of the frequency of Candida spp. in hospitalized and non-hospitalized subjects / Avaliação da frequência de candida spp. em indivíduos hospitalizados e não hospitalizados

Abstract The aim of this study was to evaluate the frequency of Candida species between a non-hospitalized and a hospitalized population. For this purpose, samples of saliva were sampled through sterile swabs, moistened in peptone water and rubbed in the oral cavity of 140 individuals, from which, 70 were hospitalized patients from the Medical Clinic of a Teaching Hospital and the other 70 were non-hospitalized subjects. All saliva samples were plated in Sabouraud Dextrose agar added with Chloramphenicol and incubated at 36 °C for 48 hours. The morphology identification was performed through macroscopic and microscopic characterization, the CHROMagar Candida medium and the VITEK® system Yeast Biochemical Card (bio Mérieux SA, France). The results showed a colonization of Candida spp. in 85.7% the hospitalized individuals, where the species found were C. albicans (60%), C. tropicalis (23.4%), C. krusei (3.3%) and Candida spp. (13.3%). In the non-hospitalized individuals the colonization by Candida spp was 47.1%, and the species found were: C. albicans (45.5%), C.krusei (9.1%), C. guilliermondii (9.1% %), C. tropicalis (3.0%), C. famata (3.0%) and Candida spp. (30.3%). In spite of their presence in oral cavity in both groups, Candida spp. was more frequently isolated in hospitalized individuals, who were 6.73 times more likely to have this fungus in the oral cavity and were 3.88 times more likely to have Candida albicans.

Resumo O objetivo deste estudo foi avaliar a frequência de espécies de Candida entre uma população de indivíduos não-hospitalizados e hospitalizados. Para isto, amostras de saliva foram coletadas através de swabs estéreis, umedecidas em água de peptona e friccionadas na cavidade bucal de 140 indivíduos, dos quais 70 eram pacientes internados em uma Clínica Médica de um Hospital Escola e os outros 70 eram indivíduos não hospitalizados sem contato com ambiente hospitalar. Todas as amostras de saliva foram plaqueadas em ágar Sabouraud dextrose adicionadas de cloranfenicol e incubadas a 36 °C durante 48 horas. A identificação morfológica foi realizada através da caracterização macroscópica e microscópica, com o meio CHROMagar Candida e do sistema VITEK® Biochemical Card (bio Mérieux SA, França). Os resultados mostraram uma colonização de Candida spp. em 85,7% dos indivíduos hospitalizados, onde as espécies encontradas foram: C.albicans (60%), C. tropicalis (23,4%), C. krusei (3,3%) e Candida spp. (13,3%). Nos indivíduos não-hospitalizados a colonização por Candida spp foi de 47,1%, e as espécies encontradas foram: C. albicans (45,5%), C. krusei (9,1%), C. guilliermondii (9,1%), C. tropicalis (3,0%), C. famata (3,0%) e Candida spp. (30,3%). Apesar de sua presença na cavidade oral em ambos os grupos, Candida spp. foi mais freqüentemente isolada em indivíduos hospitalizados, que foram 6,73 vezes mais propensos a ter este fungo na cavidade oral e foram 3,88 vezes mais propensos a ter Candida albicans.

Evaluación in vitro de la actividad antimicrobiana de un propóleo chileno sobre muestras clínicas de exudados bucofaríngeos y cepas ATCC / In vitro evaluation of the antimicrobial activity of a Chilean propolis on clinical samples of oropharyngeal exudates

Propolis is a substance manufactured by Apis mellifera and has been widely used in folk medicine due to its high concentration of bioactive compounds. The purpose of the following study was to characterize and evaluate in vitro the antimicrobial properties of propolis on clinical samples and ATCC strains. The chemical characterization of propolis presents a concentration of total polyphenols of 247 ± 9 mg EAG g-1 MS, flavones and flavonols 75± 4 mg EQ g-1 MS, flavanonones and flavanonols 118 ± 11 EP g-1 MS. HPLC-DAD identified apigenin, galangin, phenethyl ester of caffeic acid and pinocembrin, in addition to 16 compounds by HPLC MS/MS. Chilean propolis is a natural antimicrobial, showing effectiveness in strains ATCC Staphylococcus aureus, Candida albicans, Trichophyton rubrum and clinical samples of Staphylococcus aureus unlike Escherichia coli. These results demonstrate the antimicrobial effectiveness of the synergy of compounds present in propolis against different human pathogens.

El propóleos es una substancia fabricada por Apis mellifera y ha sido utilizado ampliamente en la medicina popular debido a su alta concentración de compuestos bioactivos. El propósito del siguiente estudio fue caracterizar y evaluar in vitro las propiedades antimicrobianas del propóleos sobre muestras clínicas y cepas ATCC. La caracterización química de propóleos presenta una concentración de polifenoles totales de 247 ± 9 mg EAG g-1 de MS, flavonas y flavonoles 75 ± 4 mg EQ g-1 de MS, flavanononas y flavanonoles 118 ± 11 EP g-1 de MS. Mediante HPLC-DAD se identificó apigenina, galangina, fenetil éster del ácido cafeico y pinocembrina, además de 16 compuestos mediante HPLC MS/MS. El propóleos chileno es un antimicrobiano natural, observándose efectividad en cepas ATCC Staphylococcus aureus, Candida albicans, Trichophyton rubrum y muestras clínicas de Staphylococcus aureus a diferencia de Escherichia coli. Estos resultados demuestran la efectividad antimicrobiana de la sinergia de compuestos presentes en el propóleos ante diferentes patógenos humanos.

Presence of Candida spp. and candidiasis in liver transplant patients

Abstract: BACKGROUND: Candidiasis is the most common opportunistic fungal infection of the oral cavity caused by fungi of the genus Candida and usually associated with immunosuppressed individuals. OBJECTIVES: To evaluate the presence of oral candidiasis and identify the presence of Candida spp. in liver transplant recipients and assess the association between the presence of the fungus and sociodemographic variables, dietary habits and environmental exposure. METHODS: A cross-sectional study was performed with 49 patients who had undergone liver transplants at Hospital São Vicente de Paulo in Passo Fundo - RS. Patient information was collected to obtain sociodemographic data, eating habits and environmental exposure. Fungal infections were screened by oral clinical examination and the presence of Candida spp by the collection of oral samples with a sterile swab, seeded in Sabouraud Dextrose Agar, incubated at 25°C and observed at 48 hours. To identify Candida albicans, the germ tube test was performed. RESULTS: In 49 patient samples, 39% had the yeast of the genus Candida isolated and, of these patients, 12% had candidiasis, 66% of atrophic type and 34% pseudomembranous. Eleven yeast species were (58%) Candida non-albicans and eight (42%) Candida albicans. STUDY LIMITATIONS: The present study presents as a limitation the inclusion of patients in different stages of immunosuppression. CONCLUSION: The high incidence of Candida non-albicans in the oral cavity of transplant patients with a long period of transplantation is warning to a more effective control of the health of these individuals, especially those with older age.

Changes in bacterial number at different sites of oral cavity during perioperative oral care management in gastrointestinal cancer patients: preliminary study

Abstract Objective The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery. Material and Methods We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices. Specifically, patients received professional tooth cleaning (PTC), scaling, tongue cleaning, and self-care instruction regarding tooth brushing from a dental hygienist a day before the operation. Professional oral health care was also performed by a dental hygienist two and seven days after surgery. Oral bacteria numbers were determined using a bacterial counter with a dielectrophoretic impedance measurement method. Results The number of bacteria at all three examined sites were significantly higher in the open surgery group when compared to the laparoscopic surgery group on the second postoperative day. Relevantly, bacterial count in samples from the gingiva of the upper anterior teeth remained greater seven days after the operation in patients who underwent open surgery. Furthermore, the dry mouth index level was higher in the open surgery group when compared to the laparoscopic surgery group on postoperative days 2 and 7. Conclusions Even with regular oral health care, bacterial numbers remained high in the upper incisor tooth gingiva in gastrointestinal cancer patients who received open surgery. Additional procedures are likely needed to effectively reduce the number of bacteria in the gingival area associated with the upper anterior teeth.