Chronic osteomyelitis of the maxilla and mandible: microbiological and clinical aspects / Osteomielitis crónica del maxilar y mandíbula: aspectos microbiológicos y clínicos

Osteomyelitis of the mandible and maxilla are common in developing countries and their treatment may belong-standing and difficult. Thus, the aim of this study was to discuss the main biological aspects of the chronic osteomyelitis of the jaws of especial interest for dental team. These infections are associated with a complex microbiota composed mainly by anaerobic bacteria, sometimes associated with microorganisms originated from the skin and digestive tract. These data suggest that chronic osteomyelitis of the mandible and maxilla should be treated as anaerobic infections in most cases. In addition, local surgical treatments are relevant in the therapy outcome, associated to the use of antimicrobial agents, and the failure to accomplish them is a major cause of treatment failure.

La osteomielitis maxilar y mandibular son comunes en países en desarrollo y su tratamiento puede ser difícil y de larga duración. Así, el objetivo del presente estudio fue discutir los principales aspectos biológicos de especial interés odontológico de la osteomielitis crónica del maxilar. Estas infecciones están asociadas a una microbiota compleja compuesta principalmente de bacterias anaerobias, algunas veces asociadas a microorganismos oriundos de la piel y del tracto digestivo. Estos datos sugieren que la osteomielitis crónica maxilar y mandibular deben ser tratadas como infecciones anaerobias en la mayoría de los casos. Además, tratamientos quirúrgicos locales son relevantes en el éxito de la terapia, asociados al uso de agentes anti-microbianos, e cuyos resultados no satisfactorios representan una de las principales causas de un tratamiento fallo o no adecuado.

Efeito da própolis no crescimento in vitro de microrganismos associados à periodontite em pacientes HIV-positivo / Effect of propolis on in vitro growth of microrganisms associated with periodontitis in HIV positive patients

A própolis tem demonstrado ser um bom antimicrobiano frente a diferentes microrganismos. O objetivo deste estudo foi avaliar in vitro a eficácia da própolis no controle de microrganismos que podem estar associados à periodontite em pacientes HIV-positivo. Para isto, foram utilizadas soluções de própolis marrom aquosa e alcoólica a 12%, própolis verde alcoólica a 12% e controle positivo com clorexidina 0,12%. Avaliaram-se o halo de inibição e as unidades formadoras de colônia eliminadas na presença da própolis que demonstrou resultados estatisticamente semelhantes à clorexidina sobre os microrganismos testados, sendo que a própolis verde apresentou ação antimicrobianas maior que a própolis marrom. A própolis apresentou poder antimicrobiano sobre P. aeruginosa e S.aureus semelhantes à clorexidina (p>0,05). Em relação a C. albicans, o poder antifúngico da própolis, apesar de inferior ao da clorexidina, não deve ser desconsiderado. Os dados obtidos indicam que a própolis pode ser usada como coadjuvante no controle do biofilme dental em pacientes HIV-positivo, evitando os efeitos adversos da clorexidina.

It has been demonstrated that propolis is a good antibiotic against different microorganisms. The purpose of this study was to evaluate in vitro the efficiency of propolis against microorganisms that can be related to periodontitis in HIV-positive patients. 12% alcoholic and aqueous brown propolis solutions, 12% alcoholic green propolis solution and 0.12% chlorhexidine were used. The halos of microbial growth inhibition and CFU eliminated in contact with propolis were determined. The results demonstrated differences not statistically significant between propolis and the clorhexidine on the microorganisms tested. Green propolis was more effective than brown propolis. Propolis, showed an antimicrobial effect against P. aeruginosa and S. aureus similar to clorhexidine (p>0,05). In relation to C. albicans, the antifungal effect, although inferior to clorhexidine, should not disregarded. The data obtained suggest that propolis may be used as a good substitute for chlorhexidine without its adverse effects in controlling microorganisms from HIV positive patients.