Résumé
A farmacovigilância é definida como "a ciência e atividades relativas à identificação, avaliação, compreensão e prevenção de efeitos adversos ou quaisquer problemas relacionados ao uso de medicamentos". Os medicamentos têm tanto o potencial de trazer benefícios quanto o de causar danos. O ácido 13-cis-Retinoico ou isotretinoina é um retinoide antiacne de referência no tratamento de doenças dermatológicas não responsivas a terapias convencionais, como a acne cística severa. Os efeitos adversos descritos na bula do medicamento implicam alterações em vários sistemas do corpo humano. Aqueles relacionados ao tecido ósseo, como a calcificação dos ligamentos e tendões, a redução na densidade óssea, o fechamento epifisário e hipercalcemia, possuem maior relevância na odontologia, levantando a hipótese para possível interferência na cicatrização dos alvéolos, após exodontia. Este artigo teve por objetivo realizar uma revisão de literatura reunindo informações sobre a possibilidade de interferência da isotretinoina em cirurgias maxilofaciais. Apesar da escassez de dados científicos conclusivos sobre a interferência da isotretinoína na cicatrização alveolar em humanos, estudos recentes sobre as vias de sinalização dos retinoides abrem novas perspectivas de pesquisa na influência dos retinoides no tecido ósseo alveolar. Esta possibilidade reforça a importância de uma atualização sobre os efeitos adversos da isotretinoína, bem como da anamnese criteriosa em pacientes com histórico de acne severa a fim de evitar complicações.
Pharmacovigilance is defined as "the science and activities related to identification, evaluation, understanding and prevention of adverse effects or problems related to the use of drugs". All drugs have both the potential to cause harm and benefit. 13-cis-Retinoic acid or isotretinoin is a reference anti-acne retinoid in the dermatological diseases treatment not responsive to conventional therapies, such as severe cystic acne. The drug-related side effects described in the medicine package insert imply changes in various human body systems. Those related to bone tissue, such as ligaments and tendons calcification, bone density reduction, epiphyseal closure and hypercalcemia, have great relevance for dentistry, raising the hypothesis of a possible interference in alveoli wound healing after extraction. This article aimed to conduct a literature review in gathering information about the possibility of isotretinoin interference in maxillofacial surgeries. In despite of the scarcity of conclusive scientific data about the influence of isotretinoin on human alveolar wound healing, recent studies on retinoid signaling pathways open new research perspectives for the isotretinoin interference on alveolar bone tissue. This possibility reinforces the importance of an isotretinoin drug-related side effects update, as well as a patients' careful anamnesis with historical severe acne, in order to avoid complications
Résumé
Objective: This study assessed the effects of alpha-mangostin (AM) and citronella oil (CO) working alone or in combination against Propionibacterium acnes (P. acnes) and Staphylococcus aureus (S. aureus). Methods: The screening for antibacterial activity of AM and CO against P. acnes and S. aureus was carried out using the disk diffusion method. The minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of these two substances were determined using the broth microdilution method. The fractional inhibitory concentration indices (FICI) of a combination of AM and CO were obtained by checkerboard dilution assay. Results: The results showed that alpha-mangostin and citronella oil do indeed fight against P. acnes and S. aureus. The MICs and MBCs of AM against P. acnes and S. aureus were the same at 6.25 and 50 µg/ml, respectively. Both the MIC and the MBC of CO against P. acnes were 27.81µg/ml. The MIC and the MBC of CO against S. aureus were 112.13 and 224.25 µg/ml, respectively. The FICI of a combination of AM and CO against P. acnes and S. aureus were 2.00, indicating indifferent interaction with no additional inhibitory effect. Conclusion: AM and CO are very effective against P. acnes and S. aureus, nevertheless their effect when used together was indifferent from using alone. Further research may find that either or both of these substances combined with yet a different natural agent could provide synergy againstP. acnes and S. aureus.