Effect of periodontal debridement plus systemic azithromycin in subjects with stage III periodontitis: a randomized controlled clinical trial / Efecto del desbridamiento periodontal más azitromicina sistémica en sujetos con periodontitis estadio III: un ensayo clínico controlado aleatorio

Aim: To evaluate the effect of the systemic administration of azi-thromycin (AZM) as an adjunct to non-surgical periodontal therapy (NSPT) on the clinical and microbiological variables of patients with periodontitis. Material and Methods: Eighteen volunteers received NSPT combined with placebo or AZM (500 mg/day) for 3 days (n=9/group). They were monitored clinically for probing pocket depth (PPD), clinical attachment level (CAL), O'Leary index (OI), bleeding on probing (BoP) at baseline and during the first, third and sixth month and microbiologically, at baseline and at 3 and 6 months after therapy, by conventional polymerase chain reaction tests. Results: Fourteen patients completed the study (n=7/group). Differences statistically significant were observed among both groups. The experimental group presented: A PPD mean (p=0.04) significantly lower and PPD reduction (p=0.02), at 6-months post NSPT. Regarding changes (∆), at the third month post NSPT, there was a significant increase in the number of shallow sites (p<0.001) and a decrease in the intermediate sites (p<0.001). In addition, a significant decrease in the mean number of deep sites (p=0.04) was detected at 6 months post treatment. There was also a significant decrease in periodontal index BoP at 1 (p=0.01), 3 (p<0.001) and 6 (p=0.01) months and OI at 3- and 6-months (p<0.001), post treatment. Regarding the presence of periodontal pathogens, no significant differences were observed, intra and inter groups. Conclusion: AZM as an adjuvant to NSPT provides additional beneficial effects for PPD and BoP compared to NSPT alone.

Objetivo: Evaluar el efecto de la administración sistémica de azitromicina (AZM) como coadyuvante de la terapia periodontal no quirúrgica (TPNQ) en las variables clínicas y microbiológicas de pacientes con periodontitis. Material y Métodos: Dieciocho voluntarios recibieron TPNQ combinado con placebo o AZM (500 mg/día) durante 3 días (n=9/grupo). Fueron monitoreados clínicamente para determinar Profundidad de Sondaje del Saco (PSS), Nivel de Inserción Clínica (NIC), Índice de O'Leary (IO), Sangrado al sondaje (SS) al inicio y durante el primer, tercer y sexto mes y microbiológicamente, al inicio y a los 3 y 6 meses después de la terapia, mediante la reacción en cadena de la polimerasa convencional. Resultados: Catorce pacientes completaron el estudio (n=7/grupo). Se observaron diferencias estadísticamente significativas entre ambos grupos. El grupo experimental presentó una media de PSS significativamente menor (p=0,04) y una reducción de PSS (p=0,02), a los 6 meses post TPNQ. En cuanto al delta (∆) pre y post tratamiento, al tercer mes post TPNQ, hubo un aumento significativo en el número de sitios poco profundos (p<0.001) y una disminución en los sitios intermedios (p<0.001). Además, se detectó una disminución significativa en la media de los sitios profundos (p=0.04) a los 6 meses post tratamiento. También hubo una disminución significativa en el índice SS al primer (p=0.01), tercer (p<0. 0 01) y sexto mes (p=0.01) post TPNQ y del IO al tercer y sexto mes (p<0.001), post tratamiento. En cuanto a la presencia de patógenos periodontales, no se observaron diferencias significativas tanto intra como ínter grupos. Conclusión: AZM como adyuvante a TPNQ proporciona efectos benéficos adicionales en la PSS y SS en comparación a TPNQ solo.

Cannabis. Usos y aplicaciones en la práctica odontológica diaria: revisión de la literatura / Cannabis. Uses and applications in daily dental practice: a review of the literature

La evidencia científica presente en la literatura indica que el cannabis puede ser utilizado con fines terapéuticos para tratar distintas afecciones odontológicas. Dado el acceso sencillo a la cavidad bucal, las distintas formulaciones de cannabis pueden aplicarse de forma tópica. La aplicación local de dosis bajas de cannabis ha demostrado alta efectividad para tratar distintas afecciones bucales, constituyendo un tratamiento seguro con baja probabilidad de generar repercusiones sistémicas indeseadas. En la actualidad, está siendo incorporado a materiales convencionales de uso e higiene odontológica con la finalidad de aprovechar sus efectos terapéuticos. El cannabis tiene múltiples usos en odontología: como componen-te de enjuagues bucales y soluciones para la desinfección de conductos radiculares, en tratamientos de trastornos de ansiedad bucal, como complemento en terapias oncológicas, como analgésico para atenuar el dolor inflamatorio y el neuropático, como miorrelajante y condroprotector para tratar trastornos de articulación témporomandibular (ATM) y bruxismo, como osteomodulador para el tratamiento de patologías que comprometen la integridad ósea, como la enfermedad periodontal y la osteoporosis, y para la cicatrización ósea asociada a fracturas, extracciones dentarias e implantes, y como inmunomodulador con potencial terapéutico para tratar patologías autoinmunes como las enfermedades reumáticas. El trata-miento local con cannabis es efectivo, bien tolerado por el paciente y con pocos efectos adversos. Por lo tanto, se puede concluir que el cannabis aporta un enorme abanico de posibilidades terapéuticas para tratar distintas afecciones odontológicas, aunque aún se requiere mayor cantidad de estudios científicos que avalen su utilización en cada situación fisiopatológica particular (AU)

The scientific evidence present in the literature indicates that cannabis can be used for therapeutic purposes to treat different dental conditions. Given the easy access to the oral cavity, the different cannabis formulations can be applied topically. The local application of low doses of cannabis has shown high effectiveness in treating different oral conditions, constituting a safe treatment with a low probability of generating unwanted systemic repercussions. It is currently being incorporated into conventional materials for dental use and hygiene in order to take advantage of its therapeutic effects. Cannabis has multiple uses in dentistry: as a component of mouthwashes and solutions for disinfecting root canals, in the treatment of oral anxiety disorders, as a complement in oncological therapies, as an analgesic to reduce inflammatory and neuropathic pain, as a muscle relaxant and chondroprotective to treat temporomandibular joint disorders and bruxism, as an osteomodulator for the treatment of pathologies that compromise bone integrity, such as periodontal disease and osteoporosis, and or bone healing associated with fractures, dental extractions and implants, and as immunomodulator with therapeutic potential to treat autoimmune pathologies such as rheumatic diseases. Local treatment with cannabis is effective, well tolerated by the patient and with few adverse effects. Local treatment with cannabis is effective, well tolerated by the patient and with few adverse effects. Therefore, it can be concluded that cannabis provides an enormous range of therapeutic possibilities to treat different dental conditions, although more scientific studies are still required to support its use in each particular pathophysiological situation (AU)

Myrciaria dubia: su potencial como adjunto en el tratamiento de enfermedad periodontal / Myrciaria dubia: its potential as adjunct in the treatment of periodontal disease

RESUMEN Introducción: El tratamiento de la enfermedad periodontal incluye la terapia mecánica, el cual se complementa con el uso de antibióticos/antisépticos, lo que podría plantear efectos adversos a largo plazo. Objetivo: Describir el potencial farmacológico del fruto de la M. dubia, y su aplicación como complemento en la terapia periodontal. Métodos: Se revisaron revistas internacionales de impacto de la Web of Science relacionadas con el tema (58 revistas). Se consultaron las bases de datos Google Académico, SciELO, PubMed y EBSCO, utilizando los descriptores: "review"; "phytotherapy"; "myrtaceae"; "gingivitis"; "periodontitis"; "periodontal diseases"; "anti-bacterial agents"; "anti-inflammatory agents"; "dental plaque"; "antioxidants"; "plants, toxic"; "adverse effects". Se obtuvo 517 artículos de los cuales 60 fueron incluidos en el estudio. El 91,7 por ciento de los artículos fueron de los últimos tres años. Integración de la información: Se expuso las propiedades y seguridad en humanos del uso de la M. dubia. Conclusiones: La M. dubia tiene actividad antimicrobiana in vitro frente a microorganismos de la biopelícula dental, siendo más sensibles el S. mutans, S. mitis y P. gingivalis al extracto hidroalcohólico de la semilla, y el S. aureus al extracto hidroalcohólico de las hojas y corteza. También se evidencia su actividad antiinflamatoria. Los hallazgos sugieren que el extracto etanólico de la M. dubia podría incorporarse en antisépticos de uso bucal, dado su potencial antibiopelícula y antiinflamatoria(AU)

ABSTRACT Introduction: Treatment of periodontal disease includes mechanical therapy complemented with antibiotics / antiseptics, which could lead to the occurrence of long-term adverse effects. Objective: Describe the pharmacological potential of the fruit of M. dubia and its use as adjunct in periodontal therapy. Methods: A review was conducted of international high impact journals from the Web of Sciences which dealt with the topic (58 journals). The databases Google Scholar, SciELO, PubMed and EBSCO were consulted, using the descriptors "review", "phytotherapy", "Myrtaceae", "gingivitis", "periodontitis", "periodontal diseases", anti-bacterial agents", "anti-inflammatory agents", "dental plaque", "antioxidants", "plants, toxic", "adverse effects". A total 517 papers were obtained, of which 60 were included in the study. 91.7 percent of the papers had been published in the last three years. Data integration: A description was provided of the properties and safety of the use of M. dubia in humans. Conclusions: M. dubia has in vitro antimicrobial activity against dental biofilm microorganisms, particularly S. mutans, S. mitis and P. gingivalis to the seed hydroalcoholic extract, and S. aureus to the leaf and peel hydroalcoholic extract. Anti-inflammatory activity was also observed. Results suggest that M. dubia ethanolic extract could be incorporated into oral antiseptics, given its antibiofilm and anti-inflammatory potential(AU)

Actividad antimicrobiana in vitro del Camu Camu (Myrciaria Dubia) contra microorganismos orales: una revisión sistemática / Antimicrobial activity in vitro of Camu-Camu (Myrciaria Dubia) against oral microorganisms: a systematic review

RESUMEN Objetivos. Evaluar la actividad antimicrobiana de la Myrciaria dubia sobre microorganismos orales. Materiales y métodos . Se realizó una revisión sistemática de la literatura siguiendo las recomendaciones PRISMA mediante búsquedas en Pubmed, LILACS, SciELO, ProQuest, EBSCO y Google Scholar, de estudios publicados durante 2008 y 2018. Resultados . Se recopilaron 11 estudios, in vitro, todos los estudios evidenciaron actividad antimicrobiana positiva, principalmente por cada una de las partes de sus frutos, sobre grampositivos. Sin embargo, dicha actividad fue comparada con clorhexidina en solo dos estudios y en otro resultó ser mejor que un antibiótico. Se detectó un alto riesgo de sesgo en la mayoría de estudios. Los compuestos fenólicos incluidos polifenoles y acilfloroglucinoles fueron señalados como los responsables de su actividad. Conclusiones . Existe evidencia sobre la actividad antimicrobiana de M. dubia. Su estudio como antimicrobiano contra microorganismos orales es aún incipiente, pero se advierte un gran potencial debido a los fitoquímicos potentes que posee. Además, se necesita más estudios de calidad, que comparen su actividad versus antisépticos orales y sobre más microorganismos asociados a caries dental y enfermedad periodontal.

ABSTRACT Objectives. To evaluate the antimicrobial activity of Myrciaria dubia on oral microorganisms. Materials and Methods. A systematic review of the literature following PRISMA guidelines was conducted through searches of studies published between 2008 and 2018 in Pubmed, LILACS, SciELO, ProQuest, EBSCO, and Google Scholar. Results. Eleven (11) in vitro studies were gathered; all the studies showed positive antimicrobial activity on gram-positives, mainly by each of the parts of its fruits. However, such activity compared to chlorhexidine in only two studies, and, in another study, it was better than an antibiotic. A high risk of bias was detected in most studies. Phenolic compounds, including polyphenols and acylphloroglucinols, were identified as responsible for its activity. Conclusions. There is evidence of antimicrobial activity in M. dubia. Its study as an antimicrobial against oral microorganisms is still incipient, but there is great potential thanks to the potent phytochemicals it contains. Also, additional quality studies are required: comparing their activity versus oral antiseptics and on microorganisms associated with dental caries and periodontal disease.

Efectividad del tratamiento periodontal en el control metabólico de pacientes con diabetes mellitus / Effectiveness of the periodontal treatment in the metabolic control of patients with diabetes mellitus

Se efectuó un estudio de intervención terapéutica en 60 pacientes con diabetes mellitus y periodontitis leve, atendidos en la consulta estomatológica del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, con vistas a determinar si el tratamiento realizado favorecería el control metabólico de los afectados, desde noviembre de 2015 hasta igual mes de 2016. Se formaron 2 grupos de manera aleatoria con 30 integrantes cada uno: de estudio (números pares), quienes recibieron la fase inicial del tratamiento, raspado y alisado radicular; de control (números impares), se les indicó fase inicial e irrigaciones subgingivales con clorhexidina. Antes y después del tratamiento periodontal se realizaron exámenes de glucemia y hemoglobina glicosilada. Se utilizó la prueba de Ji al cuadrado de homogeneidad para la comparación entre dichos grupos, con una significación de 95%. Se concluyó que la terapia periodontal fue eficaz en el control metabólico de los pacientes

A study of therapeutic intervention in 60 patients with diabetes mellitus and light periodontitis, assisted in the estomatological service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, aimed at determining if the treatment would favor the metabolic control of the affected patients, was carried out from November, 2015 to the same month in 2016. Two groups were formed at random with 30 members each: a study group (even numbers) who received the initial phase of the treatment, radicular scrapring and smoothing; a control group (odd numbers), they were indicated initial phase and subgingival irrigations with chlorhexidine. Before and after the periodontal treatment glycemia and glycosylated hemoglobin exams were carried out. The chi-square test of homogeneity was used for the comparison among these groups, with a significance of 95%. It was concluded that the periodontal therapy was effective in the metabolic control of the patients

Aceites esenciales: una opción quimioterapéutica en Periodoncia / Essential-oils: a chemotherapeutic option in periodontics

Las enfermedades periodontales representan un conjunto de patologías que afectan los tejidos de soporte dentario. La remoción del biofilm diaria y efectiva es suficiente para prevenirlas. La dificultad de los individuos en desarrollar hábitos de higiene oral adecuados valiéndose solamente de elementos mecánicos llevó al desarrollo de coadyuvantes químicos con el objetivo de maximizar el control del biofilm por el paciente. Los aceites esenciales son eficaces y superiores en el control de la placa supragingival y la inflamación en comparación con placebo y cloruro de cetilpiridinio. Sin embargo, fueron similares en el control de la inflamación e inferiores en el control de placa en comparación con la clorhexidina, generando menos efectos adversos. La evidencia sugiere que para el cuidado oral a corto plazo la clorhexidina es la primera opción y que los aceites esenciales muestran utilidad al ser indicados a largo plazo cuando el cuidado oral antiinflamatorio sea beneficioso.

Periodontal diseases are a group of pathologies that affect the tissues that support teeth. The efficient control of daily oral biofilm can prevent these diseases. Most individuals have difficulty in developing good oral hygiene habits and use only mechanical elements. This has led to the development of chemical adjuvants so that patients can maximize biofilm control. Essential oils (EOs) are effective and more efficient at controlling supragingival plaque and inflammation compared to a placebo and to cetylpyridinium chloride. Nevertheless, EOs were similar in their anti-inflammatory effectiveness and less efficient in plaque control than chlorhexidine, causing fewer adverse effects. Current evidence suggests that chlorhexidine remains the first choice for short-term oral health care and that essential-oils are best indicated for long-term treatments.

Curcumina, una alternativa térapéutica para la clínica dental. Parte: antiinflamatorio y analgésico / Curcumin, a therapeutic alternative for the dental clinic (Part I):An anti-inflammatory and analgesic

La curcumina es una sustancia derivada de una planta llamada Curcuma longa. A esta sustancia se le han atribuido diversos efectos terapéuticos. En relación con la clínica dental, se ha observado que, además de ayudaren el control del dolor, ha sido efectiva contra la periodontitis, estomatitis y mucositis pediátrica. El control del dolor e inflamación son aspectos muy importantes para la mayoría de los tratamientos en odontología; la búsqueda de nuevas alternativas analgésicas y antiinflamatorias que, en comparación con las actuales, sean más eficientes, efectivas y tengan menos efectos colaterales es uno de los grandes retos de las ciencias biomédicas. La presente revisión muestra algunas evidencias científicas de los efectos de la curcumina como un antiinflamatorio y analgésico, con el propósito de sentar las bases para futuros estudios clínicos y de ciencia básica que aporten un mayor entendimiento de los procesos celulares, bioquímicos, moleculares, fisiológicos y farmacológicos de la curcumina como una sustancia potencialmente útilen el consultorio dental.

Curcumin is a substance derived from the plant Curcuma longa andone that has been attributed a range of therapeutic eff ects. In dentalpractice, curcumin has not only been found to help with pain control, buthas also been eff ective against periodontitis, stomatitis, and pediatricmucositis. Controlling pain and infl ammation are both very importantaspects of most dental treatments. The search for more effi cient andeff ective analgesic and anti-infl ammatory alternatives with fewerside eff ects compared to those currently used is one of the greatestchallenges for biomedical science. This review presents some of thescientifi c evidence of the eff ects of curcumin, both as an analgesic andan anti-infl ammatory agent, in order to establish the foundations forfurther clinical and basic science studies that will provide a greaterunderstanding of the cellular, biochemical, molecular, physiological,and pharmacological processes of curcumin as a potentially usefulsubstance in dental practice.

effect of four commonly used root conditioner agents in different time periods applied on periodontally diseased and healthy teeth

Statement of Problem: Root surface contamination or infection can potentially change the consequences of regenerative periodontal therapies and therefore the modification and disinfection of the contaminated root surfaces are necessary

Objectives: This study aimed to compare the surface characteristics of the extracted human teeth after exposure to four root conditioners in different time periods

Materials and Methods: The study samples were prepared from 40 freshly extracted teeth including 20 affected teeth with periodontal diseases and 20 healthy teeth. After performing root planning, 240 dentinal block samples were prepared and each affected and healthy sample was randomly allocated to receive one of the following root conditioners; Ethylenediaminetetraaceti acid [EDTA], citric acid, doxycycline, and tetracycline or rinsed with normal saline as the control agent. The prepared specimens were evaluated using scanning electron microscope and the inter-group differences and changes in study indices; dentin [%], tubular spaces [%], and diameter of dentinal tubules [micro m[2]] were compared using one-way ANOVA test

Results: In the control group receiving normal saline, the changes in the indicators of dentin, tubular spaces, and diameter of dentinal tubules remained insignificant in all time periods. EDTA, citric acid, and tetracycline had chelating effects on the study indices; however, doxycycline led to gradual decrease of the tubular space and diameter as well as increase in dentin percentage

Conclusions: In different time intervals and when considering healthy or affected tooth surfaces, the effect of conditioning agents could be different. Amongst the four agents used, EDTA and tetracycline consistently increased the diameter of tubules and percentage of patent tubules in both healthy and diseased teeth

Efeitos do ramipril sobre a doença periodontal induzida experimentalmente em ratos / Effect of ramipril on periodontal disease experimentally induced in rats

A doença periodontal (DP) corresponde a um grupo de doenças inflamatórias que acomete as estruturas periodontais de proteção e de suporte e pode levar à perda dentária. A etiologia está relacionada à placa dentobacteriana que leva à produção de grande quantidade de citocinas pró-inflamatórias importantes na destruição tecidual. A angiotensina (Ang) II também pode contribuir para a inflamação e destruição tecidual no periodonto agindo como mediador chave. A utilização de drogas que atuem na cascata do sistema renina-angiotensina (SRA) poderia interferir no estado de saúde ou inflamação do tecido mole, na perda óssea alveolar e na expressão gênica dos componentes do SRA e mediadores inflamatórios. Portanto, o objetivo do presente trabalho foi investigar se o ramipril, um inibidor da enzima conversora de angiotensina (ECA), altera a progressão da DP induzida experimentalmente em ratos. Foi utilizado o modelo de indução da DP por colocação de ligadura ao redor do primeiro molar inferior direito de ratos. Os grupos com 10 animais cada, foram divididos em tratados com ramipril (via gavagem 10mg/kg/dia) ou água (veículo) durante 14 e 21 dias e o grupo Sham submetido à indução fictícia da DP. Outros quatro grupos foram submetidos ao pré-tratamento com ramipril durante os períodos de 7 e 14 dias e após a indução da DP e tratados por 14 ou 21 dias. As metodologias de avaliação foram: extração de RNA total, transcrição reversa seguida de reação em cadeia da polimerase quantitativa (RTqPCR),análises histológica e da perda óssea alveolar. Os dados foram analisados por meio de gráficos e os resultados foram submetidos à análise unidirecional de variância (ANOVA) e representaram médias e respectivos desvios-padrão. Diferenças entre os grupos foram consideradas estatisticamente significativas quando p < 0,05. Com base nos resultados obtidos pode-se concluir que o ramipril foi capaz de reduzir a progressão da perda óssea no grupo tratado por 21 dias (DP-21d-Rami)...

Periodontitis (PD) consists of a group of inflammatory diseases that affect the protecting and supporting periodontal structures, and may lead to tooth loss. Theetiology is related to the dentobacterial plaque that produces a large amount of proinflammatory cytokines with an important action on tissue destruction. Angiotensin(Ang) II may also contribute to the inflammation and periodontal tissue destruction byacting as a key mediator. The use of drugs that affect the cascade of the reninangiotensin system (RAS) might interfere with the healthy or inflammatory status ofthe soft tissue, alveolar bone loss and gene expression of RAS components and inflammatory mediators. Therefore, the aim of this work was to evaluate whether ramipril, an angiotensin-converting enzyme (ACE) inhibitor, alters the progression of experimentally-induced PD in rats. The model of PD induction by placement of a silk ligature around the right lower first molar was used. Groups with 10 animals each were divided into ramipril-treated (10 mg/kg/day, via gavage), water (vehicle) and thesham surgery group (sham) for 7 or 14 days previously to PD induction and after this period the drug was administered for 14 and 21 days. The techniques employed were: total RNA extraction, reverse transcription followed by quantitative polymerase chain reaction (RT-qPCR) as well as histological and alveolar bone loss analyses. Data were analyzed by means of graphs and the results submitted to unidirectional analysis of variance (ANOVA) and represent the means with respective standard deviations. Differences between groups were considered statistically significant whenp < 0.05. Based on the results obtained in this work, it was concluded that ramipril was able to reduce the progression of alveolar bone loss in the group treated for 21...

Efeitos do ramipril sobre a doença periodontal induzida experimentalmente em ratos / Effect of ramipril on periodontal disease experimentally induced in rats

A doença periodontal (DP) corresponde a um grupo de doenças inflamatórias que acomete as estruturas periodontais de proteção e de suporte e pode levar à perda dentária. A etiologia está relacionada à placa dentobacteriana que leva à produção de grande quantidade de citocinas pró-inflamatórias importantes na destruição tecidual. A angiotensina (Ang) II também pode contribuir para a inflamação e destruição tecidual no periodonto agindo como mediador chave. A utilização de drogas que atuem na cascata do sistema renina-angiotensina (SRA) poderia interferir no estado de saúde ou inflamação do tecido mole, na perda óssea alveolar e na expressão gênica dos componentes do SRA e mediadores inflamatórios. Portanto, o objetivo do presente trabalho foi investigar se o ramipril, um inibidor da enzima conversora de angiotensina (ECA), altera a progressão da DP induzida experimentalmente em ratos. Foi utilizado o modelo de indução da DP por colocação de ligadura ao redor do primeiro molar inferior direito de ratos. Os grupos com 10 animais cada, foram divididos em tratados com ramipril (via gavagem 10mg/kg/dia) ou água (veículo) durante 14 e 21 dias e o grupo Sham submetido à indução fictícia da DP. Outros quatro grupos foram submetidos ao pré-tratamento com ramipril durante os períodos de 7 e 14 dias e após a indução da DP e tratados por 14 ou 21 dias. As metodologias de avaliação foram: extração de RNA total, transcrição reversa seguida de reação em cadeia da polimerase quantitativa (RTqPCR),análises histológica e da perda óssea alveolar. Os dados foram analisados por meio de gráficos e os resultados foram submetidos à análise unidirecional de variância (ANOVA) e representaram médias e respectivos desvios-padrão. Diferenças entre os grupos foram consideradas estatisticamente significativas quando p < 0,05. Com base nos resultados obtidos pode-se concluir que o ramipril foi capaz de reduzir a progressão da perda óssea no grupo tratado por 21 dias (DP-21d-Rami)...

Periodontitis (PD) consists of a group of inflammatory diseases that affect the protecting and supporting periodontal structures, and may lead to tooth loss. Theetiology is related to the dentobacterial plaque that produces a large amount of proinflammatory cytokines with an important action on tissue destruction. Angiotensin(Ang) II may also contribute to the inflammation and periodontal tissue destruction byacting as a key mediator. The use of drugs that affect the cascade of the reninangiotensin system (RAS) might interfere with the healthy or inflammatory status ofthe soft tissue, alveolar bone loss and gene expression of RAS components and inflammatory mediators. Therefore, the aim of this work was to evaluate whether ramipril, an angiotensin-converting enzyme (ACE) inhibitor, alters the progression of experimentally-induced PD in rats. The model of PD induction by placement of a silk ligature around the right lower first molar was used. Groups with 10 animals each were divided into ramipril-treated (10 mg/kg/day, via gavage), water (vehicle) and thesham surgery group (sham) for 7 or 14 days previously to PD induction and after this period the drug was administered for 14 and 21 days. The techniques employed were: total RNA extraction, reverse transcription followed by quantitative polymerase chain reaction (RT-qPCR) as well as histological and alveolar bone loss analyses. Data were analyzed by means of graphs and the results submitted to unidirectional analysis of variance (ANOVA) and represent the means with respective standard deviations. Differences between groups were considered statistically significant whenp < 0.05. Based on the results obtained in this work, it was concluded that ramipril was able to reduce the progression of alveolar bone loss in the group treated for 21...

Estimation of N‑terminal telopeptides of type I collagen in periodontal health, disease and after nonsurgical periodontaltherapy in gingival crevicular fluid: A clinico ‑ biochemical study.

Aim: This study explored gingival crevicular fluid (GCF) N‑terminal telopeptides of type I collagen (NTx) levels in periodontal health, disease and after nonsurgical periodontal therapy along with its association with the clinical parameters. Materials and Methods: Study comprised of three groups of 10 subjects each: Healthy (Group I), gingivitis (Group II), and periodontitis (Group III), while Group III patients after scaling and root planning (SRP) constituted Group IV. Gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), and radiological parameters were recorded. GCF samples were analyzed by competitive‑enzyme‑linked immunosorbent assay. Results: Samples in Group III and Group IV tested positive for NTx whereas in Group I and Group II, NTx was not detected. Mean NTx levels were higher in Group III (6.79 ± 0.94 nanomole bone collagen equivalents per liter [nm BCE/L]) compared to Group IV (5.73 ± 0.95 nm BCE/L) which was statistically significant. Positive correlation was seen between the clinical parameters and the NTx levels in Group III and IV. Conclusion: As NTx is specific bone turnover marker, it is detected only in periodontitis Group and the values decline after SRP. Failure to detect NTx in Group I and II, relates to the minimum or no resorption at the sample sites.

Uso terapéutico de los antibióticos en el tratamiento periodontal: revisión de la literatura / Therapeutic use of antibiotics in periodontal treatment: a review of the literature

Las enfermedades periodontales son consecuencia de la acumulación de la placa dental. Las bacterias presentes en ella inician un proceso inflamatorio en los tejidos periodontales por medio de la liberación de toxinas bacterianas. El tratamiento indicado implica terapias mecánicas no quirúrgicas y quirúrgicas y, en algunos casos, terapia farmacológica. En pacientes que no responden a la terapia mecánica, los estudios sugieren el uso de terapias complementarias con antibióticos locales o sistémicos. En esos casos, es necesario el desarreglo previo de la placa dental adherida a la superficie radicular. Los antibióticos, junto con el raspado y alisado radicular (RAR) y el colgajo periodontal, son una alternativa de agentes terapéuticos, pues garantizan resultados satisfactorios en el tratamiento periodontal. El objetivo de esta revisión es analizar las propiedades de los antibióticos como agentes coadyuvantes de la terapia periodontal...

Comparative evaluation of natural curcumin and synthetic chlorhexidine in the management of chronic periodontitis as a local drug delivery: A clinical and microbiological study.

Background of the Study: The aim of this study is to evaluate the efficacy of natural curcumin in the management of chronic periodontitis as local drug delivery in comparison to synthetic chlorhexidine, which is the gold standard. Materials and Methods: Thirty chronic periodontitis patients with an age range of 20–50 years with probing pocket depth (PPD) of 4–6 mm were included. Curcumin and chlorhexidine gel was applied in the contralateral disease sites at baseline and day 15. The clinical parameters like PPD, clinical attachment level (CAL), gingival index (Loe and Silness) and plaque index (Turesky Gillmore modification of Quigley Hein) were recorded and colony forming units (CFU) were assessed microbiologically at baseline, 15 and 30 days. Results: There was a significant reduction of the clinical parameters (PPD, CAL) and microbiological parameters CFU at 15 and 30 days for both the groups. Curcumin group showed a greater reduction in the clinical parameters when compared with chlorhexidine group. Both groups had a significant reduction in parameters when compared with baseline. Conclusion: Although curcumin has equivalent benefit to chlorhexidine, curcumin being an ayurvedic herb is an excellent alternative to chlorhexidine due to minimal side‑effects.

Desenvolvimento e testes in vitro de um novo corante para terapia fotodinâmica em Periodontia / Development and in vitro tests of a new dye for photodynamic therapy in Periodontics

A terapia fotodinâmica antimicrobiana (Antimicrobial Photodynamic Therapy - aPDT) tem sido utilizada em Periodontia para redução bacteriana de bolsas periodontais na forma de tratamento adjuvante da raspagem e alisamento radicular. Seu efeito em cirurgias periodontais é pouco estudado. Pesquisas recentes têm procurado descobrir novos fotossensibilizadores para aumento da efetividade dessa terapia. O objetivo do presente estudo foi testar in vitro um novo corante à base de corantes fenotiazínicos para uso em aPDT, quanto à sua biocompatibilidade e efetividade em eliminar bactérias. Foram realizados testes para avaliar a desmineralização e desgaste causados pelo corante em esmalte e dentina bovinos, bem como o tempo de aplicação ideal para se conseguir efeitos semelhantes ao ácido cítrico; comportamento óptico dos novos corantes em relação aos corantes convencionais; teste de biocompatibilidade de fragmentos de raiz humana, tratados pelo corante, em culturas de fibroblastos gengivais humanos; efetividade dos novos corantes sozinhos ou associados ao laser na eliminação de S. aureus e E. coli. Nos experimentos de desmineralização e biocompatibilidade foi utilizado um laser vermelho (660nm, 30mW, 45J/cm2, 30s) e nos experimentos com bactérias laser vermelho (660nm, 100mW, 45J/cm2, 12s). As análises estatísticas foram realizadas com testes paramétricos e não paramétricos (p<0,05). Os resultados mostraram que o novo corante promoveu desmineralização em esmalte (perda de dureza 55,5% e desgaste 10,33μm) e dentina (perda de dureza 65,9% e desgaste 8,37μm) bovinos de forma semelhante ao ácido cítrico, sendo 180s, o tempo mais adequado. Nos ensaios ópticos, observou-se que o novo corante à base de azul de toluidina (NCTBO) reduziu a banda de absorção para 575nm e teve uma fotodegradação mais rápida, enquanto que à base de azul de metileno (NCMB) o pico manteve-se em 660nm com fotodegradação lenta. O crescimento de fibroblastos gengivais humanos sobre superfícies de raiz...

The antimicrobial photodynamic therapy (aPDT) is used in Periodontics for reduction of bacteria in periodontal pockets as an adjuvant treatment to scaling and root planning. Recent researches aim at finding new photosensitizers in order to improve its effectiveness. The aim of this study was to test in vitro the biocompatibility and efficiency of eliminating bacteria of a new phenothiazine-based dye for aPDT in Periodontics. The following tests were performed: magnitude of demineralization and wear in bovine dentin and enamel fragments; the ideal time of application to obtain results similar to citric acid conditioning; optic behavior of new dye compared to conventional dyes; biocompatibility of human root fragments treated by the new dye in human gingival fibroblasts culture; effectiveness of the new dye in elimination of S. aureus and E. coli. In the experiments of demineralization and biocompatibility a red laser (660nm, 30mW, 45J/cm2, 30s) was applied, while in the microbiology experiments the parameters were changed (660nm, 100mW, 45J/cm2, 12s). The statistical analysis were done with parametric and non-parametric tests (p<0.05). The results showed that the new dye promoted demineralization in bovine enamel (surface hardness loss 55.5% and wear 10.33μm) and dentin (surface hardness loss 65.9% and wear 8.37μm). The demineralization was similar to citric acid and the ideal time of application was 180s. The optic tests showed that the toluidine blue-based new dye (TBOND) diminished the absorption band to 575nm and had a faster photodegradation. The methylene blue-based new dye (MBND) maintained a peak of absorption in 660nm and had a slower photodegradation. Growth of human gingival fibroblasts onto human root surfaces was similar to those treated with regular dyes (3.07 x 2.6 cells after 72h). The TBOND when used alone, reduced E. coli and S. aureus in 59.6% e 54.6%, respectively. When associated to laser, the reduction of E. coli was 52.6%. The MBND...

Modulación de la respuesta del huésped en el tratamiento periodontal: revisión de la literatura / Host response modulation in periodontal treatment: a review of the literature

En la enfermedad periodontal, la acumulación de bacterias gramnegativas, genera una respuesta inmunoinflamatoria que es modulada por el mecanismo de defensa del paciente. El tratamiento de modulación del huésped (TMH), ha sido incorporado como una opción farmacológica para el control de la enfermedad periodontal. El objetivo de la revisión fue investigar los efectos de los inhibidores de la colagenasa tisular y de los analgésicos antiinflamatorios no esteroides (AINES) como agentes moduladores de la enfermedad periodontal. A tal fin, se realizó una búsqueda de estudios de casos, controles y revisiones, empleando las bases de datos Medline-PubMed, LILACS y Dialnet. Se encontró que los resultados de las terapias de modulación del huésped tienen como blanco los mediadores proinflamatorios y enzimas destructivas que degradan el colágeno y destruyen tejido óseo, equilibrando y aumentando las acciones antiinflamatorias y protectivas. Los fármacos usados en el TMH regulan los procesos destructivos de la respuesta inmunoinflamatoria en presencia de placa dental, sobre todo en pacientes susceptibles.

Effect of an essential oil mouth rinse [listerine] on interproximal plaque regrowth compared to chlorhexidine and sterile water: a randomized controlled, three periods cross-over, clinical trial

Mechanical plaque control is the most effective way in preventing periodontal diseases. However, due to some drawbacks in the mechanical methods, chemical plaque control methods have been recommended. The aim of this study was to examine the efficacy of an Essential Oil mouth rinse [Listerine] on plaque formation in interproximal areas as compared to Chlorhexidine and Sterile water. The study was an observer-blind, 4-day plaque regrowth, cross over study. The study was con-ducted at the faculty of dentistry, University of Western Cape. 60 dental students aged 16-34 years with a minimum of 20 natural teeth participated voluntarily in the study. Exclusion criteria were established. An informed consent was taken prior to the start of the study. The students used one mouth rinse for 4 days as the only oral hygiene method and then plaque was scored using Silness and Loe plaque index. The same technique was used for the 2nd and 3rd experimental period with the other two mouth rinses with an identical wash out phase of two weeks. The mean plaque index scores for the Listerine mouth wash were 0.94 +/- 0.18, for Chlorhexidine 0.54 +/- 0.09 and for sterile water were 1.54 +/- 0.08. Mean percentage of full mouth plaque free surfaces for the use of Listerine mouth wash was 25 +/- 4.32, 54 +/- 5.84 and 13 +/- 4.46 for Chlorhexidine and sterile water respectively. Mean percentage for interproximal plaque free surfaces [IPFS] for different mouth rinses were also calculated and were 22 +/- 4.84 for Listerine mouth rinse, 42 +/- 5.18 for Chlorhexidine and 9 +/- 3.78 for sterile water. Analysis of variance and construction of 95% confidence intervals showed that both Chlorhexidine and Essential Oils significantly reduced plaque as compared to sterile water. The findings of this study suggest that although Essential Oils can reduce plaque formation but their effectiveness is lesser than Chlorhexidine

A Comparative Study for Efficacy and Tolerability of Satranidazole Plus Ofloxacin Versus Ornidazole Plus Ofloxacin in Periodontal Infections.

Periodontal infections and related conditions like Chronic Gingivitis, Chronic Periodontitis, Pericoronitis, Peridontal & Periapical Abscess are common clinical problems, but sometimes Gingivitis and Periodontitis can be acute also. These all are generally treated by scaling and root planning, but studies have reported that despite conventional periodontal therapy certain sites continue to show periodontal tissue destruction. These periodontal infections can be controlled by antibiotics which are effective against Gram-negative aerobic and anaerobic bacteria and has good penetration in periodontal tissues. Objective: The purpose of the present study was to compare the efficacy and tolerability of a fixed dose combination of Satranidazole (300 mg) plus Ofloxacin (200 mg) versus fixed dose combination of Ornidazole (500 mg) plus Ofloxacin (200 mg) for the treatment of periodontal infections. Methods : One hundred and twelve adult patients (59 females and 53 males) with moderate to advanced periodontitis were enrolled and given fixed dose combination of Satranidazole (300 mg) plus Ofloxacin (200 mg) or Ornidazole (500 mg) plus Ofloxacin (200 mg) orally two times daily. Clinical assessment like Gingival Index, Periodontal Index, Mobility Index and VAS Score were done before and after the treatment. Clinical evaluation was performed on 3rd and 5th day after treatment. Results : At the baseline the values for Gingival Index, Periodontal Index, Mobility Index and VAS Score were comparable in both the groups. Both the treatment group have shown attenuation of Gingival Index, Periodontal Index, Mobility Index and VAS Score. However, treatment with Satranidazole plus Ofloxacin showed significantly (p< 0.05) better improvement in all clinical parameters compared to Ornidazole plus Ofloxacin treatment. Treatment with Satranidazole plus Ofloxacin was well tolerated and no serious adverse event was observed. 6 patients (15%) with Ornidazole plus Ofloxacin have shown side effects, which resulted in discontinuation of therapy. These side effects include allergy, nausea, vomiting & acidity. Conclusion : This study concludes that efficacy and tolerability of fixed dose combination of Satranidazole (300 mg) plus Ofloxacin (200 mg) is better than fixed dose combination of Ornidazole (500 mg) plus Ofloxacin (200 mg) in treatment of periodontal infections.

Enjuagues de Calendula officinalis como alternativa de los antisépticos orales / Calendula officinalis mouthrinses as an alternative to oral antiseptics

En la progresión de la enfermedad periodontal intervienen múltiples factores, incluyendo los diversos microorganismos orales que conforman la placa bacteriana o patógenos libres en cavidad oral que logran desencadenar una respuesta inmunológica e inflamatoria en el huésped. Existen herramientas químicas que combaten cualquier posibilidad de colonización e infección por parte de algún microorganismo. Los antisépticos orales son de gran utilidad especialmente luego de cirugías periodontales. Es allí donde su importancia se hace casi imprescindible, para controlar la noxa, pero a su vez deben facilitar el proceso de cicatrización de los tejidos involucrados. El objetivo del presente manuscrito consistió en reportar y describir un caso clínico donde el empleo de clorhexidina al 0,12 por ciento como antiséptico oral postoperatorio no favoreció la cicatrización adecuada de los tejidos mucosos luego de realizarse un injerto gingival libre. Como alternativa antiséptica se prescribieron enjuagues a base de Caléndula, observándose cicatrización de los tejidos afectados a los pocos días de uso. Se discute que posterior a todo proceso operatorio de carácter quirúrgico se debe colocar en una balanza riesgo-beneficio, donde se escoge la posibilidad de evitar la infección posoperatoria o la cicatrización oportuna de esta. Los enjuagues orales de caléndula permitieron la cicatrización oportuna; los colutorios de caléndula contemplan una pequeña proporción de capacidad antimicrobiana y una alta habilidad inductora de la cicatrización tisular(AU)

Periodontal disease progression involves multiple factors, including several oral microorganisms of the bacterial biofilm or commensal pathogens in oral cavity, which trigger inflammatory immune response in the host. There are chemical tools that fight any possibility of colonization and infection by a microorganism. Oral antiseptics are useful especially after periodontal surgery where they are almost indispensable to control the noxa, but at in the same time, they should facilitate the healing process of the cut tissues. The objective of this paper was to describe a case in which the use of 0.12 percent chlorhexidine as an oral antiseptic postoperatively favored no proper healing of mucosal tissues after free gingival grafting. As an alternative, mouthrinse with Calendula was prescribed, observing affected tissue healing within a few days. It is argued that in all post-operative surgical process, one should analyze risks and benefits and choose avoiding the possibility of postoperative infection or timely scarring. As an alternative, the calendula mouthrinse allowed timely cicatrization and it should be noticed that they have some antimicrobial properties and high-inductive ability for the tissue healing(AU)

Necesidad de tratamiento periodontal en relación al consumo de alendronato en pacientes con osteoporosis posmenopáusica / Need for periodontal treatment in relation to consumption of alendronate in patients with postmenopausal osteoporosis

Objetivo: Determinar si existe relación entre tiempo de tratamiento con alendronato y necesidad de tratamiento periodontal en pacientes con osteoporosis posmenopáusica. Pacientes y Métodos: El estudio de corte transversal, descriptivo y observacional, incluyó un total de 112 pacientes con osteoporosis posmenopáusica atendidas en los Servicios de Gineco-Obstetricia o Reumatología del Hospital Belén de Trujillo, a las que se les realizó un examen clínico para determinar la necesidad de tratamiento periodontal y se registró el inicio de tratamiento con alendronato, según la historia clínica. Resultados: Se encontró relación significativa inversa entre tiempo de tratamiento con alendronato y necesidad de tratamiento periodontal en pacientes con osteoporosis posmenopáusica (p<0.05 y r=-0.533). Además, el 84.1 por ciento de pacientes presentó más de 6 meses de consumo de alendronato y el código 2 del Índice de Necesidad de Tratamiento Periodontal en la Comunidad fue el más frecuente para esta población. Conclusión: Los resultados permiten concluir que existe relación inversa entre tiempo de tratamiento con alendronato y necesidad de tratamiento periodontal en pacientes con osteoporosis posmenopáusica. Recomendación: Se recomienda realizar investigaciones sobre la utilidad que podría tener el alendronato como coadyuvante en el tratamiento de la enfermedad periodontal en mujeres con osteoporosis posmenopáusica.

Objective: To determine the correlation between the duration of alendronate’s treatment and the need for periodontal treatment in patients with postmenopausal osteoporosis. Patients and Methods: This cross-sectional, descriptive and observational study included a total of 112 patients with postmenopausal osteoporosis treated in Gyneco-Obstetric or Rheumatology Services at Hospital Belén de Trujillo, who underwent a clinical examination to determine the need for periodontal treatment. The start of the treatment with alendronate was registered, according to medical records. Results: We found significant inverse relationship between treatment duration with alendronate and periodontal treatment need in patients with postmenopausal osteoporosis (p<0.05 and r=-0.533). In addition, 84.1 percent of patients had more than 6 months of alendronate consumption and code 2 Community Periodontal Index of Need for Periodontal Treatment was the most frequent in this population. Conclusion: The results suggest that there is an inverse relationship between treatment duration with alendronate and periodontal treatment needs in patients with postmenopausal osteoporosis. Recommendation: it is suggested to carry out research about the utility that alendronate could have as an adjunct in the treatment of periodontal disease in women with postmenopausal osteoporosis.