Modificaciones del ambiente oral en el tratamiento con ortodoncia fija / Modifications of the oral environment due fixed orthodontic treatment

Objetivo. Evaluar las condiciones del ambiente oral de distintos sectores de la boca de pacientes previo y durante el tratamiento ortodóntico. Métodos. Estudio prospectivo en 46 pacientes con tratamiento de ortodoncia fija. Los parámetros clínicos, microbiológicos de saliva y placa bacteriana fueron registrados antes del tratamiento (t0) y a los 45 (t1), 90 (t2) y 135 días (t3) del inicio. Resultados. Antes del tratamiento se registraron valores elevados del componente "cariados" del índice CPO-D y niveles regulares del IHOs. El 57% de los pacientes mostró apiñamiento dental inferior. Durante el tratamiento, el índice de placa ortodóntica IPO disminuyó respecto al IHOs a t0, aunque mantuvo valores no deseables para la salud bucal (p=0,001). La capacidad amortiguadora disminuyó en t1 y t2 pero recuperó los valores iniciales en t3 (p=0,001). Se aislaron Streptococcus mutans, Candida albicans y Lactobacillus en todas las muestras de placa bacteriana, con un aumento significativo en el sector posterior (p<0,0001). Los niveles de S. mutans, Lactobacillus y α-amilasa salival en la placa bacteriana de la zona posterior aumentaron durante el tratamiento (p =0,0002; p=0,002 y p=0,0059, respectivamente). Conclusiones. La conjunción de factores de riesgo cariogénico, tales como apiñamiento dental, baja capacidad amortiguadora salival, altos niveles de α-amilasa y S. mutans en la placa bacteriana, altos valores de IPO y el bajo flujo salival a tiempos cortos, demuestra la importancia del monitoreo individualizado de los pacientes al inicio el tratamiento ortodóntico, en especial en los sectores bucales de difícil acceso para la higiene bucal.

Objective. To evaluate the conditions of the oral environment of different sectors of the mouth in patients before and during orthodontic treatment. Methods. A prospective study in 46 patients with fixed orthodontic treatment. Clinical and microbiological parameters of saliva and bacterial plaque were collected before treatment (t0) and at 45 (t1), 90 (t2), and 135 days (t3) after the start of treatment. Results. Before treatment, high values of 'decayed' component of the DMF-T and regular levels of the OHIs were registered. Fifty-seven percent of patients showed lower dental crowding. During treatment, the orthodontic plaque index OPI decreased with respect to OHIs at t0, although it maintained undesirable values for oral health (p=0.001). The buffering capacity decreased at t1 and t2 but recovered to initial values at t3 (p=0.001). Streptococcus mutans, Candida albicans, and Lactobacillus were isolated in all the bacterial plaque samples, with a significant increase in the posterior sector (p<0.0001). Levels of S. mutans, Lactobacillus, and α-salivary amylase in the bacterial plaque of the posterior area were increased during treatment (p=0.0002; p=0.002; p=0.0059, respectively). Conclusions. The conjunction of cariogenic risk factors, such as dental crowding, low salivary buffering capacity, high levels of α-amylase and S. mutans in bacterial plaque, high values of OPI, and low salivary flow at short times, demonstrates the importance of individualized monitoring of patients at the beginning of orthodontic treatment, especially in oral sectors where oral hygiene is more difficult.

Comparative study of preventive protocols in children at high cariogenic risk.

The aim of this study was to compare the efficacy of two preventive protocols -fluoride gel (F) alone or combined with chlorhexidine varnishes (CHX) - on sialochemical, clinical and microbiological parameters in a group of children at high cariogenic risk Two therapeutic-preventive protocols were applied in 73 children at high cariogenic risk (average age 6.2 +/- 1.4 years old) and clinical parameters (simplified oral hygiene index: OHI-S; decayed, missing and filled teeth: dmf index; sugar intake and exposure to fluoride), as well as sialochemical parameters (salivary pH and flow, buffer capacity) and microbiological parameters (CFU/mg of dental biofilm of Streptococcus mutans group) were recorded and correlated before and after the protocols. Association was found between parameters that cause deficient control of dental biofilm: high values of OHIS index, CFU/mg dental biofilm, sugar intake and the d component of dmft index, and lower values of salivary flow rate and buffer capacity. After the protocols, a significant decrease was found in OHI-S and CFU/mg dental biofilm. No significant difference was found with children's gender and age. The association observed between OHI-S and cariogenic bacteria emphasizes the importance of prevention, especially regarding the oral health of the most vulnerable children. The early inclusion of F associated with CHX in the initial step of preventive and therapeutic protocols would provide benefits regarding oral microbe control while children acquire new habits of oral hygiene.

Comparative study of preventive protocols in children at high cariogenic risk

El objetivo de este trabajo fue evaluar la eficacia de dos protocolos preventivos - fluoruro (F) sólo o combinando conclorhexidina (CHX)- sobre indicadores clínicos, sialoquímicos y microbiológicos, en una población de niños de altoriesgo cariogénico. Se aplicaron dos protocolos terapéutico-preventivos en 73 niños en edad escolar de alto riesgo cariogénico y se determinarony correlacionaron parámetros clínicos (índice de higiene oral simplificado IHO-S, ceo-d, consumo de azúcar y exposición a fluoruros), sialoquímicos (pH y flujo salival, capacidad amortiguadora) y microbiológicos (UFC/mg de biofilm dental de Streptococcus grupo mutans) antes y después de la aplicación de los tratamientos. Se observó una asociación entre los parámetros que producenuna deficiente control de placa bacteriana: altos valores de IHO-S, de UFC/mg biofilm dental, de consumo de azúcar, del componente c del índice ceo-d y los menores valores de flujo salival y de capacidad amortiguadora. Luego de la aplicación de los tratamientos, se observó una disminución significativade IHO-S y UFC/mg biofilm dental. No se observaron diferencias significativas con el género y la edad de los niños.La asociación observada entre los niveles de higiene oral y de bacterias cariogénicas enfatiza la importancia de la prevención y atención de la salud de los niños más vulnerables. La incorporación del F asociada a la CHX en la etapa inicial de los protocolos terapéutico-preventivos ofrecería tempranamente beneficios en el control microbiano mientras se incorporan hábitos de higiene oral.(AU)

Comparative study of preventive protocols in children at high cariogenic risk

El objetivo de este trabajo fue evaluar la eficacia de dos protocolos preventivos - fluoruro (F) sólo o combinando conclorhexidina (CHX)- sobre indicadores clínicos, sialoquímicos y microbiológicos, en una población de niños de altoriesgo cariogénico. Se aplicaron dos protocolos terapéutico-preventivos en 73 niños en edad escolar de alto riesgo cariogénico y se determinarony correlacionaron parámetros clínicos (índice de higiene oral simplificado IHO-S, ceo-d, consumo de azúcar y exposición a fluoruros), sialoquímicos (pH y flujo salival, capacidad amortiguadora) y microbiológicos (UFC/mg de biofilm dental de Streptococcus grupo mutans) antes y después de la aplicación de los tratamientos. Se observó una asociación entre los parámetros que producenuna deficiente control de placa bacteriana: altos valores de IHO-S, de UFC/mg biofilm dental, de consumo de azúcar, del componente c del índice ceo-d y los menores valores de flujo salival y de capacidad amortiguadora. Luego de la aplicación de los tratamientos, se observó una disminución significativade IHO-S y UFC/mg biofilm dental. No se observaron diferencias significativas con el género y la edad de los niños.La asociación observada entre los niveles de higiene oral y de bacterias cariogénicas enfatiza la importancia de la prevención y atención de la salud de los niños más vulnerables. La incorporación del F asociada a la CHX en la etapa inicial de los protocolos terapéutico-preventivos ofrecería tempranamente beneficios en el control microbiano mientras se incorporan hábitos de higiene oral.

Antifungal and post-antifungal effects of chlorhexidine, fluconazole, chitosanand its combinations on Candida albicans

Objective: The aim of this work was to assess the antifungal and post-antifungal effects of chlorhexidine, fluconazole,chitosan and its combinations on virulence factors of Candida albicans. Study Design: Ten isolated strains of Candida albicans obtained from 10 patients with oral candidiasis and acollection strain of C. albicans were treated with antifungal agents in different concentrations or combinationsof them. Virulence factors analyzed were the cell surface hydrophobicity, the germinative tube development, the phospholipase activity and the post-antifungal effect of that exposure. Results: Virulence factors of the isolated strains obtained from patients together with the collection strain showed significant decreases with the different antifungal treatments, except for hydrophobicity and phospholipase activity.The development of germinative tube was the most sensitive factor to all the antifungal agents used. Untreated strains as well as the ones treated with antifungal agents showed a positive correlation among the virulence factorsanalyzed. No synergic effects arose from the combinations of the used drugs. Conclusions: C. albicans isolated strains from patients showed high phospholipase activity and germinative tubeproduction, which corroborates their capacity to infect the oral mucosa and the high prevalence of species. Asa whole, our results imply that short exposures to sub-inhibitory concentrations of the antifungal agents underanalysis, isolated or combined, can modulate the way virulence factors get manifested, thus decreasing their pathogenicity (AU)

Antifungal and post-antifungal effects of chlorhexidine, fluconazole, chitosan and its combinations on Candida albicans.

OBJECTIVE: The aim of this work was to assess the antifungal and post-antifungal effects of chlorhexidine, fluconazole, chitosan and its combinations on virulence factors of Candida albicans. STUDY DESIGN: Ten isolated strains of Candida albicans obtained from 10 patients with oral candidiasis and a collection strain of C. albicans were treated with antifungal agents in different concentrations or combinations of them. Virulence factors analyzed were the cell surface hydrophobicity, the germinative tube development, the phospholipase activity and the post-antifungal effect of that exposure. RESULTS: Virulence factors of the isolated strains obtained from patients together with the collection strain showed significant decreases with the different antifungal treatments, except for hydrophobicity and phospholipase activity. The development of germinative tube was the most sensitive factor to all the antifungal agents used. Untreated strains as well as the ones treated with antifungal agents showed a positive correlation among the virulence factors analyzed. No synergic effects arose from the combinations of the used drugs. CONCLUSIONS: C. albicans isolated strains from patients showed high phospholipase activity and germinative tube production, which corroborates their capacity to infect the oral mucosa and the high prevalence of species. As a whole, our results imply that short exposures to sub-inhibitory concentrations of the antifungal agents under analysis, isolated or combined, can modulate the way virulence factors get manifested, thus decreasing their pathogenicity.

Efecto de drogas antifungicas sobre factores de virulencia de especies candida / Effect of antifungal drugs on virulence factors of Candida species

La candidiasis bucal es la micosis más frecuente en el humano y es causada principalmente por C. Albicans. Sin embargo, otras especies están aumentando su frecuencia como agentes causantes de dicha enfermedad. La capacidad de Candida para persistir en el epitelio oral está relacionada con su virulencia, a la cual contribuyen diferentes factores como la capacidad de adhesión, la hidrofobicidad de la superficie celular, la producción y secreciçón de enzimas hidrolíticas y el dimorfismo levadura-hifa. La pared celular del hongo está involucrada en todos estos factores por lo que su composición y estructura juegan un papel importante en la patogénesis de la candidiasis. Summary: Oral candiodosis is the most common fungal infection in humans which is mainly caused by C. albicans. However, other species are increasing their frequency as etiological agents of this pathology. The ability of candida to persiste in the oral epithelium is associated with its virulence which is formed by the contribution of different factors like cell adhesion, cell surface hydrophobicity, synthesis and secretion of hydrolytic enzymes, and yeast-hyphae dimorphism. The cell wall of candida is involved in all these virulence factors; that are why its composition and structure might play an important role in the pathogenesis

Oral candiodosis is the most common fungal infection in humans which is mainly caused by C. albicans. However, other species are increasing their frequency as etiological agents of this pathology. The ability of candida to persist in the oral epithelium is associated with its virulence which is formed by the contribution of epithelium is associated with its virulence which is formed by the contribution of different factors like cell adhesion, cell surface hyphae dimorphism

Efecto del quitosán de alto peso molecular y del alginato de sodio sobre la hidrofobicidad y adhesión de Candida albicans a células / Effect of the high molecular weight chitosan and sodium alginate on Candida albicans hydrophobicity and adhesion to cells

Objetivo: Evaluar el efecto del quitosán de alto peso molecular (QAPM) y del alginato de sodio (NaAL) sobre la hidrofobicidad superficial de Candida albicans y la adhesión de esta levadura a células epiteliales y fibroblastos de distinto origen. Diseño del estudio: Para el estudio de la hidrofobicidad, las levaduras (n=7) se hicieron crecer en agar glucosado de Sabouraud suplementado con QAPM o NaAL o en ausencia de los mismos (controles). La determinación de la hidrofobicidadse realizó por el método de adhesión a hidrocarburos utilizando dos solventes orgánicos (xileno y cloroformo). En los estudios de adhesión, las levaduras se pusieron en contacto con soluciones de biopolímeros y luego se enfrentaron a diferentes células (fibroblastos humanos y de rata y células epiteliales Hep-2). La cuantificación se realizó por microscopía óptica.Resultados: Se observó una disminución del 44% de la hidrofobicidad en presencia de QAPM y del 82%, con NaAL, o del 30% con QAPM y 19% con NaAL, cuando los solventes orgánicos empleados fueron cloroformo o xileno, respectivamente. La adhesión de C. albicans a células epiteliales y fibroblastos humanos disminuyó significativamente con ambos biopolímeros. En el caso de los fibroblastos de encía de rata, sólo se observó una disminución con NaAL. En ninguno de los experimentos se observaron diferencias significativas en asociación al tipo de fibroblasto empleado. Conclusiones: Los biopolímeros resultaron efectivos en la reducción de la hidrofobicidad y la adhesión de C. albicans a células, las cuales son importantes factores de virulencia relacionados con la colonización de los tejidos blandos del hospedador o superficies acrílicas presentes en el sistema estomatognático

The aim of the present paper is to evaluate the effect of the high molecular weight chitosan (HMWC) and of sodium alginate (NaAL) on surface hydrophobicity of Candida albicans and on adhesion of the yeast to epithelial cells and fibroblasts of different proceeding.For this study, a collection strain and seven isolates of C. albicans from saliva (patients with denture stomatitis) were grown in Sabouraud glucose agar supplemented with HMWC or NaAL or in absence of them (control). Hydrophobicity was determined by adhesion to hydrocarbons method using two organic media (xylene and chloroform). For adhesion experiments, aqueous suspensions of yeasts were contacted with solutions of biopolymers and different cells (rat and human fibroblasts and epithelial cells Hep-2). The quantification of adhesion was made by optical microscopy.Results: a decrease in hydrophobicity was observed in the presence of HMWC (44%) and of NaAL (82%) when chloroformwas employed as organic medium, meanwhile the decreases were of 30% with HMWC and 19% with NaAL in the presence of xylene. Adhesion of C. albicans to epithelial cells and human fibroblasts decreased significantly with both biopolymers. In the case of rat fibroblasts, a decrease was observed only with NaAL. None of experiments showed significant differences associated to fibroblast type.Conclusions: biopolymers showed effectiveness in reducing hydrophobicity and adhesion of C. albicans to cells, which are important virulence factors related to colonization of the soft tissues of host or acrylic surfaces present in the oral system

Effect of the high molecular weight chitosan and sodium alginate on Candida albicans hydrophobicity and adhesion to cells.

UNLABELLED: The aim of the present paper is to evaluate the effect of the high molecular weight chitosan (HMWC) and of sodium alginate (NaAL) on surface hydrophobicity of Candida albicans and on adhesion of the yeast to epithelial cells and fibroblasts of different proceeding. For this study, a collection strain and seven isolates of C. albicans from saliva (patients with denture stomatitis) were grown in Sabouraud glucose agar supplemented with HMWC or NaAL or in absence of them (control). Hydrophobicity was determined by adhesion to hydrocarbons method using two organic media (xylene and chloroform). For adhesion experiments, aqueous suspensions of yeasts were contacted with solutions of biopolymers and different cells (rat and human fibroblasts and epithelial cells Hep-2). The quantification of adhesion was made by optical microscopy. RESULTS: A decrease in hydrophobicity was observed in the presence of HMWC (44%) and of NaAL (82%) when chloroform was employed as organic medium, meanwhile the decreases were of 30% with HMWC and 19% with NaAL in the presence of xylene. Adhesion of C. albicans to epithelial cells and human fibroblasts decreased significantly with both biopolymers. In the case of rat fibroblasts, a decrease was observed only with NaAL. None of experiments showed significant differences associated to fibroblast type. CONCLUSIONS: Biopolymers showed effectiveness in reducing hydrophobicity and adhesion of C. albicans to cells, which are important virulence factors related to colonization of the soft tissues of host or acrylic surfaces present in the oral system.

[High molecular weight chitosan and sodium alginate effect on secretory acid proteinase of Candida albicans]. / Efecto del quitosan de alto peso melecular y del alginato de socio sobre la proteinasa ácida secretoria de Candida albicans.

The effect of high molecular weight chitosan (HMWCh) and sodium alginate (NaAL) on acid proteinase secretion of Candida albicans (one of culture collection and five isolates) was evaluated. The secretion of acid proteinase was induced in the presence and the absence of these polymers in different concentrations and their enzymatic activity was determined. HMWCh and NaAL significantly diminished the enzymatic activity (>76% for the collection strains and > 89% for the isolates, p < 0.05). HMWCh did not modify protein concentrations, but NaAL did. It can be concluded that both polymers can inhibit the proteinase activity of Candida albicans.

Effect of Chitosan and Sodium Alginate on the adherence of autochthonous C. Albicans to oral epithelial cells (in vitro).

The aim of the present study was to evaluate the effect of Heavy Molecular Weight Chitosan (HMWCh) and Sodium Alginate (NaAl) on fungal adherence. C albicans was identified and isolated from non-stimulated saliva extracted from male and female healthy adults. The minimum inhibitory concentration (MIC) was determined for each of the biopolymers. MIC values were 0.25 % (W/V) for HMWCh and 0.10 % (W/V) for NaAl. Fungal cell hydrophobicity was evaluated against xylene in the presence of HMWCh. Statistically significant differences between the control (without HMWCh) and the different HMWCh concentrations in fungal suspension were observed (P< 0.05). The fact that HMWCh and NaAl impaired fungal adherence to buccal epithelial cells (BEC) as compared to control revealed that polymers inhibit Candida albicans adherence to BEC (HMWCh and NaAl: P= 0.00001), NaAl being more effective than HMWCh (P = 0.00001). HMWCh dettached and aggregated C. albicans, including the fungi and BEC in the mesh. NaAl inhibited adherence, aggregated and entrapped the fungi in the mesh, excluding BEC. We may conclude that both biopolymers are effective. However, NaAl is a stronger inhibitor of adherence. Thus, in combination or alone, these biopolymers could be used in the treatment of oral candidosis.