Efficacy of preprocedural mouthrinses in the reduction of microorganisms in aerosol: A systematic review.

BACKGROUND: The authors of this systematic review aimed to evaluate the efficacy of preprocedural mouthrinses in reducing the number of microorganisms disseminated by means of the aerosol generated via dental procedures when compared with a placebo, water, or no mouthrinse. TYPES OF STUDIES REVIEWED: The authors included only randomized clinical trials. They searched MEDLINE (PubMed), Embase, Google Scholar, and Latin American and Caribbean Health Sciences Literature databases through May 31, 2019. They performed random-effects meta-analysis for reduction of the number of colony-forming units (CFU) in the dental aerosol. RESULTS: Of 770 potentially relevant articles, the authors included 13 randomized clinical trials in which researchers studied the efficacy of chlorhexidine, essential oils, cetylpyridinium chloride, and herbal products. Meta-analysis of 12 studies showed that mouthrinses with chlorhexidine, essential oils, and cetylpyridinium chloride significantly reduced the number of CFU. Overall, the use of a preprocedural mouthrinse resulted in a mean reduction in the number of CFUs of 64.8% (95% confidence interval, 50.4% to 79.3%; I2 = 37%) compared with control. None of the included studies presented a low risk of bias. PRACTICAL IMPLICATIONS: Some dental procedures result in dissemination of microorganisms in the aerosol in the dental office. There is moderate evidence that preprocedural mouthrinses significantly reduce the number of microorganisms in the dental aerosol.

Periodontal status of liver transplant candidates and healthy controls.

BACKGROUND: This study aimed to compare the periodontal status of liver transplant candidates (LTCs) with healthy controls. METHODS: Fifty liver transplant candidates (LTC group) and fifty patients without liver disease (control group) underwent a complete periodontal examination. The groups were matched according to sex, age, and smoking status. A structured questionnaire was applied to record demographic data, systemic health, and information related to liver disease. Full-mouth complete periodontal examination of six sites per tooth was performed: gingival recession (GR), probing depth (PD), attachment loss (AL), bleeding on probing (BOP), and visible plaque index (VPI). The groups were compared in regard to periodontal clinical variables. RESULTS: Patients with cirrhosis had greater prevalence of periodontitis than healthy controls (P < 0.001). In addition, they had greater mean percentage of sites with AL ≥3 mm (P = 0.008) and AL ≥5 mm (P = 0.023), greater mean AL (P = 0.003), greater mean gingival recession (P < 0.001), and more missing teeth than in the control group (P = 0.02). CONCLUSION: Liver transplant candidates presented greater prevalence, extent, and severity of periodontitis than matched control patients.

Eficácia de enxaguatórios bucais pré-procedimento na redução de microrganismos no aerossol: uma revisão sistemática / Efficacy of mouthwashes pre-procedural in the reduction of microorganisms in the aerosol: a systematic review

Esta revisão teve como objetivo avaliar a eficácia do uso de enxaguatórios bucais pré-procedimento na redução do número de microrganismos disseminados pelo aerossol gerado pelos procedimentos odontológicos. Apenas ensaios clínicos randomizados (ECRs) foram incluídos. As bases de dados MEDLINE (PubMed), Google Acadêmico e LILACS foram pesquisadas para busca de artigos publicados até março de 2018. Foi realizada meta-análise de efeitos aleatórios da redução de unidades formadoras de colônia (UFCs) isoladas após realização de procedimentos odontológicos que geram aerossol. Dos 725 artigos potencialmente relevantes, 12 ECRs que estudaram a eficácia da clorexidina, óleos essenciais, cloreto de cetilpiridínio e produtos fitoterápicos foram incluídos. Todos os estudos mostraram que o enxaguatório bucal pré-procedimento promoveu redução significativa no número de UFCs. A Meta-análise mostrou que enxaguatórios bucais com óleos essenciais promoveram redução percentual média de 73,9% no número de UFCs. Nenhum dos estudos incluídos apresentou baixo risco de viés. Os resultados desta revisão permitem concluir que a realização de enxágue pré-procedimento reduz significativamente o número de microrganismos no aerossol.

Condição bucal de hepatopatas pré- transplantados e transplantados hepáticos: revisão da literatura / Oral Health Status of liver transplant candidates and post–liver transplant patients: a literature review

O transplante de fígado é o tratamento preconizado para a doença hepática terminal. Infecções são complicações frequentes e estão associadas à alta morbidade e mortalidade de pacientes pré e pós-transplantados. Assim, a prevenção de processos infecciosos é fundamental para reduzir a progressão da cirrose e diminuir o risco de complicações após o transplante. Portanto, o objetivo desta revisão de literatura é verificar quais são as condições bucais de candidatos ao transplante de fígado e de pós-transplantados, bem como verificar se a doença hepática está associada com pior condição bucal. Os artigos incluídos demonstraram higiene bucal ruim, alta prevalência de doença periodontal e de doença cárie. Alguns estudos observaram maior perda óssea e maior perda de inserção clínica em pré e pós-transplantados do que em pacientes sadios. A literatura é controversa em relação à associação entre condição hepática e doença cárie. Não há evidência suficiente para suportar a hipótese de que a doença hepática seja um fator de risco para doenças bucais

Liver transplantation is the indicated treatment for endstage hepatic disease. Infections are frequent complications in patients waiting for liver transplant and post-transplant patients, and have been associated with high morbidity and mortality.Thus, prevention of infections is important in the reduction of the progression of hepatic disease and in the reduction of complications in the transplanted patient. The aim of the review is to describe the oral conditions of liver transplant candidates and transplanted patients, and to verify if hepatic disease is associated with poor oral conditions. The included articles demonstrated poor oral hygiene, high prevalence of periodontal disease and caries disease. Some of the studies observed greater bone loss and clinical attachment loss in liver transplant candidates and transplanted patients, when compared to healthy controls. The literature is controversial regarding association between liver disease and dental caries. We concluded that there is not enough evidence to support the hypothesis that liver disease increases the risk for oral diseases