Effect of zinc oxide-eugenol endodontic paste on planktonic aggregates and biofilm of Enterococcus faecalis - An atomic force microscopy evaluation.

OBJECTIVE: This work aimed to evaluate the in vitro effect of zinc oxide-eugenol paste (ZOE) on planktonic aggregates (EfPA) and biofilm (EfBio) of Enterococcus faecalis, focusing on their morphological aspects observed and analyzed using atomic force microscopy (AFM). DESIGN: The eugenol and paste were characterized by Gas Chromatography coupled with Mass Spectrometry (GC-MS) and Fourier Transform Infrared Spectroscopy (FTIR), respectively. The effect of ZOE on EfPA and EfBio was evaluated by a direct-contact test through colony counting and crystal violet staining protocol. AFM images of untreated and treated EfPA and EfBio growth on bovine dentin were obtained to analyze the morphological damage caused by the treatments. RESULTS: The characterization showed high purity in the eugenol composition and chemical interaction between the components of the paste. A bactericidal effect on aggregates was observed after 6 h of exposure, and on biofilm after 24 h of treatment (p < 0.001). A disruptive effect on the biofilm was also evident. AFM images revealed the formation of EfPA, with a notable presence of an exopolysaccharide matrix. After 6 h of ZOE treatment, there was a significant increase in the size and surface roughness profile of treated cells (p < 0.05). Loss of typical cell morphology was observed after 24 h. The effect on the biofilm showed a tendency towards a less condensed biofilm pattern in the treated group, with no differences in surface roughness. CONCLUSION: ZOE presents bactericidal action on EfPA and EfBio, promoting significant morphological changes after treatment, especially in the aggregates.

Helicobacter pylori in oral cavity: current knowledge.

The oral cavity may play a role as a reservoir and in the transmission and colonization of Helicobacter pylori. The route of transmission for H. pylori is not fully understood. The prevalence of this pathogen varies globally, affecting half of the world's population, predominantly in developing countries. Here, we review the prevalence of H. pylori in the oral cavity, the characteristics that facilitate its colonization and dynamics in the oral microbiome, the heterogeneity and diversity of virulence of among strains, and noninvasive techniques for H. pylori detection in oral samples. The prevalence of H. pylori in the oral cavity varies greatly, being influenced by the characteristics of the population, regions where samples are collected in the oral cavity, and variations in detection methods. Although there is no direct association between the presence of H. pylori in oral samples and stomach infection, positive cases for gastric H. pylori frequently exhibit a higher prevalence of the bacterium in the oral cavity, suggesting that the stomach may not be the sole reservoir of H. pylori. In the oral cavity, H. pylori can cause microbiome imbalance and remodeling of the oral ecosystem. Detection of H. pylori in the oral cavity by a noninvasive method may provide a more accessible diagnostic tool as well as help prevent transmission and gastric re-colonization. Further research into this bacterium in the oral cavity will offer insights into the treatment of H. pylori infection, potentially developing new clinical approaches.

Metatranscriptomic analysis shows functional alterations in subgingival biofilm in young smokers with periodontitis: a pilot study

Abstract This study aimed to assess the influence of smoking on the subgingival metatranscriptomic profile of young patients affected by stage III/IV and generalized periodontal disease. Methodology In total, six young patients, both smokers and non-smokers (n=3/group), who were affected by periodontitis were chosen. The STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines for case-control reporting were followed. Periodontal clinical measurements and subgingival biofilm samples were collected. RNA was extracted from the biofilm and sequenced via Illumina HiSeq. Differential expression analysis used Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and differentially expressed genes were identified using the Sleuth package in R, with a statistical cutoff of ≤0.05. Results This study found 3351 KEGGs in the subgingival biofilm of both groups. Smoking habits altered the functional behavior of subgingival biofilm, resulting in 304 differentially expressed KEGGs between groups. Moreover, seven pathways were modulated: glycan degradation, galactose metabolism, glycosaminoglycan degradation, oxidative phosphorylation, peptidoglycan biosynthesis, butanoate metabolism, and glycosphingolipid biosynthesis. Smoking also altered antibiotic resistance gene levels in subgingival biofilm by significantly overexpressing genes related to beta-lactamase, permeability, antibiotic efflux pumps, and antibiotic-resistant synthetases. Conclusion Due to the limitations of a small sample size, our data suggest that smoking may influence the functional behavior of subgingival biofilm, modifying pathways that negatively impact the behavior of subgingival biofilm, which may lead to a more virulent community.

Unraveling the Endodontic Archaeome: A Systematic Review with Meta-Analysis.

INTRODUCTION: The controversial issue of whether the Archaea domain plays a role in endodontic infections is the focus of this systematic review with meta-analysis. The aim is to emphasize the significance of minority microbial domains in oral dysbiosis by evaluating the prevalence of archaea in root canals and its association with clinical parameters such as symptomatology and type of endodontic infection. METHODS: The search strategy involved researching 6 databases and the gray literature. Publications were accepted in any year or language that identified archaea in samples from endodontic canals. A 2-step selection process narrowed the final choice to 16 articles. The methodological quality of the studies was evaluated using tools from the Joanna Briggs Institute, and the certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS: The results showed that archaea were present in 20% (95% [confidence interval] CI = 8%-32%) of individuals with endodontic samples analyzed. The samples were about twice as likely to be archaeal-positive if collected from individuals with primary vs. persistent/secondary infection (odds ratio = 2.33; 95% CI = 1.31-4.14; I2 = 0%), or individuals with self-reported vs. symptom-free infections (odds ratio = 2.67; 95% CI = 1.47-4.85; I2 = 0%). Methanogenic archaea were reported in 66% of the included studies. Representative members of phyla Thaumarchaeota and Crenarchaeota were also identified. CONCLUSIONS: Archaea are present in about one-fifth of the infected root canals. Recognized biases in experimental approaches for researching archaea must be addressed to understand the prevalence and roles of archaea in endodontic infections, and to determine whether the decontamination process should include the elimination or neutralization of archaea from root canals (International Prospective Register of Systematic Reviews protocol = CRD42021264308).

Tratamento de lesão periradicular, de origem endodôntica, com auxílio de laserterapia: uma revisão sistemática da literatura e apresentação se caso clínico / Treatment of periradicular injury, of endodontic origin, with the aid of laser therapy: a systematic review of the literature and presentation if clinical case

É sabido que a cavidade oral é a porta de entrada para muitos microrganismos e que possui alguns gêneros de bactérias que quando se associam ou proliferam em excesso, com a falta de higienização correta, fatores ambientais e imunológicos podem causar danos em algumas partes dos dentes como no tecido pulpar e canais radiculares. Neste sentido, a endodontia tem sido capaz de tratar pessoas com problemas dentários em fases muito precoces como as medidas profiláticas até casos infeciosos que afetam a polpa dos dentes causando as lesões perirradiculares que são infecções causadas por microrganismos, Para tanto, é necessário que a odontologia ofereça transformações positivas por meio de técnicas que sejam mais previsíveis para os tratamentos. A literatura tem indicado o uso da laserterapia como técnica auxiliar para o tratamento endodôntico pelo seu potencial mínimo invasivo, preciso e eficaz em menor tempo de cura de patologias orais como as lesões perirradiculares. Este estudo pretendeu abordar a importância da laserterapia sobre as variáveis patológicas de pacientes com lesão perirradiculares. Para realiza-lo foi necessário buscar na literatura estudos que associem este tipo de tratamento e sua eficiência no tratamento desta patologia. Para realizar esta pesquisa foi necessário buscar dados na literatura que tratam sobre o tema para investigar o tempo indicado ao tratamento com a laserterapia bem como o estágio em que as lesões podem ser tratadas com auxílio deste método. Corroborando com o estudo apresentamos um caso clínico(AU)

It is known that the oral cavity is the gateway to many microorganisms and that it has some genera of bacteria that when they associate or proliferate in excess, with the lack of correct hygiene, environmental and immunological factors can cause damage in some parts of the teeth such as in pulp tissue and root canals. In this sense, endodontics has been able to treat people with dental problems at very early stages such as prophylactic measures to infectious cases that affect the pulp of teeth causing perirradicular lesions that are infections caused by microorganisms, therefore, it is necessary that dentistry offer positive transformations through techniques that are more predictable for treatments. The literature has indicated the use of laser therapy as an auxiliary technique for endodontic treatment for its minimal invasive, precise and effective potential in shorter time of cure of oral pathologies such as perirradicular lesions. This study aimed to address the importance of laser therapy on the pathological variables of patients with perirradicular lesions. To accomplish this, it was necessary to seek studies in the literature that associate this type of treatment and its efficiency in the treatment of this pathology. To carry out this research it was necessary to seek data in the literature that deal with the subject to investigate the time indicated for treatment with laser therapy as well as the stage at which lesions can be treated with the aid of this method. Corroborating the study, we present a clinical case(AU)

Newly identified pathogens in periodontitis: evidence from an association and an elimination study.

We assessed the level of evidence for the presence of new periodontal pathogens by (i) comparing the occurrence of non-classical periodontal taxa between healthy vs. periodontitis patients (Association study); (ii) assessing the modifications in the prevalence and levels of these species after treatments (Elimination study). In the Association study, we compared the prevalence and levels of 39 novel bacterial species between periodontally healthy and periodontitis patients. In the Elimination study, we analyzed samples from periodontitis patients assigned to receive scaling and root planing alone or with metronidazole+ amoxicillin TID/ 14 days. Levels of 79 bacterial species (39 novel and 40 classic) were assessed at baseline, 3 and 12 months post-therapy. All samples were analyzed using Checkerboard DNA-DNA hybridization. Out of the 39 novel species evaluated, eight were categorized as having strong and four as having moderate association with periodontitis. Our findings suggest strong evidence supporting Lancefieldella rimae, Cronobacter sakazakii, Pluralibacter gergoviae, Enterococcus faecalis, Eubacterium limosum, Filifactor alocis, Haemophilus influenzae, and Staphylococcus warneri, and moderate evidence supporting Escherichia coli, Fusobacterium necrophorum, Spiroplasma ixodetis, and Staphylococcus aureus as periodontal pathogens. These findings contribute to a better understanding of the etiology of periodontitis and may guide future diagnostic and interventional studies.

The Oral Microbiota in Health and Disease: An Overview of Molecular Findings.

Culture-independent nucleic acid technologies have been extensively applied to the analysis of oral bacterial communities associated with healthy and diseased conditions. These methods have confirmed and substantially expanded the findings from culture studies to reveal the oral microbial inhabitants and candidate pathogens associated with the major oral diseases. Over 1000 bacterial distinct species-level taxa have been identified in the oral cavity and studies using next-generation DNA sequencing approaches indicate that the breadth of bacterial diversity is even much larger. Nucleic acid technologies have also been helpful in profiling bacterial communities and identifying disease-related patterns. This chapter provides an overview of the diversity and taxonomy of oral bacteria associated with health and disease.

Evaluation of PCR primers to identify Porphyromonas endodontalis in apical periodontitis clinical samples.

We aimed to evaluate whether two commonly used PCR primers are effective to identify P. endodontalis and discriminate from other prevalent black-pigmented bacteria in apical periodontitis (AP). Endodontic canal samples from patients with asymptomatic AP (n = 20) were collected and cultured in anaerobiosis. Two primer sets to detect P. endodontalis were selected from the literature and first analyzed for their specificity in silico; and then tested on clinical isolates in vitro and finally, in apical exudates ex vivo. The identity of P. endodontalis was verified by PCR and Sanger sequencing with universal primers for bacterial V3-V6 regions 16S rDNA. Only one primer set showed specificity only for P. endodontalis clones in silico and also was specific for P. endodontalis in vitro and ex vivo.

Meta-analyses on the Periodontal Archaeome.

Recently, we have published a scoping review on the oral archaeome, showing that these microorganisms inhabit various oral niches, including periodontal sites. In order to reinforce the importance of the Archaea domain and alert the scientific community about the importance of inter-domain relationships in oral dysbiosis, we have performed meta-analyses evaluating the prevalence of archaea in periodontal diseases (PROSPERO protocol: CRD42020213109). A systematic search in the literature was conducted in several databases and in grey literature, retrieving 30 reports on periodontal archaeome, published from 1980 to 2020. The methodological quality of included studies and the certainty of evidence were evaluated by using validated tools. Most studies focused on the detection of methanogens, revealing that the diversity of the periodontal archaeome is currently underestimated. Two meta-analyses concluded that individuals with periodontitis are prone to have archaeal-positive subgingival biofilms when compared to periodontally healthy individuals (OR 6.68, 95% CI 4.74-9.41 for 16S rRNA gene analysis and OR 9.42, 95% CI 2.54-34.91 for mcrA gene analysis). Despite the archaeal enrichment in sites with periodontitis, less than half of the individuals with periodontitis tested positive for archaeal DNA (general estimative of 46%; 95% CI 36-56%). Conventional treatment for periodontitis reduced the archaeal population, but systemic antibiotics used as adjunctive therapy did not increase its effectiveness. Hence, it could conceivably be hypothesised that archaea are secondary colonizers of areas with dysbiosis, probably flourishing in the inflammatory environment. Due to their lower prevalence, archaeal cells are probably underestimated by the current detection protocols. It may also be speculated that archaea do not have a single central role in the infection, with bacterial cells directly involved in that role. New studies are necessary, with different methodological approaches, to explore the underestimated diversity of the oral archaeome.

Vigilancia clínica-microbiológica de una Periodontitis Grado C etapa III en cinco años / Clinical-microbiological vigilance of a C Grade Periodontitis Stage III in five years

Resumen Introducción: Diversas técnicas se utilizan para tratar y mantener los dientes afectados con Periodontitis de estadio III grado C, sin embargo, hay poca información sobre cómo se modifican los parámetros clínicos periodontales y la composición microbiológica durante el tratamiento convencional y quirúrgico. Objetivo: Evaluar la respuesta clínica y microbiológica en una paciente con periodontitis estadio III grado C generalizada durante 5 años. Cuyo tratamiento consistió en terapia periodontal no quirúrgica y quirúrgica utilizando material regenerativo y sustituto óseo. Metodología: Se realizó raspado y alisado radicular progresivo, combinado con antibióticos y cirugía en sitios con defectos infraóseos. Se tomó registro de placa bacteriana subgingival (PB), hemorragia (H), profundidad de la bolsa (PS) y nivel de inserción clínica (NIC) en cada momento del tratamiento. Se tomaron muestras de la profundidad de las bolsas para identificar bacterias periodontales por biología molecular. Resultados: Se observó una mejoría de PB, H, PS y ganancia de NIC a lo largo de los 5 años. Con los injertos óseos la PS disminuyó 5 mm y de NIC se ganó 5 mm, con amelogeninas las diferencias fueron de 4,5 mm respectivamente. En colgajos de acceso, la PS disminuyó 3 mm y de NIC se ganó 2 mm. Se identificó T.denticola a los 36 meses, en todas las bolsas tratadas con colgajo de acceso y en el 50% de las bolsas con injertos óseos; y P. gingivalis a los 60 meses. Conclusiones: El tratamiento periodontal aplicado evitó la pérdida de los dientes afectados. El mejoramiento de los parámetros clínicos se asoció con una microbiota no agresiva.

Abstract Introduction: There are several techniques to treat and maintain teeth affected by stage III, grade C periodontitis, nonetheless, the scientific evidence available on how periodontal clinical parameters and microbiological composition may be modified during the conventional and surgical treatment is scarce. Objective: To evaluate the clinical and microbiological response of a patient with stage III grade C, generalized periodontitis, during 5 years, treated with non-surgical and surgical periodontal therapy using regenerative material and bone substitute. Methodology: The patient was treated with scaling and progressive root planning, combined with antibiotics and surgical therapy was performed in sites with infraosseous defects. At each time of treatment, subgingival bacterial plaque (PB), haemorrhage (H), probing depth (PD) and clinical attachment level (CAL) were recorded. To identify periodontal bacteria by molecular biology samples were taken with endodontic cones from the pocket depth. Results: A significant difference of PB, H, PD was observed. The PD decreased and CAL was gained throughout the treatment. PD decreased 5 mm with the application of bone substitute, and CAL gained 5 mm, with the use of amelogenins the difference of PD and CAL was 4.5 mm. In access flap the PD decreased 3 mm and the CAL improved 2 mm. T. denticola was identified at 36 months in all pockets treated with access flap and in 50% of the pockets with bone graft, and P. gingivalis at 60 months. Conclusions: The periodontal treatment applied prevented the loss of the affected teeth. Improvement of clinical parameters was associated with a non-aggressive microbiota.

Applications of Silver Nanoparticles in Dentistry: Advances and Technological Innovation.

Silver nanoparticles (AgNPs) have been successfully applied in several areas due to their significant antimicrobial activity against several microorganisms. In dentistry, AgNP can be applied in disinfection, prophylaxis, and prevention of infections in the oral cavity. In this work, the use of silver nanoparticles in dentistry and associated technological innovations was analyzed. The scientific literature was searched using PubMed and Scopus databases with descriptors related to the use of silver nanoparticles in dentistry, resulting in 90 open-access articles. The search for patents was restricted to the A61K code (International Patent Classification), using the same descriptors, resulting in 206 patents. The results found were ordered by dental specialties and demonstrated the incorporation of AgNPs in different areas of dentistry. In this context, the search for patents reaffirmed the growth of this technology and the dominance of the USA pharmaceutical industry over AgNPs product development. It could be concluded that nanotechnology is a promising area in dentistry with several applications.

Meta-Analysis Using NGS Data: The Veillonella Species in Dental Caries.

Objectives: In light of recent technological advances in Next-generation sequencing (NGS) and the accumulation of large, publicly available oral microbiome datasets, the need for meta-analysing data on caries microbiome is becoming feasible and essential. A consensus on the identification of enriched organisms in cariogenic dysbiotic biofilms would be reached. For example, members of the Veillonella genus have been detected in caries biofilms, and may have an underestimated contribution to the dysbiotic process. Hence, we aimed to determine the abundance of Veillonella species in dental caries in studies using NGS data. Materials and Methods: Analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (registered at PROSPERO: CRD42020204150). Studies investigating microbial composition in saliva, dental biofilm, or carious dentin were included. Six databases and grey literature were searched. Two independent reviewers selected the papers and assessed the methodological quality. Results: Searches retrieved 1,323 titles, from which 38 studies were included in a qualitative synthesis, comprising a total of 1,374 caries and 745 caries-free individuals. Most studies analysed 16S rRNA amplicons, and only 5 studies used shotgun metagenomics and metatranscriptomics. A geographical bias was observed. The methodological quality was downrated in 81.5% of the studies due to the lack of criteria for defining cases and standard criteria used for measurement of the condition in a reliable way. Six studies on early childhood caries (ECC) were meta-analysed, confirming a significant enrichment of Veillonella spp. in caries-associated biofilms (but not saliva) when compared to caries-free controls [mean difference: 2.22 (0.54-3.90); p = 0.01]. Conclusions: Veillonella spp. is more abundant in individuals suffering with ECC when compared to caries-free controls (very low evidence certainty), and should be considered for further studies to observe their metabolism in dental caries. There is an urgent need for a consensus in methodologies used to allow for more rigorous comparison between NGS studies, particularly including clinical data and details of caries diagnosis, as they are currently scarce. Inconsistent reporting on the NGS data affected the cross-study comparison and the biological connexions of the relative abundances on caries microbiome.

Biocorrosive behavior of sulphate-reducing bacteria in kerr endodontic files: Determination of the corrosion.

AIMS: This study determined the corrosion rate by mass loss caused by oral strains of sulphate-reducing bacteria (SRB) in Kerr endodontic files (KF), aiming the development of a biopharmaceutical that facilitates the removal of endodontic limb fragments from root canals. MATERIALS AND METHODS: Nine new KF were analyzed after immersion in the modified Postgate E culture medium inoculated with Desulfovibrio desulfuricans oral (84 days), Desulfovibrio fairfieldensis in the consortium (84 days) and environmental D. desulfuricans (119 days). RESULTS: Optical microscopy revealed corrosion suggestive areas in all files submitted to immersion in SRB cultures, presenting a statistical difference (P < 0.05) between the samples environmental D. desulfuricans and KF control and between oral D. desulfuricans and KF control. Epifluorescence microscopy revealed an active SRB biofilm over the entire metal surface of the KF, as evidenced by the SYTO® 9 fluorophore. CONCLUSION: SRB were capable of promoting biocorrosion in Kerr type endodontic files, but with low rate.

Análise da eficácia da higiene oral de pacientes internados em unidade de terapia intensiva em um hospital de alta complexidade do sul do Brasil / Analysis of the effectiveness of oral hygiene of interns patients in intensive therapy unit in a high-complexity hospital in the south of Brazil

Introdução: As infecções orais, na Unidade de Terapia Intensiva (UTI), deveriam ser preocupações constantes dos profissionais da área da Saúde ali inseridos, devido as consequências que podem causar na saúde geral dos pacientes debilitados sistemicamente. A criação de um protocolo padrão de higiene oral e de suma importância para impedir ou tratar tais infecções, o que possibilita ao paciente conforto e qualidade de vida, devendo ser realizada por profissionais qualificados. Métodos: Foi realizado um estudo transversal e descritivo, cuja analise foi descritiva e se desenvolveu na Unidade de Terapia Intensiva de um hospital de alta complexidade no Sul do Brasil, no período de fevereiro de 2016 a fevereiro de 2017. A amostra total foi composta por 35 pacientes, com idade mínima de 18 anos, que estavam internados na UTI do referido hospital, portadores de prontuários e Termo de Consentimento Livre e Esclarecido. Resultados: Dentre os microrganismos achados nos exames laboratoriais dos pacientes, apresentaram-se em maior quantidade Klebsiella pneumoniae, Staphylococcus coagulase negativo e Escherichia coli. Apenas dois pacientes adquiriram o Acinetobacter baumannii. A maioria dos pacientes obtiveram bactérias gram-negativas presentes em sua microbiota oral. Conclusões: As bactérias patogênicas presentes no meio oral devem ser tratadas e erradicadas. Isso pode ser alcançado por meio de um protocolo padrão de higiene oral. A participação da Odontologia na equipe multidisciplinar no ambiente hospitalar e de fundamental importância para a indicação da terapêutica adequada.

Introduction: Oral infections in the Intensive Care Unit (ICU) should be a constant concern of the health professionals inserted there, due to the consequences that can cause in the general health of systemically debilitated patients. The creation of a standard protocol of oral hygiene is of paramount importance to prevent or treat such infections, allowing the patient comfort and quality of life and should be performed by qualified professionals. Methods: A cross-sectional and descriptive study was carried out, which was descriptive and developed in the Intensive Care Unit of a highly complex hospital in the South of Brazil, from February 2016 to February 2017. The total sample was composed by 35 patients with a minimum age of 18 years who were hospitalized in the ICU of the referred hospital, patients with medical records and a Consent Form, free and clear. Results: Among the microorganisms found in the laboratory exams of the patients, Klebsiella pneumoniae, Staphylococcus coagulase negative and Escherichia coli were present.Only two patients acquired Acinetobacter baumannii. Most of the patients obtained gram negative bacteria present in their oral microbiota. Conclusions: The pathogenic bacteria that are present in the oral environment must be treated and eradicated. This can be achieved through a standard oral hygiene protocol. The participation of Dentistry in the multidisciplinary team in the hospital environment is of fundamental importance for the indication of the appropriate therapy

Qualitative, quantitative and genotypic evaluation of Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum isolated from individuals with different periodontal clinical conditions.

Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum are strongly associated with periodontitis, and their evaluations are relevant to understand their role in the etiology and progression of periodontal diseases. In this study, the qualitative and quantitative detection of A. actinomycetemcomitans and F. nucleatum, as well as their genetic diversity, were evaluated in individuals with gingivitis, chronic periodontitis and periodontally healthy. In addition, the biotyping, serotyping, and prevalence of the ltx and cdt genes in A. actinomycetemcomitans were also determined. Subgingival biofilms obtained from gingivitis (70), periodontitis (75) and healthy (95) individuals were analyzed by cultures and PCR. Bacterial typing and presence of ltx and cdt genes in A. actinomycetemcomitans were also verified. DNA from A. actinomycetemcomitans and F. nucleatum was detected respectively, in 65.7% and 57.1% of gingivitis, 80% and 68% of periodontitis, and 57.8% and 37.8% of healthy. A. actinomycetemcomitans from gingivitis were biotypes I, II, IV, V, and X, and serotypes a, c, and e. In periodontitis, biotypes II, VI, and X, and serotypes a, b, and c were found. In healthy subjects, biotypes II and X, and serotypes b and c were found. The LTX and ltxA were observed in strains from gingivitis and periodontitis pockets. Subsequently, our data also showed no direct relationship between ltxA gene expression and leukotoxin gene 530-bp presence. On the other hand, cdt gene predominated during the inflammatory disease process. Our results strongly support a role of A. actinomycetemcomitans and F. nucleatum in advanced stage of periodontal disease.

Pericoronarite: etiologia, epidemiologia, microbiota, tratamento e complicações / Pericoronitis: Etiology, Epidemiology, Microbiota, Treatments and Complications

A pericoronite é uma infecção do tecido mole associada à coroa de um dente parcialmente irrompido. É mais comumente visto em relação ao terceiro molar mandibular incompletamente irrompido, incluindo a gengiva e o folículo dental. O mucoperiósteo suprajacente e fenda resultante agem como um depósito para alimentos e detritos nos quais bactérias orais se multiplicam rapidamente. Uma reação inflamatória pode resultar de toxinas liberadas pelas bactérias. De acordo com a Classificação Internacional de Doenças, a pericoronarite pode ser classificada como pericoronarite aguda e crônica, e segundo alguns autores, as complicações podem ser de âmbito mais severo e levar a situações de risco eminente de vida. O objetivo desse estudo é fazer uma revisão literária sobre a pericoronarite, envolvendo sua etiologia, epidemiologia, microbiota, tratamentos e complicações. Pesquisa em base de dados PubMed e Bireme. De acordo com essa revisão literária, encontra-se uma posição de interessante logística sobre a pericoronarite e sua etiologia, causas, tratamento e complicações. É importante salientar a gravidade que essa condição que, aparentemente simples, pode acarretar na saúde e qualidade de vida das pessoas.

Pericoronitis is an infection of the soft tissue associated with the crown of a partially erupted tooth. It is most commonly seen in relation to the mandibular third molar incompletely erupted, including the gingiva and the dental follicle. The overlying Mucoperiosteo and resultant gap act as a deposit for food and debris in which oral bacteria multiply rapidly. An inflammatory reaction can result from toxins released by bacteria. According to the International Classification of diseases, Pericoronitis can be classified as acute and chronic pericoronitis, and according to some authors, complications may be of a more severe scope and lead to situations of imminent risk of life. The aim of this study is to do a Literary Review on Pericoronitis, involving its etiology, epidemiology, microbiota, treatments and complications. Research in PubMed and Bireme database. According to this literary review, there is a position of interesting logistics on Pericoronitis and its etiology, causes, treatment and complications. It is important to emphasize the gravity that this condition, which, apparently simple, can lead to health and quality of life.

Microbiota das infecções endo-periodontais: uma revisão de literatura / Microbiota of endo-periodontal infections: a literature review

O objetivo desse estudo é revisar a literatura acerca da microbiologia presente nas doenças endoperiodontais e assim apresentar um melhor conhecimento ao clínico frente à patologia a ser tratada. Foi realizada uma busca nas plataformas: Google Acadêmico, Pubmed e Scielo. Foram selecionados artigos de 2007 até 08/2018, em língua inglesa e língua portuguesa, com os termos: "Endodontia" E/OU "Lesão endoperiodontal E/OU "Microbiologia oral" E/OU "Periodontia". Os principais resultados encontrados demonstraram uma grande variedade microbiológica associada às lesões endoperiodontais e ainda, a presença de alguns microrganismos de difícil eliminação. Na lesão endodôntica primária: Enterococcus faecalis, Parvinonas micra, Mogibacterium timiduam, Filifactor alocis, Fretibacterium fastidiosum, Parvinonas micra, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia. Anaeróbios estritos: Veillonella parvula, Porphyromonas gingivalis, Propionibacterium acnes, Lactobacillus acidophilus, Campylobacter rectus, Slackia exigua, Anaeróbios facultativos: Bactérias microaerofílicas: Aggregatibacter actinomycetemcomitans. Lesão endodôntica primária com envolvimento periodontal secundário: Enterococcus faecalis, Parvinonas micra, Mogibacterium timiduam, Filifactor alocis, Fretibacterium fastidiosum, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia; Lesão periodontal primária: Porphyromonas gingivalis, Fusobacterium nucleatum, Eikenella corrodens Fusobacterium nucleatum, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Parvimonas micra. Lesão periodontal primária com envolvimento endodôntico secundário: Bacteroidaceae sp., Fretibacterium fastidiosum. Lesão endoperiodontal verdadeira combinada: Tannerella forsythia, Porphyromonas endodontalis, Aggregatibacter aphrophilus, Peptostreptococcus stomatitis, Veillonella rogosae, Campylobacter rectus, Campylobacter concisus, Neisseria elongata; Veillonella rogosae, Fusobacterium canifelinum, Haemophilus parainfluenzae, Peptostreptococcus stomatitis, Peptostreptococcus stomatitis, Enterobacter asburiae, Aggregatibacter aphrophilus, Campylobacter rectus, Corynebacterium matruchotii, Neisseria bacilliformis, Actinomyces odontolyticus, Mogibacterium timidum. Conclui-se que o cirurgião-dentista deve melhor identificar qual a microbiota presente em cada tipo de patologia endoperiodontal para que consiga realizar os tratamentos com eficiência obtendo o sucesso(AU)

The objective of this study is to review the literature about the microbiology present in endodontic diseases and thus to present a better knowledge of the clinician regarding the pathology to be treated. By searching the platforms: Google Scholar, Pubmed and Scielo. Articles from 2007 to 08/2018, in English and Portuguese, were selected using the terms: "Endodontics" AND/OR "Endo-periodontal lesion AND/OR" Oral Microbiology "AND/OR" Periodontics ". The main results of the search were a large microbiological variety associated with endo-periodontal lesions and the presence of some microorganisms that were difficult to eliminate. Primary endodontic lesion: Enterococcus faecalis, Parvinonas micra, Mogibacterium timiduam, Filifactor alocis, Fretibacterium fastidiosum, Parvinonas micra, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia. The primary endodontic lesions with secondary periodontal involvement are: Enterococcus faecalis, Parvinonas micra, Mogibacterium timiduam, Filifactor alocis, Fretibacterium, Agrigatibacter actinomycetemcomitans, Staphylococcus aureus, Campylobacter rectus, Campylobacter rectus, Slackia exigua fastidiosum, Streptococcus constellatus, Eubacterium brachy, Tannerella forsythia. Primary periodontal lesion: Porphyromonas gingivalis, Fusobacterium nucleatum, Eikenella corrodens Fusobacterium nucleatum, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Parvimonas micra; Primary periodontal lesion with secondary endodontic involvement: Bacteroidaceae sp., Fretibacterium fastidiosum. True endo-periodontal lesion combined: Tannerella forsythia, Porphyromonas endodontalis, Aggregatibacter aphrophilus, Peptostreptococcus stomatitis, Veillonella rogosae, Campylobacter rectus, Campylobacter concisus, Neisseria elongata;Veillonella rogosae, Fusobacterium canifelinum, Haemophilus parainfluenzae, Peptostreptococcus stomatitis, Peptostreptococcus stomatitis, Enterobacter asburiae, Aggregatibacter aphrophilus, Campylobacter rectus, Corynebacterium matruchotii, Neisseria bacilliformis, Actinomyces odontolyticus, Mogibacterium timidum.It concludes that the dental surgeon must identify which microbiota is present in each type of endo-periodontal pathology, so that he can perform the treatments efficiently, achieving success. (AU)

The Oral Microbiota in Health and Disease: An Overview of Molecular Findings.

Culture-independent nucleic acid technologies have been extensively applied to the analysis of oral bacterial communities associated with healthy and diseased conditions. These methods have confirmed and substantially expanded the findings from culture studies to reveal the oral microbial inhabitants and candidate pathogens associated with the major oral diseases. Over 1000 bacterial distinct species-level taxa have been identified in the oral cavity and studies using next-generation DNA sequencing approaches indicate that the breadth of bacterial diversity may be even much larger. Nucleic acid technologies have also been helpful in profiling bacterial communities and identifying disease-related patterns. This chapter provides an overview of the diversity and taxonomy of oral bacteria associated with health and disease.

Vigilancia clínica-microbiológica de una Periodontitis Grado C etapa III en cinco años

Introducción: Diversas técnicas se utilizan para tratar y mantener los dientes afectados con Periodontitis de estadio III grado C, sin embargo, hay poca información sobre cómo se modifican los parámetros clínicos periodontales y la composición microbiológica durante el tratamiento convencional y quirúrgico. Objetivo: Evaluar la respuesta clínica y microbiológica en una paciente con periodontitis estadio III grado C generalizada durante 5 años. Cuyo tratamiento consistió en terapia periodontal no quirúrgica y quirúrgica utilizando material regenerativo y sustituto óseo. Metodología: Se realizó raspado y alisado radicular progresivo, combinado con antibióticos y cirugía en sitios con defectos infraóseos. Se tomó registro de placa bacteriana subgingival (PB), hemorragia (H), profundidad de la bolsa (PS) y nivel de inserción clínica (NIC) en cada momento del tratamiento. Se tomaron muestras de la profundidad de las bolsas para identificar bacterias periodontales por biología molecular. Resultados: Se observó una mejoría de PB, H, PS y ganancia de NIC a lo largo de los 5 años. Con los injertos óseos la PS disminuyó 5 mm y de NIC se ganó 5 mm, con amelogeninas las diferencias fueron de 4,5 mm respectivamente. En colgajos de acceso, la PS disminuyó 3 mm y de NIC se ganó 2 mm. Se identificó T.denticola a los 36 meses, en todas las bolsas tratadas con colgajo de acceso y en el 50% de las bolsas con injertos óseos; y P. gingivalis a los 60 meses. Conclusiones: El tratamiento periodontal aplicado evitó la pérdida de los dientes afectados. El mejoramiento de los parámetros clínicos se asoció con una microbiota no agresiva.

Introduction: There are several techniques to treat and maintain teeth affected by stage III, grade C periodontitis, nonetheless, the scientific evidence available on how periodontal clinical parameters and microbiological composition may be modified during the conventional and surgical treatment is scarce. Objective: To evaluate the clinical and microbiological response of a patient with stage III grade C, generalized periodontitis, during 5 years, treated with non-surgical and surgical periodontal therapy using regenerative material and bone substitute. Methodology: The patient was treated with scaling and progressive root planning, combined with antibiotics and surgical therapy was performed in sites with infraosseous defects. At each time of treatment, subgingival bacterial plaque (PB), haemorrhage (H), probing depth (PD) and clinical attachment level (CAL) were recorded. To identify periodontal bacteria by molecular biology samples were taken with endodontic cones from the pocket depth. Results: A significant difference of PB, H, PD was observed. The PD decreased and CAL was gained throughout the treatment. PD decreased 5 mm with the application of bone substitute, and CAL gained 5 mm, with the use of amelogenins the difference of PD and CAL was 4.5 mm. In access flap the PD decreased 3 mm and the CAL improved 2 mm. T. denticola was identified at 36 months in all pockets treated with access flap and in 50% of the pockets with bone graft, and P. gingivalis at 60 months. Conclusions: The periodontal treatment applied prevented the loss of the affected teeth. Improvement of clinical parameters was associated with a non-aggressive microbiota.

Avaliação da atividade antibacteriana do hidróxido de cálcio associado a diferentes veículos em blocos de dentina contaminados por Enterococcus faecalis / Evaluation of the antibacterial activity of calcium hydroxide associated different vehicles in dentin blocks contaminated with Enterococcus faecalis

Introdução: A infecção endodôntica ocasionada por Enterococcus faecalis é um problema sério no tratamento de dentes comprometidos. É de preocupação do cirurgião dentista um completo saneamento do sistema de canais radiculares pela aplicação de medicação antisséptica entre sessões. Dentre estas medicações, a pasta de hidróxido de cálcio tem sido associada a diferentes veículos para potencializar sua ação. Objetivos: Diante disto, este estudo objetivou avaliar e comparar a eficiência da atividade antimicrobiana in vitro de diferentes pastas de hidróxido de cálcio frente ao E. faecalis. Material e Métodos: Os testes foram executados em 49 blocos de dentina infectados com E. faecalis e tratados com pastas de hidróxido de cálcio em diferentes veículos por uma semana. A eficiência das pastas foi avaliada pela microscopia confocal de varredura a laser. Para comparação entre as pastas foi empregado o teste de Kruskal-Wallis e pelo teste de Dunn para comparações individuais com nível de significância estabelecido em 5%. Resultados: A aplicação das diferentes pastas proporcionou uma significativa alteração na proporção de bactérias viáveis e não viáveis encontradas no biovolume celular total dos blocos de dentina. Conclusão: A pasta que revelou melhor desempenho antimicrobiano foi aquela cujo veículo foi água destilada. A pasta de hidróxido de cálcio associada ao extrato propilenoglicólico de guaçatonga não apresentou desempenho antimicrobiano sobre células de E. faecalis. (AU)

Introduction: The endodontic infection caused by Enterococcus faecalis is a serious problem in the treatment of compromised teeth. It is a concern to the dental surgeon a complete sanitation of the root canal system by applying antiseptic medication between sessions. Among these medications, the calcium hydroxide paste has been linked to different vehicles to enhance its action. Objectives: Thus, this study aimed to evaluate and compare the efficiency of in vitro antimicrobial activity of different pastes of calcium hydroxide against E. faecalis. Material and Methods: Tests were performed in 49 blocks dentin infected with E. faecalis and treated with calcium hydroxide pastes in different vehicles for a week. The efficiency of the pastes was evaluated by confocal laser scanning. The Kruskal-Wallis test was used to compare the pastes and the Dunn test was used for individual comparisons with a significance level set at 5%. Results: The application of different pastes provided a significan change in the proportion of viable and non-viable bacteria found in the total cell biovolume of the blocks of dentin. Conclusion: The paste that revealed the best antimicrobial performance was the one whose vehicle was distilled water. The calcium hydroxide paste associated with the extract of guaçatonga in propylene glycol showed no antimicrobial performance on cells of E. faecalis. (AU)