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1.
Rev. peru. med. exp. salud publica ; 39(4): 408-414, oct. 2022. tab, ilus
Artigo em Espanhol | LILACS, LIPECS | ID: biblio-1424340

RESUMO

Objetivos . Describir la actividad antimicrobiana in vitro del extracto metanólico de las hojas de Bixa orellana L. contra las bacterias anaerobias asociadas a la vaginosis bacteriana y Lactobacillus spp. Materiales y métodos . Se incluyeron en el estudio ocho cepas de referencia ATCC; Gardnerella vaginalis, Prevotella bivia, Peptococcus niger, Peptostreptococcus anaerobius, Mobiluncus curtisii, Atopobium vaginae, Veillonella parvula y Lactobacillus crispatus, y 22 aislamientos clínicos; once aislados de Gardnerella vaginalis y once aislados de Lactobacillus. La susceptibilidad antimicrobiana se determinó mediante el método de difusión en agar. La concentración mínima inhibitoria (CMI) y la concentración bactericida mínima (CBM) fueron determinadas utilizando el método de dilución en agar y un método de dilución modificado, respectivamente. Resultados . Todas las cepas de referencia ATCC tuvieron un alto nivel de susceptibilidad al extracto, con excepción de P. vibia, V. parvula y L. crispatus. Interesantemente, los aislamientos clínicos de G. vaginalis y la cepa ATCC de G. vaginalis fueron los más susceptibles al extracto dados los bajos valores de CMI (1,0 - 2,0 mg/mL) y CBM (1,0 - 4,0 mg/mL), mientras que, los aislamientos clínicos de Lactobacillus spp. y la cepa ATCC de L. crispatus fueron los menos susceptibles debido a los altos valores de CMI (32,0 mg/mL) y CBM (≥ 32,0 mg/mL). Conclusiones . Los experimentos in vitro sugieren que el extracto posee propiedades antibacterianas selectivas dada su alta actividad contra bacterias anaerobias asociadas a vaginosis bacteriana y baja actividad contra especies de Lactobacillus.


Objective. To describe the in vitro antimicrobial activity of the methanolic extract of Bixa orellana L. leaves against anaerobic bacteria associated to bacterial vaginosis and Lactobacillus spp. Materials and methods. Eight ATCC reference strains; Gardnerella vaginalis, Prevotella bivia, Peptococcus niger, Peptostreptococcus anaerobius, Mobiluncus curtisii, Atopobium vaginae, Veillonella parvula, and Lactobacillus crispatus, and twenty-two clinical isolates; eleven Gardnerella vaginalis and eleven Lactobacillus strains, were included in the study. The antimicrobial susceptibility was determined by the agar diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by using agar dilution and a modified dilution plating method, respectively. Results. All ATCC reference strains showed high levels of susceptibility to the extract, except P. vibia, V. parvula and L. crispatus. Interestingly, all G. vaginalis clinical isolates and the G. vaginalis ATTC strain were the most susceptible to the extract, given their low MIC (1.0 - 2.0 mg/mL) and MBC (1.0 - 4.0 mg/mL) values, whereas, the Lactobacillus spp. clinical isolates and the L. crispatus ATCC strain were the least susceptible bacteria given their high MIC (32.0 mg/mL) and MBC (≥ 32.0 mg/mL) values. Conclusions. In vitro experiments suggest that the extract possesses selective antimicrobial properties given its high activity against bacterial vaginosis-associated anaerobic bacteria and low activity against Lactobacillus species.


Assuntos
Humanos , Feminino , Técnicas In Vitro , Extratos Vegetais , Bixa orellana , Vaginose Bacteriana , Peptostreptococcus , Bactérias Anaeróbias , Veillonella , Testes de Sensibilidade Microbiana , Gardnerella vaginalis , Suscetibilidade a Doenças , Antibacterianos
2.
Front Cell Infect Microbiol ; 10: 583761, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33117737

RESUMO

In order to improve our understanding on the microbial complexity associated with Grade C/molar-incisor pattern periodontitis (GC/MIP), we surveyed the oral and fecal microbiomes of GC/MIP and compared to non-affected individuals (Control). Seven Afro-descendants with GC/MIP and seven age/race/gender-matched controls were evaluated. Biofilms from supra/subgingival sites (OB) and feces were collected and submitted to 16S rRNA sequencing. Aggregatibacter actinomycetemcomitans (Aa) JP2 clone genotyping and salivary nitrite levels were determined. Supragingival biofilm of GC/MIP presented greater abundance of opportunistic bacteria. Selenomonas was increased in subgingival healthy sites of GC/MIP compared to Control. Synergistetes and Spirochaetae were more abundant whereas Actinobacteria was reduced in OB of GC/MIP compared to controls. Aa abundance was 50 times higher in periodontal sites with PD≥ 4 mm of GC/MIP than in controls. GC/MIP oral microbiome was characterized by a reduction in commensals such as Kingella, Granulicatella, Haemophilus, Bergeyella, and Streptococcus and enrichment in periodontopathogens, especially Aa and sulfate reducing Deltaproteobacteria. The oral microbiome of the Aa JP2-like+ patient was phylogenetically distant from other GC/MIP individuals. GC/MIP presented a higher abundance of sulfidogenic bacteria in the feces, such as Desulfovibrio fairfieldensis, Erysipelothrix tonsillarum, and Peptostreptococcus anaerobius than controls. These preliminary data show that the dysbiosis of the microbiome in Afro-descendants with GC/MIP was not restricted to affected sites, but was also observed in supragingival and subgingival healthy sites, as well as in the feces. The understanding on differences of the microbiome between healthy and GC/MIP patients will help in developing strategies to improve and monitor periodontal treatment.


Assuntos
Microbiota , Periodontite , Aggregatibacter actinomycetemcomitans , Desulfovibrio , Erysipelothrix , Fezes , Humanos , Incisivo , Dente Molar , Peptostreptococcus , RNA Ribossômico 16S/genética
3.
Braz. arch. biol. technol ; Braz. arch. biol. technol;63: e20190196, 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1132166

RESUMO

Abstract Endodontic infections result from oral pathogenic bacteria which reach and infect dental pulp, as well as surrounding tissues, through cracks, unrepaired caries and failed caries restorations. This study aims to determine the chemical composition of essential oil from Psidium cattleianum leaves (PC-EO) and to assess its antibacterial activity against endodontic bacteria. Antibacterial activity of PC-EO was evaluated in terms of its minimum inhibitory concentration (MIC) values by the broth microdilution method on 96-well microplates. Bacteria Porphyromonas gingivalis (MIC = 20 µg/mL), Prevotella nigrescens (MIC = 62.5 µg/mL), Fusobacterium nucleatum (MIC = 12.5 µg/mL), Actinomyces naeslundii (MIC = 50 µg/mL), Bacteroides fragilis (MIC = 12.5 µg/mL), Aggregatibacter actinomycetemcomitans (MIC = 6.25 µg/mL) and Peptostreptococcus anaerobius (MIC = 62.5 µg/mL) were evaluated and compared to chlorhexidine dihydrochloride (CDH), the positive control. PC-EO was obtained by hydrodistillation with the use of a Clevenger-type apparatus whereas its chemical composition was analyzed by gas chromatography-flame ionization detection (GC-FID) and gas chromatography-mass spectrometry (GC-MS). Viridiflorol (17.9%), β-caryophyllene (11.8%), 1,8-cineole (10.8%) and β-selinene (8.6%) were the major constituents found in PC-EO, which exhibited high antibacterial activity against all endodontic pathogens under investigation. Therefore, PC-EO, a promising source of bioactive compounds, may provide therapeutic solutions for the field of endodontics.


Assuntos
Óleos Voláteis/farmacologia , Clorexidina/farmacologia , Psidium/química , Antibacterianos/farmacologia , Peptostreptococcus/efeitos dos fármacos , Bacteroides fragilis/efeitos dos fármacos , Actinomyces/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Fusobacterium nucleatum/efeitos dos fármacos , Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Porphyromonas gingivalis/efeitos dos fármacos , Prevotella nigrescens/efeitos dos fármacos , Cromatografia Gasosa-Espectrometria de Massas
4.
Anaerobe ; 52: 43-49, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29885640

RESUMO

Diterpenes are an important class of plant metabolites that can be used in the search for new antibacterial agents. ent-Copalic acid (CA), the major diterpene in Copaifera species exudates, displays several pharmacological properties. This study evaluates the CA antibacterial potential against the anaerobic bacteria Peptostreptococcus anaerobius and Actinomyces naeslundii. Antimicrobial assays included time-kill and biofilm inhibition and eradication assays. Time-kill assays conducted for CA concentrations between 6.25 and 12.5 µg/mL evidenced bactericidal activity within 72 h. CA combined with chlorhexidine dihydrochloride (CHD) exhibited bactericidal action against P. anaerobius within 6 h of incubation. As for A. naeslundii, the same combination reduced the number of microorganisms by over 3 log10 at 24 h and exerted a bactericidal effect at 48 h of incubation. CA at 500 and 2000 µg/mL inhibited P. anaerobius and A. naeslundii biofilm formation by at least 50%, respectively. CA at 62.5 and 1.000 µg/mL eradicated 99.9% of pre-formed P. anaerobius and A. naeslundii biofilms, respectively. These results indicated that CA presents in vitro antibacterial activity and is a potential biofilm inhibitory agent. This diterpene may play an important role in the search for novel sources of agents that can act against anaerobic bacteria.


Assuntos
Actinomyces/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Diterpenos/farmacologia , Peptostreptococcus/efeitos dos fármacos , Extratos Vegetais/farmacologia , Actinomyces/fisiologia , Fabaceae/química , Testes de Sensibilidade Microbiana , Peptostreptococcus/fisiologia
5.
Rev Inst Med Trop Sao Paulo ; 59: e83, 2017 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-29267591

RESUMO

Subdural Empyema (ESD) is the collection of purulent fluid that develops between the exterior "dura mater" layer and the middle "arachnoid mater" layer that covers the brain. ESD can be caused by a primary infection located in the paranasal sinuses. In many aerobic and/or anaerobic bacterial cases, hearing or traumatic processes serve as the causative agent. This report presents pharyngitis in a young girl which later developed into a subdural empyema caused by the bacteria Peptostreptococcus sp. The report emphasizes the correct clinical valuation of pharyngitis as a risk factor for developing subdural empyema in children.


Assuntos
Empiema Subdural/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Peptostreptococcus/isolamento & purificação , Faringite/complicações , Faringite/microbiologia , Doença Aguda , Criança , Empiema Subdural/terapia , Feminino , Humanos , Faringite/terapia , Fatores de Risco , Resultado do Tratamento
6.
Anaerobe ; 42: 55-59, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27555373

RESUMO

The aim of this study was to evaluate the relationship among nutritional status, gingival health and the composition of oral microbiota in children of a public school from a very poor area of San Miguel de Tucuman. Forty-five children ranging in age from 6 to 14 years old, 13 males and 32 females were studied. Twenty of these children were undernourished (Lejarraga-Morasso Table) and twenty-five were eutrophic. A clinical study that included DMF and dmf indexes, Löe Silness Plaque Index and bleeding on probing was performed. For microbiological study, saliva samples without stimulation were taken; aliquots of them were immediately placed in TAE buffer pH 7.6, adding NaOH (N and keeping at -70 °C until processed by checkerboard DNA-DNA hybridization method to check the presence of 40 oral microorganism species. Positive bleeding on probing was present in more than 80% of children, without significant differences between eutrophic and undernourished groups. Same result were obtain for the other clinical indexes (p > 0.05, Two Way ANOVA). Significant differences were found for some oral microorganism species, with a higher percentage of undernourished children harboring them. That was the case of S. gordonii (p < 0.05), Capnocitophaga gingivalis and C. ochraceae (p < 0.01 and p < 0.10, respectively), F. nucleatum ss nucleatum (p < 0.05), P. nigrescens (p < 0.10), Campylobacter gracilis (p < 0,05), and T. denticola (p < 0.10, multiple logistic regression). Significant differences were also found between children groups for E. saborreum (p < 0.001), P. acnes (p < 0.10), G. morbillorum (p < 0.05) and L. buccalis (p < 0.10). Gingivitis and bleeding on probing would not be related to nutritional status in the groups of children studied. There were significant differences for the presence of some of the main periodontal pathogen species between eutrophic and undernourished children. It would be important to study the meaning of significant differences found for the other microorganisms more deeply.


Assuntos
DNA Bacteriano/genética , Gengiva/microbiologia , Gengivite/microbiologia , Desnutrição/microbiologia , Microbiota/genética , Adolescente , Aggregatibacter actinomycetemcomitans/classificação , Aggregatibacter actinomycetemcomitans/genética , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Argentina , Bacteroides/classificação , Bacteroides/genética , Bacteroides/isolamento & purificação , Campylobacter/classificação , Campylobacter/genética , Campylobacter/isolamento & purificação , Capnocytophaga/classificação , Capnocytophaga/genética , Capnocytophaga/isolamento & purificação , Estudos de Casos e Controles , Criança , Feminino , Fusobacterium nucleatum/classificação , Fusobacterium nucleatum/genética , Fusobacterium nucleatum/isolamento & purificação , Gengivite/fisiopatologia , Humanos , Masculino , Desnutrição/fisiopatologia , Hibridização de Ácido Nucleico , Peptostreptococcus/classificação , Peptostreptococcus/genética , Peptostreptococcus/isolamento & purificação , Porphyromonas gingivalis/classificação , Porphyromonas gingivalis/genética , Porphyromonas gingivalis/isolamento & purificação , Saliva/microbiologia
7.
J Med Microbiol ; 65(9): 937-950, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27452156

RESUMO

Copaifera trapezifolia Hayne occurs in the Atlantic Rainforest, which is considered one of the most important and endangered tropical forests on the planet. Although literature works have described many Copaifera spp., their biological activities remain little known. In the present study, we aimed to evaluate (1) the potential of the hydroalcoholic extract from C. trapezifolia leaves (CTE) to act against the causative agents of tooth decay and apical periodontitis and (2) the cytotoxicity and mutagenicity of CTE to ensure that it is safe for subsequent application. Concerning the tested bacteria, the MIC and the minimum bactericidal concentration of CTE varied between 100 and 400 µg ml-1. The time-kill assay conducted at a CTE concentration of 100 µg ml-1 evidenced bactericidal activity against Porphyromonas gingivalis (ATCC 33277) and Peptostreptococcus micros (clinical isolate) within 72 h. CTE at 200 µg ml-1 inhibited Porphyromonas gingivalis and Peptostreptococcus micros biofilm formation by at least 50 %. A combination of CTE with chlorhexidine dichlorohydrate did not prompt any synergistic effects. The colony-forming assay conducted on V79 cells showed that CTE was cytotoxic at concentrations above 156 µg ml-1. CTE exerted mutagenic effect on V79 cells, but the micronucleus test conducted on Swiss mice and the Ames test did not reveal any mutagenicity. Therefore, the use of standardized and safe extracts could be an important strategy to develop novel oral care products with antibacterial action. These extracts could also serve as a source of compounds for the discovery of new promising biomolecules.


Assuntos
Antibacterianos/farmacologia , Antibacterianos/toxicidade , Produtos Biológicos/farmacologia , Produtos Biológicos/toxicidade , Fabaceae/química , Extratos Vegetais/farmacologia , Extratos Vegetais/toxicidade , Animais , Antibacterianos/isolamento & purificação , Biofilmes/efeitos dos fármacos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Cricetinae , Humanos , Masculino , Camundongos , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Testes de Mutagenicidade , Peptostreptococcus/efeitos dos fármacos , Peptostreptococcus/fisiologia , Extratos Vegetais/isolamento & purificação , Folhas de Planta/química , Porphyromonas gingivalis/efeitos dos fármacos , Porphyromonas gingivalis/fisiologia
8.
J Appl Oral Sci ; 24(2): 181-5, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27119767

RESUMO

Objective The aim of this study was to evaluate the association of Porphyromonas endodontalis, Filifactor alocis and Dialister pneumosintes with the occurrence of periodontitis. Material and Methods Thirty subjects with chronic periodontitis (ChP) and 10 with periodontal health (PH) were included in the study. Nine subgingival biofilm samples were collected as follows: i) PH group - from the mesial/buccal aspect of each tooth in two randomly chosen contralateral quadrants; ii) ChP group - from three sites in each of the following probing depth (PD) categories: shallow (≤3 mm), moderate (4-6 mm) and deep (≥7 mm). Checkerboard DNA-DNA hybridization was used to analyze the samples. Results We found the three species evaluated in a higher percentage of sites and at higher levels in the group with ChP than in the PH group (p<0.05, Mann-Whitney test). We also observed these differences when the samples from sites with PD≤4 mm or ≥5 mm of subjects with ChP were compared with those from subjects with PH (p<0.05, Mann-Whitney test). In addition, the prevalence and levels of D. pneumosintes, and especially of F. alocis were very low in healthy subjects (0.12x105 and 0.01x105, respectively). Conclusion F. alocis and D. pneumosintes might be associated with the etiology of ChP, and their role in the onset and progression of this infection should be further investigated. The role of P. endodontalis was less evident, since this species was found in relatively high levels and prevalence in the PH group.


Assuntos
Periodontite Crônica/microbiologia , Peptostreptococcus/patogenicidade , Porphyromonas endodontalis/patogenicidade , Veillonellaceae/patogenicidade , Adulto , Biofilmes , Brasil , Estudos de Casos e Controles , Contagem de Colônia Microbiana , Sondas de DNA , DNA Bacteriano , Placa Dentária/microbiologia , Feminino , Gengiva/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Peptostreptococcus/isolamento & purificação , Porphyromonas endodontalis/isolamento & purificação , Estatísticas não Paramétricas , Veillonellaceae/isolamento & purificação
9.
J. appl. oral sci ; J. appl. oral sci;24(2): 181-185, Mar.-Apr. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-779905

RESUMO

ABSTRACT Objective The aim of this study was to evaluate the association of Porphyromonas endodontalis, Filifactor alocis and Dialister pneumosintes with the occurrence of periodontitis. Material and Methods Thirty subjects with chronic periodontitis (ChP) and 10 with periodontal health (PH) were included in the study. Nine subgingival biofilm samples were collected as follows: i) PH group - from the mesial/buccal aspect of each tooth in two randomly chosen contralateral quadrants; ii) ChP group - from three sites in each of the following probing depth (PD) categories: shallow (≤3 mm), moderate (4-6 mm) and deep (≥7 mm). Checkerboard DNA-DNA hybridization was used to analyze the samples. Results We found the three species evaluated in a higher percentage of sites and at higher levels in the group with ChP than in the PH group (p<0.05, Mann-Whitney test). We also observed these differences when the samples from sites with PD≤4 mm or ≥5 mm of subjects with ChP were compared with those from subjects with PH (p<0.05, Mann-Whitney test). In addition, the prevalence and levels of D. pneumosintes, and especially of F. alocis were very low in healthy subjects (0.12x105 and 0.01x105, respectively). Conclusion F. alocis and D. pneumosintes might be associated with the etiology of ChP, and their role in the onset and progression of this infection should be further investigated. The role of P. endodontalis was less evident, since this species was found in relatively high levels and prevalence in the PH group.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Peptostreptococcus/patogenicidade , Porphyromonas endodontalis/patogenicidade , Veillonellaceae/patogenicidade , Periodontite Crônica/microbiologia , Peptostreptococcus/isolamento & purificação , Brasil , DNA Bacteriano , Contagem de Colônia Microbiana , Sondas de DNA , Estudos de Casos e Controles , Estatísticas não Paramétricas , Biofilmes , Porphyromonas endodontalis/isolamento & purificação , Placa Dentária/microbiologia , Veillonellaceae/isolamento & purificação , Gengiva/microbiologia
10.
Salud colect ; 11(1): 115-128, ene.-mar. 2015.
Artigo em Espanhol | BINACIS | ID: bin-134160

RESUMO

Los antipsicóticos no parecen revertir las causas de la esquizofrenia y, aunque son fármacos que pueden aliviar los síntomas a corto y mediano plazo, a largo plazo pueden no ser beneficiosos e incluso ser contraproducentes. Su empleo debería limitarse a situaciones agudas con agitación y tensión incapacitante. Presentan considerables efectos adversos y, ante la negativa de una persona a seguir tomándolos, adoptar una estrategia de reducción de daños apoyando y supervisando la retirada puede ser preferible a la coerción. Existen alternativas a los neurolépticos. Los prescriptores deberían estar más atentos y considerar las valoraciones que los usuarios hacen de sus efectos. El apego a las guías de tratamiento es escaso, seguramente por basarse en ensayos clinicos de calidad deficente, que deben mejorar y prolongarse en el tiempo. La raíz del problema probablemente se encuentra en la tautología sobre la etiología y naturaleza biológica de lo que llaman esquizofrenia, que realmente no parece ser más que un constructo ideológico-comercial.(AU)


Antipsychotic drugs do not appear to reverse the causes of schizophrenia, and although they can relieve symptoms in the short to medium term, in the long term they may not be beneficial and could even be counterproductive. Their use should be limited to acute situations in which agitation and tension is disabling. The drugs have significant adverse effects, and given the refusal of a person to continue taking them, a harm reduction strategy to support and monitor the withdrawal may be preferable to coercion. There are alternatives to neuroleptics. Prescribers should be more vigilant and consider the assessments of users regarding the drugs effects. Adherence to treatment guidelines is low, probably because the guidelines are based on clinical trials of deficient quality which consequently should be improved and extended over a greater period of time. The root of the problem is likely the tautology on the etiology and biological nature of what is known as schizophrenia, which in fact does not seem to be more than a commercial and ideological construct.(AU)


Assuntos
Proteínas de Bactérias/química , Biofísica/métodos , Proteínas de Ligação a DNA/química , Microscopia de Força Atômica/métodos , Ligação de Hidrogênio , Cinética , Modelos Moleculares , Modelos Estatísticos , Método de Monte Carlo , Peptostreptococcus/metabolismo , Conformação Proteica , Desnaturação Proteica , Dobramento de Proteína , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína , Proteínas/química , Estresse Mecânico , Temperatura , Fatores de Tempo , Ubiquitina/química
11.
Salud colect ; 11(1): 115-128, ene.-mar. 2015.
Artigo em Espanhol | LILACS | ID: lil-746688

RESUMO

Los antipsicóticos no parecen revertir las causas de la esquizofrenia y, aunque son fármacos que pueden aliviar los síntomas a corto y mediano plazo, a largo plazo pueden no ser beneficiosos e incluso ser contraproducentes. Su empleo debería limitarse a situaciones agudas con agitación y tensión incapacitante. Presentan considerables efectos adversos y, ante la negativa de una persona a seguir tomándolos, adoptar una estrategia de reducción de daños apoyando y supervisando la retirada puede ser preferible a la coerción. Existen alternativas a los neurolépticos. Los prescriptores deberían estar más atentos y considerar las valoraciones que los usuarios hacen de sus efectos. El apego a las guías de tratamiento es escaso, seguramente por basarse en ensayos clinicos de calidad deficente, que deben mejorar y prolongarse en el tiempo. La raíz del problema probablemente se encuentra en la tautología sobre la etiología y naturaleza biológica de lo que llaman esquizofrenia, que realmente no parece ser más que un constructo ideológico-comercial.


Antipsychotic drugs do not appear to reverse the causes of schizophrenia, and although they can relieve symptoms in the short to medium term, in the long term they may not be beneficial and could even be counterproductive. Their use should be limited to acute situations in which agitation and tension is disabling. The drugs have significant adverse effects, and given the refusal of a person to continue taking them, a harm reduction strategy to support and monitor the withdrawal may be preferable to coercion. There are alternatives to neuroleptics. Prescribers should be more vigilant and consider the assessments of users regarding the drugs' effects. Adherence to treatment guidelines is low, probably because the guidelines are based on clinical trials of deficient quality which consequently should be improved and extended over a greater period of time. The root of the problem is likely the tautology on the etiology and biological nature of what is known as schizophrenia, which in fact does not seem to be more than a commercial and ideological construct.


Assuntos
Proteínas de Bactérias/química , Biofísica/métodos , Proteínas de Ligação a DNA/química , Microscopia de Força Atômica/métodos , Ligação de Hidrogênio , Cinética , Modelos Moleculares , Modelos Estatísticos , Método de Monte Carlo , Peptostreptococcus/metabolismo , Conformação Proteica , Desnaturação Proteica , Dobramento de Proteína , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína , Proteínas/química , Estresse Mecânico , Temperatura , Fatores de Tempo , Ubiquitina/química
12.
J Clin Periodontol ; 41(11): 1027-36, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25139407

RESUMO

AIM: To determine microbial profiles that discriminate periodontal health from different forms of periodontal diseases. METHODS: Subgingival biofilm was obtained from patients with periodontal health (27), gingivitis (11), chronic periodontitis (35) and aggressive periodontitis (24), and analysed for the presence of >250 species/phylotypes using HOMIM. Microbial differences among groups were examined by Mann-Whitney U-test. Regression analyses were performed to determine microbial risk indicators of disease. RESULTS: Putative and potential new periodontal pathogens were more prevalent in subjects with periodontal diseases than periodontal health. Detection of Porphyromonas endodontalis/Porphyromonas spp. (OR 9.5 [1.2-73.1]) and Tannerella forsythia (OR 38.2 [3.2-450.6]), and absence of Neisseria polysaccharea (OR 0.004 [0-0.15]) and Prevotella denticola (OR 0.014 [0-0.49], p < 0.05) were risk indicators of periodontal disease. Presence of Aggregatibacter actinomycetemcomitans (OR 29.4 [3.4-176.5]), Cardiobacterium hominis (OR 14.9 [2.3-98.7]), Peptostreptococcaceae sp. (OR 35.9 [2.7-483.9]), P. alactolyticus (OR 31.3 [2.1-477.2]), and absence of Fretibacterium spp. (OR 0.024 [0.002-0.357]), Fusobacterium naviforme/Fusobacterium nucleatum ss vincentii (OR 0.015 [0.001-0.223]), Granulicatella adiacens/Granulicatella elegans (OR 0.013 [0.001-0.233], p < 0.05) were associated with aggressive periodontitis. CONCLUSION: There were specific microbial signatures of the subgingival biofilm that were able to distinguish between microbiomes of periodontal health and diseases. Such profiles may be used to establish risk of disease.


Assuntos
Periodontite Agressiva/microbiologia , Biofilmes , Periodontite Crônica/microbiologia , Gengivite/microbiologia , Periodonto/microbiologia , Adulto , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Bactérias/classificação , Bactérias/isolamento & purificação , Bacteroides/isolamento & purificação , Cardiobacterium/classificação , Carnobacteriaceae/isolamento & purificação , Feminino , Fusobacterium/classificação , Fusobacterium nucleatum/isolamento & purificação , Humanos , Masculino , Microbiota , Neisseria/classificação , Peptostreptococcus/classificação , Perda da Inserção Periodontal/microbiologia , Índice Periodontal , Bolsa Periodontal/microbiologia , Porphyromonas/classificação , Porphyromonas/isolamento & purificação , Porphyromonas endodontalis/isolamento & purificação , Prevotella/classificação , Adulto Jovem
13.
J Endod ; 40(7): 899-906, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24935532

RESUMO

INTRODUCTION: The aim of the present study was to investigate the composition of the root canal microbiota in endodontic failures in order to identify and quantify these microorganisms. METHODS: Microbiological samples were taken from 36 root canals with persistent endodontic infection. The presence, levels, and proportions of 79 bacterial species were determined by checkerboard DNA-DNA hybridization. The Pearson correlation coefficient was used to investigate the relations between bacterial counts and clinical conditions (P ≤ .05). RESULTS: Enterococcus faecium (36%), Streptococcus epidermidis (36%), Eubacterium saburreum (28%), Parvimonas micra (28%), Streptococcus sanguis (28%), Capnocytophaga sputigena (28%), Leptotrichia buccalis (28%), Enterococcus faecalis (28%), and Staphylococcus warneri (28%) were the most prevalent species; and there was a low prevalence of Treponema socranskii (3%), Fusobacterium periodonticum (3%), Capnocytophaga gingivalis (3%), and Spiroplasma ixodetis (3%). The highest mean levels were found for the following species: E. faecium, Dialister pneumosintes, Staphylococcus epidermidis and Helicobacter pylori. There was a statistically significant difference between the levels of gram-negative species and gram-positive species (13.5 × 10(5) vs 6.5 × 10(5), respectively). A positive correlation was found between the area of the periapical lesion and the levels of gram-negative and rod species (P < .05). CONCLUSIONS: The microbiota from teeth with persistent apical periodontitis presents a mixed and complex profile, hosting E. faecium and S. epidermidis as the most highly prevalent species. No correlation was found between any of the species tested and clinical findings; however, periapical lesions with the largest areas presented higher counts of gram-negative and rod species.


Assuntos
DNA Bacteriano/análise , Cavidade Pulpar/microbiologia , Microbiota , Periodontite Periapical/microbiologia , Dente não Vital/microbiologia , Adulto , Idoso , Capnocytophaga/isolamento & purificação , Enterococcus faecalis/isolamento & purificação , Enterococcus faecium/isolamento & purificação , Eubacterium/isolamento & purificação , Feminino , Infecções por Fusobacteriaceae/microbiologia , Bacilos Gram-Negativos Anaeróbios Retos, Helicoidais e Curvos/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Leptotrichia/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Hibridização de Ácido Nucleico/métodos , Peptostreptococcus/isolamento & purificação , Doenças Periapicais/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus epidermidis/isolamento & purificação , Infecções Estreptocócicas/microbiologia , Streptococcus sanguis/isolamento & purificação
14.
J Endod ; 40(6): 778-83, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24862703

RESUMO

INTRODUCTION: Revascularization outcome depends on microbial elimination because apical repair will not happen in the presence of infected tissues. This study evaluated the microbial composition of traumatized immature teeth and assessed their reduction during different stages of the revascularization procedures performed with 2 intracanal medicaments. METHODS: Fifteen patients (7-17 years old) with immature teeth were submitted to the revascularization procedures; they were divided into 2 groups according to the intracanal medicament used: TAP group (n = 7), medicated with a triple antibiotic paste, and CHP group (n = 8), dressed with calcium hydroxide + 2% chlorhexidine gel. Samples were taken before any treatment (S1), after irrigation with 6% NaOCl (S2), after irrigation with 2% chlorhexidine (S3), after intracanal dressing (S4), and after 17% EDTA irrigation (S5). Cultivable bacteria recovered from the 5 stages were counted and identified by means of polymerase chain reaction assay (16S rRNA). RESULTS: Both groups had colony-forming unit counts significantly reduced after S2 (P < .05); however, no significant difference was found between the irrigants (S2 and S3, P = .99). No difference in bacteria counts was found between the intracanal medicaments used (P = .95). The most prevalent bacteria detected were Actinomyces naeslundii (66.67%), followed by Porphyromonas endodontalis, Parvimonas micra, and Fusobacterium nucleatum, which were detected in 33.34% of the root canals. An average of 2.13 species per canal was found, and no statistical correlation was observed between bacterial species and clinical/radiographic features. CONCLUSIONS: The microbial profile of infected immature teeth is similar to that of primarily infected permanent teeth. The greatest bacterial reduction was promoted by the irrigation solutions. The revascularization protocols that used the tested intracanal medicaments were efficient in reducing viable bacteria in necrotic immature teeth.


Assuntos
Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Apexificação/métodos , Hidróxido de Cálcio/uso terapêutico , Clorexidina/uso terapêutico , Cavidade Pulpar/microbiologia , Irrigantes do Canal Radicular/uso terapêutico , Traumatismos Dentários/microbiologia , Actinomyces/efeitos dos fármacos , Actinomyces/isolamento & purificação , Adolescente , Carga Bacteriana/efeitos dos fármacos , Criança , Ciprofloxacina/uso terapêutico , Cavidade Pulpar/efeitos dos fármacos , Necrose da Polpa Dentária/microbiologia , Necrose da Polpa Dentária/terapia , Ácido Edético/uso terapêutico , Fusobacterium nucleatum/efeitos dos fármacos , Fusobacterium nucleatum/isolamento & purificação , Géis , Humanos , Metronidazol/uso terapêutico , Viabilidade Microbiana/efeitos dos fármacos , Minociclina/uso terapêutico , Peptostreptococcus/efeitos dos fármacos , Peptostreptococcus/isolamento & purificação , Porphyromonas endodontalis/efeitos dos fármacos , Porphyromonas endodontalis/isolamento & purificação , Hipoclorito de Sódio/uso terapêutico , Ápice Dentário/efeitos dos fármacos , Ápice Dentário/microbiologia
15.
Gerodontology ; 31(3): 227-36, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23316683

RESUMO

OBJECTIVES: The aim of this in vivo study was to evaluate the efficacy of three antimicrobial solutions on the disinfection of toothbrushes after storage in closed containers. MATERIALS AND METHODS: Sixteen healthy subjects were enrolled in this randomized cross-over clinical investigation. The study was conducted in four phases, in which mouthrinses (chlorhexidine gluconate-based or cetilpiridinium-based) and sterile tap water (control group) were used to individually store used toothbrushes in closed containers during 7 days of toothbrushing. Five toothbrushes were used as negative control for bacterial colonisation before contact with oral cavity. Conventional culture and DNA Checkerboard hybridization were used to detect bacterial contamination on the toothbrushes. Subsequently, the number of bacterial species on the bristles was estimated by the DNA Checkerboard method. RESULTS: One toothbrush presented bacterial contamination in the negative control test. Both culture and DNA Checkerboard showed positive signals of bacterial contamination in the toothbrushes with no differences in the frequency of detection. The control group showed higher total bacterial counts when compared with the mouthrinse groups. Porphyromonas gingivalis had the highest bacterial count followed by Parvimonas micra. CONCLUSION: Culture and DNA Checkerboard showed positive signals of bacterial contamination. Mouthrinses that contains 0.12% of chlorhexidine gluconate were more effective in reducing bacterial colonisation on the toothbrushes.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Desinfetantes de Equipamento Odontológico/uso terapêutico , Contaminação de Equipamentos/prevenção & controle , Antissépticos Bucais/uso terapêutico , Escovação Dentária/instrumentação , Carga Bacteriana/efeitos dos fármacos , Técnicas Bacteriológicas , Cetilpiridínio/uso terapêutico , Clorexidina/análogos & derivados , Clorexidina/uso terapêutico , Estudos Cross-Over , DNA Bacteriano/análise , Feminino , Fusobacterium/isolamento & purificação , Humanos , Lacticaseibacillus casei/isolamento & purificação , Masculino , Hibridização de Ácido Nucleico , Peptostreptococcus/isolamento & purificação , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificação , Distribuição Aleatória , Streptococcus/efeitos dos fármacos , Streptococcus/isolamento & purificação , Adulto Jovem
16.
Braz Dent J ; 23(4): 409-16, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23207858

RESUMO

The objective of the present study was to evaluate the bacterial diversity in the saliva of patients with different oral hygiene indexes using of two 16S rRNA gene libraries. Each library was composed of samples from patients with different averages of the differentiated Silness-Löe biofilm index: the first library (A) with an index between 1.0 and 3.0 (considered a high index) and the second library (B) between 0 and 0.5 (considered a low index). Saliva DNA was extracted and the 16S rRNA gene was amplified and cloned. The obtained sequences were compared with those stored at NCBI and RDP GenBank. The saliva of patients with high index presented five known genera - Streptococcus, Granulicatella, Gemella, Veillonella and Peptostreptococcus - and 33.3% of nonculturable bacteria grouped into 23 operational taxonomic units (OTUs). The saliva of patients with low index differed significantly from the first library (p=0.000) and was composed of 42 OTUs distributed into 11 known genera - Streptococcus, Granulicatella, Gemella, Veillonella, Oribacterium, Haemophilus, Escherichia, Neisseria, Prevotella, Capnocytophaga, Actinomyces - including 24.87% of nonculturable bacteria. It was possible to conclude that there is greater bacterial diversity in the saliva of patients with low dental plaque in relation to patients with high dental plaque.


Assuntos
Bactérias/classificação , Biofilmes/classificação , Índice de Higiene Oral , Saliva/microbiologia , Actinomyces/classificação , Adulto , Idoso , Capnocytophaga/classificação , Carnobacteriaceae/classificação , Escherichia/classificação , Feminino , Gemella/classificação , Biblioteca Gênica , Haemophilus/classificação , Humanos , Masculino , Microbiota , Pessoa de Meia-Idade , Neisseria/classificação , Peptostreptococcus/classificação , Índice Periodontal , Prevotella/classificação , RNA Bacteriano/análise , RNA Ribossômico 16S/análise , Streptococcus/classificação , Veillonella/classificação , Adulto Jovem
17.
Oral Dis ; 18(6): 558-67, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22335194

RESUMO

OBJECTIVE: To compare the microbiota of endodontic infections in necrotic pulp from HIV-negative and HIV-positive subjects. MATERIALS AND METHODS: Root canal samples from necrotic pulp were collected from 40 HIV- and 20 HIV+ subjects. Pulps were amplified using multiple displacement amplification (MDA). Then, checkerboard DNA-DNA hybridization was employed to assess the levels of 107 microbial taxa. The percentage of DNA probe count and the percentage of teeth colonized by each test species were investigated. Significant differences between groups regarding proportions of taxa and prevalence of the test species were sought using the Mann-Whitney test and the Chi-square analysis, respectively. RESULTS: The most prevalent taxa detected were Dialister pneumosintes, Stenotrophomonas maltophilia, Streptococcus sobrinus, Corynebacterium diphteriae, and Helicobacter pylori among HIV- subjects and D. pneumosintes, Prevotella tannerae, Porphyromonas gingivalis, Parvimonas micra, Prevotella nigrescens, and Corynebacterium diphtheriae among HIV+ individuals. D. pneumosintes, C. diphtheria, and C. albicans were the most abundant species in the HIV- group, whereas the predominant taxa in HIV+ samples were P. tannerae, D. pneumosintes and Olsenella uli. P. tannerae, O. uli, Veilonella dispar, Bacteroides fragilis, and Actinomyces meyeri were significantly more abundant in HIV+ samples. CONCLUSIONS: There were significant differences in the prevalence and proportions of specific microbial taxa between HIV- and HIV+ individuals. The root canal microbiota may represent a reservoir of important oral and medical pathogens, mainly in HIV+ individuals.


Assuntos
Bactérias/classificação , Necrose da Polpa Dentária/microbiologia , Soronegatividade para HIV , Soropositividade para HIV/microbiologia , Actinomyces/isolamento & purificação , Adolescente , Adulto , Bacteroides fragilis/isolamento & purificação , Candida albicans/isolamento & purificação , Criança , Corynebacterium diphtheriae/isolamento & purificação , Sondas de DNA , Cavidade Pulpar/microbiologia , Feminino , Bacilos Gram-Negativos Anaeróbios Retos, Helicoidais e Curvos/classificação , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Amplificação de Ácido Nucleico , Hibridização de Ácido Nucleico/métodos , Peptostreptococcus/isolamento & purificação , Porphyromonas gingivalis/isolamento & purificação , Prevotella/classificação , Prevotella nigrescens/isolamento & purificação , Stenotrophomonas maltophilia/isolamento & purificação , Streptococcus sobrinus/isolamento & purificação , Veillonella/isolamento & purificação , Adulto Jovem
18.
Int Endod J ; 45(4): 354-62, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22233143

RESUMO

AIM: To examine cytokine expression profiles during periapical lesion development in response to synergetic human pathogens in a gnotobiotic mouse model. METHODOLOGY: Human strains of Fusobacterium nucleatum and Peptostreptococcus prevotii were inoculated into the root canals of germ-free mice in either mono- or bi-association. Animals were killed 7 and 14 days after infection, and periapical tissues were collected. mRNA expression of the cytokines IFN-γ, TNF-α, Receptor activator of nuclear factor kappa-B ligand (RANKL), IL-10, IL-4 and transforming growth factor ß (TGF-ß) was assessed using real-time PCR. Levene's test was used to assess the equality of variance of the data, whereas a t-test for independent samples was used to evaluate the significance of the differences between groups (P < 0.05). RESULTS: The mRNA expression of IFN-γ and TNF-α was up-regulated by F. nucleatum during the acute (day 7) and chronic phase (day 14) of periapical lesion development. However, in bi-infection the expression of IFN-γ and TNF-α were effectively absent at both time-points. RANKL mRNA expression was down-regulated during dual infection at the chronic phase. As IL-4 expression was similar at both time-points, IL-4 does not appear to be involved in the periapical response to these bacterial strains. IL-10 was up-regulated during the chronic phase by mono-infection with either F. nucleatum or P. prevotii. Dual infection increased TGF-ß mRNA expression on day 7, which paralleled the decrease in IFN-γ and TNF-α mRNA levels at the same time-point. F. nucleatum increased TGF-ß mRNA expression during the chronic phase. CONCLUSION: Cytokine profiles depend on the nature of the bacterial challenge. Both TGF-ß and IL-10 appeared to be regulating the proinflammatory cytokine responses at both time-points of the periapical immune response.


Assuntos
Citocinas/análise , Doenças da Polpa Dentária/microbiologia , Infecções por Fusobacterium/imunologia , Fusobacterium nucleatum/imunologia , Infecções por Bactérias Gram-Positivas/imunologia , Peptostreptococcus/imunologia , Doenças Periapicais/microbiologia , Animais , Coinfecção/imunologia , Doenças da Polpa Dentária/imunologia , Vida Livre de Germes , Humanos , Mediadores da Inflamação/análise , Interferon gama/análise , Interleucina-10/análise , Interleucina-4/análise , Camundongos , Doenças Periapicais/imunologia , Ligante RANK/análise , RNA Mensageiro/análise , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Tempo , Fator de Crescimento Transformador beta/análise , Regulação para Cima/imunologia
19.
Braz. dent. j ; Braz. dent. j;23(4): 409-416, 2012. ilus, tab
Artigo em Inglês | LILACS | ID: lil-658019

RESUMO

The objective of the present study was to evaluate the bacterial diversity in the saliva of patients with different oral hygiene indexes using of two 16S rRNA gene libraries. Each library was composed of samples from patients with different averages of the differentiated Silness-Löe biofilm index: the first library (A) with an index between 1.0 and 3.0 (considered a high index) and the second library (B) between 0 and 0.5 (considered a low index). Saliva DNA was extracted and the 16S rRNA gene was amplified and cloned. The obtained sequences were compared with those stored at NCBI and RDP GenBank. The saliva of patients with high index presented five known genera - Streptococcus, Granulicatella, Gemella, Veillonella and Peptostreptococcus - and 33.3% of nonculturable bacteria grouped into 23 operational taxonomic units (OTUs). The saliva of patients with low index differed significantly from the first library (p=0.000) and was composed of 42 OTUs distributed into 11 known genera - Streptococcus, Granulicatella, Gemella, Veillonella, Oribacterium, Haemophilus, Escherichia, Neisseria, Prevotella, Capnocytophaga, Actinomyces - including 24.87% of nonculturable bacteria. It was possible to conclude that there is greater bacterial diversity in the saliva of patients with low dental plaque in relation to patients with high dental plaque.


O objetivo do presente estudo foi avaliar a diversidade bacteriana da saliva de pacientes com diferentes índices de higiene bucal através da construção de duas bibliotecas do gene 16S rRNA. Cada biblioteca foi composta por amostras de saliva de pacientes com índice de biofilme dental de Silness-Löe diferenciado, sendo a primeira (A) com índice de 1,0 a 3,0 (denominada de alto índice) e a segunda (B), entre 0 a 0,5 (denominada de baixo índice). O DNA da saliva foi extraído e o gene 16S rRNA foi amplificado, clonado e sequenciado. As sequências obtidas foram comparadas com aquelas armazenadas no GenBank do NCBI e RDP. A saliva de pacientes com alto índice de biofilme dental apresentou cinco gêneros conhecidos: Streptococcus, Granulicatella, Gemella, Veillonella e Peptostreptococcus e 33,3% de bactérias não-cultivadas, agrupados em 23 unidades taxonômicas operacionais (UTOs). A saliva de pacientes com baixo índice de biofilme dental, foi diferente significativamente da primeira (p=0,000) e foi composta de 42 UTOs, distribuídas em 11 gêneros conhecidos: Streptococcus, Granulicatella, Gemella, Veillonella, Oribacterium, Haemophilus, Escherichia, Neisseria, Prevotella, Capnocytophaga, Actinomyces, além de 24,87% de bactérias não-cultivadas. Pode-se concluir que existe maior diversidade bacteriana na saliva de pacientes com baixo índice de biofilme dental em relação a pacientes com alto índice de biofilme dental.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Bactérias/classificação , Biofilmes/classificação , Índice de Higiene Oral , Saliva/microbiologia , Actinomyces/classificação , Capnocytophaga/classificação , Carnobacteriaceae/classificação , Escherichia/classificação , Biblioteca Gênica , Gemella/classificação , Haemophilus/classificação , Microbiota , Neisseria/classificação , Índice Periodontal , Peptostreptococcus/classificação , Prevotella/classificação , RNA Bacteriano/análise , /análise , Streptococcus/classificação , Veillonella/classificação
20.
J Endod ; 37(12): 1696-700, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22099908

RESUMO

INTRODUCTION: Procedural accidents have a negative effect on healing and might contribute to the persistence of infections in inaccessible apical areas, requiring surgical intervention. This report describes a case of persistent apical periodontitis of a lower left first molar associated with the sinus tract and a periapical lesion that required nonsurgical endodontic retreatment and apical surgery for resolution. METHODS: The tooth had received endodontic treatment 3 years ago and had to be retreated using the crown-down technique with chemical auxiliary substance (2% chlorhexidine gel), foramen patency, and enlargement and was filled in a single appointment. The occlusal access cavity was immediately restored with composite resin. After 1 month, it could be observed that the sinus tract persisted and, radiographically, the lesion remained unaltered. Therefore, endodontic microsurgery was indicated. Apical microsurgery was performed under magnification with the use of a dental operating microscope including apicectomy, root end with ultrasound, and sealing with mineral trioxide aggregate. A microbiological sample was collected from the apical lesion. The resected distal root apex was observed by scanning electron microscopy. RESULTS: The following species were detected: Actinomyces naeslundii and Actinomyces meyeri, Propionibacterium propionicum, Clostridium botullinum, Parvimonas micra, and Bacteroides ureolyticus; scanning electron microscopic analysis revealed bacterial biofilm surrounding the apical foramen and external radicular surface. Gutta-percha overfilling at the apex because of a zip caused during initial endodontic treatment could be observed. A 6-month follow-up showed apparent radiographic periapical healing, which progressed after 24 months. CONCLUSION: Gram-positive anaerobic bacteria and extraradicular biofilm seem to participate in the maintenance of persistent periapical pathology, and endodontic retreatment followed by periapical microsurgery proved to be a successful alternative in the resolution of persistent extraradicular infections.


Assuntos
Apicectomia/métodos , Biofilmes , Periodontite Periapical/microbiologia , Dente não Vital/terapia , Actinomyces/isolamento & purificação , Adulto , Compostos de Alumínio/uso terapêutico , Doenças Assintomáticas , Bacteroides/isolamento & purificação , Compostos de Cálcio/uso terapêutico , Clostridium botulinum/isolamento & purificação , Fístula Dentária/terapia , Combinação de Medicamentos , Feminino , Seguimentos , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Microscopia Eletrônica de Varredura , Microcirurgia/métodos , Óxidos/uso terapêutico , Peptostreptococcus/isolamento & purificação , Periodontite Periapical/cirurgia , Piezocirurgia/métodos , Propionibacterium/isolamento & purificação , Retratamento , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Silicatos/uso terapêutico , Ápice Dentário/microbiologia , Ápice Dentário/patologia
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