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Early detection of pre-eclampsia is challenging due to the low sensitivity and specificity of current clinical methods and biomarkers. This study investigates the potential of high-wavenumber FTIR spectroscopy (region between 2800 and 3600 cm−1) as an innovative diagnostic approach capable of providing comprehensive biochemical insights with minimal sample preparation. Blood samples were collected from 33 pregnant women and their corresponding 33 newborns during induction or spontaneous labor. By analyzing the dried blood plasma samples, we identified biomarkers associated with FTIR vibrational modes, including 2853.6 cm−1 (CH2 stretching in lipids), 2873.0 cm−1 (CH3 stretching in lipids and proteins), and 3279.7 cm−1 (O–H stretching related to water and proteins). Machine learning classification revealed 76.3% ± 3.5% sensitivity and 56.1% ± 4.4% specificity in distinguishing between pre-eclamptic and non-pre-eclamptic pregnant women, along with 79.0% ± 3.5% sensitivity and 76.9% ± 6.2% specificity for newborns. The overall accuracy for classifying all pregnant women and newborns was 71.8% ± 2.5%. The results indicate that high-wavenumber FTIR spectroscopy can enhance classification performance when combined with other analytical methods. Our findings suggest that investigating hydrophilic sites may complement plasma analysis in clinical settings.

ObjectiveTo evaluate the association between psoriasis (PSO), psoriatic arthritis (PsA) and periodontitis (PE), and the Oral Health-Related Quality of Life (OHRQoL) impacts on individuals with psoriatic disease's daily activities compared to the non-psoriatic ones.Materials & methods296 individuals with psoriatic disease (PSO n = 210, APS n = 86) (cases) and 359 without these diseases (controls) were included. Complete periodontal examinations and collection of variables of interest were performed. The Brazilian version of the Oral Impacts on Daily Performance (OIDP) instrument was applied.ResultsThe prevalence of PE was higher in PsA (57.0%; OR = 2.67 95%CI 1.65-4.32; p6 mm; clinical attachment level >6 mm; higher plaque index, % sites and teeth with bleeding on probing (pConclusionNegative impacts of PE on the OHRQoL were demonstrated. The ones having PSO and especially PsA and PE presented significantly worse indicators.

Abstract Periodontal diseases are infectious inflammatory chronic diseases of a multifactorial nature. They are primarily caused by dysbiotic ecological changes in dental biofilm, which may be influenced by risk factors. The prevention of periodontal diseases may involve different strategies focused on reducing distal, intermediate, and proximal risk factors at both the population and individual levels. Effective prevention depends on interdisciplinary and common risk factor approaches. Also, patient-centered preventive models are more effective than professional-centered models in the management of periodontal diseases. Regular and periodic control of dental biofilm is an essential measure for the different levels of prevention of periodontal diseases. The effectiveness of periodontal disease prevention largely depends on positive modifications of behavior, knowledge, health literacy, patient empowerment, motivation, and compliance.

Abstract The present manuscript discussed some relevant aspects related to private sponsored clinical trials in dentistry. For decades, the academy has been the major responsible for research in Brazil. Distant from the trade sector, academic research has not always provided clear benefits to society. A key aspect of making benefits clearer is the process of scientific knowledge transference to decision-makers, which is, in fact, the ground of evidence-based dentistry. Although private sponsoring of clinical research seems to be part of the research progress of the business rates, investment in Brazil is lower than those observed in other countries. It is particularly important to understand that instead of creating its own rules, dentistry imported the high-quality standards originally designed for pharmaceutical studies. Therefore, it is critical to understand the original rules and how dental items are classified by regulatory agencies. In fact, knowledge about international and local regulation is a basic assumption in industry-sponsored research. Despite globalization, the identification of industry-sponsored studies through open access databases is still very hard and time-demanding. A common concern when conducting industry-sponsored trials is study biases. Fortunately, many relevant organizations, academic and industry groups, have been working seriously against that. Finally, for less experienced researchers, many aspects related to industry-sponsored studies – such as confidentiality, authorship, budget – are deeply discussed until a final version of the trial agreement can be written and signed, protecting all sides. In short, the scenario should be improved, but it already represents a nice opportunity for dental research.

Abstract Introduction Salivary components can be used as biomarkers for diagnosing and monitoring oral diseases. There is evidence that one potential biomarker, arginase, is associated with the inflammatory processes of periodontal disease, and its enzymatic activity is reduced according to the improvement in the clinical parameters after treatment. Objective The present study aimed to evaluate the salivary arginase activity in gingivitis and periodontitis patients treated with full-mouth mechanical procedures combined with the adjunctive use of essential oils or chlorhexidine mouthwash, respectively. Material and method Twenty-six gingivitis and 16 periodontitis patients received complete periodontal examinations at the baseline and 3 months after therapy, in which the periodontal probing depth, clinical attachment loss, plaque index, and gingival index measurements were taken. At these same appointments, the salivary total protein level and salivary arginase activity were also established via spectrophotometry. Result There were improvements in all of the clinical parameters (p < 0.05) evaluated from the baseline to 3 months in both groups. In addition, the salivary arginase activity and total protein levels were reduced after the gingivitis treatment. Conclusion Similar to the clinical results, both therapeutic protocols positively affected the salivary arginase activity; however, further studies are necessary to clarify its potential as a salivary biomarker for periodontal monitoring.

Abstract Background The efficacy of several variants of essential oil mouthrinses has been studied extensively. This is the first study to compare the anti-plaque and anti-gingivitis efficacy of two marketed essential oil mouthrinses: one is an alcohol containing mouthrinse and the other one is an alcohol-free mouthrinse. Methods This examiner-blind, parallel-group study randomized subjects to three groups: 1) Mechanical Oral Hygiene (MOH) only; 2) MOH plus Alcohol-Containing essential oil Mouthrinse (ACM); 3) MOH plus Alcohol-Free essential oil Mouthrinse (AFM). Primary endpoint was whole-mouth mean Modified Gingival Index (MGI) at six months. Secondary endpoints included whole-mouth mean MGI at one and three months, and whole-mouth mean Plaque Index (PI) and whole-mouth mean Bleeding Index (BI) at one, three and six months. Safety assessments were conducted at all time points. Results A total of 370 subjects were enrolled; 348 subjects completed the study. After six months, subjects using essential oil mouthrinses with or without alcohol showed significant reduction (p

Properly performed daily mechanical biofilm control is the most important prevention strategy for periodontal diseases. However, proper mechanical biofilm control is not performed effectively by the majority of the population, mainly due to lack of motivation and of manual dexterity. Local biofilm retention factors may aggravate home oral hygiene quality. For this reason, patients wearing fixed orthodontic appliances comprise a group that may benefit from the daily use of mouthwashes. The purpose of this review was to perform a systematic search in the literature on antiseptics used to control supragingival biofilm and gingivitis in orthodontic patients. Six studies investigating the effect of chlorhexidine and 5 studies evaluating the effect of the daily use of antiseptics were found. Chlorhexidine showed better results in reducing plaque and gingivitis. However, because of its adverse effects after continuous use, it should not be indicated for long-term periods. Among the agents considered for daily use, the fixed combination of essential oils was the only one evaluated in a clinical trial, in which a comparative group presented a statistically significant clinical impact. There is no direct evidence supporting the indication of antiseptic agents for orthodontic patients other than chlorhexidine and essential oils. It can be concluded that, for patients undergoing orthodontic treatment, chlorhexidine should be considered for treating acute gingival inflammation, whereas essential oils should be indicated for long-term daily use in controlling supragingival biofilm.

This cross-over study was conducted to assess the germ-killing efficacy of an essential oil mouthrinse (EOM) by determining the blood levels of microorganisms associated with induced bacteremia and investigating the prevalence of this event in Brazilians with mild-to-moderate gingivitis. Thirty four (31.19%) subjects positive for bacteremia induced by chewing a ration of apple were enrolled out of 109 screened subjects (50 males and 59 females). A difference of at least 10 colony forming units between the pre- and post-insult blood samples was defined as a positive result. For the following two weeks patients underwent a toothbrush plus fluoride dentifrice normalization period, and were then scheduled for the Phase I protocol as follows. At baseline I, subjects were instructed to chew a new apple ration, had new blood samples taken before and after this oral stimulus, and were randomly assigned to an experimental essential oil (n = 17) or placebo (P) mouthrinse (n = 17) treatment for 2 weeks. These procedures were repeated at the end of Phase I and then followed by a two-week wash-out period (tooth brushing with fluoride dentifrice). Bacteremia was again induced at baseline and at the end of Phase II, when subjects were crossed-over to the other EOM or placebo groups. Bacterial count differences between baseline and 2-week post-treatment (EOM versus P) in the blood samples collected were assessed by analysis of covariance. Mean aerobic counts decreased by 45.8%, whereas mean anaerobic counts decreased by 63.3% after EOM treatment. After the P treatment, aerobic bacteria increased by 28.4% and anaerobic bacteria decreased by 18.5%. This study validated this novel methodology and showed that the germ-killing action of EOM significantly reduced bacteremia.

Antibiotics are important adjuncts in the treatment of infectious diseases, including periodontitis. The most severe criticisms to the indiscriminate use of these drugs are their side effects and, especially, the development of bacterial resistance. The knowledge of the biological mechanisms involved with the antibiotic usage would help the medical and dental communities to overcome these two problems. Therefore, the aim of this manuscript was to review the mechanisms of action of the antibiotics most commonly used in the periodontal treatment (i.e. penicillin, tetracycline, macrolide and metronidazole) and the main mechanisms of bacterial resistance to these drugs. Antimicrobial resistance can be classified into three groups: intrinsic, mutational and acquired. Penicillin, tetracycline and erythromycin are broad-spectrum drugs, effective against gram-positive and gram-negative microorganisms. Bacterial resistance to penicillin may occur due to diminished permeability of the bacterial cell to the antibiotic; alteration of the penicillin-binding proteins, or production of β-lactamases. However, a very small proportion of the subgingival microbiota is resistant to penicillins. Bacteria become resistant to tetracyclines or macrolides by limiting their access to the cell, by altering the ribosome in order to prevent effective binding of the drug, or by producing tetracycline/macrolide-inactivating enzymes. Periodontal pathogens may become resistant to these drugs. Finally, metronidazole can be considered a prodrug in the sense that it requires metabolic activation by strict anaerobe microorganisms. Acquired resistance to this drug has rarely been reported. Due to these low rates of resistance and to its high activity against the gram-negative anaerobic bacterial species, metronidazole is a promising drug for treating periodontal infections.

We evaluated the DMFT (decayed, missing and filled teeth) index and the prevalence of candidiasis, linear gingival erythema, oral hairy leukoplakia, herpes simplex, aphthous ulcers, Kaposi's sarcoma and lymphoma, as well as the association with TCD4 count, viral load (VL) and antiretroviral therapy (ART) in 140 HIV-infected adult individuals. A standardized examination to determine the DMFT index and the presence of oral lesions was conducted. Demographic data, TCD4 count and use of ART were obtained from medical records. A high number of decayed teeth detected among patients undergoing ART resulted in a mean DMFT of 16.9 teeth. It was observed that 24.2% of the individuals had at least one oral lesion. Candidiasis was the most frequent lesion and was associated with the TCD4 count. Oral hairy leukoplakia was associated with an increased VL. Regular use of ART was inversely associated with the occurrence of lesions. Overall, the studied population showed low prevalence of oral lesions and high DMFT index. The use of ART seems to reduce the occurrence of these lesions. Higher TCD4 count and a lower VL were associated with an improved oral health status in HIV+ individuals. Keywords: oral mucosal lesions, DMFT index, tooth decay, HIV infection

Studies have suggested that A. actinomycetemcomitans is involved in the aetiology of aggressive periodontitis as well as in chronic periodontitis. This study was aimed at elucidating the occurrence of A. actinomycetemcomitans in a Brazilian population with chronic periodontitis. A total of 555 (mean age 33.04 ± 12.45) individuals, living in two large areas of the São Paulo State, namely "Baixada Santista" and "Vale do Paraíba", and diagnosed with mild [180 (mean age 29.59 ± 10.94)], moderate [241 (mean age 31.18 ± 11.45)] or severe [134 (mean age 33.04 ± 12.45)] chronic periodontitis were enrolled in this survey. Clinical exams including measurements of Probing Depth, Clinical Attachment Loss, Plaque and Gingival indices and subgingival microbiological assessments were performed at all population. The genomic DNA of A. actinomycetemcomitans was identified by Polymerase Chain Reaction from periodontal pocket samples. The occurrence of A. actinomycetemcomitans among chronic periodontitis subjects as well as its association with age and gender were statistically analysed using the Chi-square and Odds Ratio tests. The significance of differences was established at 5% (p < 0.05). A. actinomycetemcomitans was detected in 102 (18.37%) individuals: 29 (16.11%) mild; 42 (17.42%) moderate; and 31 (23.13%) severe chronic periodontitis with no statistical difference among groups. A higher occurrence of the searched bacterium was found both in the youngest group (p < 0.05) as well as in the female group (p < 0.05). This study elucidated that A. actinomycetemcomitans harbored subgingival pockets of our target group of chronic periodontitis subjects and that this bacterium seems to be inversely related to age, but related to the female gender.

The aim of this study was to evaluate the ability of the BANA Test to detect different levels of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia or their combinations in subgingival samples at the initial diagnosis and after periodontal therapy. Periodontal sites with probing depths between 5-7 mm and clinical attachment level between 5-10 mm, from 53 subjects with chronic periodontitis, were sampled in four periods: initial diagnosis (T0), immediately (T1), 45 (T2) and 60 days (T3) after scaling and root planing. BANA Test and Checkerboard DNA-DNA hybridization identified red complex species in the subgingival biofilm. In all experimental periods, the highest frequencies of score 2 (Checkerboard DNA-DNA hybridization) for P. gingivalis, T. denticola and T. forsythia were observed when strong enzymatic activity (BANA) was present (p < 0.01). The best agreement was observed at initial diagnosis. The BANA Test sensitivity was 95.54% (T0), 65.18% (T1), 65.22% (T2) and 50.26% (T3). The specificity values were 12.24% (T0), 57.38% (T1), 46.27% (T2) and 53.48% (T3). The BANA Test is more effective for the detection of red complex pathogens when the bacterial levels are high, i.e. in the initial diagnosis of chronic periodontitis.

Patients frequently fail to achieve an optimal mechanical plaque control. However, many patients are not confident about using mouthrinses, and many professionals refuse to prescribe them for regular daily use. Aiming at achieving a better understanding of the use and prescription of mouthrinses in periodontics, 24 dentists with different dental educational levels were purposively chosen and interviewed in a qualitative research. Partial data was presented at the 15th Congress of the Brazilian Association for Oral Health Promotion (ABOPREV), and full data was presented at the 88th General Session and Exhibition of the International Association for Dental Research (IADR). The professionals' answers were confirmed or rejected through scientific data analysis. Additionally, scientifically supported answers were provided for the interviewees' most frequent unanswered questions. Around half of the participants (46%) reported that they recommended the use of mouthrinses, although a high percentage (64%) of the dentists answered that they knew very little about the efficacy of mouthrinses and also about the oral benefits (54%) provided by them. All interviewees reported that they were aware of the fact that their patients, and themselves, failed to floss and, less frequently, to brush their teeth, and all of them believed that oral health impacts overall systemic health. Seventy five percent answered that using mouthrinses was safe. Most participants (55%) did not declare themselves as mouthrinse users. We concluded that dentists with different levels of dental education have only partial knowledge related to mouthrinse use in periodontics. The use of effective mouthrinses on a daily basis is justified and can help patients achieve or maintain a healthier mouth. A healthier mouth will positively impact patients' quality of life and could also benefit their overall systemic health.

Knowledge about the presence of some important oral pathogens is an important step in better identifying children at risk for periodontal and/or caries diseases in later life. The purpose of this study was to detect the presence of Streptococcus mutans (Sm), Aggregatibacter actinomycetemcomitans (Aa), Campylobacter rectus (Cr), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), and Tannerella forsythia (Tf) in gingival biofilm samples from 196 children, and to assess whether any of these pathogens are more associated with gingival inflammation extension and the Decayed/Missing/Filled teeth (DMFT/dmft) index. The subjects presented plaque index greater than 80% and were divided in 3 groups according to the bleeding index (BI): I) Low bleeding (< 30%), II) Medium bleeding (31 - 59%) and III) High bleeding (> 60%). The presence of each pathogen was determined by PCR. The prevalence of Sm was 71.9% and the mean dmft/DMFT was 6.68. The prevalence in low, medium and high bleeding groups was 43.5%, 34.5% and 46.7% for Aa; 43.5%, 37.9%, and 36.7% for Cr; 99.1%, 100%, and 96.7% for Pg; 56.5%, 56.9%, and 66.7% for Pi; and 58.3%, 60.3%, and 56.7% for Tf, respectively. Pg (99.0%) was the most prevalent periodontal pathogen detected followed by Tf (58.7%), Pi (58.2%), Aa (41.3%) and Cr (40.8%). Our study indicated that in this high plaque index population studied, a high prevalence of Sm and high mean DMFT were observed. In addition, the presence of Pi was associated with the presence of inflammation (P < 0.05) whereas Cr was associated with periodontal health (P < 0.05).

Oral presence of Candida spp. was correlated with caries experience (dmft/DMFT index) in a rural population. dmft/DMFT index were evaluated in individuals between 6-12 years of age (n=57), 13-18 years of age (n=48) and 19-45 years of age (n=54). For the isolation of Candida spp., saliva samples were collected and spread on Sabouraud dextrose agar plates. The number of colony- forming units per plate (CFU/plate) was calculated and the isolates were identified. Data were analyzed by Chi-square and Spearman’s correlation coefficient (p

The aim of this study was to evaluate the prevalence and severity of periodontal disease and treatment needs in a Brazilian rural community, using the Community Periodontal Index of Treatment Needs (CPITN). This study included 183 individuals who were clinically evaluated. The results showed that 45% of the individuals between ages 0-5 years had bleeding upon probing, and 34% of individuals ages 6-12 presented dental calculus. Among the individuals ages 13-18, 15% of pathological pockets were found with probing depth (PD) of 4-5 mm. However, among individuals ages 19-34, 50% showed a PD of 4-5 mm and 12.5% PD ≥ 6 mm. In the group of individuals ages 35-44, 17% showed PD ≥ 6 mm. Ninety percent of the individuals up to 13 years old needed only oral hygiene instructions. Dental scaling was indicated to 70% and 95% of the individuals aged 13-18 and 19-34 respectively. A more complex periodontal therapy was indicated to 17% of individuals aged 35-44. These results showed the necessity of the implementation of dental preventive programs to this community, especially to individuals under 12 years, and curative programs for individuals ages older than 13 years old.

Este estudo transversal determinou a condição periodontal e sua associação com fatores de risco em uma amostra de conveniência de 588 indivíduos atendidos na Universidade Guarulhos, entre 1999 e 2003. Características geográficas, demográficas e comportamentais, parâmetros bucais e periodontais foram tabulados e analisados em SPSS 11.5. Os testes t Student e Qui-quadrado determinaram a significância (p < 0,05) das variáveis contínuas e categóricas. O teste de correlação de Pearson correlacionou a ocorrência de doença (PS média > 3,0 mm) com fatores de risco (por exemplo: idade, sexo, fumo) e comportamentais. A análise de regressão linear multivariada determinou a associação entre exposição aos fatores de risco e doença. A população estudada com média de idade de 36,1 ± 14,5 anos foi composta principalmente por mulheres (72,1%) e minoria fumante (13,3%). Os valores médios de dentes ausentes e profundidade de sondagem (PS) foram de 5,7 ± 5,9 dentes e 2,2 ± 0,8 mm, respectivamente. A prevalência de PS > 3,0mm (valor referência) foi de 13,5%; e a distribuição regional da população de acordo com este critério foi: centro, 2,0%; zona oeste, 17,8%; zona leste, 38,0%; zona sul, 6,7% ; e zona norte, 35,5%. As freqüências médias dos índices de placa e sangramento a sondagem foram de 75,3% e 34,1%, respectivamente. A condição periodontal exibiu correlação com idade, fumo e presença de biofilme supragengival. Exceto pela última, estas variáveis também mostraram associação pela análise de regressão multivariada. A população estudada exibiu elevado grau de inflamação gengival e baixo percentual de bolsas periodontais, estando a condição periodontal associada à idade e ao hábito de fumar.This cross-sectional study determined the periodontal status and its association with risk factors in a convenience sample of 588 subjects seen at the dental clinic of Guarulhos University from 1999 to 2003. To reach the study objectives, geographic, demographic and behavioral characteristics, as well as, oral and periodontal parameters were tabulated and analyzed using SPSS. Chi-square and Student's t tests determined significance (p < 0.05) of continuous and categorical variables. Pearson's correlation test correlated disease (PPD mean > 3mm) with risk (age, sex, smoking) and behavioral factors. Multivariate linear regression evaluated the association between risk factors and periodontal disease. The study population presented a mean age of 36.1 ± 14.5 years, and was primarily comprised women (72.1%), while smokers were minority (13.3%). The mean number of missing teeth and periodontal probing depth (PPD) were 5.7 ± 5.9 teeth and 2.2 ± 0.8 mm, respectively. The prevalence of PPD > 3.0mm was 13.5% and the regional distribution of the population following the same cut-off point was: center 2.0%, west zone 17.8%, east zone 38.0%, south zone 6.7%, and north zone 35.5%. The average indices for plaque and bleeding on probing were 75.3% and 34.1%, respectively. Periodontal status was correlated with age, smoking habits and presence of supragingival biofilm. However, the latter did not show association when entered on the multivariate analysis, in contrast with the others. The study population showed high levels of gingival inflammation and a low percentage of periodontal pockets. Periodontal status was associated with smoking habits and age.

The search for the etiologic agents of periodontal diseases started in the Golden Era of medical bacteriology, when the etiologic agents of many bacterial infections were isolated and characterized. After the initial enthusiasm in establishing the infectious nature and the true agents of periodontal diseases, this concept was virtually ignored for the next four decades. Until the early 1970s treatment regimens based on the non-specific plaque hypothesis were directed towards a non-specific reduction in plaque amount. Later, the specific plaque hypothesis established the role of some microorganisms such as A. actinomycetemcomitans, P. gingivalis, T. forsythensis, T. denticola, P. intermedia and F. nucleatum in different forms of periodontal diseases. It was recently suggested that these suspected periodontal pathogens seem to not act alone and interactions between species, especially the balance between pathogenic and beneficial species affect both progression of disease and response of tissues to periodontal therapy. Nowadays it is well established that one of the goals of therapy is to control such periodontal pathogens. Among the most commonly used therapies to treat periodontal infections are scaling and root planing (SRP), supragingival plaque control and periodontal surgeries. Many studies confirmed the reduction of "red complex" species by SRP, and apically repositioned flap can lead to an additional beneficial effect in the subgingival microbiota by decreasing levels of "red" and "orange complexes" species. Furthermore, the level of plaque control maintained by the patients has been considered a crucial step in preventing recurrence of destructive periodontitis.A busca pelos agentes etiológicos das doenças periodontais iniciou na Época de Ouro da bacteriologia médica, quando os agentes de diversas infecções foram identificados. Após o entusiasmo inicial em estabelecer a natureza infecciosa da doença periodontal, este conceito foi ignorado por quatro décadas. Até o início dos anos 70, terapias baseadas na hipótese da placa não-específica focavam a redução da quantidade de placa. Posteriormente, a hipótese da placa específica determinou o papel de alguns microorganismos como A.actinomycetemcomitams, P.gingivalis, T.forsythensis, T.denticola , P.intermedia e F.nucleatum nas diferentes formas de doença periodontal. Recentemente, foi sugerido que estes patógenos periodontais não atuam isoladamente e interações entre espécies, como o equilíbrio entre bactérias patogênicas e benéficas afetam a progressão da doença e a resposta tecidual à terapia periodontal. Atualmente está bem estabelecido que um dos objetivos da terapia é o controle destes patógenos. Dentre as terapias mais freqüentemente utilizadas no tratamento da periodontite estão raspagem e alisamento radicular (RAR), controle da placa supragengival e cirurgias periodontais. Muitos estudos confirmaram a redução de espécies do "complexo vermelho" pela RAR, e mostraram que o retalho reposicionado apicalmente pode levar a um efeito benéfico adicional na microbiota subgengival pela diminuição nos níveis de espécies dos "complexos vermelho" e "laranja". Além disso, o controle de placa mantido pelos indivíduos é considerado determinante para a prevenção da recorrência de doença periodontal destrutiva.

The aims of this double-blind randomized clinical trial were to evaluate the presence of periodontal pathogens and the clinical response of periodontal pockets treatment to scaling and root planing (SRP) associated with subgingival minocycline (SM). A total of 36 subjects, 26 to 60 years old (40.7 ± 9.1), who had been previously diagnosed with chronic periodontitis, were included in the present study. Eighteen subjects were selected for the test group (TG), who were treated with SRP plus SM (new treatment), and 18 subjects for the control group (CG) who received SRP plus vehicle (current treatment). Two homologous sites in each subject with a probing depth (PD) > 6 mm were chosen. To evaluate the clinical response after treatment, PD was measured at baseline and at 90 days. Microbiological evaluation was performed to detect 7 periodontal pathogens using polymerase chain reaction at baseline, 30, and 120 days. A mean reduction in PD of 2.8 and 2.1 mm was observed in the TG and CG, respectively. At baseline, P. gingivalis was the most prevalent organism in both test (65.8%) and control (48.6%) groups. After 120 days it fell to 30.8% in TG and to 23.1% in CG. There were no statistically significant differences between the test and control groups concerning PD (p > 0.05 by Wilcoxon test) or presence of periodontal pathogens (p > 0.05 by Wilcoxon and chi-square; p > 0.01 by Signal test). The results observed showed that the new treatment was as effective as the current treatment in reducing periodontal pathogens and PD among chronic periodontitis subjects.O objetivo deste estudo randomizado duplo-cego foi avaliar a presença de periodontopatógenos e o comportamento clínico de bolsas periodontais tratadas com raspagem e aplainamento radicular (RAR) associado à minociclina subgengival (MS). Foram incluídos no presente estudo 36 indivíduos de 26 a 60 anos de idade (40,7 ± 9,1), previamente diagnosticados com periodontite crônica. Dezoito indivíduos foram selecionados para o grupo teste (GT), tratado com RAR e MS (novo tratamento), e 18 indivíduos, para o grupo controle (GC), que recebeu RAR e veículo (tratamento convencional). Foram selecionados dois sítios homólogos em cada indivíduo com profundidade de sondagem (PS) > 6 mm para testar a hipótese proposta. Para avaliar o comportamento clínico após o tratamento, a mensuração da PS foi realizada inicialmente e após 90 dias. A avaliação microbiana foi realizada para detecção de 7 periodontopatógenos através de reação em cadeia da polimerase, inicialmente e após 30 e 120 dias. Observou-se redução média de 2,8 e 2,1 mm na PS nos grupos teste e controle, respectivamente. Inicialmente, P. gingivalis foi o microrganismo mais prevalente tanto no GT (65,8%) quanto no GC (48,6%). Após 120 dias, houve redução para 30,8% no GT e 23,1% no GC. Não houve diferenças estatisticamente significativas entre os grupos em relação à PS (teste Wilcoxon - p > 0,05) e presença dos periodontopatógenos (teste Wilcoxon e qui-quadrado - p > 0,05 e teste do sinal - p > 0,01). Os resultados observados demonstraram que o novo tratamento foi tão efetivo quanto o tratamento convencional na redução de periodontopatógenos e de PS em indivíduos com periodontite crônica.

Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT.A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression.Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT.Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures.

Great possibilities for oral rehabilitation emerged as a result of scientific consolidation, as well as a large number of dental implant applications. Along with implants appeared diseases such as mucositis and peri-implantitis, requiring management through several strategies applied at different stages. Biofilm accumulation is associated with clinical signs manifest by both tooth and implant inflammation. With this in mind, regular and complete biofilm elimination becomes essential for disease prevention and host protection. Chemical control of biofilms, as an adjuvant to mechanical oral hygiene, is fully justified by its simplicity and efficacy proven by studies based on clinical evidence. The purpose of this review was to present a consensus regarding the importance of antimicrobial mouthrinse use as an auxiliary method in chemical peri-implant biofilm control. The active ingredients of the several available mouthrinses include bis-biguanide, essential oils, phenols, quaternary ammonium compounds, oxygenating compounds, chlorine derivatives, plant extracts, fluorides, antibiotics and antimicrobial agent combinations. It was concluded that there is strong clinical evidence that at least two mouthrinses have scientifically proven efficacy against different oral biofilms, i.e., chlorhexidine digluconate and essential oils; however, 0.12% chlorhexidine digluconate presents a number of unwanted side effects and should be prescribed with caution. Chemical agents seem beneficial in controlling peri-implant inflammation, although they require further investigation. We recommend a scientifically proven antiseptic, with significant short and long term efficacy and with no unwanted side effects, for the prevention and/or treatment of peri-implant disease.

Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.

This study histometrically evaluated the effect of forced alcohol intake by stressed animals on the severity of ligature-induced periodontitis in rats. Thirty-two rats were randomly divided in four groups: group GAL—alcohol and ligature; group GASL—alcohol, chronic physical stress, and ligature; GNC—negative control; GPC—positive control. GAL and GASL received 20% ethanol ad libitum, and GNC received water ad libitum for 60 days. After 24 hours of exposition to alcohol intake—by GAL and GASL—immobilization was applied as a chronic stressor in the GASL group for a two-month period, six times a week, in random hours. The means of the respective groups were statistically compared (Analysis of Variance and Tukey tests, P

Abstract Background and objectives Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). Material and Methods Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p

Abstract Periodontitis can contribute to the development of insulin resistance. Gestational diabetes is a risk factor for type 2 diabetes. Therefore, periodontitis, when associated with gestational diabetes, could increase the risk for the development of type 2 diabetes after pregnancy. Objective The aim of this study was to verify the incidence on the development of type 2 diabetes in women with previous gestational diabetes with and without periodontitis after a three-year time interval. Material and Methods Initial sample of this follow-up study consisted of 90 women diagnosed with gestational diabetes who underwent periodontal examination. After three years, 49 women were subjected to new periodontal examination and biological, behavioral, and social data of interest were collected. Additionally, the quantification of the C-reactive protein in blood samples was performed. Fasting glucose and glycated hemoglobin levels were requested. Saliva samples were collected for quantification of interleukin 6 and 10, tumor necrosis factor α, matrix metalloproteinase 2 and 9. Results The incidence of type 2 diabetes mellitus was 18.4% and of periodontitis was 10.2%. There was no significant difference in the incidence of type 2 diabetes mellitus among women with and without periodontitis. It was observed impact of C-reactive protein in the development of type 2 diabetes mellitus. However, it was not observed impact of periodontitis on the development of type 2 diabetes mellitus among women with previous gestational diabetes. Conclusions It was not observed impact of periodontitis on the development of type 2 diabetes among women with previous gestational diabetes. The impact of C-reactive protein in the development of type 2 diabetes mellitus highlights the importance of an inflammatory process in the diabetes pathogenesis.

Abstract Objective: Single dose of systemic antibiotics and short-term use of mouthwashes reduce bacteremia. However, the effects of a single dose of preprocedural rinse are still controversial. This study evaluated, in periodontally diseased patients, the effects of a pre-procedural mouth rinse on induced bacteremia. Material and Methods: Systemically healthy individuals with gingivitis (n=27) or periodontitis (n = 27) were randomly allocated through a sealed envelope system to: 0.12% chlorhexidine pre-procedural rinse (13 gingivitis and 13 periodontitis patients) or no rinse before dental scaling (14 gingivitis and 15 periodontitis patients). Periodontal probing depth, clinical attachment level, plaque, and gingival indices were measured and subgingival samples were collected. Blood samples were collected before dental scaling, 2 and 6 minutes after scaling. Total bacterial load and levels of P. gingivalis were determined in oral and blood samples by real-time polymerase chain reaction, while aerobic and anaerobic counts were determined by culture in blood samples. The primary outcome was the antimicrobial effect of the pre-procedural rinse. Data was compared by Mann-Whitney and Signal tests (p

We evaluated the DMFT (decayed, missing and filled teeth) index and the prevalence of candidiasis, linear gingival erythema, oral hairy leukoplakia, herpes simplex, aphthous ulcers, Kaposi's sarcoma and lymphoma, as well as the association with TCD4 count, viral load (VL) and antiretroviral therapy (ART) in 140 HIV-infected adult individuals. A standardized examination to determine the DMFT index and the presence of oral lesions was conducted. Demographic data, TCD4 count and use of ART were obtained from medical records. A high number of decayed teeth detected among patients undergoing ART resulted in a mean DMFT of 16.9 teeth. It was observed that 24.2% of the individuals had at least one oral lesion. Candidiasis was the most frequent lesion and was associated with the TCD4 count. Oral hairy leukoplakia was associated with an increased VL. Regular use of ART was inversely associated with the occurrence of lesions. Overall, the studied population showed low prevalence of oral lesions and high DMFT index. The use of ART seems to reduce the occurrence of these lesions. Higher TCD4 count and a lower VL were associated with an improved oral health status in HIV + individuals

INTRODUCTION: Patients seem to adhere better to short-term periodontal treatment schemes. Besides, time-reduced treatments are more cost-effective. However, the degree of benefits related to this type of treatment still requires additional investigations. AIM: The present short-term study evaluated clinical and microbiological outcomes, from baseline to 3-months, of chronic periodontitis subjects treated by the one-stage full-mouth disinfection protocol. MATERIAL AND METHOD: Sixteen chronic periodontitis subjects (mean-age 49.87 ± 8.22) who met inclusion/exclusion criteria were included. A calibrated examiner measured whole-mouth plaque and gingival indices, periodontal pocket depth and clinical attachment level at baseline and at 3-months. Subgingival samples were also collected from the 5 most diseased periodontal sites to determine total bacterial load and levels of P. gingivalis and S. oralis by real time qPCR. Periodontal treatment consisted of full-mouth manual debridement plus wide intraoral use of chlorhexidine in gel and solution. Additionally, after debridement, individuals rinsed 0.12% chlorhexidine at home twice a day for the following 2 months. Data monitored were compared by paired Student-t test (p

ABSTRACT Objectives This cross-sectional study compared the frequency of oral periodontopathogens and H. pylori in the mouths and stomachs of obese individuals with or without periodontitis submitted to bariatric surgery. Material and Methods One hundred and fifty-four men and women aged 18-65 were conveniently distributed into four groups. Two groups were composed of individuals who underwent bariatric surgery with (BP) (n=40) and without (BNP) (n=39) periodontitis and two obese control groups with (CP) (n=35) and without (CNP) (n=40) periodontitis. The oral pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Parvimonas micra, Treponema denticola, Tannerella forsythia, Campylobacter rectus, and Helicobacter pylori were detected by a polymerase chain reaction technique using saliva, tongue and stomach biopsy samples. Results Statistical analysis demonstrated that periodontopathogens were highly frequent in the mouth (up to 91.4%). In the bariatric surgically treated group, orally, P. gingivalis, T. denticola and T. forsythia were more frequent in periodontitis, while C. rectus was more frequent in non-periodontitis subjects. Stomach biopsies also revealed the high frequency of five oral species in both candidates for bariatric surgery (91.6%) and the bariatric (83.3%) groups. H. pylori was frequently detected in the mouth (50.0%) and stomach (83.3%). In the stomach, oral species and H. pylori appeared in lower frequency in the bariatric group. Conclusions Obese individuals showed high frequencies of periodontopathogens and H. pylori in their mouths and stomachs. Bariatric surgery showed an inverse microbial effect on oral and stomach environments by revealing higher oral and lower stomach bacterial frequencies.

Background: Several studies have investigated the differences in salivary parameters and microbial composition between diabetic and non-diabetic patients, however, specific differences are still not clear mainly due to the effects of confounder. Aim: The aim of this case-control study was to evaluate the salivary and microbial parameters of chronic periodontitis subjects with and without type 2 diabetes mellitus. Material and method: This case-control study included 60 chronic periodontitis subjects, 30 diabetics (case group) and 30 non-diabetics (control group), paired according to periodontitis severity, gender and age. Stimulated whole saliva was collected from all volunteers to measure the salivary pH and the salivary flow rate. Bacterial samples were collected with paper points from periodontal sites showing the deepest periodontal pocket depth associated with the highest clinical attachment loss. The frequency of A. actinomycetemcomitans, P. intermedia, P. gingivalis, T. forsythia and C. rectus was evaluated by PCR. Data was statistically analyzed by Student's t, Mann-Whitney and Chi-square (p

Abstract Objective Obesity is a chronic disease that negatively affects an individual’s general and oral health. The present study aimed to compare the clinical and microbiological effects of non-surgical periodontal therapy with the full mouth disinfection (FMD) protocol on obese and non-obese individuals at 9 months post-therapy. Methodology This clinical study was first submitted and approved by the Ethics Committee. Fifty-five obese patients and 39 non-obese patients with periodontitis were evaluated. The full-mouth periodontal clinical parameters, clinical attachment level (CAL), probing depth (PD), gingival index (GI), and plaque index (PI), were monitored at baseline, 3, 6, and 9 months after periodontal treatment with full mouth disinfection (FMD) protocol. The mean count of Tannerella forsythia , Porphyromonas gingivalis , Treponema Denticola , and Aggregatibacter actinomycetemcomitans was determined by quantitative polymerase chain reaction on subgingival biofilm samples. Demographic data were assessed by Chi-square test. For clinical and microbiological parameters, two-factor repeated-measures ANOVA was used. Results In both groups, periodontal therapy using the one-stage full-mouth disinfection protocol significantly improved CAL, PD, GI, and PI (p0.05). Microbial count found no major differences (p>0.05) between obese and non-obese individuals who had undergone non-surgical periodontal therapy. Conclusions Obesity did not affect the clinical and microbiological outcomes of non-surgical periodontal therapy.