RESUMO
AIM: This study aimed to evaluate the prevalence of S. pneumoniae colonization in three different sites in healthy adults: nasopharynx, oropharynx and gingival sulcus. METHODS: Two-hundred and sixty five adults, aged 20-60 years, who attended dental clinics in one public university (n = 106) and one military institution (n = 159) were enrolled in this study. Pneumococcal detection was performed by direct culture (DC) and PCR for lytA gene after a broth enrichment step. Capsular types were determined by sequential multiplex PCR. RESULTS: We identified 18 (6.8%) pneumococcal carriers among 265 adults by PCR, but only one (0.4%) pneumococcal strain was isolated by DC method. Oropharynx (17; 6.4%) was the main source of S. pneumoniae. Colonization of gingival sulcus and nasopharynx was found in 4 (1.5%) and 2 (0.8%) adults, respectively. Nine distinct capsular types were detected from 9 adults and co-colonization with 2 serotypes was confirmed in 4 (1.5%) subjects. Factors associated with carriage were being females, low level of schooling, non-military and regular medication. We observed a low (6.8%) pneumococcal carriage prevalence, but oropharyngeal samples yielded more sensitive results, especially by the PCR-based detection methodology. CONCLUSION: Gingival sulcus was found to be a possible reservoir for S. pneumoniae independently of the oropharynx or nasopharynx colonization.
Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Adulto , Brasil/epidemiologia , Portador Sadio/epidemiologia , Feminino , Humanos , Lactente , Nasofaringe , Orofaringe , Vacinas Pneumocócicas , Prevalência , Streptococcus pneumoniae/genéticaRESUMO
The purpose of this overview was to assess the methods, quality, and outcomes of systematic reviews conducted to evaluate the impact of bisphosphonates on dental implants and the risk of developing bisphosphonate-related osteonecrosis of the jaw after dental implant surgery. An electronic search without date or language restriction was performed in the PubMed/MEDLINE, Cochrane CENTRAL, Web of Science, and LILACS databases (to January 2018). Eligibility criteria included systematic reviews that evaluated the impact of bisphosphonates on implant outcomes. The quality assessment of the included reviews was done using AMSTAR 2 guidelines. The protocol of this overview was registered in PROSPERO (CRD42018089617). The search and selection process yielded seven reviews, published between 2009 and 2017. None of the systematic reviews included in this study obtained the maximum score in the quality assessment. The scientific evidence available demonstrates that patients with a history of bisphosphonate use do not present a higher risk of dental implant failure or marginal bone loss compared to patients who have not used bisphosphonates. The literature also suggests that patients who undergo surgical trauma during the installation of dental implants may be more susceptible to bisphosphonate-related osteonecrosis of the jaw.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Implantação Dentária Endóssea , Implantes Dentários , Difosfonatos , Humanos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/complicações , Conservadores da Densidade Óssea/efeitos adversos , Falha de Restauração Dentária , Difosfonatos/efeitos adversos , Revisões Sistemáticas como AssuntoRESUMO
The aim of this study was to evaluate the effect of counterclockwise (CCW) rotation and maxillomandibular advancement (MMA) on the upper airway space using three-dimensional images. An electronic search was performed in the PubMed, Cochrane Library, Scopus, Virtual Health Library, Web of Science, and OpenGrey databases (end date July 2016); a hand-search of primary study reference lists was also conducted. The inclusion criteria encompassed computed tomography evaluations of the upper airway spaces of adult patients undergoing orthognathic surgery with CCW rotation and MMA. The articles were evaluated for risk of bias with a tool for before-and-after studies. A meta-analysis was performed with the mean differences using a random-effects model. Heterogeneity was assessed with the Q-test and the I2 index. The meta-analysis revealed significant (P<0.001) increases in both the total airway volume (effect size of 6832mm3 and confidence interval of 5554-8109mm3) and the minimum axial area (effect size of 92mm2 and confidence interval of 70-113mm2). The heterogeneity was low in both comparisons (I2=38% and 7%, respectively). The technique of mandibular advancement with CCW rotation produced significant increases in the volumes and areas of the upper airway spaces.