RESUMO
Periodontal infection is a possible risk factor for respiratory disorders; however, no studies have assessed the colonization of periodontal pathogens in endotracheal tubes (ET). This case-control study analyzed whether periodontal pathogens are able to colonize ET of dentate and edentulous patients in intensive care units (ICU) and whether oral and ET periodontal pathogen profiles have any correlation between these patients. We selected 18 dentate and 18 edentulous patients from 78 eligible ICU patients. Oral clinical examination including probing depth, clinical attachment level, gingival index , and plaque index was performed by a single examiner, followed by oral and ET sampling and processing by quantitative polymerase chain reaction (total bacterial load, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia). Data were statistically analyzed by Mann-Whitney U, two-way analysis of variance (p < 0.05). Among dentate, there was no correlation between clinical parameters and ET bacterial levels. Both dentate and edentulous patients showed similar ET bacterial levels. Dentate patients showed no correlation between oral and ET bacterial levels, while edentulous patients showed positive correlations between oral and ET levels of A. actinomycetemcomitans, P. gingivalis, and T. forsythia. Periodontal pathogens can colonize ET and the oral cavity of ICU patients. Periodontal pathogen profiles tend to be similar between dentate and edentulous ICU patients. In ICU patients, oral cavity represents a source of ET contamination. Although accompanied by higher oral bacterial levels, teeth do not seem to influence ET bacterial profiles.
Assuntos
Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Intubação/efeitos adversos , Boca/microbiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Adulto , Carga Bacteriana , Estudos de Casos e Controles , Infecção Hospitalar , Estudos Transversais , Índice de Placa Dentária , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Índice Periodontal , Pneumonia Associada à Ventilação Mecânica/epidemiologia , Pneumonia Associada à Ventilação Mecânica/microbiologia , Sepse/epidemiologia , Sepse/microbiologia , Adulto JovemRESUMO
BACKGROUND AND OBJECTIVE: Stress has been identified as an important risk factor in the development of many infectious diseases, including periodontitis. Porphyromonas gingivalis, a gram-negative oral anaerobic bacterium, is considered an important pathogen in chronic periodontitis. Microorganisms, including P. gingivalis, that participate in infectious diseases have been shown to respond to catecholamines released during stress processes by modifying their growth and virulence. Therefore, the purpose of this study was to evaluate the effects of adrenaline and noradrenaline on the growth, antimicrobial susceptibility and gene expression in P. gingivalis. MATERIAL AND METHODS: P. gingivalis was incubated in the presence of adrenaline and noradrenaline (100 µm) for different time-periods in rich (Tryptic soy broth supplemented with 0.2% yeast extract, 5 µg/mL of hemin and 1 µg/mL of menadione) and poor (serum-SAPI minimal medium and serum-SAPI minimal medium supplemented with 5 µg/mL of hemin and 1 µg/mL of menadione) media, and growth was evaluated based on absorbance at 660 nm. Bacterial susceptibility to metronidazole was examined after exposure to adrenaline and noradrenaline. The expression of genes involved in iron acquisition, stress oxidative protection and virulence were also evaluated using RT-quantitative PCR. RESULTS: Catecholamines did not interfere with the growth of P. gingivalis, regardless of nutritional or hemin conditions. In addition, bacterial susceptibility to metronidazole was not modified by exposure to adrenaline or noradrenaline. However, the expression of genes related to iron acquisition (hmuR), oxidative stress (tpx, oxyR, dps, sodB and aphC) and pathogenesis (hem, hagA and ragA) were stimulated upon exposure to adrenaline and/or noradrenaline. CONCLUSION: Adrenaline and noradrenaline can induce changes in gene expression related to oxidative stress and virulence factors in P. gingivalis. The present study is, in part, a step toward understanding the stress-pathogen interactions that may occur in periodontal disease.
Assuntos
Epinefrina/farmacologia , Norepinefrina/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Porphyromonas gingivalis/efeitos dos fármacos , Agonistas Adrenérgicos/farmacologia , Anti-Infecciosos/farmacologia , Proteínas de Bactérias/genética , Técnicas Bacteriológicas , Proteínas de Ligação a DNA/genética , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Hemaglutininas/genética , Hemina/farmacologia , Proteínas Hemolisinas/genética , Humanos , Lectinas/genética , Metronidazol/farmacologia , Estresse Oxidativo/genética , Periodontite/microbiologia , Peroxidases/genética , Peroxirredoxinas/genética , Porphyromonas gingivalis/genética , Porphyromonas gingivalis/patogenicidade , Superóxido Dismutase/genética , Fatores de Transcrição/genética , Fatores de Virulência/genéticaRESUMO
BACKGROUND AND OBJECTIVE: Tooth loss (TL), one of the most visible results of the evolution of periodontitis, causes physiological and psychological impacts on a patient's life. This prospective study aimed to evaluate the incidence, underlying reasons and influence of risk predictors for the occurrence of TL in a program of periodontal maintenance therapy (PMT) over 5 years. METHODS: The sample comprised 212 individuals diagnosed with chronic moderate-severe periodontitis, who had finished active periodontal treatment, were incorporated in a PMT program. Individuals were divided in to two groups: 96 regular compliers (RC) and 116 irregular compliers (IC). Full-mouth periodontal examination was performed. Social, demographic, behavioral and biological variables of interest were collected at all PMT visits. The effect of risk predictors and confounders for TL, as well as the underlying reasons of TL, were assessed by univariate and multivariate analysis. RESULTS: TL was significantly lower among RC (0.12 teeth lost/year) in comparison to IC (0.36 teeth lost/year; p < 0.01). Individuals that were > 55 years old, males and smokers lost significantly more teeth in both groups (with IC > RC). The number of teeth lost due to periodontal reasons was significantly higher than TL for other reasons in both groups (p < 0.01). The final linear and logistic model for TL included: male gender, smoking, probing depth 4-6 mm in up to 10% of sites and irregular compliance. CONCLUSION: IC individuals undergoing PMT presented higher rates of TL when compared to RC individuals. Findings demonstrated the influence of irregular compliance and the importance of monitoring other risk predictors for TL such as smoking, male gender and severity of probing depth during PMT.
Assuntos
Periodontite Crônica/prevenção & controle , Perda de Dente/etiologia , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Cárie Dentária/complicações , Índice de Placa Dentária , Feminino , Seguimentos , Defeitos da Furca/classificação , Hemorragia Gengival/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Perda da Inserção Periodontal/classificação , Bolsa Periodontal/classificação , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Fumar , Fraturas dos Dentes/complicações , Mobilidade Dentária/complicações , Raiz Dentária/lesões , Dente não Vital/complicações , Adulto JovemRESUMO
We report the age-related prevalence of red complex periodontal pathogens, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, along with four strains of orange complex pathogens. The bacteria present in samples isolated from tongue, cheek, and subgingival sulcus in edentulous newborns and children with mixed dentition were monitored by polymerase chain reaction (PCR). P. gingivalis was not detected in any site of any subject in the two groups tested. However, T. denticola was not only found in the 6-13 years age group, but also in edentulous newborns at a relatively high prevalence, indicating non-dentition-related colonization by T. denticola. Campylobacter rectus, Prevotella intermedia, T. forsythia, Eikenella corrodens, and Parvimonas micra were found in the oral cavity of most subjects belonging to the 6-13 years age group compared to newborns. This suggested a pronounced association between these colonizing bacteria and the presence of teeth. There was also a strong relation between T. denticola and T. forsythia for their prevalence in the subgingival sulcus of the 6-13 years age group (p < 0.0001), but not in the other sites tested, suggesting that the colonization of dentition-related T. forsythia may be associated with the increased prevalence of non-dentition-related T. denticola in the subgingival sulcus. Overall, these results suggest that dentition is a key determinant of bacterial colonization, especially orange complex bacteria and the red complex bacterium T. forsythia.
Assuntos
Bactérias Anaeróbias/classificação , Bactérias Anaeróbias/isolamento & purificação , Biodiversidade , Dentição Mista , Mucosa Bucal/microbiologia , Adolescente , Bactérias Anaeróbias/genética , Técnicas Bacteriológicas/métodos , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase/métodosRESUMO
This study investigated a large population of individuals positive for A. actinomycetemcomitans and performed a two way analysis assessing the relation between the different serotypes of the bacterium and periodontal conditions. The serotypes analysis (serotypes a, b, c, d, e, f) showed that out of the 204 selected individuals positive for A. actinomycetemcomitans, 152 were positive for a single serotype, 27 showed a variable mixed infection and 25 individuals were not positive for any of the serotypes tested. Serotypes a, b and c were largely found (98%), and serotype c was the most prevalent. Serotypes d, e, and f were either not detected or relatively rare. It was also verified that in non-periodontitis individuals, serotypes a and c were more prevalent (p<0.05); in individuals with mild or moderate/severe chronic periodontitis serotype c was also more common (p<0.05); and aggressive periodontitis subjects showed high prevalence of both serotypes b and c (p<0.05). In conclusion, our study showed that serotype c was the most prevalent in both diseased and healthy subjects. Aggressive periodontitis subjects were not exclusively associated with A. actinomycetemcomitans serotype b. Non-typeable strains were either not detected or were relatively infrequent, and serotypes d and f were not detected in the examined Brazilian population.
Assuntos
Infecções por Pasteurellaceae/microbiologia , Infecções por Pasteurellaceae/patologia , Pasteurellaceae/classificação , Pasteurellaceae/isolamento & purificação , Periodontite/microbiologia , Periodontite/patologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Pasteurellaceae/epidemiologia , Periodontite/epidemiologia , Prevalência , Sorotipagem , Adulto JovemRESUMO
OBJECTIVE: To evaluate the prevalence of periodontopathogens according to periodontal profile in a black Brazilian secluded community matched with an urban black population. PARTICIPANTS: A total of 84 subjects were selected, 42 (mean age 25.7 sd 18.0 years) from a secluded community called Santo Antonio do Guapore (SAG) and 42 (mean age 25.4 sd 18.1 years) from an urban area of Sao Paulo State (SPT). METHODS: Participants received clinical examinations as follows: periodontal pocket depth; clinical attachment loss; plaque and gingival indexes. After examination, the secluded population was classified as periodontal health (13), gingivitis (15) or periodontitis (14). Then, 182 urban volunteers were screened and 42 subjects were selected matched for the variables: periodontal diagnosis, age (+/- 2 years) and gender. Samples were taken for microbial analysis. Genomic DNA for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, Tannerella forsythia and Prevotella intermedia was provided by polymerase chain reaction. RESULTS: Except for C. rectus, all pathogens were present in both groups with no statistically significant difference. In particular, C. rectus was more prevalent only in gingivitis subjects from the SPT group (p<0.05). A high frequency of periodontopathogens was related to the severity of periodontal disease. CONCLUSION: In general, the prevalence of the examined periodontopathogens in this study did not differ between a secluded black Brazilian population and an urban black population.
Assuntos
População Negra/etnologia , Etnicidade/etnologia , Bactérias Gram-Negativas/isolamento & purificação , Doenças Periodontais/microbiologia , Saúde da População Rural/etnologia , Saúde da População Urbana/etnologia , Adolescente , Adulto , Idoso , Aggregatibacter actinomycetemcomitans/isolamento & purificação , Bacteroides/isolamento & purificação , Brasil , Campylobacter rectus/isolamento & purificação , Estudos de Casos e Controles , Criança , Índice de Placa Dentária , Feminino , Gengivite/etnologia , Gengivite/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/etnologia , Perda da Inserção Periodontal/microbiologia , Doenças Periodontais/etnologia , Índice Periodontal , Bolsa Periodontal/etnologia , Bolsa Periodontal/microbiologia , Periodontite/etnologia , Periodontite/microbiologia , Porphyromonas gingivalis/isolamento & purificação , Prevotella intermedia/isolamento & purificação , Adulto JovemRESUMO
No evidence for the role of protease-activated receptor-2 (PAR(2)) in human periodontal disease has been demonstrated so far. Thus, we sought to investigate the expression of PAR(2) mRNA in chronic periodontitis, and to examine whether its expression is related to the presence of PAR(2) potential activators. Microbiological and gingival crevicular fluid samples were collected from individuals with chronic periodontitis and control individuals, and the presence of neutrophil serine proteinase 3 (P3) and Porphyromonas gingivalis was evaluated. PAR(2) mRNA expression was higher (p < 0.001) in those with chronic periodontitis compared with control individuals, and it was statistically decreased (p = 0.0006) after periodontal treatment. Furthermore, those with chronic periodontitis presented higher (p < 0.05) levels of IL-1alpha, IL-6, IL-8, and TNF-alpha, total proteolytic activity, P. gingivalis prevalence, and P3mRNA expression compared with control individuals. We conclude that PAR(2) mRNA expression and its potential activators are elevated in human chronic periodontitis, therefore suggesting that PAR(2) may play a role in periodontal inflammation.
Assuntos
Periodontite Crônica/enzimologia , Periodontite Crônica/microbiologia , Placa Dentária/microbiologia , Mieloblastina/metabolismo , Receptor PAR-2/biossíntese , Adulto , Análise de Variância , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Periodontite Crônica/patologia , Periodontite Crônica/terapia , Feminino , Líquido do Sulco Gengival/química , Humanos , Interleucinas/biossíntese , Masculino , Pessoa de Meia-Idade , Mieloblastina/análise , Porphyromonas gingivalis/isolamento & purificação , RNA Mensageiro/biossíntese , Receptor PAR-2/análise , Receptor PAR-2/genética , Estatísticas não Paramétricas , Fator de Necrose Tumoral alfa/biossíntese , Regulação para Cima , Adulto JovemRESUMO
It is believed that an increased arginase activity may lead to less nitric oxide production, which consequently increases the susceptibility to bacterial infection. Considering the hypothesis that smoking may alter the arginase activity and that smoking is considered a risk factor to dental implant survival, the present study aimed at evaluating the effect of smoking on the salivary arginase activity of patients with dental implants. Salivary samples of 41 subjects were collected: ten non-smoking and with no dental implants (group A), ten non-smoking subjects with dental implants (group B), ten smoking subjects with implants (group C), and 11 smoking subjects with no dental implants (group D). The levels of salivary arginase activity were determined by the measurement of L-ornithine and expressed as mIU/mg of protein. A significant increase in the salivary arginase activity was verified in groups C (64.26 +/- 16.95) and D (49.55 +/- 10.01) compared to groups A (10.04 +/- 1.95, p = 0.00001 and p = 0.0110, groups C and D, respectively) and B (11.77 +/- 1.45, p = 0.00001 and p = 0.0147, groups C and D, respectively). No significant difference was found between groups C and D (p = 0.32). Within the limits of the present study, it can be concluded that salivary arginase activity is increased in smoking subjects with dental implants in contrast to non-smoking subjects with dental implants, therefore suggesting a possible mechanism by which cigarette smoking may lead to implant failure. The analysis of salivary arginase activity may represent an important tool to prevent implant failure in the near future.
Assuntos
Arginase/metabolismo , Implantes Dentários , Saliva/enzimologia , Fumar/metabolismo , Adulto , Arginase/análise , Estudos de Casos e Controles , Implantação Dentária Endóssea , Falha de Restauração Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
This present study evaluated the salivary arginase activity (SAA) in patients with chronic periodontitis and the effect of periodontal therapy on the activity of such enzyme. Thirty-six patients (mean age, 45.97 +/- 14.52), 18 chronic periodontitis subjects (test group), and 18 periodontally healthy individuals (control group) participated in the study. Clinical periodontal examinations included measurements of probing pocket depth (PD), clinical attachment level (CAL), plaque (PI), and gingival (GI) indexes. The test group received periodontal therapy according to individual needs. The saliva sample was collected from all study population at baseline (both groups) and 30 days after periodontal therapy (test group). SAA was determined by measuring the L: -ornithine formation from L-arginine and was expressed as mU/ml. The results showed that the mean values of SAA were statistically different between control and test groups. SAA was about 2.5 times higher in test than control groups. Thirty days after periodontal therapy, enzyme levels were 1.56 times lower than before periodontal therapy. We concluded that SAA is increased in chronic periodontitis subjects when compared to periodontally healthy individuals and that periodontal therapy significantly reduced SAA levels. It was suggested that in the near future, SAA may be used as a salivary marker of periodontal status.
Assuntos
Arginase/análise , Periodontite/terapia , Saliva/enzimologia , Doença Crônica , Índice de Placa Dentária , Raspagem Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Ornitina/análise , Perda da Inserção Periodontal/enzimologia , Perda da Inserção Periodontal/terapia , Índice Periodontal , Bolsa Periodontal/enzimologia , Bolsa Periodontal/terapia , Periodontite/enzimologia , Periodonto/enzimologia , Aplainamento Radicular , Curetagem SubgengivalRESUMO
OBJECTIVES: The aim of this study was to verify the prevalence of peri-implant disease and analyse possible risk variables associated with peri-implant mucositis and peri-implantitis. The study group consisted of 212 partially edentulous subjects rehabilitated with osseointegrated implants. MATERIAL AND METHODS: The implants placed were examined clinically and radiographically to assess the peri-implant status. The degree of association between peri-implant disease and various independent variables was investigated using a multinomial regression analysis. RESULTS: The prevalence of peri-implant mucositis and peri-implantitis were 64.6% and 8.9%, respectively. In univariate modelling, healthy peri-implant subjects presented lower plaque scores, less periodontal bleeding on probing, and less time elapsed since placement of supra-structures. In multivariate analyses, the risk variables associated with increased odds for having peri-implant disease included: gender, plaque scores, and periodontal bleeding on probing. Presence of periodontitis and diabetes were statistically associated with increased risk of peri-implantitis. The only two factors, which did not contribute to the presence of the disease, were the time elapsed since placement of supra-structures and the frequency of visits for maintenance care. CONCLUSION: Our data suggest that subjects with periodontitis, diabetes, and poor oral hygiene were more prone to develop peri-implantitis.