O objetivo desse estudo foi avaliar o efeito clínico da instrumentação ultra-sônica subgengival irrigada com óleos essenciais na redução de bolsas periodontais em sítios 5mm após a reavaliação. Para tanto foi conduzido um ensaio clínico aleatório, duplo-cego, paralelo e controlado com placebo. Foram convidados para participar deste estudo 64 indivíduos com periodontite crônica. Os pacientes foram aleatoriamente alocados para grupo teste (irrigação com óleos essenciais contendo Timol 0,064%, Eucaliptol 0,092% Salicilato de Metila 0,06%, Mentol 0,042% e Álcool 21,6%) ou controle (irrigação com placebo, solução alcoolica 21%). Foram avaliados os parâmetros clínicos profundidade clínica de sondagem (PCS), nível clínico de inserção (NCI), retração da margem gengival (R), sangramento à sondagem (SS) e índice de placa (IP) no início e 4, 12 e 24 semanas após. O indivíduo foi considerado a unidade estatística. As diferenças entre os grupos e as alterações ao longo do tempo foram analisadas de acordo com um modelo linear generalizado (análise de variância de medidas repetidas). Houve redução significativa de PCS (1,59mm teste e 1,16mm controle) e SS (44,4% teste e 52,62% controle) e ganho em NCI (1,15mm teste e 0,91mm controle) nos dois grupos (p<0,001). No entanto, não houve diferenças entre os grupos ao final do estudo. Quando foram analisadas apenas as bolsas com PCS inicial >7mm observou-se redução significativa na PCS no grupo teste (1,60mm, p = 0,004) e controle (1,10mm, p = 0,0008) e ganho de NCI significativo no grupo teste apenas (teste: 1,59mm, p<0,001; controle: 0,71mm, p=0,051), sendo que houve diferença significativa entre os grupos após 24 semanas (p=0,02). Concluiu-se que a instrumentação ultra-sônica subgengival em bolsas residuais promoveu redução significativa em PCS, SS e ganho significativo de NCI. Além disso, o uso de óleos essenciais como agente irrigante promoveu benefícios adicionais em ganho de NCI em bolsas > 7mm, quando comparado com o grupo controle. / The aim of this study was to evaluate the clinical effect of ultrasonic instrumentation irrigated with essential oils in the reduction of sites with a probing depth of 5 mm or more. For this purpose, a randomized, double-blind, parallel-arm and placebocontrolled clinical trial was conducted. Sixty-four individuals with chronic periodontitis were invited to participate in this study. The patients were randomly allocated to the test group (irrigation with essential oils containing 0.064% Thymol, 0.092% Eucalyptol, 0.06% Methyl Salicylate, 0.042% Menthol and 21.6% Alcohol) or control (irrigation with placebo, 21% alcoholic solution). Probing pocket depth (PD), clinical attachment level (CAL), gingival recession (R), bleeding on probing (BOP) and plaque index (PI) were assessed. The individual was considered the statistical unit. The differences between the groups and the alterations over the course of time were analyzed according to a generalized linear model (repeated measures analysis of variance). There was a significant reduction in PD (1.59mm test and 1.16mm control) and BOP (44.4% test and 52.62% control) and CAL gain (1.15mm test and 0.91mm control) in both groups (p<0.001). However, there was no difference between groups at the end of the trial. When sites with PD >7mm at baseline were analyzed, a significant reduction in PD was observed in test (1.60mm, p = 0.004) and control groups (1.10mm, p = 0.0008), as well as a significant gain in CAL in test group only (test: 1.59mm, p<0.001; control: 0.71mm, p=0.051). There was a significant difference between the groups after 24 weeks (p=0.02). It was concluded that subgingival ultrasonic instrumentation in residual pockets promoted reduction in PPD, BOP and gain in CAL. Besides, adjunctive irrigation with essential oils promoted additional benefits in gain of CAL in sites with initial pockets > 7mm, when compared to test group.

Porphyromonas gingivalis é um dos principais mircrorganismos associados à periodontite. O objetivo do presente estudo foi testar a hipótese de que a colonização por diferentes genótipos fimA de P.gingivalis resultaria em diferenças na resposta ao tratamento periodontal. Foram analisados 20 pacientes com periodontite crônica, fumantes, portadores de P.gingivalis, divididos em 2 grupos: 1 grupo recebeu tratamento periodontal mecânico (RAR) e o outro recebeu, além da RAR, antibioticoterapia (amoxicilina e metronidazol). O efeito do tratamento foi avaliado com relação a parâmetros clínicos, prevalência e níveis subgengivais de P. gingivalis e dos genótipos fimA II e fimA IV em estudo quantitativo por PCR em tempo real, antes e 180 dias após o tratamento. Os dados sugerem que RAR associado a antibiotioticoterapia sistêmica é mais eficiente na redução dos níveis de P.gingivalis do que apenas RAR. Não foram detectadas diferenças na resposta ao tratamento periodontal quanto à presença dos genótipos fimA II ou fimA IV em relação aos demais genótipos de P.gingivalis. / Porphyromonas gingivalis is one of the main mircrorganisms associate to periodontitis. The present study proposed to test the hypothesis that the colonization by different P.gingivalis genotypes fimA would lead to different results on periodontal treatment. Twenty chronic periodontitis patients, smokers, bearers of P. gingivalis was analyzed and divided in 2 groups: one group received mechanic periodontal treatment (SRP) and the other group received, besides SRP, antibiotic therapy (amoxicillin and metronidazole). The effect of treatment was appraised under clinical parameters, prevalence and subgingival levels of P. gingivalis and genotypes fimA II and fimA IV in quantitative study by Real time PCR, before and after 180 days of the treatment. Data suggest that SRP associated with systemic antibiotic administration is more efficient in reducing P. gingivalis levels than SRP only. No difference on periodontal treatment results was detected about the presence of fimA II or fimA IV genotypes related to other P.gingivalis genotypes.

Archaea ainda não foi reconhecido como patógeno de doença humana. O objetivo deste estudo foi determinar a prevalência, diversidade, níveis e proporções de Archaea no biofilme subgengival de indivíduos com periodontite agressiva (PA) e saúde periodontal (SP). Sessenta indivíduos foram selecionados para este estudo (n=30/grupo). A análise de diversidade foi realizada em 10 indivíduos/grupo. Quatro sítios/indivíduo do grupo PA e 2 sítios/indivíduo do grupo SP foram analisados por qPCR. A freqüência de Archaea foi de 60% dos indivíduos/ 15,2% dos sítios em PA e de 63,3% dos indivíduos/ 15,6% dos sítios em SP (p>0,05). Um a três filotipos foi identificado por amostra. O número de cópias e a proporção de Archaea e Bacteria foram menores no grupo SP do que no grupo PA (p<0,05). Archaea são encontrados no biofilme subgengival de indivíduos com PA e SP. Methanobrevibacter oralis é o filotipo mais prevalente, podendo ser considerado residente da cavidade bucal. A alteração ecológica na microbiota de indivíduos com PA inclui o aumento dos níveis e proporções de Archaea. / Membrers of Archaea domain may be detected in the microbiota of mucous surfaces of human and animals, but their association with diesase have not been yet stablished Some studies have suggested that Archaea domain may be indirectly associated with pathogenesis of periodontitis, since they are found restrict to subgingival sites with severe periodontal destruction. The aim of this study was to determine the prevalence, diversity, levels and proportions of microorganisms of Archaea domain in subgingival biofilm of aggressive periodontitis and periodontally healthy subjects. Thirty generalized aggressive periodontitis (GAgP) and 30 periodontally healthy (PH) subjects were selected. Archaea detection was performed by PCR using domain-specific primers in 9 subgingival samples taken from each subject. Archaea diversity was determined by evaluating a single positive sample per subject, randomly selected from 10 GAgP and 10 PH subjects. Archaeal 16S rRNA gene library were constructed to each sample and the identity of phylotypes were determined for the comparison of unrecognized sequences with gene database. The levels and proportions of Archaea in relation to total microbial load were analysed by quantitative PCR (qPCR) in 4 sites per GAgP subject and 2 sites per PH subject. A total of 540 subgingival samples were analysed to Archaea presence. This domain were detected in 18 GAgP (60%) and in 19 PH (63.3%) subjects. Forty-one (15.2%) and 42 (15.6%) samples were positive for this domain in GAgP and PH subjects, respectively. There was not difference in prevalence of this domain between subjects from GAgP and PH groups, as well as there was not difference in prevalence between sites with different probing depthsin GAgP group. Thenumber of 16S rRNA clones available to identification per sample varies from 33 to 47 in GAgP group, and from 15 to 23 in PH group, with a mean of 42.8+3.9 e 20.2 +2.2, respectively. The analysis of 629 sequencies permits an identification of 1 to 3 phylotypes of Archaea domain per sample. Methanobrevibacter oralis was detected in all archaeal positive samples, being the single detected specie of this domain in 5 subjects from GAgP group, and in 3 subjects from PH group. Methanobacterium curvum/congolense was detected in 3/10 GAgP and 6/10 PH samples, whereas Methanosarcina mazeii was detected in 4/10 samples from both groups. Archaea analysis by qPCR was carried out in 103 sites and 28 GAgP subjects and in 60 sites and 30 PH individuals. Archaea has been detected in 27/28 subjects and in 68% of studied sites in GAgP group and in 26/30 subjects and 58,3% of total analysed sites in PH group. Archaeal and bacterial 16S rRNA mean levels were smaller in PH group than in GAgP group (Mann Whitney, p<0.05). There was no statistic significance of difference in the levels of Archaea in regard to probing depth categories in GAgP group (p>0.05). Moreover, the proportion of Archaea in relation to total microbial load (Archaea + Bacteria) was 0.02% and 0.08% in PH and GAgP group (p<0.05), respectively. These data suggest that Archaea is commonly found in the subgingival biofilm of humans, and that M. oralis may be considered a member of the resident microbiota of subgingival sites. The ecological shift in the microbiota of aggressive periodontitis subjects includes the increase of levels and proportions of Archaea domain.