Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-03-24T19:12:52Z No. of bitstreams: 1 jessicadoamaralbastos.pdf: 1006529 bytes, checksum: b3c22bd9504dc4480527e616b99836a2 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-03-27T17:56:07Z (GMT) No. of bitstreams: 1 jessicadoamaralbastos.pdf: 1006529 bytes, checksum: b3c22bd9504dc4480527e616b99836a2 (MD5) / Made available in DSpace on 2017-03-27T17:56:07Z (GMT). No. of bitstreams: 1 jessicadoamaralbastos.pdf: 1006529 bytes, checksum: b3c22bd9504dc4480527e616b99836a2 (MD5) Previous issue date: 2009-08-03 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Periodontite crônica (PC) é uma doença inflamatória causada por bactérias Gram negativas que causam destruição dos tecidos de suporte do dente e tem sido considerada fator de risco não tradicional para a doença renal crônica (DRC). No presente estudo, realizado em portadores de PC, a frequência dos principais patógenos periodontais identificados em pacientes com DRC foi comparada com os detectados em indivíduos sem doença sistêmica. Foram avaliados 19 indivíduos com PC e sem evidências de doença sistêmica (grupo controle), 25 pacientes com PC e com DRC em estágio pré-dialítico (grupo pré-diálise) e 22 pacientes com PC e DRC em terapia renal substitutiva (grupo TRS). A gravidade da PC baseou-se na profundidade de sondagem (PS) e no nível de inserção clínica (NIC). O estadiamento da DRC baseou-se nos critérios do Kidney Disease Outcome Quality Initiative. A filtração glomerular (FG) foi estimada pela equação do Modified Diet in Renal Disease e a identificação dos microrganismos na placa subgengival foi realizada pela técnica de reação em cadeia da polimerase. Entre os microrganismos identificados, a C. albicans e P. gingivalis foram mais frequentes, respectivamente, nos pacientes em TRS (72,7% e 100%) e pré-diálise (52% e 94,7%) do que nos pacientes sem doença sistêmica (26,3% e 72,2% ), p< 0,05. Nos pacientes com PC e DRC, tanto nos estágios pré-dialíticos quanto em TRS, a presença de P.gingivalis, T.denticola e C. albicans se associou com níveis mais elevados de NIC comparativamente aos indivíduos sem doenças sistêmicas. Também observou-se maior gravidade da PC nos pacientes com DRC tanto nos estágios pré-dialíticos quando sujeito a tratamento dialítico. Nos pacientes com DRC, a PC é mais grave e se associa com maior frequência de C. albicans e P.gingivalis. / Chronic periodontitis (CP) is a destructive inflammatory disease of the supporting tissues of the teeth caused by Gram-negative bacterias and has been considered as a non traditional risk factor for chronic kidney disease (CKD). In this study, done in patients with CP, the frequency of the main periodontal pathogens were compared in patients with CKD and health individuals. Material and Methods: Ninetheen with no evidence of systemic disease (control group) with CP, 25 patients with CP and CKD not yet on dialysis (pre-dialysis group), and 22 patients with CP and CKD on dialysis (RRT group) were studied. The severity of the CP was based on probing pocket depth (PPD) and clinical attachment level (CAL). CKD was defined and staged as recommended by Kidney Disease Outcome and Quality Initiative. The glomerular filtration rate was estimated with the equation of Modified Diet in Renal Disease. The polymerase chain reaction was used in the identification of oral microrganisms. Candida albicans and Porphyromonas gingivalis were more frequently identified in patients with CP and CKD in RRT (72,7% and 100%) and in the pre-dialysis stages (52% and 94,7%) than in health individuals (26,3% and 72,2%) (p <0,05). In patients with elevated CP and CKD, in the pre-dialysis and RRT groups, the presence of P.gingivalis, T.denticola e C. albicans was associated with elevated index of CAL measurements comparing to the individuals without no evidence of systemic disease. It was also observed that the CP was more severe in the CKD patients than in the health controls. In patients with CKD, the CP is more severe and is due more frequently to Candida albicans and Porphyromonas gingivalis.

Hintergrund: Zahlreiche Studien haben den therapeutischen Nutzen von systemischem Antibiotika in der Behandlung schwerer Parodontitis gezeigt. Bisher ist allerdings noch nicht geklärt, welches antibiotische Behandlungkonzept das Geeignetste ist. Daher sollen in einer randomisierten, klinischen Blindstudie zwei verschiedene, systemische Antibiotika adjuvant zur konventionellen, instrumentellen Behandlung von Patienten mit rapid progressiver Parodontitis (RPP) miteinander verglichen werden. Material und Methode: 33 Patienten mit klinisch und radiologisch gesicherter RPP-Diagnose wurden auf 2 Gruppen verteilt: (1) AM-Gruppe (n=17): 500 mg Amoxicillin und 250 mg Metronidazol (3*/ Tag - 10 Tage), (2) D-Gruppe (=16) 200mg Doxycyclin am 1.Tag und 100mg Doxycyclin 13 Tage. Zu Beginn erhielten alle Patienten 3* eine professionelle Zahnreinigung, und anschlie§end Scaling und Wurzelglättung unter Lokalanästhesie in 2 Sitzungen. 3 Monate später wurde ein Recall und die Antibiose durchgeführt. Im Abstand von jeweils 3 Monaten erfolgten 2 weitere Recallsitzungen. Nach erfolgreicher Mundhygieneinstruktion und zu allen Recallsitzungen wurden alle klinischen Parameter wie Taschentiefe, relatives Attachmentlevel und das Bluten bzw. Pus nach Sondieren mit der Florida probe eruiert. Die Bestimmung 8 verschiedener Parodontalpathogene wurde mit dem DNS-Sondentest von Meridol durchgeführt. Die mikrobiologischen Proben wurden mit sterilen Papierspitzen an den vier tiefsten Taschen vor der Antibiose und zu den anschlie§enden Recalls entnommen und mit der Gensondentechnik im Labor der Wybert GmbH elmex Forschung, Lörrach, analysiert. Zur Bestimmung des IL-1-Genpolymorphismus wurde venöses Blut in der 1. Sitzung abgenommen. Die Auswertung erfolgte mit dem GenoType(R) PRTest (Hain Diagnostika GmbH). Ergebnisse: Die klinischen Parameter zeigen sowohl durch die konservative als auch durch die antibiotisch adjuvante Therapie eine signifikante klinische Verbesserung (p / Background: Several studies have shown a therapeutical benefit from systemic antibiotics in the treatment of severe periodontitis. However, it has not yet been layed down which concept of antibiotic treatment is the best. Therefore the purpose of this study is to compare two different systemic antibiotics adjunctive to a conventional, mechanical treatment of patients with rapidly progressive periodontitis (RPP) in a randomised, blinded, clinical trial. Material and methods: 33 patients with a clinically and radiographically confirmed diagnosis of RPP were distributed in two groups: (1) AM-group (n=17): 500 mg amoxicillin and 250 mg metronidazole (3*/ d - 10days), (2) D-group (=16) 200mg doxycyclin on the 1st day and 100mg doxycyclin for 13days. In the beginning the patients received 3* professional tooth cleaning, and subsequently scaling and root planning under local anaesthesia in two sessions. 3 months later a recall visit and the antibiotic regimen were carried out. In 3 months-intervals another 2 recall visits were performed. After successfull oral hygiene instructions and during all recall visits all clinical parameters like pocket depths, relative attachment level, and bleeding and pus on probing were evaluated with the Florida probe. The determination of 8 different periodontal pathogens was performed with the DNS-Sondentest of Meridol. Before the antibiotic treatment and during the following recall visits the microbiological samples were taken from the 4 deepest pockets with sterile paper points and analysed by PCR-technique in the laboratory of Wybert GmbH elmex Forschung, Lörrach. To determine the IL-1 genetic polymorphism venous blood samples were taken in the first session. The analysis was done by GenoType(R), PRTest (Hain Diagnostika GmbH). Results: The clinical parameters show a significant clinical improve by the conservative as well as by the adjunctive antibiotic treatment (p

Marginale Parodontitis, die multikausale Erkrankung des Parodonts ist eine Infektionskrankheit, modifiziert durch Wirtsfaktoren und äußere Einflüße. Die als pathogene Mischflora bezeichnete Kombination kommensaler Mikroorganismen spielt die primäre Rolle in der Ätiopathogenese der Parodontitis. In der Aufstellung des Studienziels wurden einzelne Bakterienarten (T. forsythensis, P. gingivalis, A. actinomycetemcomitans, C. rectus, F. nucleatum, Fusobacterium spp., P. intermedia, E. corrodens, V. parvula und C. ochracea) ausgewählt, die eventuell als "Markerkeime" in der aggressiven Form der Parodontitis betrachtet werden können. Dazu wurde eine Kontrollgruppe untersucht, die eine gesunde parodontale Flora besitzt. Die angewandte Nachweismethode basiert auf der PCR-Amplifikation von 16S rDNA und darauffolgender dot-blot Hybridisierung mit Oligonukleotidsonden. Die entsprechenden Sonden wurden hergestellt, optimiert und evaluiert. Für die epidemiologische Untersuchung wurde subgingivale Plaque von vier Parodontaltaschen und einer Kontrollstelle von 45 Patienten mit aggressiver Parodontitis, sowie an fünf Stellen von 21 Senioren entnommen. Die Prävalenz der einzelnen Bakterienarten wurde mit Hilfe des Chi-Quadrat Test verglichen. Obgleich eine hohe interindividuelle Variabilität der Kolonisationsmuster zu beobachten war, konnten T. forsythensis, P. gingivalis, C. rectus und F. nucleatum signifikant häufiger in den Parodontaltaschen als an den gesunden Stellen nachgewiesen werden und können deswegen als "Leitkeime" der aggressiven Parodontitis angesehen werden. A. actinomycetemcomitans konnte nur bei einzelnen Patienten mit aggressiver Parodontitis festgestellt werden. Die Ergebnisse für P. intermedia und E. corrodens ließen keine eindeutige Assoziation sowohl mit der aggressiven Parodontitis als auch mit dem gesunden Parodontalzustand zu. Bei Senioren wurde C. ochracea besonders häufig nachgewiesen. Die Ergebnisse dieser Studie bewiesen die erfolgreiche Einsetzbarkeit der hergestellten Oligonukleotidsonden. / A multifactorial risk pattern of periodontitis has been recognized, where in addition to host and environmental factors, a pathogenic microbiota plays a primary role. The purpose of the current research was to analyze the prevalence of periodontitis-associated microorganisms in patients with aggressive periodontitis and periodontally healthy elders by using molecular-biologic detection methods like eubacterial PCR-amplification of 16S rDNA in combination with dot-blot hybridization. The oligonucleotide probes for the detection of T. forsythensis, P. gingivalis, A. actinomycetemcomitans, C. rectus, F. nucleatum, Fusobacterium spp., P. intermedia, E. corrodens, V. parvula and C. ochracea were designed and evaluated. The PCR products of 42 cultivated target and closely related bacteria were used for the optimization of hybridization conditions. For the epidemiological study, subgingival plaque was sampled from four pockets and one healthy site of 45 aggressive periodontitis patients as well as from five sites of 21 elderly. The differences in the prevalence of bacterial species were analyzed by the chi-square test. The data revealed frequent colonization by T. forsythensis, P. gingivalis, F. nucleatum and C. rectus in patients with aggressive periodontitis, however individual variations were obvious. These species could be predominantly identified in periodontal pockets, but were significantly less common in the healthy sites of the periodontitis patients and in the elderly. These putative pathogens can be conclusively determined as the key-bacteria in patients with aggressive periodontitis. No direct association for P. intermedia and E. corrodens with aggressive periodontitis or periodontal health could be seen. A. actinomycetemcomitans could be detected in only a few patients, reducing its suspected importance in the etiology of aggressive periodontitis. C. ochracea was highly prevalent in the well-maintained elderly, suggesting its association with healthy flora. The results of the study confirmed the reliability of the oligonucleotide probes in a specific and sensitive detection of the respective oral species.