Submitted by Maria Aparecida (cidazen@gmail.com) on 2017-08-03T15:13:21Z No. of bitstreams: 1 SUZANNI DO AMARAL RODRIGUES VELOSO.pdf: 261140 bytes, checksum: 00ad145cedf0454b51cf4f7e62d05356 (MD5) / Made available in DSpace on 2017-08-03T15:13:21Z (GMT). No. of bitstreams: 1 SUZANNI DO AMARAL RODRIGUES VELOSO.pdf: 261140 bytes, checksum: 00ad145cedf0454b51cf4f7e62d05356 (MD5) Previous issue date: 2007-03-27 / The goal of the present work is to correlate different levels of apical periodontitis (AP) with radiographic signs such as: crown decay, presence of crown, endodontic treatment, distance from the end of the root canal filling to radiographic apice, assembly of restorative material, presence of external resorption and presence of intra-radicular post and its distance to the radiographic apice. A population of 300 cases with apical periodontitis collected from orthodontic offices. A total of 159 (53%) males and 141 (47%) females with ages ranging from 20 to 45 were used in this study. The apical condition was radiographically determined by means of the Apical Periodontitis Indice (API). The data were analyzed statistically using the chi-squared test. In relation to the age, greatest frequency of cases ranged between 26 to 30 years old (20,67%) and 36 to 40 (23%). The greatest incidence of AP was in first lower molars (21,3%), followed by upper incisor (17%) and second lower molars (13,7%). The results showed an association of AP and factors like, distance from the root canal filling to the apice (p<0.0001), assembly of the restorative material (p<0.0001), external resorption (p<0.0001) and distance from the intra-radicular post to the radiographic apice (p<0.0001). However, no significant difference was detected in relation to age, sex, coronal filling and decay. / Este trabalho teve como objetivo relacionar os diversos graus de periodontite apical com achados radiográficos tais como: a presença de cárie, restauração coronária, presença de coroa protética, presença de tratamento endodôntico, distância da obturação ao ápice radiográfico, adaptação do material restaurador; presença de reabsorção externa, presença de pino intra-radicular e sua distância do ápice radiográfico. A amostra consiste em 300 casos de dentes com PA provenientes de consultório de ortodontistas, colhidas de pacientes com idade entre 20 e 45 anos, que possuíam radiografias de boca total (14 radiografias periapicais). Foi realizada a análise radiográfica da condição periapical, usando-se o Índice de Periodontite Apical (PAI). Os dados foram analisados estatisticamente através do teste do Qui-quadrado de independência. Dentre os 300 casos 159 (53%) pacientes são do sexo feminino; e 141 (47%), do sexo masculino. Quanto à faixa etária, houve maior freqüência de pacientes entre 26 a 30 anos (20,67%), e entre 36 a 40 anos (23%). O dente mais acometido por PA foi o primeiro molar inferior (21,3%) seguido do incisivo superior (17%) e do segundo molar inferior (13,7%). A análise estatística dos resultados revelou uma relação de dependência do índice de periodontite apical com as variáveis: distância da obturação ao ápice (p<0,0001), adaptação do material obturador (p<0,0001), reabsorção externa (p<0,001) e distância do pino intra-radicular ao ápice radiográfico (p<0,0001). No entanto, não houve diferença com relação às seguintes variáveis: idade, sexo, restauração coronária, cárie e presença de coroa protética.

Magister Chirurgiae Dentium (MChD) / Chlorhexidine has been established as the gold standard against which new chemical plaque control agents are tested (Jones, 1997). The addition of alcohol in a chlorhexidine mouthwash had been widely used, however the comparative efficacy of alcohol free chlorhexidine mouthwash had not fully been explored in this study, two chlorhexidine mouthwash preparations were tested to evaluate their comparative efficacy in the treatment of periodontal disease. Aims: To assess the efficacy of alcohol-free chlorhexidine mouth wash in comparison to alcohol containing chlorhexidine mouth wash. Objectives: To determine pre- and post- operative clinical parameters and microbial load in the management of patients with chronic periodontitis. Methodology: A double blinded randomised control trial was conducted. Patients diagnosed with active chronic periodontitis were included in the study and randomised to either a test (chlorhexidine without alcohol) or control group (chlorhexidine with alcohol). A total of 50 patients were selected for the study. Results: The Wilcoxon Signed Rank test was used to test the difference between the pre-post pair per clinical indicator and Bana-Zyme. The differences between before and after treatment per indicator were significant at P<0.001 for respectively Paroex and Peridex. These values demonstrated the difference between the clinical parameters taken before the treatment and six weeks post treatment. Conclusion: Both mouth wash solutions with and without alcohol had proven to reduce the microbial load as shown by the BANA-Zyme test, with the alcohol containing solution having been more effective.

A periodontite produz uma descarga de quimiocinas inflamatórias que pode ser refletida na saliva. Com base nisso, o objetivo desse estudo foi mensurar as concentrações salivares de interleucina-8 (IL-8), RANTES (Regulated upon Activation, Normal T Cell Expressed and Secreted), MIG (monokine induced by gamma interferon), IP-10 (interferon &gamma;-inducible protein of 10 kD), e MCP-1 (macrophage chemotactic protein-1) em pacientes com periodontite crônica e saudáveis. 32 indivíduos foram divididos em dois grupos: saudáveis (Controle, n=11) e pacientes com periodontite crônica (DP, n=21). Dados clínicos foram registrados. Amostras de saliva não-estimulada foram analisadas e biomarcadores inflamatórios na saliva foram identificados utilizando a citometria de fluxo em ensaios multiplex. Dos biomarcadores analisados, IL-8, MCP-1, PI e MIG-10 foram encontrados em maior abundância nas amostras da saliva. Verificou-se diferenças estatisticamente significativas entre as proteínas salivares: IL-8 (p=0,0008), MCP-1 (p=0003), e RANTES (p=0,03). Nenhuma diferença estatística entre grupos foi observada para IP-10 (Controle 193,85 ± 64,21; PD 423,78 ± 85,67, p=0,08), e MIG (Controle 173,33 ± 79,28; DP 341,26 ± 77,23. p=0,05). Todos os biomarcadores avaliados estavam mais elevados nos pacientes com DP em comparação com o grupo controle. Os dados sugerem que o aumento dos níveis de quimiocinas MCP-1, IL-8 e RANTES na PD podem ser responsáveis pela manutenção de leucócitos específicos no local. Esse mecanismo pode servir para promover a migração de leucócitos para os sítios de inflamação e a manutenção da cronicidade da periodontite / Objective: Periodontitis produces an inflammatory proteins discharge that can be reflected in saliva. The aim of this study was to measure salivary concentrations of interleukin-8 (IL-8), RANTES (Regulated upon Activation, Normal T Cell Expressed and Secreted), MIG (monokine induced by gamma interferon), IP-10 (interferon &gamma;-inducible protein of 10 kD), e MCP-1 (macrophage chemotactic protein-1) in patients with chronic periodontitis and healthy. Material and Methods: A total of 32 subjects was divided in 2 groups: healthy (Control, n=11) and patients with periodontitis (PD, n=21. Clinical data were recorded. Non-stimulated saliva samples were analyzed and identified simultaneously using the human flow cytometry multiplex assays. Results: Of the target biomarkers examined, IL-8, MCP-1, MIG and IP-10 were found in greatest abundance in the saliva samples. It was found statistically significant differences among screened salivary proteins: IL-8 (p = 0.0008), MCP-1 (p = 0.003), and RANTES (p= 0.03). No statistical differences between the groups were observed for IP-10 (Ctrl 193.85 ± 64.21. PD 423.78 ± 85.67, p = 0.08), and MIG (Ctrl 173.33 ± 79.28; PD 341.26 ± 77.23. p = 0.05). All cytokines levels were higher on PD patients in comparison with controls samples. Only samples that stayed within the detection limit for the assay were considered for statistical analysis. For Control group, no correlation was found between clinical parameters and the chemokines levels. In PD group, positive Spearman correlation was observed between total amount of MCP-1 and Age (r 0.648; p<0.001) and negative correlation was observed between MCP-1 with PPD (r -0.462, p = 0.03) and CAL (r -0,461, p = 0.003). Significant negative correlation was found between total amount of RANTES and the percentage of SUP (r -0.457, p = 0.03). Conclusion: The above results suggest that the increased levels of chemokines MCP-1, RANTES and IL-8 in PD individuals may be responsible for maintaining the infiltration of specific leukocytes. This mechanism would serve to promote the migration of leukocytes into the sites of inflammation and the chronicity of inflammation in human periodontitis.

A doença periodontal é uma das doenças inflamatórias crônicas mais comuns que acometem a população. A grande destruição tecidual observada durante o seu desenvolvimento tem sido atribuída ao processo inflamatório exacerbado e ao desequilíbrio favorável à geração de espécies reativas de oxigênio em relação àcapacidade de defesa dos antioxidantes. A epigalocatequina-3-galato (EGCG) obtida da Camellia sinensis é uma substância que apresenta potencial antioxidante e antiinflamatório e, mais recentemente, testes in vitro têm mostrado que também possui atividade anti-osteoclastogênica, sendo apontada como uma possível droga para uso terapêutico nas patologias ósseas com excessiva atividade osteoclástica e destruição óssea. O objetivo do trabalho foi verificar morfométricamente em imagens obtidas pela tomografia microcomputadorizada (micro-CT) e cortes histológicos se a administração diária de EGCG reduz o processo inflamatório e a perda óssea alveolar na doença periodontal induzida por ligadura em ratos. O primeiro molar inferior direito de 60 ratos foi amarrado com fio de seda 3.0 e divididos em grupo sem tratamento (GST), grupo tratado com EGCG (GTEGCG) que recebeu diariamente por gavagem 100mg/Kg de EGCG e grupo Sham (GTsalina) que recebeu apenas solução salina. Nos períodos de 0, 7, 14 e 21 dias (n=5 animais/período/grupo) imagens digitais foram obtidas no microtomógrafo sendo submetidos à análise do nível ósseo periodontal (PBL) e da densidade óssea (BV/TV) inter-radicular. Nos cortes longitudinais do M1 corados pela HE foi avaliado o PBL e morfometricamente o percentual e volume de processo inflamatório e tecido ósseo, além do número osteoclastos/cm2. Os dados foram submetidos à ANOVA a dois critérios e ao teste de Tukey (p<0,05). O PBL determinado nas imagens microtomográficas e histológicas mostraram que a perda óssea aumenta em todos os grupos durante a fase aguda da doença (0 a 14 dias) e estabiliza na fase crônica (14 dias-21 dias). Em geral, o PBL foi menor no GTEGCG (média de 0,839 mm) comparado aos GST e GTsalina (média de 0,953 ). Quanto à densidade óssea o BV/TV foi maior no GTEGCG (68%) comparados aos GST (62,06%). O percentual do processo inflamatório e o número de osteoclastos foram menores no GTEGCG, com pico aos 14 dias (3,4% de processo inflamatório e 32 osteoclastos/cm2), comparados aos GST e GTsalina cujo o pico foi aos 7 dias (média de 8,6% de processo inflamatório e 68 osteoclastos/cm2). Concluímos que, no modelo de periodontite induzida por ligadura, o tratamento com EGCG diminui o processo inflamatório e a osteoclastogênese e consequentemente a perda óssea e a severidade da doença. / Periodontal disease is currently one of the most common chronic inflammatory diseases affecting the population. The large tissue destruction observed during its development, has been attributed to exacerbated inflammatory process and unbalance response between production of reactive oxygen species and antioxidant defense capacity. Recently, the substance epigallocatechin-3-gallate (EGCG) obtained from Camellia sinensis have been associated to antioxidant and antiinflammatory actions. In vitro studies have shown that EGCG has also antiosteoclastogenic activity suggesting to be a potencial drug for use in therapeutic treatment of bone diseases with excessive osteoclast formation and bone destruction. The aim of this study was to verify morphometrically in micro-ct and histological images whether daily administration of EGCG inhibits/decreases alveolar bone loss in periodontal disease induced in rats by ligature. The lower right first molar of 60 rats was tied with surgical suture thread 3.0. The animals were divided into untreated group (GST), EGCG treated group (GTEGCG) which received 100mg/kg of EGCG by gavage daily and Sham group (GT saline) which received saline solution only. In periods of 0, 7, 14 and 21 days (n=5 animals/period/group) digital images were obtained in microtomography (SkyScan1176) and subjected to analysis of PBL in the mesial, distal, buccal and lingual root and BV/TV bone volume percentage. In the sagittal slides PBL volumetric points and inflammatory process as well as the number of osteoclasts/cm2 was analyzed. Data were submitted to twoway ANOVA and Tukey test (p <0.05). PBL determined in microtomographic and histological images showed that bone loss increased and stabilized, respectively, in the all groups acute phase (days 0 to 14) and chronic phase (14 days, 21 days) of the disease. In general, the PBL was lower in GTEGCG (average 0,839 mm) compared to GST and GTsaline (average 0,953). Regarding bone density BV/TV in GTEGCG was higher (68%) compared to GST (62.06%). The percentage of inflammation and the number of osteoclasts was more mild in GTEGCG, reaching peak at 14 days (3.4% inflammatory process and 32 osteoclasts / cm2) compared to GST and GTsaline whose peak was at 7 days (average 8.6% inflammatory process and 68 osteoclasts / cm2). It was concluded that in the current model of periodontal disease induced by ligature, EGCG treatment decreases inflammatory process, osteoclastogenesis activity, bone loss, and consequently the severity of the disease.

A hipertensão e a obesidade têm sido descritas como graves problemas de saúde pública, tendo uma prevalência de obesidade no Brasil de 20%. Além de causar problemas sistêmicos, a hipertensão e a obesidade podem afetar as condições bucais. Diante disso, o objetivo deste estudo foi identificar doença periodontal em indivíduos obesos hipertensos e não hipertensos, no pré e pós-cirurgia bariátrica (CB), com seguimento de 12 meses. A amostra foi composta por 70 indivíduos distribuídos em dois grupos: grupo obeso com hipertensão (G01=35) e grupo obeso sem hipertensão (G02=35), ambos os grupos foram avaliados no pré e pós cirurgia bariátrica. A avaliação antropométrica dos indivíduos foi realizada através do IMC e circunferência da cintura. O sangramento a sondagem foi realizado por meio do índice de sangramento gengival, da profundidade de sondagem e do nível de inserção clínica e recessão gengival. Foi analisado o fluxo salivar não estimulado e estimulado para mensurar o volume (mL/min). Foram adotados os testes de Kruskal- Wallis, Mann-Whitney, Qui-quadrado e Exato de Fisher (p<0,05). O gênero feminino foi o mais prevalente na amostra avaliada, em ambos os grupos avaliados (G01=85,3%; G02=80%). O modelo ajustado utilizando regressão logística mostrou que apenas a idade (p<0,0001) e a recessão gengival (p=0,0320) foram determinantes na diferença entre os hipertensos e não hipertensos. O período de 12 meses (p=0,913), sexo (p=0,608), IMC (p=0,412), RCQ (p=0,577), profundidade média de bolsa (p=0,114), recessão máxima (p=0,236), escore de recessão (p=0,319), nível de inserção periodontal (p=0,486), escore de nível de inserção periodontal (p=0,074), cálculo (p=0,745), sangramento (p=0,172), fluxo salivar não estimulado (p=0,980), fluxo salivar estimulado (p=0,964) e escolaridade (p=0,448), não foram significativos. Concluiu-se que indivíduos obesos mórbidos com hipertensão arterial apresentam pior condição periodontal e que a CB não interferiu negativamente na saúde periodontal, dentro de cada grupo. / Hypertension and obesity have been described as serious public health problems as they have increased in alarming proportions both globally and nationally, with a prevalence of obesity in Brazil of 20%. In addition to causing systemic problems, hypertension and obesity can affect oral conditions. Therefore, the objective of this study was to identify periodontal disease in hypertensive and non-hypertensive obese individuals, before and after bariatric surgery (CB), with a follow-up of 12 months. The sample consisted of 70 individuals divided into two groups: obese group with hypertension (G01 = 35) and obese group without hypertension (G02 = 35), both groups were evaluated before and after bariatric surgery. The anthropometric evaluation of the individuals was performed through BMI and waist circumference. Bleeding was performed by means of gingival bleeding index, depth of probing and level of clinical insertion and gingival recession. The non-stimulated and stimulated salivary flow was analyzed to measure the volume (mL / min). The Kruskal-Wallis, Mann-Whitney, Chi-square and Fisher Exact tests were used (p <0.05). The female gender was the most prevalent in the sample evaluated, in both groups (G01 = 85.3%, G02 = 80%). The adjusted model using logistic regression showed that only age (p <0.0001) and gingival recession (p = 0.0320) were determinants of the difference between hypertensive and non-hypertensive individuals. (P = 0.368), mean BMI (p = 0,412), BMI (p = 0,412), WHR (p = 0.577), mean bursal depth (p = 0,114), maximum recession (P = 0.745), bleeding (p = 0,172), non-stimulated salivary flow (p = 0,319), periodontal insertion level (p = 0,419), periodontal insertion level P = 0.980), stimulated salivary flow (p = 0.964) and schooling (p = 0.448), were not significant. It was concluded that morbidly obese individuals with arterial hypertension present worse periodontal conditions and that CB did not negatively affect periodontal health within each group.

O objetivo geral deste estudo foi monitorar a atividade da doença periodontal e sugerir potenciais biomarcadores salivares relacionados a esta atividade em pacientes com periodontite crônica associada ou não Diabetes mellitus tipo 2, a partir da avaliação do perfil da expressão gênica de sítios periodontais progressivos e de proteínas inflamatórias salivares. Foram incluídos 56 pacientes, sendo 21 com periodontite crônica (DP), 20 com periodontite crônica associada ao Diabetes mellitus tipo 2 (DP+DM) e 15 periodontal e sistemicamente saudáveis (controle). Foi realizado exame radiográfico antes e dois meses após a terapia periodontal básica, e posteriormente foi feita a subtração radiográfica a partir dos pares das radiografias. As medidas das áreas com perda de densidade foram registradas. Coleta de saliva não estimulada, verificação da hemoglobina glicada (HbA1c) e exame clínico periodontal profundidade de sondagem (PS), nível clínico de inserção relativo (NCIR), sangramento à sondagem (SS) e índice de placa (IP) também foram realizados antes e dois meses após a terapia periodontal básica. Os sítios periodontais com perda de inserção progressiva 1 mm na reavaliação foram considerados ativos de acordo com uma adaptação do método de tolerância. Biópsias de tecido gengival de sítios ativos e inativos com parâmetros clínicos semelhantes foram analisadas com real time PCR Array para análise do perfil de expressão gênica da resposta imune-inflamatória. As amostras de saliva foram submetidas ao imunoensaio Multiplex Cytokine Profiling para análise de expressão de proteínas. No grupo DP, 9% dos sítios foram classificados como ativos e no grupo DP+DM, 12% (p > 0,05). A média de perda de inserção clínica foi maior no grupo DP+DM (1,34 mm) em relação ao grupo DP (1,21 mm) (p < 0,05). Houve correlação entre a perda de inserção clínica e a área da perda de densidade radiográfica tanto nos sítios ativos do grupo DP (R = 0,79; p = 0,001), quanto do grupo DP+DM (R = 0,86; p < 0,001). Ambos os grupos DP e DP+DM apresentaram um perfil down-regulated em relação aos pacientes saudáveis (grupo controle). Quando comparado o grupo DP+DM ao grupo DP, pacientes diabéticos apresentaram um perfil up-regulated. Sítios ativos do grupo DP mostraram nove genes (ABCF1, CD40LG, IL10, IL5, CCR2, CCR4, CCR7, CCL18 e CXCL1) diferencialmente expressos (p < 0,05) com um perfil up-regulated. Sítios ativos do grupo DP+DM mostraram seis genes (LTA, CXCR1, CCL19, CCL8, CCL17 e CXCL12) diferencialmente expressos (p < 0,05) com um perfil up-regulated. Após a terapia periodontal básica, houve uma significante redução de algumas proteínas salivares (IL1b, IL1ra, IL10, IL17, TGFb, IL8, eotaxin e MCP-3) nos grupos DP e DP+DM, mas sem diferença estatisticamente significante (p > 0,05). Concluindo, este estudo foi capaz de monitorar a atividade da doença periodontal em pacientes com e sem diabetes após a terapia periodontal básica; foi possível identificar genes diferencialmente expressos em sítios ativos de ambos os grupos, que podem ser úteis na indicação de potenciais biomarcadores para diagnóstico da doença periodontal na fase ativa; as proteínas salivares analisadas mostram uma tendência em diferenciar o padrão de saúde e de doença, podendo ser futuramente utilizadas como potenciais biomarcadores de periodontite associada ou não ao diabetes. / The overall aim of this study was to monitor the periodontal disease activity and suggest potential salivary biomarkers related to this activity in chronic periodontitis patients with or without type 2 Diabetes mellitus (DM), based on the evaluation of gene expression profile of progressive periodontal sites and salivary inflammatory proteins. Fifty-six patients were enrolled, 21 with chronic periodontitis (PD group), 20 with chronic periodontitis and DM (PD+DM group) and 15 periodontal- and systemically healthy (control). Radiographs were taken before and two months after non-surgical periodontal therapy, and radiographic subtraction was performed from pairs of these radiographs. Measurements of the areas with density loss were recorded. Unstimulated saliva collection, glycated hemoglobin (HbA1c) measurement and periodontal examination probing pocket depth (PPD), relative clinical attachment level (rCAL), bleeding on probing (BOP) and plaque index (PI) were also conducted before and two months after non-surgical periodontal therapy. The periodontal sites with progressive attachment loss 1 mm at the recall visit were considered active sites according to the adapted method of tolerance. Gingival biopsies of active and non-active sites with similar clinical parameters were harvested for gene expression analysis of the immune-inflammatory response with Real Time PCR Array. Saliva samples were analyzed by Multiplex Cytokine Profiling Immunoassay for analysis of protein expression profile. In PD group, 9% of the sites were classified as active and in PD+DM group, 12% (p > 0.05). The clinical attachment loss mean was higher in the PD+DM group (1.34±0.23 mm) compared to the PD group (1.21±0.16 mm) (p < 0.05). There was a correlation between clinical attachment loss and darkened radiographic areas in active sites of the PD group (R = 0.79, p = 0.001) and PD+DM group (R = 0.86, p < 0.001). Both PD and PD+DM groups showed a down-regulated profile compared to healthy subjects (control group). When compared PD group to PD+DM, patients with diabetes had an upregulated profile. Active sites of the PD group showed nine genes (ABCF1, CD40LG, IL10, IL5, CCR2, CCR4, CCR7, CCL18 and CXCL1) differentially expressed (p < 0.05) with an up-regulated profile. Active sites of the PD+DM group showed six genes (LTA, CXCR1, CCL19, CCL8, CCL17 and CXCL12) differentially expressed (p < 0.05) with an up-regulated profile. After non-surgical periodontal therapy, there was a significant reduction of clinical parameters and HbA1c levels (p < 0.05), accompanied by a reduction of some salivary proteins (IL1b, IL1ra, IL10, IL17, TGFb, IL8, eotaxin and MCP-3) in groups PD and PD+DM, but without statistically significant difference (p > 0.05). In conclusion, this study was able to monitor the periodontal disease activity in periodontal patients with or without diabetes after the non-surgical periodontal therapy; it was possible to identify genes differentially expressed in active sites from both groups, which may be considered useful in indicating potential biomarkers for the diagnosis of active periodontal disease; salivary proteins show a trend in distinguishing the standard of health and disease and may be used in the future as potential biomarkers of periodontitis with or without diabetes.

Orientador: Ana Lia Anbinder / Banca: Maria Aparecida Neves Jardini / Banca: Lucilene Fernandes Ricardo / Resumo: A doença periodontal (DP) é caracterizada pela destruição dos tecidos de proteção e suporte dentário, osso alveolar, ligamento periodontal, cemento e gengiva, e é a principal causa de perda dentária na população adulta, um grande problema socioeconômico e de saúde pública. Com o aumento da resistência antibiótica, existe interesse no uso de outras substâncias para o combate de doenças infecciosas, como os probióticos. O uso de probióticos na prevenção e tratamento de doença periodontal em animais tem apresentado bons resultados. O estudo dos efeitos do Lactobacillus reuteri viável e inativado (paraprobiótico) pode esclarecer mecanismos de ação e possibilitar o uso comercial de outras preparações, dado que os paraprobióticos teriam produção facilitada. O objetivo deste trabalho foi analisar os efeitos de L. reuteri, viável e inativado, em doença periodontal induzida em ratos. Foram utilizados 32 ratos machos, divididos em 4 grupos: (1) Grupo Controle: com saúde periodontal (n=8); (2) Grupo LIP: periodontite induzida (n=8); (3) Grupo LIP/PRO: periodontite induzida e probiótico (n=8); e (4) Grupo LIP/PARAPRO: periodontite induzida e paraprobiótico (n=8). A indução da doença periodontal foi realizada com a inserção de fio de algodão ao redor dos primeiros molares inferiores e foi realizado o tratamento com L. reuteri viável ou inativado pelo calor, via oral, diariamente, 30 dias antes da ligadura e 14 dias após, quando ocorreu a eutanásia. As hemimandíbulas direitas foram removid... (Resumo completo, clicar acesso eletrônico abaixo) / Periodontal disease (PD) is characterized by the destruction of dental protection and support tissues, alveolar bone, periodontal ligament, cementum and gingiva, and is the major cause of tooth loss in the adult population, a major socioeconomic and public health problem. With the increase of antibiotic resistance, there is interest in the use of other substances to combat infectious diseases, such as probiotics. The use of probiotics in the prevention and treatment of periodontal disease in animals has shown good results. The study of the effects of viable and inactivated Lactobacillus reuteri (paraprobiotic) can clarify mechanisms of action and enable the commercial use of other preparations, since paraprobiotics would have facilitated production. The aim of this study was to evaluate the effects of viable and inactivated L. reuteri on induced periodontal disease in rats. Thirty-two male rats were divided into four groups: (1) Control group: with periodontal health (n = 8); (2) LIP group: induced periodontitis (n = 8); (3) LIP/PRO group: induced periodontitis and probiotic (n = 8); and (4) LIP/PARAPRO group: periodontitis induced and paraprobiotic (n = 8). Induction of periodontal disease was performed with the insertion of cotton thread around the lower first molars and treatment was performed with viable or heatinactivated L. reuteri daily, 30 days prior to ligation and 14 days later, when euthanasia occurred. The right hemimandible were removed and submitted to radiographic analysis for quantification of the bone support. A computerized microtomography was performed to evaluate the alveolar microarchitecture in the first molar region. The use of paraprobiotic led to a higher percentage of weight gain when compared to other treatments. In the radiographic and microtomographic analyzes, the efficacy of the DP induction was verified, with a significant difference... (Complete abstract click electronic access below) / Mestre

Periodontal diseases (PD) affect 46% of American adults over age 30. These diseases cause symptoms including bleeding and swelling of the gums, bone resorption, and tooth loss, that affect quality of life and have a high economic burden. Periodontal diseases are caused by an imbalance in the oral microbiome, from a healthy state that contains anti-inflammatory commensals like Streptococcus gordonii and mitis, to a diseased state that has pro-inflammatory anaerobic pathogens including Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, and Tannerella forsythia. The latter initiate disease progression in the oral cavity. However, it’s the host immune response that causes a majority of the symptoms. Ideally, treatment for PD would be approached from both sides to reduce the numbers of pro-inflammatory bacterial cells in the oral cavity but also reduce the host immune response. A novel therapeutic, amixicile, has been created, which specifically targets anaerobes through the pyruvate:ferredoxin oxidoreductase (PFOR) system, the mechanism of energy metabolism found in anaerobic organisms. Our studies show that amixicile inhibits in vitro growth of oral anaerobes in monospecies cultures at concentrations as low as 0.5 µg/mL in broth and 1 µg/mL in biofilms, without affecting the Gram-positive commensal species. In multispecies cultures, amixicile specifically inhibited anaerobes, even in biofilms, with the concentration as low as 5 µg/mL in broth and 10 µg/mL in biofilms. By not affecting the commensal bacteria, we think this treatment could restore a healthy oral microbiome. Aside from the bacterial presence, the host response, particularly the innate immune response is not well understood. Using a Drosophila melanogaster infection model, we elucidated the innate immune response to both mono- and multispecies infections. The 7-Species infection included bacteria mentioned above and Aggregatibacter actinomycetemcomitans in order to replicate in vivo-like disease conditions. We determined that both Drosophila Toll and Imd pathways, which mimic TLR/IL-1 and TNF signaling pathways of mammalian innate immunity respectively, respond to the 7-Species challenge. We also verified virulent bacteria in Drosophila, including P. gingivalis and P. intermedia. Future directions include RNA sequencing to determine the full scope of immune gene expression and using human immune cells to further clarify the response.

Periodontitis is an inflammatory disease of the oral cavity induced by anaerobic bacteria, that remains to be the primary cause of tooth loss in adults worldwide. Finding an anti-microbial therapeutic to selectively target periodontal pathogens has proven to be difficult, and current treatment modalities only provide a transient benefit. Amixicile is a non-toxic, readily bioavailable novel antimicrobial that targets strict anaerobes through inhibition of the activity of Pyruvate Ferredoxin Oxidoreductase (PFOR), a major enzyme mediating oxidative decarboxylation of pyruvate, a critical step in metabolism. Our study aimed to evaluate the efficacy of amixicile in inhibiting the growth of bacteria harvested from the complex sub-gingival biofilm of patients with chronic periodontitis. We hypothesize that amixicile will selectively inhibit pathogenic anaerobic bacteria collected from patients, with the same efficacy as metronidazole, the current accepted treatment modality. Plaque samples were harvested from patients with severe chronic periodontitis and cultured under anaerobic conditions. The microbiomes were grown in the presence of amixicile and metronidazole and the growth was compared to that of bacteria grown in the absence of the antimicrobials. Following 24 hour incubation, bacterial DNA was isolated and bacterial quantity was evaluated by quantitative PCR (qPCR) using primers specific for 12 bacterial species: P. gingivalis (Pg), P. intermedia (Pi), F.nucleatum (Fn), S.gordonii (Sg), S. anginosus (Sa), V. atypical (Va), L. acidophilus (La), A.actinomycetemcomitans (Aa), T.denticola (Td), S.mutans (Sm), S.sanguis (Ss), and 16s. Individual qPCR runs were combined to represent an overall average of CT value differences. Amixicile treatment groups exhibited statistical significant reductions (PP. intermedia, F. nucleatum and Veillonella atypical. When comparing amixicile to metronidazole, amixicile performed with similar efficacy with the largest effect seen for PFOR bacteria. Our conclusion supports amixicile as a potent inhibitor of anaerobic bacteria, and could be a potential new therapeutic antimicrobial in the treatment of periodontal disease

Background: In this study, we enhanced a diagnostic questionnaire which had been previously developed to measure stress and social support. Methods: 101 patients with chronic periodontitis and 50 healthy control subjects completed our questionnaire package after which we analyzed the data for trends and associations. Results: Our enhanced questionnaire provided a valid and reliable measure of stress and social support in patients with chronic periodontitis. Conclusion: Our enhanced questionnaire provided both a valid and a reliable measure of stress and social support in patients with chronic periodontitis however requires further refinement to predict periodontal disease experience and severity.