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Andrucioli MCD, Ferreira Amato PA, Kuchler ÉC, Matsumoto MAN, Bergamo AZN, Silva RABD, Silva LABD, Nelson-Filho P. Effect of chlorhexidine mouthwashes on periodontal parameters and extrinsic tooth staining in orthodontic patients. Am J Orthod Dentofacial Orthop 2023; 164:855-861. [PMID: 37642605 DOI: 10.1016/j.ajodo.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Periodontal health and biofilm control are primordial to success in orthodontic treatment. This study aimed to evaluate the effect of chlorhexidine (CHX) mouthwashes on periodontal status and extrinsic tooth staining in orthodontic patients. METHODS Thirty-three patients of both sexes, aged 11-33 years, under orthodontic treatment with fixed appliances at <16 months, were randomly distributed into 2 groups. In the control group, patients received mechanical hygiene instruction, and in the experimental group, patients also used CHX wash twice a week for 60 days. The effectivity of the protocols was evaluated using the plaque, gingival, gingival bleeding, and discoloration indexes before the hygiene protocol was applied, 15, 30, and 60 days after protocol implementation. RESULTS In the experimental group, there was a decrease in the plaque, gingival, and gingival bleeding indexes at the different evaluation periods (P <0.05). In addition, there was a significant difference in the discoloration index at 60 days compared with initial time points after implementing hygiene protocols in the experimental group (P <0.05). In contrast, there were no significant differences in plaque, gingival, gingival bleeding, and discoloration indexes in the control group at any time (P >0.05). CONCLUSIONS CHX mouthwash administered 30 days, twice a week, significantly improved the periodontal status with mild brown staining. After this period, expressive extrinsic tooth staining was observed.
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Affiliation(s)
| | | | - Érika Calvano Kuchler
- Department of Orthodontics, University Medical Centre of Regensburg, Regensburg, Germany
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Ana Zilda Nazar Bergamo
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Léa Assed Bezerra da Silva
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Nelson-Filho P, Perdiza M, Ribeiro YJS, Saraiva MDCP, Neuppmann Feres MF, Feres M, Delgado RZR, Silva RAB, Silva LAB. Assessment of microbial contamination in removable orthodontic appliances with and without the use of antimicrobial agents by checkerboard DNA-DNA hybridization analysis. Am J Orthod Dentofacial Orthop 2023; 164:593-601. [PMID: 37306639 DOI: 10.1016/j.ajodo.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This clinical, crossover, double-blind trial evaluated the microbial contamination of removable orthodontic appliances used by children and the efficacy of 0.12% chlorhexidine gluconate spray use for disinfection. METHODS Twenty children aged 7-11 years were instructed to wear removable orthodontic appliances for 1 week. They were instructed to use a placebo solution (control) or 0.12% chlorhexidine gluconate (experimental) to clean the appliances on days 4 and 7 after installation. After this period, the microbial contamination on the surfaces of the appliance was analyzed using checkerboard DNA-DNA hybridization for 40 bacterial species. Data were analyzed by Fisher exact, t, and Wilcoxon tests (α = 0.05). RESULTS Removable orthodontic appliances were heavily contaminated by the target microorganisms. Streptococcus sanguinis, Streptococcus oralis, Streptococcus gordonii, and Eikenella corrodens were found in 100% of the appliances. Among cariogenic microorganisms, Streptococcus mutans and Streptococcus sobrinus were more abundant than Lactobacillus acidophilus and Lactobacillus casei. Red complex pathogens were more abundant than orange complex species. Purple complex bacteria were the most prevalent among bacterial complexes not associated with specific pathologies, detected in 34% of the samples. After the use of chlorhexidine, the number of cariogenic microorganisms (S. mutans, S. sobrinus, and L. casei) decreased significantly (P <0.05), and the numbers of periodontal pathogenic species from the orange and red complex also decreased significantly (P <0.05). There was no reduction for Treponema socranskii. CONCLUSIONS Removable orthodontic appliances were densely contaminated by several bacterial species. Twice-a-week application of chlorhexidine spray effectively reduced cariogenic and orange and red complex periodontal pathogens.
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Affiliation(s)
- Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
| | - Marcela Perdiza
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Yuri Jivago Silva Ribeiro
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Murilo Fernando Neuppmann Feres
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Magda Feres
- Department of Periodontology, Division of Dentistry Research, University of Guarulhos, Guarulhos, São Paulo, Brazil
| | - Renata Zoraida Rizental Delgado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lea Assed Bezerra Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Ribeiro YJS, Delgado RZR, Paula-Silva FWG, Rematal-Valdes B, Feres MG, Palma-Dibb RG, Faraoni JJ, Segato RAB, Silva LABD, Queiroz AMD, Nelson Filho P. Sports mouthguards: Contamination, roughness, and chlorhexidine for disinfection - A randomized clinical trial. Braz Dent J 2022; 32:66-73. [PMID: 35019020 DOI: 10.1590/0103-6440202104533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/08/2021] [Indexed: 05/31/2023] Open
Abstract
The aim of the present in vivo study was to evaluate the bacterial contamination of sports mouthguards, surface roughness, and the efficacy of chlorhexidine gluconate spray in the disinfection of these devices. A randomized, blinded cross-over clinical trial was performed with twenty 9 to 13 years old children who practiced martial arts and participated in all phases of the study. They were instructed to wear mouthguards 3 alternated days a week for 1 hour and, after use, to spray sterile tap water or chlorhexidine 0.12%. The mouthguards were analyzed by MTT assay, Checkerboard DNA-DNA hybridization, and confocal laser microscopy prior and after use for 2 weeks. Data were analyzed by Wilcoxon and t-Student, and Pearson correlation tests, with 5% significance level. Were observed that mouthguards of the control group were more contaminated with cariogenic microorganisms than those of the chlorhexidine group (p<0.05). The mouthguards use of spray of chlorhexidine reduced significantly the bacteria contamination compared with control group (p = 0.007). The surface roughness of the mouthguards increased significantly after use, irrespective of application of chlorhexidine spray. A moderate correlation (r=0.59) was observed between surface roughness and the cariogenic microorganism's contamination only for control group. Sports mouthguards had intense microbial contamination and increased surface roughness after its use. The use of chlorhexidine spray was effective for reducing the mouthguards contamination used by children.
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Affiliation(s)
- Yuri Jivago Silva Ribeiro
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata Zoraida Rizental Delgado
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Belen Rematal-Valdes
- Professor of Periodontology, Department of Periodontology - Division of Dentistry Research, University of Guarulhos, Guarulhos, São Paulo, Brazil
| | - Magda Gomes Feres
- Professor of Periodontology, Department of Periodontology - Division of Dentistry Research, University of Guarulhos, Guarulhos, São Paulo, Brazil
| | - Regina Guenka Palma-Dibb
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Juliana Jendiroba Faraoni
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Raquel Assed Bezerra Segato
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Lea Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alexandra Mussolino de Queiroz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Paulo Nelson Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Feres MFN, Vicioni-Marques F, Romano FL, Roscoe MG, Souza VMD, Torneri AL, Bueno-Silva B. Streptococcus mutans adherence to conventional and self-ligating brackets: an in vitro study. Dental Press J Orthod 2021; 26:e212019. [PMID: 34932711 PMCID: PMC8690864 DOI: 10.1590/2177-6709.26.6.e212019.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/31/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Although self-ligating brackets presumably provide better hygiene conditions, no consensus has been reached so far. OBJECTIVE Therefore, the objective of this study was to evaluate, in an in vitro experimental design, the adherence of Streptococcus mutans (SM) in self-ligating and conventional brackets of different manufacturers and ligature types. METHODS Four commercial brands of maxillary premolar metal brackets were tested (Abzil®; Morelli®; 3M Unitek®; and GAC®). Each one was subdivided into three groups, which varied according to the type of ligature and bracket model (metallic, elastic, and self-ligating), totalizing twelve groups, composed of six brackets each. Previously sterilized brackets were initially immersed in saliva for one hour, and subsequently washed and added in a bacterial suspension, maintained in aerobiosis for 72 hours. The adhered bacteria were then separated and quantified by colony forming units (CFU/mL) counting after 48 hours of growth. The groups were compared by Kruskal-Wallis and Dunn post-hoc tests (p< 0.05). RESULTS Regardless of the commercial brand, self-ligating brackets had significantly less CFU/mL. However, according to comparisons performed within each commercial brand, only Abzil® self-ligating brackets had significantly lower biofilm adhesion. Among all of the self-ligating models, GAC® brackets presented the highest bacterial adhesion rate. CONCLUSIONS Self-ligating brackets are likely to present lower rates of biofilm adhesion. Particularly, Abzil® and GAC® self-ligating brackets are less likely to accumulate biofilm. Although such results are derived from an in vitro study, practitioners might acknowledge findings concerning bacterial adhesion as one of the relevant features to be considered during bracket selection.
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Affiliation(s)
- Murilo Fernando Neuppmann Feres
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Fernanda Vicioni-Marques
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Fábio Lourenço Romano
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil (Ribeirão Preto/SP, Brazil)
| | - Marina Guimarães Roscoe
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Biomateriais e Biologia Oral (São Paulo/SP, Brazil)
| | | | - Aline Lira Torneri
- Universidade de Guarulhos, Programa de Pós-Graduação, Mestrado em Ortodontia (Guarulhos/SP, Brazil)
| | - Bruno Bueno-Silva
- Universidade de Guarulhos, Programa de Pós-Graduação, Mestrado em Ortodontia (Guarulhos/SP, Brazil)
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Alteration of the oral microbiota may be a responsible factor, along with estrogen deficiency, by the development of larger periapical lesions. Clin Oral Investig 2020; 25:3651-3662. [PMID: 33188615 DOI: 10.1007/s00784-020-03688-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/06/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To answer the questions: (1) Does reducing estrogen levels influence the microbial composition of the oral cavity? (2) Does the presence of periapical lesion (PL) cause changes in the oral microbiota? (3) Since estrogen deficiency alters the oral microbiota, can this be one of the factors that contribute to the increase of the PL? MATERIALS AND METHODS Thirty-six rats were divided into four groups: sham (control), ovariectomy (OVX), control with PL (Sham + PL), and OVX + PL. After 9 weeks of OVX, the lower first molars were submitted to PL induction. After 21 days, the microbiological collection of the oral cavity was performed, and the animals were euthanized. The contents were evaluated by the checkerboard DNA-DNA hybridization method, to verify the prevalence of 40 bacterial species (divided into 7 microbial complexes). The blocks containing the lower first molars were submitted to histotechnical processing and staining with hematoxylin and eosin (HE), for the measurement of the periapical lesion area. The results were submitted to ANOVA and Kruskal-Wallis tests and Tukey and Dunn post-tests, with a significance level of 5%. RESULTS In conditions of estrogen deficiency, there was alteration of the oral microbiota. The OVX groups had a higher amount of bacteria compared to the SHAM group in most of the microbial complexes (p < 0.001). The animals in the control group (with or without lesion) did not present a statistically significant difference (p > 0.001) in any of the microbial complexes. The PLs in OVX animals were significantly higher compared to SHAM animals (p < 0.001). CONCLUSIONS Hypoestrogenicity conditions interfere in the oral microbiota by increasing the amount of bacteria in the saliva and influencing the progression of periapical lesions. CLINICAL RELEVANCE This inedited study shows that deficiency of estrogen leads to alteration of the oral microbiota.
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Saravia ME, da Silva LAB, da Silva RAB, Cudmani NM, Tineo S, Hillen NE, Lucisano MP, de Queiroz AM, Emilson CG, Nelson-Filho P. Morphological identification of Streptococcus mutans and Streptococcus sobrinus in SB-20M culture medium has efficiency comparable to proteomic identification by the MALDI-TOF mass spectrometry technique. Arch Oral Biol 2019; 110:104595. [PMID: 31733583 DOI: 10.1016/j.archoralbio.2019.104595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/08/2019] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The objective of this study was to evaluate the efficiency of SB-20 M culture medium to perform differential morphological identification of S. mutans and S. sobrinus compared to biochemical identification and to proteomic identification by the MALDI-TOF mass spectrometry technique. MATERIAL AND METHODS Unstimulated saliva samples from 266 dental students were seeded on SB-20 M culture medium by the wooden spatula technique. After incubation, S. mutans and S. sobrinus colonies were identified by stereomicroscopy based on their differential morphological characteristics. Following these procedures, 135 colonies with characteristic morphology of S. mutans (89 colonies) and S. sobrinus (46 colonies) were randomly selected, submitted to biochemical identification (biotyping) and proteomic identification by the MALDI-TOF mass spectrometry technique. The results were compared using the Kappa test, with a 5% significance level. RESULTS All (100%) S. mutans colonies were correctly identified after culture in SB-20 M medium compared to biotyping and proteomic identification. For S. sobrinus, morphological identification in SB-20 M medium was correct for 43 colonies (93.5%) compared to biotyping and proteomic identification. However, there was no statistically significant difference when comparing the capacity to identify S. mutans and S. sobrinus of the three techniques (p < 0.001; K = 0.951). CONCLUSIONS It was concluded that the SB-20 M culture medium for morphological identification of S. mutans and S. sobrinus was highly reliable, being comparable to the MALDI-TOF mass spectrometry technique. CLINICAL RELEVANCE The efficiency evaluation of identification methods of S. mutans and S. sobrinus is clinically relevant in order to determine caries risk and activity of patients.
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Affiliation(s)
- Marta Estela Saravia
- Department of Preventive Dentistry, School of Dentistry, National University of Tucuman, San Miguel de Tucuman, Tucumán, Argentina
| | - Lea Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Raquel Assed Bezerra da Silva
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Norma Mercedes Cudmani
- Department of Preventive Dentistry, School of Dentistry, National University of Tucuman, San Miguel de Tucuman, Tucumán, Argentina
| | - Silvina Tineo
- Department of Preventive Dentistry, School of Dentistry, National University of Tucuman, San Miguel de Tucuman, Tucumán, Argentina
| | - Norma Elena Hillen
- Department of Preventive Dentistry, School of Dentistry, National University of Tucuman, San Miguel de Tucuman, Tucumán, Argentina
| | - Marília Pacífico Lucisano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | - Alexandra Mussolino de Queiroz
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Claes-Göran Emilson
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Hepyukselen BG, Cesur MG. Comparison of the microbial flora from different orthodontic archwires using a cultivation method and PCR: A prospective study. Orthod Craniofac Res 2019; 22:354-360. [PMID: 31294901 DOI: 10.1111/ocr.12335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/02/2019] [Accepted: 07/07/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of superelastic nickel-titanium (SE NiTi), copper-nickel-titanium (CuNiTi) and titanium-molybdenum alloy (TMA) archwires with different surface properties on dental plaque retention and microbial colonization. SETTING AND SAMPLE POPULATION Totally 25 individuals, consisting of 16 girls and nine boys with mean age of 15.69 ± 1.70, were included in this study. MATERIAL AND METHODS The effects of the SE NiTi, CuNiTi and TMA archwires with different surface properties on the amount of Streptoccocus sp and Lactobacillus sp were investigated with three different parameters including clinical periodontal indexes, microbial swab and archwire samples. Phenotypic isolation was performed from microbial swab and archwire samples using culture method; genotypic isolations were performed by the polymerase chain reaction method. RESULTS There was no statistically significant difference between SE NiTi, CuNiTi and TMA archwires in terms of periodontal parameters (P > .05). When microbial swabs and archwires samples from different archwire groups were evaluated by culture method, no statistically significant difference was found between the groups (P > .05). A statistically significant difference was found between the amount of Lactobacillus sp in the swab samples of the CuNiTi archwire after the purification period (P = .023). S mutans were found to be more quantity than other bacterial types in all archwires. CONCLUSION The amount of microbial involvement was found to be lower in CuNiTi archwires than in the post-purification period. This may be due to the antimicrobial effect of copper.
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Affiliation(s)
| | - Mine Gecgelen Cesur
- Department of Orthodontics, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
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Bergamo AZN, de Oliveira KMH, Matsumoto MAN, Nascimento CD, Romano FL, da Silva RAB, da Silva LAB, Nelson-Filho P. Orthodontic appliances did not increase risk of dental caries and periodontal disease under preventive protocol. Angle Orthod 2018; 89:25-32. [PMID: 30239218 DOI: 10.2319/022118-139.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES To assess periodontal parameters and microbial species levels after orthodontic appliance placement in patients who received oral hygiene instructions and who were monitored and motivated throughout the study. MATERIALS AND METHODS The Periodontal Index was recorded and saliva collection was performed before (T0) and 30 (T1), 60 (T2), and 90 (T3) days after orthodontic appliance placement in 15 patients (mean age 17.53 ± 8.0 years). Analysis was carried out using checkerboard DNA-DNA hybridization. Nonparametric statistical analysis was performed. RESULTS The Periodontal Index did not change. The total amount of the purple and red complexes and Candida species showed a significant decrease from T2. The green, yellow, and orange complex showed a significant decrease at T3. The specific species analysis showed that Prevotella nigrescens, Pseudomonas putida, Fusobacterium periodonticum, Pseudomonas aeruginosa, Peptostreptococcus anaerobius, and Tanerella forsythia showed high incidence before bonding, and their levels decreased at T2 and T3. Only Porphyromonas gingivalis showed increased levels at T2 and displayed the highest level at T3. The Streptococcus group decreased their levels from T2 onward. CONCLUSIONS A dynamic change in microbial levels was identified. The decrease in the levels of complexes present was only possible due to the mechanical method of oral hygiene implemented in this sample.
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Andrucioli MCD, Matsumoto MAN, Saraiva MCP, Feres M, Figueiredo LCD, Sorgi CA, Faccioli LH, Silva RABD, Silva LABD, Nelson-Filho P. Successful and failed mini-implants: microbiological evaluation and quantification of bacterial endotoxin. J Appl Oral Sci 2018; 26:e20170631. [PMID: 29995147 PMCID: PMC6025887 DOI: 10.1590/1678-7757-2017-0631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/23/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives Using two groups of mini-implants (successful and failed) the objectives of this in vivo study were: to evaluate the microbial contamination by the checkerboard DNA-DNA hybridization technique and to quantify the bacterial endotoxin by the limulus amebocyte lysate assay. Material and Methods The 15 successful and 10 failed mini-implants (1.6 mm diameter × 7.0 or 9.0 mm long), placed in the maxilla and/or mandible, were obtained from 15 patients undergoing orthodontic treatment. Data were analyzed statistically by the Wilcoxon rank-sum test using the SAS software (a=0.05). Results All 40 microbial species were detected in both groups of mini-implants, with different frequencies. No differences were observed between the groups with respect to microbial complexes (blue, purple, yellow, green, orange, red and other species) and endotoxin quantification (p>0.05). Conclusion Neither microbial contamination nor endotoxin quantification was determinant for the early loss of stability of the mini-implants.
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Affiliation(s)
- Marcela Cristina Damião Andrucioli
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Mírian Aiko Nakane Matsumoto
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Maria Conceição Pereira Saraiva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Magda Feres
- Universidade de Guarulhos, Divisão de Pesquisa Odontológica, Departamento de Periodontia, Guarulhos, São Paulo, Brasil
| | | | - Carlos Artério Sorgi
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, São Paulo, Brasil
| | - Lucia Helena Faccioli
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, São Paulo, Brasil
| | - Raquel Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Lea Assed Bezerra da Silva
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
| | - Paulo Nelson-Filho
- Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Departamento de Clínica Infantil, Ribeirão Preto, São Paulo, Brasil
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Shirozaki MU, Ferreira JTL, Küchler EC, Matsumoto MAN, Aires CP, Nelson-Filho P, Romano FL. Quantification of Streptococcus mutans in Different Types of Ligature Wires and Elastomeric Chains. Braz Dent J 2017; 28:498-503. [PMID: 29160403 DOI: 10.1590/0103-6440201601401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 03/13/2017] [Indexed: 11/22/2022] Open
Abstract
This study aimed to test the hypothesis that Streptococcus mutans contamination levels differ according to the type of the orthodontic ligature. Thirteen patients were selected. Each quadrant was randomly subjected to one of the following ligature-use protocols: I) elastomeric chain, II) steel ligature crossed over the archwire, III) steel ligature crossed under the archwire, and IV) steel ligature in a figure-eight pattern under the archwire. After seven days, the devices were removed and the Streptococcus mutans colony-forming unit count per mg of biofilm weight was determined. Twelve specimens (n=3) were also processed for scanning electron microscopy analysis. ANOVA and Tukey-Kramer test were used for comparisons to assess S. mutans differences between groups at a 5% significance level. There was no statistical difference in detectable levels of S. mutans among the groups (p=0.294). Scanning electron microscopy results showed abundant biofilms and microbial contamination in all groups. In conclusion, S. mutans contamination levels are similar in the different orthodontic ligatures.
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Affiliation(s)
- Mariana Umekita Shirozaki
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo Ribeirão Preto, SP, Brazil
| | - José Tarcísio Lima Ferreira
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo Ribeirão Preto, SP, Brazil
| | - Erika Calvano Küchler
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo Ribeirão Preto, SP, Brazil
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo Ribeirão Preto, SP, Brazil
| | - Carolina Patrícia Aires
- Department of Physics and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, USP - University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo Ribeirão Preto, SP, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, USP - Universidade de São Paulo Ribeirão Preto, SP, Brazil
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Influence of pre-irradiation time employed in antimicrobial photodynamic therapy with diode laser. Lasers Med Sci 2017; 33:67-73. [PMID: 28963589 DOI: 10.1007/s10103-017-2336-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/22/2017] [Indexed: 12/12/2022]
Abstract
The aim of the present study was to evaluate, in vitro, the effect of different pre-irradiation times of the photosensitizer in photodynamic therapy in biofilms formed by Streptococcus mutans and Candida albicans, through the evaluation of the microbial load. The factors under study were as follows: times of pre-irradiation of the photosensitizer in three levels (1, 2, or 5 min). For the control of the cariogenic dental biofilm with antimicrobial photodynamic therapy (aPDT), methylene blue (0.01%) was used in association with the diode laser (InGaAlP) with a wavelength of 660 nm. Chlorhexidine digluconate (0.12% CHX) and saline were used as positive and negative controls, respectively. The study design was carried out in complete and randomized blocks. The sample consisted of 15 S. mutans biofilms cultures, randomly divided into five groups and 15 C. albicans cultures, also divided into five groups. The experiment was performed in triplicate (n = 3) and the response variables were obtained through quantitative analysis of bacterial viability, expressed in colony-forming units (CFU) per square millimeter of the specimen area. The data were analyzed with the aid of the ANOVA one-way test and Tukey's post-test. All analyses were performed using the Graph Pad Prism 4.0 program, with a significance level of 5%. For the S. mutans group, only the saline solution presented a statistically significant difference when compared to the other treatments (p < 0.05), that is, the treatment with aPDT, irrespective of the irradiation time applied, was similar to the treatment with CHX and both were more effective in reducing cariogenic biofilm compared to saline. For the group of C. albicans, there was no statistical difference between the groups (p > 0.05). Therefore, it can be concluded that the treatment with aPDT reduced the number of CFUs of S. mutans in a similar way to CHX, independently of the pre-irradiation time applied. No effect of this therapy or of the different pre-irradiation times on the C. albicans biofilm could be observed. In this way, the pre-irradiation time of 1 min can be used to reduce the microbial load of S. mutans.
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Al-Bazi SM, Abbassy MA, Bakry AS, Merdad LA, Hassan AH. Effects of chlorhexidine (gel) application on bacterial levels and orthodontic brackets during orthodontic treatment. J Oral Sci 2017; 58:35-42. [PMID: 27021538 DOI: 10.2334/josnusd.58.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The objectives of this study were to evaluate the effects of applying 0.50% chlorhexidine (CHX) gel using the dental drug delivery system (3DS) on salivary Streptococcus mutans (S. mutans) and on the surface topography of metal and ceramic orthodontic brackets. The study involved 20 orthodontic patients with high levels of salivary S. mutans. The patients were treated with professional mechanical tooth cleaning followed by application of 0.50% CHX using individual trays (3DS). Salivary S. mutans levels were repeatedly measured 1, 2, 4, and 8 weeks post-treatment. In vitro study utilized forty ceramic and metallic brackets that were immersed in 0.50% CHX gel for 10 min, whereas another untreated forty brackets served as controls. The frictional resistances of stainless steel wires to the brackets before and after CHX treatment were recorded using a universal testing machine. Scanning electron microscopy was used to compare changes in the surface topography of brackets. Statistical analyses were used to determine the effect of CHX on bacterial count and to evaluate the effect of CHX on frictional resistance. According to the results of this study, S. mutans levels were reduced significantly (P < 0.05). There were no significant changes in the frictional resistance and surface topography of brackets before or after application of CHX. (J Oral Sci 58, 35-42, 2016).
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Affiliation(s)
- Samar M Al-Bazi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University
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Bagatin CR, Andrucioli MCD, Ferreira JTL, Matsumoto MAN, da Silva RAB, da Silva LAB, Romano FL, Nelson-Filho P. Biofilm formation in Haas palatal expanders with and without use of an antimicrobial agent: an in situ study. Microsc Res Tech 2016; 80:471-477. [PMID: 27935660 DOI: 10.1002/jemt.22817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/19/2016] [Accepted: 11/20/2016] [Indexed: 11/12/2022]
Abstract
Orthodontic appliances causes specific alterations in oral environment, including reduction of pH, increase of dental biofilm and elevation of salivary microbial levels, causing an increased risk for dental caries. This study evaluated, using microbial culture and scanning electron microscopy (SEM), the in situ contamination by mutans streptococci (MS) of different surfaces of Haas palatal expanders with and without use of chlorhexidine gluconate mouthrinses (CHX). Thirty-four patients were randomly assigned to two groups (n = 17/group), using placebo (Group I) and 0.12% CHX (Group II-Periogard® ) mouthrinses twice a week. After 4 months, appliances were submitted to microbiological processing and after fragments were analyzed by SEM. Mann-Whitney U test (α = 5%) was used to assess differences between groups on the appliances' different surfaces and to compare the contamination on the free and nonfree surfaces of these components. There was no difference (p = 0.999) between groups regarding the number of MS colonies/biofilms on the nonfree surfaces, which showed intense contamination. However, free surfaces of Group II presented less contamination (p < 0.001) than those of Group I in all appliances' components. Results of the microbial culture were confirmed by SEM. Use of 0.12% CHX was effective in reducing the formation of MS colonies/biofilms on free surfaces of Haas expanders, in situ.
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Affiliation(s)
- Cristhiane Ristum Bagatin
- Department of Pediatric Clinic School of Dentistry of Ribeirão Preto, University of São Paulo, SP, Brazil
| | | | | | | | | | - Lea Assed Bezerra da Silva
- Department of Pediatric Clinic School of Dentistry of Ribeirão Preto, University of São Paulo, SP, Brazil
| | - Fábio Lourenço Romano
- Department of Pediatric Clinic School of Dentistry of Ribeirão Preto, University of São Paulo, SP, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinic School of Dentistry of Ribeirão Preto, University of São Paulo, SP, Brazil
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Bergamo AZN, Nelson-Filho P, Andrucioli MCD, do Nascimento C, Pedrazzi V, Matsumoto MAN. Microbial complexes levels in conventional and self-ligating brackets. Clin Oral Investig 2016; 21:1037-1046. [PMID: 27270902 DOI: 10.1007/s00784-016-1865-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 05/26/2016] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The aims were to evaluate the levels of bacterial species in saliva and in situ and to assess whether the design of brackets influences the risk of developing periodontal disease. MATERIALS AND METHODS Twenty patients (13.3 mean age) were bonded with self-ligating brackets and a conventional bracket. Saliva was collected before bonding and 30 and 60 days after bonding. One sample of each bracket was removed 30 and 60 days after bonding. The analysis was determined by checkerboard DNA-DNA hybridization. The data was evaluated by the non-parametric test. RESULTS A significant increase in the levels of bacterial species in the saliva occurred in 15 of the 22 analyzed species. The self-ligating brackets presented the highest incidence percentages for the orange and red complexes 60 days after bonding. In situ analyses showed different patterns according to the bracket design. The levels of Campylobacter rectus showed significant differences (p = 0.011) 60 days after bonding among the three brackets; the highest values were observed in the In-Ovation®R bracket. CONCLUSIONS The bracket design seems to influence the levels of bacterial species involved in periodontal disease. Considering the wide variety of bacterial species, additional studies are needed to aid in the establishment of effective protocols to prevent the development of periodontal disease during orthodontic treatment. CLINICAL RELEVANCE A dynamic alteration in the oral microbiota may lead to inflammatory reactions in the supporting soft and hard tissues. The different types of brackets interfere with bacterial adherence. Bracket design should be considered in orthodontic treatment.
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Affiliation(s)
- Ana Zilda Nazar Bergamo
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil.
| | - Paulo Nelson-Filho
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil
| | - Marcela Cristina Damião Andrucioli
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil
| | - Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Vinícius Pedrazzi
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, SP, Brazil
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, Avenida do Café, S/N, Monte Alegre, Ribeirão Preto, SP, CEP: 14040-904, Brazil
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Pithon MM, Sant'Anna LIDA, Baião FCS, dos Santos RL, Coqueiro RDS, Maia LC. Assessment of the effectiveness of mouthwashes in reducing cariogenic biofilm in orthodontic patients: a systematic review. J Dent 2015; 43:297-308. [PMID: 25572792 DOI: 10.1016/j.jdent.2014.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 12/03/2014] [Accepted: 12/12/2014] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The use of fixed orthodontic appliances makes it difficult to clean the teeth and accessories associated with it. For this reason, orthodontic patients have used oral antiseptics as coadjuvent means to reduce cariogenic plaque. The aim of this systematic review was to evaluate the effectiveness of oral antiseptics on the reduction of cariogenic plaque on orthodontic patients. DATA This review has been registered at PROSPERO--international prospective register of systematic reviews under the number CRD42013006857. SOURCES A systematic review of the literature was conducted in the following electronic databases: Scopus, PubMed, Web of Science, Medline, Embase and Cochrane, Grey literature and Clinical Trials, without limitations on the year of publication or language. Clinical studies in patients with fixed orthodontic appliances, who were making use of oral mouthwashes in order to reduce cariogenic plaque, were included. Articles with patients using systemic drugs, syndromic patients, those using mouthwashes for other purposes and/or using different cleaning techniques, and clinical cases were excluded. After selection by title and abstract, potentially eligible articles were read in full. The methodological quality and risk of biases of articles included were evaluated according to the characteristics of the study, measurements and statistical analyses of the study. The methodological quality was classified as high, moderate or low. STUDY SELECTION The search identified 2716 articles, of which 15 met the inclusion criteria. Of these, 8 analyzed chlorhexidine-based mouthwashes, while in 1 article Cetylpyridinium was used; 1 analyzed the mouthwash containing sanguinaria; 1 the use of NaF; 2 articles the use of AmF/SnF2; 2 the use of Listerine(®), 1 also analyzed the association between mouthwashes with octenidine and with PVP-I. Of the articles analyzed, 11 were classified as having high and 4 as having moderate methodological quality. CONCLUSION There is evidence of effectiveness of the use of oral mouthwashes in the control of cariogenic plaque in patients with fixed orthodontic appliances. The orthodontists may suggest the use of oral antiseptics in the oral hygiene of their patients as coadjuvent means to reduce cariogenic plaque. CLINICAL SIGNIFICANCE Given current evidence, orthodontists may prescribe mouthwash as an auxiliary method in the control of cariogenic biofilm in orthodontic patients.
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Affiliation(s)
- Matheus Melo Pithon
- Department of Healthy, Southwest Bahia State University UESB, Jequié, Bahia, Brazil.
| | | | | | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Nelson-Filho P, Carpio-Horta KO, Andrucioli MCD, Feres M, Bezerra da Silva RA, Garcia Paula-Silva FW, Romano FL. Molecular detection of Aggregatibacter actinomycetemcomitans on metallic brackets by the checkerboard DNA-DNA hybridization technique. Am J Orthod Dentofacial Orthop 2012; 142:481-6. [PMID: 22999671 DOI: 10.1016/j.ajodo.2012.04.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 04/01/2012] [Accepted: 04/01/2012] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this randomized clinical study was to evaluate the presence of the periodontal pathogen Aggregatibacter actinomycetemcomitans on metallic brackets and the effectiveness of a 0.12% chlorhexidine digluconate mouthwash in inhibiting this microorganism. METHODS The study involved 35 patients of both sexes having orthodontic treatment with fixed appliances between the ages of 14 and 22 years, randomized into 2 groups: experimental (n = 17) and control (n = 18). Two new metallic brackets were placed on the patients' premolars, and the subjects rinsed with a solution of 0.12% chlorhexidine digluconate or a placebo solution twice a week for 30 days. After that, the brackets were removed and underwent microbiologic analysis with the checkerboard DNA-DNA hybridization technique. Data were analyzed by using the Student t, Fisher exact, and Mann-Whitney tests at the significance level of 5%. RESULTS The results showed that A actinomycetemcomitans was present in all brackets from the subjects in the control group vs 83% of the subjects who rinsed with chlorhexidine digluconate (P <0.0001). There were also significantly lower levels of this species in the chlorhexidine digluconate group compared with the control group (P = 0.0003). CONCLUSIONS We concluded that 0.12% chlorhexidine digluconate rinsing, twice a week for 30 days during orthodontic treatment, is effective in reducing the presence and levels of A actinomycetemcomitans on metallic brackets.
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Affiliation(s)
- Paulo Nelson-Filho
- Department of Pediatric Clinics, Preventive and Social Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
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Gonzalez-Perez JC, Scougall-Vilchis RJ, Contreras-Bulnes R, De La Rosa-Gómez I, Uematsu S, Yamaguchi R. Adherence ofStreptococcus mutansto orthodontic band cements. Aust Dent J 2012. [DOI: 10.1111/adj.12004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Komori R, Sato T, Takano-Yamamoto T, Takahashi N. Microbial composition of dental plaque microflora on first molars with orthodontic bands and brackets, and the acidogenic potential of these bacteria. J Oral Biosci 2012. [DOI: 10.1016/j.job.2012.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nelson-Filho P, Valdez RMA, Andrucioli MCD, Saraiva MCP, Feres M, Sorgi CA, Faccioli LH. Gram-negative periodontal pathogens and bacterial endotoxin in metallic orthodontic brackets with or without an antimicrobial agent: An in-vivo study. Am J Orthod Dentofacial Orthop 2011; 140:e281-7. [DOI: 10.1016/j.ajodo.2011.06.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 06/01/2011] [Accepted: 06/01/2011] [Indexed: 11/25/2022]
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