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Senpuku H, Yoshimura K, Takai H, Maruoka Y, Yamashita E, Tominaga A, Ogata Y. Role of Macrophage Colony-Stimulating Factor for Staphylococcal Infection in the Oral Cavity. J Clin Med 2023; 12:5825. [PMID: 37762764 PMCID: PMC10532062 DOI: 10.3390/jcm12185825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE There are few valid indicators of oral infection owing to the complexity of pathogenic factors in oral diseases. Salivary markers are very useful for scrutinizing the symptoms of disease. To provide a reliable and useful predictive indicator of infection for opportunistic pathogens in individuals with compromised immune systems, such as those with periodontal diseases and Human Immunodeficiency Virus (HIV), this study examines opportunistic pathogens such as C. albicans and staphylococci and macrophage colony-stimulating factor (M-CSF) and CA125/MUC16 in saliva. The aim was to explore the correlations investigated among these factors. METHODS Samples were divided into two groups (based on patient sex, the absence and presence of dentures in elderly, or HIV-positive patients and healthy subjects), and the correlation was analyzed in two groups of elderly patients with periodontal disease (64.5 ± 11.2 years old) and HIV-infected patients (41.9 ± 8.4 years old). Healthy subjects (33.8 ± 9.1 years old) were also analyzed as a control. Levels of C. albicans, staphylococci, and M-CSF, which is an immunological factor for the differentiation of macrophage, and CA125/MUC16, which provides a protective lubricating barrier against infection, were investigated. RESULTS A significant and positive correlation between the levels of M-CSF and staphylococci was found in elderly individuals and HIV-positive patients treated with antiretroviral therapy. A significant and positive correlation between the levels of M-CSF and CD125/MUC16 was also found in both patients. These correlations were enhanced in both patients as compared with healthy subjects. CONCLUSION Salivary M-CSF might be useful as a new indicator of opportunistic infection caused by staphylococci and a defense against infection in immunocompromised hosts.
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Affiliation(s)
- Hidenobu Senpuku
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
- Department of Microbiology and Immunology, Nihon University of School of Dentistry at Matsudo, Matsudo 271-8587, Japan
| | | | - Hideki Takai
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.)
| | - Yutaka Maruoka
- National Center for Global Health and Medicine, Tokyo 162-8655, Japan;
| | - Erika Yamashita
- Department of Orthodontics, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan;
| | - Akira Tominaga
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Yorimasa Ogata
- Department of Periodontology, Nihon University School of Dentistry at Matsudo, Matsudo 271-8587, Japan; (H.T.)
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Tawfik SA, Azab M, Ramadan M, Shabayek S, Abdellah A, Al Thagfan SS, Salah M. The Eradication of Helicobacter pylori Was Significantly Associated with Compositional Patterns of Orointestinal Axis Microbiota. Pathogens 2023; 12:832. [PMID: 37375522 DOI: 10.3390/pathogens12060832] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is significantly linked to various diseases that seriously impact human health, such as gastric ulcers, chronic gastritis and gastric adenocarcinoma. METHODS The compositional shifts in bacterial communities of the orointestinal axis were surveyed pre/post-eradication of H. pylori. In total, 60 samples, including stool and salivary specimens, were collected from 15 H. pylori-positive individuals (HPP) before beginning and 2 months after receiving the eradication therapy. The V3-V4 regions of the 16S rRNA gene were sequenced using MiSeq. RESULTS Overall, oral microbiomes were collectively more diverse than the gut microbiomes (Kruskal-Wallis; p = 3.69 × 10-5). Notably, the eradication of H. pylori was associated with a significant reduction in the bacterial diversity along the orointestinal axis (Wilcoxon rank sum test; p = 6.38 × 10-3). Interestingly, the oral microbiome of HPP showed a positive correlation between Proteobacteria and Fusobacteria, in addition to a significant predominance of Streptococcus, in addition to Eubacterium_eligens, Haemophilus, Ruminococcaceae, Actinomyces and Staphylococcus. On the other hand, Fusobacterium, Veillonella, Catenibacterium, Neisseria and Prevotella were significantly enriched upon eradication of H. pylori. Generally, Bacteroidetes and Fusobacteria positively coexisted during H. pylori infection along the orointestinal axis (r = 0.67; p = 0.0006). The eradication of H. pylori was positively linked to two distinctive orotypes (O3 and O4). Orotype O4 was characterized by a robust abundance of Veillonella and Fusobacteria. The gut microbiomes during H. pylori infection showed a remarkable predominance of Clostridium_sensu_stricto_1 and Escherichia_Shigella. Likewise, Bifidobacterium and Faecalibacterium were significantly enriched upon eradication of H. pylori. CONCLUSIONS Finally, the impact of eradication therapy clearly existed on the representation of certain genera, especially in the oral microbiome, which requires particular concern in order to counteract and limit their subsequent threats.
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Affiliation(s)
- Sally Ali Tawfik
- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Marwa Azab
- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Mohammed Ramadan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt
| | - Sarah Shabayek
- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Ali Abdellah
- Department of Microbiology and Immunology, Faculty of Pharmacy, Suez Canal University, Ismailia 41522, Egypt
| | - Sultan S Al Thagfan
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al Madinah Al Munaearah 42353, Saudi Arabia
| | - Mohammed Salah
- Department of Microbiology and Immunology, Faculty of Pharmacy, Port Said University, Port Said 42511, Egypt
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Montano TCP, Wanderley MIA, Sampaio RO, Alves CGB, Neves ILI, Lopes MA, Tarasoutchi F, Strabelli TMV, Neves RS, Grinberg M, Santos-Silva AR, Siciliano RF. Demographic, cardiological, microbiologic, and dental profiles of Brazilian patients who developed oral bacteria-related endocarditis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:418-425. [PMID: 34400124 DOI: 10.1016/j.oooo.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/06/2021] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Infective endocarditis (IE) may cause devastating complications with high morbidity and mortality rates. The aim of the present study was to study the demographic, cardiological, microbiologic, and dental profiles of patients with oral bacteria-related IE. STUDY DESIGN We present a retrospective study of patients with oral bacteria-related IE treated at Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil, between January 2009 and December 2019. RESULTS Of the 100 patients included, 70% were male with a mean age of 45.4 years at diagnosis. The most affected sites were aortic and mitral valves, 60% in prosthetic heart valves, 34% in native valves, and 3% in pacemakers. The most common cause of valvular disease was rheumatic cardiopathy (51.9%), and the most frequent complications were valvular and perivalvular damage (26%). Streptococcus viridans was the most common species (96%), dental caries were present in 57% of the patients, 78% had tooth loss, 45% had apical periodontitis, and 77% were at high/moderate risk for periodontal disease. CONCLUSION Oral bacteria-related IE among Brazilians was predominant in the prosthetic heart valves of young male adults previously affected by rheumatic cardiopathy. Streptococcus viridans was the main cause of IE, which was linked to patients with a poor oral health status.
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Affiliation(s)
- Tânia Cristina Pedroso Montano
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil; Unidade de Odontologia, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Roney Orismar Sampaio
- Unidade de Valvopatias, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Itamara Lúcia Itagiba Neves
- Unidade de Odontologia, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Flavio Tarasoutchi
- Unidade de Valvopatias, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Tânia Mara Varejão Strabelli
- Unidade de Controle de Infecção Hospitalar, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ricardo Simões Neves
- Unidade de Odontologia, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Max Grinberg
- Unidade de Controle de Infecção Hospitalar, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
| | - Rinaldo Focaccia Siciliano
- Unidade de Valvopatias, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Presence of non-oral bacteria in the oral cavity. Arch Microbiol 2021; 203:2747-2760. [PMID: 33791834 PMCID: PMC8012020 DOI: 10.1007/s00203-021-02300-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/20/2020] [Accepted: 03/22/2021] [Indexed: 12/30/2022]
Abstract
A homeostatic balance exists between the resident microbiota in the oral cavity and the host. Perturbations of the oral microbiota under particular conditions can contribute to the growth of non-oral pathogens that are hard to kill because of their higher resistance to antimicrobials, raising the probability of treatment failure and reinfection. The presence of these bacteria in the oral cavity has been proven to be associated with several oral diseases such as periodontitis, caries, and gingivitis, and systemic diseases of importance in clinical medicine such as cystic fibrosis, HIV, and rheumatoid arthritis. However, it is still controversial whether these species are merely transient members or unique to the oral cavity. Mutualistic and antagonistic interactions between the oral microbiota and non-oral pathogens can also occur, though the mechanisms used by these bacteria are not clear. Therefore, this review presents an overview of the current knowledge about the presence of non-oral bacteria in the oral cavity, their relationship with systemic and oral diseases, and their interactions with oral bacteria.
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Franceschi D, Giuliani V, Giuntini V, Pini Prato G. Brain abscess and periodontal pathogens ( Fusobacterium Nucleatum). Report of a case. Clin Case Rep 2020; 8:2488-2493. [PMID: 33363764 PMCID: PMC7752455 DOI: 10.1002/ccr3.3173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/30/2020] [Accepted: 07/05/2020] [Indexed: 11/05/2022] Open
Abstract
Patients who develop brain abscesses must be evaluated through a complete set of diagnostic tests including a microbiological and clinical periodontal assessment. A genetic comparison of the pathogens from intracranial/extracranial sites is necessary.
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Affiliation(s)
- Debora Franceschi
- Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| | - Valentina Giuliani
- Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
| | - Veronica Giuntini
- Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
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Figuero E, Han YW, Furuichi Y. Periodontal diseases and adverse pregnancy outcomes: Mechanisms. Periodontol 2000 2020; 83:175-188. [PMID: 32385886 DOI: 10.1111/prd.12295] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Adverse pregnancy outcomes (APOs) have been defined as (a) pre-term birth, when there is a delivery before 37 completed weeks (<259 days); (b) pre-eclampsia, which is a multisystem disorder of pregnancy characterized by maternal hypertension and proteinuria after the 20th gestational week; (c) low and very low birthweight, depending on whether the weight of the baby is less of 2500 g or <1500 g and (d) the spontaneous death of the fetus with <20 weeks (miscarriage) or between 20 and 36 weeks (stillbirth). In 2012, during the Consensus Report from the Joint EFP/AAP workshop on periodontitis and systematic diseases the role of periodontal diseases on APOs was reviewed. Some years later, this evidence has grown, and an update on the literature regarding the mechanisms related to this potential association (APOs and periodontal diseases) needs to be presented. The two major pathways (direct and indirect) already accepted in 2012 are still valid nowadays. Most evidence published in the last 5 years deals with a strong and solid evidence coming from the direct pathway while there is as scarce new evidence regarding indirect pathway. In this direct pathway, the haematological dissemination of oral microorganisms and their products, would later induce an inflammatory/Immune response in the foetal-placental unit. The most plausible route for this direct pathway is the hematogenous transmission through dental bacteremia, although not many new studies dealing with bacteremia has been performed lately.
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Affiliation(s)
- Elena Figuero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, Department of Dental Clinical Specialties, Faculty of Dentistry, University Complutense of Madrid (UCM), Madrid, Spain
| | - Yiping W Han
- Departments of Microbiology & Immunology, OB&GYN, Medical Sciences (Oncology), College of Dental Medicine, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY, USA
| | - Yasushi Furuichi
- Division of Periodontology & Endodontology, Department of Oral Rehabilitation, Health Sciences, University of Hokkaido, Hokkaido, Japan
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Hickey NA, Shalamanova L, Whitehead KA, Dempsey-Hibbert N, van der Gast C, Taylor RL. Exploring the putative interactions between chronic kidney disease and chronic periodontitis. Crit Rev Microbiol 2020; 46:61-77. [PMID: 32046541 DOI: 10.1080/1040841x.2020.1724872] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic kidney disease (CKD) and chronic periodontitis (CP) are both common diseases, which are found disproportionately comorbid with each other and have been reported to have a detrimental effect on the progression of each respective disease. They have an overlap in risk factors and both are a source of systemic inflammation along with a wide selection of immunological and non-specific effects that can affect the body over the lifespan of the conditions. Previous studies have investigated the directionality of the relationship between these two diseases; however, there is a lack of literature that has examined how these diseases may be interacting at the localized and systemic level. This review discusses how oral microorganisms have the ability to translocate and have distal effects and provides evidence for microbial involvement in a systemic disease. Furthermore, it summarizes the reported local and systemic effects of CKD and CP and discusses how the interaction of these effects may be responsible for directionality associations reported.
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Affiliation(s)
- Niall A Hickey
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Liliana Shalamanova
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Kathryn A Whitehead
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Nina Dempsey-Hibbert
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Christopher van der Gast
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
| | - Rebecca L Taylor
- Centre for Bioscience, Department of Life Sciences, Manchester Metropolitan University, Manchester, UK
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Guandalini Cunha B, Duque C, Sampaio Caiaffa K, Massunari L, Araguê Catanoze I, dos Santos DM, de Oliveira SHP, Guiotti AM. Cytotoxicity and antimicrobial effects of citronella oil (Cymbopogon nardus) and commercial mouthwashes on S. aureus and C. albicans biofilms in prosthetic materials. Arch Oral Biol 2020; 109:104577. [DOI: 10.1016/j.archoralbio.2019.104577] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/20/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
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Azad A, Modaresi F, Zahed M, Zarei M, Ranjbaran A, Jahrom ZK. Multiplex polymerase chain reaction for detection of bacteremia during dental extraction. ACTA ACUST UNITED AC 2019; 10:e12425. [PMID: 31175710 DOI: 10.1111/jicd.12425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/20/2019] [Accepted: 04/27/2019] [Indexed: 11/29/2022]
Abstract
AIM Incidence of transient bacteremia following dental extractions ranges 30%-70% among adults and 58%-100% in children. This study aims to assess the multiplex polymerase chain reaction (PCR) technique in detection of transient bacteremia during dental extraction. METHODS Twenty volunteers for dental extraction entered the study. Blood samples were taken at baseline and 30 seconds and 15 minutes after extraction. Five types of bacteria were selected, namely Streptococcus mutans, S. salivarius, S. sanguinis, Enterococcus faecalis and Lactobacillus. Blood samples were evaluated by microbial culture and multiplex PCR. RESULTS Blood culture showed rates of 0%, 80% and 25% for bacteremia before, during and after dental extraction, respectively. A significant difference was observed between baseline and during extraction. Using PCR, bacteremia was deemed 20%, 100% and 30% before, during and after extraction, respectively, and a significant difference was witnessed between the baseline and during extraction. The highest incidence was at the 30-second mark after extraction, and the most prevalent type of bacteria was S. mutans. CONCLUSIONS Multiplex PCR can be used to determine bacterial diversity with high accuracy during occurrence of bacteremia. Therefore, in cases where positive blood cultures only indicate the presence of one species, we recommend the use of this method to detect more diverse bacteria types.
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Affiliation(s)
- Azita Azad
- Department of Oral and Maxillofacial Medicine, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzan Modaresi
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Department of Advanced Medical Sciences and Technology, Jahrom University of Medical Sciences, Jahrom, Iran.,Central Laboratory Research, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Maryam Zahed
- Department of Oral and Maxillofacial Medicine, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahshid Zarei
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Ranjbaran
- Department of Oral and Maxillofacial Medicine, Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kargar Jahrom
- Zoonoses Research Center, Jahrom University of Medical Sciences, Shiraz, Jahrom
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Beutler J, Jentsch HFR, Rodloff AC, Stingu CS. Bacteremia after professional mechanical plaque removal in patients with chronic periodontitis. Oral Dis 2019; 25:1185-1194. [PMID: 30680855 DOI: 10.1111/odi.13047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 11/26/2018] [Accepted: 01/13/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the characteristics of bacteremia caused by professional mechanical plaque removal (PMPR) in two groups of patients with generalized moderate chronic periodontitis. MATERIALS AND METHODS Venous blood samples were taken at multiple time points for one hour following PMPR in fifty patients with generalized moderate chronic periodontitis. Subjects consisted of two groups, one group was receiving supportive periodontal therapy (SPT, n = 25) and the other group was receiving initial periodontal therapy (IPT, n = 25). Blood samples were processed and analyzed for cultivable microflora. Pertinent clinical parameters were recorded for each patient in both groups. RESULTS Bacteremia was detected in 10 of 25 SPT and 8 of 25 IPT patients (p = 0.796). In both groups, the prevalence of bacteremia was dependent on the time of blood sampling and varied in magnitude between <102 CFU/ml and 106 CFU/ml. Sixteen different bacterial species were identified in both groups, mostly Actinomyces naeslundii (SPT n = 3, IPT n = 4) and Streptococcus spp. (SPT n = 6, IPT n = 2). In regression models, Grade II furcation involvement (p = 0.004) and Gingival Bleeding Index (p = 0.036) had affected the occurrence of bacteremia but in the SPT group only. CONCLUSION Professional mechanical plaque removal was associated with bacteremia regardless of whether a patient was receiving SPT or IPT.
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Affiliation(s)
- Jakob Beutler
- Center for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | - Holger F R Jentsch
- Center for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Leipzig, Germany
| | - Arne C Rodloff
- Institute of Medical Microbiology and Epidemiology on Infectious Diseases, Leipzig, Germany
| | - Catalina-Suzana Stingu
- Institute of Medical Microbiology and Epidemiology on Infectious Diseases, Leipzig, Germany
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Ambrosio N, Marín MJ, Laguna E, Herrera D, Sanz M, Figuero E. Detection and quantification of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in bacteremia induced by interdental brushing in periodontally healthy and periodontitis patients. Arch Oral Biol 2018; 98:213-219. [PMID: 30503977 DOI: 10.1016/j.archoralbio.2018.11.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This study was aimed to compare the presence and amounts of bacteremia induced by interdental brushing in periodontally healthy (H) and periodontitis (P) individuals using culture based (direct culture [DC]) and molecular based techniques (real-time quantitative polymerase chain reaction [qPCR]) in a cross-sectional study model. MATERIALS AND METHODS After a full mouth periodontal evaluation, blood samples were taken before and 1 min after professionally-administered interdental brushing. These samples were analyzed by DC and qPCR, targeting Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Subgingival samples were also collected and analyzed. Student t-test, chi-squar tests and correlations were used for analyzing the data. RESULTS Thirty individuals per group were included. P. gingivalis and A. actinomycetemcomitans were detected with qPCR methods, but not with DC. At baseline, bacteremia was observed in 5 P patients (16.7%) and in 2 H individuals (6.6%) (p = 0.421). After interdental brushing, bacteremia was only observed in 2 P patients (6.6%) (p = 0.901). A positive correlation between subgingival and blood levels of A. actinomycetemcomitans was observed (r = 0.3; p = 0.013). CONCLUSION Bacteremia related to A. actinomycetemcomitans and P. gingivalis did not significantly increase after a single session of use of interdental brushes.
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Affiliation(s)
- Nagore Ambrosio
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
| | - María José Marín
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
| | - Estefanía Laguna
- Section of Post-Graduate Periodontology - Faculty of Odontology, University Complutense, Madrid, Spain.
| | - David Herrera
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
| | - Mariano Sanz
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
| | - Elena Figuero
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, University Complutense, Madrid, Spain.
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Akbulut Y, Goymen M, Zer Y, Buyuktas Manay A. Investigation of bacteremia after debonding procedures. Acta Odontol Scand 2018; 76:314-319. [PMID: 29566581 DOI: 10.1080/00016357.2018.1451654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the effect of debonding procedures after completion of orthodontic treatments on bacteremia. MATERIALS AND METHODS Twenty-eight patients who were treated with fixed orthodontic treatment at the Faculty of Dentistry's Department of Orthodontics at Gaziantep University and who had an indication of debonding were selected for this study, and blood samples were taken from these patients at different times and examined for bacteremia. Blood culture samples were taken from the antecubital veins of the patients prior to debonding (T0), immediately after removing the bracket (T1), and immediately after cleaning the composite residues and plaque deposits on the enamel surface (T2). The blood samples were then inoculated in blood culture bottles and investigated for bacterial growth. RESULTS The results showed that there was no bacterial growth in the blood samples taken at T0 and T1, whereas 10 of the blood culture samples taken at T2 showed bacterial growth including the following bacteria; Streptococcus viridans, Streptococcus mitis, Streptococcus parasanguinis, Streptococcus salivarius, Streptococcus oralis, Staphylococcus aureus, Actinomyces oris, Actinomyces naeslundii and Klebsiella pneumoniae. CONCLUSION It was concluded that patients in the risk group could develop bacteremia during debonding procedures. The presence of these bacteria in sterile blood suggested the possibility of bacterial endocarditis.
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Affiliation(s)
- Yasin Akbulut
- Diyarbakır Education and Research Hospital, Ministry of Health, Health Sciences University, Diyarbakır, Turkey
| | - Merve Goymen
- Department of Orthodontics, Gaziantep University, Gaziantep, Turkey
| | - Yasemin Zer
- Department of Microbiology, Gaziantep University, Gaziantep, Turkey
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Artese HPC, Longo PL, Kawamoto D, Gomes GH, Mayer MPA, Romito GA, Horliana ACRT. Bacteremia after chewing in a patient with severe chronic periodontitis and diabetes mellitus type 2: A brief report. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2017. [DOI: 10.1016/j.jecr.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Marin MJ, Ambrosio N, Virto L, Diz P, Álvarez M, Herrera D, Sanz M, Figuero E. Detection and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Streptococcus oralis in blood samples with different microbiological identification methods: An in vitro study. Arch Oral Biol 2017; 74:55-62. [DOI: 10.1016/j.archoralbio.2016.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 10/11/2016] [Accepted: 11/06/2016] [Indexed: 12/19/2022]
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Bermúdez-Bejarano EB, Serrera-Figallo MÁ, Gutiérrez-Corrales A, Romero-Ruiz MM, Castillo-de-Oyagüe R, Gutiérrez-Pérez JL, Torres-Lagares D. Prophylaxis and antibiotic therapy in management protocols of patients treated with oral and intravenous bisphosphonates. J Clin Exp Dent 2017; 9:e141-e149. [PMID: 28149479 PMCID: PMC5268104 DOI: 10.4317/jced.53372] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 10/01/2016] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Osteonecrosis of the jaw (MRONJ) linked to bisphosphonate treatment has specific characteristics that render its therapeutic management challenging for clinicians. Poor response to standard treatment makes it essential to take special precautions when treating this type of disease; therefore, antibiotic prophylaxis and/or antibiotic therapy have been proposed as effective and helpful tools in these situations. OBJECTIVES This article seeks to assess published evidence in order to evaluate the different protocols used for antibiotic prophylaxis and/or antibiotic therapy in the general context of patients treated with bisphosphonates. MATERIAL AND METHODS A literature review of the last 10 years was carried out in PubMed using the following keywords: "antibiotic prophylaxis and osteonecrosis," "bisphosphonates AND osteonecrosis AND dental management," "bisphosphonate AND osteonecrosis AND antibiotic prophylaxis AND oral surgery." A total of 188 articles were obtained, of which 18 were ultimately selected. RESULTS AND DISCUSSION In patients treated with oral and intravenous bisphosphonates without chemotherapy-associated osteonecrosis of the jaw, antibiotic prophylaxis prior to oral surgery is an important tool to avoid osteonecrosis and promote healing of the affected area. If the patient previously exhibited chemotherapy-associated osteonecrosis after tooth extraction, antibiotic prophylaxis is indicated to prevent recurrent osteonecrosis and promote healing of the extraction site. If chemotherapy-associated osteonecrosis is already present, antibiotic therapy is a vital part of conservative management to reduce the symptomatology of MRONJ and keep it from worsening. Finally, a lack of clinical data and randomized controlled trials makes it difficult to choose the most appropriate protocol for the various clinical situations studied. Key words:Bisphosphonates, antibiotic prophylaxis, maxillary osteonecrosis, antibiotic treatment.
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Affiliation(s)
| | - María-Ángeles Serrera-Figallo
- Associate Professor. Integrated Dentistry and Patients with Special Diseases. School of Dentistry. University of Seville
| | | | | | - Raquel Castillo-de-Oyagüe
- Professor of Prostheses. Department of Stomatology. School of Dentistry. Complutense University of Madrid
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Perić M, Perković I, Romić M, Simeon P, Matijević J, Mehičić GP, Krmek SJ. The Pattern of Antibiotic Prescribing by Dental Practitioners in Zagreb, Croatia. Cent Eur J Public Health 2016; 23:107-13. [PMID: 26851419 DOI: 10.21101/cejph.a3981] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 05/11/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Bacterial resistance is considered a consequence of misuse or overuse of antibiotics. Dentistry significantly contributes to this increasing public health problem. The aim of this cross-sectional study was to examine the pattern of antibiotics prescribed by Croatian dentists in Zagreb area. METHODS Out of 220 Doctors of Dental Medicine (DMDs) from Zagreb 110 responded to survey. Prior to the research an ethical approval was obtained. Participants were directly contacted. The questionnaire consisted of two parts: general data on DMDs and the part concerning indications, duration, type and dosage of antibiotic therapy. Data were processed using MS Excel and SPSS for Windows, Version 17.0. Statistical significance was tested by Fisher's exact test, chi-square test, Mann-Whitney U test and Spearman's rank correlation at the level of statistical significance p<0.05. RESULTS During the period of two months, the doctors prescribed antibiotics to 1,500 patients, 690 (46%) were men and 810 (54%) women. The most often prescribed antibiotics were penicillin (72.5% of patients), represented mostly by amoxicillin in combination with clavulanic acid (57.6%). The most common indication for the prescribed antibiotics was periapical or periodontal abscess (44%). Definite clinical indication (71.2%) was stated as the most common reason for antibiotic prescription. Antibiotic therapy usually lasted 7 days (62.9%). The doctors prescribed daily doses of antibiotics according to the instructions for the use of specific drugs. CONCLUSION The examined subjects prescribe antibiotics according to the curriculum taught at the School of Dental Medicine for majority of types, doses and duration of the treatments, although antibiotics over-prescription in cases without medical indication was observed. The national guidelines on antibiotic regimens are required in order to reduce unnecessary antibiotic use.
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Affiliation(s)
- Marina Perić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Perković
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Martina Romić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Paris Simeon
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Jurica Matijević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Goranka Prpić Mehičić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Koukos G, Sakellari D, Arsenakis M, Tsalikis L, Slini T, Konstantinidis A. Prevalence of Staphylococcus aureus and methicillin resistant Staphylococcus aureus (MRSA) in the oral cavity. Arch Oral Biol 2015; 60:1410-5. [DOI: 10.1016/j.archoralbio.2015.06.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 06/08/2015] [Accepted: 06/13/2015] [Indexed: 11/25/2022]
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Barbosa M, Prada-López I, Álvarez M, Amaral B, de los Angeles CDCM, Tomás I. Post-tooth extraction bacteraemia: a randomized clinical trial on the efficacy of chlorhexidine prophylaxis. PLoS One 2015; 10:e0124249. [PMID: 25955349 PMCID: PMC4425363 DOI: 10.1371/journal.pone.0124249] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 02/24/2015] [Indexed: 12/20/2022] Open
Abstract
Objectives To investigate the development of post-extraction bacteraemia (PEB) after the prophylactic use of chlorhexidine (CHX). Patients and Methods A total of 201 patients who underwent a tooth extraction were randomly distributed into four groups: 52 received no prophylaxis (CONTROL), 50 did a mouthwash with 0.2% CHX before the tooth extraction (CHX-MW), 51 did a mouthwash with 0.2% CHX and a subgingival irrigation with 1% CHX (CHX-MW/SUB_IR) and 48 did a mouthwash with 0.2% CHX and a continuous supragingival irrigation with 1% CHX (CHX-MW/SUPRA_IR). Peripheral venous blood samples were collected at baseline, 30 seconds after performing the mouthwash and the subgingival or supragingival irrigation, and at 30 seconds and 15 minutes after completion of the tooth extraction. Blood samples were analysed applying conventional microbiological cultures under aerobic and anaerobic conditions performing bacterial identification of the isolates. Results The prevalences of PEB in the CONTROL, CHX-MW, CHX-MW/SUB_IR and CHX-MWSUPRA_IR groups were 52%, 50%, 55% and 50%, respectively, at 30 seconds and 23%, 4%, 10% and 27%, respectively, at 15 minutes. The prevalence of PEB at 15 minutes was significantly higher in the CONTROL group than in the CHX-MW group (23% versus 4%; p = 0.005). At the same time, no differences were found between CONTROL group and CHX-MW/SUB_IR or CHX-MW/SUPRA_IR groups. Streptococci (mostly viridans group streptococci) were the most frequently identified bacteria (69–79%). Conclusions Performing a 0.2% CHX mouthwash significantly reduces the duration of PEB. Subgingival irrigation with 1% CHX didn’t increase the efficacy of the mouthwash while supragingival irrigation even decreased this efficacy, probably due to the influence of these maneuvers on the onset of bacteraemia. Clinical Relevance These results confirm the suitability of performing a mouthwash with 0.2% CHX before tooth extractions in order to reduce the duration of PEB. This practice should perhaps be extended to all dental manipulations. Trial Registration Clinicaltrials.gov NCT02150031
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Affiliation(s)
- Mario Barbosa
- School of Dentistry, Instituto Superior de Ciências da Saúde-Norte, Centro de Investigação de Ciências da Saúde, Gandra, Portugal
| | - Isabel Prada-López
- Oral Sciences Research Group, Special Needs Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Barbas Amaral
- Department of Stomatology and Maxilo-Facial Surgery, St. António General Hospital, Oporto, Portugal
| | - Casares-De-Cal María de los Angeles
- Oral Sciences Research Group, Special Needs Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Inmaculada Tomás
- Oral Sciences Research Group, Special Needs Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- * E-mail:
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Benítez-Páez A, Álvarez M, Belda-Ferre P, Rubido S, Mira A, Tomás I. Detection of transient bacteraemia following dental extractions by 16S rDNA pyrosequencing: a pilot study. PLoS One 2013; 8:e57782. [PMID: 23469240 PMCID: PMC3587628 DOI: 10.1371/journal.pone.0057782] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 01/24/2013] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The current manuscript aims to determine the prevalence, duration and bacterial diversity of bacteraemia following dental extractions using conventional culture-dependent methods and 16S rDNA pyrosequencing. METHODS The study group included 8 patients undergoing dental extractions under general anaesthesia. Peripheral venous blood samples were collected at baseline, 30 seconds and 15 minutes after the dental extractions. Blood samples were analysed for bacteraemia applying conventional microbiological cultures under aerobic and anaerobic conditions as well as pyrosequencing using universal bacterial primers that target the 16S ribosomal DNA gene. RESULTS Transient bacteremia was detected by culture-based methods in one sample at baseline time, in eight samples at 30 seconds, and in six samples at 15 minutes after surgical procedure; whereas bacteraemia was detected only in five blood samples at 30 seconds after dental extraction by using pyrosequencing. By applying conventional microbiological methods, a single microbial species was detected in six patients, and Streptococcus viridans was the most frequently cultured identified bacterium. By using pyrosequencing approaches however, the estimated blood microbial diversity after dental extractions was 13.4±1.7 bacterial families and 22.8±1.1 genera per sample. CONCLUSION The application of 16S rDNA pyrosequencing underestimated the prevalence and duration of bacteraemia following dental extractions, presumably due to not reaching the minimum DNA required for PCR amplification. However, this molecular technique, unlike conventional culture-dependent methods, revealed an extraordinarily high bacterial diversity of post-extraction bacteraemia. We propose that microorganisms recovered by culture may be only the tip of an iceberg of a really diverse microbiota whose viability and potential pathogenicity should be further studied.
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Affiliation(s)
- Alfonso Benítez-Páez
- Genomics and Health Department, Centre for Advanced Research in Public Health (CSISP), Valencia, Spain
| | - Maximiliano Álvarez
- Department of Microbiology, University Hospital Complex, Institute for Biomedical Research, Vigo, Spain
| | - Pedro Belda-Ferre
- Genomics and Health Department, Centre for Advanced Research in Public Health (CSISP), Valencia, Spain
| | - Susana Rubido
- School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
| | - Alex Mira
- Genomics and Health Department, Centre for Advanced Research in Public Health (CSISP), Valencia, Spain
| | - Inmaculada Tomás
- School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
- * E-mail:
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Jones DJ, Munro CL, Grap MJ. Natural history of dental plaque accumulation in mechanically ventilated adults: a descriptive correlational study. Intensive Crit Care Nurs 2011; 27:299-304. [PMID: 22014582 DOI: 10.1016/j.iccn.2011.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 08/08/2011] [Accepted: 08/09/2011] [Indexed: 10/16/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the pattern of dental plaque accumulation in mechanically ventilated adults. Accumulation of dental plaque and bacterial colonisation of the oropharynx is associated with a number of systemic diseases including ventilator associated pneumonia. RESEARCH METHODOLOGY/DESIGN Data were collected from mechanically ventilated critically ill adults (n=137), enrolled within 24 hours of intubation. Dental plaque, counts of decayed, missing and filled teeth and systemic antibiotic use was assessed on study days 1, 3, 5 and 7. Dental plaque averages per study day, tooth type and tooth location were analysed. SETTING Medical respiratory, surgical trauma and neuroscience ICU's of a large tertiary care centre in the southeast United States. RESULTS Plaque: all surfaces >60% plaque coverage from day 1 to day 7; molars and premolars contained greatest plaque average >70%. Systemic antibiotic use on day 1 had no significant effect on plaque accumulation on day 3 (p=0.73). CONCLUSIONS Patients arrive in critical care units with preexisting oral hygiene issues. Dental plaque tends to accumulate in the posterior teeth (molars and premolars) that may be hard for nurses to visualise and reach; this problem may be exacerbated by endotracheal tubes and other equipment. Knowing accumulation trends of plaque will guide the development of effective oral care protocols.
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Affiliation(s)
- Deborah J Jones
- University of Texas Health Science Center at Houston, School of Nursing, 6901 Bertner Ave, Houston, TX 77030, USA.
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Tomás I, Diz P, Tobías A, Scully C, Donos N. Periodontal health status and bacteraemia from daily oral activities: systematic review/meta-analysis. J Clin Periodontol 2011; 39:213-28. [PMID: 22092606 DOI: 10.1111/j.1600-051x.2011.01784.x] [Citation(s) in RCA: 189] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2011] [Indexed: 11/24/2022]
Affiliation(s)
- Inmaculada Tomás
- Special Needs Unit; School of Medicine and Dentistry; Santiago de Compostela University; Santiago de Compostela
| | - Pedro Diz
- Special Needs Unit; School of Medicine and Dentistry; Santiago de Compostela University; Santiago de Compostela
| | - Aurelio Tobías
- Institute of Environmental Assesssment and Water Research; Spanish Council for Scientific Research; Barcelona; Spain
| | | | - Nikolaos Donos
- Periodontology Unit; UCL Eastman Dental Institute; London; UK
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain J. [Relationship between odontogenic infections and infective endocarditis]. Med Clin (Barc) 2011; 138:312-7. [PMID: 21632067 DOI: 10.1016/j.medcli.2011.03.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Revised: 03/26/2011] [Accepted: 03/31/2011] [Indexed: 10/18/2022]
Abstract
Revised guidelines for the prevention of infective endocarditis published by national and international associations in the last years do not support the indiscriminate use of antibiotic prophylaxis for dental procedures. However, some of them still recommend its use in high-risk patients before dental treatments likely to cause bleeding. Given the high prevalence of bacteremia of dental origin due to tooth-brushing, mastication or other daily activities, it appears unlikely that infective endocarditis from oral microorganisms can be completely prevented. A good oral health status and satisfactory level of oral hygiene are sufficient to control the consequences of the systemic spread of oral microorganisms in healthy individuals. However, caution is still needed and prophylactic antibiotics must be administered to susceptible or medically compromised patients. This review briefly outlines the current concepts of odontogenic bacteremia and antibiotic prophylaxis for patients undergoing dental treatment.
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Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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Bonz A, Babin-Ebel J, Hofmann U, Hagl C, Ertl G, Klaiber B. Auswirkung der präoperativen Zahnsanierung vor Herzklappenersatz auf die Inzidenz einer postoperativen Endokarditis. ZEITSCHRIFT FUR HERZ THORAX UND GEFASSCHIRURGIE 2011. [DOI: 10.1007/s00398-010-0819-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Eine klinisch prospektive Untersuchung zum Einfluss der Fokussanierung vor Herzklappenoperation auf den langfristigen zahnärztlichen Behandlungsbedarf. Wien Med Wochenschr 2009; 159:608-19. [DOI: 10.1007/s10354-009-0694-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2008] [Accepted: 06/24/2009] [Indexed: 10/19/2022]
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Kummer TR, Calvo MC, Cordeiro MMR, de Sousa Vieira R, de Carvalho Rocha MJ. Ex vivo study of manual and rotary instrumentation techniques in human primary teeth. ACTA ACUST UNITED AC 2008; 105:e84-92. [PMID: 18329573 DOI: 10.1016/j.tripleo.2007.12.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 12/04/2007] [Accepted: 12/07/2007] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to evaluate, ex vivo, time and dentin removal by manual and rotary instrumentation in human primary teeth. STUDY DESIGN Eighty primary teeth were divided into 2 groups, embedded in resin, and sectioned for evaluation before and after instrumentation. For manual technique, teeth were prepared using K-type files and rotary preparation was performed with Hero 642. All root canals were prepared up to size 40, and the instrumentation time was recorded. Dentin removal was calculated using digital image software. Data was statistically analyzed using chi-squared, Mann-Whitney, and t tests. RESULTS Manual instrumentation removed more dentin in all groups compared with rotary instrumentation (P < .05). In some specimens, root perforations were observed in areas coinciding with largest root resorption. Rotary technique showed the shortest instrumentation time (P < .05). CONCLUSIONS Deciduous teeth, without significant root resorption, have enough root structure for instrumentation up to size 40. Rotary technique required less time and generated less dentin removal.
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Affiliation(s)
- Thais Regina Kummer
- Brazil School of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina.
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Deppe H, Auer-Bahrs J, Kolk A, Hall D, Wagenpfeil S. Need for dental treatment following cardiac valve surgery: A clinical study. J Craniomaxillofac Surg 2007; 35:293-301. [PMID: 17761432 DOI: 10.1016/j.jcms.2007.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Accepted: 05/05/2007] [Indexed: 11/16/2022] Open
Abstract
AIM The aim of the present study was to evaluate the long-term need for dental treatment following non-radical treatment modes prior to cardiac valve surgery. PATIENTS From 1995 to 2001, a total of 305 patients were screened prior to cardiac surgery. After an average period of 36 months, 80 of these patients could be re-evaluated clinically (26%). Another 117 patients (38%) and their family doctors were contacted by telephone. METHODS Dental evaluation prior to cardiac valve replacement was performed clinically and radiographically. Tooth extraction was recommended in cases of carious or periodontal destruction, root remnants, partial retention or apical osteolysis despite endodontic treatment with poor prognosis for apicectomy. Periodontal therapy was recommended if attachment loss was less than 1/2 of the root length. No measures were undertaken for endodontically treated teeth without apical osteolysis and impacted teeth. In October 2002, oral health was re-evaluated in 80 patients. Dental treatment carried out in the follow-up period was documented and compared with the current findings. RESULTS At the time of re-evaluation, 60 of the total of 80 patients required dental treatment in 155 teeth; oral surgery was indicated in 51 of these 60 patients, mostly due to periodontal pathology. During the follow-up period, only 99 of the 142 dental interventions having taken place had been carried out with prophylactic antibiotic treatment. CONCLUSION From the results of this study it may be concluded that non-radical dental treatment modes prior to cardiac valve replacement can only be successful over the long-term if adequate postoperative dental care is provided. To achieve this aim, common follow-up monitoring forms, similar to those used for care of cancer patients, could facilitate communication.
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Affiliation(s)
- Herbert Deppe
- Department of Oral and Craniomaxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Germany.
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Vasanthan A, Dallal N. Periodontal treatment considerations for cell transplant and organ transplant patients. Periodontol 2000 2007; 44:82-102. [PMID: 17474927 DOI: 10.1111/j.1600-0757.2006.00198.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Asvin Vasanthan
- Department of Periodontics, School of Dentistry, University of Missouri-Kansas City, USA
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Diz Dios P, Tomás Carmona I, Limeres Posse J, Medina Henríquez J, Fernández Feijoo J, Alvarez Fernández M. Comparative efficacies of amoxicillin, clindamycin, and moxifloxacin in prevention of bacteremia following dental extractions. Antimicrob Agents Chemother 2006; 50:2996-3002. [PMID: 16940094 PMCID: PMC1563553 DOI: 10.1128/aac.01550-05] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We evaluated the efficacies of oral prophylactic treatment with amoxicillin (AMX), clindamycin (CLI), and moxifloxacin (MXF) in the prevention of bacteremia following dental extractions (BDE). Two hundred twenty-one adults who required dental extractions under general anesthesia were randomly assigned to a control group, an AMX group, a CLI group, and an MXF group (the individuals in the drug treatment groups received 2 g, 600 mg, and 400 mg, respectively, 1 to 2 h before anesthesia induction). Venous blood samples were collected from each patient at the baseline and 30 s, 15 min, and 1 h after the dental extractions. The samples were inoculated into BACTEC Plus aerobic and anaerobic blood culture bottles and were processed in a BACTEC 9240 instrument. Subculture and the further identification of the isolated bacteria were performed by conventional microbiological techniques. The prevalences of BDE in the control group, AMX group, CLI group, and MXF group were 96, 46, 85, and 57%, respectively, at 30 s; 64, 11, 70, and 24%, respectively, at 15 min; and 20, 4, 22, and 7%, respectively, at 1 h. Streptococcus spp. were the most frequently identified bacteria in all groups (44 to 68%), with the lowest percentage being detected in the AMX group (44%). AMX and MXF prophylaxis showed high efficacies in reducing the prevalence and duration of BDE, but CLI prophylaxis was noneffective. As a consequence, MXF prophylaxis is a promising antibiotic alternative for the prevention of BDE when beta-lactams are not indicated.
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Affiliation(s)
- P Diz Dios
- Department of Special Needs, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela 15872, Spain.
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Brincat M, Savarrio L, Saunders W. Endodontics and infective endocarditis – is antimicrobial chemoprophylaxis required? Int Endod J 2006; 39:671-82. [PMID: 16916356 DOI: 10.1111/j.1365-2591.2006.01124.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this review is to evaluate the evidence implicating nonsurgical endodontic procedures in inducing infective endocarditis (IE). The literature is reviewed and findings about dental procedures that elicit bacteraemia [in particular root canal treatment (RCT)], sequelae of bacteraemia, relationship between IE and RCT and variation between antibiotic prophylaxis (AP) guidelines are highlighted. At present, there is still significant debate as to which dental procedures require chemoprophylaxis and what antibiotic regimen should be prescribed. Currently, there are insufficient primary data to know whether AP is effective or ineffective against IE. Practitioners are bound by current guidelines and medico-legal considerations. Thus, the profession requires clear, uniform guidelines that are evidence-based.
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Affiliation(s)
- M Brincat
- Department of Periodontology, Glasgow Dental Hospital and School, Glasgow, UK.
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Önçağ Ö, Aydemir Ş, Ersin N, Koca H. Bacteremia Incidence in Pediatric Patients under Dental General Anesthesia. CONGENIT HEART DIS 2006; 1:224-8. [DOI: 10.1111/j.1747-0803.2006.00039.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Goldberg MH, Katz J. Infective endocarditis caused by fastidious oro-pharyngeal HACEK micro-organisms. J Oral Maxillofac Surg 2006; 64:969-71. [PMID: 16713816 DOI: 10.1016/j.joms.2006.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Morton H Goldberg
- Department of Oral and Maxillofacial Surgery, University of Connecticut, Hartford Hospital, West Hartford, CT.
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Abstract
BACKGROUND The authors reviewed the clinical features, epidemiology, pathogenesis and risk factors, medical management, dental findings and dental management of patients with restless legs syndrome (RLS). TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search for the years 2000 through 2004 using the key terms "restless legs syndrome," "epidemiology," "pathophysiology," "treatment" and "dentistry." They selected articles published in English in peer-reviewed journals for further review, and they gave preference to articles reporting randomized controlled trials. CONCLUSIONS RLS is a neurological disorder that is characterized by unpleasant sensations in the legs that occur at rest, especially at bedtime. These symptoms cause an irresistible urge to get out of bed and move the legs to relieve the discomfort, thereby delaying sleep onset and resulting in fatigue and dysphoria the next day. CLINICAL IMPLICATIONS The prevalence of dental disease may be extensive in patients with RLS because of diminished salivary flow resulting from the medications used to treat RLS. Patient education, saliva substitutes and anticaries agents are indicated. Special precautions must be taken when prescribing or administering sedative-hypnotic agents that are likely to have adverse reactions with the medications used to treat RLS.
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Affiliation(s)
- Arthur H Friedlander
- General Medical Education, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.
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Bailey R, Gueldner S, Ledikwe J, Smiciklas-Wright H. The Oral Health of Older Adults: An Interdisciplinary Mandate. J Gerontol Nurs 2005; 31:11-7. [PMID: 16047955 DOI: 10.3928/0098-9134-20050701-05] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Regan Bailey
- Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
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Abstract
Bacterial endocarditis (BE), a rare heart infection caused by a bacteremia, has frequently been blamed on but rarely caused by dental procedures. Viridans group streptococci are found abundantly in the mouth and the gingival sulcus but have been surpassed by staphylococci as the leading cause of BE. Antibiotic prophylaxis has been recommended before dental procedures in patients at risk for BE, but it remains controversial because studies have failed to show that antibiotic prophylaxis is an effective preventive for BE or that dental procedures are an important cause of BE. The risks and costs of antibiotic prophylaxis, including antibiotic resistance, cross-reactions with other drugs, allergy, anaphylaxis, and even death, may exceed the benefits in preventing BE. The rationale for the use of antibiotic prophylaxis to prevent BE allegedly caused by dental procedure bacteremias must be seriously reexamined based on recent evidence, particularly the absolute risk rates for endocarditis after a given dental procedure.
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Affiliation(s)
- Michael J Wahl
- Wahl Family Dentistry, 1601 Concord Pike, Wilmington, DE 19803, USA.
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Takai S, Kuriyama T, Yanagisawa M, Nakagawa K, Karasawa T. Incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures. ACTA ACUST UNITED AC 2005; 99:292-8. [PMID: 15716834 DOI: 10.1016/j.tripleo.2004.10.022] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to determine the incidence and bacteriology of bacteremia associated with various oral and maxillofacial surgical procedures. METHODS A total of 237 patients who underwent oral and maxillofacial surgery were included in this study. Blood samples were obtained for bacteriological examination immediately after the essential steps of the surgical procedure had been performed. RESULTS Bacteremia was detected in patients who underwent surgery for tumor, infection and trauma, and surgical reconstruction of jaw. In particular, decortication for osteomyelitis and tooth extraction resulted in a higher incidence of bacteremia compared with other surgical procedures. The incidence of bacteremia was not affected by oral hygiene, gingival inflammation, blood loss, and duration of surgery. Furthermore, concerning tooth extraction, there was no statistical difference in the incidence of bacteremia with respect to the number of teeth extracted and the method of extraction. Extraction of teeth with odontogenic infection (periodontitis, periapical infection, and pericoronitis) did however produce a significantly increased incidence of bacteremia compared with infection-free teeth (P < .01). Viridans streptococci were the predominant group of bacteria isolated from the bacteremias. CONCLUSION Oral and maxillofacial surgery involving transoral incision produces bacteremia, regardless of the extent and degree of surgical invasion. In particular, surgical procedure at infected sites is more likely to result in bacteremia compared with infection-free sites.
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Affiliation(s)
- Sumie Takai
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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Abstract
In dentistry, chronic periodontitis often leads to bone resorption together with an increasing risk of bacteremia. Bioactive glass has found extensive application as dental graft material. A successful antimicrobial bactericidal effect has been shown from the introduction of Ag2O into the glass composition. In this study, the cytotoxicity of soluble silver, calcium and silica ions on primary human osteoblasts was investigated by measurements of mitochondrial activity and neutral red dye uptake. Silver concentrations of 4 - 6 ppm (1 mg/ml conc.) and 6 - 9 ppm (2 mg/ml conc.) have been measured in complete culture medium. It was found that the bioactive gel-glass extract with an initial concentration of 1 mg/ml (1mg glass per ml of culture medium) has no negative effect, whereas increased gel-glass concentration of 2 mg/ml seemed to have a toxic effect on the cell viability of human osteoblasts. It might be concluded that a reduction of the rate of silver dissolution from the bioactive gel-glass might preserve a maximum cell viability.
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Abstract
Oral infections can be odontogenic or nonodontogenic in origin. Odontogenic infections are most prevalent and include dental caries, periodontal disease, and suppurative deep space infections. Nonodontogenic infections include sialadenitis and parotitis, vesiculobullous gingivostomatitis, aphthous ulcers, oropharyngeal candidiasis, and severe oral mucositis in the immunocompromised host. Clinical presentations can be variable. An understanding of the underlying anatomic structures, the oral microflora, and associated medical conditions of the host is critical to guide appropriate diagnosis and management. In this paper, preventative strategies to reduce dental plaque formation and promote oral health are emphasized.
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Affiliation(s)
- Mark W Hull
- Division of Infectious Diseases, Vancouver Hospital, 2733 Heather Street, Vancouver, BC V5Z 3J5, Canada.
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Abstract
BACKGROUND This article reviews the clinical features, epidemiology, pathophysiology, dental findings, and dental and medical management of the care of patients with panic disorder, or PD. TYPES OF STUDIES REVIEWED The authors conducted a MEDLINE search for the period 1998 through 2003, using the key term "panic disorder" to define the pathophysiology of the disorder, its epidemiology and dental implications. The articles they selected for further review included those published in peer-reviewed journals. RESULTS PD is a common and debilitating psychiatric disease in which a person experiences sudden and unpredictable panic attacks, or PAs, with symptoms of overwhelming anxiety, chest pain, palpitations and shortness of breath. Persistent concern about having another attack and worry that it may indicate a heart attack or "going crazy" impairs the person's social, family and working lives. Frequently accompanying the disorder is agoraphobia, depression and mitral valve prolapse, or MVP. CLINICAL IMPLICATIONS In patients with PD, the prevalence of dental disease may be extensive because of the xerostomic effects of psychiatric medications used to treat it. Dental treatment consists of preventive dental education and prescribing saliva substitutes and anticaries agents. Precautions must be taken when prescribing or administering analgesics, antibiotics or sedative agents that may have an adverse interaction with the psychiatric medications. Because there is a connection between PAs and MVP, the dentist needs to consult with the patient's physician to determine the presence of MVP and whether there is associated mitral valve regurgitation. Patients with MVP and accompanying mitral valve regurgitation require prophylactic antibiotics when undergoing dental procedures known to cause a bacteremia and heightened risk of endocarditis.
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40
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Abstract
Oral health is influenced by oral microbial flora, which are concentrated in dental plaque. Dental plaque provides a microhabitat for organisms and an opportunity for adherence of the organisms to either the tooth surface or other microorganisms. In critically ill patients, potential pathogens can be cultured from the oral cavity. These microorganisms in the mouth can translocate and colonize the lung, resulting in ventilator-associated pneumonia. The importance of oral care in the intensive care unit has been noted in the literature, but little research is available on mechanical or pharmacological approaches to reducing oral microbial flora via oral care in critically ill adults. Most research in oral care has been directed toward patients’ comfort; the microbiological and physiological effects of tooth brushing in the intensive care unit have not been reported. Although 2 studies indicated reductions in rates of ventilator-associated pneumonia in cardiac surgery patients who received chlorhexidine before intubation and postoperatively, the effects of chlorhexidine in reducing ventilator-associated pneumonia in other populations of critically ill patients or its effect when treatment with the agent initiated after intubation have not been reported. In addition, no evaluation of the effectiveness of pharmacological and mechanical interventions relative to each other or in combination has been published. Additional studies are needed to develop and test best practices for oral care in critically ill patients.
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Affiliation(s)
- Cindy L. Munro
- School of Nursing, Virginia Commonwealth University, Richmond, Va
| | - Mary Jo Grap
- School of Nursing, Virginia Commonwealth University, Richmond, Va
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Friedlander AH, Sung EC, Child JS. Radiation-induced heart disease after Hodgkin’s disease and breast cancer treatment. J Am Dent Assoc 2003; 134:1615-20. [PMID: 14719759 DOI: 10.14219/jada.archive.2003.0108] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND People with Hodgkin's disease and breast cancer often receive therapeutic irradiation to the chest (mediastinum) as an element of treatment. While the therapy often cures the malignancy, it has been implicated in causing late-onset heart disease that may influence the provision of dental treatment. TYPE OF STUDIES REVIEWED The authors conducted a MEDLINE search of the years 1995 through 2002 using the key terms "Hodgkin's disease," "breast cancer," "radiation therapy," "cardiac valves" and "coronary artery" to define the pathophysiology of the disorder, its epidemiology and dental implications. The articles they selected for further review included those published in English in peer-reviewed journals. RESULTS Therapeutic irradiation of the chest results in the inadvertent inclusion of the heart within the irradiation field. Over the next 10 to 20 years, some of these people may experience pathological changes of the heart valves that could predispose them to endocarditis, accelerated atherosclerosis of the coronary artery that heightens their risk of experiencing a fatal myocardial infarction or both. CLINICAL IMPLICATIONS Dentists need to identify patients who have received therapeutic irradiation to the chest and consult with the patients' physicians to determine whether the therapy has damaged the heart valves or coronary arteries. Patients with radiation-induced valvular disease may require prophylactic antibiotics when undergoing specific dental procedures that are known to cause a bacteremia and a heightened risk of developing endocarditis. Patients with radiation-induced coronary artery disease should be administered only limited amounts of local anesthetic agents containing a vasoconstrictor, and they may require the administration of sedative agents and cardiac medications to preclude ischemic episodes.
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Abstract
Tooth brushing is known to cause bacteraemias, which could theoretically potentially lead to the development of infective endocarditis. It is therefore paradoxical that tooth brushing is not thought to cause infective endocarditis. The reasons for this lack of association are not clear, but may be related to the fact that most oral procedures do not have a high association with infective endocarditis. There is no definitive data on the relative risks of using manual or electric toothbrushes in patients predisposed to infective endocarditis. It may be prudent to advise patients predisposed to infective endocarditis to use adjunctive chlorhexidine when cleaning their teeth with either a manual or electric toothbrush. The use of adjunctive chlorhexidine reduces the magnitude of any bacteraemia caused by tooth brushing and may interfere with the bacteria that could potentially cause infective endocarditis. Prophylactic antibiotics are not warranted for tooth brushing in patients at risk of infective endocarditis.
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Affiliation(s)
- Michael Martin
- Department of Clinical Dental Sciences, University of Liverpool, UK.
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Abstract
OBJECTIVES To review the potential of periodontal infections to cause nonoral diseases. Therapeutic recommendations are provided to help patients and dental practitioners prevent systemic complications from periodontal infections. FINDINGS Systemic diseases from oral bacteria are mostly caused by transient bacteraemias, which can occur spontaneously from dental foci of infection, from mastication, brushing, flossing or other daily manipulations, or from dental treatments. Examples of systemic infections that may involve oral microorganisms include infective endocarditis, aspiration pneumonia, HIV-related disseminated candidiasis and cancrum oris, septicaemia associated with cancer chemotherapy and radiotherapy, necrotising faciitis and various other life-threatening infections. Inflamed gingiva constitutes a significant reservoir for herpes viruses, which have the potential to cause serious systemic diseases in immunocompromised patients. Periodontal disease may also aggravate chronic insulin insensitivity and thus interfere with glycaemic control in diabetic patients. Controversy surrounds the involvement of periodontal infections in coronary heart disease. CONCLUSIONS Cumulative evidence suggests that periodontal disease can be an important cause of morbidity and mortality of various systemic diseases, especially in individuals exhibiting compromised host defence. Maintaining a healthy dentition and periodontium by means of daily oral hygiene practice and regular professional care is the most effective way of preventing systemic diseases from oral infections.
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Affiliation(s)
- Jørgen Slots
- University of Southern California, School of Dentistry, Los Angeles 90089-0641, USA.
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Holmstrup P, Poulsen AH, Andersen L, Skuldbøl T, Fiehn NE. Oral infections and systemic diseases. Dent Clin North Am 2003; 47:575-98. [PMID: 12848466 DOI: 10.1016/s0011-8532(03)00023-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
An association between periodontal infection and CVD has been revealed in some epidemiologic studies, whereas other studies were unable to demonstrate such an association. A link between the two diseases may be explained by shared established or nonestablished risk factors. Future studies with extended control of confounding factors and intervention studies may add to the understanding of a possible relationship between the diseases. In some cases, IE is caused by dental plaque bacteria. Several studies are suggestive of oral bacteria causing respiratory infection. The pathogenesis and course of a number of other diseases including DM and rheumatoid arthritis have been associated wish periodontitis, but more research is necessary to elucidate possible pathogenic interactions.
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Affiliation(s)
- Palle Holmstrup
- Department of Periodontology, School of Dentistry, University of Copenhagen, 20 Nørre Allé DK-2200, Copenhagen, Denmark.
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Sixou JL, Magaud C, Jolivet-Gougeon A, Cormier M, Bonnaure-Mallet M. Microbiology of mandibular third molar pericoronitis: incidence of beta-lactamase-producing bacteria. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:655-9. [PMID: 12789143 DOI: 10.1067/moe.2003.238] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the predominant flora associated with pericoronitis in third molars and to investigate the presence of beta-lactamase-producing strains. STUDY DESIGN The third molars in 26 adults were evaluated by cultures with nonselective media and with selective media containing amoxicillin, pristinamycin, spiramycin, metronidazole, and spiramycin plus metronidazole. RESULTS In the majority of cases (19/26), the flora found in an anaerobic atmosphere predominated. Obligate anaerobes were present in 21 of the 26 samples. The bacteria most commonly detected were alpha-hemolytic streptococci (26/26) and the genera Prevotella (15/26), Veillonella (15/26), Bacteroides (9/26), and Capnocytophaga (9/26). Amoxicillin and pristinamycin were the most active in reducing the anaerobic cultivable counts. beta-Lactamase-producing strains were detected in 9 samples and were mostly bacteria of the genera Prevotella, Staphylococcus, and Bacteroides. CONCLUSIONS These results highlight (1) the diversity of the microflora associated with pericoronitis and the importance of the anaerobic flora and (2) the existence of selection pressure related to the use of beta-lactams that may culminate in failure of prescribed penicillins.
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Abstract
The diagnosis of infective endocarditis has been notoriously difficult. Over the last decade, the modified Duke criteria have assumed an increasingly important role in the early detection of this often occult disease. Echocardiography has assumed increasing importance. Transesophageal echocardiography is recognized as more sensitive and specific than transthoracic echocardiography at detecting vegetations less than 10 mm in diameter. Vegetations greater than 10 mm in diameter are thought to be at increased risk of embolizing. Combined medical and surgical medical management result in the lowest mortality for those patients with hemodynamic compromise.
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Affiliation(s)
- Blaithnead Murtagh
- University of Texas Medical School, Department of Medicine, Houston 77030, USA
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Scully C, Kumar N. Dentistry for those requiring special care. PRIMARY DENTAL CARE : JOURNAL OF THE FACULTY OF GENERAL DENTAL PRACTITIONERS (UK) 2003; 10:17-22; quiz 30. [PMID: 12621856 DOI: 10.1308/135576103322504067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Individuals with special needs, namely those whose dental care is complicated by a physical, mental or social disability, often have a higher level of unmet dental need and poorer oral hygiene than the general population, and offer unique challenges to the dental practitioner. This paper outlines the dental management of the three most common groups of individuals with special needs.
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Affiliation(s)
- Crispian Scully
- International Centres for Excellence in Dentistry, Eastman Dental Institute for Oral Healthcare Sciences, University College London, UK.
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