Laurylene César de Souza Vasconcelos

Use of Punica granatum as an antifungal agent against candidosis associated with denture stomatitis

The aim of this study was to evaluate the use of a gel containing the extract of Punica granatum as an antifungal agent against candidosis associated with denture stomatitis. Sixty patients with denture stomatitis confirmed by clinical and mycologic examination were selected. The patients were randomly allocated in two groups of 30 individuals each according to the medication prescribed: group A used miconazole (Daktarin® gel oral) and group B used a gel of P. granatum Linné (pomegranate). Both groups used the medicines three times per day for 15 days. Forty‐eight hours after finishing the treatment the patients were re‐examined and a second set of samples was collected for mycologic examination. The medicines were evaluated for their clinical response and negativity for Candida. The clinical results showed a satisfactory and regular response in 27 and 21 subjects of groups A and B, respectively. Negativity of yeasts was observed in 25 subjects of group A and 23 of group B. It can be concluded that the extract of P. granatum may be used as a topical antifungal agent for the treatment of candidosis associated with denture stomatitis.

Minimum inhibitory concentration of adherence of Punica granatum Linn (pomegranate) gel against S. mutans, S. mitis and C. albicans

The purpose of this study was to investigate the antimicrobial effect of a Punica granatum Linn (pomegranate) phytotherapeutic gel and miconazole (Daktarin oral gel) against three standard streptococci strains (mutans ATCC 25175, sanguis ATCC 10577 and mitis ATCC 9811), S. mutans clinically isolated and Candida albicans either alone or in association. The effect of minimum inhibitory concentrations of the gels on the adherence of these microorganisms to glass was assessed in the presence of 5% sucrose, using increasing and doubled concentrations of the diluted solution of the gels ranging from 1:1 to 1:1024. The minimum inhibitory concentrations of adherence of Punica granatum L. gel against the test organisms were: 1:16 for S. mutans (ATCC), S. mutans (CI) and S. sanguis; 1:128 for S. mitis and 1:64 for C. albicans. The minimum inhibitory concentrations of adherence of miconazole against the same organisms were: 1:512, 1:64, 1:4, 1:128 and 1:16, respectively. In experiments with three and four associated microorganisms, the Punica granatum L. gel had greater efficiency in inhibiting microbial adherence than the miconazole. The results of this study suggest that this phytotherapeutic agent might be used in the control of adherence of different microorganisms in the oral cavity.

Cell Viability of Candida albicans Against the Antifungal Activity of Thymol

Candida albicans is a commensal fungus, but circumstantially it may cause superficial infections of the mucous membranes, such as denture stomatitis, when a biofilm is formed on the surface of dental prostheses. This study evaluated the cell viability of C. albicans biofilms against the antifungal activity of thymol when compared with miconazole, by the fluorescence imaging using SYTO 9 and propidium iodide dyes, and counting of colony forming units. C. albicans standard strains (ATCC 11006) were used. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of drugs were determined by broth microdilution tests and the inoculum was standardized to match 0.5 on the McFarland scale (106 cfu/mL). Biofilms were grown on the surface of acrylic resin disks in parallel flow chambers from Sabouraud broth supplemented with 10% dextrose. For counting of colony forming units, the fungal solution was sequentially diluted and plated in Sabouraud dextrose agar. Data were analyzed using two-way ANOVA and Tukeys test (a=5%). Biofilms treated with thymol and miconazole presented low numbers of viable cells at the evaluated exposure times. There was statistically significant difference (p<0.05) when compared with control, and the mean value of the exposure times between miconazole and thymol did not differ significantly (p>0.05). In conclusion, both drugs have similar efficiency as antifungal agents against biofilms of C. albicans formed on acrylic surfaces.

Evaluation of an oral health program for children in early childhood

Purpose: To evaluate an educative and oral health promotion program for children from three public daycare facilities in the city of Joao Pessoa (PB), in the Northeastern region of Brazil. Methods: Sample was composed of 219 children who were divided into four age groups: 0 to 12, 13 to 24, 25 to 36 and 37 to 48 months. All children were submitted to clinical exams and preventive procedures of hygiene and topical application of fluoride at 3-month intervals during 12 months. Mothers were given instructions of oral hygiene of their children. The dmft index and the presence of active white spots (AWS) were recorded. Results: Mean (SD) values of the initial and final dmft were 0.65 (1.3) and 0.72 (1.5), respectively (P < 0.05). The initial and final numbers of AWS were 44 and 08, respectively. The absence of nocturnal hygiene was associated with AWS for children that received nocturnal breast-feeding. The most relevant variables for dental caries development were: age group, absence of nocturnal oral hygiene and nocturnal breast-feeding; for AWS only the absence of nocturnal oral hygiene was significant (P < 0.05). Conclusion: This oral health program showed to be effective in the maintenance of oral health. The most relevant risk factors for dental caries were absence of nocturnal oral hygiene and nocturnal breast-feeding.

Streptococcus mutans in denture stomatitis patients under antifungal therapy

PURPOSE: To assess the number of Streptococcus mutans in saliva of patients with denture stomatitis before and after antifungal therapy. METHODS: After examining 93 patients, 47 were selected for fungal test. Then, from this sample, thirty patients were selected: 15 with positive and 15 with negative diagnosis for candidiasis that were evaluated for S. mutans counting, salivary flow and buffer capacity evaluation. Oral hygiene and prosthesis hygiene, period using prosthesis, lesion type and salivary data were related with clinical laboratorial characteristics of the patients with Candida. RESULTS: The most frequent lesions were type I (43.5%) and II (53.5%). The amount of S. mutans was six times higher in patients with candidiasis and it was associated with low salivary flow and poor oral hygiene. After therapy, a reduction of S. mutans was verified particularly in patients with normal salivary flow. The values ranged from 0.01 to 3.88 x 104 cfu/mL. CONCLUSION: The data suggest that Streptococcus spp collaborates with Candida spp in the etiology and pathogenesis of denture stomatitis. The use of oral antimicrobial agents may provide a beneficial effect for denture stomatitis patients that are under antifungal therapy and that have poor oral hygiene and unfavorable salivary parameters.