Leandro Dorigan de Macedo

Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis

The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45 masculine angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm.

Complete denture biofilm after brushing with specific denture paste, neutral soap and artificial saliva

This study compared the levels of biofilm in maxillary and mandibular complete dentures and evaluated the number of colony-forming units (cfu) of yeasts, after using auxiliary brushing agents and artificial saliva. Twenty-three denture wearers with hyposalivation and xerostomia were instructed to brush the dentures 3 times a day during 3 weeks with the following products: Corega Brite denture dentifrice, neutral liquid soap, Corega Brite combined with Oral Balance (artificial saliva) or tap water. For biofilm quantification, the internal surfaces of the dentures were disclosed, photographed and measured using a software. For microbiological analysis, the biofilm was scrapped off, and the harvested material was diluted, sown in CHROMagar™ Candida and incubated at 37°C for 48 h. Data were analyzed statistically by two-way ANOVA and Tukeys test (α=0.05). Mandibular dentures presented a mean biofilm percentage (µ=26.90 ± 21.10) significantly greater than the maxillary ones (µ=18.0 ± 15.0) (p<0.05). Brushing using Corega Brite combined with Oral Balance (µ=15.87 ± 18.47) was more effective (p<0.05) than using the denture dentifrice (µ=19.47 ± 17.24), neutral soap (µ=23.90 ± 18.63) or tap water (control; µ=32.50 ± 20.68). For the microbiological analysis, the chi-square test did not indicate significant difference between the hygiene products for either type of denture. The more frequently isolated species of yeasts were C. albicans, C. tropicalis and C. glabrata. In conclusion, mandibular dentures had more biofilm formation than maxillary ones. Denture brushing with Corega Brite dentifrice combined with the use of Oral Balance was the most effective method for reduction of biofilm levels, but the use of products did not show difference in yeast cfu counts.

Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) who received intravenous or oral bisphosphonates (BP) were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI), amplitude-dependent speed of sound (AD-SoS), bone biophysics profile (BBP), and bone transmission time (BTT) were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82); 10 (58.8%) were male and seven (41.1%) were female, of whom 11 (64.7%) suffered from multiple myeloma, three (17.6%) from osteoporosis, one (5.8%) from prostate cancer, one (5.8%) from kidney cancer, and one (5.8%) from leukemia. Fourteen (82.3%) of them received intravenous BP whereas three (17.6%) received oral BP. Nine (9/17; 52.9%) patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004). The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.

Oral Health Conditions of Patients with Sjögren's Syndrome

older than 18 years (62.5%) was observed. A higher frequency of neurological and psychomotor disorders (54.5%), hypertension (29.5%), and diabetes mellitus (15.9%) was found. Further, 21.6% of the patients reported “dry mouth.” The drugs often used were anticonvulsants (46.5%), anxiolytics (35.2%), and anti-hypertensives (34%). The highest percentage of lesions corresponded to gingival enlargement (19.3%), followed by gingivitis (10.2%) and candidiasis (7.9%), in patients with the most common systemic disorders. Conclusion: It is expected that the results derived from this research can contribute to a better understanding of the interrelationship between the use of drugs and the appearance of lesions in the oral mucosa, as well as, indirectly, to improving oral health of patients with special needs.

Relationship between human immunodeficiency virus (HIV-1) infection and chronic periodontitis

ABSTRACT Introduction: Current studies show that, even in the era of antiretroviral therapies, HIV-1 infection is associated with more severe and frequent refractory chronic periodontitis. Areas covered: This review, based on a systematic analysis of the literature, intends to provide an update on factors that may be involved in the pathogenesis of periodontal disease in HIV-1-infected patients, including local immunosuppression, oral microbial factors, systemic inflammation, salivary markers, and the role of gingival tissue as a possible reservoir of HIV-1. Expert commentary: The therapeutic revolution of ART made HIV-1 infection a chronic controllable disease, reduced HIV-1 mortality rate, restored at least partially the immune response and dramatically increased life expectancy of HIV-1-infected patients. Despite all these positive aspects, chronic periodontitis assumes an important role in the HIV-1 infection status for activating systemic inflammation favoring viral replication and influencing HIV-1 status, and also acting as a possible reservoir of HIV-1. All these issues still need to be clarified and validated, but have important clinical implications that certainly will benefit the diagnosis and management of chronic periodontitis in HIV-1-infected patients, and also contributes to HIV-1 eradication.

Fine needle aspiration biopsy of mandible: an effective alternative to conventional biopsy for the differential diagnosis between metastasis and osteonecrosis in oncologic patients treated with bisphosphates - Case report

1 Residência Multiprofissional em Atenção Integral a Saúde do HCRP; Cirurgiã-dentista autônomo. Ribeirão Preto, SP, Brazil. 2 Master (2004) and PhD in Sciences (2010) in Human Pathology by the Medical School of Ribeirão Preto University of São Paulo USP; Assitent Doctor of Patology Service of Clinical Hospital of Medicine Faculty of Univesity of São Paulo. Ribeirão Preto, SP, Brazil. 3 Specialization in Oral and Maxillofacial Surgery and Traumatology, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, Brazil (2006; Dentistry Assistant of Odontology and Stomatology Service of Clinical Hospital of Medicine Faculty of Univesity of São Paulo. Ribeirão Preto, SP, Brazil. 4 Master’s degree in Integrated Dental Clinic, with emphasis on Oral Pathology and Diagnosis 2010. PhD from the Graduate Program In Stomatopathology of the Faculty of Dentistry of Piracicaba 2013; Dentistry Assistant of Odontology and Stomatology Service of Clinical Hospital of Medicine Faculty of Univesity of São Paulo. Ribeirão Preto, SP, Brazil. 5 Master and Doctorate in Oral Impairment by the School of Dentistry of Ribeirão Preto USP; Dentistry Assistant of Odontology and Stomatology Service of Clinical Hospital of Medicine Faculty of Univesity of São Paulo. Ribeirão Preto, SP, Brazil.