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Background: Leukaemia is a malignant neoplasm characterized by clonal proliferation of white blood cells within the bone marrow. Despite an increase in the white blood cell count, the leukaemic leukocytes are non-functional. The oral complications arising in leukaemic patients can be attributed to the direct and indirect effects of immunosuppressive chemotherapy. Methods: This case report describes severe maxillary and mandibular necrotizing stomatitis and osteomyelitis in a young female patient after chemotherapy for acute leukaemia. On physical examination, the patient presented malnourished with pale skin, cervical lymphadenitis, frequent fever and generalized pain. The intra-oral clinical examination found halitosis, multiple ulcers, necrotizing stomatitis and osteomyelitis located in the maxillary and mandibular regions. The necrotizing stomatitis and osteomyelitis were treated locally with atraumatic removal of the necrotized tissues. The patient received a daily preventive protocol consisting of oral hygiene care, including twice daily brushing, and mouthrinses with a solution of chlorhexidine. She was also treated with systemic metronidazole and amoxicillin for 21 days. Results: During the course of management the patient's oral condition improved with some re-epithelialization being noted. However, severe alveolar bone destruction remained evident. Thirty-two months after presentation of the initial symptoms, the patient died due to complications related to leukaemia recurrence (haemorrhage, sepsis and respiratory distress syndrome). Conclusions: Dental monitoring during cancer treatment is imperative in order to emphasize the importance of dental plaque control and the maintenance of a healthy periodontal condition throughout medical treatment. [ABSTRACT FROM AUTHOR]

Background: Anxiety symptoms are frequently observed in dental patients, whether they are undergoing simple or more invasive procedures such as surgery. This research aimed to compare the effects of Passiflora incarnata and midazolam for the control of anxiety in patients undergoing mandibular third molar extraction., Material and Methods: Forty volunteers underwent bilateral extraction of their mandibular third molars in a randomized, controlled, double-blind, crossover clinical trial. Passiflora incarnata (260 mg) or midazolam (15 mg) were orally administered 30 minutes before surgery. The anxiety level of participants was evaluated by questionnaires and measurement of physical parameters, including heart rate (HR), blood pressure (BP), and oxygen saturation (SpO2)., Results: Considering each procedure independently, there were no significant differences between the protocols in BP, HR, and SpO2. Over 70% of the volunteers responded that they felt quiet or a little anxious under both protocols. With midazolam, 20% of the participants reported amnesia (not remembering anything at all), while Passiflora showed little or no ability to interfere with memory formation., Conclusions: Passiflora incarnata showed an anxiolytic effect similar to midazolam, and was safe and effective for conscious sedation in adult patients who underwent extraction of their mandibular third molars., Competing Interests: The authors have declared that no conflict of interest exist.

Childhood obesity is an increasing problem at the global level and considered as a risk factor for obesity development and the associated co-morbidities in adult life. In this study, the occurrence of Bacteroides fragilis group, Clostridium spp., Bifidobacterium spp. and Escherichia coli in 84 faecal samples from 30 obese, 24 overweight and 30 lean children was verified by culture technique and quantitative determination by quantitative PCR. In addition, Lactobacillus spp. and Methanobrevibacter smithii were also analysed. A correlation between the body mass index (BMI) and these bacteria was sought. Bacteroides vulgatus, Clostridium perfringens and Bifidobacterium adolescentis were most prevalent in all samples evaluated by culture-method. The B. fragilis group were found at high concentrations in obese and overweight children when compared with the lean ones (p 0.015). The obese and overweight children harboured higher numbers of Lactobacillus spp. than lean children (p 0.022). The faecal concentrations of the B. fragilis group (r = 0.24; p 0.026) and Lactobacillus spp. (r = 0.44; p 0.002) were positively correlated with BMI. Bifidobacterium spp. were found in higher numbers in the lean group than the overweight and obese ones (p 0.042). Furthermore, a negative correlation between BMI and Bifidobacterium spp. copy number (r = -0.22; p 0.039) was observed. Our findings show some difference in the intestinal microbial ecosystem of obese children compared with the lean ones and a significant association between number of Lactobacillus spp. and B. fragilis group and BMI., (Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Objective: To compare the antimicrobial activity of tea tree oil, garlic, and chlorhexidine solutions against oral microorganisms., Method: The five-week study consisted of thirty subjects. The first week was considered baseline. All subjects used a control solution (second week), and were randomly divided into the three groups (third week): G1-0.12% chlorhexidine; G2 - 2.5% garlic (Allium sativum, L.); and G3 - 0.2% tea tree oil (Melaleuca alternifolia). Dishes containing blood agar and Mitis Salivarius Bacitracin agar (MSB) were inoculated with the subjects' saliva (collected twice a week). Total microorganisms and mutans streptococci were counted in blood agar and MSB, respectively., Results: Chlorhexidine and garlic groups showed antimicrobial activity against mutans streptococci, but not against other oral microorganisms. The tea tree oil group showed antimicrobial activity against mutans streptococci and other oral microorganisms. Maintenance of reduced levels of microorganisms was observed only for garlic and tea tree oil during the two consecutive weeks (fourth and fifth). Unpleasant taste (chlorhexidine 40%, tea tree oil 30%, garlic 100%), burning sensation (chlorhexidine 40%, tea tree oil 60%, garlic 100%), bad breath (chlorhexidine 40%, tea tree oil 20%, garlic 90%), and nausea (chlorhexidine 0%, tea tree oil 10%, garlic 30%) were reported., Conclusion: Garlic and tea tree oil might be an alternative to chlorhexidine.

Few reports are available about tissue concentration of amoxicillin. The techniques used to measure tissue concentration usually require rupture and are expensive. The objective of the present study is to assess the utility of an animal model to predict tissue concentration of amoxicillin using induced granulomatous tissue. We used 160 rats with four polyurethane sponges previously implanted in their backs. At 7, 14, 21 and 28 d after sponge introduction, groups of eight animals each received 3.5, 7.0, 40.0 or 80.0 mg/kg of amoxicillin (p.o.) or 1 ml of 0.9% NaCl solution (control group). One hour after drug administration, 10 microl of serum and granulomatous tissue were obtained. Tissue and serum were placed on different plates containing Mueller Hinton agar inoculated with 10(8) cfu (colony forming unit) of Staphylococcus aureus (ATCC 25923), and the diameters of the inhibition zones were measured after 18 h of incubation. Analysis of variance showed no statistically significant differences (p>0.05) among time periods for the same dose of amoxicillin. These results suggest that the pharmacokinetics of amoxicillin did not change in relation to the development of granulomatous tissue; therefore this method is valid to measure the tissue concentration of amoxicillin.

The purpose of this study was to evaluate the influence of caffeine and theophylline on the development of dental caries in rats. Six Wistar dams (spf), mutans streptococci free, were obtained, each with six male pups. The dams were infected by Streptococcus sobrinus 6715 and divided into three groups which received during the lactating period: (1) diet 2000; (2) diet 2000 plus caffeine (2 mg/100 g) and (3) diet 2000 plus theophylline (0.57 mg/100 g). After weaning, the pups were infected by S. sobrinus, placed in a König-Höfer programmed feeder machine, and received 17 meals daily at hourly intervals, for five weeks. During this time the pups were fed with the same diet that their dams were. The percentage of S. sobrinus relative to total flora was significantly higher in the theophylline group. The results for slight (Ds) and moderate (Dm) dentine lesions, for smooth-surface and sulcal scores were statistically higher for the theophylline group than the other groups. Salivary assays did not demonstrate significant inorganic alterations in salivary composition. Caffeine and theophylline groups showed the highest ulcer score. It is concluded that caffeine does not affect the cariogenic potential of the diet, however theophylline can increase the development of dental caries, and this effect may be related to organic alterations of salivary composition.