Detecção precoce de bactérias periodontopatogênicas e a ação de um gel de metronidazol 25% em crianças com Diabetes mellitus tipo I / Early detection of periodontopathogenic bacteria and the effect of a topic metronidazole 25% gel in children with type I Diabetes mellitus

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

Type I Diabetes mellitus (IDDM) is a metabolic disease characterized by deficiency on the insulin production, causing great systemic alterations, including at the oral cavity. Periodontal disease is more aggressive in diabetic patients, even during the childhood, and presents as etiological microorganisms the Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), formerly Actinobacillus actinomycetemcomitans. This microorganisms in association to alterations in the immune and inflammatory answers caused by diabetes, can promote a larger and early alveolar bone resorption even in children. So, the early identification of these aggressors could be extremely useful for the institution of preventive and therapeutic measures in order to inhibit or minimize the noxious effects of IDDM and their consequences in the oral cavity. Aiming this early identification, molecular biology methods of investigation are being used more frequently, pointing out the Real Time Polymerase Chain Reaction (Real-Time PCR), which presents high specificity and sensibility to detect and to quantify microorganisms, even in small number and in different media little explored like saliva. The use of a safe topical antibiotic, such as metronidazole 25% gel, which used in association with dental brushing, could reduce or eliminate A. actinomycetemcomitans, avoiding the progression of the periodontal disease. This study evaluated the presence of A. actinomycetemcomitans before and after the use of metronidazole 25% gel once a day, in substitution to one of the daily teeth brushing. It also evaluated the influence of this treatment protocol on the plaque, gingival and probing depth indexes. Thirty-two children, aging from 3 to 12 years were included in this study and they were divided into two groups: type I diabetic (D) and no diabetic (ND). Real-Time PCR methods were used to evaluate the presence of A. actinomycetemcomitans. The obtained data suggest that metronidazole 25% gel, applied according to the established protocol in this study, effectively reduced plaque and gingival indexes and the number of A. actinomycetemcomitans. However, no influence was observed regarding the probing depth. The obtained data suggest that, although the number of bacteria has been small and the difference between the D and ND groups was not observed only regarding probing depth, the studied antibiotic gel demonstrated to be promising in preventing periodontal disease in diabetic children. More randomized clinical trials are necessary for a final conclusion.

ASSUNTO(S)

diabetes mellitus gingival diseases doenças da gengiva metronidazole actinobacillus actinomycetemcomitans reação em cadeia da polimerase actinobacillus actinomycetemcomitans metronidazol diabetes mellitus polymerase chain reaction

ACESSO AO ARTIGO

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