Letteratura scientifica selezionata sul tema "Periodontium Infections"
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Articoli di riviste sul tema "Periodontium Infections"
1
Bukhari, Csilla, Luminița Lazăr, Adriana Maria Monea, Alexandru Vlasa, Imola Zsuzsa Buka, Raluca Sabău, Mónika Kovács, Liana Bereșescu, Blanka Petcu e Enikő Pál. "Effects of Viral and Bacterial Infections on Marginal Periodontium". Journal of Interdisciplinary Medicine 2, n. 2 (1 giugno 2017): 122–26. http://dx.doi.org/10.1515/jim-2017-0048.
Testo completoAbstract (sommario):
Abstract Background: There are several risk factors, general and local, which favor the onset of periodontal destruction, and their knowledge is essential to their correct identification and for the adoption of a suitable therapeutic management. The aim of the study was to assess periodontal health status of patients suffering from viral and bacterial infections and to determine the eventual relationship between periodontal diseases and infectious diseases. Material and methods: Twenty-five patients with a mean age of 25 years (range 23–27 years) admitted to the Clinic of Infectious Diseases of Tîrgu Mureș between December 1, 2013 – May 31, 2014 and diagnosed with bacterial and viral infections were included in the study (17 women, 8 men). Eight were infected with bacteria, and 17 with human immunodeficiency virus (HIV). Patients were examined in the clinic using Williams periodontal probe, dental mirror, and lip retractor, and different periodontal parameters were recorded: the Silness Löe plaque index, papilla bleeding index, Community Periodontal Index in Treatment Needs (CPITN), periodontal pocket depth, gingival retraction. Results: Values were significantly higher in patients infected with HIV in the following cases: among women in the Full Mouth Plaque Score (FMPS, p = 0.0312), among men in the depth of periodontal pockets (p = 0.0126), among men in the FMPS (p = 0.0282). Conclusions: The FMPS showed a high value both in women and men infected with HIV. More and deeper pockets were found in men infected with HIV. The gingival retraction and the papillary bleeding index calculated for the entire oral cavity were not influenced by the type of infection. A periodic inspection and maintenance of oral hygiene instructions could play a significant role in preventing periodontal disease in these vulnerable groups.
2
Teng, Y. T. A. "Protective and Destructive Immunity in the Periodontium: Part 1—Innate and Humoral Immunity and the Periodontium". Journal of Dental Research 85, n. 3 (marzo 2006): 198–208. http://dx.doi.org/10.1177/154405910608500301.
Testo completoAbstract (sommario):
Based on the results of recent research in the field, the present paper will discuss the protective and destructive aspects of the innate vs. adaptive (humoral and cell-mediated) immunity associated with the bacterial virulent factors or antigenic determinants during periodontal pathogenesis. Attention will be focused on: (i) the Toll-like receptors (TLR), the innate immune repertoire for recognizing the unique molecular patterns of microbial components that trigger innate and adaptive immunity for effective host defenses, in some general non-oral vs. periodontal microbial infections; (ii) T-cell-mediated immunity, Th-cytokines, and osteoclastogenesis in periodontal disease progression; and (iii) some molecular techniques developed and used to identify critical microbial virulence factors or antigens associated with host immunity (using Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis as the model species). Therefore, further understanding of the molecular interactions and mechanisms associated with the host’s innate and adaptive immune responses will facilitate the development of new and innovative therapeutics for future periodontal treatments. Abbreviations used in the paper are as follows: A. actinomycetemcomitans ( Aa), Actinobacillus actinomycetemcomitans; Ab, antibody; DC, dendritic cells; mAb, monoclonal antibody; pAb, polyclonal antibody; PAMP, pathogen-associated molecular patterns; P. gingivalis ( Pg), Porphyromonas gingivalis; and TLR, Toll-like receptors.
3
Lačević, Amela, Edina Vranić e Irfan Zulić. "Etiological findings in endodontic-periodontal infections". Bosnian Journal of Basic Medical Sciences 4, n. 1 (20 febbraio 2004): 57–61. http://dx.doi.org/10.17305/bjbms.2004.3464.
Testo completoAbstract (sommario):
The endodontium and periodontium are closely related and disease of one may lead to secondary disease in the other. The differential diagnosis of endodontic and periodontal disease is of vital importance, so that the appropriate treatment can be done. Microorganisms play a primary role in endodontic and periodontal infections. The magnitude of the host response will be directly proportional to the virulence and the number of microbial cells present. Tissue damage caused by bacteria is mediated by either direct or indirect mechanisms. Direct harmful effects caused by bacteria involve their products, such as enzymes (collagenase, hyaluronidase, condroitinase, acid phosphatase), exotoxins and metabolites (bytrate, propionate, ammonium polyamines, sulphured compounds). In addition, bacterial components such as peptidoglycan, teichoic acid, fimbriae, outer membrane proteins, capsule, and lypopolysaccharide, stimulate the development of host immune reaction capable of causing severe tissue destruction.
4
MARTY, MATHIEU, MATHIEU LEMAITRE, PHILIPPE KÉMOUN, JEAN-JACQUES MORRIER e PAUL MONSARRAT. "Trichomonas tenax and periodontal diseases: a concise review". Parasitology 144, n. 11 (6 giugno 2017): 1417–25. http://dx.doi.org/10.1017/s0031182017000701.
Testo completoAbstract (sommario):
SUMMARYPeriodontal diseases (gingivitis and periodontitis), result from a disruption of the host–oral microbiome homoeostasis. Whereas the pathological role of some specific bacterial strains during periodontal diseases is well documented, the impact of parasites in periodontium pathophysiology is still under debate. This review aims to collect data about the prevalence and the potential role of Trichomonas tenax during periodontal diseases. Data from 47 studies revealed that T. tenax prevalence in diseased periodontium ranged from 0 to 94·1%. The prevalence of oral protozoan infections was found to be largely greater in patients with periodontal diseases than with healthy periodontium. The parasite detection was mainly performed by direct microscopy. Trichomonas tenax presence was clearly correlated with periodontal disease. The high heterogeneity of its periodontal prevalence may be correlated with the diversity of the population screened (age, sex, systemic diseases), and the methods used for diagnosis. This protozoan seems to have the capacity to be involved in the inflammatory process of gum disease. Animal experimentation, using relevant physiopathological models of periodontitis, needs to be performed to investigate the ability of T. tenax to cause and/or worsen the disease. Further investigations using standardized experimental designs of epidemiologic studies are also needed.
5
Li, Xiaojing, Kristin M. Kolltveit, Leif Tronstad e Ingar Olsen. "Systemic Diseases Caused by Oral Infection". Clinical Microbiology Reviews 13, n. 4 (1 ottobre 2000): 547–58. http://dx.doi.org/10.1128/cmr.13.4.547.
Testo completoAbstract (sommario):
SUMMARY Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. The purpose of this review is to evaluate the current status of oral infections, especially periodontitis, as a causal factor for systemic diseases. Three mechanisms or pathways linking oral infections to secondary systemic effects have been proposed: (i) metastatic spread of infection from the oral cavity as a result of transient bacteremia, (ii) metastatic injury from the effects of circulating oral microbial toxins, and (iii) metastatic inflammation caused by immunological injury induced by oral microorganisms. Periodontitis as a major oral infection may affect the host's susceptibility to systemic disease in three ways: by shared risk factors; subgingival biofilms acting as reservoirs of gram-negative bacteria; and the periodontium acting as a reservoir of inflammatory mediators. Proposed evidence and mechanisms of the above odontogenic systemic diseases are given.
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Ji, S., e Y. Choi. "Microbial and Host Factors That Affect Bacterial Invasion of the Gingiva". Journal of Dental Research 99, n. 9 (11 maggio 2020): 1013–20. http://dx.doi.org/10.1177/0022034520922134.
Testo completoAbstract (sommario):
Periodontitis is a chronic inflammation of the periodontium caused by the loss of homeostasis between subgingival biofilms and susceptible hosts. Bacterial invasion into the gingival tissue and persistent infection are major events that lead to chronic inflammation. The intratissue bacterial communities are as complex as the subgingival biofilms and can also form biofilm-like structures, which will serve as a reservoir for local and systemic infections. The epithelium forms physical, chemical, and immunological barriers against invading microbes. Nevertheless, many bacterial species can invade the gingival epithelium through transcellular and paracellular pathways. In addition, both genetic and environmental factors of the hosts can affect epithelial barrier functions and thus bacterial invasion of the gingiva. In this review, current evidence for the bacterial invasion of the gingival tissue in periodontitis has been summarized, and the microbial and host factors that determine bacterial invasion of the gingiva have been reviewed.
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Gheorghe, Dorin Nicolae, Liliana Foia, Vasilica Toma, Amelia Surdu, Elena Herascu, Dora Maria Popescu, Petra Surlin, Cristin Constantin Vere e Ion Rogoveanu. "Hepatitis C Infection and Periodontal Disease: Is there a Common Immunological Link?" Journal of Immunology Research 2018 (2018): 1–9. http://dx.doi.org/10.1155/2018/8720101.
Testo completoAbstract (sommario):
Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects’ immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients’ saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients’ inflammatory status.
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Anand, Pradeep S., e K. Nandakumar. "Management of Periodontitis Associated with Endodontically Involved Teeth: A Case Series". Journal of Contemporary Dental Practice 6, n. 2 (2005): 118–29. http://dx.doi.org/10.5005/jcdp-6-2-118.
Testo completoAbstract (sommario):
Abstract The pulp and the periodontal attachment are the two components that enable a tooth to function in the oral cavity. Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The function of the tooth is severely compromised when either one of these is involved in the disease process. Treatment of disease conditions involving both of these structures can be challenging and frequently requires combining both endodontic and periodontal treatment procedures. This article presents cases of periodontitis associated with endodontic lesions managed by both endodontic and periodontal therapy. Citation Anand PS, Nandakumar K. Management of Periodontitis Associated with Endodontically Involved Teeth: A Case Series. J Contemp Dent Pract 2005 May;(6)2:118-129.
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Nahid, Md A., Mercedes Rivera, Alexandra Lucas, Edward K. L. Chan e L. Kesavalu. "Polymicrobial Infection with Periodontal Pathogens Specifically Enhances MicroRNA miR-146a in ApoE−/−Mice during Experimental Periodontal Disease". Infection and Immunity 79, n. 4 (24 gennaio 2011): 1597–605. http://dx.doi.org/10.1128/iai.01062-10.
Testo completoAbstract (sommario):
ABSTRACTPorphyromonas gingivalis,Treponema denticola, andTannerella forsythiaare periodontal pathogens associated with the etiology of adult periodontitis as polymicrobial infections. Recent studies demonstrated that oral infection withP. gingivalisinduces both periodontal disease and atherosclerosis in hyperlipidemic and proatherogenic ApoE−/−mice. In this study, we explored the expression of microRNAs (miRNAs) in maxillas (periodontium) and spleens isolated from ApoE−/−mice infected withP. gingivalis,T. denticola, andT. forsythiaas a polymicrobial infection. miRNA expression levels, including miRNA miR-146a, and associated mRNA expression levels of the inflammatory cytokines tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β) were measured in the maxillas and spleens from mice infected with periodontal pathogens and compared to those in the maxillas and spleens from sham-infected controls. Furthermore, in response to these periodontal pathogens (as mono- and polymicrobial heat-killed and live bacteria), human THP-1 monocytes demonstrated similar miRNA expression patterns, including that of miR-146a,in vitro. Strikingly, miR-146a had a negative correlation with TNF-α secretionin vitro, reducing levels of the adaptor kinases IL-1 receptor-associated kinase 1 (IRAK-1) and TNF receptor-associated factor 6 (TRAF6). Thus, our studies revealed a persistent association of miR-146a expression with these periodontal pathogens, suggesting that miR-146a may directly or indirectly modulate or alter the chronic periodontal pathology induced by these microorganisms.
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Ruby, John, Kunal Rehani e Michael Martin. "Treponema denticola Activates Mitogen-Activated Protein Kinase Signal Pathways through Toll-Like Receptor 2". Infection and Immunity 75, n. 12 (8 ottobre 2007): 5763–68. http://dx.doi.org/10.1128/iai.01117-07.
Testo completoAbstract (sommario):
ABSTRACT Treponema denticola, a spirochete indigenous to the oral cavity, is associated with host inflammatory responses to anaerobic polymicrobial infections of the root canal, periodontium, and alveolar bone. However, the cellular mechanisms responsible for the recognition of T. denticola by the innate immune system and the underlying cell signaling pathways that regulate the inflammatory response to T. denticola are currently unresolved. In this study, we demonstrate that T. denticola induces innate immune responses via the utilization of Toll-like receptor 2 (TLR2) but not TLR4. Assessment of TLR2/1 and TLR2/6 heterodimers revealed that T. denticola predominantly utilizes TLR2/6 for the induction of cellular responses. Analysis of the mitogen-activated protein kinase (MAPK) signaling pathway in T. denticola-stimulated monocytes identified a prolonged up-regulation of the MAPK extracellular signal-related kinase 1/2 (ERK1/2) and p38, while no discernible increase in phospho-c-Jun N-terminal kinase 1/2 (JNK1/2) levels was observed. With the aid of pharmacological inhibitors selectively targeting ERK1/2 via the mitogen-activated protein kinase/extracellular signal-related kinase 1/2 kinase and p38, we further demonstrate that ERK1/2 and p38 play a major role in T. denticola-mediated pro- and anti-inflammatory cytokine production.
Tesi sul tema "Periodontium Infections"
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Díaz, Patricia I. "Studies on the oxidative stress response of porphyromonas gingivalis : a thesis submitted in fulfillment of the requirements for admission to the degree of Doctor of Philosophy /". Title page, summary and table of contents only, 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phd5426.pdf.
Testo completo
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Ferreira, Ana Filipa Franco Ladislau. "Periodontite apical e a associação com doenças crónicas inflamatórias". Master's thesis, [s.n.], 2014. http://hdl.handle.net/10284/4394.
Testo completoAbstract (sommario):
Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaA Periodontite Apical é uma doença crónica inflamatória cujo desenvolvimento envolve uma resposta imunológica contra um antigénio de origem bacteriana, levando à produção de mediadores inflamatórios e consequente destruição tecidular. Doenças Crónicas Inflamatórias como a Artrite Reumatoide, o Lupus, a Doença de Crohn e a Colite Ulcerativa, parecem ter por base uma resposta inflamatória e um mecanismo imunopatológico muito semelhante à Periodontite Apical. O desenvolvimento deste trabalho tem como principal objetivo estudar a imunopatologia de cada uma das doenças e assim identificar o que há em comum e de que forma as Doenças Crónicas Inflamatórias podem influenciar o desenvolvimento e a severidade da Periodontite Apical. Para a elaboração desta revisão efetuou-se uma pesquisa bibliográfica recorrendo a meios eletrónicos e utilizando as seguintes palavras-chave: Rheumatoid Arthritis; Digestive Chronic Disease; Lupus; Apical Periodontitis; Microbial Root Infection; Root Canal Treatment, com limite temporal de 2004 a 2014. Com este trabalho conclui-se que as células de defesa ativadas nas Doenças Crónicas Inflamatórias são as mesmas que estão envolvidas na patologia da Periodontite Apical. Em ambas as doenças também são detetáveis a presença dos mesmos mediadores inflamatórios, incluindo citoquinas Th1, prostaglandinas, moléculas de adesão e proteínas do sistema de complemento. Assim sendo, a presença de Doenças Crónicas Inflamatórias pode agravar a Periodontite Apical, uma vez que há uma dupla ativação da resposta imunológica. Por outro lado a terapêutica anti-inflamatória usada nas Doenças Crónicas pode diminuir a severidade da Periodontite Apical atuando como antagonista e prevenindo o desenvolvimento de mais lesões. The apical periodontitis is a chronic inflammatory disease and its development involves an immune response against an antigen of bacterial origin leading to the production of inflammatory mediators and subsequent tissue destruction. Chronic inflammatory diseases such as Rheumatoid Arthritis, Lupus, Crohn's Disease and Ulcerative Colitis, seem to be based on a very similar inflammatory response and immunopathological mechanism of apical periodontitis. The development of this work aims to study the immunopathology of each disease and thus identify what is common and how the Chronic Inflammatory Disease can influence the development and severity of apical periodontitis. For the preparation of this review we performed a literature search using electronic means and using the following key words: Rheumatoid Arthritis; Chronic Digestive Disease; lupus; Apical Periodontitis; Microbial Infection Root; Root Canal Treatment, with time limit from 2004 to 2014. With this work it is concluded that the defense active cells in chronic inflammatory diseases are the same involved in apical periodontitis pathology. Thus, in both diseases is detectable the presence of the same inflammatory mediators, including Th1 cytoquines, prostaglandins, adhesion molecules and complement proteins. Thus, the presence of chronic inflammatory diseases may aggravate the apical periodontitis, since there is a dual activation of the immune response. Moreover the therapeutics of Chronic Inflammatory Diseases may decrease the severity of apical periodontitis acting as an antagonist and preventing the development of more lesions.
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Pereira, Maurício Fabiano [UNESP]. "Microbiota bucal e sua relação com infecções oportunistas em pacientes edêntulos mantidos em unidades de terapia intensiva". Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/134196.
Testo completoAbstract (sommario):
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000857768.pdf: 1204540 bytes, checksum: 89db662b79a3371070dc58369f2917f9 (MD5)Introdução: A relação entre a microbiota bucal e infecções graves em pacientes mantidos internados em unidades de terapia intensiva (UTI) vem sendo estabelecida, principalmente para os portadores de próteses totais ou parciais, visto que o biofilme bucal pode se converter em reservatório de microrganismos que não fazem parte dessa microbiota. Objetivo: Esse estudo objetivou avaliar a presença dos principais patógenos periodontais e oportunistas na boca de pacientes mantidos em unidades de terapia intensiva. Material e Método: Foram obtidos dados referentes às condições de saúde de 156 pacientes mantidos por mais de 72 horas em ambiente de UTI. Realizou-se exames clínicos intrabucais e coleta de amostras de saliva e mucosas bucais, de secreções respiratórias, sangue e urina. A presença dos principais microrganismos bucais e oportunistas associados às infecções hospitalares foi avaliada por meio da reação em cadeia da polimerase (PCR). A análise estatística foi realizada pelos testes de Mann-Whitney e Test T, enquanto a correlação entre as variáveis foi obtida pelo Teste de Spearman, todos ao nível de significância de 5%. Resultados: Houve correlação negativa entre a presença de leucócitos e alguns patógenos oportunistas bucais e exógenos. Os microrganismos estudados foram mais prevalentes no gênero masculino e os anaeróbios obrigatórios e microrganismos capnofílicos oriundos do ambiente bucal se mostraram mais relevantes nas infecções sistêmicas do que os patógenos oportunistas exógenos, como as enterobactérias e os pseudomonados. Conclusão: Concluiu-se que a fragilidade da saúde bucal de pacientes internados em UTI, por vezes com imunossupressão, associada a colonização e/ou infecção de microrganismos oportunistas, pode ser um fator agravante na deterioração e piora do quadro sistêmico do paciente
Introduction: The relationship between the oral microbiota and serious infections in patients kept in intensive care units (ICU) has been established, mainly for patients with dentures or partials, since oral biofilm can become reservoir of micro-organisms that are not part of this microbiota. Objective: This study aimed to evaluate the presence of the main periodontal pathogens and infections in the mouth of patients kept in intensive care units. Material and method: Data were obtained on the health conditions of 156 patients held for more than 72 hours in the ICU environment. Intraoral clinical examination was carried out and collection of samples of saliva and oral mucosa, respiratory secretions, blood and urine. The presence of the main oral and opportunistic micro-organisms associated with hospital-acquired infections were evaluated by means of the polymerase chain reaction (PCR). Statistical analysis was performed by Mann-Whitney tests and Test T, while the correlation between the variables was obtained by Spearman test, all at a significance level of 5%. Results: There was a negative correlation between the presence of leukocytes and some oral opportunistic pathogens and exogenous. The microorganisms studied were more prevalent in male gender and obligate anaerobes and capnofilicos microorganisms from oral cavity were more relevant in systemic infections than the exogenous opportunistic pathogens, such as Enterobacteriaceae and Pseudomonas. Conclusion: It was concluded that the fragility of the oral health of patients admitted to ICU, sometimes with immune suppression associated with the colonization and/or infection from opportunistic micro-organisms can be an aggravating factor in the deterioration and worsening of the patient's systemic framework
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Pereira, Maurício Fabiano. "Microbiota bucal e sua relação com infecções oportunistas em pacientes edêntulos mantidos em unidades de terapia intensiva /". Araçatuba, 2015. http://hdl.handle.net/11449/134196.
Testo completoAbstract (sommario):
Orientador: Elerson Gaetti Jardim JuniorBanca: Ana Cláudia Okamoto
Banca: Adriana de Sales Cunha Correia
Resumo: Introdução: A relação entre a microbiota bucal e infecções graves em pacientes mantidos internados em unidades de terapia intensiva (UTI) vem sendo estabelecida, principalmente para os portadores de próteses totais ou parciais, visto que o biofilme bucal pode se converter em reservatório de microrganismos que não fazem parte dessa microbiota. Objetivo: Esse estudo objetivou avaliar a presença dos principais patógenos periodontais e oportunistas na boca de pacientes mantidos em unidades de terapia intensiva. Material e Método: Foram obtidos dados referentes às condições de saúde de 156 pacientes mantidos por mais de 72 horas em ambiente de UTI. Realizou-se exames clínicos intrabucais e coleta de amostras de saliva e mucosas bucais, de secreções respiratórias, sangue e urina. A presença dos principais microrganismos bucais e oportunistas associados às infecções hospitalares foi avaliada por meio da reação em cadeia da polimerase (PCR). A análise estatística foi realizada pelos testes de Mann-Whitney e Test T, enquanto a correlação entre as variáveis foi obtida pelo Teste de Spearman, todos ao nível de significância de 5%. Resultados: Houve correlação negativa entre a presença de leucócitos e alguns patógenos oportunistas bucais e exógenos. Os microrganismos estudados foram mais prevalentes no gênero masculino e os anaeróbios obrigatórios e microrganismos capnofílicos oriundos do ambiente bucal se mostraram mais relevantes nas infecções sistêmicas do que os patógenos oportunistas exógenos, como as enterobactérias e os pseudomonados. Conclusão: Concluiu-se que a fragilidade da saúde bucal de pacientes internados em UTI, por vezes com imunossupressão, associada a colonização e/ou infecção de microrganismos oportunistas, pode ser um fator agravante na deterioração e piora do quadro sistêmico do paciente
Abstract: Introduction: The relationship between the oral microbiota and serious infections in patients kept in intensive care units (ICU) has been established, mainly for patients with dentures or partials, since oral biofilm can become reservoir of micro-organisms that are not part of this microbiota. Objective: This study aimed to evaluate the presence of the main periodontal pathogens and infections in the mouth of patients kept in intensive care units. Material and method: Data were obtained on the health conditions of 156 patients held for more than 72 hours in the ICU environment. Intraoral clinical examination was carried out and collection of samples of saliva and oral mucosa, respiratory secretions, blood and urine. The presence of the main oral and opportunistic micro-organisms associated with hospital-acquired infections were evaluated by means of the polymerase chain reaction (PCR). Statistical analysis was performed by Mann-Whitney tests and Test T, while the correlation between the variables was obtained by Spearman test, all at a significance level of 5%. Results: There was a negative correlation between the presence of leukocytes and some oral opportunistic pathogens and exogenous. The microorganisms studied were more prevalent in male gender and obligate anaerobes and capnofilicos microorganisms from oral cavity were more relevant in systemic infections than the exogenous opportunistic pathogens, such as Enterobacteriaceae and Pseudomonas. Conclusion: It was concluded that the fragility of the oral health of patients admitted to ICU, sometimes with immune suppression associated with the colonization and/or infection from opportunistic micro-organisms can be an aggravating factor in the deterioration and worsening of the patient's systemic framework
Mestre
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Diehl, Jeremy Howard. "CHANGES IN SERUM ICAM-1, SERUM VCAM-1, AND SERUM E-SELECTIN CONCENTRATION FOLLOWING PERIODONTAL SCALING AND ROOT PLANING". VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd_retro/133.
Testo completoAbstract (sommario):
Cellular adhesion molecules (CAMs) and selectins are cell-surface proteins involved in the binding of cells to the vascular endothelium. Elevated levels of sCAMs and soluble E-selectin (sE-selectin) have been reported in patients with periodontitis. The aim of this study was to determine if periodontal scaling and root planing would influence the serum concentration of sICAM-1, sVCAM-1, and sE-selectin. Twenty-one subjects with chronic periodontitis received scaling and root planing in conjunction with blood serum sample analysis using enzyme-linked immunosorbent assay (ELISA), to determine if periodontal instrumentation results in changes in serum concentrations of sICAM-1, sVCAM-1, and sE-selectin. No change was observed in serum concentration of sICAM-1 or sVCAM-1. However, in a subset of 17 patients a statistically significant change in serum sE-selectin was observed (P < 0.05). This suggests that there is a decrease in endothelial activation following periodontal treatment.
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Murad, Cristiana Francescutti. "Análise da diversidade microbiana em infecções endodônticas persistentes". Universidade do Estado do Rio de Janeiro, 2014. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8089.
Testo completoAbstract (sommario):
O presente trabalho teve por objetivo investigar a microbiota de canais radiculares relacionadas ao insucesso do tratamento endodôntico, buscando a identificação e a quantificação destes micro-organismos. Foram selecionados 36 dentes com infecção endodôntica persistente. O material obturador foi removido do canal radicular e amostras microbiológicas foram coletadas dos canais com o auxílio de limas tipo Hedströen e cones de papel absorvente estéril. A técnica do Checkerboard DNA-DNA hybridization foi utilizada para detecção de até 79 espécies bacterianas em cada amostra, utilizando sondas de DNA específicas. Os dados microbiológicos foram expressos em percentagem média (prevalência), proporção e nível médio de cada espécie em cada amostra. Os testes t independente e de correlação de Pearson foram usados para correlacionar a contagem das bactérias testadas com os dados clínicos (p≤ 0,05). Foi encontrada uma média de 11 espécies por amostra. E. faecium (36%), S. epidermidis (36%), E. saburreum (28%), P. micra (28%), S. sanguis (28%), C. sputigena (28%), L. buccalis (28%), E. faecalis (28%) e S. warneri (28%) foram as espécies mais prevalentes, e as espécies encontradas em níveis médios mais altos foram E. faecium, D. pneumosintes, S. epidermidis, H. pylori e C. sputigena. T. socranskii (3%), F. periodonticum (3%), C. gingivalis (3%), S. ixodetis (3%) apresentaram prevalências mais baixas. E. faecium e S. epidermidis apresentaram os maiores valores de prevalência, níveis médios e proporção. Não houve correlação entre a microbiota detectada nas amostras com os sinais e sintomas clínicos apresentados pelos pacientes, porém nas lesões periapicais de maior área foi detectada contagem significativamente maior de bacilos e espécies Gram-negativas (p<0,05). Baseado nos resultados obtidos é possível concluir que a microbiota presente em dentes com periodontite apical persistente possui perfil misto e complexo, e que uma maior área de lesão perirradicular pode estar associada a contagem elevada de bacilos e de espécies Gram-negativas.The present study investigated the composition of the root canal microbiota in endodontic failures, aiming to identify and quantify these microorganisms. Thirty six teeth with persistent endodontic infection were selected. The root-filling materials were removed and microbiological samples were taken from the root canals with a Hedströen-type file and sterile paper points. The Checkerboard DNA-DNA hybridization technique was used for the detection of 79 bacterial species in each sample, using specific DNA probes. Microbiological data were express in mean prevalence, proportions and levels of each species in each sample. t independent test and Pearson correlation test were use to correlate bacterial counts and clinical conditions (p≤ 0,05). There were found a mean of 11 different species per sample. E. faecium (36%), S. epidermidis (36%), E. saburreum (28%), P. micra (28%), S. sanguis (28%), C. sputigena (28%), L. buccalis (28%), E. faecalis (28%) and S. warneri (28%) were the most prevalent species, and the species found in highest mean levels were E. faecium, D. pneumosintes, S. epidermidis, H. pylori and C. sputigena. T. socranskii (3%), F. periodonticum (3%), C. gingivalis (3%) and S. ixodetis (3%) were found in low prevalence. E. faecium and S. epidermidis presented the highest values of prevalence, means levels and proportions. No correlation was found between the detected microbiota and clinical findings; however in periapical lesions with highest areas, higher levels of rods and Gram-negative species were detected (p<0.05). Based on these results it may be concluded that the microbiota in teeth with persistent apical periodontitis presents a mixed and complex profile, and periapical lesions with larger area might be high associated with higher counts of rods and Gram-negative species.
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Reed, Lucas A. "The Effects of Amixicile, A Pyruvate Ferredoxin Oxidoreductase Inhibitor, on Oral Treponemes". VCU Scholars Compass, 2016. http://scholarscompass.vcu.edu/etd/4184.
Testo completoAbstract (sommario):
Periodontal disease (PD) is a polymicrobial infection characterized by inflammation of the gingiva, alveolar bone resorption, and tooth loss (edentulism). Treponema denticola along with Porphyromonas gingivalis and Tannerella forsythia are among the “Red Complex” and are main etiological agents in PD. Treponemes are a member of the Spirochaeta phylum and are obligate anaerobes, that express pyruvate ferredoxin oxidoreductase (PFOR). The enzyme catalyzes the oxidation of pyruvate to acetyl-CoA and reduced ferredoxin. Amixicile is a novel bacteriostatic derivative of nitazoxanide and an inhibitor of PFOR. In light of the fact that Treponemes express PFOR, this study was conducted to investigate the susceptibility of oral Treponemes to AMX. All oral Treponemes tested were susceptible to AMX and the MIC values were determined ranging of 1.5-4.5 μg mL-1 for an initial starting cell concentration of 1.9x106 cells mL-1. Other potentially therapeutic effects for AMX for T. denticola were investigated: motility, hydrogen sulfide production, and serum sensitivity. AMX reduced overall spirochete motility by 50% at sub-MIC concentrations. There was a dose dependent decrease in H2S production in T. denticola at sub-MIC and MIC values. Furthermore, prior exposure of AMX led to increases in serum sensitivity. Taking into account the fact that other periodontal red complex bacteria express PFOR, AMX could serve as a new selective adjunctive treatment for periodontal disease.
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Nardello, Laura Cristina Leite. "Análise da atividade metabólica de bactérias persistentes após os procedimentos endodônticos de desinfecção: estudo molecular baseado em RNA e DNA". Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/23/23156/tde-12062018-094527/.
Testo completoAbstract (sommario):
Micro-organismos persistentes que permanecem viáveis e em níveis elevados nos canais radiculares após os procedimentos endodônticos podem influenciar no sucesso do tratamento endodôntico. O objetivo deste estudo foi avaliar a quantidade e a atividade metabólica de bactérias persistentes utilizando métodos moleculares baseados em rDNA e rRNA. Foram selecionados 15 pacientes com infecções endodônticas primárias assintomáticas. Amostras microbiológicas foram coletadas dos canais radiculares após a cirurgia de acesso (S1), após o preparo químico-cirúrgico realizado com Sistema Reciproc e NaOCl 2.5% (S2) e após medicação intracanal com Ca(OH)2 por 14 dias (S3). As amostras dos canais radiculares foram submetidas à extração de DNA e RNA. O RNA foi submetido à reação de transcrição reversa para confecção de DNA complementar (cDNA). O efeito dos procedimentos endodônticos na redução bacteriana foi determinado por qPCR baseada em rDNA, utilizando iniciadores universais para a região 16S rRNA do domínio Bacteria e iniciadores espécie-específicos para Bacteroidaceae [G-1] sp oral taxon 272. A atividade metabólica de bactérias totais e Bacteroidaceae [G-1] sp oral taxon 272 foi calculada pela razão rRNA/rDNA baseados nos dados dos ensaios de qPCR. Os dados foram analisados pelo teste de Wilcoxon para análise quantitativa e teste de McNemar para comparação da taxa de detecção dos métodos, com nível de significância de 5%. Todas as amostras S1 foram positivas para bactérias totais, com uma mediana de 1,87 x 105 cópias de rDNA por amostra. Após o preparo químico-cirúrgico houve uma redução significativa de rDNA de bactérias totais (mediana 7,86 x 104, P = 0,01). Entretanto, não houve redução de rDNA bacteriano após a medicação intracanal quando comparada à etapa anterior (mediana 7,97 x 104, P > 0,05). Os resultados da razão rRNA/rDNA revelaram que houve uma redução do metabolismo de bactérias totais em S2 (mediana 1, P = 0,04) e um aumento do metabolismo bacteriano em S3 (mediana 2, P = 0,04). Na análise de Bacteroidaceae [G-1] sp oral taxon 272, o tratamento endodôntico não influenciou na redução nem no metabolismo bacteriano. Concluiu-se que o número total de bactérias foi drasticamente reduzido após o preparo químico-cirúrgico, assim como seu metabolismo. Entretanto, o metabolismo bacteriano aumentou após o uso da medicação intracanal com Ca(OH)2. Bacteroidaceae [G-1] sp. oral taxon 272 permaneceu metabolicamente ativo após o preparo químico-cirúrgico e medicação intracanal, participando, assim, da composição da microbiota persistente.High levels of microorganisms that persist viable in root canals after endodontic procedures may influence endodontic treatment outcome. This study aimed to evaluate the amount and the metabolic activity of persistent bacteria using rRNA- and rDNA-based molecular methods. Fifteen patients with primary endodontic infections were selected. Microbiological samples were taken from root canals after access cavity (S1), after chemomechanical preparation with Reciproc System and 2.5% NaOCl (S2) and after intracanal medication with calcium hydroxide for 14 days (S3). DNA and RNA were extracted from root canal samples, and cDNA was synthetized using reverse transcription reaction. The effect of endodontic procedures on bacterial reduction was determined by rDNA-based qPCR using universal primers for 16S rRNA Bacteria domain and species-specific primers to Bacteroidaceae [G-1] sp oral taxon 272. The metabolic activity of total bacteria and Bacteroidaceae [G-1] sp oral taxon 272 was calculated by rRNA/ rDNA ratio estimated by qPCR. The data was analyzed by the Wilcoxon test for quantitative analysis and McNemar test for comparison of the detection rate of the methods, with 5% significance level. All S1 samples were positive for total bacteria, with a median value of 1.87 x 105 bacterial cells. After chemomechanical preparation a significant reduction of bacterial rDNA was observed (median 7.86 x 104, P = 0.01). Nevertheless, there was no bacterial rDNA reduction after intracanal medication when compared to S2 samples (median 7.97 x 104, P > 0.05). The rRNA/ rDNA ratio showed a reduction of total bacteria metabolism in S2 (median 1, P = 0,04), and an increase of bacterial metabolism in S3 (median 2, P = 0,04). Bacteroidaceae [G-1] sp oral taxon 272 analysis showed that endodontic treatment did not impact the amount and the metabolic activity of this taxon. In conclusion, the number and metabolism of total bacteria were severely reduced after chemomechanical preparation. On the other hand, the bacterial metabolism increased after intracanal dressing with Ca(OH)2. Bacteroidaceae [G-1] sp. oral taxon 272 remained metabolically active after chemomechanical preparation and intracanal dressing thus participating in the composition of the persistent microbiota.
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Vieira, Evanice Menezes Marçal. "Estudo das condições de saúde bucal e avaliação da microbiota periodontopatogênica de uma população indígena brasileira /". Araçatuba : [s.n.], 2009. http://hdl.handle.net/11449/102343.
Testo completoAbstract (sommario):
Orientador: Elerson Gaetti Jardim JúniorBanca: Marcelo Macedo Crivelini
Banca: Cristiane Yumi Koga Ito
Banca: Maria Aparecida de Andrade Moreira Machado
Banca: Odila Pereira da Silva Rosa
Resumo: A região do complexo bucomaxilofacial freqüentemente é acometida por doenças e variações de normalidade, algumas das quais apresentam notável relação com grupos étnicos e raciais. Os estudos sobre a distribuição das doenças bucais e variações de normalidade em comunidades indígenas normalmente são direcionados principalmente para o estudo da cárie dentária nas crianças e doenças periodontais em adultos, negligenciando-se ampla gama de demais doenças existentes na boca. Assim, foi objetivo desse estudo, avaliar as condições de saúde bucal de oito etnias (Umutina, Paresi, Bororo, Bakairi, Kayabi, Irantxe, Nambikwara and Terena) que residem na terra indígena Umutina, no Estado de Mato Grosso. Um total de 291 índios, de ambos os sexos e com idade variando de 1 a 96 anos, foram examinados, sendo que alterações de normalidade ou patologias bucais foram observadas em um total de 132 indivíduos,evidenciando uma elevada ocorrência de anquiloglossia, a qual esteve presente em 108 casos (37,11%), seguida de glossite migratória benigna em 5 casos (1,72%); tórus mandibular e candidose em 3 casos (1,03%), dentre outras. Nenhuma lesão de caráter maligno foi identificada na referida população. Apesar da elevada freqüência de anquiloglossia na Reserva Indígena Umutina, a mesma não parece ser responsável por alterações associadas à fonação, mastigação, presença de diastema e problemas periodontais, uma vez que essas alterações foram observadas em baixa freqüência e não foram motivos de queixas da população. As condições dentárias foram avaliadas com o objetivo de identificar a prevalência de cárie dentária e necessidade de tratamento odontológico das crianças da aldeia Umutina, por meio de um estudo epidemiológico transversal. Para análise da cárie dentária foram utilizados: os índices de dentes cariados, perdidos e obturados (CPOD) para... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The oromaxillofacial complex is frequently envolved by diseases and variations from normality, some of which closely related to ethnical and racial groups. Studies on the distribution of oral diseases and variations from normality in Indian communities are generally directed mainly to the study of dental caries in the children and periodontal diseases in the adults, disregarding a wide range of other oral diseases. Thus, the aim of this study was to evaluate the oral health conditions of eight ethnic groups living in the Umutina Indian Reservation, in the State of Mato Grosso, Brazil. The total of 291 Indians, of both generes, with ages ranging from 1 to 96 years, were examined and were found between them 132 abnormalities and/or oral diseases, evidencing a high occurrence of ankyloglossia, which was present in 108 cases (37.11%), followed by benign migratory glossitis in 5 cases (1.72%); mandibular torus and candidosis in 3 cases (1.03%) among others. No malign lesion was identified in that population. Even thought the high frequency of the ankyloglossia in the ethnicities living in the Umutina Indian reservation, it does not seem to be responsible for alterations associated to phonation, mastication, presence of diastema and periodontal problems, since those alterations were observed with a low frequency and were not reason for complaint from the population. The dental conditions were evaluated with the aim to identify the prevalence of dental caries and the need of dental treatment in children from Umutina Village using a transversal epidemiological study. To analyze dental caries prevalence the decayed, missing, and filled teeth (DMFT) or decayed, extracted, and filled teeth (deft) indexes were used for, respectively, permanent or primary dentition and the need of treatment index. Statistical analysis was done with the software GraphPad Prism. The Mann Whitney analysis was used with... (Complete abstract click electronic access below)
Doutor
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Vieira, Evanice Menezes Marçal [UNESP]. "Estudo das condições de saúde bucal e avaliação da microbiota periodontopatogênica de uma população indígena brasileira". Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/102343.
Testo completoAbstract (sommario):
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vieira_emm_dr_araca.pdf: 1601223 bytes, checksum: f06fc8bb7426a58149377c1b4041a77a (MD5)A região do complexo bucomaxilofacial freqüentemente é acometida por doenças e variações de normalidade, algumas das quais apresentam notável relação com grupos étnicos e raciais. Os estudos sobre a distribuição das doenças bucais e variações de normalidade em comunidades indígenas normalmente são direcionados principalmente para o estudo da cárie dentária nas crianças e doenças periodontais em adultos, negligenciando-se ampla gama de demais doenças existentes na boca. Assim, foi objetivo desse estudo, avaliar as condições de saúde bucal de oito etnias (Umutina, Paresi, Bororo, Bakairi, Kayabi, Irantxe, Nambikwara and Terena) que residem na terra indígena Umutina, no Estado de Mato Grosso. Um total de 291 índios, de ambos os sexos e com idade variando de 1 a 96 anos, foram examinados, sendo que alterações de normalidade ou patologias bucais foram observadas em um total de 132 indivíduos,evidenciando uma elevada ocorrência de anquiloglossia, a qual esteve presente em 108 casos (37,11%), seguida de glossite migratória benigna em 5 casos (1,72%); tórus mandibular e candidose em 3 casos (1,03%), dentre outras. Nenhuma lesão de caráter maligno foi identificada na referida população. Apesar da elevada freqüência de anquiloglossia na Reserva Indígena Umutina, a mesma não parece ser responsável por alterações associadas à fonação, mastigação, presença de diastema e problemas periodontais, uma vez que essas alterações foram observadas em baixa freqüência e não foram motivos de queixas da população. As condições dentárias foram avaliadas com o objetivo de identificar a prevalência de cárie dentária e necessidade de tratamento odontológico das crianças da aldeia Umutina, por meio de um estudo epidemiológico transversal. Para análise da cárie dentária foram utilizados: os índices de dentes cariados, perdidos e obturados (CPOD) para...
The oromaxillofacial complex is frequently envolved by diseases and variations from normality, some of which closely related to ethnical and racial groups. Studies on the distribution of oral diseases and variations from normality in Indian communities are generally directed mainly to the study of dental caries in the children and periodontal diseases in the adults, disregarding a wide range of other oral diseases. Thus, the aim of this study was to evaluate the oral health conditions of eight ethnic groups living in the Umutina Indian Reservation, in the State of Mato Grosso, Brazil. The total of 291 Indians, of both generes, with ages ranging from 1 to 96 years, were examined and were found between them 132 abnormalities and/or oral diseases, evidencing a high occurrence of ankyloglossia, which was present in 108 cases (37.11%), followed by benign migratory glossitis in 5 cases (1.72%); mandibular torus and candidosis in 3 cases (1.03%) among others. No malign lesion was identified in that population. Even thought the high frequency of the ankyloglossia in the ethnicities living in the Umutina Indian reservation, it does not seem to be responsible for alterations associated to phonation, mastication, presence of diastema and periodontal problems, since those alterations were observed with a low frequency and were not reason for complaint from the population. The dental conditions were evaluated with the aim to identify the prevalence of dental caries and the need of dental treatment in children from Umutina Village using a transversal epidemiological study. To analyze dental caries prevalence the decayed, missing, and filled teeth (DMFT) or decayed, extracted, and filled teeth (deft) indexes were used for, respectively, permanent or primary dentition and the need of treatment index. Statistical analysis was done with the software GraphPad Prism. The Mann Whitney analysis was used with... (Complete abstract click electronic access below)
Libri sul tema "Periodontium Infections"
1
N, Shah Haroun, Mayrand D e Genco Robert J, a cura di. Biology of the species Porphyromonas gingivalis. Boca Raton: CRC Press, 1993.
Cerca il testo completoCapitoli di libri sul tema "Periodontium Infections"
1
Gupta, Priya, e Vinita Boloor. "Chapter-21 Acute Gingival Infections". In Essential Quick Review: Periodontics, 95–100. Jaypee Brothers Medical Publishers (P) Ltd., 2016. http://dx.doi.org/10.5005/jp/books/12903_22.
Testo completo
2
"Acute Gingival Infections". In Essentials of Clinical Periodontology and Periodontics, 203. Jaypee Brothers Medical Publishers (P) Ltd., 2018. http://dx.doi.org/10.5005/jp/books/18042_21.
Testo completo
3
Reddy, Shantipriya. "Acute Gingival Infections". In Essentials of Clinical Periodontology and Periodontics, 175. Jaypee Brothers Medical Publishers (P) Ltd., 2011. http://dx.doi.org/10.5005/jp/books/11392_20.
Testo completo
4
Banerjee, Avijit, e Timothy F. Watson. "Essentials of minimally invasive operative dentistry". In Pickard's Guide to Minimally Invasive Operative Dentistry. Oxford University Press, 2015. http://dx.doi.org/10.1093/oso/9780198712091.003.0008.
Testo completoAbstract (sommario):
All members of the oral healthcare team have a part to play in patient management, and the team is comprised of the lead dentist (plus other colleagues in the dental practice), the dental nurse, hygienist, receptionist, laboratory technician, and possibly a dental therapist. In the UK, registered dental nurses can take further qualifications in teaching, oral health education, and radiography, and can specialize in other aspects of dentistry, including orthodontics, oral surgery, sedation, and special care. If the dentist wishes to have a second specialist opinion regarding a difficult diagnosis, formulating a care plan or even executing it, they may refer the patient to a specialist dentist working in another practice, or to a hospital-based consultant specialist in restorative dentistry. These specialists have undergone further postgraduate clinical and academic training and gained qualifications enabling them to be registered as specialists with the General Dental Council (GDC) in the UK in their specific trained fields (e.g. endodontics, periodontics, prosthodontics), or have further specialist training in restorative dentistry. The lead dentist will act as a central hub in the coordinating wheel of patient management, possibly outsourcing different aspects of work to relevant specialist colleagues, as spokes of that wheel. This is the clinical environment in which patients are diagnosed and treated. This room has traditionally been known as the ‘dental surgery’, but a more appropriate modern description might be the ‘dental clinic’, as much of the more holistic care offered to patients within its four walls will be non-surgical in the first instance. The operator and nurse must work closely together. To be successful, each must build up an understanding of how the other works. The clinic consists of a dental operating chair with an attached or mobile bracket table carrying the rotary instruments and 3-1 air/water syringe (and possibly the light-cure unit and ultrasonic scaler), work surfaces (which should be as clutter-free as possible for good-quality infection control; see later), cupboards for storage, and two sinks, one for normal hand washing and another for decontaminating soiled instruments prior to sterilization. Often the surgery will also house an X-ray unit for taking intra-oral radiographs. Most clinics are designed to accommodate right-handed practitioners, in terms of the location of many of the instruments and controls.
Atti di convegni sul tema "Periodontium Infections"
1
Zhu, L., M. Salloum, S. Feteih, J. Hough, D. Arola e M. Tolba. "Experimental Study of Temperature Elevations in Extracted Teeth Using a System B Heating Catheter for Bacterial Disinfection". In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19125.
Testo completoAbstract (sommario):
Total bacterial disinfection and elimination from the human root canal system are crucial in clinical endodontic procedures [Card et al., 2002; Kakoli et al., 2009]. The current approaches relying on mechanical instrumentation and root canal irrigation and medicaments have demonstrated that eradication of bacteria occurs when the bacteria are in direct contact with the medicaments. However, persistent infection following routine treatments has suggested that bacteria may harbor in the root canal anatomical irregularities and/or deep dentinal tubules, therefore, surface irrigation of medicaments may not be able to reach those regions. Heat treatment has been used for obturation of the root canal in endodontic practice. In this study we hypothesize that as an alternative, surface heating using a System B heating catheter through the root canal surface would be effective for bacterial elimination in the deep dentin. The heat-induced cytotoxic response kills bacteria in the root dentin via heat conduction from the thermal energy incident on the root canal wall. In principle, a high power setting and/or a long heating duration can always achieve sufficient temperature elevations in deep dentin. Yet, the detailed temperature distribution inside the dentin and possible thermal damage to the supporting periodontium are unknown. Therefore, it is of clinical importance to perform and investigate temperature elevations in dentin to provide clinicians with an optimized and effective treatment protocol to minimize unnecessary thermal damage to the surrounding structure.