This study investigated the prevalence of apical periodontitis (AP) and its association with endodontically treated teeth in residents of São Luís, MA, Brazil. Two-hundred complete series of periapical radiographs taken over a 10-year period (1993-2003) were retrieved from the files of four prosthesists and five periodontists. The Periapical Index (PAI) was used and the age range, sex, tooth groups, location and association with endodontic treatment (ET) were also analyzed. The Cohen Kappa and Chi-square tests were used for statistical analysis. Out of 200 patients, 135 presented at least one case of AP, which corresponds to a prevalence of 67.5%. Of the 5008 teeth examined, 296 had AP and 553 had ET. Therefore, considering the total number of teeth, AP and ET prevalences were 5.9% and 11%, respectively. Of the 553 endodontically treated teeth, 235 (42.5%) were associated with AP. Chi-square test showed a strong correlation between AP and ET (p<0.05). The 40-year-old age group was significantly the most prevalent (p<0.05). There was no association between AP and patient's sex (p>0.05). The maxillary incisors were the most affected group of teeth (p<0.05). AP had predilection for the maxilla and was strongly associated with endodontically treated teeth (p<0.05). The prevalence of apical periodontitis and endodontically treated teeth with AP was high and similar to the results of studies performed in other countries.
The aim of this study was to detect possible associations between respiratory pathogens from tracheal aspirate and oral biofilm samples in intubated patients in an intensive care unit (ICU), and to identify the most common respiratory pathogens in oral biofilm, particularly in patients that developed ventilator-associated pneumonia (VAP). Two oral biofilm samples were collected from the tongue of intubated patients (at admission and after 48 hours) and analyzed by culture with the Antibiotic Sensitivity Test. The results from the tongue biofilm samples were compared with the tracheal secretions samples. A total of 59.37% of patients exhibited the same species of pathogens in their tracheal aspirate and oral biofilm, of which 8 (42.1%) developed VAP, 10 (52.63%) did not develop pneumonia and one (5.26%) had aspiration pneumonia. There was a statistically significant association between presence of microorganisms in the tracheal and mouth samples for the following pathogens: Klebsiella pneumoniae, Candida albicans, Pseudomonas aeruginosa, Enterobacter gergoviae, Streptococcus spp and Serratia marcescens (p < 0.05). Pathogens that are present in tracheal aspirates of intubated patients can be detected in their oral cavity, especially in those who developed VAP or aspiration pneumonia. Thus, the results indicate that an improved oral care in these patients could decrease ICU pneumonia rates.
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