Aparatologia ortodôntica : associação com queilite angular, aspecto clínico gengival e atividade enzimática das leveduras do gênero candida

Abstract

This study sought to verify the possible correlation between the gingival clinical aspect in patients with and without fixed orthodontic appliance and the presence of yeast of the genus Candida, as well as the appearance of lesions in the corner of the mouth and virulence of yeast given enzyme activity. For both was a study of analytical and descriptive type cross-section where saliva samples were taken from 40 patients who used fixed orthodontic appliance and 40 patients of the control group who haven't used. After isolation of yeast phenotypic analyses were carried out classic (tube proof germinal, Riddell – outdoor grows), followed by identification by automated method (VITEK 2). Then was assessed the enzyme activity (phospholipases and proteinases) in order to assess the virulence of yeasts. Of 80 patients surveyed, were isolated yeast of the genus Candida, 27 (64.3%), which used orthodontic apparatus and fixed and (35.7%) 15 that haven't used. Was verified the existence of statistically significant association considering the two groups (yeast isolation in relation to the use of apparatus) (p < 0.05) and (OR = 3.4). Among all species isolated, the most frequent was the Candida albicans with isolated 31, being 17 (42.5%) present in the group with fixed orthodontic appliance (35.0%) 14 and in the control group. Of the total number of patients who made use of fixed orthodontic appliance fixed (n = 40), 63.2% (n = 12) have angular Cheilitis, whereas in the control group, only 36.8% (n = 7) exhibited such clinical demonstrating that there was no statistical difference between the groups. There was no statistical association between clinical aspect gingival (healthy and unhealthy) in relation to the presence of yeasts and the presence of angular cheilitis. There was a statistically significant association between the gingival clinical aspect of patients and the presence of fixed orthodontic appliance (p < 0.05). Patients of the control group (those who did not use fixed orthodontic appliance fixed) showed a higher probability of having a clinical healthy gingival aspect, therefore, this condition was a protective factor (OR=0.2). The association between the use of fixed orthodontic appliance and enzyme activity (indexes 2 and proteinases = 3) was present in 100% of patients in both groups. Already, considering the phospholipases, positivity for its indexes: 2 and 3 was equal to 22.5% for patients who have used the instrument and equal to 15.0% for those belonging to the group control. Unable to infer that the addition of the fixed orthodontic appliance in the buccal environment can predispose to a different oral microbiota with higher probability of having a clinical aspect and unhealthy gingival expression of virulence of isolated strains considering the enzymatic activity of phospholipases and indexes defined by proteinases. However, there was no significant association in the appearance of angular Cheilitis and isolation of yeasts. Also there was no association between the gingival clinical aspect (healthy and unhealthy) and isolation of yeasts or presence of angular Cheilitis.