Clinical signs of gingivitis range from oedema, abnormal staining of normal gums, unusual

redness, and loss of normal contour of gingival.7 Periodontitis is defined as an inflammatory disease that involves the tissues of dental support, leading to irreversible alveolar bone resorption and destruction of the collagen fibres of the periodontal ligament. Selleck SB431542 The severity and progression of this disease is influenced by local or systemic conditions or from both a combination of both.8 Local factors are associated with poor oral hygiene, the presence of cavities, and the presence of dentures that can cause plaque accumulation. Systemic factors are related to the metabolism of the host, immunosuppressive therapy, malnutrition, diabetes mellitus and HIV infection (Table 1 and Table 2).7 A complex microbiota can be found in the periodontal pocket affected by the disease, where approximately 500 species of bacteria can occur, amongst them are A. actinomycetemcomitans, and other microorganisms such as Entamoeba sp., virus, some Enterobacteriaceae, Pseudomonas sp., and Candida species. 9, 10, 11 and 12 This fact has led to

an extensive study of microbiological samples from periodontal lesions, especially in cases where there is a poor response to conventional treatment. In many Nintedanib solubility dmso of these cases, fungi have been found colonizing the periodontal pockets. There are several reports associating the occurrence of severe periodontitis with the isolation of Candida species from periodontal lesions. 13 and 14 However, the clinical significance of these observations and the role of microorganisms in the pathogenesis of periodontal diseases are not well understood. Many scientific investigations have been performed in order to extend the knowledge in this area. 15 However, the presence of fungi in periodontal pockets has not yet received the necessary focus to understand its role as periodontal pathogens, although they have been recognized for their ability to adhere to the epithelium, express virulence factors and induce inflammatory reactions. 16 The treatment of

periodontal many disease includes scaling and root planning (SRP) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a attachment loss, so the use of antimicrobials is needed as an adjuvant to SRP treatment.17 The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species. 18 and 19 The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment associated with SRP has been recommended for the treatment of periodontal disease.