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Monographs in Oral Science 2021The goal of modern periodontal therapy, both during the initial stages and during maintenance, is to create biologically acceptable tooth surfaces through sub- and... (Review)
Review
The goal of modern periodontal therapy, both during the initial stages and during maintenance, is to create biologically acceptable tooth surfaces through sub- and supragingival cleaning, which enables binding of the connective tissue to the greatest extent possible. In past centuries, the focus of periodontal treatment was on the removal of the supposed cause of periodontal disease, the supra- and supragingival calculus and "infected" root cementum. The findings on the importance of biofilm
1 (plaque) and the endogenous responses to biofilm metabolism have shifted the therapeutic focus to elimination of the biofilm. The importance of avoiding injury to the hard and soft dental tissue is nowadays of upmost importance. For classical scaling and root planing to remove mineralized deposits and "infected" cementum, only hand instruments were available in the past. The regular, long-term use of these tools is associated with changes in the hard and soft tooth tissues, and with pain and sensitivity experienced by the patient during and after treatment. Modern root-surface debridement primarily uses ultrasound systems to remove hard mineralized deposits. For biofilm management, air polishing devices with low-abrasive powders are increasingly gaining acceptance. With this new technology, biofilm management can now be performed much more effectively and efficiently, using materials more sparingly; this also causes less pain and discomfort for patients during and after treatment, and less fatigue for practitioners. The modern systems allow gentle, optimal biofilm management, whereas the traditional hand instruments (curettes, scalers) and classic rotating instruments used for polishing do not. Current knowledge suggests that these instruments are not best suited for biofilm management.Topics: Biofilms; Dental Plaque; Humans; Periodontal Diseases; Reference Standards; Root Planing
PubMed: 33427229
DOI: 10.1159/000510187 -
European Review For Medical and... Apr 2015Chlorhexidine (CHX) is one of the most widely used antiseptic, especially in dentistry. At low concentrations CHX is bacteriostatic and at high concentrations acts... (Review)
Review
OBJECTIVES
Chlorhexidine (CHX) is one of the most widely used antiseptic, especially in dentistry. At low concentrations CHX is bacteriostatic and at high concentrations acts bactericidal causing cell death by cytolysis. In this study, we performed a systematic review of pharmaco-biological activity and application of CHX.
MATERIALS AND METHODS
Articles for inclusion in this review were retrieved from online databases PubMed/Medline. The selected papers were included in the present manuscript according to their relevance for the topic.
RESULTS
Totally 75 papers were enrolled in this research. CHX has strong biocidal activity against Gram-positive bacteria and weaker activity against Gram-negative bacteria. It is also active against yeasts, some dermatophytes and some lipophilic viruses. The most widely application CHX has found in dentistry and antisepsis. Numerous studies have confirmed the beneficial effects of CHX in reducing of plaque accumulation, in tooth caries, gingivitis, periodontitis and in alveolar osteitis. Unfortunately, CHX exhibits cytotoxic activity on human cells, can cause colorization of teeth and fillings, and its activity depends on the pH of the environment and the presence of organic substances.
CONCLUSIONS
CHX play a valuable role in the dentistry and antisepsis. However, it can also cause side effects, limiting its application time.
Topics: Anti-Infective Agents, Local; Antisepsis; Biological Availability; Chlorhexidine; Dental Plaque; Humans
PubMed: 25912596
DOI: No ID Found -
Dental Clinics of North America Apr 2017The human oral cavity contains more than 500 different bacterial species. These organisms belong to several phyla including Bacteroidetes, Firmicutes, Tenericutes,... (Review)
Review
The human oral cavity contains more than 500 different bacterial species. These organisms belong to several phyla including Bacteroidetes, Firmicutes, Tenericutes, Actinobacteria, Proteobacteria, Euryarchaeota, Chlamydiae, and Spirochaetes. Many of these have the ability to colonize the gingival crevices and the outer surface of the tooth forming biofilms often leading to dental plaque formation. These bacteria produce acid that erode teeth causing cavities or infections. The diagnosis of these infections is often clinical and antibiotics are used empirically to treat some infections or as prophylaxis. The characterization, definitive diagnosis, and susceptibility testing of oral bacterial infections are valuable in guiding appropriate therapy and in prevention of disease.
Topics: Bacterial Infections; Dental Caries; Dental Plaque; Humans; Mouth Diseases
PubMed: 28317568
DOI: 10.1016/j.cden.2016.12.003 -
Frontiers in Cellular and Infection... 2022Dental calculus has long been considered as a vital contributing factor of periodontal diseases. Our review focuses on the role of dental calculus as a repository and... (Review)
Review
Dental calculus has long been considered as a vital contributing factor of periodontal diseases. Our review focuses on the role of dental calculus as a repository and discusses the bioinformation recently reported to be concealed in dental calculus from three perspectives: time-varying oral condition, systemic diseases, and anthropology at various times. Molecular information representing an individual's contemporary oral health status could be detected in dental calculus. Additionally, pathogenic factors of systemic diseases were found in dental calculus, including bacteria, viruses and toxic heavy metals. Thus, dental calculus has been proposed to play a role as biological data storage for detection of molecular markers of latent health concerns. Through the study of environmental debris in dental calculus, an overview of an individual's historical dietary habits and information about the environment, individual behaviors and social culture changes can be unveiled. This review summarizes a new role of dental calculus as a repository of bioinformation, with potential use in the prediction of oral diseases, systemic diseases, and even anthropology.
Topics: Humans; Dental Calculus; Periodontal Diseases; Bacteria; Microbiota
PubMed: 36579339
DOI: 10.3389/fcimb.2022.1035324 -
Periodontology 2000 Jun 2021Ecologists have long recognized the importance of spatial scale in understanding structure-function relationships among communities of organisms within their... (Review)
Review
Ecologists have long recognized the importance of spatial scale in understanding structure-function relationships among communities of organisms within their environment. Here, we review historical and contemporary studies of dental plaque community structure in the context of three distinct scales: the micro (1-10 µm), meso (10-100 µm) and macroscale (100 µm to ≥1 cm). Within this framework, we analyze the compositional nature of dental plaque at the macroscale, the molecular interactions of microbes at the microscale, and the emergent properties of dental plaque biofilms at the mesoscale. Throughout our analysis of dental plaque across spatial scales, we draw attention to disease and health-associated structure-function relationships and include a discussion of host immune involvement in the mesoscale structure of periodontal disease-associated biofilms. We end with a discussion of two filamentous organisms, Fusobacterium nucleatum and Corynebacterium matruchotii, and their relevant contributions in structuring dental plaque biofilms.
Topics: Biofilms; Corynebacterium; Dental Plaque; Fusobacterium nucleatum; Humans; Microbiota
PubMed: 33690940
DOI: 10.1111/prd.12364 -
Journal of the California Dental... Jul 2016Characterizing the evolution of the oral microbiome is a challenging, but increasingly feasible, task. Recently, dental calculus has been shown to preserve ancient... (Review)
Review
Characterizing the evolution of the oral microbiome is a challenging, but increasingly feasible, task. Recently, dental calculus has been shown to preserve ancient biomolecules from the oral microbiota, host tissues and diet for tens of thousands of years. As such, it provides a unique window into the ancestral oral microbiome. This article reviews recent advancements in ancient dental calculus research and emerging insights into the evolution and ecology of the human oral microbiome.
Topics: Dental Calculus; Dental Caries; Fossils; History, Ancient; History, Medieval; Humans; Microbiota; Mouth; Paleodontology; Periodontal Diseases
PubMed: 27514153
DOI: No ID Found -
BioMed Research International 2015Black stain is characterized as a dark line or an incomplete coalescence of dark dots localized on the cervical third of the tooth. Over the last century, the etiology... (Review)
Review
Black stain is characterized as a dark line or an incomplete coalescence of dark dots localized on the cervical third of the tooth. Over the last century, the etiology of black stain has been the subject of much debate. Most of the studies concerning this issue were conducted in pediatric population. According to the reviewed articles published between 2001 and 2014, the prevalence of black stain varies from 2.4% to 18% with equal sex distribution. The majority of the authors confirm the correlation between the presence of black stain and lower caries experience. The microflora of this deposit is dominated by Actinomyces spp. and has lower cariogenic potential than nondiscolored dental plaque. Iron/copper and sulfur complexes are thought to be responsible for the dark color. In patients with black stain saliva has higher calcium concentrations and higher buffering capacity. Factors such as dietary habits, socioeconomic status, and iron supplementation may be contributing to the formation of black stain.
Topics: Dental Caries; Dental Plaque; Humans; Prevalence; Saliva; Tooth Discoloration
PubMed: 25802850
DOI: 10.1155/2015/469392 -
Periodontology 2000 Feb 2019Like any other chronic disease, periodontal disease can be treated, but not eradicated. Personal maintenance of periodontal health requires the continuous elimination of... (Review)
Review
Like any other chronic disease, periodontal disease can be treated, but not eradicated. Personal maintenance of periodontal health requires the continuous elimination of bacterial accumulation at the gingival level, which demands periodical professional assistance. Of upmost importance is the patient being able to actively follow the counsel of the care providers. Thus, patient compliance, adherence, and persistence are paramount for the long-term success of periodontal therapy. Unfortunately, in medicine as well as in dentistry, most studies show that, sooner rather than later, an unacceptable percentage of patients quit maintenance care. However, different studies have shown that there are behavioral techniques which may significantly improve the degree of motivation, compliance and persistence of patients with oral hygiene and supportive periodontal treatment. The right interval between maintenance visits has not been determined yet, but should be implemented according to patient needs, which do not necessarily coincide with the standard three-month interval historically accepted as adequate. Adherence to periodontal maintenance results in reduction of plaque and bleeding on probing, and potentially slowing down or halting the disease progression. Finally, based on numerous retrospective studies, patient compliance could be considered a disease-modifying factor positively affecting tooth survival. However, a lack of randomized clinical trials means this last statement is still open to question.
Topics: Dental Care; Dental Plaque; Humans; Oral Hygiene; Periodontal Diseases; Retrospective Studies
PubMed: 30892763
DOI: 10.1111/prd.12256 -
The Journal of International Medical... Oct 2017Objective The natural accumulation of supragingival plaque on surfaces of human teeth is associated with gingival inflammation and the initiation of common oral...
Objective The natural accumulation of supragingival plaque on surfaces of human teeth is associated with gingival inflammation and the initiation of common oral diseases. This study evaluated the distribution of dental plaque and gingivitis scores within the dental arches after prophylaxis. Methods Adult subjects from the Dharwad, India area representing the general population who provided written informed consent were scheduled for screening. Healthy subjects over the age of 18 years, not currently requiring any medical or dental care, and presenting with a complement of at least 20 natural teeth were recruited for this parallel design study. Enrolled subjects (n = 41) underwent oral examinations for dental plaque (PI) and gingivitis (GI) using the Turesky modification of the Quigley-Hein and the Löe-Silness Index, respectively, at the baseline visit, followed by a whole mouth dental prophylaxis. Subjects were given fluoride toothpaste for twice daily oral hygiene for the next 30 days. Subjects were recalled on days 15 and 30 for PI and GI examinations identical to baseline. Results Analyses indicated that mean scores for PI and GI on either arch and the whole mouth were higher than 2 and 1, respectively, during all examinations. Anterior surfaces consistently exhibited lower PI scores than posterior regions of either arch, or the entire dentition. Regional GI differences within the dentition were similar to PI scores, with lower scores on anterior than posterior teeth. Prophylaxis reduced both the frequency and mean scores of both PI and GI, irrespective of arch, with lower scores observed on anterior than posterior regions during all recall visits. Molar and lingual regions consistently exhibited higher PI and GI scores compared with anterior surfaces. At all examinations, mean scores for both plaque and gingivitis were higher on approximal vestibular than mid-vestibular surfaces. Conclusions Differences observed in PI and GI within the dentition have several practical implications: (a) there are advantages of whole mouth assessments for oral health (b) a need for oral hygiene formulations to reduce the larger deposits of dental plaque in the posterior region and resultant gingival inflammation, and
Topics: Adolescent; Adult; Dental Arch; Dental Plaque; Dentition; Female; Gingiva; Gingivitis; Humans; Male; Middle Aged; Young Adult
PubMed: 28795618
DOI: 10.1177/0300060517705476 -
Implant Dentistry Apr 2019Patient-administered and professionally administered periimplant maintenance have been recommended to ensure long-term periimplant tissue health. In this narrative... (Review)
Review
PURPOSE
Patient-administered and professionally administered periimplant maintenance have been recommended to ensure long-term periimplant tissue health. In this narrative review, the effectiveness of patient and professionally administered interventions and the current level of evidence that periimplant maintenance therapy is effective in preventing the occurrence of periimplant disease were examined.
MATERIALS AND METHODS
A systematic literature search was performed in Ovid MEDLINE, EMBASE, Cochrane Library, and Web of Science, for evidence-based articles in support of the above topics.
RESULTS
Twenty-six clinical trials were included and stratified into categories based on topics.
CONCLUSIONS
The following conclusions were reached: (a) mechanical plaque removal is the foundation of successful periimplant therapy; (b) patient- and professionally administered plaque control has been shown to reduce periimplant inflammation, although complete resolution of inflammation is not always evident; (c) the use of adjunctive chemical agents in maintaining periimplant health still remains to be determined; and (d) regular periimplant maintenance plays a significant role in maintaining periimplant soft and hard tissue health.
Topics: Dental Plaque; Humans; Inflammation; Prostheses and Implants
PubMed: 30601226
DOI: 10.1097/ID.0000000000000837