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Oral Health & Preventive Dentistry Apr 2024To investigate the microbiological outcomes obtained with either subgingival debridement (SD) in conjunction with a gel containing sodium hypochlorite and amino acids... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
PURPOSE
To investigate the microbiological outcomes obtained with either subgingival debridement (SD) in conjunction with a gel containing sodium hypochlorite and amino acids followed by subsequent application of a cross-linked hyaluronic acid gel (xHyA) gel, or with SD alone.
MATERIALS AND METHODS
Forty-eight patients diagnosed with stages II-III (grades A/B) generalised periodontitis were randomly treated with either SD (control) or SD plus adjunctive sodium hypochlorite/amino acids and xHyA gel (test). Subgingival plaque samples were collected from the deepest site per quadrant in each patient at baseline and after 3 and 6 months. Pooled sample analysis was performed using a multiplex polymerase chain reaction (PCR)-based method for the identification of detection frequencies and changes in numbers of the following bacteria: Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g), Tannerella forsythia (T.f), Treponema denticola (T.d), and Prevotella intermedia (P.i).
RESULTS
In terms of detection frequency, in the test group, statistically significant reductions were found for P.g, T.f, T.d and P.i (p < 0.05) after 6 months. In the control group, the detection frequencies of all investigated bacterial species at 6 months were comparable to the baseline values (p > 0.05). The comparison of the test and control groups revealed statistically significant differences in detection frequency for P.g (p = 0.034), T.d (p < 0.01) and P.i (p = 0.02) after 6 months, favouring the test group. Regarding reduction in detection frequency scores, at 6 months, statistically significant differences in favour of the test group were observed for all investigated bacterial species: A.a (p = 0.028), P.g (p = 0.028), T.f (p = 0.004), T.d (p <0.001), and P.i (p = 0.003).
CONCLUSIONS
The present microbiological results, which are related to short-term outcomes up to 6 months post-treatment, support the adjunctive subgingival application of sodium hypochlorite/amino acids and xHyA to subgingival debridement in the treatment of periodontitis.
Topics: Humans; Hyaluronic Acid; Sodium Hypochlorite; Aggregatibacter actinomycetemcomitans; Porphyromonas gingivalis; Female; Middle Aged; Male; Prevotella intermedia; Tannerella forsythia; Treponema denticola; Adult; Dental Plaque; Amino Acids; Periodontal Debridement; Bacterial Load; Gels; Combined Modality Therapy; Follow-Up Studies; Cross-Linking Reagents; Periodontal Pocket; Periodontitis
PubMed: 38687029
DOI: 10.3290/j.ohpd.b5281925 -
BMC Oral Health Apr 2024Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation.... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation. Conventional toothbrushing may not be enough, requiring additional oral hygiene aids like interproximal brushes, dental flosses, and water flossers. Limited research exists on comparing water flossing and interdental flossing in orthodontic patients. Therefore, this study aims to assess their effectiveness in maintaining oral hygiene during active orthodontic treatment.
METHODS
A single-blind, randomized, parallel clinical study recruited orthodontic patients with full-mouth brackets and archwires. Thirty participants were randomly assigned to either water jet flossing or interdental flossing groups. All participants were instructed to brush twice daily with a provided toothbrush and toothpaste and use the assigned intervention once daily at night. Clinical measures, including the Gingival Bleeding Index (BI), Plaque Index (PI), and Gingival Index (GI), were recorded at baseline and day 14. Descriptive statistics and statistical tests were performed using SPSS software.
RESULTS
The water jet flossing group demonstrated a slightly higher, albeit non-significant, benefit in plaque removal (median difference of 6.79%%, P = 0.279) and bleeding reduction (median difference of 5.21%%, P = 0.172) compared to the interdental flossing group after two weeks. Both groups showed significant reductions in gingival bleeding index and plaque index from baseline to the 2-week follow-up. The interdental flossing group had median mean percentage differences of 16.13%% (plaque index) and 23.57% (gingival bleeding index), while the water jet flossing group had median percentage differences of 21.87% (plaque index) and 32.29% (gingival bleeding index). No significant changes in gingival index grades were observed in either group.
CONCLUSION
Both water jet flossing and interdental flossing were effective in reducing plaque accumulation and gingival bleeding among orthodontic patients. While no significant differences were found between the two methods, water jet flossing showed a potential advantage. Further research is needed to validate its effectiveness, assess long-term impact, and understand its benefits for orthodontic patients.
Topics: Humans; Dental Devices, Home Care; Female; Single-Blind Method; Oral Hygiene; Male; Periodontal Index; Dental Plaque Index; Adolescent; Orthodontic Appliances, Fixed; Dental Plaque; Young Adult; Toothbrushing; Water; Adult
PubMed: 38678246
DOI: 10.1186/s12903-024-04166-0 -
British Dental Journal Apr 2024Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is... (Review)
Review
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
Topics: Humans; Dental Caries; Biofilms; Cariostatic Agents; Dental Plaque; Dental Restoration, Permanent
PubMed: 38671111
DOI: 10.1038/s41415-024-7292-0 -
Clinical Oral Investigations Apr 2024Chewing gums containing antiseptics or other antimicrobial substances may be effective in reducing plaque and gingivitis. Therefore, the aim of this randomized... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Chewing gums containing antiseptics or other antimicrobial substances may be effective in reducing plaque and gingivitis. Therefore, the aim of this randomized placebo-controlled clinical trial was to investigate the efficacy of a novel antimicrobial chewing gum containing essential oils (cinnamon, lemon, peppermint) and extracts on reduction of dental plaque and gingivitis as well as on oral health-related quality of life (OHRQoL) in adolescent orthodontic patients.
MATERIALS
52 patients (11-22 years of age) were randomly assigned to use a test chewing gum (COVIDGUM, Clevergum) or a commercially available control chewing gum over a period of 10 days. Approximal plaque index (API), papillary bleeding index (PBI) and an OHRQoL questionnaire for children (COHIP-G19) were assessed at baseline (BL), after 10 days (10d) and 30 days (30d). In addition, oral health and oral hygiene related questions of the COHIP-G19 questionnaire were evaluated separately in subscales at each timepoint. Data were analyzed using non-parametrical statistical procedures (α = 0.05).
RESULTS
API and PBI decreased significantly over time from BL to 10d and from BL to 30d in both groups, without significant differences between the groups. In both groups, the COHIP-G19 score, oral health subscale and oral hygiene subscale decreased significantly over time. Regarding the oral hygiene subscale, the test group showed significantly better scores at 30d (p = 0.011).
CONCLUSION
Both chewing gums performed similarly effective in terms of reducing plaque accumulation and gingival inflammation and improving OHRQoL.
CLINICAL RELEVANCE
Chewing gums without antimicrobial ingredients may be sufficient to decrease plaque accumulation and gingival inflammation.
Topics: Humans; Gingivitis; Adolescent; Chewing Gum; Female; Male; Dental Plaque; Quality of Life; Child; Young Adult; Surveys and Questionnaires; Anti-Infective Agents; Treatment Outcome; Oils, Volatile; Dental Plaque Index; Periodontal Index
PubMed: 38664261
DOI: 10.1007/s00784-024-05669-4 -
Oral Health & Preventive Dentistry Apr 2024To investigate the effect of full-mouth disinfection on the sizes of the periodontal wound and periodontal inflammatory burden and whether it leads to a decrease in...
PURPOSE
To investigate the effect of full-mouth disinfection on the sizes of the periodontal wound and periodontal inflammatory burden and whether it leads to a decrease in C-reactive protein (CRP) levels.
MATERIALS AND METHODS
The study included 20 systemically healthy subjects (11 women and 9 men) 30 to 68 years old with localised or generalised periodontitis (stage III, grade C). The sizes of the periodontal wound and periodontal inflammatory burden were measured with the web application "Periodontalwound", which is based on measurements of average tooth cervices, as well as probing depths and bleeding on probing assessed at six sites around each tooth present in the oral cavity. The levels of hsCRP (high-sensitivity CRP) were measured with an immunochemical method. All three parameters were measured before initial treatment and 3 months after therapy. Full-mouth disinfection included removal of plaque and calculus with ultrasonic and hand instruments in one session.
RESULTS
The results showed a statistically significant decrease in the size of the periodontal wound (p < 0.001), a statistically significant decrease in the size of periodontal inflammatory burden (p < 0.001), and a decrease in hsCRP levels 3 months after therapy.
CONCLUSION
Full-mouth disinfection leads to a decrease in the periodontal wound and periodontal inflammatory burden size, as well as a decrease in the levels of hsCRP in patients with localised or generalised periodontitis (stage III, grade C).
Topics: Humans; Male; Female; C-Reactive Protein; Middle Aged; Adult; Aged; Disinfection; Periodontitis; Periodontal Index; Dental Plaque; Dental Calculus; Periodontal Pocket; Ultrasonic Therapy
PubMed: 38652288
DOI: 10.3290/j.ohpd.b5245853 -
Journal of Conservative Dentistry and... Mar 2024Teeth bleaching, although considered safe and conservative, cause microscopic changes in the tooth structure. The aim of this study is to evaluate the bleaching efficacy...
BACKGROUND AND AIM
Teeth bleaching, although considered safe and conservative, cause microscopic changes in the tooth structure. The aim of this study is to evaluate the bleaching efficacy of carbamide peroxide (CP) bleaching gel when modified with the incorporation of bioactive glass (BG) and hydroxyapatite (HA) and its effect on enamel microhardness.
MATERIALS AND METHODS
Forty-five maxillary incisors were decoronated, artificially stained and mounted in acrylic. The samples were divided into three groups of 15 each and subjected to the following bleaching protocol for 8 h/day at 37°C for 2 weeks: Group 1 - 16% CP, Group 2 - CP modified with BG, and Group 3 - CP modified with hydroxyapatite (HA). Spectrophotometric color assessment using CIE L*a*b* system and Vickers microhardness were assessed before and after bleaching. Data were analyzed using Student's paired -test and one-way ANOVA followed by Tukey's analysis.
RESULTS
There was a significant change in color (L*a*b*) in all the three groups when compared to the baseline values. However, no significant difference in the total color change (ΔE) was observed between the three groups. Enamel microhardness reduced significantly in the CP group, whereas it increased in the BG and HA group after bleaching. Scanning electron microscopy images of BG and HA groups showed crystalline deposits suggesting mineral deposition.
CONCLUSION
Addition of biomaterials can be a beneficial alternative to bleaching with CP alone, considering the increase in microhardness without hindering the bleaching action.
PubMed: 38634034
DOI: 10.4103/JCDE.JCDE_310_23 -
Journal of Nanobiotechnology Apr 2024Periodontitis is an inflammatory disease induced by the complex interactions between the host immune system and the microbiota of dental plaque. Oxidative stress and the...
Periodontitis is an inflammatory disease induced by the complex interactions between the host immune system and the microbiota of dental plaque. Oxidative stress and the inflammatory microenvironment resulting from periodontitis are among the primary factors contributing to the progression of the disease. Additionally, the presence of dental plaque microbiota plays a significant role in affecting the condition. Consequently, treatment strategies for periodontitis should be multi-faceted. In this study, a reactive oxygen species (ROS)-responsive drug delivery system was developed by structurally modifying hyaluronic acid (HA) with phenylboronic acid pinacol ester (PBAP). Curcumin (CUR) was encapsulated in this drug delivery system to form curcumin-loaded nanoparticles (HA@CUR NPs). The release results indicate that CUR can be rapidly released in a ROS environment to reach the concentration required for treatment. In terms of uptake, HA can effectively enhance cellular uptake of NPs because it specifically recognizes CD44 expressed by normal cells. Moreover, HA@CUR NPs not only retained the antimicrobial efficacy of CUR, but also exhibited more pronounced anti-inflammatory and anti-oxidative stress functions both in vivo and in vitro. This provides a good potential drug delivery system for the treatment of periodontitis, and could offer valuable insights for dental therapeutics targeting periodontal diseases.
Topics: Humans; Curcumin; Reactive Oxygen Species; Multifunctional Nanoparticles; Esters; Dental Plaque; Nanoparticles; Periodontitis; Hyaluronic Acid; Boronic Acids; Glycols
PubMed: 38622641
DOI: 10.1186/s12951-024-02461-0 -
Compendium of Continuing Education in... Apr 2024Oral piercing habits are associated with various degrees of complications. Tongue piercing increases the risk of gingival recession and infrabony defects, subsequently...
Oral piercing habits are associated with various degrees of complications. Tongue piercing increases the risk of gingival recession and infrabony defects, subsequently leading to localized periodontitis. In the case presented, the patient had persistent swelling and suppuration around her mandibular anterior teeth attributed to tongue piercing jewelry that was placed approximately 12 years prior. Intraoral examinations revealed a localized deep pocket, purulent discharge, swelling, plaque accumulation, bleeding on probing, gingival recession, and teeth mobility. The patient was diagnosed with localized stage III, grade C periodontitis. Following full-mouth debridement and the placement of an extracoronal lingual splint, minimally invasive, papillae-sparing incisions were made, and regenerative therapy with bone allograft and collagen membrane was used to manage the infrabony defects. During the 18-month postoperative follow-up, complete soft-tissue healing was observed along with a significant reduction in pocket depth and the absence of bleeding on probing or suppuration. Radiographic evaluation showed evidence of bone fill. The reported case demonstrates how careful diagnosis and treatment planning are crucial for managing different periodontal defects and emphasizes the importance of proficient periodontal management, which can save teeth that would otherwise be extracted and replaced with implant therapy or fixed bridgework.
Topics: Humans; Female; Body Piercing; Periodontitis; Gingival Recession; Dental Plaque; Guided Tissue Regeneration, Periodontal; Suppuration; Periodontal Attachment Loss; Alveolar Bone Loss; Follow-Up Studies
PubMed: 38622080
DOI: No ID Found -
Journal of the Indian Society of... Jan 2024In cariology studies, mitis-salivarius-bacitracin (MSB) agar has been commonly considered as the selective medium for Streptococcusmutans growth. The present study was... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In cariology studies, mitis-salivarius-bacitracin (MSB) agar has been commonly considered as the selective medium for Streptococcusmutans growth. The present study was the part of a funded project (a noninferiority randomized controlled trial) which compared the efficacy of a plant extract-based mouth rinse with that of a fluoride mouth rinse on the S.mutans counts of the children.
AIM
This study aimed to identify the frequency of detection of S.mutans and nonstreptococcal bacterial species from the dental plaque of caries active children using a combined technique of anaerobic culture and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry.
SETTINGS AND METHODS
Caries-active children (8-12 years old) were enrolled from a pediatric dental outpatient department at a tertiary care hospital. From each participant, dental plaque samples were collected from carious surfaces under sterilized conditions and then subjected to anaerobic culture. After 48 h of incubation, the bacterial colonies were isolated by sub-culture and identified by the MALDI-TOF.
RESULTS
In all, 13 different bacterial species were isolated from the MSB agar medium. Other than S.mutans species, colonies of bacterial species such as Veillonelladispar,Streptococcusanginosus, Veillonellaparvula, and Streptococcusgordonii were also frequently observed from the medium.
CONCLUSIONS
The study concluded that several bacterial strains, both streptococcal and nonstreptococcal, could be isolated from the MSB agar medium; hence, this medium should no longer be considered selective medium for the culture of S.mutans in clinical and epidemiological studies.
Topics: Child; Humans; Agar; Bacitracin; Dental Caries Susceptibility; Dental Plaque; Mouthwashes; Dental Caries
PubMed: 38616422
DOI: 10.4103/jisppd.jisppd_17_24 -
Nutrients Mar 2024The aim was to determine the association between plaque and gingival inflammation reported by dietary interventions. Data of four clinical studies dealing with changed...
The aim was to determine the association between plaque and gingival inflammation reported by dietary interventions. Data of four clinical studies dealing with changed nutrition and gingival examination were reanalyzed with regard to gingival inflammation (GI), plaque (PI), and bleeding on probing (BOP). Dietary changes basically involved avoiding sugar, white flour and sweetened drinks and focusing on whole foods for 4 weeks. The control groups were to maintain their usual diet. All participants had to reduce their oral hygiene efforts. Linear regression models taking the clustering of the data due to several studies into account were applied. In total, data of 92 participants (control groups: 39, test-groups 53) were reanalyzed. While both groups showed a slight increase in dental plaque, only the test groups showed a significant decrease in inflammatory parameters: GI (mean value difference End-Baseline (Δ): -0.31 (±SD 0.36)) and BOP (Δ: -15.39% (±16.07)), both < 0.001. In the control groups, there was a constant relation between PI and GI, while the experimental group showed a decreasing relationship in GI/PI ( = 0.016), and even an inverted relationship BOP/PI under a changed diet ( = 0.031). In conclusion, diet seems to be a determining factor how the gingiva reacts towards dental plaque.
Topics: Humans; Dental Plaque; Diet; Gingivitis; Gingiva; Inflammation
PubMed: 38612955
DOI: 10.3390/nu16070923