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BMC Oral Health Apr 2020Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health...
BACKGROUND
Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health deterioration. The use of probiotics has been proposed to be useful in the prevention or treatment of oral pathologies such as caries and diseases of periodontal tissues. Our aim was to investigate the effects of probiotic use on inflammation of the gingival tissues and the decalcification of the enamel in patients being treated with fixed orthodontic appliances.
METHODS
We searched without restrictions 8 databases and performed hand searching until September 2019. We searched for randomized controlled trials (RCTs) evaluating whether individuals with fixed orthodontic appliances benefit from probiotic treatment in terms of the inflammation of the gingivae and decalcification of the enamel. Following the selection of studies and the extraction of pertinent data, we appraised the risk of bias and the confidence in the observed effects based on established methodologies.
RESULTS
From the final qualifying studies, three did not show any statistically significant effect on gingival inflammation after probiotic administration of up to 1 month. Similarly, non-significant differences were noted in another study regarding white spot lesions development (mean administration for 17 months). No adverse effects were reported and the level of evidence was considered moderate.
CONCLUSIONS
Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel. Additional RCTs, with longer intervention and follow-up periods, and involving different combinations of probiotic strains are required.
TRIAL REGISTRATION
PROSPERO (CRD42018118008).
Topics: Adolescent; Adult; Child; Dental Caries; Dental Plaque; Dental Prophylaxis; Female; Gingivitis; Humans; Male; Oral Health; Oral Hygiene; Orthodontic Appliances; Orthodontic Appliances, Fixed; Probiotics; Tooth Discoloration; Young Adult
PubMed: 32334590
DOI: 10.1186/s12903-020-01109-3 -
BMC Complementary Medicine and Therapies Feb 2020Despite the large number of trials conducted using herbal oral care products for the reduction of dental plaque or gingivitis, results are conflicting and inconclusive. (Comparative Study)
Comparative Study Meta-Analysis
BACKGROUND
Despite the large number of trials conducted using herbal oral care products for the reduction of dental plaque or gingivitis, results are conflicting and inconclusive.
OBJECTIVE
To assess the effectiveness of herbal oral care products compared to conventional products in reducing dental plaque and gingivitis adults.
METHODS
We searched the following databases for Randomised controlled trials (RCTs): MEDLINE Ovid, EMBASE Ovid etc. which yielded 493 trails. Of which 24 RCTs comparing herbal toothpaste or mouth rinse with over the counter toothpaste or mouth rinse in adults aged 18 to 65 years were included. Two authors extracted information and assessed the methodological quality of the included studies using Risk of Bias. Meta-analyses using the random-effects model were conducted for four outcomes for tooth paste and mouth rinse respectively. Mean difference (MD) or standardized mean difference (SMD) were used to estimate the effect, with 95% confidence intervals.
RESULTS
A total of 1597 adults participated in 24 RCT studies. These were classified as herbal toothpaste (HTP) (15 trials, 899 participants) and herbal mouth rinse (HMR) (9 trials, 698 participants) compared with non-herbal toothpaste (NHTP) or non-herbal mouth rinse (NHMR). We found that HTP was superior over NHTP (SMD 1.95, 95% CI (0.97-2.93)) in plaque reduction. The long-term use of NHMR was superior in reduction of dental plaque over HMR (SMD -2.61, 95% (CI 4.42-0.80)). From subgroup analysis it showed that HTP was not superior over fluoride toothpaste (SMD 0.99, 95% CI (0.14-2.13)) in reducing dental plaque. However, HTP was favoured over non-fluoride toothpaste (SMD 4.64, 95% CI (2.23-7.05)).
CONCLUSION
For short-term reduction in dental plaque, current evidence suggests that HTP is as effective as compared to NHTP; however, evidence is from low quality studies.
Topics: Dental Plaque; Gingivitis; Humans; Mouthwashes; Oral Hygiene; Plant Preparations; Randomized Controlled Trials as Topic; Toothpastes
PubMed: 32046707
DOI: 10.1186/s12906-020-2812-1 -
Medicina Oral, Patologia Oral Y Cirugia... Mar 2020To improve the results of the classic periodontal treatment, probiotics have been suggested recently to decrease the number of bacteria and the expression of mediators...
BACKGROUND
To improve the results of the classic periodontal treatment, probiotics have been suggested recently to decrease the number of bacteria and the expression of mediators of inflammation. This systematic review aimed to assess the literature for the effectiveness of different probiotic strains as adjuvants to non-surgical periodontal therapy.
MATERIAL AND METHODS
The electronic database of MEDLINE (via Pubmed) was searched up to December 2017 for randomised clinical trials in English comparing non-surgical periodontal treatment and probiotics versus periodontal treatment and placebo. The primary outcome investigated was reduction in pocket probing depth. Secondary outcomes were bleeding on probing, plaque index reduction and bacteria counts.
RESULTS
Nine trials were included. A narrative data synthesis did not result in any major improvement of overall pocket probing depth but moderate pockets from 4 to 6 mm showed larger reductions in study groups, which could decrease the need for surgery. Sites with bleeding on probing and presence of plaque decreased after treatment. For periimplant mucositis, there was a small tendency to better results in the study group.
CONCLUSIONS
With the available data, it is concluded that probiotics may provide an additional benefit to manual debridement in chronic periodontitis. More studies are required on dose, route of administration and strains of probiotics used.
Topics: Chronic Periodontitis; Dental Plaque; Dental Plaque Index; Dental Scaling; Humans; Probiotics; Stomatitis
PubMed: 31893476
DOI: 10.4317/medoral.23147 -
International Journal of Dental Hygiene May 2020The aim of this systematic review was to establish the adjuvant clinical effect of brushing with a dentifrice containing purported active ingredients as compared to a... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of this systematic review was to establish the adjuvant clinical effect of brushing with a dentifrice containing purported active ingredients as compared to a regular sodium fluoride dentifrice with respect to the inhibition of overnight dental plaque regrowth from studies with human participants.
METHODS
MEDLINE-PubMed, EMBASE and Cochrane CENTRAL were searched, up to June 2019. The inclusion criteria were controlled clinical trials with participants aged ≥ 18 years in good general health. Studies were included that evaluated the effect of toothbrushing with a dentifrice on the inhibition of overnight dental plaque regrowth when an active ingredient was added to the dentifrice as compared to a common sodium fluoride product. Data were extracted from the eligible studies, the risk of bias was assessed, and a meta-analysis was performed where feasible.
RESULT
Independent screening of 213 unique papers resulted in 10 eligible publications that provided 14 comparisons. Stannous fluoride and triclosan dentifrices were found as the active ingredients. The descriptive analysis indicated that all, but two comparisons demonstrated an additional effect on the active-ingredient dentifrice. The meta-analysis supported and strengthened these findings. It showed that when plaque was scored digitally, a DiffM was -3.15(95% CI [-4.61:-1.69], P < .001, prediction interval [-5.07;-1.24]). When plaque was scored clinically, the difference of means (DiffM) was -0.33(95% CI [-0.49:-0.16], P < .001, prediction interval [-0.87; 0.21]).
CONCLUSION
The results of this review demonstrate moderate-quality evidence that brushing with an active-ingredient dentifrice with stannous fluoride or triclosan does provide an added clinically relevant effect concerning plaque inhibition capabilities that surpass the effect of a regular sodium fluoride dentifrice.
Topics: Adolescent; Dental Plaque; Dentifrices; Humans; Sodium Fluoride; Tin Fluorides; Toothbrushing; Toothpastes; Triclosan
PubMed: 31675470
DOI: 10.1111/idh.12423 -
Brazilian Oral Research 2019The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy...
The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy implants, or of teeth with periodontitis and implants with peri-implantitis. A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE and Cochrane databases were searched up to February 2018 for studies comparing microbiological data of biofilm samples collected from healthy teeth and implants or from teeth with periodontitis and implants with peri-implantitis. The weight of evidence was defined in three categories (strong, moderate and mild/some), according to the difference in number of studies showing statistically significantly higher counts and/or proportions and/or abundance and/or prevalence of microorganisms in health or in disease. Of the 132 articles identified, 8 were included. A wide range of microorganisms were present in different conditions but no microorganisms showed strong, moderate or mild/some evidence for a specific association with either teeth or implants. The results of this systematic review indicated that there is insufficient evidence in the literature to support specific differences between microorganisms colonizing teeth and implants, either in health or in disease.
Topics: Bacteria; Biofilms; Case-Control Studies; Dental Implants; Dental Plaque; Gingiva; Humans; Microbiota; Peri-Implantitis; Periodontitis
PubMed: 31576948
DOI: 10.1590/1807-3107bor-2019.vol33.0064 -
BMC Oral Health Sep 2019This systematic scoping review aimed to identify changes in biomarkers of microbiological, immunological and biochemical origin during experimental gingivitis (EG)...
BACKGROUND
This systematic scoping review aimed to identify changes in biomarkers of microbiological, immunological and biochemical origin during experimental gingivitis (EG) studies that might indicate resistance and resilience.
METHODS
The term 'experimental gingivitis' was run in PubMed from inception to April 11th, 2018. From the 411 studies retrieved, 22 studies were included for this review.
RESULTS
Studies reporting data on biomarker changes during and after full mouth EG trial were included. Two studies reported findings on changes in biomarkers of microbiological, 12 on immunological and eight on biochemical origin. Changes were reported in the induction phase, and occasionally in the resolution phase. The microbiological composition of both supragingival and subgingival dental plaque changed over the course of EG to a more pathogenic direction, but showed a shift back to a more normal composition. This indicates resilience of the oral microbiome. For immunological biomarkers, it was challenging to retrieve a robust pattern of changes across multiple studies. IL-1β and IL-6 in saliva and in gingival crevicular fluid increased during induction phase and returned in the resolution phase below baseline values. The biochemical parameters cystatin-SN, cystatin-S and lactoferrin in saliva were increased at the end of induction phase, however also here no clear pattern emerged based on all available studies.
CONCLUSIONS
More research is needed to investigate which microbiological, immunological, and biochemical biomarkers can be useful for future investigations into the resistance and resilience of the oral cavity to experimental gingivitis.
Topics: Adolescent; Adult; Aged; Animals; Child; Dental Plaque; Female; Gingival Crevicular Fluid; Gingivitis; Humans; Male; Microbiota; Periodontal Index; Vascular Endothelial Growth Factor A; Young Adult
PubMed: 31511002
DOI: 10.1186/s12903-019-0889-z -
International Journal of Dental Hygiene Feb 2020To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration.... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores.
MATERIAL AND METHODS
MEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed.
RESULTS
Screening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [-0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [-0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [-0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [-0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [-3.98; -1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [-3.32; 3.55]).
CONCLUSION
There is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Dental Plaque; Gingivitis; Humans; Mouthwashes; Tooth Discoloration
PubMed: 31054209
DOI: 10.1111/idh.12402 -
International Journal of Dental Hygiene Feb 2020In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal?
METHODS
MEDLINE-PubMed and Cochrane-CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley-Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta-analysis and subanalysis for brands and mode of action being oscillating-rotating (OR) and side-to-side (SS) were performed when feasible.
RESULTS
Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was -0.14 (P < 0.001; 95%CI [-0.19; -0.09]) for the Q&HPI and -0.10 (P < 0.001; 95%CI [-0.14; -0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM -0.16 (P < 0.001; 95%CI [-0.22, -0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed -0.10 (P < 0.001; 95%CI [-0.15; -0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of -0.15 (P < 0.001; 95%CI [-0.22; -0.08]) and the Colgate SS for RMNPI showed a DiffM of -0.15 (P < 0.001; 95%CI [-0.18; -0.12]).
CONCLUSION
There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.
Topics: Adolescent; Adult; Dental Plaque; Dental Plaque Index; Equipment Design; Humans; Periodontal Index; Randomized Controlled Trials as Topic; Single-Blind Method; Toothbrushing
PubMed: 31050195
DOI: 10.1111/idh.12401