Bleeding On Probing Scores Research Articles

Reconstructive surgical treatment of peri-implantitis with use of a chitosan brush for decontamination- case series with 1-year follow-up

Introduction and aimThere is a need for studies assessing the efficacy of different therapeutic approaches in the reconstructive surgical treatment of peri-implantitis. The aim of this case series is to evaluate the clinical outcomes and radiographic bone fill of reconstructive surgical treatment using the oscilating chitosan brush for implant surface decontamination.Materials and methodsNine patients with 11 Class I and III peri-implantitis defects were included. Following implant surface decontamination performed with a chitosan brush, guided bone regeneration (GBR) was performed by means of a bovine derived cancellous bone graft and collagen membrane. Clinical parameters such as full mouth plaque score (FMPS), probing depth (PD), bleeding on probing (BoP), recession, and radiographic bone level (RBL) were recorded at baseline and 1 year following treatment.ResultsAll evaluated parameters, including PD, BoP, recession, RBL, and full mouth plaque scores, revealed significant improvements at 1 year follow-up compared to baseline (p < 0.05). The mean PD values reduced from 7.30 ± 1.29 to 3.78 ± 0.65 (p = 0.000). RBL was detected 5.50 ± 1.31 and 1.38 ± 0.74 at baseline and 1-year, respectively (p = 0.010).ConclusionReconstructive surgical treatment of Class I and III peri-implantitis defects with GBR may be an effective treatment protocol when an oscilitating chitosan brush is used for surface decontamination.Clinical trial numberNot applicable.

Effectiveness of different types of toothbrushes on periodontal health in orthodontic patients with gingivitis: A randomized controlled study

BackgroundThe aim of the study is to evaluate the effectiveness of different toothbrushes in reducing gingival inflammation and dental biofilm removal in gingivitis patients with fixed orthodontic appliances.MethodsFollowing baseline clinical assessments, including the Turesky modification of the Quigley-Hein plaque index (TQHI), gingival index (GI), bleeding on probing (BOP), and probing pocket depth (PPD), all patients received nonsurgical periodontal therapy. Patients were then randomly assigned to one of three groups: conventional toothbrush (C-TB), orthodontic toothbrush (O-TB), or single-tufted toothbrush (ST-TB). Each group received tailored oral hygiene instructions based on their assigned toothbrush type. Clinical assessments were repeated and recorded in the first week, sixth week, and third month.ResultsThirty-six patients with a mean age of 23.14 ± 3.86 (18–32 years) participated in the study. All groups with twelve patients each demonstrated significant improvements in clinical parameters compared to baseline. In the sixth week, the O-TB and ST-TB groups showed significantly greater improvements in TQHI and BOP scores compared to the C-TB group (p < 0.05). By the third month, the ST-TB group maintained significantly lower TQHI and BOP scores, while the O-TB group’s scores became similar to those of the C-TB group. ST-TB and C-TB groups had significantly lower GI scores than the O-TB group in all time points. Although the effectiveness of ST-TB was significantly higher than that of other toothbrushes, all toothbrushes demonstrated lower efficacy in the posterior region.ConclusionsThe ST-TB was shown to be more effective in reducing gingival inflammation over three months, while it demonstrated similar efficacy to the O-TB in dental biofilm removal. Further research is necessary to substantiate these findings and to demonstrate the efficacy of this approach in promoting periodontal tissue health in patients with fixed orthodontic appliances.Trial registrationThis study was registered with the National Library of Medicine Clinical Trials Registry Platform on 19/07/2024 as NCT06510179.

Comparative Efficacy of Medium and Soft Toothbrushes in Plaque Removal and Gingivitis Control.

BACKGROUND Regularly removing dental plaque is key to good oral hygiene and gingival health promotion. This study aimed to compare the effects of using soft and medium toothbrushes using the plaque index (PI), gingival index (GI), and bleeding on probing (BOP) index. MATERIAL AND METHODS A randomized parallel-group study design was used. Sixty-four participants were randomly assigned to 2 similar intervention groups (medium and soft toothbrush groups). The PI, GI, and BOP indexes were used. The median and median difference of PI, GI, and BOP were calculated. SPSS was used for data entry and analysis. Wilcoxon and Mann-Whitney U tests were used for data analysis. RESULTS The median scores of GI, PI, and BOP significantly decreased from 1.8, 1.7, and 2.0, respectively, before using medium toothbrushes to 0.0, 0.1, and 0.0, respectively, after using medium toothbrushes (all P<0.0001). Similarly, the median scores of GI, PI, and BOP significantly decreased from 2.0, 1.7, and 2.0, respectively, before using soft toothbrushes to 1.1, 0.9, and 1.0, respectively, after using soft toothbrushes (P<0.0001). The median differences in GI, PI, and BOP scores among those using medium toothbrushes were higher than the median differences among those using soft toothbrushes [(1.8 vs 0.9), (1.6 vs 0.8), and (2.0 vs 1.0), respectively]. These differences were statistically significant (P<0.0001). CONCLUSIONS This study concludes that medium and soft toothbrushes were effective in removing plaque and controlling gingivitis. Medium toothbrushes were more effective than soft toothbrushes in achieving these outcomes.

Salivary levels of catalase, total antioxidant capacity and interleukin-1β and oral health-related quality of life after matcha and green tea consumption for patients with gingivitis: A randomized clinical trial.

To evaluate the changes in salivary levels of catalase (CAT), total antioxidant capacity (TAC) and IL-1β (primary outcomes) as well as gingival health and oral health-related quality of life (OHRQOL) 1 month after the consumption of matcha and green tea in adult patients with gingivitis. This study was a parallel randomized clinical trial. Forty gingivitis adult patients were randomly assigned to drink either matcha or green tea cup twice daily for a duration of 1 month. They were asked to keep their habitual oral hygiene measures. Plaque index (PI) and bleeding on probing (BOP) were recorded. In addition, saliva was collected at baseline and 1 month after tea consumption. Salivary levels of CAT, TAC and IL-1β were determined by ELISA. Each participant was asked to fill OHIP-14 questionnaire before and after tea consumption. Following tea intake, 40.6% of the study sample had healthy gingiva. Both groups similarly showed reductions in PI (0.32 ± 0.11-0.22 ± 0.08) and BOP (0.24 ± 0.08-0.13 ± 0.07) scores after tea consumption. There was a significant difference between mean TAC before and after matcha tea consumption only. Non-significant reductions in salivary levels of CAT and IL-1β were detected after tea consumption. OHRQOL of participants was improved after tea, both types, consumption. Despite study limitations, daily consumption of matcha and green tea might be beneficial as they potentially enhance OHRQOL of individuals with gingivitis and reduce the extent of gingivitis despite non-significant changes in salivary antioxidants and IL-1β levels.

Evaluation of minimally invasive esthetic crown lengthening using an open flap versus flapless surgical approach: A randomized controlled clinical trial.

Esthetic crown lengthening (ECL) is commonly advocated to treat patients with altered passive eruption (APE). Since the introduction of the minimally invasive surgical concept, a limited number of studies have investigated this technique in a standardized manner, with further studies required to verify the validity and predictability of the minimally invasive FL-technique. The current randomized trial compares a minimally invasive (ECL), using piezosurgery with flapless-approach (FL), versus an open-flap (OF) approach in the management of patients with APE Type 1B. Twenty-four patients diagnosed with APE Type 1B were randomly assigned into test (FL) with tunneling approach or control (OF) group with minimally invasive flap reflection (n = 12/group). Postoperative pain was assessed during the first 48 h. Gingival margin (GM) level relative to a custom-made stent (rGM) and patient satisfaction were assessed preoperative, immediately after surgery, at 3 and 6 months postsurgically. Postoperative swelling was reported for the first week postsurgically. Plaque index (PI), bleeding on probing (BoP), clinical attachment level (CAL), pocket depth (PD) and pink esthetic score (PES), were evaluated at baseline and 6 months. Linear regression analysis was conducted for pain. OF-group reported significantly higher pain and swelling scores than FL-group during the first 48 h (p < 0.05). FL-group showed no significant differences regarding rGM between 3 and 6 months, in contrast to OF-group, where a significant decrease in rGM was notable (p < 0.05). No significant differences in PI, BoP, CAL, PD, PES, and patient satisfaction scores were evident between groups (p > 0.05). Regression analysis demonstrated that treatment and gender were significant predictors for pain (p < 0.05). Within the current study's limitations, piezo-surgical ECL with FL-approach presented significantly lower postoperative pain, swelling, and early GM stability compared to OF-approach. Piezosurgical ECL with a FL-approach can be considered a predictable technique with advantages over the OF-approach in the management of patients with APE Type1B.

Mobile Application-Based Support for Periodontal Treatment Improves Clinical, Cognitive, and Psychomotor Outcomes: A Randomized Controlled Trial Study.

This study aims to evaluate the clinical, cognitive, and psychomotor changes that emerged among patients with gingivitis and patients with periodontitis via mobile application assistance. Forty subjects were randomly and evenly distributed into test and control groups and were administered a professional mechanical plaque removal (PMPR) procedure. The clinical parameters examined were bleeding on probing (BoP), probing pocket depth (PPD), and the oral hygiene index (OHI-S). The test group was administered a mobile application intervention, namely PerioUICare, which provided users with continuous education and motivation and served as a daily dental hygiene reminder. The comparative results of the mean values of all parameters between the groups (inter-group) and within the groups (intra-group) after one- and three-month evaluations were analyzed. A one-month inter-group evaluation uncovered significant differences in the BoP, PPD, cognitive, and psychomotor scores of subjects with gingivitis and the BoP, OHI-S, cognitive, and psychomotor scores of subjects with periodontitis. A three-month inter-group evaluation revealed significant differences across all parameters except for PPD in subjects with periodontitis. The results of the intra-group comparison demonstrated statistically significant differences in all parameters in the test group but no significant differences in the cognitive and psychomotor scores of the control group. This study revealed that mobile application-based support for periodontal treatment can be considered effective.

Systemic Melatonin Supplementation as an Adjunct to Non-Surgical Periodontal Treatment in Obese Patients with Periodontitis

Background: Obesity is considered an important risk factor for periodontal disease. It has been reported that reactive oxygen species linking both diseases, systemic melatonin supplementation as antioxidant therapy, was addressed as an adjuvant to scaling and root surface debridement (SRP) to enhance the treatment of periodontitis. Objective: To investigate the efficacy of systemic melatonin administration in periodontitis-obese patients as an adjuvant to scaling and root surface debridement (SRP). Methods: A randomized clinical trial was conducted at a dental-specialized center. Eighty subjects were included and allocated into group-I: twenty periodontium-healthy, normal-weight people; group-II: 30 obese patients with stage-III treated only with SRP; and group-III: 30 obese patients with stage-III periodontitis treated with SRP and 5mg melatonin. periodontitis and subjected to estimation, serum levels of Receptor Activator of Nuclear Factor-Kappa B Ligand (RANKL) were estimated in all groups. Probing pocket depth (PPD), bleeding on probing (BOP), and relative attachment level (RAL) were estimated in Groups II and III at baseline and after a one-month visit. Results: RANKL baseline visits were significantly different between the control and studied groups, with no significant difference in clinical parameters except for PPD. The 2nd visit showed a significant difference in BOP score-1 compared to RAL and BOP score 0. In the second visit, only weak negative and positive significant correlations were found between RANKL and BOP. Conclusion: Daily use of 5 mg of melatonin improves periodontal parameters and decreases serum RANKL levels.

A tangible prospect for the treatment of gingivitis using a potentially probiotic strain Lactobacillus plantarum MK06 isolated from traditional dairy products: a triple blind randomized clinical trial

BackgroundFrequent bacterial plaque buildup at the gingival margin and crevice can provoke an inflammatory reaction in gingival tissues which manifests as gingivitis. Probiotics could serve as a beneficial complementary therapy for treating gingival inflammation. The main aim of this research was to investigate the effect of the Lactobacillus plantarum MK06 probiotic strain on the treatment of gingivitis.MethodsPatients with gingivitis, who were referred to a private clinic and were systematically healthy, were included in this randomized, triple-blind, placebo-controlled trial. They were instructed to use either placebo or Lactobacillus plantarum suspensions for one minute two times a day after tooth-brushing for four weeks. Then, the clinical parameters of gingivitis, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), and oral hygiene index (OHI-s), were measured in the first, second, and fourth weeks. A total of forty-two patients were randomly assigned to the experimental (n = 21) and control (n = 21) groups. The mean age of the experimental and control groups was 29.10 and 28.48, respectively.ResultsThe mean scores of BOP, GI, PI, and OHI-s reduced over time in both the control and test groups. However, according to the Mann-Whitney test, the difference between the two groups was not significant at the same time intervals (P ≥ 0.05) and only GI showed a significant difference in the fourth week (GI-3, P = 0.006). Nevertheless, the experimental group experienced a higher overall reduction rate than the control group. The BOP, GI, PI, and OHI-s scores decreased by 0.081, 0.204, 0.186, and 0.172 times in the second week, respectively, resulting from the interaction of time and the intervention, which considerably diminished these indices.ConclusionThis study shows the potential of the probiotic Lactobacillus plantarum MK06 suspension as a promoting therapeutic adjuvant in the treatment of gingivitis.

Impact of the uninstructed use of a herbal, ayurvedic toothpaste on parameters of gingival health in periodontal aftercare patients: A randomized, double-blinded, two-arm parallel-group study.

The aim of this study was to evaluate the impact of the uninstructed use of a toothpaste containing herbal ayurvedic ingredients on parameters of gingival health in a cohort of periodontal aftercare patients affected by gingival inflammation compared to the use of a standard, non-herbal toothpaste. The monocentric, randomized, double-blinded, two-arm parallel-group intervention was performed in a cohort of 88 periodontal aftercare patients with clinical signs of gingival inflammation. At baseline, bleeding on probing (BoP), gingival index (GI) and Quigley-Hein plaque index (QHI) were recorded. Subsequently, the study patients were randomly provided with a herbal ayurvedic toothpaste (n = 44) or a conventional, non-ayurvedic control toothpaste (n = 44) and without additional oral hygiene training instructed to use it 2× daily for the next 28 days. On day 28, BoP, GI and QHI were recorded again. At baseline, there were no significant differences between both groups. On day 28, mean GI and BoP scores were significantly lower (p < 0.001) compared to baseline in both groups. Differences between the groups could not be verified. Mean QHI scores did not change significantly between day 0 and day 28 in both groups. The impact of uninstructed toothbrushing with an ayurvedic toothpaste on the manifestation of gingival inflammation in periodontal aftercare patients is not significantly different to the use of a conventional, non-herbal toothpaste.

Impact of an Okinawa/Nordic based diet on endocrinological and periodontal conditions in individuals with type 2 diabetes. A randomized case–control study

ObjectivesTo assess if the results following intake of a diet using an Okinawan-based Nordic diet (OBND) over one month differs in endocrinological, periodontal clinical outcome, and serum cytokine levels compared to a standard hospital care diet in individuals with diabetes type 2 (T2D) (control group).BackgroundScientific evidence suggests that the use of diet for individuals with T2D may be beneficial.MethodsParticipating individuals with T2D were randomly assigned to a test (OBND) (n = 14), or control group (n = 16). Anthropometric data, blood glucose levels, HbA1c levels, lipids, serum inflammation markers (CRP, and a routine panel of 24 cytokines), blood pressure, gingival bleeding on probing (BOP), probing pocket depths (PPD), and clinical attachment levels (CAL) were studied.ResultsStatistical analyses of baseline study data failed to demonstrate study group differences. The mean weight reduction was greater in the OBND group (4.1 kg) versus the control group (1.3 kg) (p < 0.01). The reduction in BMI was 1.4 kg/m2 in OBND (p < 0.001) and 0.5 kg/m2 in the control group, respectively (p < 0.01). Diastolic and systolic blood pressure reductions were greater in the OBND group than in the control group (p < 0.01). Periodontal study parameters (BOP % scores) and (PPD values) decreased (p < 0.001) overall with no between group differences. The OBND resulted in reduction of serum levels of IFNγ, Eotaxin IL-9, IP10,IL17a, MCP-1,m and PDFBB compared to the control diet.ConclusionsA strict T2D- diet provides an association between reduction in serum HbA1c and BOP scores. Serum levels decreases in IFNγ, Eotaxin IL-9, IP-10, IL17a. MCP-1, and PDFBB were only found in the test group.

Clinical and bacterial periodontal parameters with methylene blue-loaded nanoparticles incorporated in a natural plant-based vehicle for the treatment of Stage III Grade B periodontitis.

AimThe aim of the present clinical trial was to assess the effectiveness of antimicrobial photodynamic therapy (PDT) versus poly-L-glycolic acid nanoparticles loaded methylene blue in aloe vera gel (PGA/MB/AV) on periodontal and microbial outcomes in patients with Stage III Grade B periodontitis. MethodsSeven-five patients undergoing scaling and root planing (SRP) were randomized equally into three groups: Group-I: PGA/MB/AV + SRP, Group-II: PDT + SRP, and Group-III: SRP alone. The assessed clinical periodontal parameters included plaque scores (PS), bleeding on probing (BOP), pocket depth (PD), and clinical attachment levels (CAL). Plaque samples were acquired from the patients to assess the levels of Tannerella forsythia (Tf) and Porphyromonas gingivalis (Pg). Clinical and bacterial recording were documented at the start of the study, 3 months, and 6 months after completion of treatment. ResultsA significant improvement was observed in both PS and BOP at the 3 months (p<0.01) and 6 months (p<0.001) follow-up in all three groups. A significant reduction in BOP scores was observed in Group II in comparison to the other groups on the inter-group comparison. Group-I showed significant PD reduction and CAL gain compared to Group II and III (p<0.01). Group-I displayed a significant decrease in the Tf and Pg after 3 months (p<0.05). A decrease was observed after six months of treatment for Tf only (p<0.05). Group I displayed a high decrease for only Tf at three months (p<0.05). ConclusionMethylene blue-loaded nanocarrier in AV gel produced pronounced periodontal healing compared to aPDT alone in stage III grade B periodontitis patients.

Salivary matrix metalloproteinase-9 (MMP-9) as a biomarker of periodontitis in pregnant patients with diabetes.

Pregnancy and diabetes increase the risk of developing pathological conditions in the periodontium. Salivary biomarkers, such as matrix metalloproteinase-9 (MMP-9), as well as antioxidants can be used as diagnostic indicators in monitoring periodontitis. The aim of the study was to assess the periodontal status of pregnant women with regard to the presence of diabetes. In addition, we aimed to assess antioxidant activity and the level of MMP-9 in saliva in order to establish the optimal noninvasive determinants of periodontitis. The study included 104 pregnant women: 35 patients had gestational diabetes mellitus (GDM); 30 patients had type 1 diabetes (T1D); and 39 patients did not have diabetes (the control group). The physical examination included the assessment of the approximal plaque index (API), the gingival index (GI), bleeding on probing (BOP), the probing pocket depth (PPD), and clinical attachment loss (CAL). In the saliva study, MMP-9 concentration as well as the ferric reducing ability of plasma (FRAP), and the activity of superoxide dismutase (SOD), glutathione reductase (GR) and glutathione peroxidase (GPX) were measured. The pregnant patients with GDM and T1D had higher GI, BOP, PPD, and CAL scores than the control women (p < 0.0001, p = 0.0040, p = 0.0100, p = 0.0030, and p < 0.0001, p < 0.0009, p < 0.0001, p < 0.0001, respectively). The T1D patients had higher API scores as compared to the control women (p = 0.0010). The patients with periodontitis had higher salivary MMP-9 levels than the patients without periodontitis (p = 0.0001). The salivary antioxidant levels and activity were comparable among the study groups. The determinants of periodontitis (p < 0.0001) were MMP-9 concentration (p = 0.0008) and oral hygiene (p = 0.0001). The concentration of MMP-9 was also a useful determiner of the presence of periodontitis (p < 0.0001). In the pregnant women with diabetes, we observed worse gingival conditions, deeper periodontal pockets and greater attachment loss in comparison with the women from the control group. The concentration of MMP-9 in saliva is a good predictor of periodontitis and might be a useful tool for diagnosing periodontitis.

Evaluation of gingival health and pain level in orthodontics treatment with clear aligners: A systematic review and meta-analysis

Objectives: The aim of the study was to assess the proficiency of clear aligners (CAs), and to evaluate all aspects of this orthodontic procedure including bleeding on probing (BOP), plaque index (PI), gingival index (GI), and probing pocket depth (PD), which all are clinical parameters of gingival inflammation in addition to the pain score. Material and Methods: We performed an electronic search in the different databases such as Cochrane CENTRAL for eligible studies, SCOPUS, PubMed, and Web of Science. The quality of the involved trials has been measured according to Cochrane’s risk of bias tool. The following outcomes have been assumed: BOP, PI, GI, probing PD, and pain score. The homogeneous and heterogeneous data have been evaluated using random-effects model and fixed-effects model, consistently. Results: Ten clinical trials have been included in the study. The pooled analysis that The CAs has been associated with a significant decrease in the pain score (standardized mean difference = 0.74 [0.46, 1.02]), (P = 0.0001). No significant variations between post-treatment and pre-treatment group were found regarding plaque index (mean difference [MD] = −0.11 [−0.45, 0.22]), (P = 0.5), BOP (MD = 0.20 [−0.01, 0.41]), (P = 0.06), GI (MD = 0.17 [−0.06, 0.40]), (P = 0.15), and BOP (MD = 0.01 [−0.16, 0.17]), (P = 0.94). Conclusion: Patients treated by CAs showed a noticeable decrease in pain scores. On contrary, there was not any difference between the pre-treatment data and post-treatment data regarding other indices.

Clinical and Radiographic Outcomes of Resective Surgery with Adjunctive Implantoplasty Over a 6- to 11-Year Follow-up: A Case Series.

Diverse surgical approaches, such as resective, reconstructive, and combined therapy, have been proposed for peri-implantitis treatment. A resective surgical approach with an adjunctive modified implantoplasty refers to the modification of the implant body into a constricted area to mimic a 'waist' silhouette. This modified technique forms an adequate concave smooth area that may favor the outcomes of resective surgical therapy for soft tissue adaptation, biofilm control, and possible peri-implant bone gain over the long term. The present case series aimed to exhibit the long-term clinical and radiographic outcomes of resective surgery with adjunctive implantoplasty over a 6- to 11-year follow-up. Four patients presenting four implants (one per patient) diagnosed with peri-implantitis (according to an established case definition) were included in the present case series. Patients underwent resective surgery, a modified implantoplasty approach, and implant surface decontamination. After surgical therapy, clinical and radiographic outcomes such as bleeding on probing (BoP), suppuration on probing (SoP), probing depth (PD), marginal recession (MR), modified plaque index (mPI), and marginal bone levels (MBLs) were recorded over a long-term follow-up period. Over the 6- to 11-year follow-up, mean BoP, PD, and SoP scores amounted to 17% ± 24%, 3.2 ± 0.66 mm, and 0%, respectively. Mean BoP, PD, and SoP scores were reduced by 67% ± 24%, 2.5 ± 1.26 mm, and 100%, respectively. Radiographic analysis revealed a mean radiographic bone gain of 3.1 ± 1.84 mm. Peri-implant marginal bone loss surface area decreased by 5.7 ± 3.77 mm2 over the long-term follow-up. Resective therapy with adjunctive implantoplasty promoted favorable clinical and radiographic outcomes at treated peri-implantitis sites over a long-term period.

Differences in the oral hygiene status and clinical periodontal status between conventional and electric smokers

Conventional and electrical cigarette use could result in bad pathological conditions in the oral cavity, which may lead to periodontal diseases. This research aimed to determine the differences in the oral hygiene and clinical periodontal status between conventional and electric smokers. This research was a quantitative observational research and was designed as a cross-sectional study. The samples were selected using purposive sampling. A total of 110 respondents (n = 110) were involved, consisted of 60 conventional smokers and 50 electric smokers. Their oral hygiene status were examined using oral hygiene index simplified (OHI-S) measurement, while their periodontal tissue status were assessed using bleeding on probing (BOP) and probing pocket depth (PPD) measurements. The data were analyzed using the Mann-Whitney test with a significance level of α &lt; 0.05. The median and first quartile of OHI-S scores of the conventional smokers’ group were 2.7 and 2.2, while the electric smokers’ group was 2.2 and 1.4 respectively, with a significant value of p &lt; 0.001. The median and first quartile BOP scores of the conventional smokers’ group were 36% and 29%, while the electric smokers’ group were 35% and 28% respectively, with a significant value of p = 0.750. The median and first quartile of PPD scores in the conventional smokers’ group were 3.2 and 2.7, while the electric smokers’ group were 3.1 and 2.6 respectively with a significant value of p = 0.765. Conventional smokers had worse oral hygiene status than electric smokers. Conventional and electric smokers did not have significant differences in periodontal health including gingival bleeding and poor pocket depth.

Effect of melatonin supplementation on the gingival health and lipid profiles in obese periodontitis patients

Background: Obesity increases the host’s susceptibility by modulating the immune and inflammatory systems in a manner that predisposes to inflammatory tissue destruction and leaves an individual at greater risk of periodontitis. Melatonin is a pineal secretory product involved in numerous actions, such as regulation of internal biological clocks and energy metabolism, and it functions as an antioxidant and anti-inflammatory agent. There exists a substantial amount of evidence supporting the beneficial effect of melatonin supplementation on obesity and its complications. Aim of the study: To investigate the effects of systemic melatonin intake on periodontal health status and lipid profiles in obese periodontitis patients. Subjects and methods: Subjects included in the study were distributed into the following groups: Group I, 20 subjects with normal weight and healthy periodontium (controls) not subjected to any treatment. Group II: 30 obese periodontitis patients subjected to scaling and root planing (SRP) only. Group III: 30 obese periodontitis patients subjected to SRP and supplemented with 5mg melatonin tablets for 1 month. Study groups subjected to estimation of plaque index (PLI), bleeding on probing (BOP), cholesterol (chol), triglycerides (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) at baseline and after 4 weeks recall visit. Results: Regarding the clinical parameters, the second visit exhibited decreasing in all parameters in both study groups except BOP score 0 were it increased significantly. Regarding lipid profiles, the second visit showed decreasing in all profiles except HDL where it increased in both study groups with a significant difference. All correlations between lipid profiles in recall visit in both study groups exhibited a positive significant correlation between chol and TG, chol and LDL, LDL and TG in group III. In group II all results exhibited a positive significant correlation, whereas the only strong negative correlation was found between chol and HDL, HDL and LDL. Conclusion: Daily supplementation with 5mg melatonin tab significantly improved periodontal health and reduced chol, TG, LDL with increasing HDL.

Comparative assessment of periodontal status and genotoxicity in orthodontic patients on fixed mechanotherapy with and without adjunct chlorhexidine mouthrinse: A randomized control clinical trial.

Adjunct chlorhexidine mouthrinse is used routinely in orthodontic clinical practice for plaque control. However, chlorhexidine has genotoxic effects on the oral cells. Moreover, orthodontic appliance leach Ni, Cr metals ions into saliva causing toxicity of surrounding mucosa. Hence, the aim of the study was to assess the periodontal status and genotoxicity in orthodontic patients on fixed mechanotherapy with and without adjunct chlorhexidine using micronucleus (MN) test. A randomized control clinical trial was conducted in 30 patients who were on fixed mechanotherapy. The patients were randomly assigned into two treatment groups; Group-A (Control Group): Included 15 patients who are on fixed orthodontic therapy with mechanical plaque control measures only., Group-B (Experimental Group:) included 15 patients on fixed orthodontic therapy with mechanical plaque control and adjunct chlorhexidine mouthrinse (0.2%) for 2 weeks. Periodontal status and genotoxicity using MN test were done at following time points; T0: Just before start of the orthodontic treatment., T1: 2 weeks after start of the orthodontic treatment., T2: 6 weeks after start of the orthodontic treatment., T3: 12 weeks after start of the orthodontic treatment. Plaque index (PI) and bleeding on probing (BOP) were significantly decreased in Group B as compared to Group A in the time intervals; T0-T2, T0-T3, T1-T3 (P < 0.05). Probing pocket depth (PPD) and Clinical attachment level (CAL) showed no significant change in both the groups. The genotoxicity assessed by MN test was significantly increased in Group B than Group A at time intervals; T0-T1, T0-T2 and T0-T3. Adjunct chlorhexidine resulted in decreased PI and BOP scores but nonsignificant change in PPD and CAL. However, the genotoxicity increased significantly in both the groups but more with adjunct chlorhexidine.

Randomised controlled trial demonstrating the impact of behaviour change intervention provided by dental professionals to improve gingival health

AimsTo determine impact of oral hygiene behaviour change intervention compared to the prevailing standard of oral hygiene advice provided in general dental practice, on bleeding on probing (BOP) in gingivitis patients, over 3-months. The effect of providing power-brushes was also evaluated. Materials and methodsNHS dental practices were cluster-randomised to intervention or control (2:1). Dentists at intervention sites received behaviour modification training. Participants were stratified to high (≥20% BOP) or low (<20% BOP) presence of gingivitis and a subset assigned a power-brush. BOP and plaque scores were assessed at baseline and 3-months. ResultsA total of 538 participants (369:169; intervention: control) completed the study. BOP reduced in both gingivitis groups with significantly greater reduction in intervention compared to control group (BOP:38% vs 19%, p = 0.0236); Borderline significance favouring the intervention was demonstrated for the low gingivitis group (BOP:37% vs 15%, p = 0.0523). A highly significant reduction in BOP (intervention vs control) was demonstrated for volunteers who swapped from manual to power-brush (44% vs 37%, p = 0.0039). Plaque score improved more in control than intervention group (Plaque:37% vs 44%, p = 0.00215). ConclusionsBehaviour change techniques were readily mastered by the dental professional researchers. The introduction of an oral hygiene behaviour change intervention significantly reduced gingivitis in volunteer patients compared to control at 3 months. Swapping to a power-brush significantly favoured BOP reduction compared to manual brush continuation although plaque reduction did not follow expectation in comparison to BOP scores. Behaviour change techniques should routinely be considered in patient care. Clinical significancePlaque-induced gingivitis is highly prevalent in the UK despite being preventable with good oral hygiene. Its continuum, periodontitis, negative impacts quality of life. This study suggests oral hygiene behavioural interventions (GPS) significantly reduce gingivitis and that GPS introduction will improve oral health and may improve quality of life.

Effectiveness of orally administered probiotic Lactobacillus reuteri in patients with peri-implant mucositis: a prospective clinical study

Aim The aim of the present prospective clinical study was to evaluate the effectiveness of orally administered probiotic Lactobacillus reuteri in the treatment of peri-implant mucositis. Materials and methods Eighty patients showing peri-implant mucositis were enrolled and assigned to two different treatment groups. In the test group subjects were instructed to take one probiotic lozenge daily for 30 days. In the control group, patients received placebo. Periodontal indices including plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were clinically recorded around natural teeth and implants at baseline and after a period of 1 month and 3 months. Results After 3-month evaluation in the test group the differences of plaque and bleeding indices remained statistically significantly lower compared to baseline at both teeth and implants. Contrariwise, no statistically significant differences of PI and BOP were observed in the control group. The intergroup comparison at 3 months yielded statistically significantly lower values for all periodontal parameters around teeth when the probiotic was used. Conversely, no statistically significant differences in periodontal parameters were observed between test and control groups at 3 months around implants. Conclusions Probiotic intake was effective in reducing PI, BOP, and PD scores around natural teeth and dental implants affected by peri-mucositis, in particular around natural teeth at 3 months.

Assessment of Gingival Health Status among Patients with Fixed Orthodontic Appliance

Fixed orthodontic appliances corrupt plaque removal, proper oral hygiene, and gingival health so periodontal evaluation is important to be checked in every appointment. The aim of the present study was to assess gingival health among patients with a fixed orthodontic appliance. A clinical comparative study conducted on 25 patients with an aged ranged from 15 to 25 years. Clinical parameters included plaque index (PI), gingival index (GI), and bleeding on probing (BOP) were recorded at base line before starting orthodontic treatment and after 1 month of treatment. A double paired t-test was applied to the data collected for statistical analysis. The mean value of PI (1.11), GI (1.155), and BOP (0.600) scores was increased after placement of fixed orthodontic appliance, but with no statistically significant difference with base line for PI (P-value = 0.596), GI (P-value = 0.355), and BOP (P-value = 0.256), respectively. Regarding age group, mean PI (1.46), GI (1.22), and BOP (0.875) were increased with increasing age, patients who age’s ≥20 showed statistical significant difference for gingival and plaque means P-value = 0.006 and P-value = 0.03) for ≥20, respectively. The finding of this study had shown that patients with fixed orthodontic appliances had non-significant increase in the mean value of plaque, gingival, and BOP indices scores. All mean scores were increased with increasing age, but with non-significantly for BOP only.