Chemical Plaque Research Articles

The comparative effect of propolis in two different vehicles; mouthwash and chewing-gum on plaque accumulation and gingival inflammation.

Objective:In general, chemical plaque agents have been used in mouthwashes, gels, and dentifrices. In some situations, application of mouthwashes and dentifrices can be difficult. Therefore, different approaches for oral health-care have been needed. The aim of this study was to evaluate the effect of propolis chewing-gum compared to propolis-containing mouthwash on gingival inflammation and plaque accumulation on patients that refrained from daily oral hygiene procedures for 5 days.Materials and Methods:10 college students with systemically healthy and very good oral hygiene and gingival health were included in this randomized, single-blind, crossover 5-day plaque regrowth with a 3-day washout period clinical study. After plaque scores were reduced to zero, participants were asked to refrain from oral hygiene procedures and allocated to either propolis mouthwash or chewing-gum group. Chewing-gum was performed after meals 3 times a day for 20 min mouthwash group was instructed to rinse mouthwash 2 times a day for 1 min. On day 5, the clinical periodontal measurements containing plaque and gingival indexes were taken from the participants.Results:The both plaque and gingival indexes of propolis mouthwash group were significantly lower than that of the propolis chewing-gum group (P = 0.005).Conclusion:It was demonstrated that the propolis mouthwash was more effective than the propolis chewing gum on the plaque inhibition and the gingival inflammation.

Primary prevention of periodontitis: managing gingivitis.

Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with someevidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.

Efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis. A systematic review.

To systematically assess the efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis (PM). Randomized (RCTs) and Controlled Clinical Trials (CCTs) were identified through an electronic search of three databases complemented by manual search. Identification, screening, eligibility and inclusion of studies was performed independently by two reviewers. Studies without professional intervention or with only mechanical debridement professionally administered were included. Quality assessment was performed by means of the Cochrane Collaboration's tool for assessing risk of bias. Eleven RCTs with a follow-up from 3 to 24months were included. Definition of PM was lacking or heterogeneously reported. Complete resolution of PM was not achieved in any study. One study reported 38% of patients with complete resolution of PM. Surrogate end-point outcomes of PM therapy were often reported. The choice of control interventions showed great variability. The efficacy of powered toothbrushes, a triclosan-containing toothpaste and adjunctive antiseptics remains to be established. High quality of methods and reporting was found in four studies. Professionally- and patient-administered mechanical plaque control alone should be considered the standard of care in the management of PM. Therapy of PM is a prerequisite for the prevention of peri-implantitis.

Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: a systematic review and meta-analysis.

The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials (RCTs). A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences (WMD) and 95% confidence intervals. After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD -0.217), modified gingival index (n=23, -0.415), gingivitis severity index (n=26, -14.939%) or bleeding index (n=23, -7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD -0.475), Silness & Löe (n=26, -0.109), and plaque severity (n=12, -23.4%) indices, with significant heterogeneity. Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices.

Efficiency of nonsurgical periodontal therapy in moderate chronic periodontitis.

Chronic periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by microorganisms in the dental biofilm, resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation and gingival recession. Treatment of chronic periodontitis aims at arresting the inflammation and stopping the loss of attachment by removal and control of the supra- and subgingival biofilm and establishing a local environment and microflora compatible with periodontal health. The AIM of this study was to evaluate the effectiveness of non-surgical therapy (scaling and root planning) in the treatment of moderate chronic periodontitis. The study included 30 patients aged between 33 and 75 years, of which 46.7% women and 53.3% men, diagnosed with moderate and, at some sites, severe periodontitis. They were treated with non-surgical periodontal therapy methods (scaling and root planning and curettage if indicated). Additionally, chemical plaque control with rinse water containing chlorhexidine was applied. The diagnostic and reassessment procedures included measuring the periodontal indices of 601 periodontal units before and after the therapy. The indices measured were the papillary bleeding index (PBI), the hygiene index (HI), the probing pocket depth (PPD) and the clinical attachment level (CAL). Significant reduction of plaque and gingival inflammation was found in all treated patients; we also found a statistically significant reduction of periodontal pockets with clinically measured depth < 5 mm (PD < 5 mm). Pockets with PD > 5 mm did not show statistically significant lower incidence rates probably due to the initially small percentage of deep pockets in the patients studied. There was a statistically significant reduction of all sites with attachment loss, the highest significance found at sites where the attachment loss was greater than 5 mm. The results of the study suggest that nonsurgical periodontal therapy is effective in managing the moderate chronic periodontitis. Given a good patient compliance, the antimicrobial periodontal therapy can be quite efficient in arresting the inflammatory process and reducing the depth of periodontal pockets; it can also achieve a stable attachment loss level and obviate the need to use a surgical periodontal treatment modality.

A prospective case-control study to assess and compare the role of disclosing agent in improving the patient compliance in plaque control

Introduction: Dental caries and periodontal diseases are multifactorial oral health problems that have dental bacterial plaque as their main etiological agent. Dental plaque removal plays an important role in oral health maintenance, which could be achieved by either mechanical or chemical plaque control. Disclosing agents in dentistry are being used to identify bacterial plaque for instruction, evaluation and research purposes. Hence, the current study is aimed at evaluating the effect of at home use of disclosing agent in improving the quality of daily oral hygiene. Materials and Methods: The present randomized, prospective case-control study was conducted among 100 subjects who were selected from the outpatient department of periodontology and divided into two groups. Group A (n = 50) is the case group who were instructed to use a disclosing agent and Group B (n = 50) is the control group who were not instructed to use a disclosing agent. Plaque status of the subjects was assessed using Turesky-Gilmore-Glickman Modification of the Quigley Hein Plaque Index at baseline. Both the groups were trained to perform the similar brushing technique along with same oral hygiene instructions. After 21 days, both groups were recalled, and their plaque status was re-assessed by the same method. The pre and postplaque scores of both the groups were evaluated by unpaired t-test and value of P < 0.05 was considered significant. Results: Preevaluation plaque score of Group A was 2.02 ± 0.24 and postevaluation score was 1.08 ± 0.26. Similarly in Group B, the preevaluation plaque score was 1.80 ± 0.92 and postevaluation score was 1.62 ± 0.48. The difference in the plaque scores was statistically significant with a P = 0.00001.Conclusion: The result shows that usage of plaque disclosing agent improves the quality of daily oral hygiene measures performed at home.

Evaluation of holy basil mouthwash as an adjunctive plaque control agent in a four day plaque regrowth model.

Objectives: Various antibacterial and antiplaque agents are used in chemical plaque control but none are without their shortcomings. Chlorhexidine considered a gold standard, also has an array of side effects. To overcome these, numerous herbal extracts have been tried and tested and one among them is holy basil. The present study evaluated the antibacterial efficacy of holy basil in vitro against some periodontopathogens and its antiplaque effect in vivo. Study Design: Thirty periodontally healthy volunteers were randomly divided into three groups and refrained from all mechanical oral hygiene measures for 4 days and used one of the randomly assigned mouthwash (1- chlorhexidine; 2- holy basil; and 3- sterile water [placebo]) twice daily. The Plaque Index (PI) was assessed at days 0 and 5. Aqueous extract of holy basil was tested against Prevotella intermedia (P. intermedia) and Fusobacterium nucleatum (F.nucleatum). Results: Holy basil extract showed inhibition of both the tested periodontopathogens (P.intermedia and F.nucleatum) at various concentrations. In all groups, the PI increased from baseline to day 5. There was a statistically significant difference (p < .05) between the chlorhexidine and placebo rinse and the holy basil and placebo rinse, but no statistically significant difference was found between the chlorhexidine and holy basil rinse with respect to PI. Conclusions: These results indicate that the holy basil mouthwash has an antiplaque effect and is efficacious against P. intermedia and F. nucleatum strains in vitro. Hence holy basil mouthwash may have potential as an antiplaque mouthwash with prophylactic benefits. Key words:Antibacterial agent, basil, Fusobacterium nucleatum, mouthwashes, Prevotella intermedia.

Effect of Essential Oil and Chlorhexidine Mouthwashes on Gingival Fibroblast Survival and Migration

Chemical plaque control is the most commonly recommended means of oral hygiene after periodontal surgery. Commercially available mouthwashes contain a variety of active ingredients that have bactericidal properties but may potentially be toxic to the host cells. The goal of this in vitro study is to investigate the effect of commercially available mouthwashes on the survival and migratory capacity of human fibroblasts. Human gingival and periodontal ligament (PDL) fibroblasts were treated with commercially available mouthwashes that contained either chlorhexidine (CHX) or essential oils (EO) as the active ingredient. Each mouthwash was tested over a range of concentrations for its ability to affect fibroblast survival and migration, as well as long-term effects on cell viability. Undiluted mouthwashes induced near-complete cell death 24 hours after only a 60-second treatment. Dilutions of 15% to 20% for both CHX and EO mouthwashes resulted in 50% cell death. When diluted to 10% to 15%, EO did not reduce cell migration, whereas similar dilutions of CHX resulted in reduced cell migration. Concentrations of 10% of both EO and CHX mouthwashes retained most of their antibacterial capacity. Treatment with EO did not result in gingival fibroblast death, whereas 5% CHX resulted in near-complete gingival fibroblast death 7 days after exposure. The results of this in vitro study indicate that diluted EO displayed no detectable detrimental effects on human gingival and PDL fibroblasts, whereas diluted CHX reduced both cell migration and long-term survival. Both solutions retained their antimicrobial activity in lower concentrations.

Antimicrobial effect of &amp;lt;i&amp;gt;Anacardium occidentale&amp;lt;/i&amp;gt; leaf extract against pathogens causing periodontal disease

The oral cavity is perpetually colonized by different species of microorganisms and at times it is difficult to characterize the periodontal pathogen causing breakdown of tissue and bone. But over the years, based on scientific knowledge, it has been observed that various gram negative anaerobic bacteria have been involved with the initiation of periodontal disease. Based on literature reviews, a study was undertaken to investigate the antimicrobial effect of Anacardium occidentale (cashew) leaf extract on Porphyromonas gingivalis and Prevotella intermedia. Methanol and aqueous extracts of cashew leaves were prepared. Its antimicrobial activity against P. gingivalis and P. intermedia was tested using the agar diffusion method at various dilutions of 75 μ, 50 μl, 25 μl, 10 μl and 5 μl respectively. 0.2% Clorhexidine gluconate (CHX) was used as control. Cultures of P. gingivalis and P. intermedia strains were maintained on Kanamycin blood agar. The agar plates were then incubated at 37?C for 72 hours after which the zone of inhibition was measured and the mean was recorded for each test solution. The results of this study demonstrated that, for both P. gingivalis and P. intermedia, the highest concentration (75 μl) of both the extracts showed maximum antimicrobial action. For P. ginigvalis, the aqueous extract demonstrated significant inhibitory activity compared to the methanolic extract (p = 0.005), which was comparable to that of CHX. For P. intermedia, similar results were observed with aqueous extract being more effective compared to methanolic (p = 0.007), however, CHX was most effective compared to both the extracts (p = 0.007). This study revealed that Anacardium occidentale leaf extracts have efficient antimicrobial activity against P. gingivalis & P. intermedia. Hence, this preliminary study suggests that the antimicrobial action of A. occidentale leaf could be utilized for the preparation of chemical plaque control formulations.

Efficacy of a commercially available multi-herbal formulation in periodontal therapy

Objective:This prospective clinical trial was designed to evaluate the clinical effects of a commercially available powder (Periocare® Gum massage powder), containing various herbal medicaments, in the reduction of plaque and gingival inflammation in subjects diagnosed with gingivitis.Materials and Methods:Seventy-five subjects diagnosed with chronic generalized gingivitis were selected and randomly divided into the following three groups: Group I - Scaling + Periocare® Gum Massage powder, Group II - Periocare® Gum Massage powder alone, and Group III - Scaling only. Clinical evaluation was done at baseline, 2 weeks, 4 weeks, and 6 weeks using gingival index, plaque index, and microbiological culturing of plaque samples.Results:Periocare® Gum Massage (multi-herbal formulation) powder as an adjunct to mechanical therapy (scaling) showed significant clinical and microbiological improvement in the gingival index and plaque index scores as compared to other groups. Periocare® Gum Massage powder as a monotherapy did not prove to be effective for plaque control.Conclusion:Periocare® Gum Massage may be a useful herbal formulation for chemical plaque control and improvement in plaque scores and gingival status.

Antimicrobial activity of four commercially available mouthwashes against streptococcus Mutans: An in vitro study

Background: Antimicrobial agents have been used as a chemical plaque control agent to prevent oral disease and to improve oral health. The aim of the study was to evaluate the antimicrobial activity against Streptococcus mutans in vitro of four commercially available mouthwashes. Materials and Methods: Four commercially available mouthwashes containing chlorhexidine, triclosan, tea tree leaves, and Aloe vera were selected. Two different techniques were used: (1) Agar disc diffusion method to determine the zone of inhibition in mm and (2) contact test method to determine the bacterial count of S . mutans in vitro . The samples were incubated anaerobically for 24 h. Comparisons among various mouthwashes were tested using analysis of variance. All analyses were done at 5% level of significance. Results: Triclosan mouthwash was most effective in terms on zone of inhibition having mean diameter of 21 ΁ 1.41 mm. Significant difference ( P P Conclusion: Chlorhexidine mouthwash showed excellent antimicrobial activity against S. mutans . Triclosan and tea tree leaves mouthwashes had intermediate level of efficacy.

Clinical and microbiologic effects of commercially available gel and powder containing Acacia arabica on gingivitis

There is a need for an anti-plaque agent that can be used on a daily basis without the side effects of antibacterial chemicals such as chlorhexidine. The present study was designed to evaluate the clinical and microbiologic effects of commercially available gel and powder containing Acacia arabica in subjects with gingivitis. One hundred and twenty subjects with chronic generalized gingivitis were selected and randomly divided into four groups: Group 1 - placebo group; Group 2 -Acacia arabica gel group; Group 3 -Acacia arabica powder group; and Group 4 - 1% chlorhexidine gel group. Microbial counts of plaque samples, the gingival index of Loe and Silness and the plaque index were evaluated at baseline, 6 weeks, 12 weeks and 24 weeks. Microbial counts of plaque samples were evaluated at all visits. Acacia arabica gel and powder showed significant clinical improvement in gingival and plaque index scores as compared to a placebo. This improvement was comparable to 1% chlorhexidine gel. The difference between gel and powder with regard to clinical and microbiological parameters was not found to be significant at any time interval. Both Acacia arabica gel and powder may be useful herbal formulations for chemical plaque control in subjects with gingivitis.

Clinical and Microbiologic Effects of Commercially Available Dentifrice Containing Aloe Vera: A Randomized Controlled Clinical Trial

Certain plants used in folk medicine serve as a source of therapeutic agents that have antimicrobial and other multipotential effects. This prospective, randomized, placebo, and positively controlled clinical trial was designed to evaluate the clinical and microbiologic effects of a commercially available dentifrice containing aloe vera on the reduction of plaque and gingival inflammation in patients with gingivitis. Ninety patients diagnosed with chronic generalized gingivitis were selected and randomly divided into three groups: group 1, placebo toothpaste; group 2, toothpaste containing aloe vera; and group 3, toothpaste with polymer and fluoride containing triclosan. Clinical evaluation was undertaken using a gingival index, plaque was assessed using a modification of the Quigley-Hein index, and microbiologic counts were assessed at baseline, 6 weeks, 12 weeks, and 24 weeks. A subjective evaluation was also undertaken by questionnaire. Toothpaste containing aloe vera showed significant improvement in gingival and plaque index scores as well as microbiologic counts compared with placebo dentifrice. These improvements were comparable to those achieved with toothpaste containing triclosan. Toothpaste containing aloe vera may be a useful herbal formulation for chemical plaque control agents and improvement in plaque and gingival status.

Maintaining periodontal health in patients undergoing orthodontic treatment

Presence of fixed orthodontic appliances in the mouth leads to accumulation of food debris and an elevation in the amount of plaque. It also hinders plaque removal by tooth brushing alone. Chemical agents may be used during the active phase of orthodontic treatment to reduce the bacterial plaque accumulation and decrease the occurrence of periodontal disease in these patients. The present study was therefore done to compare the efficacy of chemical plaque control by chlorhexidiene in patients undergoing orthodontic treatment. Forty five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10 days after prophylaxis), and at the end of one month in all the three groups. The data obtained was subjected to stastical analysis. Anova test showed significant difference among all the three groups for bleeding index, modified gingival index and plaque index. Paired t test showed significant differences in bleeding index for pre and post treatment recordings for chlorhexidine group. Modified gingival index showed significant difference in the chlorhexidine group. For plaque index significant difference was found for chlorhexidine, and control groups. Chlorhexidine mouthrinse 0.12% was found to be the most effective in reducing the bleeding scores, modified gingival index scores and the plaque index scores. It can therefore be said that chlorhexidine mouthrinse 0.12% provides greater benefits to the patients undergoing fixed orthodontic treatment.

Clinical and microbiological effects of commercially available dentifrice containing amine fluoride: A randomized controlled clinical trial.

Background:The inability of the normal adult population to perform adequate tooth brushing has led to the search for chemotherapeutic agents in order to improve plaque control. This 6 month, single center, randomized controlled clinical trial was conducted to assess the clinical and microbiological effects of a dentifrice containing only amine fluoride (AF) as the active ingredient on gingivitis.Materials and Methods:Ninety subjects diagnosed with chronic generalized gingivitis were selected and randomly divided in three groups: Group 1 – placebo toothpaste, Group 2 – AF containing toothpaste, and Group 3 – triclosan containing toothpaste with polymer and fluoride. Clinical evaluation was undertaken using the gingival index of Loe and Silness and the plaque index and microbiological counts were assessed at baseline, 6 weeks, 12 weeks, and 24 weeks. A subjective evaluation was also undertaken by a questionnaire.Results:AF containing toothpaste showed significant improvement in gingival and plaque index scores as well as microbiologic counts compared with placebo dentifrice. These improvements were comparable to triclosan containing toothpaste.Conclusions:AF containing toothpaste may be a useful formulation for chemical plaque control agent and improvement in plaque and gingival status and add to the list of various therapeutic agents used for maintenance of gingival health.

Biological plaque control: novel therapeutic approach to periodontal disease

Despite its important role in the control of periodontal disease, mechanical plaque control is not properly practiced by most individuals. Therefore, adjunctive chemical plaque control using chlorhexidine and antibiotics has also been suggested as an additional therapeutic strategy to augment mechanical plaque control. However, the additional effects of adjunctive antibiotic therapy are small, and topical chlorhexidine therapy is not without side effects. Given current limitations, new approaches for the control of biofilm are required. The new therapeutic approaches discussed in this review are divided into two categories: probiotics and vaccines. Probiotics is an interesting new field of periodontology research that aims to achieve biological plaque control by eliminating pathogenic bacteria. In addition, passive immunization using egg yolk antibody raised against periodontal pathogens may be an effective approach for the treatment of periodontitis. Further study to evaluate the possible effects of these biological plaque control methods against periodontal disease is warranted.

Systemic Antimicrobials Adjunctive to a Repeated Mechanical and Antiseptic Therapy for Aggressive Periodontitis: A 6‐Month Randomized Controlled Trial

The purpose of this study is to compare the additional benefit of systemic antimicrobials versus placebos to a repeated mechanical instrumentation combined with comprehensive local chemical plaque control for the periodontal treatment of generalized aggressive periodontitis (GAgP). This was a 6-month randomized, double-masked, placebo-controlled clinical trial. All GAgP patients received full-mouth disinfection followed by staged scaling and root planing without (placebo group; n = 17) or with (test group; n = 18) systemic antimicrobials (500 mg amoxicillin [AMX] + 250 mg metronidazole [MET]; three times a day for 10 days). Clinical parameters were measured at baseline and 3 and 6 months post-therapy. Significant differences between groups at baseline were sought by using the Mann-Whitney U test, whereas comparisons over time were examined by using a general linear model repeated measures procedure. Both groups demonstrated similar improvements in most parameters over time. The test group presented a greater mean probing depth (PD) reduction and clinical attachment level (CAL) gain at sites with initially moderate PD at 6 months (P <0.03). No differences were seen between groups regarding mean reductions and mean gains, respectively, for PD and CAL initially ≥7 mm. The test group presented a higher percentage of sites that improved ≥2 mm and ended up with PD ≤4 mm or a lower percentage of sites that worsened ≥2 mm and remained with PD >4 mm at 3 months (P <0.01). No differences were noticed between groups for these parameters at 6 months. AMX + MET brought additional clinical effects to the repeated mechanical and antiseptic treatment of GAgP in a very short time (3 months), which tended to fade away over time (6 months).

Antibacterial effects of Oradex, Gengigel and Salviathymol-n mouthwash on dental biofilm bacteria

Three mouthwashes Gengigel, Oradex and Salviathymol N, were tested using experimental microorganisms included Fusobacterium nucleatum, Streptococcus mitis, Streptococcus constellatus, Eikenella corrodens and dental plaque. Staphylococcus aureus and Escherichia coli were used as internal controls. Antibacterial activity was done by diffusion test. Minimum inhibitory concentration test and assessment of bacterial morphology was carried out using scanning electron microscopy (SEM). Results showed that Oradex had a higher antibacterial effect, followed by Salviathymol N; Gengigel mouthwash have weak antibacterial effects against tested microorganisms and dental plaque. SEM observations demonstrated that chlorhexidine exhibited obvious changes in that most of the bacteria loss their original shape and became irregular. The cell also shrunk, became reduced in size. Salviathymol N showed some significant changes while Gengigel failed to exhibited changes on the bacterial morphology of the tested microorganisms. In conclusion Oradex and Salviathymol N can be used as antibacterial mouthwash for chemical plaque control. Gengigel demonstrated weak antibacterial effects which could not be recommended as anti-dental plaque agent.

A clinical evaluation of the effect of 0.2% chlorhexidine gluconate as a mouthrinse on gingival inflammation in pregnant and non-pregnant women with and without undergoing scaling and root planing procedures

There is a high incidence of gingivitis in pregnant women due to combined effect of local and systemic factors. Chlorhexidine is an effective chemical plaque control agent by virtue of its property substantivity. Aim and Objective: In the present work we propose to study the effect of 0.2% chlorhexidine gluconate solution as a mouth rinse on gingival inflammation in pregnant women in comparison with non-pregnant women, before and after scaling and polishing procedures. Materials and Methods: A total number of seventy six healthy pregnant and non pregnant females in the age group of 20 to 30 years were included for the study. All the subjects used 0.2% chlorhexidine gluconate mouthrinse twice a day for 3 weeks. Weekly observations were made in both subgroups. Results: There was no significant reduction in plaque index, papilla,marginal gingiva and attached gingiva index and gingival bleeding index when 0.2% chlorhexidine gluconate mouth rinse was used alone without scaling and polishing procedures. When 0.2% chlorhexidine gluconate mouthrinse was used after scaling and polishing procedures at the end of 3 weeks, there was highly significant reduction in PMA index and gingival bleeding index in nonpregnant women group, whereas in pregnant women group there was only a significant reduction in the gingival bleeding index. Conclusion: 0.2% chlorhexidine gluconate used as mouth rinse twice a day for three weeks reduces gingival inflammation and gingival bleeding in both pregnant and non pregnant women, but significantly more in non pregnant women.

Bacterial Adhesion on Commercially Pure Titanium and Anatase‐Coated Titanium Healing Screws: An In Vivo Human Study

Little is known about the mechanisms of bacterial interaction with implant materials in the oral cavity. Other surface characteristics, in addition to surface roughness, seem to be extremely important in relation to plaque formation. Different adhesion affinities of bacteria were reported for different materials. Anatase is a nanoparticle that can be applied to titanium surfaces as a coating. The anatase coating gives special characteristics to the implant surface, including some genetic effects on osteoblasts. In this study, the antibacterial effect of anatase is investigated. The aim of this study is to characterize the percentages of surfaces covered by bacteria on commercially pure (cp) titanium and anatase-coated healing screws. Ten patients participated in this study. The protocol of the study was approved by the ethics committee of the University of Chieti-Pescara. A total of 20 healing screws (10 test and 10 control screws) were used in the study. The control screws were made of cp titanium, whereas the test screws were coated with anatase. Cleaning procedures and agents for chemical plaque control were not applied to the healing screws for the complete duration of the test period. After 7 days, all healing screws were removed, substituted, and processed under scanning electron microscopy for evaluation of the portions of the surfaces covered by bacteria. The supracrestal screw surfaces covered by bacteria on test specimens were not significantly lower than those of control screws (P = 0.174). The subcrestal screw surfaces and threads covered by bacteria on test specimens were significantly lower than those of control screws, and P values were 0.001 and 0.000, respectively. Results show that anatase could be a suitable material for coating implant abutments, with a low colonization potential.