Chronic Gingivitis Research Articles

A randomized, double-blind, split-mouth controlled clinical trial of systemically administered Lycopene on periodontal health

Background/PurposeThis research aimed to compare the effects of systemically prescribed Lycopene as a monotherapy and as an alternative to scaling and root planing in patients with chronic gingivitis. Materials and methodsThe participants were randomly assigned to one of two treatment groups: the experimental group (n = 50), which received 10 mg of Lycopene a day for two weeks, or the control group (n = 50) received a placebo for two weeks. For each category, quadrant distribution was randomized, with two quadrants receiving oral prophylaxis (OP) and two quadrants receiving no care (non-OP). At baseline, 1st, and 2nd weeks, the sulcus bleeding index, plaque index, gingival index, and salivary uric acid level were measured. ResultsAll clinical criteria, including SBI, PI, GI, and salivary uric acid levels, showed a statistically significant decline in all patient types. Both clinical parameters were significantly reduced (p < 0.001) in the OP-lycopene group relative to the non-OP-placebo group and non-OP lycopene group (p < 0.05). The PI value in the OP-lycopene group was statistically significantly lower (p < 0.001) than in the non-OP-placebo group; there was no statistically significant difference in the other groups. Salivary uric acid levels in the OP- and non-OP- lycopene groups were significantly lower (p < 0.001) than in the non-OP-placebo population. ConclusionBased on the findings of this study, Lycopene seems to have a bright future as a treatment option for plaque-induced generalized chronic marginal gingivitis. More research with a broad sample size and multicentre trials is required. Clinical relevanceThe article reveals the positive relationship between Lycopene and gingivitis. The analysis shows that a combination of systemically administered Lycopene with oral prophylaxis can be a valuable tool in treating chronic gingivitis and controlling respiratory oxidative stress.

Modification of gingival proteoglycans by reactive oxygen species: potential mechanism of proteoglycan degradation during periodontal diseases

Reactive oxygen species (ROS) overproduction and oxidative stress are increasingly being implicated in the extracellular matrix (ECM) degradation associated with chronic inflammatory conditions, such as periodontal diseases. The present study investigated the effects of ROS exposure on the proteoglycans of gingival tissues, utilizing an in vitro model system comprised of supra-physiological oxidant concentrations, to ascertain whether gingival proteoglycan modification and degradation by ROS contributed to the underlying mechanisms of ECM destruction during active gingivitis. Proteoglycans were purified from ovine gingival tissues and exposed to increasing H2O2 concentrations or a hydroxyl radical (·OH) flux for 1 h or 24 h, and ROS effects on proteoglycan core proteins and sulfated glycosaminoglycan (GAG) chains were assessed. ROS were capable of degrading gingival proteoglycans, with ·OH species inducing greater degradative effects than H2O2 alone. Degradative effects were particularly manifested as amino acid modification, core protein cleavage, and GAG chain depolymerization. Proteoglycan core proteins were more susceptible to degradation than GAG chains with H2O2 alone, although core proteins and GAG chains were both extensively degraded by ·OH species. Proteoglycan exposure to ·OH species for 24 h induced significant core protein amino acid modification, with decreases in glutamate, proline, isoleucine, and leucine; and concomitant increases in serine, glycine, and alanine residues. As clinical reports have previously highlighted proteoglycan core protein degradation during chronic gingivitis, whereas their sulfated GAG chains remain relatively intact, these findings potentially provide further evidence to implicate ROS in the pathogenesis of active gingivitis, complementing the enzymic mechanisms of periodontal tissue destruction already established.

Necrotizing Gingivitis: Microbial Diversity and Quantification of Protein Secretion in Necrotizing Gingivitis.

Necrotizing gingivitis (NG) is a necrotizing periodontal disease that differs from chronic gingivitis (CG). To date, both the microbiological causes and the involved host cytokine response of NG still remain unclear. Here, we investigated corresponding interdental plaque and serum samples from two groups of Chinese patients with CG (n = 21) or NG (n = 21). The microbiota were studied by 16S rRNA Illumina MiSeq sequencing of the microbial metagenome and by assessing quantitatively the abundance of the phylum Bacteroidetes, the genus Prevotella and the species T. forsythia, P. endodontalis, and P. gingivalis using fluorescence in situ hybridization (FISH). With respect to the associated host response, the levels of 30 inflammatory mediators were quantified by multiplex immunoassay analysis. Differential microbial abundance analysis of the two disease groups revealed at the phylum level that Proteobacteria accounted for 67% of the differentially abundant organisms, followed by organisms of Firmicutes (21%) and Actinobacteria (9%). At the species level, significant differences in abundance were seen for 75 species of which 58 species were significantly more abundant in CG patients. Notably, the FISH analysis revealed that Bacteroidetes was the most prevalent phylum in NG. The multiplex cytokine assay showed significant quantitative differences between the disease groups for eight analytes (GM–CSF, G–CSF, IFN–α, IL–4, IL–13, TNF–α, MIG, and HGF). The G–CSF was found to be the most significantly increased inflammatory protein marker in NG. The next-generation sequencing (NGS) data supported the understanding of NG as a multi-microbial infection with distinct differences to CG in regard to the microbial composition.

Рівень санітарно-гігієнічних знань щодо гігієни ротової порожнини в осіб підліткового та юнацького віку, які палять

Numerous studies in recent years have shown that the prevalence of dental disease, periodontal tissue and dental anomalies remains high among children, despite the development and implementation of new prevention and treatment regimens. Thus, the prevalence of dental caries in children in the period of temporary occlusion reaches 80–90%, in the period of permanent occlusion — 70–80%. The prevalence of chronic catarrhal gingivitis in children 12–15 years of age is 70–80%, reaching 95–98% in some regions, and localized and generalized periodontitis – 4.1–16.4%. It is known that the pathogenesis of dental diseases is closely related to the presence of a bad habit — smoking, mostly there is a strict correlation between the intensity and experience of smoking and the emergence and development of pathological changes in various organs and systems, including the oral cavity. Maintaining proper oral hygiene is an important factor influencing the occurrence of periodontal disease. It is known that the formation of oral care skills is formed in childhood, so the study of oral hygiene and the level of hygienic knowledge in adolescents with healthy periodontitis and catarrhal gingivitis in order to further develop a scheme of preventive measures remains one of the most important areas of pediatric dentistry. Purpose — to study the level of hygienic oral care and knowledge in teenagers and young adults who smoke. Materials and methods. The level of knowledge on the observance of individual oral hygiene in 87 people aged 15 to 24 years was studied. The main group included 40 adolescents and young people who smoked, in the comparison group we included 47 people of the same age without a bad habit of smoking. Results. It was found that the majority of all respondents have information on how to properly care for the hygiene of RP, respectively 67.54±3.75% — in the main group, 72.78±4.81% — in the comparison group. However, not all respondents have the full amount of information, as indicated by 23.43±7.51% of adolescents and young people in the main group and 17.86±6.42%. In addition, the individual assessment of their own oral care skills according to the respondents revealed that not all respondents regularly oral care. In the main group only 59.56±4.61% indicated regular oral care, which was 1.4 times less than in the comparison group 81.42±5.73% (p&lt;0.001). Conclusions. It is necessary to conduct additional hygienic training, mandatory reinformation on the risks of dental diseases, in order to form a system of sustainable understanding and awareness of the need for adolescents and young people to observe individual oral hygiene. Particular attention should be paid to aspects of the emergence and rooting of bad habits, namely the bad habit of smoking, both traditional and alternative types of smoking, which adversely affects somatic and dental health, because it is known that without smoking it is impossible to achieve sustainable and long-term results of treatment and prevention measures. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: teenager, young adult, oral hygiene, smoking.

The effect of removing dental plaque with low-frequency ultrasound and ozonized contact medium on the microbiota of the gingival sulcus with diagnosis chronic catarrhal gingivitis of young age patients

As a result of the study, it was found that the removal of dental plaque using low-frequency ultrasound and ozonized contact medium in chronic generalized catarrhal gingivitis of young people can significantly improve the state of microbiocenosis of the gingival sulcus. The preservation of the main resident species is noted, occasional transient species disappear and the frequency of isolation of aggressive representatives of beta-hemolytic streptococci and periodontopathogenic species decreases. When using ozonated water for the removal of dental deposits, the efficiency of eradication of the microbiota of the gingival sulcus, especially of representatives of aggressive species, is higher than when removing dental deposits without the use of ozonated water.

THE USE OF LOW-INTENSITY RADIATION IN TREATMENT OF PERIODONTAL TISSUE DISEASES (LITERATURE REVIEW)

Topic relevance. Periodontal tissue diseases currently take a significant place among infectious diseases, both in dentistry and in medicine in general. Traditional methods of treatment of inflammatorydystrophic periodontal diseases do not bring the desired results, so the question arises of finding alternative, non-drug treatments. Among such means, special attention is paid to the use of various types of low-intensity radiation, as well as the cumulative effect of light and photosensitizers.&#x0D; The aim of the study is to analyze literary sources regarding the use of various types of low-intensity radiation in the treatment of periodontal tissue diseases.&#x0D; Materials and methods. The research and analysis of scientific literature on the basis of Google Scholar, Research Gate, Wiley Online Library and Academia.edu on the use of various types of radiation in the treatment of periodontal tissue diseases was carried out.&#x0D; Results and discussion. Laser radiation shows anti-inflammatory, antimicrobial, immunomodulatory and&#x0D; desensitizing effect, stimulates tissue reparation, and also reduces histohemmatic barriers in the inflammatory process, reduces gum hyperemia, which indicates the high efficiency of this method in optimizing the processes of restoring periodontal structures. With wavelengths of 630 and 870 nm, laser radiation at certain parameters increases the sensitivity of S. aureus and P.aeruginosa to commonly used antibiotics.&#x0D; With long-term exposure, PILER (polychromatic polarized incoherent low-energy radiation) has a similar effect on soft tissues, which improves the results of treatment of chronic catarrhal gingivitis in complex therapy, activates regenerative processes, reduces the spread and pain, normalizes immune processes. Polychromatic and monochromatic PILER shows a pronounced antimicrobial effect against opportunistic pathogens, although complete data on its use in periodontology is not yet available.&#x0D; LED radiation, in turn, also increases the sensitivity of conditionally pathogenic microorganisms to some antibiotics, causes improvement of oral hygiene indicators, bleeding of gums and stabilization of tooth mobility, inhibits the activation of pro-inflammatory cytokins, has a biostimulating effect on gum fibroblast and antiinflammatory effect.&#x0D; Experimental studies show that the use of low-intensity radiation and photosensitizers for photodynamic treatment (PDT) show significant improvement of treatment outcomes in periodontal patients. Thus, PDT in combination with mechanical cleaning of periodontal pockets leads to a significant decrease in their depth compared to traditional treatment methods.&#x0D; Conclusion. Application of various methods of irradiation of periodontal tissues using a certain dose of low-intensity radiation, wavelength and exposure, both individually and in combination with photosensitizers, can be employed in the treatment of inflammatory and inflammatory-dystrophic periodontal diseases as an effective antimicrobial method.

Застосування лікувально-профілактичного комплексу при карієсі та гінгівіті у дітей шкільного віку

Актуальність. Єдність найбільш значущих патогенетичних механізмів розвитку карієсу та захворювань тканин пародонту обґрунтовує сучасну концепцію профілактики цих захворювань, що включає розробку лікувально-профілактичних програм з урахуванням клінічних особливостей поєднаного перебігу карієсу та захворювань пародонту в дітей та основних патогенетичних механізмів розвитку цих захворювань. Мета дослідження: оцінити вплив розробленого лікувально-профілактичного комплексу в дітей шкільного віку при поєднаному перебігу карієсу та хронічного катарального гінгівіту з урахуванням основних патогенетичних механізмів розвитку цих захворювань. Матеріали та методи. Клінічні дослідження проводили за участю 138 дітей віком від 7 до 10 років, у яких визначали індекс кп + КПУ, приріст інтенсивності карієсу зубів, редукцію та карієспрофілактичний ефект, ТЕР-тест, індекс Greenn — Wermillion, спрощений індекс зубного нальоту О’Leary, індекс ефективності гігієни порожнини рота (РНР), індекс РМА, Basic Periodontal Examination-Simplified (BPES) перед проведенням лікувально-профілактичного комплексу (ЛПК) та через 18 місяців після його триразового застосування. Результати. Результати клінічного дослідження показали, що при позитивній динаміці клінічних показників у дітей всіх досліджуваних груп, у підгрупах, де ми застосовували розроблений і запропонований ЛПК, ми визначили добрий стан гігієни порожнини рота (0,37 ± 0,03; 0,46 ± 0,04) та добру ефективність проведення гігієнічних заходів (0,58 ± 0,05; 0,60 ± 0,03); низький рівень приросту інтенсивності карієсу (0,11–0,18) із редукцією 67,27–80,70 % при карієспрофілактичній ефективності 66,53–76,79 % на відміну від контрольних груп дітей, в яких рівень приросту інтенсивності карієсу становив 0,35–0,57, гігієнічний стан порожнини рота залишився на задовільному рівні. Серед дітей із хронічним катаральним гінгівітом повне усунення основних клінічних ознак запалення з подальшою довготривалою ремісією при застосуванні ЛПК ми спостерігали в більшому відсотку випадків на відміну від дітей, при лікуванні яких використовували стандартні підходи. Висновки. Отримані результати клінічних досліджень, а саме запобігання подальшому розвитку карієсу та усунення основних клінічних проявів запалення ясен із тривалою ремісією, свідчать про позитивний вплив та ефективність розробленого ЛПК.

Clinical relevance of interdental papilla biopsy in chronic erosive gingivitis (desquamative gingivitis): retrospective bicentric study of 148 specimens

BackgroundChronic erosive gingivitis, also called desquamative gingivitis, defines a clinical picture that can be generated by several inflammatory and immune diseases. Pathology is therefore essential for the differential diagnosis. However, when the gingival lesion is initial, exclusive or predominant, selecting the biopsy site and protocol may be problematic due to tissue fragility. Especially since there are few studies on the subject, the aim of our study was to assess the protocol, diagnostic relevance and tolerance of an original protocol using interdental papilla biopsy.MethodsWe conducted a retrospective bicentric study, from October 2011 to July 2019, including all patients with a chronic erosive gingivitis who had received, for diagnostic purposes, a interdental papilla biopsy.ResultsThe contribution levels for the two hospital departments were 94.7% and 97.1%, respectively. No postoperative complication was recorded in the short or long term.ConclusionThe interdental papilla biopsy protocol is perfectly adapted to the anatomopathological examinations required to establish differential diagnosis of chronic erosive gingivitis. This surgical protocol is simple to perform, non iatrogenic with a very good tolerance and and accessible to all clinicians. It is highly efficient with an excellent contribution level.ClinicalTrials NCT04293718 (March 3, 2020). Health Data Hub N° F20201109083211 (November 9, 2020).

Impact of chronic gingivitis management on the cytokine and anti‐PPAD expressions in juvenile systemic lupus erythematosus: A six‐month follow‐up

To evaluate how chronic gingivitis treatment impacts the oral and circulating cytokine expressions after six-month follow-up in patients with juvenile systemic lupus erythematosus (jSLE) and also to evaluate the circulating expression of anti-Porphyromonas gingivalis peptidylarginine deiminase antibodies (anti-PPAD) before and after treatment. Juvenile systemic lupus erythematosus patients present a worse periodontal condition associated with higher gingival crevicular fluid (GCF) levels of interleukin (IL)-1β, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein (MCP)-1. Twenty-one adolescents with jSLE (mean age: 16.2±1.5years) were recruited. Participants were rheumatologically and periodontally examined. All individuals were clinically diagnosed with gingival inflammation. Chronic gingivitis treatment consisted of supragingival scaling, prophylaxis and oral hygiene instructions. The cytokine levels were determined by bead-based multiplex assays and the anti-PPAD levels by ELISA. Gingival crevicular fluid (GCF) and serum samples were collected at baseline and 6months after treatment. We observed a reduction in attachment loss, SLE Disease Activity Index (SLEDAI), IL-1β, IL-10 and MCP-1 GCF levels, and the IL-4 and IL-5serum levels 6months after periodontal treatment. On the contrary, a significant increase in GCF expression of IL-4, IL-12, IL-17, IFN-γ and serum levels of anti-PPAD antibody was observed. Juvenile systemic lupus erythematosus patients seem to positively benefit from periodontal treatment by a significantly reduced CAL, a GCF reduction of pro-inflammatory cytokines and an increasing of anti-inflammatory ones. However, an increase in the GCF expression of IL-17 and the serum expression of anti-PPAD antibody 6months after periodontal treatment might negatively affect the treatment outcome of such patients in the long term.

Investigating the role of gingiva in the tactile function of teeth at the cortical level

The role of the gingiva in the tactile perception of teeth is unclear, and the physiological basis of tooth tactile function needs to be examined at the cortical response level. In the presented study, gingiva from the upper left canine was removed under local anesthesia from five cats. Intrinsic signal optical imaging was used to measure population response characteristics of the cat oral-related cortex when punctate mechanical stimuli were separately applied to the left gingiva-stripped canine and right intact canine. Then, their response characteristics were compared. There were no significant differences in the cortical response strength between the anesthetized and unanesthetized canines. Signal strength of the gingiva-stripped tooth was significantly weaker than that of the intact tooth at low stimulus strength. However, no significant differences between the gingiva-stripped tooth and intact tooth were found after saturation. Based on the evoked cortical responses, the gingiva is involved in low-intensity tactile perception of teeth, which could explain the reason why chronic gingivitis results in the paresthesia of natural teeth.

Efficacy of Herbal Mouthwash with Extracts of Coriandrum Sativum, Mint and Clove in the Treatment of Chronic Gingivitis- A Randomized Controlled Clinical Trial

Introduction: Herbal antiseptic or antibiotic agents are introduced very widely that are effective against plaque microorganisms for the healing of gingival and periodontal tissue. However, none of literature has shown antibacterial effect of coriandrum sativum, clove and mint on the levels of dental plaque when used as a mouthwash.&#x0D; Aim: To assess the efficacy of a newly formulated mouthwash containing Coriandrum sativum, mint and clove to reduce plaque and inflammation to maintain the oral hygiene.&#x0D; Methodology: Twenty systemically healthy patients were randomly allocated to either the test group [G1(coriandrm sativum, mint,clove = 10 patients)] or the control group [G2 (Placebo gel = 10 patients]. Full mouth Gingival Index (GI); Full mouth Plaque Index (PI) was evaluated at baseline and on 14 and 21st day. &#x0D; Result: The mean reduction in PI from 2.28 to 0.85 and 2.13 to 1.21 was noted in the experimental and control groups, respectively. The experimental group (2.21–0.76) comparatively showed better reduction in mean PBI than the control group (2.17–1.29). The results obtained were statistically significant at baseline and 14th and 21st day in all the groups. Remarkable improvement was noted from baseline to 14th and 21st day in all the groups.&#x0D; Conclusion: The encouraging results of our study suggest that the newly formulated mouthwash containing coriandrum Sativum, mint and clove demonstrates anti-inflammatory properties, which may be useful as an adjunctive to mechanical therapy in the prevention and treatment of gingivitis.

Results of assessment of oral acid-base balance in patients with mandibular fractures combined with periodontal pathology

Aim. To estimate the condition of acid-main balance of oral cavity in patients with fracture of the mandible in combination with parodontal pathology.Material and methods. 40 patients with fractures of the mandible in combination with parodontal pathology were observed in the study. They were divided into three groups. Patients of the first group had a fracture of the mandible in combination with chronic periodontitis. Patients of the second group had fractures of the mandible and chronic gingivitis. Patients of the third group had no bone-traumatic damages and parodontal pathology.Results and discussion. The activity of the parodontal microflora of the oral cavity in patients with the bone trauma of the mandible in combination with periodontitis is higher and characterizes the quick response component of the acid-main balance regulation in the oral cavity.Conclusion. Lingual raid is the main reservoir of oral microflora and its role under existing bone-traumatic damage on the background of parodontal pathology in maintaining microbiocenosis not only increases but also becomes the factor of destabilization regenerators processes at fracture of the mandible.

Comparison of the Clinical Efficacy of Hi-Ora, Chlorhexidine and Normal Saline Mouthwash in Management of Chronic Gingivitis

Comparison of the Clinical Efficacy of Hi-Ora, Chlorhexidine and Normal Saline Mouthwash in Management of Chronic Gingivitis

Erratum to: Effects of a novel dye containing toothpaste versus regular fluoridated toothpaste for supragingival biofilm reduction in patients with chronic gingivitis: A Randomized Controlled Trial. Rath, A., Chong, J.N., HR, P., Teo, B., Zhen, N., &amp; Yin, O. (2021). Dentistry 3000 2021; 9(1). DOI: https://doi.org/10.5195/d3000.2021.117

The name of one of the authors was misspelled by the author during the submission process as well as a name of a collaborator in the acknowledgement section. The author’s name Chong Junning was corrected to Chong Jun Ning. In the acknowledgment section Mr. Che Vern was corrected to Mr. Yeoh Chin Vern. The original manuscript has been updated to reflect the aforementioned changes.

Role of antimicrobial peptides system in inflammatory periodontal diseases non-specific oral cavity protection.

The system of antimicrobial peptides (AMP) is one of the most ancient mechanisms of the macroorganism resistance to infectious pathogens invasion. The aim of the study was to determine the role of the antimicrobial peptides system and periodontal pathogenic markers in the development and progression of inflammatory periodontal diseases. Gingival pocket washes (91 samples in total) for the research were received from patients with inflammatory periodontal diseases (chronic periodontitis and gingivitis) and intact periodontium. Using ELISA, the content of antimicrobial peptides was determined: human alpha-defensin (HNP 1-3), beta-defensin (HBD 1-3) and cathelicidin (LL-37). Periodontal pathogenic markers were isolated during RT-PCR. The study revealed differences in AMP concentrations by groups: level of HBD 2 in patients with chronic periodontitis was 1,36 times higher than those in the group of patients with chronic gingivitis (p=0,023) and 2,39 times higher than those in the control group (p<0,001), the content of HNP 1-3 in the group of patients with chronic periodontitis was reduced by 1,23 times compared with the indicators of the group of patients with gingivitis (p=0,045) and by 1,97 times compared with the indicators of the control group (p<0,001). The frequency of detection of periodontal pathogenic bacteria genes was 88,0% in patients with periodontitis, 76,92% in patients with gingivitis and 33,3% in the group with intact periodontium. HBD 2 content moderately correlated with the definition of P. gingivalis (r=0,612; p=0,022), T. forsythensis (r= 0,434; p=0,015), A. actinomycetemcomitans (r=0,483; p=0,006), a moderate negative correlation was detected between the content of HNP 1-3 and the release of periodontal pathogens in associations (P. gingivalis with T. forsythensis and T. denticola) (r=-0,388; p=0,031) in the group of patients with chronic periodontitis. Thus, the revealed relationships and correlations indicate shifts in the processes of reparative regeneration of the oral cavity and the regulation of local immunity in response to microbial invasion.

Optimization of periodontal disease diagnosis by the results of clinical laboratory tests

Relevance. The authors have established that the microbiological and local risk factors prevail in changing the clinical condition of the periodontium. Aim – сlinical and diagnosis argumentation of the gingival tissue condition according to the criteria of the New International Classification of Periodontal and Peri-implant Diseases and Conditions and Proceedings of the 2017 World Workshop jointly held together by the American Association of Periodontology (AAP) and the European Federation of Periodontology (EFP).Materials and methods. Clinical and laboratory assessment of 105 young patients was conducted. Three patient groups were formed according to the detected risk factor and according to the data of the New International Classification of Periodontal and Peri-implant Diseases and Conditions. The main group consisted of 70 (66.6%) patients with diagnosed chronic plaque-induced gingivitis (33.3%) and initial periodontitis (33.3%) (mild chronic periodontitis). The control group comprised 35 patients with clinically healthy gingiva on an intact periodontium (71.1%) and reduced periodontium (22.9%). Periodontal pathogens as a risk factor were assessed by PCR using DNA-express commercial sets (Liteh, LLC, scientific manufacturing company, Russia). Cytology of the gingival crevicular fluid impression smears stained by Romanovsky-Giemsa method was performed.Results. Changes in the hygiene and periodontal indices were revealed on full dental examination. PCR detected low or critical number of periodontal pathogens in the studied samples. Neutrophilic leukocytes, histiocytes and epithelial cells were present in the impression smears, polymorphonyclear neutrophils significantly increased and macrophages, histiocytes, epithelial cells appeared; macrophages decreased.Conclusion. Full dental examination and laboratory tests revealed the following clinical conditions: clinically healthy gingiva on an intact periodontium, clinically healthy gingiva on a reduced periodontium, plaque-induced gingivitis, stage I periodontitis – initial periodontitis, which corresponded to the New International Classification of Periodontal and Peri-Implant Diseases and Conditions and Proceedings of the 2017 World Workshop held by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP).

Comprehensive study of the toothpaste containing fluoride and 67% aqueous sodium bicarbonate solution

Relevance. A wide variety of oral care products is available nowadays. Sometimes aggressive advertising rather than doctor’s advice determines our patients’ choice. In our research, we provide evidence of the clinical use of toothpaste containing fluoride and sodium bicarbonate.Materials and methods. During four weeks, we followed up a group of students who used the toothpaste containing 1400 ppm fluoride and 67% aqueous sodium bicarbonate solution. The clinical, biochemical and microbiological tests and saliva crystallization score assessed the characteristics stated by the manufacturer.Results. The statistically significant correlation between all studied criteria is evidence of the effectiveness of the toothpaste. In addition to the significant remineralization and antiplaque effect, biochemical and microbiological tests confirmed the anti-inflammatory effect of the toothpaste. An immediate cleaning effect was observed after the first brushing as well as in long-term use.Conclusion. Improvement of oral hygiene indices and reduction of periodontal inflammation confirmed the successful result of the comprehensive treatment of chronic gingivitis.

Effects of a novel dye containing toothpaste versus regular fluoridated toothpaste for supragingival biofilm reduction in patients with chronic gingivitis: A Randomized Controlled Trial

AIM:To compare the effects of a plaque disclosing toothpaste with a regular fluoridated toothpaste for supragingival biofilm reduction in patients with chronic gingivitis.MATERIALS AND METHODS:This study was a randomized controlled trial with a parallel design. Forty patients, both males and females aged 18-25 years with chronic generalized gingivitis (N=40) were randomly allocated to two groups of twenty each (n=20), using lottery method. Participants in the experimental group brushed with a plaque disclosing toothpaste, while participants in the control group brushed with regular fluoridated toothpaste. Clinically, biofilm was measured using Silness &amp; Loe Plaque Index, both at baseline and at follow up visits by two assessors who were blinded to group allocation. Adjunctly, intraoral photographs were taken for Digital Plaque Image Analysis of the remaining dental biofilm in the upper and lower anterior labial tooth surfaces, and calculated based on the area of stained pixels. Data was analyzed using SPSS version 22. Mean plaque scores between the groups were compared using independent sample t-test and p&lt;0.05 was considered significant.RESULTS:Data of all the 40 participants were analyzed as they were no drop outs. No significant differences were found in the mean plaque scores between the two groups (p=0.059) at the end of the study. Similarly, Digital Plaque Image Analysis showed no significant difference in the mean plaque scores between the groups (p= 0.93).CONCLUSION:This study showed that there are no additional benefits of using a plaque disclosing toothpaste, in enhancing the removal of the supragingival dental biofilm during routine oral hygiene maintenance.

LONG-TERM OUTCOMES OF DENTAL TREATMENT OF PATIENTS WITH BACTERIAL VAGINOSIS AND THEIR SEXUAL PARTNERS

Patients with bacterial vaginosis are often diagnosed as having chronic generalized inflammatory and inflammatory-dystrophic periodontal diseases including chronic catarrhal gingivitis, mild and moderate periodontitis. The aim of this study was to compare the effectiveness of the treatment of inflammatory and inflammatory-dystrophic periodontal diseases in women with bacterial vaginosis and their sexual partners. The study included 28 heterosexual couples aged 18-45. Clinical dental check-up was performed during the treatment and in 3 months after the treatment completion. Green-Vermilion indices, РMA (in Parma modification), complex periodontal index (CPI) according to Leus, Svrakov's iodine number were determined. Both groups of patients were examined for the presence of Gardnerella vaginalis and Atopobium vaginae in the oral cavity by PCR testing. The therapeutic course was the same for all groups of patients. General therapy included "Fluconazole" in a dose of 50 mg once a day for 7 days, "Clindamycin" in a dose of 150 mg every 6 hours for 5 days, probiotic "Symbiter acidophilus concentrated" was prescribed to be taken starting from the 3rd day of antibiotic therapy for 21 days, and Calcium-D3-Nycomed (1 tab. during dinner for 30 days). Local treatment included oral baths of the drug "Stomatophyte" after morning and evening hygienic procedures for 7 days, "Metrogil-dent" ointment for gum application for 7 days, the chewing drug "Lizak" (1 tab. every 6 hours for 5 days), "Symbiter omega" in silicone caps for gum application overnight following the for 21 days.&#x0D; Chronic generalized catarrhal gingivitis was detected in 10.71% of women, mild chronic generalized periodontitis – in 64.29% and moderate chronic generalized periodontitis – in 25% of the women. In men who were carriers of pathogens of bacterial vaginosis, chronic generalized catarrhal gingivitis was found in 7.14% of individuals, mild chronic generalized periodontitis – in 60.71% and moderate chronic generalized periodontitis – in 32 male subjects. General and local dental treatment of women with bacterial vaginosis and their sexual partners showed a positive evidence-based dynamics of dental status. 3 months after clinical and laboratory observations, no complaints were presented and the oral hygiene status improved significantly. Before the treatment, the Green-Vermilion index mean values in women with bacterial vaginosis were 1.323 ± 0.035; by the end of 3 month therapy they equalled to 1.032 ± 0.021. A similar dynamics was seen in the men: from the initial index values of 1.336 ± 0.041, the Green-Vermilion index lowered to 1.048 ± 0.036. By the end of 3 month therapy, the PMA decreased by 49.03% in women and by 51.95% in men; no significant difference between the indicators of groups I and II was registered, while the difference between the results in the middle of groups I and II is significant.&#x0D; The analysis of the СPI index values demonstrated the women had a significant difference between baseline and post-treatment outcomes of 1.98 scores, while the men had 2.01 scores. No significant difference was found between the findings of groups I and II both before and after the therapy. A similar positive dynamics was confirmed by the Svrakov's iodine number indicator and according to this indicator obtained before and after the therapy, difference between groups was not detected. The significant difference between the indicators in the group of women and men was 2,789 and 2,831, respectively. The detection Gardnerella vaginalis and Atopobium vaginae in the oral cavity before and after the therapy did not demonstrate a significant difference between the group of men and women, but there was a clear difference between the parameters obtained at the initial examination and 3 months after the therapy. Gardnerella vaginalis was detected by 67.87% and 61.59% less, Atopobium vaginae – by 65.79% and 58.65% less in the women and men, respectively. This patented treatment regimen for patients with bacterial vaginosis contributes to the regression of inflammatory manifestations, improves oral hygiene, and is effective for the treatment of women with this comorbidity and for the therapy of their sexual partners. The dynamics of reducing the percentage of detection of bacterial vaginosis pathogens reflects the dynamics of the clinical picture of periodontal disease in both women with bacterial vaginosis and men who are their sexual partners that confirms the effectiveness of the therapy for both gender groups.

The Oral Manifestation of Hepatitis Patients Visiting Tertiary Care Clinics of Karachi

Background: The present study aimed to find out the most frequent Oral lesions in hepatitis B and C patients in the local population and correlate it with age and gender. Materials and Methods: A retrospective study was designed at Sindh Institute of Oral Health Sciences at the department of Oral medicine. We studied the records of patients coming to OPD from 2016 till 2021 diagnosed with hepatitis B and C for treatment. Convenience sampling was done. Incomplete forms and data of the patients with comorbid conditions such as Diabetes, Rheumatoid Arthritis or Hypertension were removed as a part of the protocol. Results: Data of sixty-seven patients was included in the study. Data analysis was done through SPSS ver.18. Frequency of the oral lesions in hepatitis B and C was assessed and the relationship between hepatitis and oral lesions was also explored by applying t-test. Male to female ratio was 1: 1.5. The most frequent lesion in both hepatitis B and C was Periodontitis followed by gingivitis and oral lichen planus. Also, the relationship between hepatitis C and oral lesions was significant at the level of p-value of 0.05% while for hepatitis B and effect on the treatment of hepatitis was no significant. Conclusion: The findings of the study show that the Hepatitis C has a significant relationship with oral lesions and presence of chronic periodontitis or gingivitis and oral lichen planus requires further testing for HCV and HBV status which would result in early diagnosis and treatment decreasing the chances of complications such as liver cirrhosis in long term and spread of infection. Keywords: Periodontitis, Oral lesions, Hepatitis B, Hepatitis C, Gingivitis.