Calculus Deposits Research Articles

Effect of Artificial Aging on Mechanical and Tribological Properties of CAD/CAM Composite Materials Used in Dentistry.

With easy-to-process 3D printing materials and fast production, the quality of dental services can be improved. In the conventional procedure, the dentist makes temporary crowns directly in the patient’s mouth, e.g., from the most commonly used bis-acrylic composites. Temporary crowns made directly in the office without the use of CAD/CAM are often of inferior quality, which directly results in impaired hygiene, poorer masticatory mechanics, greater deposition of plaque, calculus and sediment, and may adversely affect periodontal and gum health. The mechanical strength, resistance to aging and abrasion of 3D printing materials are higher than those of the soft materials used in conventional methods. This translates into durability. The patient leaves the surgery with a restoration of higher utility quality compared to the conventional method. The objective of the paper was to determine the influence of aging in artificial saliva of AM (additive manufacturing) orthodontic composites on their functional properties. For the purpose of the study, fillings well-known worldwide were selected. These were traditional UV-curable resins (M I, M II, M III, M V) and a hybrid material based on a UV-curable resin (M VI). Samples were stored in artificial saliva at 37 ± 1 °C in a thermal chamber for 6 months. Indentation hardness, frictional tests and sliding wear measurements were conducted. A comparison between various materials was made. Descriptive statistics, degradation coefficients, H2E, Archard wear and specific wear rate were calculated. The Weibull statistical test for indentation hardness was performed and Hertzian contact stresses for the frictional association were calculated for unaged (M I, M II, M III, M V, M VI) and aged (M I AS, M II AS, M III AS, M V AS, M VI AS) samples. M I exhibited the lowest average hardness among the unaged materials, while M III AS had the lowest average hardness among the aged materials. Comparably low hardness was demonstrated by the M I AS material. The coefficient of friction values for the aged samples were found to be higher. The lowest wear value was demonstrated by the M I material. The wear resistance of most of the tested materials deteriorated after aging. The M VI AS material had the highest increase in wear. According to the results provided, not only the chemical composition and structure, but also aging have a great impact on the indentation hardness and wear resistance of the tested orthodontic materials.

A deep learning approach to automatic gingivitis screening based on classification and localization in RGB photos

Routine dental visit is the most common approach to detect the gingivitis. However, such diagnosis can sometimes be unavailable due to the limited medical resources in certain areas and costly for low-income populations. This study proposes to screen the existence of gingivitis and its irritants, i.e., dental calculus and soft deposits, from oral photos with a novel Multi-Task Learning convolutional neural network (CNN) model. The study can be meaningful for promoting the public dental health, since it sheds light on a cost-effective and ubiquitous solution for the early detection of dental issues. With 625 patients included in this study, the classification Area Under the Curve (AUC) for detecting gingivitis, dental calculus and soft deposits were 87.11%, 80.11%, and 78.57%, respectively; Meanwhile, according to our experiments, the model can also localize the three types of findings on oral photos with moderate accuracy, which enables the model to explain the screen results. By comparing to general-purpose CNNs, we showed our model significantly outperformed on both classification and localization tasks, which indicates the effectiveness of Multi-Task Learning on dental disease detection. In all, the study shows the potential of deep learning for enabling the screening of dental diseases among large populations.

CASE REPORT: ORAL MANIFESTATIONS OF YOUNG PATIENT SUFFERING FROM BOTH THALASSEMIA MAJOR AND HEPATITIS B

<h3>Introduction</h3> Thalassemia is a hereditary hemolytic anemia characterized by the inability of erythroblasts to produce the beta-chain of the hemoglobin structure. Patients with thalassemia acquire hepatitis most often from viruses contracted from blood transfusions especially in developing countries like Pakistan. This case reports the distinct oral manifestations in a young patient with thalassemia major and hepatitis B. <h3>Case Report</h3> An 8-year-old male patient visited Jinnah Sindh Dental Outpatient Department with the complaint of bleeding gums. According to the history, the patient was suffering from beta-thalassemia congenitally. Both parents were normal (carrier). He had 5 siblings of which 4 were phenotypically healthy (carriers). A 12-year-old sister had died because of beta-thalassemia. The patient had undergone regular blood transfusion from the age of 5 years. The patient was diagnosed with hepatitis 2 months ago, possibly due to contaminated blood transfusion. <h3>Clinical Findings</h3> The clinical examination showed that the patient was poorly built and undernourished with short stature. The prominent dental arch parameters evident were the characteristic appearance known as "chipmunk face" (caused by hyperplasia of bone marrow in the maxilla that exceeds the mandible). Frontal and parietal bossing with depressed nasal bridge were present. <h3>Oral Findings</h3> Intraoral examination demonstrated class II malocclusion along with maxillary protrusion. Other findings included overcrowding of mandibular anteriors, proclined upper anterior teeth, generalized yellowish discolored teeth, mild generalized diastema, and localized periodontitis affecting the lower anteriors. Multiple decayed teeth with heavy deposition of calculus and plaque on teeth with dark stains were also seen.

Prevalence of Oral Manifestations of Diabetic Patients in a Group of Egyptian Population

Purpose: This study aimed to assess the prevalence of oral manifestations of diabetic patients in a group of Egyptian population. Subjects and Methods: A cross- sectional study was conducted on 245 diabetic Egyptian patients. They were recruited from outpatient clinic of the Faculty of Dental Medicine for girls and Al-Azhar university hospitals. We assessed prevalence by collecting data from patients by questionnaire then clinical examination. We used HbA1c test to show its relation with oral manifestations. Results: The most frequent oral symptoms were xerostomia 77.1%, followed by toothache 51.1%, taste abnormality 50.2%, tender gum 38.8%, halitosis 32.7%, burning sensation 6.5% and mouth soreness 5.7%. While the most frequent dental findings were plaque accumulation in 92.1% followed by calculus deposition in 86.3%, bleeding with probing in 85.1%, dental caries in 62.6%, tooth mobility in 28.6% and finally gingival recession in 28.2%. Almost uncontrolled patients had more frequent manifestations than controlled ones. Conclusion: DM associated many oral manifestations and they are more prevalent in uncontrolled diabetic patients.

Oromucosal lesions in women smokers: an Indian perspective

Women smoking is looked down upon by Indian society. However, a young woman smoking is not a rare sight on college campuses in metro cities. Substantial body of literature indicates that nicotine is the major component which leads to addiction. The habit which starts to look cool and fashionable in no time becomes an addiction. Indian society, which doesn’t acknowledge that women are indulging in smoking, makes the whole fight about tobacco addiction a turbulent journey. As society doesn’t accept that women smoke, there is no need to create awareness about its gendered impact. The study was undertaken by evaluating the oromucosal conditions and haemoglobin levels of 100 women smokers. Smokers’ palate, smoking associated pigmentation on lips and calculus deposits were observed in most of the participants. The participants were not aware about the hormonal issues and detrimental side effects of smoking to their health.

A re-evaluation of scaling and root planing.

Extensive reviews on the role of scaling and root planing (SRP) in the treatment of periodontitis have been previously published. This commentary will address the importance of subgingival calculus in the progression and treatment of periodontitis and addresses factors that make the execution of a "definitive" SRP a critical part of therapy. A search for articles, using keywords relevant to the subject , (e.g., periodontitis, dental scaling, root planing, dental calculus, biofilm, inflammation) was conducted using PubMed, Ovid Medline, Cochrane Reviews and the ADA Center for Evidence Based Dentistry data bases. Additionally, references cited in relevant articles were also considered. Surfaces of subgingival calculus are covered with a biofilm of metabolically active bacteria. Periodontal inflammation is clearly related to the presence of calculus and biofilm. The primary goal of SRP is removal of subgingival calculus and biofilm deposits to create a biologically compatible root surface and reduce the inflammatory burden. Current evidence suggests that inflammation associated with periodontal infections affects both the immediate oral environment and the patient's systemic health. SRP is still critical to the treatment of periodontitis. SRP involving deep probing depths (≥ 5mm) and root surfaces with anatomical and surface irregularities, regardless of the type of instrumentation, requires time, exceptional skill and perseverance, and patient compliance with periodontal maintenance. Sites with persistent nonresponding probing depths and signs of inflammation following a definitive SRP, should be considered for surgical intervention.

Assessment of effect of Cigarette Smoking on Periodontal Health of Patients Reporting to Dental Section of Bacha Khan Medical College Mardan

Background: Smoking is considered a major risk factor of oral cancer. The oral health and hygiene are majorly affected by tobacco products. It is needed to provide the periodontal health status of smokers for better understanding to treat and to develop a periodontal treatment guideline for smokers. The objective of this study was to assess the effect of smoking on periodontal health of patients attending the dental section of Bacha khan Medical College Mardan. Methods: This was descriptive cross-sectional study carried out among 227 adult smokers attending dental unit of Bacha khan Medical College for treatment from the duration of September 2018 to November 2019. After taking written consent from the head of department, an assessment questionnaire was developed, and face validated from the respective field experts. A written formal consent was taken from each patient willing to participate in the study. The predesigned validated questionnaire was filled after assessment of patients from respective experts. The collected data was about probing depth, gum recession, attachment loss, color of gingival, presence and amount of plaque, calculus deposits and mobility of teeth. Data was collected and analyzed by using SPSS version 16. Results: A total 227 cigarette smokers male patients were assessed for different periodontal parameters. Study provided that 98(43%) and 68 (30%) smokers were with the age range 31-45 years and 46-60 years respectively. It was also found that 92(40.5%) smokers male patients were found with bleeding on probing and the bleeding frequency were high in elder ages and study provided a significant difference of bleeding frequency with respect to age p&lt;0.00001. A significant difference was found in gum recession between different age group and elder patients were with high frequency in gum recession p=0.0073.The study also provided that majority of smokers patients were having a moderate stain 103(45.4%) in their teeth and it was found a significant difference in the severe stain level and plaque on teeth p&lt;0.0001. A strong association was found between plaque and stain level. Conclusion: The study provided that smoking is a major factor in periodontitis. The health severity of periodontal parameters were high among smokers patients and the high age smokers were found more prone to periodontitis and associated anomalies.

The correlation of altitude with gingival status among adolescents in western China: a cross-sectional study

Periodontal disease is common in Chinese adolescents. There is little information about the effect of different altitudes on gingival health. This study aimed to investigate the gingival status at different altitudes and to identify relative factors that affect adolescents' gingival status. A total of 1033 adolescents aged 12-14years were included in this cross-sectional study in Ganzi (plateau, 1400m, 2560m, 3300m) and Suining (plain, 300m). Gingival status was assessed by the presence of gingival bleeding on probing (BOP) and dental calculus (DC). Demographic variables, socioeconomic status, dairy habits and oral health-related knowledge, attitudes and behaviors were obtained via questionnaire. Univariate and multivariate binary logistic regression analyses were performed to identify potential relative factors. A total of 64.09% and 77.15% of adolescents had BOP and DC, respectively. The prevalence rates of BOP and DC were higher in the plateau than the plain (P < 0.05). After adjusting for all other factors and interaction terms, residence altitudes of 2560m [300m as reference: P < 0.001, odds ratio (OR) = 4.072] and 3300m (300m as reference: P = 0.002, OR = 4.053) were significant relative factors of BOP, and an altitude of 2560m (300m as reference: P = 0.001, OR = 3.866, 1400m as reference: P = 0.001, OR = 3.944) was an important relative factor of DC. Gingival bleeding and calculus deposits were common at different altitudes. High altitude was a significant relative factor of gingival bleeding and calculus deposits.

Chemical cleansing as an adjunct to subgingival instrumentation with ultrasonic and hand devices in deep periodontal pockets: a randomized controlled study.

PurposeThe aim of this randomized clinical trial was to assess whether chemical cleansing using a sulfonic/sulfuric acid gel solution (HBX) as an adjunct to scaling and root planing (SRP) resulted in a decrease in residual plaque and calculus in deep periodontal pockets compared to SRP alone.MethodsFifty-six patients with 56 hopeless posterior teeth, scheduled for extraction due to severe periodontitis, were enrolled in this study. Each tooth was randomly assigned to 1 of the 2 experimental procedures. The test teeth were subjected to the irrigation of the subgingival area with HBX for 2 minutes, followed by SRP with hand and ultrasonic instruments for 14 minutes, and then extracted. The control teeth received only mechanical instrumentation before extraction. Residual biofilm was evaluated on photographs and measured as total area and percentage of root surface covered by remaining plaque (RP) or calculus (RC) after treatment.ResultsThe initial pocket depth (PD) and total subgingival root surface area were similar between the 2 treatment groups. After treatment, the total subgingival root area covered by RP and RC was statistically significantly larger (P<0.001) in the control group than in the test group. The test teeth showed a lower percentage of RP, but a higher percentage of RC than the control teeth (both P<0.001). Complete calculus removal was achieved in 42% of the control teeth surfaces and in 25% of the test teeth surfaces for a PD of 4 mm.ConclusionsThe additional chemical cleansing with HBX resulted in a statistically significant improvement in bacterial plaque removal during SRP of deep pockets, but it was not effective in reducing calculus deposits.

Clinical and Microbiological Efficacy of Pyrophosphate Containing Toothpaste: A Double-Blinded Placebo-Controlled Randomized Clinical Trial.

(1) Background: Dental calculus works as a niche wherein pathogenic bacteria proliferate in the oral cavity. Previous studies revealed the anticalculus activity of pyrophosphates, however there was no clinical study that evaluated microbiome changes associated with calculus inhibition. Therefore, the aim of this randomized clinical trial was to evaluate the calculus inhibition of pyrophosphate-containing toothpaste and its effect on oral microbiome changes. (2) Methods: Eighty subjects with a calculus index ≥2 on the lingual of the mandibular anterior tooth were randomly allocated to the test group that pyrophosphate-containing toothpaste was given to or the placebo control group. Full mouth debridement and standardized tooth brushing instruction were given before the allocation. Plaque index, gingival index, calculus index, probing depth, and bleeding on probing were measured at the baseline, and at 4, 8 and 12 weeks. Genomic DNA was extracted from the plaque samples collected at the baseline and at 12 weeks, and 16S ribosomal RNA gene amplicon sequencing was applied for microbiome analysis. (3) Results: None of the clinical parameters showed significant differences by visits or groups, except the plaque index of the test group, which reduced significantly between 4 and 12 weeks. A significant difference of microbiome between the baseline and 12 weeks was observed in the test group. Between baseline and 12 weeks, the proportion of Spirochetes decreased in the control group, and the proportions of Proteobacteria, Fusobacteria and Spirochetes in the phylum level and the proportions of Haemophilus, Fusobacterium and Capnocytophaga in the genus level decreased in the test group. In the test group, as plaque index decreased, Streptococcus increased, and Fusobacterium and Haemophilus parainfluenza decreased. (4) Conclusion: The use of pyrophosphate-containing toothpaste effectively inhibited the dysbiosis of the oral microbiome and the proliferation of pathogenic species in periodontal disease. Clinically, plaque formation in the pyrophosphate-containing toothpaste group was effectively decreased, however there was no significant change in calculus deposition.

Impact of household vinegar on calculus removal and mechanical properties of orthodontic resin.

This study evaluated calculus removal efficacy of household vinegar and its effect on autopolymerizing orthodontic resin following repeated immersion. A total of 72sectioned specimens of orthodontic retainers with calculus deposits following cleaning with the help of immersion in vinegar of different dilutions between 12.5% and 100%, tap water, effervescent tablets, and mechanical debridement were digitally analyzed. Changes in Ca and Fe ions in vinegar were assessed by atomic emission spectroscopy (AES). For mechanical testing, autopolymerizing polymethyl methacrylate (PMMA) samples were similarly grouped and immersed for 78cycles and their flexural strength and hardness measured. Fourier-transform infrared spectroscopy (FTIR) was performed to evaluate changes in their chemical composition. One-way analysis of variance (ANOVA) and Tukey's test were used to analyze the differences in the mean flexural strength and hardness between the groups (p ≤ 0.05). Aminimum immersion of 2 h in 25% vinegar solution combined with brushing attained efficiency of 74.13 ± 22% calculus removal. Whereas, tap water and effervescent tablets had 15% and 49% efficiency, respectively. AES results showed diffusion of Ca ions from calculus into the vinegar solution as aplausible mechanism for its structural weakening and removal. Results of mechanical testing showed that undiluted vinegar solution affected the flexural strength of PMMA and this effect was significantly different from that of the effervescent tablets and the remaining vinegar concentrations. There was no significant difference in hardness between the groups. The FTIR showed no changes in the chemical composition of PMMA samples following repeated immersions. Vinegar can be useful in the removal of calculus from dental appliances but should be used in diluted forms to minimize side effects.

Accuracy of dental calculus detection using digital radiography and image manipulation.

The aim of this study was to determine if image enhancement improves a clinician's ability to identify the presence of calculus on digital radiographs. Seventy-one hopeless teeth were collected from 34 patients. Teeth were stained with 1% methylene blue, the largest interproximal calculus deposit was scored, and photographs of each interproximal root surface were taken. The surface area of calculus deposit was determined as a percentage of the total interproximal root surface area. Digital radiographs of teeth taken before extraction were modified using the following enhancements: auto-contrast, emboss, invert, and sharpen. Radiographic presence of calculus was determined by two examiners. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each examiner and enhancement. A receiver operating characteristic curve was used to compare differences between the image enhancements in the detection of dental calculus. The kappa statistic was used to compare ratings between examiners. None of the enhanced images were statistically superior to original images in identifying radiographic calculus (P> 0.05). The average sensitivity of digital radiography was 50%, average specificity was 82.2%, PPV was 94%, and NPV 23.2%. A threshold of >30% of interproximal root surface covered with calculus and increasing size of deposits were associated with improved detection (P< 0.05). Digital enhancements do not significantly improve radiographic detection of dental calculus. As area of calculus on the root surface and size of calculus deposits increased, sensitivity of detection also increased.

Periodontal disease and its complications in cats from a shelter in the Central Region of Rio Grande do Sul

ABSTRACT: Periodontal disease is the most common infectious disease that occurs in feline patients. Although it occurs in both sexes, different age groups, and any breeds, the prevalence and severity seem much higher in cats living in animal shelters. This paper aimed to describe the clinical, radiological, cytopathological, and virological aspects of periodontal disease and its complications in cats, based on these aspects and, consequently, on the importance it brings to cat feline medicine in shelter cats. For this, nine cats with periodontal disease from a single animal shelter were evaluated. These cats demonstrated a disease characterized by halitosis, excessive salivation, and oral discomfort. Lymphadenomegaly of the mandibular and retropharyngeal lymph nodes was observed in 44.4% of the cases. Oral lesions consisted of varying degrees of gingival hyperemia, complete loss of free gingival margins, and consequently gingival retraction, dental calculus deposition, dental mobility, complete exposure of the furcation of premolars and molars, and dental roots of canines and incisors, loss of bone radiopacity due to alveolar bone resorption and tooth loss. Complications included chronic ulcerative paradental stomatitis (22.2%), faucitis (22.2%), and chronic gingivostomatitis (11.1%). None of the cats affected by periodontal disease was positive for FIV or FeLV. In 33.3% of the cases, cats were carriers of feline calicivirus, but not feline herpesvirus.

Validity of Self-Reported Periodontitis in Japanese Adults: The Japan Public Health Center-Based Prospective Study for the Next-Generation Oral Health Study.

This study evaluated the validity of self-reported periodontitis measures among 2404 Japanese adults aged 40 to 75 years. A self-administered questionnaire survey and a clinical periodontal examination were conducted from 2013 through 2016. The self-reported periodontitis questions included 3 sociodemographic, 3 health, and 5 periodontal health-related items. Based on the clinical case definition of periodontitis, 26.5% of participants were found to be periodontally healthy, 2.7% had mild periodontitis, 55.2% moderate periodontitis, and 15.6% severe periodontitis. No single self-reported question demonstrated satisfactory validity in predicting the presence or absence of periodontitis. The predictive ability in mild and/or moderate periodontitis was poor even after combining multiple sociodemographic, health, and periodontal health-related questions. In severe periodontitis, the model including age, sex, education level, smoking status, diabetes history, body mass index, informed by a dentist, gingival bleeding, calculus deposit, and tooth mobility, presented moderate predictive performance (C-statistic: 0.676, sensitivity: 65.2%, and specificity: 61.1%). An age-stratified analysis on severe periodontitis showed that sensitivity was higher, and specificity was lower in older age group (60-75 years) than younger age group (40-59 years). Further refinement of questions in the self-report is required to increase the accuracy of the prediction of clinical periodontitis.

A comparative scanning electron microscopy study between the effect of an ultrasonic scaler, reciprocating handpiece, and combined approach on the root surface topography in subgingival debridement.

ObjectiveThis study aimed to analyze the effectiveness of root‐shape inserts mounted on a reciprocating handpiece during the procedure of root surface debridement (RSD) on extracted teeth. Three different approaches were compared: ultrasonic scaling, employment of root‐shape inserts mounted on a reciprocating handpiece, and a combination of both.Materials and MethodsA total of 51 extracted teeth were divided into three groups. The first group was instrumented with an ultrasonic scaler, the second group with flexible root‐shape inserts mounted on a reciprocating handpiece (grain size 40, 15, and 4 μm), whereas the final group underwent a combination of both approaches. The time required for the instrumentation was taken. The specimens were subjected to optical and scanning electron microscopy (SEM), and the photographs were evaluated by three examiners who were blinded to the study. The parameters included were: SEM roughness index (SRI) for the roughness calculation, remaining calculus Index (RCI) to evaluate the residual calculus deposits, and loss of tooth substance index (LTSI) to evaluate the loss of tooth substance caused by instrumentation.ResultThe results revealed that the time taken for the instrumentation was on average longer when the root‐shape inserts were employed alone, meanwhile the combined approach did not show significant difference in comparison with the ultrasonic scaling. The lower average RCI was obtained with a combined approach. The use of root‐shape inserts seems to cause a moderate increase in LTSI, especially in a combined approach, whereas it resulted in a better average SRI.ConclusionThe employment of root‐shape inserts seems to be effective in the RSD for its ability to obtain a smooth and calculus‐free instrumented surface, especially when used in combination with an ultrasonic scaler, and their use can so represent a valid approach to be tested in further in vivo studies.

Gigapixel-like imaging strategies for dental anthropology: Applications for scientific communication and training in digital image analysis

Gigapixel and gigapixel-like (GPL) imaging strategies are a powerful means of communicating scientific results of visual observations in academic and public spheres. GPL images are made from a photomosaic of multiple, adjacent extended focus images, which allows users to “pan and zoom” across a surface to document or analyze specific features. Microscopic approaches using GPL imaging strategies are gaining popularity in use-wear analyses of lithics and bone implements but have not been applied to the study of human skeletal or dental remains. Here we present three examples of GPL imaging using scanning electron microscopy (SEM) of the dental surfaces of teeth excavated from the Chalcolithic contexts of El Mirador Cave (Sierra de Atapuerca, Burgos, Spain). Numerous common features are identifiable in the GPL examples from El Mirador Cave that include wear features (e.g., enamel chipping, labial striations), perikymata, calculus deposits, hypoplasias, and postmortem taphonomic features. One GPL example shows a less-commonly documented pair of lingual surface features (i.e., lingual surface attrition of the maxillary anterior teeth [LSAMAT] and a continuous cingular lesion [CCL]) for which co-occurrence has not been previously documented. Another example using a combination of GPL, macrophotography, and additional high magnification SEM images shows a case of chemical erosion on a labial surface of the tooth - a seldom documented form of wear in bioarchaeological contexts. This latter example also highlights the complementary nature of SEM (and GPL) with digital macrophotography for documenting dental wear features. Together, these examples illustrate the utility of GPL images of dental surfaces for didactic purposes and analysis.

The occurrence of periodontal diseases and its correlation with different risk factors among a convenient sample of adult Egyptian population: a cross-sectional study

Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited. The present study was carried out to evaluate the occurrence and the severity of periodontal disease and its correlation with different risk factors. Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire. Results: It was found that 58.9% of participants had calculus deposits. The occurrence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, and crackers, as well as caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level. Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the occurrence and the severity of periodontal diseases.

The occurrence of periodontal diseases and its correlation with different risk factors among a convenient sample of adult Egyptian population: a cross-sectional study.

Background: Even though extensive studies on the prevalence of periodontal diseases in various populations worldwide have been carried out, data for the Egyptian population is limited. The present study was carried out to evaluate the occurrence and the severity of periodontal disease and its correlation with different risk factors. Methods: Periodontal examination was performed on 343 adults attending the outpatient clinics of the Faculty of Dentistry, Cairo University, as well as three private clinics. Socio-demographic data, brushing frequency, body mass index (BMI) and dietary habits were recorded using a questionnaire. Results: It was found that 58.9% of participants had calculus deposits. The occurrence of periodontitis was 89.8%, where 70.8% of participants had stage I and 15.2% had stage II, while only 4.4% and 2.05% suffered from stage III and stage IV, respectively. Calculus was positively correlated with age, grains, and sugar in drinks and negatively correlated with socioeconomic status, education level, brushing frequency and milk. Calculus was not correlated with gender and BMI. Periodontitis was positively correlated with age, carbohydrates other than bread, grains, and crackers, as well as caffeinated drinks, while negatively correlated with gender, socioeconomic status, brushing frequency. Periodontitis was not correlated with BMI or education level. Conclusion: The present study clarifies that age, brushing frequency, carbohydrates and caffeinated drinks consumption are significant factors influencing the occurrence and the severity of periodontal diseases.

Antimicrobial photodynamic chemotherapy mediated by PapaMBlue on chronic periodontal disease: Study protocol for a randomized, blind, controlled trial.

Background:The elimination of the pathogenic microorganisms of the periodontal pocket is one of the main points for success in periodontal treatment. The objective of this study is to investigate the clinical and antimicrobial effect of papain-mediated photodynamic therapy in the clinical treatment of periodontal disease.Methods:Twenty patients with chronic periodontitis will be selected. Patients will be randomly divided into 2 groups (n = 10). Group 1 will receive conventional periodontal treatment and group 2 will receive conventional treatment and antimicrobial photodynamic therapy (PACT). Conventional treatment will consist of oral hygiene guidance, with brushing technique instructions and recommendation of daily flossing. The calculus deposits on the teeth will be removed with ultrasound equipment and curettes for scraping and root planning. The PACT will be performed at the end of each periodontal treatment session, at sites with bags ≥4 mm. PapaMblue photosensitizer will be deposited in the periodontal pockets with a syringe and a pre-irradiation time of 1 minute will be adopted. Then, the laser emitting wavelength of 660 nm, with power of 100 mW, for 2 minutes, radiant exposure of 30 J/cm2 and power density of 250 mW/cm2 will be applied. Patients will undergo clinical evaluations before treatment (day 1) at 30, 60, and 90 days after the end of treatment; and microbiological evaluations before and immediately after treatment. The distribution of the data within each group and the homogeneity of the variances will be verified. With this information, the most appropriate statistical test in each evaluation will be used. The sample calculation is based on the literature and the significance level of 5% will be adopted.Discussion:The combination of PACT with methylene blue in a papain gel and the conventional treatment may increase the reduction of bacteria in periodontal pockets.

Comparison of the Periodontal Status of Patients Undergoing Labial and Lingual Orthodontic Therapy.

AimTo compare the periodontal status in relation to the lower anteriors of patients between labial and lingual orthodontic therapy.Materials and methodsThe study includes a total of 20 patients in the age group of 20-30 years. All the included patients were selected with limited lower anterior crowding within 0-8 mm. The subjects were randomly divided into two groups: labial (n=10) and lingual (n=10) fixed orthodontic therapy. The periodontal status was evaluated using three indices, plaque index, calculus index, and gingival index, at two different treatment intervals - the first month and the third month - of orthodontic treatment. ResultsThe values of all the three indices at both time intervals were tabulated. There was no statistical significance when compared to the values in the first month. In the third month, all three indices were statistically significant for both labial and lingual therapy (p<0.001). The lingual appliance had more plaque and calculus accumulation.ConclusionTherefore, the study proves that the lingual surface of patients undergoing lingual orthodontic treatment exhibits more plaque and calculus deposition, thereby the weakening of the periodontal status.