Full-mouth Plaque Score Research Articles

Single application of 0.8% hyaluronic acid as a coadjuvant of nonsurgical treatment in nonsmoking patients with periodontitis: A split-mouth, randomized, controlled pilot clinical trial.

Background:Topical coadjuvants might be indicated to increase the results of nonsurgical periodontal treatment and overcome some of its limitations. The aim of this study was to evaluate the clinical benefits of a single topical application of 0.8% hyaluronic acid (HA) as a coadjuvant to scaling and root planing (SRP) in periodontal patients.Materials and Methods:Sixteen patients diagnosed with periodontitis were recruited to participate in this split-mouth randomized controlled trial. At baseline, oral hygiene instructions, prophylaxis, and SRP were performed in both sides; additionally, a subgingival application of HA at 0.8% was made in the test side. Several clinical parameters were assessed at baseline, 6, and 12 weeks later: full mouth plaque score, gingival score, bleeding on probing (BoP), probing depth (PD), and clinical attachment level (CAL).Results:At the end of 12 weeks, there was a overall improvement in all periodontal parameters in both sides (P < 0.05). Test sides showed less BoP when compared to the control sides (9.4 ± 4.0 vs. 14.9 ± 8.9, P < 0.05). Other periodontal parameters such as PD and CAL showed a slight improvement in comparison with the control sides, but the difference was not statistically significant (P > 0.05).Conclusion:Results from this study indicate that a single subgingival application of 0.8% HA seems to reduce gingival inflammation and improve clinical parameters, particularly BoP. Further studies are needed to evaluate the effect of repeated application of HA and long-term results.

Report of the use of topical ozone together with professional oral hygiene procedures in patient with gingival mucous membrane pemphigoid

Event Abstract Back to Event Report of the use of topical ozone together with professional oral hygiene procedures in patient with gingival mucous membrane pemphigoid Paola Carcieri1*, Roberto Broccoletti1, Alessio Gambino1, Davide Conrotto1, Mario Carbone1 and Paolo Giacomo Arduino1 1 University of Turin, Department of Surgical Sciences, Oral Medicine Section, Italy Aim. Mucous membrane pemphigoid (MMP) is a heterogeneous group of autoimmune chronic inflammatory, subepithelial blistering disorder, predominantly involving the mucous membranes. It has a female predilection and commonly occurring after the fifth decade of life. The oral mucosa is affected in more than 90% of cases. Even if this condition has been reported as non-plaque induced, effective dento-gingival plaque control sometimes could resolve the gingival inflammation. Ozone is naturally produced by the photo dissociation of molecular oxygen into activated oxygen atoms which then react with further oxygen molecules. This transient radical anion rapidly becomes protonated, which in turn decomposes to an even powerful oxidant, the hydroxyl radical OH. Application of ozone in periodontics comes as a result of its physic-chemical properties. Ozone therapy has a wide range of applications in treating various diseases owing to its unique properties including antimicrobial, immunostimulant, analgesic, detoxicating, bioenergetic and biosynthetic actions. Materials and Methods. A 70-year-old female patient presented with 1-year history of intact blisters in her mouth, which ruptured leaving throbbing ulcers and peeling of the gingiva; she also reported pain and burning sensation while taking hot and spicy foods. A biopsy was performed with MMP evidence. A professional oral hygiene regimen was started to deal with the gingival status associated together with the use of local ozone applications. Severity of pain was detailed using a Visual Analogue Scale (VAS). Patient received non-surgical periodontal therapy, including personalized oral hygiene instructions, and thorough supragingival scaling and polishing with the removal of all deposits and staining. Clinical outcome variables were recorded at baseline and after the intervention and included full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), and the clinical extension of gingival involvement. Results. After finishing the proposed protocol, a significant and statistical reduction was observed for FMPS, FMBS, and clinical gingival involvement, without using any topical or systemic immunosuppressant. Discussion. Professional oral hygiene procedures and non-surgical periodontal therapy, including topical use of ozone therapy, were associated with a prominent improvement of gingival clinical outcomes in this female with exclusive MMP related gingivitis.

Identification of subgingival periodontopathogen in subjects with chronic periodontitis

Abstract Objective The aim of this study was to identify the presence of subgingival periodontopathogen in subjects diagnosed with chronic periodontitis among patients attending International Islamic University Malaysia, Kulliyyah of Dentistry Polyclinic, Kuantan, State of Pahang. Materials and Methods: Fifty systemically healthy Malaysian subjects were enrolled in this study. Thirty of those who diagnosed with chronic periodontitis were recruited for the test group, and 20 subjects were considered the control group based on the absence of clinical attachment loss. The clinical periodontal parameters including full mouth plaque scores, bleeding on probing, pocket depth and clinical attachment loss were recorded. Subgingival plaque samples were collected using periodontal curette from deep pockets of each individual and pooled for analysis and DNA extraction. The presence of Porphyromonas gingivalis (Pg) was assessed by polymerase chain reaction. Result: There was highly significant difference between both groups in respect to the clinical periodontal parameters (p

Efficacy of photodynamic therapy vs ultrasonic scaler for preventing gingival inflammation and white spot lesions during orthodontic treatment.

The complex designs of fixed orthodontic appliances hinder proper access for cleaning, favouring the development of gingival inflammation and white spot lesions around brackets. The aim of this study was to evaluate the effectiveness to avoid these undesirable effects by using two prophylactic methods: Photodynamic Therapy (PDT) and conventional ultrasonic scaler (US), in patients during fixed orthodontic treatment. Twenty patients under orthodontic treatment for at least 15 months were randomly divided into two groups: PDT mediated by methylene blue (MB) and US. Both treatments were applied in repeated doses (four times in intervals of 2 weeks in the beginning of the study (T0), with booster doses at 3, 6 and 9 months, T1, T2 and T3, respectively). Periodontal clinical parameters (full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS) and probing depth (PD)) were recorded as well as the International Caries Detection and Assessment System (ICDAS) index. Samples of subgingival plaque and saliva (for determination of 4 periodontopathogens and mutans streptococci, respectively), were collected at T0 and at the follow-ups of T1, T2 and T3. The evolution of FMPS, FMBS, PD, ICDAS scores as well as the counts of periodontopathogens and salivary mutans streptococci was similar after US or PDT implementation. Greatest periodontal scores reduction took place at T1 for FMBS and PD and at T2 for FMPS. Main microbial reduction took place at T1. ICDAS index began to increase from T2. No statistically significant intergroup differences were observed. Additional treatment of PDT or US in repeated doses delayed undesired side effects during fixed orthodontic treatment in young patients with low caries risk and signs of gingival inflammation.

Comparative evaluation of the use of magnification loupes in supragingival scaling procedures

The main aim of the present investigation was to evaluate clinical and patient-centered outcomes of supragingival scaling performed with or without the use of 2.5× magnification loupes and illumination. A total of 30 patients, divided into three groups, were treated with 2.5× loupes and 2.5× loupes and illumination, and without any magnification device. Full-mouth plaque score percentage (FMPS%) and full-mouth bleeding score percentage (FMBS%) were registered before and after the treatment. Moreover, perceived pain and quality of the treatment were recorded using a visual analog scale. Appropriate statistical analysis was adopted to analyze between-group differences for the investigated parameters. All of the patients completed the study protocol. All the groups were homogeneous at baseline. Supragingival scaling caused a significant reduction of FMPS% and FMBS% in all groups without differences among them. Moreover, no differences could be found for patient-centered outcomes. The duration of the treatment was significantly higher in the group in which loupes and illumination was used than in the control group. The use of magnification loupes (with or without illumination) did not significantly improve clinical and patient-centered outcomes of supragingival scaling procedures.

Interdental plaque reduction after use of different devices in young subjects with intact papilla: A randomized clinical trial.

To determine the efficacy of 4 different oral hygiene regimens involving adjunctive interdental cleaning devices in unsupervised young subjects with intact interdental papilla. Sixty periodontally healthy subjects were randomly allocated to 4 groups following different oral hygiene regimens (T-7): use of manual toothbrush alone; manual toothbrush plus dental floss; manual toothbrush plus interdental brushes; and manual toothbrush plus rubber interdental picks. Oral hygiene instructions (OHI) were given. One week after (T0), professional supragingival scaling and polishing was performed, and subjects were then reseen every 2weeks (T14 and T28). At T-7, T0, T14 and T28, full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS) and angulated bleeding index (AngBI) were taken. During the first week (T-7/T0 unclean phase), FMPS decreased significantly in all groups except the group using dental floss. At T28, a significant decrease in FMPS (P<.001, all groups) and FMBS (P<.05, all groups except the group using flossing P<.001) was noted. Interdental FMPS showed significantly lower values in subjects treated with interdental brushes or rubber interdental picks vs toothbrushing alone (P<.05). The use of interdental picks was associated with reduced interdental FMBS when compared to flossing (P<.05). In young subjects, with no interdental attachment loss, toothbrushing or toothbrushing and adjunctive interdental cleaning devices such as dental floss, interdental brushes or interdental rubber picks can significantly reduce both plaque and gingival inflammation. Use of interdental brushes or rubber picks reduces more interdental plaque in comparison with toothbrushing alone.

Are periodontal outcomes affected by personality patterns? A 18-month follow-up study

Objectives: This research aims to study the relationship between personality traits and periodontal clinical outcomes by taking into account the level of anxiety and depression, periodontal health and oral hygiene behaviour of patients affected with gingivitis or moderate periodontitis requiring periodontal therapy.Material and methods: The periodontal data of 40 systemically healthy patients affected by gingivitis or moderate periodontitis were collected at baseline and 18 months later. The psychological variables, dental awareness and adherence intent of the patients were assessed through questionnaires, and only those patients that exhibited a higher degree of compliance were included in the study. The personality traits (cluster A: paranoid, schizoid, schizotypal; cluster B: borderline, antisocial, narcissistic, and histrionic; cluster C: avoidant, dependent, and obsessive-compulsive) and the level of anxiety and depression of the patients were assessed. Patients were instructed with oral hygiene measures and were treated with periodontal therapy.Results: Clusters A and B showed a consistent tendency for reduced levels of oral hygiene (increased full-mouth plaque score – FMPS). The results from cluster B were found to be significantly related to deep periodontal pockets at baseline. On the contrary, cluster C seemed to be linked to clinically better indices, particularly in terms of full-mouth-bleeding-score and pocket depth, both at baseline and 18 months later. The results collected from clusters B and C were directly correlated with anxiety, depression and FMPS. Moreover, anxiety was directly correlated with the patient’s need for professional oral-care.Conclusions: Personality traits appear to play a significant role in determining the therapeutic outcomes of periodontal therapy in themselves. Thus, it is ideal for several important psychological, affective or behavioural factors to be associated with various personality traits so as to orient the outcome of periodontal therapy.

One year results of a randomized controlled clinical study evaluating the effects of non-surgical periodontal therapy of chronic periodontitis in conjunction with three or seven days systemic administration of amoxicillin/metronidazole.

BackgroundTo evaluate the clinical outcomes 12 months after systemic administration of amoxicillin (AMX) and metronidazole (MET) adjunctive to subgingival debridement (SD) in patients with severe chronic periodontitis (sChP).Material and methods102 patients with sChP were treated randomly as follows: SD within 2 consecutive days and placebo for 7 days (group A), SD+AMX+MET (both 500mg x3 times daily TID) for 3 days (group B), SD+AMX+MET (both 500mg x 3 TID) for 7 days (group C). At baseline, at 3-, 6-, and 12-months post-treatment probing pocket depth (PD), clinical attachment level (CAL), furcation involvement, bleeding on probing (BOP), full-mouth plaque score (FMPS) were determined. The reduction in the number of sites with PD≥6mm was defined as main outcome variable.Results75 patients completed the study. At 12 months, all three treatment groups showed statistically significant improvements (p<0.001) of mean PD, CAL, BOP and number of sites with PD≥6mm compared to baseline. Mean residual PD were statistically significantly lower and CAL gain statistically significantly greater in the two antibiotic groups as compared to placebo. While PD reductions (p = 0.012) and CAL gain (p = 0.017) were statistically significantly higher in group C compared to group A, only the 3-day AB group showed statistically significantly fewer sites with PD≥6mm at 12 m (p = 0.003). The reduction in the number of sites with PD≥6 mm (primary outcome) showed no statistical significant differences between the 3 treatment groups. However, in both antibiotic groups significantly more patients compared to the placebo group reached a low risk for disease progression at 12 months (≤4 sites with PD≥5mm).ConclusionAt 12 months, both adjunctive antibiotic protocols resulted in statistically significantly greater clinical improvements compared to placebo.

Effects of Viral and Bacterial Infections on Marginal Periodontium

Abstract Background: There are several risk factors, general and local, which favor the onset of periodontal destruction, and their knowledge is essential to their correct identification and for the adoption of a suitable therapeutic management. The aim of the study was to assess periodontal health status of patients suffering from viral and bacterial infections and to determine the eventual relationship between periodontal diseases and infectious diseases. Material and methods: Twenty-five patients with a mean age of 25 years (range 23–27 years) admitted to the Clinic of Infectious Diseases of Tîrgu Mureș between December 1, 2013 – May 31, 2014 and diagnosed with bacterial and viral infections were included in the study (17 women, 8 men). Eight were infected with bacteria, and 17 with human immunodeficiency virus (HIV). Patients were examined in the clinic using Williams periodontal probe, dental mirror, and lip retractor, and different periodontal parameters were recorded: the Silness Löe plaque index, papilla bleeding index, Community Periodontal Index in Treatment Needs (CPITN), periodontal pocket depth, gingival retraction. Results: Values were significantly higher in patients infected with HIV in the following cases: among women in the Full Mouth Plaque Score (FMPS, p = 0.0312), among men in the depth of periodontal pockets (p = 0.0126), among men in the FMPS (p = 0.0282). Conclusions: The FMPS showed a high value both in women and men infected with HIV. More and deeper pockets were found in men infected with HIV. The gingival retraction and the papillary bleeding index calculated for the entire oral cavity were not influenced by the type of infection. A periodic inspection and maintenance of oral hygiene instructions could play a significant role in preventing periodontal disease in these vulnerable groups.

A comparative study of antibacterial and anti-inflammatory effects of mouthrinse containing tea tree oil.

A pilot study, randomized 4 × 4, controlled, cross-over, double-blind. 16 subjects with gingivitis (7 males and 9 females) aged 21-37 years, were randomly divided into four groups based on mouthwash that had to be used for domiciliary oral hygiene: mouthwash with essential oils, mouthwash with chlorhexidine 0,12 %, mouthwash containig tea tree oil and mouthwash placebo. Clinical evaluation was performed by: Full Mouth Plaque Score (FMPS), Full Mouth Bleeding Score (FMBS), Gingival Index (GI), discolorations, language examination and alteration of taste. The data were recorded before and 2 weeks after treatment. Statistical analysis shows that treatments with tea tree oil, essential oils and chlorhexidine are effective. Comparing treatments should be noted that the tea tree oil gives a greater improvement in the GI and FMBS, while it is the least effective in the control of bacterial plaque. Although further studies are needed, the anti-inflammatory properties of the mouthwash made from TTO would seem to be a valuable non-toxic adjunct in the management of gingivitis.

How Intraday Index Changes Influence Periodontal Assessment: A Preliminary Study.

It is reputed that periodontal indices remain unchanged over a 24-hour period, with great clinical significance. This preliminary study analyzes daily index changes. In 56 selected patients, full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), periodontal screening and recording (PSR) indices, and periodontal risk assessment (PRA) were recorded at baseline and three times per day (check-I: 08.30, check-II: 11.30, and check-III: 14.30), after appropriate cause-related therapy. Correlation between variables was statistically analyzed by Stata. All periodontal indices improved at the examination phase. Statistical differences were detected for FMPS comparing all thrice daily checks. Statistical differences were detected for FMBS and PRA comparing check-III with check-I and check-II. PSR showed no significant changes. The worst baseline indices produced the widest daily fluctuation at the examination phase. Significant variation of indices is directly related to clinical severity of periodontal conditions at baseline. Patients affected by severe periodontal disease may show significantly greater index changes. As indices are routinely recorded only once per day, the index daily variation has clinical significance. This greatly affects therapeutic strategy as correct periodontal assessment requires multiple evaluations at standardized times, particularly when baseline conditions are severe.

Gingival Margin Stability After Mucogingival Plastic Surgery. The Effect of Manual Versus Powered Toothbrushing: A Randomized Clinical Trial.

Oscillating-rotating power toothbrushes have been proven to be clinically efficacious. To the best of the authors' knowledge, a clinical evaluation of the safety of these toothbrushes after surgical root coverage procedures has not been published. The aim of this study is to evaluate the gingival margin (GM) stability with the use of an oscillating-rotating toothbrush compared with a manual toothbrush. Sixty healthy individuals with at least one Miller Class I or II gingival recession underwent a surgical root coverage procedure. Soft-bristle manual and powered toothbrushes were given to participants randomly assigned to control and test groups, respectively. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), and recession depth (RD) were recorded at baseline and 1, 3, and 6 months after completion of the surgical procedure. Data analyses were performed using linear random-intercept models to take into account within-participant correlations over time. Temporal trend differences across treatments by including treatment-time interaction terms were then tested using a global Wald test. Use of a powered toothbrush resulted in a significantly greater reduction of recorded periodontal clinical indices compared with a manual device (FMPS, P = 0.05; FMBS, P = 0.005; RD, P = 0.004). No significant differences were noticed between the two experimental groups both for PD (P = 0.03) and clinical attachment level (P = 0.11). Complete root coverage was significantly higher in participants who used the powered toothbrush compared with the manual toothbrush at 6 months (control, 66.67%; test, 96.67%; P = 0.002). Use of an oscillating-rotating powered toothbrush with a soft-bristle head resulted in higher GM stability after root coverage procedures compared with the use of a manual soft-bristled toothbrush.

Chronic periodontitis is associated with lacunar infarct: a case-control study.

Chronic periodontitis (ChP) and lacunar infarct (LI) are two common diseases amongst the elderly. Although several studies have shown an association between ischaemic stroke and ChP, little is known about the relationship between ChP and LI. The study aims to investigate whether ChP is associated with the presence of lacunar stroke. An age- and gender-matched case-control study of 62 cases (subjects diagnosed with LI) and 60 controls is reported. Clinical periodontal measures (probing pocket depth, recession, clinical attachment level, full mouth plaque score and full mouth gingival bleeding on probing score) were assessed, and associated risk factors for periodontitis and lacunar stroke were ascertained by means of a structured questionnaire. Chronic periodontitis showed a strong association with LI after adjusting for common vascular risk factors (odds ratio 4.20; 95% confidence interval 1.81-10.20; P = 0.001). Likewise, severe ChP and LI also tended to be significantly associated, independent of other vascular covariates (odds ratio 3.53; 95% confidence interval 1.07-12.77; P = 0.04). Chronic periodontitis was independently associated with the presence of LI after adjusting for well-known vascular risk factors for lacunar stroke. Further observational studies are necessary to investigate the pathophysiological mechanisms that can explain this relationship.

Non-surgical periodontal treatment in conjunction with 3 or 7days systemic administration of amoxicillin and metronidazole in severe chronic periodontitis patients. A placebo-controlled randomized clinical study.

To evaluate the effect of 3 or 7days systemic administration of amoxicillin (AMX) and metronidazole (MET) or placebo as adjunct to non-surgical periodontal treatment in severe chronic periodontitis patients. One hundred and two patients with severe chronic periodontitis [e.g. ≥1 site with probing pocket depth (PD)≥6mm per quadrant] were randomly divided into three equally sized groups and treated with either scaling and root planing within 24h (SRP)+placebo (Group A) or SRP+AMX+MET (both 500mg×3 times daily) for 3days (Group B) or SRP+AMX+MET (both 500mg×3 times daily) for 7days (Group C). PD, clinical attachment level (CAL), bleeding on probing (BOP), full-mouth plaque scores (FMPS) and gingival bleeding index (GBI) were assessed prior to treatment (baseline), and at 3 and 6months post-treatment. The primary outcome variable was the difference (Δ) in the number of sites with PD≥6mm. Ninety-one patients completed the study. At both 3 and 6months, all three treatment protocols resulted in statistically significant improvements compared to baseline for all evaluated clinical parameters (p<0.001). At 6months, astatistically significantly greater reduction in the mean number of sites with PD≥6mm was observed in group B (28.62±15.32 sites) and group C (30.45±15.04 sites) compared to the placebo group (17.10±14.68 sites). Furthermore, both the 3- and the 7-day antibiotic regimen resulted in statistically significantly higher clinical improvements compared to the placebo group (p<0.05). The present findings indicate that in patients with severe chronic periodontitis, non-surgical periodontal therapy in conjunction with a 3 or 7days systemic administration of AMX+MET may lead to significantly greater clinical improvements compared to non-surgical therapy alone.

Prediction of individual implant bone levels and the existence of implant "phenotypes".

To cluster implants placed in patients of a private practice and identify possible implant "phenotypes" and predictors of individual implant mean bone levels (IIMBL). Clinical and radiographical variables were collected from 72 implant-treated patients with 237 implants and a mean 7.4±3.5years of function. We clustered implants using the k-means method guided by multidimensional unfolding. For predicting IIMBL, we used principal component analysis (PCA) as a variable reduction method for an ensemble selection (ES) and a support vector machines models (SVMs). Network analysis investigated variable interactions. We identified a cluster of implants susceptible to peri-implantitis (96% of the implants in the cluster were affected by peri-implantitis) and two overlapping clusters of implants resistant to peri-implantitis. The cluster susceptible to peri-implantitis showed a mean IIMBL of 5.2mm and included implants placed mainly in the lower front jaw and in mouths having a mean of eight teeth. PCA extracted the parameters such as number of teeth, full-mouth plaque scores, implant surface, periodontitis severity, age and diabetes as significant in explaining the data variability. ES and SVMs showed good results in predicting IIMBL (root-mean-squared error of 0.133 and 0.149, 10-fold cross-validation error of 0.147 and 0.150, respectively). Network analysis revealed limited interdependencies of variables among peri-implantitis-affected and non-affected implants and supported the hypothesis of the existence of distinct implant "phenotypes." Two implant "phenotypes" were identified, one with susceptibility and another with resistance to peri-implantitis. Prediction of IIMBL could be achieved by using six variables.

Fixed prosthodontic treatment outcomes in the long-term management of patients with periodontal disease: a 20-year follow-up report.

The aim of this long-term cohort study was to evaluate the efficacy and complications of fixed partial dentures in a convenience sample of 100 patients with periodontal disease who were treated and maintained periodontal patients after 20 years. After active treatment, including periodontal surgery and endodontic and prosthetic treatment, patients were enrolled in a supportive periodontal care (SPC) program with 3- to 6-month recalls. All patients showed clinical data recorded at (1) the original consultation (T0), (2) the first SPC visit following the completion of prosthetic treatment (T1), and (3) at the latest SPC clinical session 20 years after T1 (T2). Multivariate analyses were performed to investigate the influence of clinical variables on the risk of prosthetic abutment (PA) loss after 20 years' visits. The final sample comprised 100 patients. At T1, a total of 948 PAs represented the original sample of experimental teeth. At the 20-year follow-up, a total of 854 PAs (90.1%) were still in function, while 94 (9.9%) PAs in 41 patients (41%) were lost during SPC; 98% of lost PA were endodontically treated. Vertical root fracture (48%) was the major cause of PA loss, while progression of periodontitis caused 31% of PA loss. Age (P = .002), Full-Mouth Plaque Score (P < .0001), Full-Mouth Bleeding Score (P = .0002), and oral parafunctions (P = .0083) were associated with increased probability of PA failure. Among clinical-related factors, endodontic treatment (P = .0082), root resection/ amputation (P < .0001), multi-rooted teeth (P = .0005), and abutment associated with parafunction (P < .0001) were associated with increased risk of abutment loss after 20 years. Perioprosthetic treatment in compliant patients is highly successful after 20 years of SPC.

Antimicrobial photodynamic therapy using diode laser activated indocyanine green as an adjunct in the treatment of chronic periodontitis: A randomized clinical trial

IntroductionClinical studies have shown the usefulness of antimicrobial photodynamic therapy (aPDT) as an adjunctive in periodontal therapy. These studies did not utilize indocyanine green (ICG) as a recently introduced photosensitizer. The aim of this study was to perform a full-mouth double-blind randomized controlled clinical study to test the efficacy of adjunctive aPDT with ICG compared with scaling and root planing (SRP) alone in chronic periodontitis treatment. Materials and methodsFifty patients were selected for this study. All patients received SRP. Then, each patient was randomly assigned to either the test group (aPDT+SRP) or the control group (SRP). aPDT was performed with a diode laser (wavelength: 810nm, power: 200mW) and ICG as photosensitizer. The adjunctive procedure was repeated after 7, 17 and 27 days. The clinical parameters including bleeding on probing (BOP), clinical attachment loss (CAL), plaque index (PI), probing pocket depth (PPD), full mouth plaque score (FMPS) and full mouth bleeding score (FMBS) were measured at baseline and after 1 and 3 months. ResultsThere were no significant differences between two groups at baseline. BOP, PPD and FMBS showed significant improvements in the test group (P≤0.001). In terms of PI, FMPS and CAL, no significant differences were observed between both groups (P≥0.05). ConclusionaPDT as an adjunctive approach yielded complete resolution of inflammation and significant reduction in periodontal pocket depth. However, aPDT had no additional advantages in clinical attachment gain and plaque score.

A cross-sectional study of dentine sensitivity in periodontitis patients in Trinidad and Tobago.

This cross-sectional study aimed to determine the prevalence, distribution and associated factors of dentine sensitivity (DS) among periodontitis patients in Trinidad. Sequential patients meeting the periodontitis criteria (BPE 4/4*) were included and completed a questionnaire on DS prior to a full periodontal examination. Clinically elicited symptoms of DS and presence of cervical tooth wear were recorded. DS prevalence was 73.1% (n = 130; mean age 50 years). Mean number of sensitive teeth increased with increased severity of gingival recession. Most common initiating factors of DS were cold stimuli (70.5%), brushing (25.3%) and sour food (11.6%). Correlations were obtained for DS and race, toothbrush texture hardness, cervical tooth wear and gingival recession severity (P < 0.05; binary logistic regression). Cervical tooth wear was recorded in 46.3% of DS patients. Full-mouth plaque scores (FMPS) and full-mouth bleeding scores (FMBS) were statistically significantly (P < 0.05; Mann-Whitney U) test lower for DS versus non-DS patients. Patients reported a low usage (27.4%) and satisfaction (53.8%) rating for desensitizing agents. The high prevalence of DS was comparable to other studies on periodontitis patients. Progressive periodontal disease and toothbrush abrasion were possible aetiological factors for DS in this study. Knowledge of local dietary practices and the role of acidic (sour) foods in eliciting DS may aid in management. The high prevalence of cervical tooth wear and the lower FMPS and FMBS among DS patients may reflect more aggressive tooth brushing. DS does not seem to be a limitation to plaque control in DS versus non-DS patients in this study.

Childhood overweight-obesity and periodontal diseases: is there a real correlation?

The association between obesity and periodontitis has been extensively investigated in adults but not in young people. The aim of this study was to examine the association between overweight-obesity and periodontal disease in pediatric subjects. Controlled cross-sectional study involving 100 school children of both gender (50 M and 50 F) between 7 and 12 years of age (mean age 9,19±1,57). Two groups were formed based on Body Mass Index value: test group with BMI ≥ 25 Kg/m2 and control group with BMI ≤ 24 Kg/m2. Diet intake and oral hygiene habits were recorded by a specific questionnaire and the periodontal clinical parameters were evaluated. The periodontal examination in the control group revealed a full-mouth plaque score (FMPS) value equal to 21.86% against 50.08% in the group of patients overweight/obese; the full-mouth bleeding score (FMBS) in the control group amounted to 12.7% against 26.24% of test group. No patient in either group included in the study presented a probing pocket depth (PPD) ≥3, so a significant difference regarding this value was not found. Regarding the frequency and quantity of food consumption, the number of obese patients who did not follow a balanced diet largely exceeded the number of normal-weight patients (70 versus 20%). These results focus the attention on the negative impact of obesity on gingival health in young subjects, probably due to a combination of metabolic and inflammatory profiles and the result of a careless attitude towards prevention diseases of the oral cavity.

Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances.

The purpose of this study was to explore the microbiological and periodontal changes occurring in adolescents during 12months of orthodontic therapy with removable aligners and with fixed appliances. During the years 2012-2013, 50teenagers aged 10-18years with similar initial orthodontic conditions participated in this trial in a university clinic in northern Italy. After receiving professional oral hygiene and instructions on a standardized oral hygiene protocol, the adolescents were randomly assigned to either orthodontic treatment with traditional fixed brackets (n = 25) or to treatment with Invisalign® aligners (n = 25). Subgingival microbiological samples, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were obtained and documented from the mesiovestibular subgingival sulcus of the upper right first molar and left central incisor at the beginning of treatment and 3, 6, and 12months later. Compliance with oral hygiene procedures, full mouth plaque score (FMPS), and full mouth bleeding score (FMBS) were assessed at the beginning of treatment and 12months later. Two sample independent t-tests and the χ(2) test were used to study whether the indices of periodontal health differed in the teenagers due to the experimental conditions. None of the patients was positive for the periodontal anaerobes analyzed. The PI, PD, BOP, FMPS, and FMBS scores were significantly lower and compliance with oral hygiene was significantly higher in the group treated with Invisalign® than in the group treated with fixed brackets. Teenagers treated with removable appliances display better compliance with oral hygiene, less plaque, and fewer gingival inflammatory reactions than their peers with fixed appliances.