Gingival Bleeding Index Scores Research Articles

Evaluation of periodontal parameters on abutment teeth rehabilitated with single-unit crowns: A 12-month follow-up

PurposeThis prospective study evaluated the effects of the metal-free crowns on the periodontal tissues of abutment teeth during a 12-month follow-up. Materials and Methods:A sample of 24 patients (N = 32 abutment teeth) who needed a single-tooth restoration were enrolled to receive either a metal-ceramic (n = 21) or lithium disilicate (n = 11). The single-unit crowns were evaluated at baseline, 3-and 12-month follow-up. The periodontal parameters were evaluated: plaque index (PI), gingival bleeding index (GBI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), radiographically and clinical crown fitting, bone resorption, and marginal finish lines. Statistical analyses were performed using the Exact Fisher and Mann-Whitney tests, and the Wilcoxon signed-rank test as a post hoc test for Friedman (95 % confidence interval). Results:The marginal finish line showed a statistical difference with a biomaterial type (p =.004). After a 12-months, a significant increase was observed in PI and mean PD for abutment teeth of metal-ceramic crowns. The metal-free crowns presented higher values for GBI and CAL (p2 < 0.05). Only distal cervical evaluation and dental biofilm formation in the abutment teeth showed a statistical difference between the groups at the 12-month follow-up. The supragingival margin metal-ceramic group revealed higher PI values (p2 = 0.005) between the period and the subgingival margin of both biomaterials showed greater GBI scores (p2 < 0.05). Conclusions:Metal-free crowns showed better periodontal outcomes compared to metal-ceramic crowns. Single-unit crown marginal location affects the periodontal tissue condition of the abutment teeth. The marginal fit was not changed regarding the biomaterial type.

Six-month follow-up of salivary antioxidant defense outcomes of individuals using medicated toothpaste.

The objective of this study was to study the effect of medicated toothpaste on oral health, a 6-month follow-up. Four hundred and twenty-seven participants were screened and followed up for 6 months. The intraoral examination was performed to record caries, gingival bleeding, and plaque index. Saliva collected was evaluated for pH, total antioxidant capacity (TAC), malondialdehyde (MDA), and Vitamin C level for 6 months, and data were analyzed. On the usage of medicated toothpaste with herbal extract for 6 months, the salivary pH levels were increased, the interquartile range for plaque, and the gingival bleeding index decreased. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-free group of subgroup I was 174.8, 58.06, and 59.98, respectively, in subgroup II was 133.3, 52.08, and 58.51, and in subgroup III was 63.77, 45.11, and 47.77. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-active group of subgroup I was 136.62, 57.27, and 72.83, subgroup II was 108.59, 37.50, and 61.55, and in subgroup III was 35.62, 30.82, and 54.10, respectively. The salivary pH levels increased on the usage of medicated toothpaste with herbal extract; plaque and the gingival bleeding index scores were decreased. The salivary antioxidant defense was increased in individuals using medicated toothpaste with herbal extracts which signifies an improvement in overall oral health in the 6-month follow-up.

Effectiveness of Tooth Brushes on Gingival Health in Patients undergoing Orthodontic Treatment

Aim: To evaluate and compare the effectiveness of two different manual toothbrushes on gingival health among patients undergoing orthodontic treatment. Methodology: In the present randomized cross-over controlled trial, 60 subjects were recruited, to receive either crisscross or multilevel bristle design. Modified Gingival Index (MGI), Modified Silness and Loe Plaque Index, and Gingival Bleeding Index (GBI) and were assessed for 120 days. Statistical analysis was done using SPSS version 21 (SPSS; Chicago, IL, USA). Owing to the ordinal nature of the indices, non-parametric tests of significance were used. Results: The efficacy of the two-bristle design brush showed an overall reduction in the mean score. Overall significant differences were seen in the efficacy of the two different bristle designs. Both the study groups showed a reduction in the mean MGI, PL, and GBI with a P value less than 0.001 which was statistically significant. Conclusion: In the present study, the criss-cross bristle design was found to be significantly more effective as compared to the multilevel toothbrush design for reducing MGI, PL, and GBI scores.

Assessment of effect of health song on oral hygiene status among visually impaired children

Background: The visually impaired depend much on sound, speech, and touch, and therefore, promotion of oral hygiene maintenance through a health song can improve their oral hygiene practices. Aim and Objectives: To assess the effectiveness of oral health song on oral hygiene status among visually impaired children at baseline and after oral health education (OHE) at different time intervals. Materials and Methods: A study was carried out in Government Blind School, Salem, with prior permission. Out of 63 students, 57 students were taken to the study based on the inclusion and exclusion criteria. Seven students were lost to follow-up during the second visit and 9 students during the last visit. During the first visit, a health talk about brushing techniques was given without using any audiovisual aids, and oral health song which is of 2 min duration was taught to the students. Each of the students was given a tooth cast model and was taught how to brush. The oral hygiene status was assessed at baseline and 15th and 45th day using visible plaque index (VPI) and gingival bleeding index (GBI). Statistical analysis was done using IBM SPSS Statistics 25. The Bonferroni test was to compare the VPI and GBI scores between the baseline, 15 days, and 45 days, and P < 0.05 was considered statistically significant. Results: VPI and GBI scores were found to be statistically significant at different intervals (P < 0.001). The VPI anterior and posterior percentage (P < 0.001) and GBI anterior and posterior percentage (P < 0.001) at different intervals were found to be statistically highly significant. Conclusion: A song with music can increase interest and helps them retain information easily, which was found to be effective in the present study.

Comparative efficacy of coconut oil-pulling therapy versus 0.2% chlorhexidine mouthrinse on dental plaque and gingival health: A clinicomicrobiological study

Introduction: Periodontitis is an inflammatory microbial disease caused by complex of microbes. Prevention and control of periodontal disease must be based on the regular and complete removal of bacterial plaque n.Various modes of mechanical and chemical means of plaque control exist Conventionally, essential oils have also been used to cure many oral conditions. Many oils have been investigated for their effectiveness as anti plaque and anti gingivitis agents. Very few studies have used coconut oil or this purpose. Aim: The present study was undertaken with the aim to investigate the efficacy of virgin coconut oil pulling therapy versus 0.2% CHX mouthrinse and their effect on clinical parameters and total microbial load in salivary sample of periodontally healthy volunteers. Material and Methods: A total of 30 periodontally healthy volunteers with the age range of 18–45 years were randomly divided into two groups:-Group 1:virgin coconut oil mouthrinse (Plant Lipids®, Cochin, India) and Group 2: 0.2% CHX mouthrinse (Clohex Plus®, Dr Reddy's, India). Clinical parameters such as Plaque Index (PI), Gingival Index (GI), and Gingival Bleeding Index (GBI) were recorded for all the subjects. An unstimulated salivary sample was collected in a sterile calibrated bottle and sent for baseline examination of oral microbial load. Subjects were asked to perform oil pulling in (Group 1) and 0.2% CHX rinse in (Group 2) in front of the instructor and were asked to continue for rest of the trial period in the same manner. Results: The mean PI at day 10, day 21, and day 30 was significantly more among coconut oil than CHX group. The mean CFU at day 10, day 21, and day 30 was significantly more among coconut oil than the CHXgroup. Conclusion: Both the study groups showed reductions in PI, GI, and GBI scores, higher reductions were seen in the CHX group.It was observed that CHX and virgin coconut oil were effective against microorganisms, thus causes a reduction in CFU and thus serve as a good alternative.

English

BACKGROUND The present study was conducted to compare clinical outcomes and gingival crevicular fluid (GCF) interleukin (IL)-6 cytokine levels in microsurgical and conventional open flap debridement procedure. METHODS Thirty sites in chronic periodontitis patients were randomly assigned into Group I (microsurgical) and Group II (conventional) open flap debridement in a split-mouth design. Gingival bleeding index (GBI), probing pocket depth (PPD), relative attachment level (RAL) were recorded at baseline and 3 months. GCF IL-6 cytokine levels were assessed at baseline and on 3rd day postoperatively. Pain perception using visual analog score (VAS) and soft tissue healing using early healing index (EHI) were assessed after on 7th day post-surgery. RESULTS There was a significant reduction in gingival bleeding index, probing pocket depth, relative attachment level within both the groups. Intergroup gingival bleeding index scores were statistically significant at the end of 3 months. The difference in visual analog scores between the two groups was found to be statistically insignificant whereas early healing index scores between the groups was found to be statistically significant. Group I showed lower levels of IL-6 on 3rd day postoperatively. It was also found that there was positive correlation of IL-6 levels with clinical parameters such as PPD and RAL. CONCLUSIONS Open flap debridement using microsurgical approach can substantially improve clinical parameters and wound healing compared with conventional macrosurgical approach. IL-6 levels were lower in microsurgical group indicating less invasive surgical approach. KEY WORDS Open Flap Debridement, Periodontal Microsurgery, Wound Healing, IL-6, Cytokine, GCF.

Psychological impact and patient perception of occlusion and orthodontic treatment in periodontitis patients

Background: This study analyzed, in patients with periodontitis, the impact of the degree of self-perceived malocclusion, the experienced negative psychosocial impact of periodontitis, and the history and timing of orthodontic treatment. Methods: For the study were enrolled 54 patients undergoing a routine dental health visit. They answered the Negative Impact of Dental Aesthetics Scale (NIDAS), the Perception of Occlusion Scale (POS). Moreover, undergoes to the Approximal Plaque Index (API), the Gingival Bleeding Index (GBI), and the number of decayed teeth (DT) and missing teeth (MT). All data were analyzed using different statistical procedures. Results: The subjects ranging within the upper POS quartile scored higher on the GBI (contrast: P= 0.037) and DT (P= 0.028) than did those in the lower POS quartiles. Different to the patients who had minor negative impacts in the NIDAS, those with strong impacts had higher scores on the API (P<005). Compared to patients without previous orthodontic treatment, those with a history of orthodontic treatment lasting 24 months had a lower API (P <0.05), GBI and DT (each P = 0.008) scores. Conclusion: The present results suggest that self-perceived dental irregularity and the negative impact of periodontitis might affect oral health, whereas previous extensive orthodontic treatment may have favourable effects by improving dental health compliance.

An 8-week randomized controlled trial comparing the effect of a novel oscillating-rotating toothbrush versus a manual toothbrush on plaque and gingivitis

To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations (Oral-B iO) to a manual brush for gingivitis and plaque reduction. Adult subjects with gingivitis and plaque were randomized to use either the O-R or the manual toothbrush with standard fluoride dentifrice twice daily. Efficacy was assessed at baseline, week 1, and week 8 using the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status ('healthy'/'not healthy') was also assessed, per the American Academy of Periodontology/European Federation of Periodontology criteria. One hundred and ten subjects were enrolled and completed the randomized controlled trial. The baseline mean number (SD) of bleeding sites for all subjects was 32.11 (16.703). At week 8, 82% of subjects using the O-R toothbrush were categorized as 'healthy' (<10% bleeding sites), versus 24% of subjects using the manual brush (P<0.001). Subjects using the O-R toothbrush showed statistically significantly greater reductions (P<0.001) in the number of bleeding sites, GBI scores and MGI scores versus those using a manual toothbrush as early as 1week and throughout the 8-week study. The O-R toothbrush also provided statistically significantly greater reductions (P<0.001) in all plaque measures, including sub-regions, versus the manual toothbrush after a single brushing and at weeks 1 and 8. The novel O-R electric toothbrush with micro-vibrations provided statistically significantly greater plaque and gingivitis reductions versus a manual toothbrush, with performance benefits demonstrated after a single brushing and continuing throughout the 8-week study.

Evaluation of Dental Status and Temporomandibular Joint in Children With Generalized Joint Hypermobility.

The aim of this study was to evaluate the dental status and temporomandibular diseases (TMDs)-related symptoms in children with generalized joint hypermobility (GJH) and compare them with healthy controls (HCs). This is a cross-sectional, observational study carried out between September 2016 and April 2017. A total of 124 children with GJH (n = 62) and HC (n = 62) were enrolled. The GJH was assessed with the Beighton hypermobility score. The subjects were screened for dental status and TMD-related symptoms. The assessment included the index for "decayed," "missing," and "filled teeth" (DMFT, dmft); plaque; gingival bleeding; tooth mobility; and temporomandibular joint (TMJ) evaluation. The mean Beighton hypermobility score was 6.3 ± 1.2 in the GJH group. Visible plaque index and gingival bleeding index scores were found to be significantly higher in children with GJH then in the HC (p = 0.031, p = 0.023). No differences were found regarding the DMFT scores between the groups (p = 0.16). Temporomandibular disorder-related symptom frequencies were significantly higher in children with GJH (p < 0.001). The most common clinically determined sign of TMD was clicking with a maximum active mouth-opening. Combined TMJ symptoms and TMD were observed in approximately one third of the children with GJH. The presence of GJH in a child may be indicative of future dental or TMJ problems, and it may cause dental problems due to increased gingival bleeding index and visible plaque index scores. Therefore, children with GJH require preventive dental and TMJ care.

JUUL and Pod e-Cigarette Flavors Impose Oxidative Stress and Inflammatory Responses in Lung Epithelial Cells and Macrophages

Purpose: To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations (Oral-B iO) to a manual brush for gingivitis and plaque reduction. Methods: Adult subjects with gingivitis and plaque were randomized to use either the O-R or the manual toothbrush with standard fluoride dentifrice twice daily. Efficacy was assessed at baseline, week 1, and week 8 using the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status (‘healthy’/‘not healthy’) was also assessed, per the American Academy of Periodontology/European Federation of Periodontology criteria. Results: One hundred and ten subjects were enrolled and completed the randomized controlled trial. The baseline mean number (SD) of bleeding sites for all subjects was 32.11 (16.703). At week 8, 82% of subjects using the O-R toothbrush were categorized as ‘healthy’ (<10% bleeding sites), versus 24% of subjects using the manual brush (P < 0.001). Subjects using the O-R toothbrush showed statistically significantly greater reductions (P < 0.001) in the number of bleeding sites, GBI scores and MGI scores versus those using a manual toothbrush as early as 1 week and throughout the 8-week study. The O-R toothbrush also provided statistically significantly greater reductions (P < 0.001) in all plaque measures, including sub-regions, versus the manual toothbrush after a single brushing and at weeks 1 and 8. Conclusions: The novel O-R electric toothbrush with micro-vibrations provided statistically significantly greater plaque and gingivitis reductions versus a manual toothbrush, with performance benefits demonstrated after a single brushing and continuing throughout the 8-week study.

Effectiveness of musical toothbrush on oral debris and gingival bleeding among 6-10-year-old children: A randomized controlled trial.

Motivation serves to be an integral part of health promotion to children at the learning phase of their life. Evaluation of the effectiveness of musical toothbrush over regular toothbrush in the debris and gingival bleeding scores among children. This was a single-blinded parallel, randomized controlled trial conducted among 6-10-year-old schoolchildren in Chennai. One hundred participants with allocation ratio of 1:1 were assigned to musical and regular toothbrush group by simple randomization. After baseline evaluation (T0) of Debris Index-Simplified (DI-S) and Gingival Bleeding Index (GBI), outcome variables were assessed for a period of 3 months (T1, T2, and T3). Friedman test and Mann-Whitney statistical test were used to compare the outcome variables within and across the two groups. Thirty-two boys and 68 girls (mean age: 8.53 years) participated in the study. Statistically significant difference was seen in DI-S score among musical toothbrush group (mean: 0.50 [T3] and GBI score: 8.18% [T3]) when compared to regular toothbrush group (mean: 1.59 [T3] and GBI score: 23.54 [T3]) at the end of the 3rd month. Although both the musical and regular toothbrushes effectively reduced the DI-S and GBI scores, former showed effective change among children when compared to the latter.

A Clinical Evaluation of Dantaraksha (An Ayurvedic Tooth Powder) in the Management of Chronic Periodontitis

Chronic periodontitis is the inflammation of the periodontal tissue caused due to the accumulation of dental plaque. If untreated it will lead to progressive attachment loss, bone loss & ultimately tooth loss. It can be correlated to Dantavestaka in Ayurveda. Acharya Sushruta says it manifests due to Dusta Shonita (Vitiated blood). It has symptoms like bleeding gums, pus discharge & mobility in teeth. Conventional periodontal therapy consists of mechanical debridement that is scaling & root planning. Ayurvedic medication Dantaraksha – Tooth powder has been used as an adjunct in the management of chronic periodontitis to avoid the side effects of chemicals. Objective: To evaluate the efficacy of Dantaraksha – Tooth powder, as an adjunct to scaling & root planning in Chronic Periodontitis patients. Material and methods: 40 patients selected for the study were equally divided in two groups: Group A – Only Scaling and Root planning, Group B – Scaling and root planning followed by application of Dantaraksha tooth powder to the gums & teeth, twice daily, and massaging the same on gums & teeth gently with finger. Plaque index, gingival bleeding index scores and probing pocket depth were evaluated at baseline & after one month of treatment. Results: The results show statistically significant difference between Groups A vs B. By looking at the mean value of Group A & Group B it was found that Group B gingival index, plaque index & probing pocket depth was significant over Group A. Conclusion: Dantaraksha powder is effective as an adjunct in the management of chronic periodontitis patients when compared to conventional scaling & root planning alone.

Evaluation of Irimedadi Taila as an adjunctive in treating plaque-induced gingivitis

Ayurvedic drugs have been used since ancient times to treat diseases including periodontal diseases. Oral rinses made from ayurvedic medicines are used in periodontal therapy to control bleeding and reduce inflammation. To evaluate the efficacy of herbal preparation (Irimedadi taila) on reduction of plaque induced gingivitis. A total of 100 volunteers with clinical signs of mild to moderate gingivitis were selected and assigned to Group A (only scaling done) and Group B (scaling along with the use of Irimedadi taila). After recording the clinical parameters, the patients were instructed to use 2–3 drops of Irimedadi taila and gently massage the gums twice daily in Group B and oral hygiene instructions were given to all patients. Plaque and gingivitis assessment were carried out using the plaque index (Silness and Loe, 1964), Gingival index (Loe and Silness, 1963), and modified sulcular bleeding index (Mombelli et al.) at baseline and at 21 days post treatment. Statistically analysis was carried out using the student's paired t test for intra group comparison and unpaired t test for inter group comparison. Results showed that Irimedadi taila is effective in reducing gingival index and gingival bleeding index scores in comparison to scaling alone and the values are statistically significant with p < 0.0001. Irimedadi taila is effective in treatment of plaque induced gingivitis and can be effectively used as an adjunct to mechanical therapy.

Outflow Facility in Tube Shunt Fenestration.

ABSTRACTAimDetermination of the effect of varying fenestration technique, and simulated patch graft on outflow facility for Baerveldt tube.Materials and methodsSilicone tubing similar to Baerveldt implant (AMO, Santa Ana, CA) with different fenestrations techniques was connected to a digital manometer in a closed system with a fluid-filled syringe on a stand to adjust pressure. The venting slits included: (A) 4 piercings with 7–0 TG140-8 needle; (B) a 2-mm slit with a 15° blade; (C) 4 piercings with a 15° blade; (D) 9–0 Nylon on CS140-6 needle with suture stenting the fenestration.ResultsFor pressures of 10, 20, 30, 40 mm Hg in groups A to D, the average outflow facility (mL/min/mm Hg) were group A: 0.11, 0.20, 0.28, 0.40; group B: 0.30, 0.69, 0.98, 0.93; group C: 0.73, 0.80, 0.81, 0.88; group D: 0.58, 0.65, 0.80, 0.87. For external compression with 10 gram weights at pressures of 10, 20, 30, 40 mm Hg, outflow were group A: 0.0, 0.18, 0.20, 0.53; group B: 0.75, 0.70, 0.97, 1.21. Group C: 0.18, 0.03, 0.57, 0.04. Group D: 0.73, 0.90, 1.13, 0.91.ConclusionEffectivity of venting slits in maintaining adequate IOP in the early postoperative period for non-valved glaucoma implant is variable, multifactorial and largely intraocular pressure (IOP) dependent.Clinical significanceThis study explores methods of producing fenestration and the effects on outflow at different pressures in an attempt to determine which fenestration technique has more reproducible results that can be made applicable in clinical practice. This is also the first study to evaluate the effect of external pressures similar to scleral patch graft on the tube fenestrations.How to cite this articleOlayanju J, Borras T, Qaqish B, Fleischman D. Outflow Facility in Tube Shunt Fenestration. J Curr Glaucoma Pract 2018;12(3):113-118.

Evaluation of clinical effificacy of Terminalia chebula inplaque-induced gingivitis: A randomized control trial

Introduction: Plaque control is fundamental to the prevention and management of periodontal diseases. However, most of the individuals do not practice plaque removal in an adequate manner. Hence, there is a need for an antiplaque agent that can be used on a daily basis without the side effects of antibacterial chemicals. The aim of the study is to evaluate the clinical efficacy of Terminalia chebula in patients with chronic gingivitis. Materials and Methods: Eighty patients, 18–40 years of age, diagnosed with chronic generalized gingivitis were selected and randomly divided into two groups. Group I underwent oral prophylaxis alone whereas Group II underwent oral prophylaxis and advised to do gingival massage by T. chebula powder. Clinical evaluation was done using plaque index (PI), gingival index (GI), and gingival bleeding index (GBI) at baseline and after 1 month. Results: Gingival massage with T. chebula powder showed a significant reduction in PI, GI, and GBI scores from baseline to 1 month. Conclusion: T. chebula powder is a useful herbal formulation for plaque control in patients with chronic gingivitis.

Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets.

The aim of this study was to evaluate the alterations on plaque index (PI), gingival index (GI), gingival bleeding index (GBI), and gingival crevicular fluid (GCF) volume after use of three different brackets types for 60 days. Setting Participants: The sample comprised 20 patients of both sexes aged 11-15 years (mean age: 13.3 years), with permanent dentition, adequate oral hygiene, and mild tooth crowding, overjet, and overbite. A conventional metallic bracket Gemini™, and two different brands of self-ligating brackets - In-Ovation®R and SmartClip™ - were bonded to the maxillary incisors and canines. PI, GI, GBI scores, and GCF volume were measured before and 30 and 60 days after bonding of the brackets. Data were analysed statistically using non-parametric tests coefficient at a 5% significance level. There was no statistically significant correlation (P > 0.05) between tooth crowding, overjet, and overbite and the PI, GI, GBI scores, and GCF volume before bonding, indicating no influence of malocclusion on the clinical parameters. Regardless of the bracket design, no statistically significant difference (P > 0.05) was found for GI, GBI scores. PI and GCF volume showed a significant difference among the brackets in different periods. In pairwise comparisons a significant difference was observed when compared before with 60 days after bonding, for the teeth bonded with SmartClip™ self-ligating bracket, (PI P = 0.009; GCF volume P = 0.001). There was an increase in PI score and GCF volume 60 days after bonding of SmartClip™ self-ligating brackets, indicating the influence of bracket design on these clinical parameters.

Comparative antiplaque and antigingivitis effectiveness of tea tree oil mouthwash and a cetylpyridinium chloride mouthwash: A randomized controlled crossover study.

Objective:The aim of this study was to compare the antiplaque and antigingivitis effects of a mouthwash containing tea tree oil (TTO) with a cetylpyridinium chloride (CPC) mouthwash.Materials and Methods:This was a randomized 4 × 4, controlled, cross-over, involving 20 healthy volunteers in a 5-day plaque re-growth model. Test mouthwashes were TTO (Tebodont®) and a mouthwash containing CPC 0.05% (Aquafresh®). A 0.12% chlorhexidine (CHX) mouthwash (Oro-Clense®) was used as positive and colored water (placebo [PLB]) as negative controls. Gingival bleeding index (GBI) and plaque index (PI) scores were recorded before and after each test period. Test periods were separated with 2 weeks washout period.Results:All four mouthwashes significantly (P < 0.001) reduced the GBI scores when compared to the baseline GBI scores. There was no significant difference between PLB and active mouthwashes in the GBI scores. CHX and CPC mouthwashes were found more effective in reducing the PI scores than TTO and PLB mouthwashes. There was no significant difference in PI scores of CHX and CPC mouthwashes.Conclusion:0.05% CPC mouthwash can be an alternative to CHX mouthwash since it is alcohol free and found as efficient as CHX in dental plaque reduction with lesser side effects. More studies are needed to test antigingivitis effects of the mouthwashes used in this study, preferably without initial scaling and polishing.

Changes in the oral environment after placement of lingual and labial orthodontic appliances

BackgroundThis study compared the oral hygiene and caries risk of patients treated with labial and lingual orthodontic appliances throughout a prospective evaluation of the status of the oral environment before and after bracket placement.MethodsA total of 20 orthodontic patients aged 19 to 23 years were included in the study and were divided into two groups: 10 patients wore Roth labial appliance (American Orthodontics, Sheboygan, WI, USA) and 10 patients wore STb lingual appliance (Ormco Corporation, Glendora, CA, USA). Plaque index (PI), gingival bleeding index (GBI), salivary flow rate, saliva buffer capacity, salivary pH, and Streptococcus mutans and Lactobacillus counts in saliva were determined at three time points: before orthodontic appliance placement (T0), 4 weeks after bonding (T1), and 8 weeks after bonding (T2). After appliance placement, all patients were periodically educated to the oral hygiene procedures. Wilcoxon rank and Mann-Whitney U tests were used to determine intragroup and intergroup differences as regards qualitative data. To compare quantitative data between the groups, chi-square and Fisher's exact tests were undertaken, while intragroup differences were tested with McNemar test. The level of statistical significance was set at p < 0.05.ResultsStatistical analysis of the data obtained revealed a statistically significant difference between the data of T0 and T1 and the data of T0 and T2 of the PI scores and between T0 and T2 of the GBI scores in the group treated with the lingual appliance. The GBI value increased significantly between T0 and T1 but decreased significantly between T1 and T2 (p < 0.01) in the group treated with labial appliance. S. mutans counts increased significantly between T0 and T2 in the saliva samples of patients treated with lingual appliance. No statistically significant differences were found between S. mutans and Lactobacillus counts at the three terms of saliva collection in patients treated with labial appliance. No statistically significant differences were found between the two groups at the three time points as regards the salivary flow rate and saliva buffer capacity.ConclusionsLingual and labial orthodontic appliances showed a different potential in modifying the investigated clinical parameters: patients wearing STb lingual orthodontic appliance had more plaque retention 4 and 8 weeks after bonding, while there were more gingival inflammation and more S. mutans counts 8 weeks after bonding. No differences were found between the two groups as regards the Lactobacillus counts, the salivary flow rate, and saliva buffer capacity.

Comparison of combined application treatment with one-visit varnish treatments in an orthodontic population

Objective: To evaluate the effect of chlorhexidine-thymol varnish alone, its combination with chlorhexidine-fluoride containing dentifrice and fluoride varnish on oral hygiene and caries prevention in orthodontic patients. Study design: Sixty patients, aged 12-18, with orthodontic fixed appliances were randomly assigned into three groups as follows: Group 1 (n=20): 1% chlorhexidine and 1% thymol varnish (Cervitec®Plus); Group 2 (n=20): Cervitec®Plus+ 0.2% chlorhexidine and 0.2% sodium fluoride (900 ppm fluoride) (Cervitec®Gel)); and Group 3 (n=20): 0.1% fluoride varnish (Fluor Protector®). Mutans streptococci (MS), lactobacilli (LB) levels, buffering capacity (BC), visible plaque index (VPI), and gingival bleeding index (GBI) scores were evaluated at four stages: T0, before orthodontic bonding; T1, one week after orthodontic bonding; T2, one week; and T3, four weeks after the first application, respectively. Inter and intra group comparisons were made by the Kruskal-Wallis, Mann-Whitney U, Friedman and Wilcoxon Signed-Rank tests with Bonferroni step-down correction (P<0.017). Results: Significantly lower MS and LB levels were found in Group 2 than Group 1 (T2) and 3 (T2, T3) (P<0.017). Groups 1-2 (T2) showed significantly higher BC (P<0.017) and lower VPI and GBI (P<0.017) scores compared with Group 3. Decreased MS levels at T2 (P<0.017) and T3 (P>0.017) were found in Group1-2 compared with T0. Significantly lower LB levels were recorded in Group 2 at T2 compared with T0 (P<0.017) while no significant differences were seen in Group 1 and 3 (P>0.017). Conclusions: Addition of Cervitec®Plus+Cervitec®Gel combination to the standard oral hygiene regimen may be beneficial for orthodontic patients for maintaining oral health by reducing bacterial colonisation and gingivitis. Key words:Chlorhexidine, flouride, mutans streptococci, lactobacilli, antibacterial effect, plaque, gingivitis, orthodontic treatment.

The oral health status of healthy and obese children in a Turkish population: a cross-sectional study

To compare the oral health status of a group of obese and healthy Turkish children. Materials and methods: The study involved 43 healthy (19 boys and 24 girls, mean age: 9.88) and 53 obese (18 boys and 35 girls, mean age: 10.4) children who were admitted to a pediatric dentistry clinic in 2008 and 2009. The parents were asked to complete a questionnaire concerning medical history and dietary/oral hygiene habits. The number of decayed, missing, and filled permanent teeth (DMFT); number of decayed, missing, and filled primary teeth (dmft); and gingival bleeding index (GBI) scores of patients were recorded. Statistical differences were evaluated using Student's t-test and the Mann-Whitney U test and the nominal variables were tested with Pearson's chi-square test and Fisher's exact test (P =< 0.05). Results: The educational status of parents did not differ significantly between obese and healthy children (P = 0.064). On a daily basis, obese children consumed significantly more snacks (P = 0.003). The carbohydrate intake of healthy children was restricted to mealtimes (P < 0.001) while obese children consumed significantly more carbohydrates as snacks (P < 0.001). In both groups, the participants displayed similar oral hygiene habits and DMFT and dmft scores although GBI scores were significantly higher in obese children. Conclusion: No relationship was found between obesity and the oral health status of the child population evaluated. Similar oral hygiene habits and socioeconomic status might have contributed to this result.