Gingival Bleeding Index Research Articles

Effects of Scaling and Root Planing on Salivary Interleukine-6 Levels in Chronic Periodontitis Patients and Glycemic Controls.

Type 2 diabetes mellitus (DM) and periodontitis have a bidirectional relationship that is well documented in many reviews and epidemiological studies. Periodontitis has been referred to as the sixth complication of diabetes mellitus. Various studies showed improvement inInterleukin-6 levels as well as metabolic parameters after non-surgical periodontal therapy in chronic periodontitis patients with type 2 DM. Objective: To evaluate the effect of scaling and root planing (SRP) on salivary levels of IL-6 and assessment of clinical parameters in CP patients with and without T2DM. We included 50 CP patients with well-controlled T2DM (Group I), and 50 CP patients without T2DM as controls (Group II) with evident clinical inflammation, ≥ 5mm probing depth (PD) and a relative attachment level (RAL) of ≥ 5mm. Following a brief medical and dental history plaque index (PI), gingival index (GI), gingival bleeding index (BI), PD, and RAL were recorded, and an unstimulated saliva was collected.Following SRP therapy, the clinical parameters and IL-6 levels were measured after seven days, 14 days, and 30 days. Intragroup and intergroup comparisons were carried out using a paired t-test and an independent t-test. The statistical significance was set atP< 0.05. Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) v. 22.0 (IBM Corp., Armonk, NY). Intergroup comparisons of IL-6 levels at different intervals showed a significantly higher reduction in Group II than in Group I (p=0.000). While the mean difference in the GI scores from baseline to 30 days was significantly higher in Group I patients (p=0.000), the difference in the mean PI (p=0.004), mean BI (p=0.000), mean PD (p=0.000) and mean RAL scores (p=0.000) were significantly higher in Group II patients. This study indicates that scaling and root planing is effective in glycemic control and also has a role to play in the level of salivary IL-6 in periodontal healthand T2DM with chronic periodontitis. Elevated salivary IL-6 levels indicate periodontal inflammation which is further increased in T2DM patients. Hence, elevated IL-6 can be considered a marker of periodontal destruction.

Antigingivitis and Antiplaque Effects of Oral Probiotic Containing the Streptococcus salivarius M18 Strain: A Randomized Clinical Trial.

We aimed to assess the effect of oral probiotic containing the Streptococcus salivarius M18 strain on gingival inflammation, bleeding on probing, and oral biofilm. Sixty-one consenting participants aged between 18 and 25 with gingivitis were recruited in this double-blind, parallel-group study and randomly divided into the probiotic group (n = 31) and the placebo group (n = 30). Fifty-seven participants completed the entire study protocol, 27 in the probiotic group and 30 in the placebo group. The outcomes were assessed after 4 weeks of intervention and 4 weeks of follow-up. There was a significant decrease in the Gingival Index, with the effect size of 0.58 [95%CI 0.05-1.10], and Turesky modification of the Quigley and Hein Plaque Index, with the effect size of 0.55 [95%CI: 0.02-1.07], in the probiotic group after the intervention. However, after a 4-week follow-up, the only significant treatment outcome was improved gingival condition according to the Gingival Index. The Gingival Bleeding Index also decreased significantly in the probiotic group after the intervention period; after the follow-up, this parameter did not differ significantly in both groups from the baseline values. In the placebo group, there were no significant improvements in the assessed parameters throughout this study. No serious side effects were registered. Within the limitations of this study, we conclude that the use of oral probiotic containing the Streptococcus salivarius M18 strain resulted in a significant improvement in gingival condition and oral hygiene level in young adults with gingivitis. Trial registration NCT05727436. Funding: none.

Sociodemographic disparities in oral health-related quality of life of schoolchildren in rural and urban areas.

To assess the association between residence place, socioeconomic conditions and oral health-related quality of life (OHRQoL) among schoolchildren from southern Brazil. Participants were 9-14-year-old schoolchildren from rural and urban municipal schools from Rosário do Sul, Brazil. The Child Perceptions Questionnaire (CPQ11-14) was used to assess OHRQoL. A structured questionnaire collected data on sociodemographic condition (family income), residence place (urban or rural), use of dental services, and behavioral variables. Clinical oral examination recorded the presence of missing teeth and the gingival bleeding index. Multilevel Poisson regression analysis with a hierarchical approach assessed the association between predictors and CPQ11-14 scores. Rate ratios (RR) and 95% confidence intervals (CI) were estimated. A total of 373 schoolchildren were included (rural area=122; urban area=251), with a mean CPQ11-14 score of 11.83, ranging from 0 to 42. Low-income schoolchildren living in rural areas had 15% higher CPQ11-14 scores than high-income schoolchildren living in urban areas. In urban areas, family income predicted OHRQoL, with low-income schoolchildren having 9% higher CPQ11-14 scores than high-income children. In rural areas, schoolchildren with low household income had 19% higher CPQ11-14 scores than high-income children. Schoolchildren from low-income families had a poorer OHRQoL irrespective of their area of residence (rural or urban). The association between family income and OHRQoL was more pronounced among children living in rural areas.

Effect of chlorhexidine mouthwashes on periodontal parameters and extrinsic tooth staining in orthodontic patients

Periodontal health and biofilm control are primordial to success in orthodontic treatment. This study aimed to evaluate the effect of chlorhexidine (CHX) mouthwashes on periodontal status and extrinsic tooth staining in orthodontic patients. Thirty-three patients of both sexes, aged 11-33 years, under orthodontic treatment with fixed appliances at<16 months, were randomly distributed into 2 groups. In the control group, patients received mechanical hygiene instruction, and in the experimental group, patients also used CHX wash twice a week for 60 days. The effectivity of the protocols was evaluated using the plaque, gingival, gingival bleeding, and discoloration indexes before the hygiene protocol was applied, 15, 30, and 60 days after protocol implementation. In the experimental group, there was a decrease in the plaque, gingival, and gingival bleeding indexes at the different evaluation periods (P<0.05). In addition, there was a significant difference in the discoloration index at 60 days compared with initial time points after implementing hygiene protocols in the experimental group (P<0.05). In contrast, there were no significant differences in plaque, gingival, gingival bleeding, and discoloration indexes in the control group at any time (P>0.05). CHX mouthwash administered 30 days, twice a week, significantly improved the periodontal status with mild brown staining. After this period, expressive extrinsic tooth staining was observed.

Associations of blood glucose, helper T cells and cytokine levels with degree of periodontal lesion in type 2 diabetes mellitus patients accompanied by chronic periodontitis.

To explore the associations of blood glucose with degree of periodontal lesions in patients with type 2 diabetes mellitus (T2DM) accompanied by chronic periodontitis (CP). Sixty-five eligible patients were included as a T2DM+CP group, another 65 patients with T2DM alone were included as a T2DM group, and another 65 patients with CP alone were included as a CP group. Their blood glucose, insulin, Th cells and cytokine levels and periodontal indices were compared. The correlations between each index and periodontal indices were analysed. The influencing factors for T2DM accompanied by CP were explored. The levels of fasting plasma glucose (FPG), glycated hemoglobin A1c (HbA1c), fasting insulin (FINS) and homeostasis model assessment-insulin resistance (HOMA-IR) of T2DM+CP, T2DM and CP groups followed a descending order (P<0.05). FPG, HbA1c, FINS, CD4+ Th1 cell, CD4+ Th17 cell, interferon-gamma (IFN-γ) and interleukin-17 (IL-17) all had positive correlations with gingival index, bleeding index, probing depth and attachment loss in T2DM patients accompanied by CP (P<0.05). Periodontal lesions were more severe in T2DM patients accompanied by CP, and the severity was positively correlated with the levels of FPG, HbA1c, Th1, Th17, IFN-γ and IL-17. High levels of FPG, HbA1c, IFN-γ and IL-17 are independent risk factors for T2DM accompanied by CP.

Comparison of Vitamin-D binding protein levels in gingival crevicular fluid of pre- and postmenopausal women with and without chronic periodontitis: A clinico-biochemical study

ABSTRACT Background: Periodontitis is a multifactorial chronic inflammatory condition that affects the supporting tissues of the teeth, and menopause can contribute to its progression. Vitamin-D Binding Protein (DBP) is a multifunctional protein that acts as an acute phase reactant and plays a key role in bone metabolism. Aim: The aim of this study was to assess and compare DBP levels in Gingival Crevicular Fluid (GCF) of pre- and postmenopausal women with and without chronic periodontitis. Materials and Methods: Fifty-two female participants aged 35–60 were selected from outpatients’ clinics and divided into premenopausal and postmenopausal groups. Plaque index, gingival bleeding index, probing pocket depth, and clinical attachment level were measured. GCF DBP levels were evaluated using an enzyme-linked immunosorbent assay kit. Results: There was a significant correlation between menopausal status and periodontal status in relation to GCF DBP levels (P = 0.000). However, regardless of the menopausal status, participants with periodontitis exhibited a five-fold increase in mean GCF DBP levels compared to those without periodontitis. There was a significant positive correlation existed between the periodontal parameters and GCF DBP levels. Conclusion: Based on the findings, we conclude that GCF DBP is influenced more by participants’ periodontal health than by their menopausal status, and it correlates favorably with the degree of periodontal destruction.

Comparative Evaluation of Recession Coverage Obtained Using the Pinhole Surgical Technique With and Without Platelet-Rich Fibrin: A Randomized Clinical Trial.

This randomized controlled clinical trial evaluated the pinhole surgical technique (PST) combined with platelet-rich fibrin (PRF) for the management of multiple recession defects compared to PST alone. Ten patients with 51 Miller Class I/ II or III gingival recessions were selected. Control sites were treated with PST alone, whereas test sites were treated with PST with PRF. Gingival recession depth (GRD), gingival recession width (GRW), probing depth (PD), clinical attachment level (CAL), keratinized tissue width (KTW), total soft tissue gain (TSTG), Plaque Index (PI), Gingival Index (GI), and gingival bleeding index (GBI) were measured at baseline and at 1, 3, and 6 months posttreatment. Both groups showed statistically significant root coverage. The mean recession coverage was 60.25% in the test group and 49.6% in the control group. The recession reduction from baseline was 2.50 mm for the test group and 1.88 mm for the control group. At the end of 6 months, all sites achieved adequate root coverage. PRF is a feasible alternative to connective tissue grafts as an adjunct to PST for the treatment of multiple recession defects.

Assessment of Outcome of Oral Supplementation of Vitamin D3 as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients with Type II Diabetes Mellitus - A Randomized Controlled Clinical Trial.

Both diabetes and periodontitis affect millions of people worldwide and Vitamin D insufficiency may create a conducive environment for the progression of diabetes and periodontal disease. The aim of the study was to assess the outcome of oral supplementation of Vitamin D3 in patients with Type 2Diabetes Mellitus with generalized chronic periodontitis, as an adjuvant toscaling and root planing. A total of 92 patients, including 46 each in non-diabetic and diabetec group. Clinical parameters including Plaque Index (PI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), levels of Vitamin D in serum, and Fasting Blood sugar were assessed at the baseline. SRP was finished for each participant in the trial. Following SRP, the first 25people in each group got 60,000 IU of oral vitamin D3 granules once a week for eight weeks, while the remaining 21 subjects from each group did not. At the conclusion of the 8th week following interventions, all the indicators were reviewed. Following SRP and Vitamin D supplementation there was a measurably critical reduction in every one of the periodontal clinical indicators in both groups. In both groups, there was a statistically significant rise in serum vitamin D levels. In addition to SRP, vitamin D supplementation shows promise as a host immunomodulatory drug in the management of periodontitis, particularly in patients with diabetes mellitus.

Comparative Analysis of Various Forms of Local Drug Delivery Systems on a Class 2 Furcation - A Systematic Review.

Class II mandibular furcation defect is a periodontal condition characterized by a cul-de-sac lesion, a definite parallel constituent with only a portion of alveolar bone remaining intact. There may be involvement of vertical bone loss. Local drug deliveries such as Boric acid, alendronate gel, and other drugs exhibited anti-inflammatory, antibacterial & osteoblastic differentiation activity. The present systematic review compares the drugs based on their outcomes and pharmacological action. To analzse & compare various forms of local drug delivery systems on a class II furcation. A search was conducted using PubMed, Google scholar, science direct, and Pub Med central using MeSH terms - local drug delivery in periodontics, boric acid in the management of class II mandibular furcation, simvastatin in the treatment of furcation. A total of 560 articles were screened; 58 out of 560 were full-text articles accessed for eligibility, and five articles were included in the systematic review. PRISMA guidelines were used for reporting this review. In addition, five randomized controlled trials were enclosed and used in this systematic review. The various local drugs used in treating class II mandibular furcation defects are effective in the prevention of bleeding on probing, bone resorption, gingival bleeding index and increase in the bone fill, and microbial deposit removal. The managing of class II mandibular furcation defect with the drugs mentioned in this review can be effective by reducing several clinical parameters such as bleeding on probing, gingival indices, osteoblastic differentiation, bone fill, etc., Considering the results of the studies, it can be concluded that it can be used as a therapeutic therapy against class II furcation defects with positive outcomes.

Systemic and Oral Health Parameters in Eutrophic and Overweight/Obese Adolescents: A Cross-Sectional Study.

To date, studies focusing on oral health in obese adolescents have provided controversial data. The aim of this cross-sectional study was to investigate systemic and oral health parameters in eutrophic and overweight/obese adolescents. In total, 100 adolescents, mean aged 13.33 ± 2.04 years, were divided into two groups: 59 overweight/obese adolescents in the study group (SG) and 41 eutrophic-weight adolescents in the control group (CG). Chi-squared and Fisher exact tests were performed to compare dichotomous and categorical variables between the two groups. The subjects in the SG (mean aged 13.21 ± 2.21) reported a body mass index (BMI) of 29.05 ± 4.09 kg/m2, corresponding to over 95° percentile for both genders, and the subjects in the CG (mean aged 13.49 ± 1.77) reported a BMI of 18.26 ± 4.81 kg/m2, corresponding to 25° percentile for both genders. In the SG, the serum level of 25-hydroxy-vitamin D was significantly lower (p-value < 0.001), whereas fasting blood glucose (p = 0.006), waist circumference, and hip circumference were significantly higher (p-value < 0.001). Plaque Index (PI), Plaque Control Record (PCR), Oral Hygiene Index (OHI), Gingival Index (GI), and Gingival bleeding index (GBI) depicted a significantly worse level of oral health in the SG. Moreover, the number of subjects with caries was significantly higher in the SG. Nutritional and physical activity status according to the Mediterranean Diet Quality Index for children and teenagers (KIDMED test) and the International Physical Activity Questionnaire (IPAQ-Adolescent) were reported to be significanlty better in the CG. In light of our results, obesity and poor oral health coexist in a cohort of adolescents. A screening of oral health status should be considered in obese subjects to focus resources on therapeutic interventions aiming at improving oral health.

Periodontal Status of Tuberculosis patients - Inter linked with each other

Background: Evidence suggests periodontitis may contribute to the development and progression of respiratory illnesses. However, few studies currently look at the coexistence of periodontitis and tuberculosis. The current study investigates the relationship between periodontal health and tuberculosis. Aim: To assess various clinical dental parameters of periodontal health among patients with and without TB. Methods: The participants in the present case-control study were individuals who obtained informed permission forms to participate when they were patients in the outpatient dentistry department. The current study included 585 patients in total. Three hundred-one individuals with normal pulmonary function were added to the control group, whereas 284 patients with tuberculosis were added to the cases group. The diagnosis of the pulmonary conditions was confirmed using spirometry. Using SPSS software 21, we evaluated the demographics &amp; clinical indicators such as plaque, different gingival parameters of periodontitis, Gingival bleeding, and gingival index (GI), and compared cases and controls. Results: The population comprised two hundred eighty-seven women (49.1%) and 298 men (50.9%). There was a significant association between tuberculosis and periodontitis, and it has been observed that 159 (56%) tuberculosis patients had 6.23 (4.2 – 9.1) times higher effects on oral periodontitis issues (P&lt;0.001*). Patients with gingivitis had a significantly higher number of bleeding, accounting for 241 (72.8), p&lt;0.001. Practical implication: The study suggests that healthcare providers, particularly those involved in the treatment of TB, should consider incorporating oral health screening and assessment as part of the overall care for TB patients. This could help identify and address periodontal issues that may exist, hence dental professionals can play a role in the early detections of TB Conclusion: This study suggest that important relationship between TB and periodontitis. TB patients should be educated about the potential impact of their disease on periodontal health and encouraged to maintain regular dental visit and oral hygiene. Keywords: Tuberculosis (TB), Periodontitis (PD), Gingival bleeding, and gingival index (GI)

Human Neutrophil Peptide 1- 3 and Vitamin D levels in periodontitis

Human neutrophil peptides 1-3 (HNP1-3) contribute to oral health by playing a role in innate response against oral diseases, owing to their antimicrobial, antiplaque and immunomodulatory activity. Vitamin D may reduce the risk of infection through multiple mechanisms and boosts innate immunity by modulating the production of antimicrobial peptides and cytokine response. This study was performed to evaluate the level of human HNP1-3 in periodontitis patients and controls and to study the effect of vitamin D on the levels of peptides in periodontitis. Eighty-five subjects were enrolled in this observational case-control study aged 20-59 years. The subjects were divided into fifty patients with periodontitis and 35 healthy controls. Periodontal parameters used in this study were plaque index, gingival index bleeding on probing, probing pocket depth and clinical attachment loss. Blood samples were collected from all subjects, and then ELISA was done to estimate the levels of HNP1-3 and vitamin D in patients and controls. The finding revealed a significant increase (P˂0.01) in the mean level of HNP1-3 among the patient's group compared to the control group. Moreover, there is no significant correlation with all parameters except the gingival index, which has a considerable result (r=0.367, p=0.009). On the other hand, this study showed a significant decrease (P&lt;0.01) in the mean level of vitamin D in patients compared to controls, and also that there was no significant decrease in the serum level of HNP1-3 among vitamin D insufficient group in comparison to vitamin D sufficient group. These results indicated that the increased levels of HNP1-3 and its correlation with GI provide evidence for the critical role of neutrophils in the inflammatory process in periodontitis and vitamin D, which plays a role in antimicrobial peptide production. Keywords: periodontitis, antimicrobial peptides, human neutrophils peptides

Periodontitis in individuals with few remaining teeth and a high gingival bleeding index increases the probability of dyslipidemia.

Dyslipidemia, a silent multifactorial condition, is characterized by changes in blood lipid levels, affecting all socioeconomic strata, increasing the risk for atherosclerotic diseases. This study investigated whether there is an association between dyslipidemia and the combined exposure of periodontitis plus the number of remaining teeth, gingival bleeding, or caries. A two-center cross-sectional study was conducted involving 1270 individuals, with a minimum age of 18years. Socioeconomic and demographic data, health conditions, lifestyle parameters, and anthropometric, biochemical, and oral clinical examinations were performed. The exposures considered were the presence of periodontitis, dental caries, number of remaining teeth, and gingival bleeding. The outcome was dyslipidemia as defined by the Brazilian Guidelines on Dyslipidemia and Prevention of Atherosclerosis. The combined associations between periodontitis plus other oral health conditions and dyslipidemia were estimated using confounder-adjusted prevalence ratios (PRsingle , PRmultiple , for single and multiple covariable adjustments) with 95% confidence intervals (95% CIs), in a Poisson regression model with robust variance. The occurrence of dyslipidemia was 70.1% and periodontitis was 84.1%. A positive association between periodontitis and dyslipidemia existed: PRsingle =1.13; 95% CI: 1.01-1.26. Combined exposure of periodontitis plus <11 remaining teeth (PRmultiple =1.23; 95% CI: 1.05-1.43), as well as combined exposure of periodontitis plus ≥10% gingival bleeding and <11 remaining teeth (PRmultiple =1.22; 95% CI: 1.03-1.44), represented greater probabilities of 23% and 22% of individuals having a diagnosis of dyslipidemia. Periodontitis combined with fewer than 11 teeth doubled the likelihood of being diagnosed with dyslipidemia.

Oral hygiene status: The critical parameter in orthodontic patient

Aim: The aim of this study was to evaluate the oral hygiene status of patients with fixed mechanotherapy appliances. Methods and materials: The following indices were used to evaluate the oral hygiene status of patients in orthodontic treatment: Gingival Bleeding Index (GBI), Plaque index (PI) and OrthoPlaque Index (OPI) at three intervals.T0 (day 1), T1 (15 days), T2 (30 days) for a period of one month. Results: 10 patients (15-30 years old) were selected for the study from among the orthodontic patients treated at the Department of Orthodontics &amp; Dentofacial Orthopedics, AIDSR, Adesh University. Results showed that the mean PI decreased significantly from T0 to T1 &amp; then from T1 to T2, GI decreased significantly from T0 to T1, but then, no significant difference could be found in GI from T1 to T2, OPI decreased significantly from T0 to T1, but then, no significant difference could be found in OPI from T1 to T2. No significant difference was observed between male and female patients for the PI, GI and OPI. Conclusion: Inadequate oral home care among orthodontic patients may increase their risk of gingivitis during treatment. As a result, oral hygiene instructions and a hygiene maintenance program must not be overlooked during orthodontic treatment.

Assessment of sclerostin levels in the gingival crevicular fluid of patients with periodontitis: A clinico-biochemical crosssectional study.

Sclerostin, a glycoprotein, plays a key role in regulating bone mass. In this study, sclerostin levels in the gingival crevicular fluid (GCF) were assessed in patients with Stage III Grade C generalized periodontitis (SIII-GC) and Stage III Grade B generalized periodontitis (SIII-GB). This cross-sectional study included 30 participants divided equally into three groups: group I (gingival health), group II (SIII-GC), and group III (SIII-GB). Clinical periodontal parameters like plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PD), and clinical attachment level (CAL) were recorded. A sandwich ELISA was used to determine the sclerostin levels in GCF samples. One-way ANOVA and post hoc Tukey tests were used to analyze the clinical parameters and GCF sclerostin levels. The association between GCF sclerostin levels and periodontal parameters was assessed using Pearson's correlation coefficient (r). Patients in groups II and III had much higher sclerostin levels in their GCF than in group I (P≤0.05). In contrast, no significant difference in sclerostin levels was observed between the two diseased conditions (P=0.841). Concerning periodontal parameters, a statistically significant difference was observed between the three groups. There was a positive correlation between the periodontal clinical parameters and the expression levels of sclerostin in GCF (P≤0.05). Increased expression of sclerostin in GCF in patients with periodontitis indicated that it could be considered a reliable biomarker of periodontal disease activity.

Do Maternal Beliefs, Knowledge and Practices for Own and Young Child Oral Care Reflect on Actual Child Oral Health?

The aim of the present study was to evaluate whether mother's oral health habits and knowledge for child oral care actually reflect on her young child's oral health and hence sought for direct evidence for this association. One hundred mothers accompanied their children, aged 2-5 years to a University Pediatric Dentistry Clinic and completed a three-arm questionnaire. Child dental caries (decayed, missing, filled surfaces-dmfs) and gingival bleeding index (GBI) were recorded. Correlations were sought by the analysis of variance (ANOVA). A negative correlation was observed between maternal education and family income with child dmfs (p < 0.01). Additionally, other maternal factors such as age and correct knowledge of the appropriate age for a child's first dental visit, the initiation of toothbrushing, and fluoride exposure were positively associated with lower dmfs and GBI. Additionally, some maternal practices also contributed to these results. Maternal practices and knowledge are predictors of child oral health. Mothers-to-be, especially those with low socioeconomic characteristics, should be involved in dental education and motivation interventions in order to practice proper oral hygiene for their children.

Effects of water flossing on gingival inflammation and supragingival plaque microbiota: a 12-week randomized controlled trial

ObjectivesThe effects of water flossing on dental plaque removal have been suggested, but its ecological impact on dental plaque microbiota needs further investigation. In addition, whether this plaque control measure by water flossing promotes the control of halitosis still needs clinical validation. The aim of this study was to evaluate the effects of water flossing on gingival inflammation and supragingival plaque microbiota.Materials and methodsSeventy participants with gingivitis were randomly assigned to control (toothbrushing) and experimental (toothbrushing + water flossing) groups (n = 35). Participants were recalled at 4, 8, and 12 weeks, and their gingival index, sulcus bleeding index, bleeding on probing, dental plaque index, and oral malodor values were measured. The microbiota of supragingival plaque was further investigated using 16S rRNA sequencing and qPCR.ResultsSixty-three participants completed all revisits (control: n = 33; experimental: n = 30). The experimental and control groups exhibited similar clinical characteristics and dental plaque microbiota at baseline. Adjunctive water flossing effectively reduced the gingival index and sulcus bleeding index as compared to the toothbrushing control group. The water-flossing group showed reduced oral malodor at week 12 as compared to the baseline. Consistently, the water-flossing group exhibited altered dental plaque microbiota at week 12, characterized by a depletion of Prevotella at genus level and Prevotella intermedia at species level as compared to the toothbrushing control. In addition, the plaque microbiota of water-flossing group exhibited a more aerobic phenotype, while the control group was more anaerobic.ConclusionsDaily water flossing can effectively alleviate gingival inflammation and reduce oral malodor, possibly by depleting oral anaerobes and altering the oral microbiota to a more aerobic phenotype.Clinical relevanceWater flossing adjunctive to toothbrushing effectively alleviated gingival inflammation, representing a promising oral hygiene practice to promote oral health.Clinical trial registrationThe trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/showprojen.aspx?proj=61797, #ChiCTR2000038508) on September 23, 2020.

The clinical effect of sodium hypochlorite oral rinse on peri-implantitis lesion: A pilot study

Peri-implantitis poses an imminent challenge to the field of implant dentistry. Considering the promising findings of sodium hypochlorite and periodontal lesions, the aim of the present study was to evaluate the clinical effects of sodium hypochlorite oral rinse on peri-implantitis lesions. Twelve peri-implantitis patients were instructed to rinse with 15 mL of a fresh solution of 0.25% sodium hypochlorite for 30 s twice a week for 3 months. At baseline and 3-month visits, probing depth and modified sulcular bleeding index were recorded at 6 points per lesion (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual). Individual and total bacterial loads of 18 pre-designated species of microorganisms were analyzed by real-time PCR methods. Probing depth decreased after the experiment, with an average difference of 1.1 mm and a standard deviation of 1.7 mm. The modified sulcular bleeding index decreased by a mean value of 0.8 with a standard deviation of 1.1. This study demonstrated the clinical effects of sodium hypochlorite oral rinse on peri-implantitis lesions and the reduction of periodontal probing depth and gingival bleeding index. This study suggested that the concentration of 0.25% be used for treatment of peri-implantitis.

S-1-propenyl-L-cysteine suppresses lipopolysaccharide-induced expression of matrix metalloproteinase-1 through inhibition of tumor necrosis factor-α converting enzyme-epidermal growth factor receptor axis in human gingival fibroblasts.

Periodontal disease is the most common dental health problem characterized by the destruction of connective tissue and the resorption of alveolar bone resulting from a chronic infection associated with pathogenic bacteria in the gingiva. Aged garlic extract has been reported to improve gingival bleeding index and probing pocket depth score in patients with mild to moderate periodontitis. Although our previous study found that aged garlic extract and its constituents suppressed the tumor necrosis factor-α-induced inflammatory responses in a human gingival epithelial cell line, the mechanism underlying the effect of aged garlic extract on the destruction of the gingiva remains unclear. The present study investigated the effect of S-1-propenyl-L-cysteine, one of the major sulfur bioactive compounds in aged garlic extract, on the lipopolysaccharide-induced expression of matrix metalloproteinases in human gingival fibroblasts HGF-1 cells. Matrix metalloproteinases are well known to be closely related to the destruction of the gingiva. We found that S-1-propenyl-L-cysteine suppressed the lipopolysaccharide-induced expression and secretion of matrix metalloproteinase-1 in HGF-1 cells. In addition, S-1-propenyl-L-cysteine inhibited the lipopolysaccharide-induced phosphorylation of epidermal growth factor receptor and expression of the active form of tumor necrosis factor-α converting enzyme. Furthermore, the inhibitors of epidermal growth factor receptor tyrosine kinase and tumor necrosis factor-α converting enzyme, AG-1478 and TAPI-1, respectively, reduced the lipopolysaccharide-induced protein level of matrix metalloproteinase-1, as did S-1-propenyl-L-cysteine. Taken together, these results suggested that S-1-propenyl-L-cysteine suppresses the lipopolysaccharide-induced expression of matrix metalloproteinase-1 through the blockade of the tumor necrosis factor-α converting enzyme-epidermal growth factor receptor axis in gingival fibroblasts.

Long-term stability of infrabony defects treated with enamel matrix derivative alone: A retrospective two-centre cohort study.

To assess the long-term stability of attachment gain in infrabony defects (IBDs) 10 years after regenerative treatment with an enamel matrix derivative (EMD) alone. Two centres (Frankfurt [F] and Heidelberg [HD]) invited patients for re-examination 120 ± 12 months after regenerative therapy. Re-examination included clinical examination (periodontal probing depths (PPD), vertical clinical attachment level (CAL), plaque index (PlI), gingival index (GI), plaque control record, gingival bleeding index and periodontal risk assessment) and review of patient charts (number of supportive periodontal care [SPC] visits). Both centres included 52 patients (29 female; median baseline age: 52.0 years; lower/upper quartile: 45.0/58.8 years; eight smokers), each contributing one IBD. Nine teeth were lost. For the remaining 43 teeth, regenerative therapy showed significant CAL gain after 1 year (3.0; 2.0/4.4 mm; p < .001) and 10 years (3.0; 1.5/4.1 mm; p < .001) during which CAL remained stable (-0.5; -1.0/1.0 mm; p = 1.000) after an average SPC of 9 years. Mixed-model regression analyses revealed a positive association of CAL gain from 1 to 10 years with CAL 12 months post operation (logistic: p = .01) as well as a higher probability for CAL loss with an increasing vertical extent of a three-walled defect component (linear: p = .008). Cox proportional hazard analysis showed a positive association between PlI after 12 months and tooth loss (p = .046). Regenerative therapy of IBDs showed stable results over 9 years. CAL gain is associated with CAL after 12 months and decreasing initial defect depth in a three-walled defect morphology. Tooth loss is associated with PlI 12 months post operation. DRKS00021148 (URL: https://drks.de).