Gingival Index Scores Research Articles

Assessment of Interleukin-6 Levels and Lactobacillus casei Counts in Pediatric Stainless Steel and Zirconia Crowns: A Comparative Study.

Pediatric dental crowns play an integral role as they maintain the form and function and prolong the life of the affected tooth. However, placing a crown in the oral cavity creates a new niche for the adhesion of microorganisms that can lead to plaque accumulation, gingival inflammation, and the development of secondary caries, which in the long term might determine the clinical success of the restored tooth. The present study allowed us to assess the changes caused by the full coverage restorations at a clinical, immunological, and microbiological level using enzyme-linked immunosorbent assay (ELISA) and microbial analysis. The in vivo analysis consisted of a total of 26 children aged 3-10 years. They were divided into two groups, group I (n = 13) children receiving preformed zirconia crowns and group II receiving stainless steel crowns (SSCs). Plaque index (PI) scores, gingival index (GI) scores, and interleukin-6 (IL-6) levels were assessed at baseline and at 45 days of follow-up. The in vitro part of the study consisted of 13 preformed zirconia crowns and 13 SSCs which were immersed in artificial saliva containing strains of Lactobacillus casei which were then processed for their microbial analysis. On mean comparison, preformed zirconia crowns performed superiorly both clinically and immunologically compared to SSCs. Microbial analysis using independent t-test revealed that the colony-forming units (CFU) per milliliter was statistically significantly higher for the SSCs, and the mean difference among the groups was statistically significant (p < 0.01). Preformed zirconia crowns can be a relative replacement for SSCs in primary teeth with the advantage of esthetics and superior periodontal health. Saharia NP, Malik M, Jhingan P, et al. Assessment of Interleukin-6 Levels and Lactobacillus casei Counts in Pediatric Stainless Steel and Zirconia Crowns: A Comparative Study. Int J Clin Pediatr Dent 2024;17(4):395-403.

Comparative Evaluation of Salivary Glutathione Peroxidase levels in Subjects with Generalized Stage III Periodontitis before and after Periodontal Therapy – A Biochemical Study

Introduction To assess the levels of glutathione peroxidase in the saliva of subjects with generalized stage III periodontitis before and after periodontal treatment. Material and Methods This study, compares salivary glutathione peroxidase levels in generalized stage III periodontitis subjects before and after therapy. A total of 20 participants were selected. The clinical and biochemical evaluation was done at specific time intervals as described. The data was collected and analyzed. Levels of dental plaque and gingival index were recorded at baseline and 2 months post periodontal therapy. Salivary glutathione peroxide levels were assessed by ELISA kit at baseline and 2 months post periodontal therapy. Results At baseline, the mean plaque index scores were found to be 2.5585 ± 0.06685 (SD). After 2 months, the values were found to have reduced to 0.9080 ± 0.04224. At baseline, the mean gingival index scores were found to be 2.5475 ± 0.3380 (SD). After 2 months, the values were found to have reduced to 0.8700 ± 0.1676. At baseline, the mean glutathione peroxidase levels were found to be 5.1595 ± 0.3713 (SD). After 2 months, the values were found to have reduced by 4.4040 ± 1.1142 (SD). Conclusions Glutathione peroxidase level was elevated in disease conditions and is associated with the free radical formation in tissue inflammation. Following periodontal therapy, glutathione peroxidase levels are lowered significantly, indicating reduced tissue inflammation. Key-words: Antioxidants, Biomarkers, ELISA, Glutathione Peroxidase, Saliva

Combined Efficacy of Advanced Oral Hygiene Aids and Active Reminders in Maintaining the Oral Hygiene of Patients with Fixed Orthodontic Appliances: A Randomized Clinical Trial

Objectives To evaluate the efficacy of water irrigating devices, powered toothbrushes, and active repeated oral hygiene reminders on oral hygiene of fixed orthodontic patients. Materials and Methods This was a randomized, examiner-blind clinical trial involving fixed orthodontic appliance patients. Patients were recruited within six months of bonding on both the arches. Eighty patients were randomly assigned to four groups; groups 1 and 3 subjects received standard oral hygiene procedures and used manual orthodontic toothbrushes, and subjects in groups 2 and 4 used powered toothbrushes and water irrigators for oral hygiene maintenance during the study period. In addition, repeated oral hygiene reminders via SMS were sent to subjects in groups 1 and 2, whereas groups 3 and 4 subjects received only oral motivation. The principal investigator assessed the plaque index (PI) and gingival index (GI) at baseline (T0) and after 2, 4, 8, and 12 weeks, that is, T1, T2, T3, and T4, respectively. Results Group 2 and group 4 subjects showed statistically significant reduction in PI ( p &lt; .001) and GI ( p &lt; .001) scores at the end of study interval; however, the magnitude of decrease was less in group 4 in comparison to group 2. Intergroup comparisons between group 1 versus group 3 and group 2 versus group 4 were made to evaluate the efficacy of reminders. Statistically significant reduction was observed in group 2 as compared to group 4 at T4 ( p &lt; .001) when compared to T1 ( p &lt; .87). Conclusion Using powered toothbrushes and oral irrigators resulted in a statistically more significant reduction in plaque and gingivitis scores than conventional procedures. Active reminders had a catalytic effect in improving the oral hygiene.

Clinical effects of Lactobacillus reuteri probiotic in chronic periodontitis - a systematic review.

This systematic review examines the effectiveness of Lactobacillus reuteri as an adjunct to scaling and root planing in the treatment of chronic periodontitis. Scopus, PubMed, and Web of Science databases were searched according to specific inclusion and exclusion criteria in October 2022. Randomized control trials that evaluated the effects of Lactobacillus reuteri in patients with periodontitis were included. The primary outcome was pocket depth and clinical attachment levels, while the secondary outcome considered was bleeding on probing, microbial levels, and gingival index score. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. A total of eleven studies that examined 369 subjects were included in the review. Adults in the age group of 18-70 years of age suffering from chronic periodontitis were evaluated. Eight out of the eleven studies reported statistically significant improvement in the intergroup pocket depths, whereas seven studies showed a statistically significant reduction in the clinical attachment levels in the probiotic group. Three studies showed no significant improvement in the pocket depth levels in the probiotic group as compared to the controls. Four studies showed no significant reduction in clinical attachment levels between the two groups. The overall risk of bias was high in four studies, while seven studies reported some concerns about the risk of bias. Based on the limited evidence available, the adjunctive use of Lactobacillus reuteri to scaling and root planing may provide some additional benefit in improving periodontal parameters.

Efficacy of 38% silver diamine fluoride in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes: A randomized controlled pilot trial

ObjectivesEmerging from earlier case reports the potential benefits of 38 % silver diamine fluoride (SDF) in addressing pathogenic biofilms and mitigating gingival inflammation and enlargement have sparked interest. Our study aimed to evaluate the efficacy of 38 % SDF in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes. MethodsThis 7-week randomized, controlled, double-blinded pilot trial employed a parallel assignment design. The study enrolled older adults (aged ≥65) residing in retirement homes in Dallas County, ultimately comprising a cohort of 40 participants who were evenly divided into two arms. The experimental group received SDF treatment, whereas the comparator group received a placebo. Over three consecutive weeks, both groups had solutions applied to the facial surfaces of all their teeth once per week. The primary outcomes measured the change in Löe-Silness Gingival Index (GI) and Silness-Löe Plaque Index (PI) at 7 weeks following baseline treatment. Repeated measures ANOVA was utilized to assess changes over time within each group (n = 15 each). Post-hoc paired t-tests were conducted to compare changes between week 1 and each subsequent follow-up time point (weeks 3, 5, 7), supplemented with 95 % confidence intervals for change from week 1. ResultsIn the SDF group, within-group comparisons demonstrated significant reductions (adjusted p < .05) in GI scores within 3 weeks (-.93±.37), as opposed to week 1 (1.90±.39). Between-group comparisons unveiled reductions in both mean GI (p < .05) and PI (p < .05), indicating less gingival inflammation and plaque accumulation in the SDF group at all time points, commencing at week 3. ConclusionsThis study showed that 38 % SDF was effective in reducing gingival inflammation and plaque accumulation in older adults living in retirement-homes. Clinical significanceOral health in older adults is a public health concern, especially for the medically compromised or those without traditional care. Our findings offer hope for enhancing oral health quality of life by introducing a cost-effective, compliance-free, noninvasive, and accessible therapeutic. Trial registrationNCT03445286.(clinicaltrials.gov)

Clinical Evaluation of Diode Laser as an Adjunct to Scaling and Root Planing in Patients With Chronic Periodontitis and Type II Diabetes Mellitus: A Split-Mouth Study.

The primary goal of periodontal therapy is to arrest the inflammatory disease process which is done by non-surgical and surgical therapies in order to reduce the microorganisms.The outcome of periodontal therapy may not reveal the desired results owing to inaccessible areas for instrumentation, pathogenicity, resistance of the microorganisms, or even due to compromised host response to the treatment. Thus, adjunctive laser therapy has been proposed as a novel treatment modality in the treatment of periodontal disease. Aim: The aim of this study was to clinically evaluate the effect of a 980 nm diode laser (DEN10B; Wuhan Gigaa Optronics Technology Co., Ltd., Wuhan, China) therapy as an adjunct to scaling and root planing in patients with chronic periodontitis and type II diabetes. Twenty patients were divided into two groups in a split-mouth study design. Group I (Control) comprised mechanical debridement alone and Group II (test) comprised mechanical debridement followed by adjunctive laser therapy. The clinical parameters were recorded at baseline, six weeks, and three months, and the results were analyzed. There was a significant improvement in gingival and plaque index in the test group. Though there was no significant improvement in probing pocket depth and clinical attachment, the results in the test group were superior relative to the control group. Non-surgical periodontal therapy with adjunctive use of diode laser is effective in the management of generalized chronic periodontitis in patients with type II diabetes which led to a significant reduction in plaque score, gingival index score, probing pocket depth, and gain in clinical attachment level.

Effectiveness of oral health education on oral hygiene status among adult male inmates in central jail, Kolkata – an interventional study

PurposeOral health is an integral part of general health. Different population groups have been assessed for oral health status in India, but still, many have been neglected; one such group is the prisoners. The prison population is a unique and challenging one with many health problems, including poor oral health, which may be due to lack of knowledge about good oral health practices. This study aims to assess effectiveness of oral health education on oral health knowledge, attitude and practices and oral hygiene status among the male prison inmates of central jail in Kolkata, India.Design/methodology/approachAn interventional study was done among 240 male convicts. The data was elicited using a structured proforma; oral health status was assessed by recording OHI-S index, and the severity of gingivitis was assessed by recording the gingival index. Oral health education was delivered by using audio-visual aid. Oral health knowledge, attitude, practices and oral hygiene and gingival status were reassessed among the inmates before and after dental education at the end of three and six months.FindingsA significant change in oral health knowledge, attitude and practices was seen, which in turn resulted in an appreciable decrease in the mean gingival index score (1.73 ± 0.382 to 1.20 ± 0.321) and OHI-S (3.31 ± 0.815 to 2.57 ± 0.551) in all the inmates after oral health education program over the period of time.Originality/valueThe oral health education with reinforcement proved to be an effective tool to instil good oral hygiene practices in the inmates.

Assessing the Impact of Smoking Cessation Interventions on Periodontal Health and Gingival Inflammation in Smokers with Periodontitis

ABSTRACT Background: Smoking is a well-established risk factor for periodontitis, a chronic inflammatory disease of the oral cavity. While smoking cessation has been linked to improved overall health, its specific impact on periodontal health and gingival inflammation in individuals with periodontitis remains less explored Materials and Methods: We conducted a prospective cohort study involving 200 smokers diagnosed with periodontitis. Participants were divided into two groups: Group A received comprehensive smoking cessation interventions, including counseling and pharmacotherapy, while group B continued smoking without intervention. Periodontal health was assessed through clinical parameters, including probing depth (PD) and clinical attachment level (CAL), at baseline and 6 months post intervention. Gingival inflammation was evaluated using the Gingival Index (GI). Results: After 6 months, group A exhibited a significant reduction in mean PD (from 4.5 mm to 3.2 mm) and CAL (from 5.0 mm to 3.5 mm) compared to group B. Conversely, group B showed no significant change in these parameters. The GI score significantly decreased in group A (from 2.8 to 1.2) but remained unchanged in group B. Furthermore, group A demonstrated a higher rate of smoking cessation (72%) compared to group B (14%) Conclusion: Smoking cessation interventions play a crucial role in improving periodontal health and reducing gingival inflammation in smokers with periodontitis. The observed reductions in PD, CAL, and gingival inflammation highlight the potential benefits of smoking cessation on oral health outcomes in this high-risk population.

Enhancing Oral Hygiene in Children With Hearing Impairment: The Impact of Skit Video Interventions -A Randomized Controlled Trial.

Aim. This study aimed to assess the effectiveness of 3 interventions-skit video, pictorial, and sign language-in improving the oral hygiene of children with hearing impairment. Materials and Methods. Sixty children randomly divided into 3 groups: Skit video, Pictorial, and Sign language. The mean gingival and Oral Hygiene Index scores were recorded before and after interventions. A 1-way ANOVA was used for statistically significant difference between pre and post intervention scores. Results. A significant difference in mean oral hygiene and gingival index scores before and after interventions was found in Group A (P < .005). A statistically significant difference was also found between group A and B in inter group comparison of OHI and GI scores post intervention (P < .004). Conclusion. Skit video and pictorial intervention effectively improves oral health resulting in reduced mean oral hygiene and gingival scores.

A Cross-Sectional Analysis of Periodontal Health in Adult Orthodontic Patients Using Three Bracket Types: Conventional Metal, Conventional Ceramic, and Metal Self-Ligating

Objective: This study aims to evaluate the periodontal health of adult orthodontic patients using three types of brackets: conventional metal, conventional ceramic, and metal self-ligating brackets. It further examines the geometry and surface roughness of each bracket type, correlating these factors with periodontal health outcomes. Methods: A cross-sectional analysis was conducted with 150 adult orthodontic patients divided into three groups based on the type of brackets used. Clinical parameters, including probing depth (PD), clinical attachment level (CAL), gingival index(GI), and plaque index (PI), were measured. The geometry and surface roughness of the brackets were analyzed using a profilometer. Statistical analysis was performed to compare periodontal health among the groups. Results: The results indicated significant differences in PD, CAL, GI, and PI among the three groups. Metal self-ligating brackets exhibited the lowest PD and GI scores, while conventional ceramic brackets showed the highest scores. Additionally, metal self-ligating brackets had superior surface roughness characteristics. Conclusion: The type of orthodontic bracket used, along with its geometry and surface roughness, can significantly affect periodontal health in adult patients. Metal self-ligating brackets may provide a favorable periodontal outcome compared to conventional brackets.

Comparison between effects of mini-implant anchorage and face-bow anchorage in orthodontics for children.

To study the values of mini-implant anchorage in orthodontics for children in the mixed dentition stage, 78 children in the mixed dentition stage who had accepted orthodontic treatment in our hospital from January 2020 to January 2021 were enrolled into this study. All children were treated with straight-wire appliance. According to their anchorages, children were divided into observation group and control group based on the random number table. Children in the control group used face-bow to control the anchorages and children in the observation group used mini-implants to control the anchorages. After treatment, the upper central incisor convex distance difference, inclination angle of the upper central incisor, displacement of the molar, gingival health, masticatory function, treatment effect and adverse reaction rate of children in two groups were compared. One year after treatment, compared with children in the control group, children in the observation group had smaller the upper central incisor convex distance difference, inclination angle of the upper central incisor, displacement of the molar, small scores of plaque index (PLI), bleeding index (BI) and gingival index (GI), stronger biting force and higher masticatory efficiency, lower adverse reaction rate during treatment, better treatment effect, higher satisfaction of orthodontic treatment. And differences of all the above indexes were statistically significant (p < 0.05). Mini-implant anchorages have good stability and directive force, and have certain values in orthodontics for children in the mixed dentition stage.

Assessment of oral bacteria potentially associated with the mobile microbiome in children with congenital heart disease.

In this case-control study, we aimed to investigate the specific oral pathogens potentially associated with the mobile microbiome in children with congenital heart disease (CHD). Caries, oral hygiene and gingival indices were evaluated in 20 children with CHD and a healthy control group, and venous blood samples and saliva were collected. Using quantitative polymerase chain reaction (qPCR), blood samples were analyzed for the presence of bacterial DNA to determine the mobile microbiome, and saliva samples were analyzed to identify and quantify target microorganisms, including Streptococcus mutans (Sm) and its serotype k (Smk), Fusobacterium. nucleatum (Fn), Porphyromonas gingivalis (Pg), Scardovia wiggsiae (Sw) and Aggregitibacter actinomycetemcomitans (Aa) and its JP2 clone (JP2). The findings were analyzed by Mann Whitney U, chi-square, Fisher's exact and Spearman's Correlation tests. Bacterial DNA was identified in two blood samples. No significant differences were found between the groups regarding the presence and counts of bacteria in saliva. However, the CHD group exhibited significantly lower caries and higher gingival index scores than the control group. The presence of Pg and Aa were significantly associated with higher gingival index scores. Sm and Smk counts were significantly correlated with caries experience. A positive correlation was found between Fn and total bacteria counts. In conclusion, the mobile microbiome, which has been proposed as a potential marker of dysbiosis at distant sites, was very rare in our pediatric population. The counts of target microorganisms which are potentially associated with the mobile microbiome did not differ in children with CHD and healthy children.

The Effect of Different Finish Line Designs and Material Types on the Periodontal Response of Single Crown Restoration: A 3-year Follow-up Study

Purpose: Different restorative materials and marginal finish lines may contribute to periodontal inflammation, in spite of patients' proper oral hygiene habits. The aim of this study was to evaluate the effect of different finish line designs and restorative materials on periodontal health. Materials and Methods: In this retrospective clinical study, the periodontal clinical parameters of 450 crown restorations fabricated with different finish line designs (chamfer, shoulder, knife-edge) and different materials (Metal-ceramic, Zirconia, Glass-ceramic) were evaluated at baseline and at 12th, 24th and 36th months after the cementation. The data were analyzed with Repeated Measures ANOVA and post hoc least significant difference tests were performed (α=.05). Results: Periodontal clinical parameters significantly increased during the 36-month follow-up period. The marginal finish line and material type had no significant effect on the probing depth and gingival index scores. The highest plaque index scores were observed in zirconia restorations with knife edge finish lines at the 36th month after crown placement. Conclusions: The periodontal health of the prepared tooth was negatively affected by the increased follow-up duration regardless of the marginal finish line design and material type. The clinicians should consider the favorable effect of the glass-ceramic crown restorations with a chamfer finish line on the plaque control for long-term success.

COMPARATIVE EFFICACY OF CHLORHEXIDINE AND SODIUM BICARBONATE DENTIFRICES IN PLAQUE AND GINGIVAL INFLAMMATION REDUCTION: A RANDOMIZED CONTROLLED TRIAL

Objectives: To determine the effi cacy of Chlorhexidine dentifrice compared to Sodium Bicarbonate dentifrice in plaque and gingival Infl ammation reduction. Materials and Methods: From May 2022 to August 2022, a randomized controlled experiment was carried out in the Periodontology Department of Sardar Begum Dental College and Hospital Peshawar. Using WHO formulae for sample size, 98 patients were selected. The age range of the patient was chosen between 13-40 years. The mean age presentation was 19.7 ± 4.9 years. The females were N=56 (57.1%) predominant than males N=42 (42.9%). The patients were placed into two groups of 49 each. Group A received dentifrice containing chlorhexidine, whereas Group B received dentifrice containing sodium bicarbonate. The data was entered into a structured proforma. SPSS 22.0 was used to analyze data. The Chi-Square test was used to compare the means of the two groups. Values of ≤ .05 were considered signifi cant. Results: The mean plaque scores for both groups are shown in Table 7. Group A (Chlorhexidine group) participants had an initial mean plaque score of 2.7, while the plaque score after the intervention was 1.2. The initial mean plaque score was 2.7 in the participants of group B (Sodium Bicarbonate group), while the mean plaque score after intervention was 1.75. This shows that both dentifrices reduced plaque but chlorhexidine was more eff ective than sodium bicarbonate in plaque reduction. Similarly, both (Chlorhexidine and Sodium Bicarbonate) reduced the gingival index score, but chlorhexidine was more eff ective than sodium bicarbonate in reducing gingival inflammation. Conclusion: Both the dentifrices show a significant reduction in both the plaque scores and gingival scores after usage. Chlorhexidine group showed a notable reduction in plaque and gingival scores as compared to sodium bicarbonate.

Prefabricated zirconia crown versus resin-bonded composite strip crown in the restoration of primary incisors: A 36-month parallel randomized controlled trial

AimThe trial aimed to compare the gingival health and clinical performance of prefabricated zirconia crown (PZC) versus resin-bonded composite strip crowns (RCSC) in the restoration of primary maxillary incisors over 36-month. Materials and methodsA parallel randomized controlled trial included 200 maxillary primary incisors (100 teeth per group) restored either with PZCs or RSCS. The gingival health and plaque accumulation were assessed using gingival index (GI) and plaque index (PI) respectively. To evaluate the clinical performance, the modified United States Public Health Service (USPHS) criteria were used. Intergroup comparison was performed using a Chi-square test. Restoration longevity was assessed over the predetermined intervals using Kaplan-Meier analysis. Generalized Estimating Equation (GEE) with robust standard errors was used to test the effect of time over the changes of repeated measures. The significance level was set to 5%. ResultsThe gingival health around PZCs is significantly better than that of RCSCs after 6 months. However, at the following follow-ups, GI scores of both restorations were comparable (p > 0.05). All PZCs showed no plaque accumulation with a significant difference compared to the RCSCs over the follow-up intervals. The clinical performance of PZCs was significantly superior to that of RCSCs over the follow-ups in terms of retention and anatomical contour after 24 and 36 months. The survival rates of PZC and RCSC were 100% and 87% respectively. ConclusionsAfter 36 months, the gingival health of PZC and RCSC was comparable. The retention and anatomical continuity of PZC were superior compared to RCSC.

Household smoking impact on the oral health of 5- to 7-years-old children

BackgroundChildren’s exposure to secondhand smoke, particularly by their parents, could adversely affect their oral health. Thereby, this study aimed to assess the oral health status of children subjected to household smoking and the impact of smoking patterns on the severity of oral health deterioration.MethodsA total of 210 healthy children were enrolled in this case-control study and allocated into children subjected to household smoking (HS) and control groups. Participants’ guardians were asked to complete a questionnaire regarding sociodemographic characteristics and parental smoking habits. All participants were subjected to clinical dental examination to assess dental caries (ICDAS), hypomineralized primary molars (HSPM), and gingival status (GI). Stimulated saliva samples were collected to assess saliva composition and characteristics. Urine samples were collected and analyzed for cotinine concentration. Data were analyzed using SPSS (v.25) software at a test value of p ≤ 0.05. The t-student test was used to find significant differences between participants’ age, gingival index score, saliva pH, flow rate, sIgA, and cotinine level. The Chi-square test was used to test for the significance of parental employment, number of rooms, gender, sweets consumption, brushing frequency, and HMPM. The correspondence analysis was used to test for significance of parents’ levels of education, type of house ventilation, ICDAS score, smoking form, frequency, and smoking pattern. The correlation between cotinine level and sIgA was tested for association using Bivariate correlation test.ResultsThe HS group showed a significantly increased risk for dental caries (p < 0.000), HSPM lesions (p = 0.007), and GI score (p < 0.000). A significant reduction in salivary flow rate, saliva pH, and sIgA were evident in HS group (p < 0.000). Parental consumption of more than 20 cigarettes/day was accompanied by increased dental caries activity (p < 0.000) and higher risk for increased severity of gingival inflammation (p < 0.000) of children in the HS group. Children of parents who smoke cigarettes and use the hubble/bubble anywhere in the house found to have greater distribution of HSPM (p < 0.000). Reduced sIgA values were found to be significantly associated with increased cotinine concentrations in HS children (p < 0.000).ConclusionsFrequent exposure to household smoking could be associated with an increased risk of dental caries progression, enamel hypomineralization, gingival inflammation, and saliva characteristics changes in children.

Evaluation of platelet-rich fibrin in the treatment of decorticated intrabony defects: a randomized clinical trial.

The objective of the present study was to evaluate the clinical and radiographic outcomes of intrabony defects treated with decortication (intramarrow penetration) alone versus decortication combined with platelet-rich fibrin in periodontitis patients followed up for 6 months postsurgery. A total of 46 intrabony defects from periodontitis patients with a mean age of 36.30 ± 6.10 years were randomly assigned into two treatment groups. The control group (n = 23) intrabony sites were accessed with simplified papilla preservation flap (SPPF) followed with debridement, decortication, and closure. The test group (n = 23) sites were accessed with SPPF, followed with debridement, decortication, platelet-rich fibrin placement, and closure. The clinical parameters Plaque Index, Gingival Index, probing pocket depth, relative attachment level, gingival marginal level, along with radiographic defect depth and defect width were recorded at baseline, 3 months, and 6 months postsurgery. Gain in clinical attachment level was the primary outcome, and probing pocket depth reduction and radiographic bone fill were secondary outcomes of the study. The Plaque Index and Gingival Index scores showed nonsignificant difference on intra- and intergroup comparison at baseline, 3 months, and 6 months. The probing pocket depth was 8.17 ± 1.56 mm, 6.65 ± 1.30 mm, and 5.26 ± 1.18 mm for the control group, and 8.17 ± 2.01 mm, 6.26 ± 1.42 mm, and 4.78 ± 1.28 mm for the test group, at baseline, 3 months, and 6 months, respectively. The relative attachment level was 8.83 ± 1.40 mm, 6.78 ± 1.31 mm, and 5.39 ± 1.16 mm for the control group, and 8.39 ± 1.62 mm, 6.96 ± 1.36 mm, and 5.48 ± 1.20 mm for the test group at baseline, 3 months, and 6 months, respectively. Statistically significant reductions were observed for probing pocket depth for the control (2.91 mm, P < .001) and test groups (3.39 mm, P < .001), as well as for relative attachment level for the control (3.44 mm, P < .001) and test groups (2.91 mm, P < .001). However, intergroup differences were nonsignificant for probing pocket depth and relative attachment level. The radiographic defect depth was reduced by 0.31 mm for the control and 1.57 mm for the test group. The radiographic defect width was reduced by 0.18 mm for the control and 0.83 mm for the test group. Intergroup statistically significant differences were observed at the 6-month follow-up (P < .001) for radiographic defect depth and width. Within the limitations of the present study, the results demonstrate statistically significant intragroup improvements in clinical outcomes with decortication alone and decortication combined with platelet-rich fibrin in the treatment of intrabony defects in periodontitis patients. The addition of platelet-rich fibrin did not improve the clinical results beyond decortication alone, and unacceptable postsurgery residual pockets were observed in both the protocols. Considering the small sample size, the addition of platelet-rich fibrin resulted in significant bone fill over and above that of decortication alone.

A tangible prospect for the treatment of gingivitis using a potentially probiotic strain Lactobacillus plantarum MK06 isolated from traditional dairy products: a triple blind randomized clinical trial

BackgroundFrequent bacterial plaque buildup at the gingival margin and crevice can provoke an inflammatory reaction in gingival tissues which manifests as gingivitis. Probiotics could serve as a beneficial complementary therapy for treating gingival inflammation. The main aim of this research was to investigate the effect of the Lactobacillus plantarum MK06 probiotic strain on the treatment of gingivitis.MethodsPatients with gingivitis, who were referred to a private clinic and were systematically healthy, were included in this randomized, triple-blind, placebo-controlled trial. They were instructed to use either placebo or Lactobacillus plantarum suspensions for one minute two times a day after tooth-brushing for four weeks. Then, the clinical parameters of gingivitis, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), and oral hygiene index (OHI-s), were measured in the first, second, and fourth weeks. A total of forty-two patients were randomly assigned to the experimental (n = 21) and control (n = 21) groups. The mean age of the experimental and control groups was 29.10 and 28.48, respectively.ResultsThe mean scores of BOP, GI, PI, and OHI-s reduced over time in both the control and test groups. However, according to the Mann-Whitney test, the difference between the two groups was not significant at the same time intervals (P ≥ 0.05) and only GI showed a significant difference in the fourth week (GI-3, P = 0.006). Nevertheless, the experimental group experienced a higher overall reduction rate than the control group. The BOP, GI, PI, and OHI-s scores decreased by 0.081, 0.204, 0.186, and 0.172 times in the second week, respectively, resulting from the interaction of time and the intervention, which considerably diminished these indices.ConclusionThis study shows the potential of the probiotic Lactobacillus plantarum MK06 suspension as a promoting therapeutic adjuvant in the treatment of gingivitis.

Therapeutic effect of aged garlic extract on gingivitis in dogs.

Periodontal disease is one of the most common dental health problems in dogs. Clinical studies in humans have shown that aged garlic extract (AGE), which contains stable and water-soluble sulfur-containing bioactive compounds, improves the symptoms of periodontal diseases. Our previous study demonstrated that oral administration of AGE in healthy Beagle dogs at 90 mg/kg/day for 12 weeks had no adverse effects such as hemolytic anemia, which is well known to occur as a result of ingestion of Allium species, including onions and garlic, in dogs. However, the therapeutic potential of AGE in canine periodontal disease remains unclear. Accordingly, we investigated the therapeutic effects of AGE in Beagle dogs with mild gingivitis. Feeding 18 mg/kg/day of AGE for 8 weeks resulted in the improvement of gingival index score, level of volatile sulfur compounds in exhaled air, and enzyme activity of periodontal pathogens without any adverse effects on clinical signs and hematological and serum biochemical parameters. Moreover, AGE increased the concentration of salivary cathelicidin, an antimicrobial peptide that contributes to the oral innate immune response. These results suggest that AGE could be a potential therapeutic agent for canine gingivitis.

The effect of triangular cross-section neck design on crestal bone stability in the anterior mandible: A retrospective study with a 5-year follow-up.

The objective of this study, which included a 5-year follow-up, was to compare peri-implant soft tissue health, crestal bone loss (CBL), and buccal bone thickness (BBT) around triangular cross-section neck (TN) or round neck (RN) implants, using cone-beam computed tomography. This study was initially designed as a prospective 1-year randomized controlled study and then extended with a 5-year retrospective evaluation of clinical and radiographic records. In the initial 1-year study, a total of 20edentulous patients receiving 40 implants with similar diameters were randomly assigned to the RN or TN groups using a split-mouth design. Pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were recorded at postoperative month 12. CBL and BBT at three levels (0, -2, and -4 mm) were evaluated 1 year after insertion. Five years after insertion, PPD, PI, GI, CBL, and BBT were recorded as patients were recalled for clinical and radiographic monitoring. Nineteen patients completed the study. After 5 years, no significant differences in PPD, PI, and GI scores and BBT values between the two groups (p > .05). The mean ± SD CBL values at the final follow-up visit were -0.71 ± 0.69 mm for TN and -1.03 ± 0.86 mm for RN (p < .01). These results suggest better crestal bone preservation using implants with TN when compared to RN after a 5-year follow-up. However, TN showed similar results to RN regarding peri-implant soft tissue health and BBT.