Gingival Index Research Articles

A combination technique of strip free gingival grafts and xenogeneic collagen matrix in augmenting keratinized mucosa around dental implants: a single-arm clinical trial

BackgroundThe aim of this study was to assess the outcomes of the combination technique of strip free gingival grafts (SFGG) and xenogeneic collagen matrix (XCM) in augmenting the width of keratinized mucosa (KMW) around dental implants, and compare its efficacy with the historical control group (FGG).MethodsThirteen patients with at least one site with KMW ≤ 2 mm after implant surgery were included and received SFGG in combination with XCM. Another thirteen patients with the same inclusion and exclusion criteria from the previous trial received FGG alone. The same outcomes as the previous trial were evaluated. KMW, thickness of keratinized mucosa (KMT), gingival index (GI) and probing depth (PD) were measured at baseline, 2 and 6 months. Postoperative pain, patient satisfaction and aesthetic outcomes were also assessed.ResultsAt 6 months after surgery, the combination technique could attain 3.3 ± 1.6 mm of KMW. No significant change could be detected in GI or PD at 6 months compared to those at 2 months (p > 0.05). The postoperative pain and patient satisfaction in VAS were 2.6 ± 1.2 and 9.5 ± 1.2. The total score of aesthetic outcomes was 3.8 ± 1.2. In the historical FGG group, 4.6 ± 1.6 mm of KMW was reported at 6 months, and the total score of aesthetic outcomes was higher than the combination technique (4.8 ± 0.7 vs. 3.8 ± 1.2, p < 0.05).ConclusionsThe combination technique of SFGG and XCM could increase KMW and maintain peri-implant health. However, this combination technique was associated with inferior augmentation and aesthetic outcomes compared with FGG alone.Trial registrationThis clinical trial was registered in the Chinese Clinical Trial Registry with registration number ChiCTR2200057670 on 15/03/2022.

The impact of 0.24% hyaluronic acid gel on pain level and periodontal status following labial frenectomy

Aim: The labial frenum is a mucosal fold that connects the upper lip to the alveolar ridge. Frenectomy involves the surgical removal of a mucosal fold. The traditional surgical technique utilizing a scalpel remains popular for performing a frenectomy. The study aims to examine the effectiveness of applying Hyaluronic Acid (HA) Gel after conventional frenectomy. Methods: This research comprised 48 young patients (25 girls and 23 boys) aged 8 to 14. Participants were randomly divided into two groups. Group 1: Conventional Scalpel Surgery and Sterile Saline (SS) (n=24) and Group 2: Conventional Scalpel Surgery+HA (Aftamed, Child Gel 24% HA) (n=24). After measuring the participants’ periodontal parameters, the frenectomy was performed. Postoperative pain levels were evaluated daily for one week utilizing a 10-point Visual Analog Scale. Before frenectomy, Plaque Index (PI), Gingival Index (GI), Pocket Depth (PD), Bleeding On Probing (BOP), Keratinized Gingival Width (KGW), Attached Gingival Thickness (AGT) values were measured and recorded. The periodontal parameters were assessed and analyzed after a 3-month follow-up period. Results: VAS (Visual Analogue Scale) was assessed. The application of Although 0.24% HA gel caused less pain from days 1-3.6, there was no significant difference in pain levels between the HA gel and control groups (p&gt;0.05). Pain levels were equal between groups on day 7. No significant changes in PI, GI, PD, BOP, KGW, or AGT values after three months of follow-up (p&gt;0.05). Conclusions: During the first week after a frenectomy performed with classic scalpel surgery, the application of 0.24% HA gel did not significantly reduce pain levels. It did not result in significant changes in other measured periodontal parameters after three months of follow-up.

Efficacy of F-ACP-Containing Dental Mousse in the Remineralization of White Spot Lesions after Fixed Orthodontic Therapy: A Randomized Clinical Trial.

Fixed appliance (FA) therapy predisposes patients to white spot lesions (WSLs). The F-ACP complex (amorphous calcium phosphate nanoparticles enriched with carbonate and fluorine and coated with citrate) has been effective for in vitro enamel remineralization. The aim of this study was to evaluate the efficacy of the F-ACP complex in remineralizing WSLs after FA therapy. One hundred and six adolescents (aged 12-20 years) were randomized into study and control groups after FA therapy. Patients in the study group were advised to use dental mousse containing F-ACP applied within Essix retainers for six months. The presence of WSLs was recorded at baseline (T0), 3 months (T1), and 6 months (T2) according to the International Caries Detection and Assessment System (ICDAS). Visual Plaque Index (VPI) and Gingival Bleeding Index (GBI) were recorded. Among 106 study participants, 91 (52 and 39 in study and control groups, respectively) completed the study. The results showed that the ICDAS score was significantly lower (p < 0.001) in the study group than in the control group between T0 and T2. The application of mousse containing the F-ACP complex inside Essix retainers for six months is effective in remineralizing white spot lesions in patients after FA therapy without side effects.

Differences in maternal subgingival microbiome between preterm and term births: The MOHEPI study.

Periodontitis is a potential risk factor for preterm birth (PTB) in women; however, the causal relationship or the exact mechanism remain unknown. This study aimed to compare the oral microbiome features of mothers with full-term birth (FTB) with those who had preterm delivery. This study prospectively enrolled 60 women (30 mothers with PTB and 30 mothers with FTB), and subgingival plaque samples were collected and analysed by metagenomic 16S rDNA sequencing. Clinical measurements, including periodontal probing depth, clinical attachment level, modified gingival index (mGI) and plaque index, were performed to determine the periodontal state of the participants. Medical and obstetric data were collected as well. Among the periodontal measurements, mGI score, reflecting the level of gingival inflammation, exhibited a statistically significant association with PTB (adjusted odds ratio 2.705, 95% confidence interval 1.074-6.811, p = .035). When subgroup analysis was conducted based on mean mGI scores (mGI ≥ 2, high inflammation [HI] versus mGI < 2, low inflammation [LI]), microbiome analysis revealed clear distinctions in microbial compositions between PTB and FTB mothers in both the HI and LI groups. Especially in the HI group, alpha diversity exhibited a decreasing trend in PTB mothers compared to FTB mothers. Beta diversity also revealed significant differences between the two groups. In Linear Discriminant Analysis Effect Size analysis, certain anaerobic taxa, including the genera Spirochaetes, Treponema and Porphyromonas, were relatively abundant in the FTB/HI group, whereas the PTB/HI group showed a high abundance of the order Actinomycetales. Network analysis showed that the FTB/HI had relatively stronger connectivity in microbial composition than the PTB/HI group. Dysbiosis ratio of plaque microbiome, in terms of periodontitis, was significantly lower in PTB/HI group compared to FTB/HI group. The compositions of maternal subgingival microbiomes differed between PTB and FTB mothers in both the high and low levels of gingival inflammation groups. In the presence of high level of gingival inflammation, dysbiosis in plaque microbiome, in terms of periodontitis, was decreased in PTB mothers compared to FTB mothers.

Clinico-immunological evaluation of use of omega-3 fatty acids as nutraceutical approach in management of patients with chronic periodontitis: A randomized clinical trial

BackgroundSubgingival bacterial colonization and biofilm formation are known to be the main etiology of periodontal disease progression. This biofilm elicits host response and the interaction between host defence mechanisms with plaque microorganisms and their products results in periodontal disease. Host modulatory therapy (HMT) is a form of treatment of periodontitis that focuses on treatment of the host in the host–bacteria interaction. Omega-3 fatty acids have emerged as a potential HMT agent to treat inflammation associated with periodontal disease. MethodsA total of 60 cases of chronic periodontitis were allocated into two groups; the test group (n = 30) were treated with scaling and root planing (SRP) and given a dietary supplementation of omega-3 fatty acid while the control group were treated with SRP alone. Clinical parameters carried out were plaque index (PI), gingival bleeding index (GBI), pocket probing depth (PPD) and clinical attachment level (CAL) and immunological parameter included interleukin-1β level in saliva at baseline, 3 months and 6 months after therapy. ResultsAt 6 months, both the groups showed significant improvements with regards to all clinical and immunological parameters compared to baseline (all p < 0.05). However, test group presented with more favourable statistically significant results. ConclusionThe use of omega-3 fatty acid as nutraceutical agent to conventional method acted as beneficial therapeutic measures and effective in patients with chronic periodontitis when compared with SRP alone.

Oral health status of Egyptian children with lysosomal storage diseases: An evaluation of dental indices, salivary cytokines level, and bacterial bioburden.

Lysosomal storage diseases (LSDs), a group of inborn errors of metabolism, include various subtypes, for example, mucopolysaccharidosis (MPS) and Gaucher disease (GD). Besides the physical/mental disabilities, they suffer from several oral deteriorations. To evaluate the oral health status of Egyptian children with LSD. Thirty LSD children and thirty non-LSD children were enrolled for this study according to the inclusion and exclusion criteria. Dental indices were used to assess caries prevalence and periodontal status. Saliva samples were collected from all enrolled children to estimate interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and protein levels as well as Streptococcus mutans and Lactobacilli colony counts. Children with MPS and GD showed non-significant differences in decayed, missing, or filled teeth (DMFT) scores (p = .115). Scores of dmft showed a significant increase in MPS, but not in GD children (p = .020, p = .127). Children with LSD showed significantly increased Modified Gingival Index (MGI), Plaque Index (PI), Oral Hygiene Index (OHI-s) scores (p < .001) and salivary IL-6 and TNF-α (p = .007, p = .001, p < .0001, p = .002, respectively) and salivary total proteins (p = .001) levels. Unexpectedly, non-significant differences were observed in salivary Streptococcus mutans or Lactobacilli counts in children with MPS and GD (p = .058, p = .420, p = .502, p = .053, respectively). To our knowledge, this is the first article that evaluates Egyptian children with LSD. We demonstrated high caries prevalence in primary teeth, not permanent teeth, in children with MPS and poor gingival/hygiene status in children with MPS and GD, which triggered a state of inflammation. The daily supplement intake prevented oral bacterial growth. The most probable cause of oral alterations is decreased salivary flow rate, as deduced from a significantly increased salivary protein.

Effect of non-surgical periodontal therapy on salivary and gingival crevicular fluid concentration of visfatin in periodontal health and disease

Background and objectiveVisfatin, a pleotropic mediator mostly produced by visceral fat, is crucial in controlling the immunological and defensive systems. It serves the roles of a cytokine, an enzyme involved in energy metabolism, and a growth factor. The objective of the present study was to assess the impact of non-surgical periodontal therapy (scaling and root planing) on visfatin concentrations in saliva and gingival crevicular fluid in individuals with Periodontitis (stage-II grade-A) Materials and methods54 individuals were divided into Group A (Periodontally Healthy) and Group B1(Periodontitis baseline) based on periodontal parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and radiographic parameters. After NSPT (SRP), Group B1 patients were recalled after 4 weeks, constituting Group B2 (post NSPT group B1). At baseline and 4 weeks after non-surgical periodontal therapy (SRP), all clinical parameters, salivary and GCF samples were recorded. An ELISA kit was used to measure the levels of visfatin. Using the paired t-test, unpaired t-test, and Pearson's correlation coefficient, data were analysed using SPSS 15. ResultsAfter non-surgical periodontal treatment (SRP), the mean salivary and gingival crevicular fluid concentration of visfatin considerably decreased to a level comparable to periodontal health. In all groups, GCF visfatin concentration was higher than salivary concentration of visfatin. In periodontitis patients, visfatin concentration in GCF was 1.5 times higher than in saliva. ConclusionThe results of this investigation suggest a direct correlation between salivary and gingival crevicular fluid visfatin concentration and periodontal tissue inflammation and disease activity.

Comparative evaluation of the efficacy of Triphala mouthwash and Curcumin mouthwash in the treatment of gingivitis – A randomized controlled study

BackgroundNumerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance. ObjectivesTo access the efficacy of all the mouthwashes in the management of gingivitis. MethodsBy purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05. ResultsThe study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation. ConclusionBoth Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.

A Comparative Clinical Evaluation of Subgingivally Delivered 0.5% Azithromycin Gel and 1% Chlorhexidine Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis.

Chronic periodontitis is a prevalent inflammatory condition affecting the supporting structures of teeth. Adjunctive therapies to scaling and root planing (SRP) play a crucial role in enhancing treatment outcomes. This study aimed to compare the clinical effectiveness of subgingivally delivered 0.5% azithromycin gel and 1% chlorhexidine gel as adjuncts to SRP in the management of chronic periodontitis. A comparative clinical evaluation was conducted involving 60 participants diagnosed with chronic periodontitis. They were randomly assigned to two groups: Group A received subgingival application of 0.5% azithromycin gel after SRP, whereas Group B received 1% chlorhexidine gel in a similar manner. Clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), and gingival index (GI) were recorded at baseline and 3-month follow-up. Both groups demonstrated significant improvements in clinical parameters after treatment. However, Group A exhibited a greater reduction in PPD (mean decrease of 2.5 mm) compared with Group B (mean decrease of 1.8 mm). Similarly, Group A showed a higher gain in CAL (mean gain of 2.3 mm) compared with Group B (mean gain of 1.5 mm). In addition, a significant reduction in GI was observed in both groups, with Group A showing slightly better outcomes. Subgingivally delivered 0.5% azithromycin gel demonstrated superior clinical efficacy as an adjunct to SRP in the treatment of chronic periodontitis compared with 1% chlorhexidine gel. The findings suggest that azithromycin gel may serve as a promising therapeutic option in managing periodontal disease.

Evaluation of Salivary Parameters and Oral Health Status in Periodontally Healthy Subjects and Chronic Periodontitis Subjects

Introduction: Periodontal disease is a chronic disease of the oral cavity that consists of a group of inflammatory disorders affecting the supporting structures of the dentition. Saliva can be used to predict the early onset of periodontitis. Several investigations have been carried out to evaluate the salivary chemical compounds that lead to the destruction and/or protection of periodontal tissues. The present study aimed to assess and compare salivary parameters and oral health status in periodontally healthy and chronic generalised periodontitis patients. Materials and Methods: This is an in vivo study designed to compare salivary parameters (albumin, urea, total proteins, amylase, glucose and pH) of unstimulated saliva and oral health status of periodontally healthy subjects (n = 65) and chronic generalised periodontitis subjects (n = 65). Human whole unstimulated saliva was collected by spitting method with the subject seated in an upright position after refraining from oral intake for 2 h before saliva collection. Approximately 5 mL of saliva was collected and stored in graduated saliva-collecting vials and refrigerated at 4°C for 1 h. The samples were centrifuged at 2800 rpm for 10 min, and the supernatant was separated from the substrate and stored at 20°C. Next, the sample was defrosted at room temperature and centrifuged at 3000 rpm. The supernatant was separated again to determine the concentrations of glucose, amylase, urea, total protein and albumin using the respective kits and analysed using an automated analyser. Salivary pH was estimated electrometrically with the help of a pH meter. Results: A significant association was found between salivary parameters (amylase and albumin total proteins) and clinical parameters (plaque index [PI], gingival index) [GI], probing depth and calculus index in generalised chronic periodontitis subjects when compared to periodontally healthy subjects. Conclusion: The increase in salivary parameters (amylase, total proteins and albumin) was statistically significant except for salivary glucose and urea (statistically non-significant) in generalised chronic periodontitis subjects compared to the healthy subjects. As the clinical parameters (probing depth, loss of attachment, PI, GI, calculus index and decay missing filled teeth) in periodontitis subjects increased, the salivary parameters also increased, suggesting a linear relationship between the generalised chronic periodontitis and salivary parameters (total proteins, albumin and amylase).

Probiotics for maintaining oral health during fixed orthodontic treatment: A systematic review and meta-analysis.

To systematically review the effect of probiotics on oral health during treatment with fixed orthodontic appliances. PubMed, Embase and the Cochrane Library were searched up to August 2022 using broad MeSH terms and keywords. Randomized clinical trials comparing a probiotic with a control/no treatment; at least 10 patients/group undergoing fixed orthodontic therapy; and reporting at least one oral health-related parameter were included. The most reported parameters in the 14 included studies were the microbiological counts of mutans streptococci and lactobacilli, microorganisms associated with white spot lesions (WSL). A meta-analysis of these showed a positive effect of probiotics on mutans streptococci. Probiotic treatment led to significantly less patients with high counts and significantly more with low counts of these bacteria. An effect on the lactobacilli counts was not seen. However, the sole clinical study investigating WSL could not demonstrate a clinical effect of probiotics on these lesions. Additionally, one study reported encouraging results of probiotics on bad breath and one on the occurrence of traumatic oral lesions. One study found reduced counts of Porphyromonas gingivalis in the probiotic group. The clinical results of probiotics on plaque index were ambiguous: one study reported that probiotics reduce the plaque and gingival index, and two that probiotics had no significant influence on plaque index. Probiotics are a promising option to lower mutans streptococci counts in patients undergoing fixed orthodontic therapy. However, due to the heterogeneity of the studies, it is not possible to draw conclusions about one specific probiotic.

Preparation and Characterization of Ferulic Acid Hydrogel and Its Application as a Local Drug Delivery Agent in Periodontitis.

Introduction Periodontitis, a persistent inflammatory condition, impacts the tissues supporting teeth. Beyond mechanically eradicating the biofilm, additional host-modulating agents can aid in the treatment of periodontitis. Among these, gels are a very popular choice for use in the field of dentistry as these systems boast high biocompatibility and bioadhesiveness. These qualities make them easily administered and fabricated. They aretypically placed into the periodontal site via wide-port needle syringes. Many investigations have demonstrated that hydrogels possess the ability for controlled drug release and aid in periodontal wound healing. Hence, this study aimed to develop a ferulic acid hydrogel and assess its effectiveness for managing periodontitis. Materials and methods Ferulic acid hydrogel was prepared followed by haemolysis assay and biocompatibility assay. After the in vitro analysis, a clinical trial was conducted: 20 patients were divided into Group A (comprising patients in whom scaling and root planing (SRP) was done) and Group B (comprising patients in whom SRP along with hydrogel application was done). Each patient's pocket depth (PD), clinical attachment loss (CAL), gingival index (GI), and plaque index (PI) were recorded at baseline and at three months. Intergroup and intragroup comparisons of the parameters were made. Results Ferulic acid hydrogels exhibit a minimal ratio of red blood cell destruction, indicating their low haemolytic activity. Beyond 94 hours, ferulic acid hydrogel demonstrates minimal toxicity towards human fibroblasts, suggesting it has good biocompatibility. When clinical parameters were compared after three months of treatment with SRP alone, significant reductions were observed in all parameters. However, when hydrogel application was done along with SRP, greater reduction was seen in terms of all clinical parameters indicating the efficacy of the ferulic acid hydrogel as an adjunct. Conclusion Ferulic acid has distinct haemolytic activity as well as good biocompatibility. Its use also led to a considerable reduction in all clinical parameters, necessitating its role as a local drug delivery agent in the treatment of periodontitis.

Comparative Evaluation of Gingival Health Among Children With Stainless Steel Crowns and Stainless Steel Bands: A Split-Mouth Randomized Controlled Trial.

Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction applianceto maintain the space for the eruption of underlying teeth in case of early loss in children are some of the most commonly practised proceduresthat pediatric dentists undertake in their day-to-day lives. Maintaining good oral hygiene for better gingival health is important. If it is not taken care of,gradual destruction of supporting soft and hard tissues of the teeth occurs. There were numerous studies conducted over the past few years,but no split-mouth study compares the crowns and bands. Hence, this study compares the gingival health between stainless steel crowns and band and loop space maintainers. Materials and methods This split-mouth randomised controlled trial included 31 children aged between four and nine years who had stainless steel crowns on one side and a band and loop space maintainer on the other side of the mandibular arch. The split-mouth study was carried out to minimise the outcome bias as oral hygiene practices differ from one individual to another. Presence/absence of bleeding on probing (BOP)and the Gingival Index (GI) using theLoeandSilness GI were assessed at baseline and at six months. Data was entered in an Excel sheet (Microsoft Corporation,Redmond, Washington, United States) and analysed in IBMSPSSStatistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). The significance level was fixed as 5% (α = 0.05). The Shapiro-Wilktest was used to assess the normality of parameters of gingival health. The parameters are described in terms of mean, standard deviation, frequency and percentages. Intragroup analysis was done using Friedman tests across the timelines. Intergroup analysis using Mann-Whitney U tests was done between the groups at different timelines. Results At the beginning of the study, 46 children (22 girlsand 24 boys) were enrolled considering the dropout. However, 15 children did not attend the follow-up review, resulting in a loss to follow-up. Consequently, only 31 children, each with a band and loop space maintainer and a stainless steel crown, were included for the final interpretation of the results in this study. At one month, both BOP and GI were significantly different (p<0.05) between the stainless steelcrown and stainless steel band where the crown showed better gingival health and absence of bleeding than the band and loop. At three months and six months, gingival health improved in both groups, but there was no significant difference between the groups. The Friedman test revealed that both the stainless steel crown and stainless steel band groups had a significant difference at six months from baseline. Mann-Whitney tests were done to analyse the difference in parameters at baseline and at six months between both groups. There was no significant difference in the baseline in the parameters between the groups. Conclusion Within the limitations of the study, this study concludes that the gingival health based on BOP and GI shows a significant difference across the timeline within the groups, namely, stainless steel crown and stainless steel band, but no significant difference between the groups at various timelines.

Effectiveness of dental floss in the management of gingival health: A 6-month follow-up of a randomized controlled clinical trial.

To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health. Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (p < 0.05). 68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone. OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae. Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health. GOV : (53831716.5.0000.5346). The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration.

Periodontal Health and Its Relationship with Psychological Stress: A Cross-Sectional Study

Background: Studies suggest that chronic psychological stress can lead to oral health deterioration, alter the immune response, and possibly contribute to increased inflammation, which can impact the physiological healing of periodontal tissues. This cross-sectional study seeks to assess and improve clinical understanding regarding the relationship between perceived stress, mindfulness, and periodontal health. Methods: A total of 203 people were analyzed from December 2022 to June 2023. The Periodontal Screening and Recording (PSR) score and Gingival Bleeding Index (GBI), and Plaque Control Record (PCR) of every patient were registered. Subsequently, participants completed the Sheldon Cohen Perceived Stress Scale (PSS) and the Mindfulness Awareness Attention Scale (MAAS) questionnaires. The collected data underwent statistical analysis, encompassing the evaluation of correlations and dependencies. Applying Welch’s t-test to assess the relationship between MAAS and the variable indicating the presence or absence of periodontitis, a noteworthy p-value of 0.004265 was obtained. Results: This underscores a significant distinction in MAAS scores between patients affected by periodontitis and those unaffected by the condition. Additionally, Pearson correlations were computed for GBI and perceived stress, PCR and perceived stress, PCR and MAAS. The resulting p-values of 2.2–16, 3.925–8, and 2.468–8, respectively, indicate a statistically significant correlation in each instance. Conclusions: These findings contribute valuable insights into the interconnectedness of these variables, emphasizing the significance of their associations in the study context. Despite the limitations, the findings of this study suggest a significant relationship between psychological stress, mindfulness, and periodontal tissue health. Clinical trials are necessary to incorporate the assessment of a patient’s psychological status as a new valuable tool in the management of periodontal health.

Effects of Smokeless Tobacco on Oral Health: A Cross-Sectional Study.

Smokeless tobacco (SLT) consumption poses a significant global public health challenge because of its adverse effects on oral health. Although the detrimental impact of SLT on oral tissues is well-documented, understanding its multifaceted effects is essential for effective prevention and intervention strategies. This study aimed to comprehensively assess the impact of SLT on oral health, focusing on various clinical parameters and their differences between placement and non-placement sites of SLT. A cross-sectional study involving 528 habitual users of SLT was conducted. Clinical parameters included the plaque index (PI), gingival index (GI), gingival bleeding index (GBI), gingival recession (GR), and probing depth (PD). Oral mucosal changes at SLT placement sites have also been reported. Statistical analysis was performed to compare parameters between the placement and non-placement sites. The study involved 528 subjects, mostly male (82%) and aged 21-40 years (mean±SD=31.14±9.10), habitual users of SLT. Prevalent SLT types included tobacco with betel nuts/masala/gutkha (59.9%) and tobacco with lime (54.5%). Significant differences were observed between SLT placement and non-placement sites: higher gingival inflammation (GI) at placement sites (1.54±0.61 vs. 1.45±0.54, p=0.01), lower GBI at placement sites (40.0% vs. 84.3%, p=0.001), and more prevalent GR (65.7% vs. 34.3%, p=0.03) at placement sites. Probing depths ≥ 3 mm were also less frequent at placement sites (2.67±0.72) than non-placement sites (3.37±1.03, p=0.001). These results highlight the detrimental impact of SLT on periodontal health, emphasizing the need for targeted interventions among SLT users. SLT use is associated with adverse effects on oral health, including GI, plaque accumulation, gingival bleeding, GR, and changes in the oral mucosa. Targeted interventions and public health policies are needed to address these issues effectively.

Oral microbiota of patients with phenylketonuria: A nation-based cross-sectional study.

The oral microenvironment contributes to microbial composition and immune equilibrium. It is considered to be influenced by dietary habits. Phenylketonuria (PKU) patients, who follow a lifelong low-protein diet, exhibit higher prevalence of oral diseases such as periodontitis, offering a suitable model to explore the interplay between diet, oral microbiota and oral health. We conducted 16S rDNA sequencing on saliva and subgingival plaque from 109 PKU patients (ages 6-68 years) and 114 age-matched controls and correlated oral microbial composition and dental health. PKU patients exhibited worse dental health, reduced oral microbial diversity and a difference in the abundance of specific taxa, especially Actinobacteriota species, compared to controls. PKU patients with poor periodontal health exhibited higher alpha diversity than the orally healthy ones, marked by high abundance of the genus Tannerella. Notably, the observed taxonomic differences in PKU patients with normal indices of decayed/missing/filled teeth, plaque control record, gingival bleeding index and periodontal screening and recording index generally differed from microbial signatures of periodontitis. PKU patients' reduced microbial diversity may be due to their diet's metabolic challenges disrupting microbial and immune balance, thus increasing oral inflammation. Higher alpha diversity in PKU patients with oral inflammation is likely related to expanded microbial niches.

Salivary interleukin-17A and interleukin-18 levels in patients with celiac disease and periodontitis.

An increased level of interleukin-17A and interleukin-18 in the serum and intestinal mucosa of celiac disease patients reflecting the severity of villous atrophy and inflammation was documented. Thus, the objective of this study was to evaluate the concentrations of salivary-17A, interleukin-1 beta, and interleukin-18 in patients with celiac disease who are on a gluten-free diet, both with and without periodontitis, and to compare these levels with those in healthy individuals. The study involved 23 participants with serologically confirmed celiac disease (CD) and 23 control subjects. The CD patients had been following a gluten-free diet (GFD) for a minimum of 1 year and had no other autoimmune disorders. The research involved collecting demographic data, conducting periodontal examinations, gathering unstimulated whole saliva, and performing enzyme-linked immunosorbent assays to measure salivary interleukin-17A, interleukin-1 beta, and interleukin-18 levels. Spearman's correlation analysis was utilized to explore the relationships between CD markers in patients on a GFD and their periodontal clinical findings. The periodontal findings indicated significantly lower values in celiac disease patients adhering to a gluten-free diet compared to control subjects (p = 0.001). No significant differences were found in salivary IL-17A, IL-18, and IL-1B levels between celiac disease patients and control subjects. Nevertheless, the levels of all interleukins were elevated in periodontitis patients in both the celiac and control groups. The IL-1 Beta level was significantly higher in periodontitis patients compared to non-periodontitis patients in the control group (p = 0.035). Significant negative correlations were observed between serum IgA levels and plaque index (r = -0.460, p = 0.010), as well as gingival index (r = -0.396, p = 0.030) in CD patients on a gluten-free diet. Celiac disease patients on gluten-free diet exhibited better periodontal health compared to control subjects. However, increased levels of salivary IL-17A, IL-18 and IL-1B levels were associated with periodontitis. Additionally, serum IgA level was significantly inversely associated with periodontitis clinical manifestations and with salivary inflammatory mediators in CD patients on GFD.

Comparison Between the Conventional and Electronic Smoking Effects on Periodontal Health-A Cross-Sectional Study.

To compare the adverse effect of e-cigarettes and conventional cigarette smoking on periodontal health. Sixty participants were split into two groups of 30 each (Group A-traditional cigarettes and Group B-e-cigarette smokers). Socio-demographic data, smoking, and oral health status were gathered using a self-administered questionnaire. Gingival index (GI), Russell's periodontal index, and clinical attachment loss (CAL) were recorded in patients of both the groups. The mean GI (1.79), periodontal index (5.92), and CAL (3.44) were higher in patients using traditional cigarettes than e-cigarettes. The questionnaire revealed that patients using traditional cigarettes had bleeding gums (32.22%), pus in the gums (39.22%), extracted teeth due to mobility (59.65%), discolored tooth (89.66%), and tongue (71.76%), which was more than e-cigarette smokers. E-cigarette smokers have similar adverse effects on the periodontal tissues but are less as compared to normal cigarette smokers.

Quantitative Analysis of Bifidobacterium and Scardovia wiggsiae in Dental Plaque from Children in Northern Thailand and Their Association with Caries Factors

Abstract Objectives The aim of this study were to measurably detect Bifidobacterium and Scardovia wiggsiae in plaque from severe early childhood caries (S-ECC) and caries-free children and to analyze the interrelation between these bacteria and clinical caries presentation and caries-related factors assessed by questionnaire. Materials and Methods One-hundred forty supra gingiva plaque samples from children aged between 2 and 5 years were used in this study. There were 70 children in each group. Recorded plaque index, modified gingival index, and decay, missing, and filled tooth (dmft) scores. Parents' attitudes, child's oral hygiene, and diet were assessed by questionnaire. DNA was extracted from plaque samples and quantitative real-time polymerase chain reaction using fluorescent dye was performed. Results Plaque (p &lt; 0.001) and modified gingival indices (p &lt; 0.001) in the S-ECC group were higher than in the caries-free group. Prevalence of Bifidobacterium (p = 0.004) and S. wiggsiae (p &lt; 0.001) in the S-ECC group was higher than in the caries-free group. The numbers of total bacteria (p = 0.003), Bifidobacterium (p &lt; 0.001), and proportion of Bifidobacterium to total bacteria (p &lt; 0.001) were higher in the S-ECC group. Detections of both bacteria, Bifidobacterium + S. wiggsiae (p &lt; 0.001), were higher in the S-ECC group than in the caries-free group. In the S-ECC group, dmft scores (p &lt; 0.001; p = 0.024) and the modified gingiva index (p = 0.004; p = 0.002) were higher in the presence of Bifidobacterium and S. wiggsiae, respectively. In the S-ECC group, the dmft scores (p = 0.005) and modified gingiva index (p = 0.004) were higher in the presence of both Bifidobacterium + S. wiggsiae. There were positive correlations between the Bifidobacterium level (p = 0.003), the proportion of Bifidobacterium to total bacteria (p = 0.017), and S-ECC. The level of Bifidobacterium (p &lt; 0.001) and ratio of Bifidobacterium to total bacteria (p &lt; 0.001) were correlated with the dmft score and modified gingival index in the S-ECC group. From the questionnaire, S-ECC were associated with major caregiver (p = 0.002), parent education levels (p = 0.02), prolonged bottle-feeding (&gt;18 months) (p = 0.015), night-time feeding (p &lt; 0.001), eating cariogenic snacks (p = 0.019), and frequency of dental visits (p = 0.003). Conclusions Levels of total bacteria, Bifidobacterium, S. wiggsiae and plaque, and the modified gingival indices were higher in the S-ECC group. Factors associated with S-ECC included the major caregiver, parent education levels, feeding patterns, cariogenic snacks consumption, and frequency of dental visits.