Gingival Index Research Articles

Clinical and Microbiological Evaluation of Diode Laser and Systemic Doxycycline as an Additive to Scaling and Root Planing for Stage II and Stage III Periodontitis Patients.

To assess and contrast the effectiveness of systemic doxycycline and diode laser as supplements to scaling and root planing (SRP) in terms of clinical and microbiological parameters. A total of 33 patients diagnosed with periodontitis stages II and III were included and randomized into group A (SRP + diode laser), group B (SRP + doxycycline), and group C (SRP alone). Selected sites were assessed for clinical and microbial parameters-plaque index (PI), gingival index (GI), pocket probing depth (PPD), relative attachment level (RAL), and colony-forming units (CFUs). Every clinical parameter was noted at baseline and after three months. The arithmetic mean, followed by the standard deviation, was calculated for the required assessment intervals. Analysis of variance (ANOVA) was used to compare all parameters between groups, and if the results of the ANOVA test were significant, post hoc analysis was performed. For intragroup comparison, student t-tests were performed. The clinical parameters significantly improved within three months for all groups. In terms of relative attachment level, a statistically significant difference (P < 0.001) was obtained at the three-month interval compared to the baseline value, with the most statistically significant difference seen in group A (3.36±0.50 to 0.64±0.50), followed by group B (3.18±0.40 to 2.18±0.40). The mean pocket probing depth observed at three months, compared to the baseline value, showed a statistically significant difference (P < 0.001) in group A (5.91±0.70 to 2.18±0.40) compared to group B (6.18±0.75 to 4.36±0.50), followed by group C (5.82±0.75 to 5.27±0.64). The use of diode laser-assisted pocket disinfection and systemic doxycycline, in addition to scaling and root planing, has proven to be efficient for treating periodontal pockets.

The effect of early childhood caries on chewing function and tolerated food texture levels in preschool children.

The early form of caries can affect solid food consumption. The aim of the study was to evaluate the effect of oral health status on chewing performance, and tolerated food texture among preschool children suffering from early childhood caries (ECC). A cross-sectional study was conducted with a sample of 109 children aged between 3 and 6 years, who were allocated to three groups (severe-ECC (s-ECC), ECC and control) on the basis of their caries. Chewing function was evaluated by using the 'Karaduman Chewing Performance Scale (KCPS)' and the Turkish version of the 'Mastication Observation and Evaluation instrument (T-MOE)', and the tolerated food texture was determined by the 'International Dysphagia Diet Standardization Initiative (IDDSI)'. Carious lesions, oral hygiene and gingival health status were evaluated by using the 'decayed, missing, filled tooth/surface indices (dmft/s)', 'plaque and gingival indices'; respectively. A total of 56 children (51.4%) had s-ECC, 39 (35.8%) had ECC and 14 (12.8%) had no caries (control group). KCPS showed that 26 (86.7%) children suffering from s-ECC were at level 1, and 11 (100%) children were at level 2. Seven (100%) children with s-ECC had IDDSI level-5. All children with healthy oral status had IDSSI level-7. Compared to the ECC and control groups, the s-ECC group had significantly lower scores from the T-MOE total and subscale scores (p < .001). The evaluation of chewing performance during routine dental examinations of children with ECC (especially s-ECC) may considerably contribute to the early diagnosis of chewing problems and the provision of necessary oral rehabilitation.

The periodontal health status of postmenopausal women and its relationship to bone mineral density

The relationship between changes in postmenopausal women and periodontalcondition had been studied in many countries. It has been suggested that estrogendeficiency may play a role in periodontal disease following menopause. The aim ofthis study was to investigate the influence of postmenopausal alteration on the clinicalperiodontal parameters and teeth loss. In addition, to determine the relationshipbetween systemic bone mineral density and periodontal disease in postmenopausal.womenSixty Iraqi women in total were involved in this study, 20 women as a controlgroup of age (35-45) years and forty postmenopausal women divided into two.subgroups: groupl for age (50-60) years and group 2 of age (60-70) years:Questionnaire involved the following periodontal parametersPlaque index (PI), gingival index (GI), bleeding on probing (BOP), pocketdepth (PD), clinical attachment level (CAL). All these parameters were measured andtabulated according to redefined scores, or counts, and the data was analyzed.statistically- Fifteen of forty postmenopausal women, were examined using dual energy xray absorptiometry (DEXA) equipment to measure bone mineral density (BMD) inorder to determine the relationship between (BMD) and any of the above periodontalparameters. The means, Gl, BOP, PD and CAL were found to be significantly higher.)in the postmenopausal group than the control (P&lt;0.05It was found that BMD is negatively associated with Gl, BOP, PD and CALbut the correlation is either of high significant or of slight of difference but notsignificant at (P&lt;0.05). The clinical parameters may increase depending on theexpected negative effects during menopause further, it is concluded that BMD of the.lumbar spine is related to CAL, PD, number of teeth loss and to a lesser extent BOP&#x0D;

Evaluation of the efficacy of inter-dental brush and dental floss for peri-implant mucositis: A crossover randomized clinical trial.

To evaluate the most effective method for mechanical inter-dental plaque removal between inter-dental brushes (IDB) and dental floss (DF), in addition to toothbrushing in patients affected by peri-implant mucositis (PIM); to identify possible factors related to the patient or to the single implant-supported element that could influence plaque accumulation and inflammation of peri-implant tissues. Forty patients with PIM were recruited. They were randomly assigned to two different groups depending on inter-dental device used (IDB or DF). At baseline (T0), interproximal area (IA), interproximal emergence angle of the implant crown (A°) and manual dexterity (evaluated with Purdue Pegboard) have been recorded. At 14 days (T1), the inter-dental cleaning devices have been inverted between groups. After 14 days (T2), the Plaque Index (PI) and Gingival Index (GI) have been recorded. A questionnaire has been submitted to a patient for the analysis of preferences at T0, T1 and T2. Both inter-dental cleaning devices were effective in reducing PI and GI in the inter-dental area after 14 days of use. GI reduction was influenced by manual dexterity of the dominant hand. No significant differences were found for PI and GI at the variation of IA and A°. IDB was the most effective method for inter-dental plaque removal in all subjects regardless of their manual dexterity. DF seems to be more effective than IDB only in subjects with good dexterity.

Serum levels of antimicrobial peptides (Cathelicidins and Beta Defensins-1) in patients with periodontitis

Background: periodontitis is a multifactorial oral inflammatory disease characterized by the gradual loss of bone and eventual tooth loss. It starts with microbes and is then influenced by the environment. A diverse family of host defense major compounds known as antimicrobial peptides react quickly to combat microbial invasion and challenge. These little cationic peptides are crucial for the development of innate immunity. The goal of this study was to evaluate the blood levels of healthy individuals and patients with periodontitis for cathelicidins and human beta-defensin-1. In this case-control study, 35 healthy volunteers (matched exactly by age and sex to the patients) and 50 periodontitis patients (aged 20 to 59) participated. In this investigation, periodontal parameters such as plaque index, gingival index bleeding on probing, probing pocket depth, and clinical attachment loss were employed. The levels of cathelicidins and human beta-defensin-1 in patients and controls were estimated using ELISA after blood samples from all individuals were taken. The current findings showed that the mean levels of cathelicidin and human beta defensin-1 were significantly higher (P˂0.01) in the patient group compared to the control group, and that there was no significant correlation with all clinical periodontal parameters. These findings support the notion that antimicrobial peptides play a crucial role in periodontitis' inflammatory process.

Association between Gingival Phenotype and Periodontal Disease Severity-A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment.

This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full mouth bleeding score (FMBS), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), keratinized tissue width (KTW), transgingival probing, and gingival biotype assessment, were recorded at baseline and 6 months into treatment for both orthodontic groups and a control group. Statistical analysis evaluated differences in parameters between groups and across time points. In the thick phenotype, both Invisalign and FOT groups showed a significant mean reduction in FMPS (baseline to 6 months) by -24.8707 and -12.3489, respectively (p < 0.05). The gingival index decreased significantly for both groups, with Invisalign and FOT showing reductions of -0.83355 and -1.10409, respectively (p < 0.05). FMBS (baseline to 6 months) decreased significantly for Invisalign and FOT, with mean differences of -9.10298 and -12.6579 (p < 0.05). Probing pocket depth (baseline to 6 months) was also significantly reduced for both Invisalign and FOT groups while CAL showed non-significant differences in both groups (p > 0.05). Similar changes were seen in the thin phenotype too. This study highlights the positive influence of both Invisalign and fixed orthodontic therapy on periodontal health, particularly in patients with thin and thick gingival biotypes. These findings, with significant reductions in key periodontal parameters, offer valuable insights to guide orthodontic treatment decisions and enhance patient outcomes.

Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay.

The study aims is to evaluate the antibacterial effect of vitamin D3 against the red complex bacteria, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia in chronic periodontitis patients. The study comprised 98 participants with chronic periodontitis. All clinical parameters including plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and a microbiological assay of P. gingivalis, T. denticola, T. forsythia were assessed at the baseline. All study participants who underwent scaling and root planning were divided into two groups, A and B, each with 49 patients and only group B patients were advised to take vitamin D supplementation of 60,000 IU granules, once daily for 2 months. All the patients of both the groups were recalled at the end of 2nd month and all the clinical and microbiological parameters were reassessed. After two months, there was a reduction in all the clinical markers in both groups, but the group B patients showed more improvement following non-surgical treatment vitamin D intake. There was also a statistical reduction in P. gingivalis, T. denticola, and T. forsythia following administration of vitamin D in group B patients compared to group A. These discoveries proposed that vitamin D has a superb antimicrobial impact against red complex periodontal microbes and might be considered a promising compound in the counteraction of periodontal disease. Vitamin D is considered to possess anti-inflammatory and antimicrobial activity, which may help to delay the progression of periodontitis. So, vitamin D3 can be used as a potential supplement that could be employed to stop the advancement of periodontal disease. How to cite this article: Govindharajulu R, Syed NK, Sukumaran B, et al. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024;25(2):114-117.

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.

Efficacy of adjunctive octenidine hydrochloride as compared to chlorhexidine and placebo as adjuncts to instrumentation in stage I-II periodontitis: A double-blinded randomized controlled trial.

This randomized, controlled, double-blinded clinical trial aimed to evaluate the efficacy of octenidine hydrochloride and chlorhexidine mouthwashes as adjuncts to instrumentation in stage I-II periodontitis patients. Forty-five patients with mild-to-moderate periodontitis were randomly allocated to three groups: 0.1% octenidine dihydrochloride (OCT), placebo, and 0.12% chlorhexidine (CHX) mouthwashes. Patients were instructed to use the mouthwash after instrumentation for twice a day up to 3 weeks. Periodontal parameters such as probing pocket depth (PPD), clinical attachment loss (CAL), O'Leary plaque index (PI), Loe and Silness gingival index (GI), Lobene stain index (SI), and oral soft tissue changes were recorded at baseline and once every week for 3 weeks. The visual analogue scale (VAS) was also recorded as a self-administered questionnaire at the end of the study. The one-way ANOVA was used to compare VAS scores between the groups. The repeated measures ANOVA and post hoc Newman-Keuls tests were used to assess the differences in the periodontal parameters between groups at different time intervals. The Kruskal-Wallis test was used to compare the mean SI. There was a significant reduction in the mean GI of the OCT and CHX groups compared to placebo (p < 0.05). OCT usage resulted in significantly less staining, according to mean SI, when compared to CHX. Furthermore, VAS scores revealed that OCT was significantly the preferred mouthwash (p < 0.01). Adjunctive octenidine hydrochloride may be an alternative to chlorhexidine in its ability to control the periodontal parameters in patients with stage I-II periodontitis. Further larger studies are necessary to confirm these findings.

Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals

ObjectiveTo compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial.Materials and methodsTwenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico–incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson’s Chi-Square, Fisher’s Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan–Meier analysis (p < 0.05).ResultsAfter 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months.ConclusionGH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism.Clinical significanceAfter 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.

Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial

Introduction: Proper tooth brushing is a complicated process for children. Therefore, the aim of this study was to investigate the effect of differential learning to improve tooth brushing in children. Methods: In this prospective, controlled, single-blinded, randomized clinical trial, 58 children between 3 and 8 years of age (mean: 5.7 ± 1.5 years; 29 female) were randomly assigned to test or control group through the child’s self-drawing of an unlabeled envelope from a box. All children received oral hygiene instructions and information in these sealed envelopes and were asked to follow the corresponding instructions at home for 28 days. Children in the test group received instructions with exercises using the differential learning method, whereas the children in the control group received the usual tooth brushing instructions. Results: At baseline and planned follow-ups after 4 and 12 weeks, plaque and gingival indices (QHI, PBI) were recorded in both groups by 2 calibrated and blinded investigators. At baseline, there were no significant differences between the test and control groups regarding plaque and gingival indices (QHI: 4.1 ± 0.5 vs. 4.1 ± 0.4; p = 0.7; PBI: 0.6 ± 0.3 vs. 0.6 ± 0.3; p = 0.7). At the 1st and 2nd follow-up, both groups showed improved oral health indices, but there was an overall better improvement in the test group. While the difference in gingival indices was statistically significant in the 1st recall (PBI/test: 0.1 ± 0.2 vs. control: 0.3 ± 0.2; p < 0.001), the difference in plaque indices was not (QHI/test: 2.1 ± 0.9; control: 2.6 ± 0.9; p = 0.07). At the 2nd recall (mean week = 19.5 weeks), the test group showed statistically significant and clinically relevant better oral health indices than the control group (2nd recall, QHI/test: 2.1 ± 0.9 vs. control: 3.2 ± 1; p < 0.001; PBI/test: 0.1 ± 0.2 vs. control: 0.5 ± 0.2; p < 0.001). Conclusion: In conclusion, differential learning leads to oral hygiene improvement in children with high caries risk and initially poor oral hygiene, which was superior to the conventional learning method through repetition in the medium term.

Associations between immune-inflammatory markers, age, and periodontal status: a cross-sectional study.

Since periodontal disease is associated with many systemic diseases, it is important to evaluate its effects on host responses in elderly individuals. To this end, this study investigated salivary interleukin (IL)-17, IL-18, toll-like receptor (TLR) 2, TLR4, and tumor necrosis factor-alpha (TNF-α) levels in patient groups with different periodontal health statuses and immunologically evaluated the relationship between age and periodontal health status. A total of 60 individuals aged 18-40years (young individuals) and 60 individuals aged 65years or older (elderly individuals) were included in this study. According to periodontal disease status, the patients were divided into periodontally healthy, gingivitis, and periodontitis subgroups. Clinical periodontal parameters, including probing depth (PD), clinical attachment level (CAL), plaque index (PI), and gingival index (GI), were recorded. Saliva samples were collected and analyzed using ELISA to determine the levels of IL-17, IL-18, TLR2, TLR4, and TNF-α. Higher clinical periodontal parameter (PD, CAL, PI, and GI) and inflammatory marker (IL-17, IL-18, TNF-α, TLR2, and TLR4) levels were found in patients with periodontitis than those in periodontally healthy individuals and patients with gingivitis (P < 0.05). Salivary inflammatory marker levels were significantly higher in elderly individuals than those in young individuals in all subgroups (P < 0.05). A positive correlation was found between inflammatory marker levels and clinical periodontal parameters, but there was no correlation between TLR2 and PI or GI. This study suggests a significant increase in host response to periodontal disease as the disease progresses, with the levels of cytokines and TLR expression exhibiting an increasing trend with age. Increased IL-17, IL-18, TLR2, TLR4, and TNF-α levels in elderly individuals in all periodontal health subgroups might suggest the role of these cytokines and TLR pathway in the pathogenesis of periodontal diseases.

Comparative Efficacy of Ceramic Burs and Scalpels in Gingivectomy Procedures for Orthodontic Patients: A Case Series

Background: Orthodontic treatment often leads to gingival hyperplasia, which may complicate oral hygiene and necessitate surgical interventions such as gingivectomy. This study compared the efficacy of ceramic burs versus scalpels in gingivectomy procedures for orthodontic patients, focusing on periodontal outcomes and pain. Methods: This case series describes six orthodontic patients with gingival hyperplasia. The patients were between 15-25 years and were non-smokers. They underwent gingivectomy using two methods: ceramic burs (NTI® Soft Tissue Trimmers) and traditional scalpels. Preoperative oral hygiene instructions were given, and intraoral photographs were obtained. Clinical measurements included the plaque index (PI), gingival index (GI), and bleeding index (BI). Bleeding, pain (using a visual analog scale), and periodontal indices were assessed at several time points postoperatively. Results: Both groups showed significant improvements in gingival hyperplasia, PI, and mean GI. However, the ceramic bur group experienced lower postoperative pain compared to the scalpel group. One patient in the scalpel group required analgesics for pain management. The results highlighted the effective management of gingival hyperplasia with both methods but with a potential advantage in pain management for the ceramic bur group. Conclusion: This study indicated that both ceramic burs and scalpels are effective for gingivectomy in orthodontic patients. Ceramic burs might offer a less painful alternative, although both methods effectively manage gingival hyperplasia. Further studies with a larger sample size and longer follow-ups are required to confirm the present findings and potentially recommend ceramic burs as a preferred method for gingivectomy.

Clinical parameters and inflammatory biomarkers among patients with multibracket appliances: a prospective clinical trial

BackgroundAim of the presented study was to investigate changes in clinical parameters and active matrix metalloproteinase-8 (aMMP-8) levels in gingival crevicular fluid of patients before and during treatment with multibrackets appliances.MethodsFifty-five adolescents scheduled for the treatment were included. Clinical parameters and subgingival samples were obtained at six time points: 1 week before appliance insertion (T0), 3 (T1), 6 (T2) weeks, 3 (T3), 6 (T4) months, and 1 year (T5) after that. Gingival index and plaque index were assessed to evaluated changes on the clinical status. Subgingival samples were collected to analyze changes in aMMP-8.ResultsScores for gingival and plaque index increased after bracket insertion. The gingival index increased from T2 (p < 0.05) until T5 (p < 0.0001). Plaque index also increased, reaching its maximum peak at T3 (p < 0.05). Moreover, an increase of aMMP-8 levels (p < 0.05) was noted. There was no significant between upper and lower jaws.ConclusionsTreatment with multibracket appliances in adolescents favors dental plaque accumulation and may transitionally increase gingival and plaque index and aMMP-8 levels leading to gingival inflammation, even 1 year after therapy began.Trial registrationThis study was approved by the Ethics Committee of the dental medical association Rheiland-Pfalz, Germany (process no. 837.340.12 (8441-F)), and followed the guidelines of Good Clinical Practices.

Serum 25 hydroxycholecalciferol in periodontitis patients with type 2 diabetes mellitus - A socioeconomic and clinicobiochemical study in Chhattisgarh.

Very few studies have examined the impact of the concurrent presence of periodontitis (PD) and type 2 diabetes mellitus (T2DM) on serum Vitamin D levels, particularly in developing nations like India, and needs further investigation. This study aims to assess the relationship between serum Vitamin D values and PD in T2DM patients and to study the correlation between socioeconomic and demographic variables that influence the serum Vitamin D levels and the extent of PD in patients with T2DM. This was a cross-sectional, hospital-based research. Medical, dental, and diet histories were obtained from the participants, and their socioeconomic status (SES) was determined. Clinical parameters - plaque index (PI), gingival index (GI), sites with gingival bleeding, probing pocket depth (PPD), and clinical attachment level (CAL) were compared among three groups -patients with generalized Stage III Grade B PD with T2DM (n=35), patients with generalized stage III Grade B PD (n=35) and healthy controls (n=35) and the clinical parameters - plaque index(PI), gingival index(GI), sites with gingival bleeding, probing pocket depth(PPD), and clinical attachment level(CAL) were measured. Biochemical tests included the evaluation of serum 25-hydroxyvitamin D (25[OH] D) and hemoglobin A1C (HbA1c) levels. Periodontal and biochemical parameters were compared using a one-way analysis of variance across the three groups. The association between clinical parameters, SES, and 25(OH)D was examined using Pearson's correlation coefficient test and linear regression analysis. The serum 25(OH)D levels were lowest in the subjects with generalized Stage III Grade B PD with T2DM (13.54 ± 3.31 ng/mL). Furthermore, there was a significant (P < 0.01) negative correlation between serum 25(OH)D and periodontal parameters, PI (-0.442), PPD (-0.474), CAL (-0.459), sites with gingival bleeding (-0.354), and GI (-0.346) among the groups. The regression analyses showed that an increase in periodontal parameters (PI, GI, PPD, and CAL) and a higher HbA1c was linked to a lower 25(OH)D. However, the periodontal parameters and 25(OH)D levels showed no correlation with socioeconomic and demographic parameters in the study. Serum Vitamin D values are negatively influenced by the synergistic effect of PD and T2DM or by the presence of PD alone. However, the association of SES on serum Vitamin D values in individuals with PD and T2DM or PD alone could not be demonstrated.

Comparative Assessment of the Efficacy of the GumChucks Flossing System and String Floss for Plaque Removal in Mentally Disabled Children: A Randomized Clinical Trial.

Mentally disabled children have been found to have poor oral hygiene, a greater prevalence of periodontal disease, and higher caries prevalence. Flossing is an important oral hygiene skill adjacent to toothbrushing in plaque removal than brushing alone in children. GumChucks is a novel flossing device designed to assist children with easy and proper flossing techniques. To compare the efficacy of the GumChucks flossing system and string floss (SF) for plaque removal in mentally disabled children. Participants were randomly assigned to either GumChucks or SF. At baseline, a toothbrushing and flossing demonstration was given to all the participants. Gingival index (GI) and plaque index (PI) were recorded at baseline, 1 week, and 4 weeks postusage. Overall, there was a significant reduction in GI and PI after first use with children using GumChucks compared to SF floss. After 1 week and 4 weeks of postusage, children in the GumChucks group demonstrated significantly greater improvement in GI (1.03 ± 0.60), (1.12 ± 0.66), and PI (0.97 ± 0.53), (1.10 ± 0.54) from baseline p ≤ 0.05. GumChucks was an effective alternative plaque removal, with recommended caretakers' supervision for mentally disabled children. Takle TV, Vishwakarma PY, Dodamani AS, et al. Comparative Assessment of the Efficacy of the GumChucks Flossing System and String Floss for Plaque Removal in Mentally Disabled Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2024;17(3):255-259.

Psychological Stress and its relationship to Periodontal flora and salivary Nitrite/Nitrate

ObjectivePsychological stress can be a common risk factor for the development of oral and systemic disease; therefore, analysis of a pathophysiologic mechanisms that may explain this association may be significant in planning preventive strategies. The aim of this study was to investigate the association amongst academic stress, periodontal health, and salivary cortisol and nitrite and nitrate levels in a sample of university students. MethodsParticipants (N = 14) were classified into 2 groups according to their exposure to academic stress due to periods of university exams (n = 6 and n = 8, respectively). All participants were subjected evlauted for their behavioural, psychological, and anthropometric parameters, as well as an oral health examination. A real-time polymerase chain reaction analysis in samples of saliva and plaque was used to detect Prevotella intermedia and Veillonella dispar as well as the total bacterial count. Nitrite/nitrate ratio (NR ratio) and cortisol in saliva were evaluated by enzyme-linked immunosorbent assay. ResultsFull Mouth Bleeding Score, Full Mouth Plaque Score, and Gingival Index were significantly higher in the group exposed to academic stress. Nitrite was directly related to the presence of V dispar (coefficient, 0.13; P = .00; CI, 0.07 to 0.19) and inversely related to total bacterial count (coefficient, −0.07; P = .012; CI, −0.13 to 0.02). NR ratio was directly related to V dispar (coefficient, 4.35; P = .010; 95% CI, 1.35 to 7.36) and inversely related to total bacterial count (coefficient, −4.05; P = .018; 95% CI, −7.32 to 0.86). ConclusionsThese results confirm the importance of stress on periodontal health and salivary nitrite concentration and highlight a potential differential role of specific bacteria on nitrite concentration in saliva.

Assessment of peri-implant tissues in posterior implants placed using flapless approach: A clinicoradiographic study.

It is important to prognosticate the hard- and soft-tissue alterations in immediate and delayed implants, as inadequacy can lead to complications affecting the long-term survival of the implant. Therefore, the purpose of this study was to evaluate and compare the hard- and soft-tissue changes in immediate and delayed posterior implants with a flapless approach. With an equal allocation ratio, the study included 46 patients requiring implant treatment in the posterior segment, including the premolars and molars. Group 1 consisted of patients with immediate implants, whereas Group 2 consisted of patients who received delayed implants. The clinical parameters, including plaque index (PI), gingival index, modified sulcus bleeding index, probing depth, and soft-tissue assessment using the Testori esthetic score (TS), were evaluated at baseline, 3, 6, 9, and 12 months. Hard-tissue parameters, such as buccal bone thickness (BBT), crestal bone height (CBH), and ridge width, were evaluated radiographically with cone-beam computed tomography at baseline and 12 months posttherapy. Intragroup comparisons in both the groups showed significant differences in PI, probing pocket depth, and TS over time (P = 0.00). The mean BBT at the crest in delayed implants (1.76 ± 0.24) significantly reduced after 12 months compared to immediate implants. A significantly higher TS score was observed after 12 months in both the groups. A significant difference in TS scores after 12 months was found between the two groups, with better esthetics in Group 1 compared to Group 2. However, no significant changes in BBT or CBH were observed after 12 months in Group 1.

Closed sinus lift and fixed prostheses versus implant-assisted overdentures in management of atrophied distal extension maxillary ridges: A one-year randomized clinical trial

Rehabilitation of elderly or medically compromised patients with an atrophied unilateral posterior maxillary ridge by an implant-supported prosthesis may be complicated by maxillary sinus pneumatization with insufficient bone for implant placement. This short-term clinical trial assessed clinical results of closed sinus lift and fixed prosthesis versus implant-assisted overdentures in the management of participants with atrophied distal extension maxillary ridges. Forty participants with unilateral atrophying distal extension maxillary ridges were randomly assigned into 2 groups. The CSL group (n=20) participants received fixed prostheses supported by 3 implants following a closed sinus lift. The IOD group (n=20) participants received removable partial overdentures assisted by a single implant that was positioned mesially to the maxillary sinus. The modified plaque index (MPI), modified gingival index (MGI), pocket depth (PD), implant stability (IS), and vertical bone loss (VBL) were measured at prosthesis delivery (T0), and 6 (T6) and 12 months (T12) after delivery. The oral health impact profile (OHIP-14) questionnaire was used to assess oral health-related quality of life (OHRQoL) at T12. Significant differences between observation times were performed using Friedman and Wilcoxon signed-rank tests for MPI and MGI and using repeated measures ANOVA with Bonferroni correction of P values for PD, IS, VBL, and OHIP. Between-group comparison of MPI and MGI the Mann-Whitney test was used, while for PD, IS, VBL, and OHIP comparison was made using independent samples t test (α=.05 for all tests). The implant survival rates were 100% for both groups. MPI and PD significantly increased with time for both groups. MGI significantly increased with time for the CSL group only (P=.049). The IS significantly decreased with time for the IOD group. VBL increased significantly from T6 to T12 for the CSL (P=.042) and the IOD (P=.002) groups. The CSL group recorded higher MPI, MGI, PD, and IS values than the IOD group (P<.05). The IOD group recorded higher VBL than the CSL group (P<.001). The CSL group scored significantly lower OHIP-14 values (better OHRQoL) than the IOD group for all values (P<.05). In comparison with implant-assisted partial overdentures, closed sinus lift with fixed prostheses had higher implant stability, reduced bone loss, and higher participant OHRQoL. However, peri-implant soft tissue health was found to be better with implant overdentures.

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.