Gingivitis Research Articles

Herpesvirus-Bacteria pathogenic interaction in juvenile (aggressive) periodontitis. A novel etiologic concept of the disease.

Localized juvenile (aggressive) periodontitis starts at puberty in otherwise healthy individuals and involves the proximal surfaces of permanent incisors and first molars. The disease destroys a sizeable amount of periodontal bone within a few months despite minimal dental plaque and gingival tissue inflammation. Cytomegalovirus and Epstein-Barr virus, as well as the two main periodontopathic bacteria Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, are linked to juvenile periodontitis. Juvenile periodontitis-affected teeth show cementum hypoplasia. We hypothesize that an active herpesvirus infection, at the time of root formation, hampers cementum formation and, at puberty, herpesvirus reactivation triggers an upgrowth of bacterial pathogens which produce rapid periodontal destruction on teeth with a defective periodontium. A pathogenic interaction between active herpesviruses and bacterial pathogens can potentially explain the etiology and incisor-first molar destructive pattern of juvenile periodontitis. Effective treatment of juvenile periodontitis may target the herpesvirus-bacteria co-infection.

Indications, limitations, and outcomes of clear aligners in orthodontic treatment

Clear aligners have gained popularity in orthodontic treatment as a comfortable and aesthetically pleasing alternative to traditional braces. The use of clear aligners has increased due to their advantages, including improved aesthetics, easy removability, and minimal soft tissue irritation. The treatment process involves sequential aligners custom-made for each patient, using computer-aided design and manufacturing technology. Clear aligners employ controlled forces to gradually move teeth into proper alignment. However, clear aligners have limitations, such as the need for patient compliance and their effectiveness in addressing complex malocclusions. Clinical considerations include thorough assessment, regular follow-up visits, and patient education. Treatment outcomes vary depending on the specific malocclusion characteristics. Clear aligners have demonstrated benefits in treating mild malocclusions, spacing issues, and certain types of malocclusion corrections. Treatment duration may be shorter compared to fixed appliances in mild cases. Stability and periodontal health can be influenced by clear aligner therapy, which has effects on plaque levels and gingival inflammation. Root resorption is a concern, but aligners have shown a lower prevalence compared to fixed appliances. Compliance, eruption of permanent teeth, and limitations in visualizing hard and soft tissues are important considerations. Overall, clear aligners offer an aesthetic orthodontic treatment option for a variety of dental abnormalities and mild to moderate orthodontic issues.

Clinical indicators of gingival inflammation in smokers with periodontitis

Relevance. According to the latest international classification of periodontal diseases of 2018, smoking, along with diabetes mellitus, belongs to the main modifying factors of the periodontitis course. At the same time, the clinical signs of gingival inflammation in smokers are not very pronounced.The study aimed to determine significant clinical indicators of gingival inflammation in tobacco-dependent peri- odontal patients.Materials and methods. The study interviewed and examined 82 patients with generalized periodontitis aged 20 to 63 years. Patients with diabetes mellitus were excluded. The examination evaluated the caries prevalence (DMFT index), the degree of periodontal attachment loss, the periodontitis progression type by an indirect indicator, oral hygiene status (Green-Vermilion index), tooth mobility (D.A. Entin), bleeding on probing (Mühlemann modified by Cowell; Ainamo, Wow). Based on their attitude to smoking, patients were randomized into three groups: the first group consisted of 18 patients who smoked up to 10 cigarettes per day; the second group included 15 patients who smoked 10-20 or more cigarettes per day; and the third group (comparison group) consisted of 18 non-smokers.Results. The oral hygiene status, caries prevalence, the number of extracted teeth, the mobility of remaining teeth and the bleeding on probing score appeared to be the same in non-smoking and smoking periodontal patients. However, the number of patients with severe periodontitis was statistically significantly higher in heavy smokers with periodontitis (more than ten cigarettes per day); every other patient had comorbidity, rapid progression of the disease, and the clinical indicator of gingival inflammation based on the prevalence of bleeding on probing was at 100%.Conclusion. We believe that the prevalence of bleeding on probing should be the main parameter for gingival inflammation assessment in smokers, which allows for the objective follow-up of the process progression in such patients and motivation for treatment and smoking cessation.

Matrix Metalloproteinase Activity in Gingival Crevicular Fluid and Periodontal Health Status in Down Syndrome Patients: A Comparative Study.

Introduction Periodontal diseases, caused by gram-negative bacteria, often begin as gingivitis and can progress to periodontitis, characterized by inflammation extending to the periodontal ligament and alveolar bone. Individuals with Down syndrome (DS) commonly exhibit poorer oral hygiene and a higher prevalence of severe chronic periodontitis. This study aimed to identify unregulated risk factors in DS that contribute to increased periodontal breakdown. Materials and methods We conducted a study with 60 age-matched patients, including 20 DS patients from Balavihar Special School and 40 systemically healthy patients with and without periodontitis from Thai Moogambigai Dental College and Hospital. We collected patients' complete case histories and blood samples for evaluating matrix metalloproteinase 8 (MMP8) and matrix metalloproteinase 9 (MMP9) levels. All patients underwent nonsurgical periodontal therapy, and the samples were processed at the Central Research Laboratory at Meenakshi Ammal Dental College and Hospital. We calculated each group's mean and standard deviation and compared them using one-way analysis of variance and Kruskal-Wallis tests, followed by post hoc (Tukey honestly significant difference) multiple group comparisons. Statistical analysis was performed using Statistical Product and Service Solutions (SPSS) Statistics for Windows, Version 17.0. (Chicago: SPSS Inc.). Results The mean value of MMP8 in the DS group with chronic periodontitis was -18.1895, which was statistically significant (P<.001) compared to the mean value of -20.3720 in systemically healthy subjects with chronic periodontitis and -21.7120 in systemically healthy controls. Similarly, the mean value of MMP9 in the DS group with chronic periodontitis was 18.6455, which was statistically significant (P<.001) compared to the mean values of 19.8540 in systemically healthy subjects with chronic periodontitis and 25.2505 in systemically healthy controls. These findings indicate that DS subjects exhibit increased levels of pro-inflammatory cytokines MMP8 and MMP9, serving as markers for identifying periodontal disease. The mean differences in MMP8 and MMP9 in the DS group with chronic periodontitis showed highly statistically significant levels compared to both systemically healthy groups. Conclusion This study aimed to identify unregulated risk factors in DS that contribute to increased periodontal breakdown. Our findings revealed elevated MMP8 and MMP9 in DS patients with periodontitis, indicating an increased risk for early development of destructive forms of periodontal disease in this population. Extensive gingival tissue inflammation, bleeding on probing, increasing probing depths, loss of periodontal attachment, and alveolar bone loss are all common symptoms.

Factors associated with oral health status in individuals with Asperger syndrome – A cross-sectional study

Objectives: This study aimed to evaluate oral health and factors that may influence it in individuals with Asperger’s syndrome. Methods: This observational cross-sectional study was divided into two stages: a question- naire and an oral examination, using the decayed-missing-filled index, the gingival index, and the simplified oral hygiene index. Data were analyzed using SPSS® software (version 26.0), considering a significance level of 0.05. After verifying the non-normality with the Kolmogorov-Smirnov test, the Mann-Whitney and Kruskal-Wallis tests were used. Results: The investigation included 23 adults with Asperger syndrome. A decayed-miss- ing-filled index of 2.65(±2.81), a gingival index of 1.06(±0.36) and a simplified oral hygiene index of 2.08(±0.73) were found. Most respondents (60.8%) brushed their teeth twice a day. Individuals with higher brushing frequency and those who recently had an oral appointment had lower calculus deposits (p=0.038 and p=0.021, respectively). Conclusions: The individuals had a low dental caries prevalence, mild gingival inflammation, and a fair oral hygiene status. Although there are factors capable of influencing the oral health of these individuals, good results can be obtained if adequate oral hygiene habits are maintained, namely brushing twice a day.

Evaluation of Gingival Bleeding Awareness Among Dental Students at University of Tripoli

Background and objectives. Bleeding of the gingiva is considered as an early sign of gingival inflammation and periodontal destruction. Bleeding on probing is used by clinicians to measure the prevalence and progression of periodontal disease, evaluate treatment outcome, and motivate patients to perform regular professional home care. The aims of this study were to assess self-experience gingival bleeding and to determine the oral health attitude and behavior among Libyan dental students. Methods. About 230 undergraduate dental students were given a questionnaire administered by three investigators after taking verbal consent. The answers of the filled questionnaires have been collected within 30 days and analyzed through SPSS version 25. Results. A total of 220 students answered the questionnaire and the frequency of gingival bleeding during tooth brushing were (55.0%) of students rarely experience gingival bleeding, twenty-nine participants (13.2%) frequently practiced gingival bleeding, and nearly one third (70, 31.8%) of students conveyed no bleeding. More than 72% of the students answered that smoking might increase gingival bleeding. Regarding mechanical stimuli, tooth brushing was considered by 77.7% of students as the main cause of gingival bleeding. Along with 18.7% have bleeding while eating hard food. Furthermore, only 3.6% of the study sample have early morning gingival bleeding. After bleeding, 33.2% of students visited the dentist whereas 23.6% of students stopped tooth brushing. Conclusions. Knowledge and awareness concerning cause of gingival bleeding is still poor among Libyan dental students. Furthermore, many responses of these students were inappropriate or not optimal regarding the management of the gingival bleeding. Therefore, more dental health education is needed to improve oral health and prevent periodontal disease.

Drug-induced gingival enlargement – Oral implications for prescribing physicians

A male patient presented with a main complaint of persistent growth of the upper and lower gingiva that bled easily and resulted in an inability of maintaining proper oral hygiene. He reports that the growth of the gingiva started approximately three years prior to consultation in our clinic and is asymptomatic. His medical history revealed that he suffers from epilepsy and was being treated with a daily anticonvulsant, namely Phenytoin (100mg). Full-mouth non-surgical periodontal therapy was performed and supplemented with an adjunctive chlorhexidine mouth rinse as a chemical plaque control mechanism. Part of the systemic phaseof management of the patient, involved requesting the medical physician change the current epilepsy medication to Epilim®, which was benefi cial in contributing to the resolution of gingival enlargement. Signifi cant reduction in gingival infl ammation and enlargement were achieved with the non-surgical treatment.Corrective surgery therapy was performed to treat those areas of DIGE that had not resolved.

Effects of orthodontic treatment on porphyromonas gingivalis, gingipains and gingival inflammation

Purpose: To assess the effects of orthodontic treatment on the changes of Porphyromonas gingivalis ( P.g) and gingipains as well as gingival inflammation. Materials and methods: A total of 105 patients who had healthy gingivae and were treated as research subjects, the gingival crevicular fluid of whom was all collected before treatment and in the 1st, 2nd, 3rd, and 6th months after wearing an appliance. Then, the 16S ribosomal deoxyribonucleic acid (rDNA) polymerase chain reaction (PCR) technique was employed to detect the levels of P.g, Lys-gingipain (Kgp) and Arg-gingipain (Rgp) in the specimens. It was followed by a statistical analysis of the data via the SPSS 23.0 software package. Results: In P.g detection, the 16S rDNA PCR technique presented specific advantages and high sensitivity. The positive detection rate of P.g in the 1st, 2nd and 3rd month of treatment ( p &lt; .05), that of Kgp in P.g-positive patients in the 2nd and 3rd months of treatment ( p &lt; .05), and that of Rgp in P.g-positive patients in the 2nd and 3rd months of treatment ( p &lt; .05) were higher than the pre-treatment results. Compared with gingival index (GI)-0 patients, GI-1 patients exhibited higher positive detection rates of P.g and Kgp and Rgp, which were further found to be positively correlated with the treatment duration and GI ( p &lt; .05). Conclusion: In the early stage of orthodontic treatment, the levels of P.g, Kgp and Rgp rise after wearing the appliance, inducing gingival inflammation.

The adiponectin receptor agonist AdipoAI attenuates periodontitis in diabetic rats by inhibiting gingival fibroblast-induced macrophage migration.

Low-grade inflammation, which is a common feature of both diabetes and periodontitis, partly accounts for the complexity and refractory of the diabetes-associated periodontitis. Adiponectin (APN), the most abundant adipokine in human blood, has been widely reported to have anti-inflammatory functions. Herein, we investigated the ability of an APN receptor agonist, AdipoAI, to alleviate diabetes-associated periodontitis. Furthermore, we revealed the possible mechanism underlying its anti-inflammatory effects. The maxillary first molar of Zucker diabetic fatty (ZDF) rats was ligated to construct a diabetes-associated periodontitis model, and the rats were administered AdipoAI by gavage. We examined diabetes-related indexes, pathological changes in insulin target organs, alveolar bone resorption and systemic and local inflammation. In vitro, transwell assays were used to evaluate monocyte/macrophage migration induced by human gingival fibroblasts (hGFs) with/without AdipoAI treatment. Additionally, we examined chemokine expression levels in hGFs and hGF-induced monocyte/macrophage migration upon siRNA knockdown of Adiponectin receptors (AdipoRs) expression. Expression of AdipoR1/AdipoR2 and inflammation-related signalling pathways was examined by IHC and WB, which was followed by confirmation with an NF-κB P65 inhibitor (BAY 11-7082). AdipoAI lowered fasting blood glucose and serum insulin in ZDF rats and alleviated inflammation in insulin target tissues. Locally, AdipoAI reduced alveolar bone absorption and inflammation in gingiva. Mechanistically, AdipoAI inhibited hGF-induced monocyte/macrophage migration by reducing CCL2 secretion. In hGFs, AdipoAI attenuated LPS-induced activation of NF-κB P65 and CCL2 expression, which was dependent on AdipoR1. AdipoAI, with its ability to alleviate inflammatory damage in tissues, is a candidate for diabetes-associated periodontitis treatment.

Immune checkpoint inhibitors-associated periodontitis: A propensity score-matched retrospective cohort study.

e14618 Background: Immune checkpoint inhibitors (ICIs) have been associated with a wide spectrum of immune-related adverse events (irAE) including oral mucositis and xerostomia. Periodontitis is another form of common oral pathology characterized by severe gingival inflammation but has not been investigated in patients receiving ICIs. We aimed to evaluate the risk of periodontitis associated with the use of ICI and to determine the clinical outcome of ICI-associated periodontitis. Methods: We conducted a 1:1 propensity score-matched retrospective cohort study involving patients receiving ICIs between January 2010 and November 2021. The primary outcome was periodontitis and the secondary outcomes were overall survival (OS), progression-free survival (PFS), and objective response rates. The propensity score matching was performed using basic demographics, underlying comorbidities, cancer type, and cancer therapy. The risk of periodontitis and associations between periodontitis and survival were evaluated using Cox proportional hazard analysis and Kaplan-Meier survival analysis. Results: We matched 868 patients receiving ICIs to patients who did not receive ICIs. Among ICI users, 41 (4.7%) patients developed periodontitis. The incidence rate of periodontitis was about 2-fold higher in ICI users than non-users (55.3 vs 25.8 per 100 patient-years; incidence rate ratio: 2.1 [95% CI: 1.4-3.3], p &lt; 0.001). In Cox regression analyses, the use of ICI was associated with an 80-90% increased risk of periodontitis. The presence of immune-related periodontitis was associated with improved OS (median not reached vs. 17.8 months, p &lt; 0.001), PFS (median 14.9 vs. 5.6 months, p = 0.009), and objective response rates (complete or partial response, 55% vs. 27%, p &lt; 0.001). In Cox regression analyses, ICI use was associated with a 30-60% lower risk of all-cause mortality or disease progression. Conclusions: ICIs were associated with an increased risk of periodontitis. ICI-related periodontitis was associated with better survival outcomes and treatment responses.[Table: see text]

Resolvin D1 (RvD1) Regulates Porphyromonas Gingivalis Lipopolysaccharide-induced Del-1 and Cytokine Expressions in Human Gingival Fibroblasts

Purpose: To detect the effect of Resolvin D1 (RvD1) on Developmental endothelial locus-1 (Del-1) and cytokine expressions of human gingival fibroblast cells exposed to Porphyromonas gingivalis lipopolysaccharide (P. gingivalis-LPS).&#x0D; &#x0D; Material and Methods: The effect of RvD1 on cell viability of human gingival fibroblasts exposed to P. gingivalis-LPS were determined by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Meanwhile, the effect of RvE1 on Del-1 and cytokine (IL-1β, IL-6, IL-8, IL-10, IL-17) expressions of human gingival fibroblasts exposed to P. gingivalis-LPS were studied by real-time PCR experiment, statistical analysis was performed using GraphPad Prism version 5 for Windows.&#x0D; &#x0D; Results: Cell viability assay results demonstrated that RvD1 concentrations upregulated cell number compared to control group at 24 and at 72 hours. While RvD1 reduced IL-6, IL-8, IL-17 mRNA expression, IL-10 and Del-1 mRNA expression increased as a time- and dose-dependent manner. Also, IL-1β was not affected by RvD1 treatments. &#x0D; &#x0D; Conclusion: The increased expression of Del-1 and IL-10 by RvD1 down-regulated the pro-inflammatory cytokine expressions induced by P. gingivalis-LPS in gingival fibroblast. RvD1 displayed regulatory effects on gingival inflammation in P. gingivalis LPS-induced cell culture experiment. In particular, results of study display that Del-1 induced by RvD1 may have therapeutic potential to modulate periodontal inflammation.

Free sugars and gingival inflammation: A systematic review and meta-analysis.

Consumption of free sugars has been associated with chronic non-communicable diseases. The aim of the study was to investigate the effect of free-sugar consumption on gingival inflammation using a systematic review and meta-analysis based on the PICO question 'What impact does the restriction of free sugars have on the inflammation of gingival tissue?' Literature review and analyses were based on the Cochrane Handbook for Systematic Reviews of Interventions. Controlled clinical studies reporting on free-sugar interventions and gingival inflammation were included. Risk of bias was performed with ROBINS-I and ROB-2, and effect sizes were estimated with robust variance meta-regressions. Of the 1777 primarily identified studies, 1768 were excluded, and 9 studies with 209 participants with gingival inflammation measures were included. Six of these studies reported on the dental plaque scores of 113 participants. Restriction of free sugars, when compared with no such restriction, was associated with statistically significantly improved gingival health scores (standard mean difference [SMD] = -0.92; 95% confidence interval [CI]: -1.43 to -0.42, p < .004; I2 [heterogeneity] = 46.8) and a trend towards lower dental plaque scores (SMD = -0.61; 95% CI: -1.28 to 0.05, p < .07; I2 = 41.3). The observed improvement of gingival inflammation scores with restricted consumption of free sugar was robust against various statistical imputations. No meta-regression models were feasible because of the limited number of studies. The median publication year was 1982. Risk-of-bias analysis showed a moderate risk in all studies. Restriction of free sugar was shown to be associated with reduced gingival inflammation. The systematic review was registered at PROSPERO (CRD 42020157914).

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

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

(105) The Discovery of New Incredible Positive Actions of Hormone Replacement Therapy and Sex in Menopause

Abstract Introduction Every year, two or more benefits of the use of hormone replacement therapy (HRT) in menopause and andropause appear in medical literature. We present an extensive review of the literature describing the classical and novel benefits of hormonal replacement therapy and sex in menopause. Additionally, we present recent findings from our own patient population. Objective To contribute to the presently known benefits of the use of HRTs, and additionally to present new findings from our own practice not previously described. Methods We conducted an extensive literature review and described our own experience and findings within our centers. Results `- In the area of prevention and treatment of genitourinary syndrome of menopause, we have found: - Prevention and treatment of false positive cervical dysplasia in perimenopause. - Prevention and treatment of vulvar, labial, and vaginal occlusion in late menopause. - Prevention and treatment of recurrent urinary tract infections in geriatric patients for prevention of sepsis, secondary pneumonia, and even death. - Prevention and treatment of clitoral atrophy, phimosis, and urethral caruncles - Dermatology: We have found: - Prevention and treatment of wrinkles, alopecia related, postmenopause. - Prevention in prostrated geriatric patients of decubitus ulcers. - Internal Medicine: prevention of obesity, decreased metabolic rate, and insulin resistance. - Ophthalmology: - Prevention and treatment of macular degeneration. - Prevention of glaucoma (increased intraocular pressure), most notably in primary open- angle glaucoma. - The prevention of aging of optic nerve and neuroprotection of retinal cells. - Oncology: - Prevention of kidney cancers, and breast cancer (only estrogen hormone replacement therapy). - Enhanced visualization of the transformation zone during cervical cancer screening - Gastroenterology: protection of the gut microbiome and serum metabolome, especially in premature ovarian insufficiency - Dentistry: prevention of tooth loss through decreased gingival inflammation and periodontitis, mandibular bone loss, and oral dysesthesia. - Neurology: - Protection against intracranial aneurysm rupture in ovariectomized mice. - The prevention of Parkinson’s and Alzheimer’s disease - Rheumatology: prevention of rheumatoid arthritis. Conclusions To demonstrate the number of studies with the anti-aging mechanism of the use of HRT. How this knowledge, alongside our own findings of hundreds of menopausal women within our centers justify the generalized use of this therapy. Disclosure No

Oral health-related quality of life and oral manifestations of Syrian children with congenital heart disease: a case-control study

BackgroundThere was an immense need for studies evaluating the oral health status of Syrian children with congenital heart disease (CHD) and its impact on their quality of life. No contemporary data are available. The objective of this study was to investigate oral manifestations and oral health-related quality of life (OHRQoL) of children with CHD and compare them with healthy controls aged 4–12 years.MethodsA case-control study was undertaken. A total of 200 patients with CHD and 100 healthy children belonging to the same patient’s family were included. Decayed, missed, and filled permanent teeth index (DMFT) and decayed, missed, and filled primary teeth index (dmft), Oral Hygiene Index (OHI), Papillary Marginal Gingivitis Index (PMGI), and dental abnormalities were recorded. The Arabic version of the Child Oral Health-Related Quality of Life Questionnaire (COHRQoL, 36-item) which was divided into 4 different domains (Oral Symptoms, Functional Limitations, Emotional Well-Being, Social Well-Being) were studied. Chi-square test and independent- t-test were used to perform statistical analysis.ResultsCHD patients experienced more periodontitis, dental caries, poor oral health, and enamel defects. The dmft mean was significantly higher in CHD patients than in healthy children (5.245 vs. 2.660, P < 0.05). No significant difference was found between patients and controls in the DMFT Mean (P = 0.731). There was a significant difference between CHD patients and healthy children in the mean of the OHI (5.954 vs. 1.871, P < 0.05), and PMGI (1.689 vs. 1.170, P < 0.05). CHD patients have significantly higher enamel opacities (8% vs. 2%) and hypocalcification (10.5% vs. 2%) than controls. Also, the 4 COHRQoL domains, showed significant differences between CHD children and controls.ConclusionsEvidence about the oral health and COHRQoL of children with CHD was provided. Further preventive measures are still required to improve the health and quality of life of this vulnerable group of children.

Effects of blue-light LED toothbrush on reducing dental plaque and gingival inflammation in orthodontic patients with fixed appliances: a crossover randomized controlled trial

BackgroundPatients with fixed orthodontic appliances have higher plaque accumulation and gingival inflammation. Our aim was to compare the effectiveness of a light emitting diode (LED) toothbrush with a manual toothbrush in reducing dental plaque and gingival inflammation in orthodontic patients with fixed appliances, and to investigate the effect of the LED toothbrush on Streptococcus mutans (S. mutans) biofilm in vitro.MethodsTwenty-four orthodontic patients were recruited and randomly assigned into 2 groups: (1) started with manual and (2) started with LED toothbrushes. After a 28-day usage and 28-day wash-out period, the patients switched to the other intervention. The plaque and gingival indices were determined at baseline and 28 days after each intervention. The patients’ compliance and satisfaction scores were collected using questionnaires. For the in vitro experiments, S. mutans biofilm was divided into 5 groups (n = 6) with 15-, 30-, 60-, or 120-sec LED exposure, and without LED exposure as a control group.ResultsThere was no significant difference in the gingival index between the manual and LED toothbrush groups. The manual toothbrush was significantly more effective in reducing the plaque index in the proximal area on the bracket side (P = 0.031). However, no significant difference was found between the two groups in other areas around the brackets or on the non-bracket side. After LED exposure in vitro, the percentages of bacterial viability after LED exposure for 15–120 s were significantly lower compared with the control (P = 0.006).ConclusionClinically, the LED toothbrush was not more effective in reducing dental plaque or gingival inflammation than the manual toothbrush in orthodontic patients with fixed appliances. However, the blue light from the LED toothbrush significantly reduced the number of S. mutans in biofilm when it was exposed to the light for at least 15 s in vitro.Clinical Trial RegistrationThai Clinical Trials Registry (TCTR20210510004). Registered 10/05/2021.

Role of nutritional supplements on oral health in adults - A systematic review.

Purpose: The word 'diet' usually encompasses the consumption of food that includes all the necessary nutrients required for the optimal functioning of the body. Nutritional supplements hold a supreme position due to the demanding lifestyles or medical conditions in this current era. Although medical literature has sufficient evidence exploring the effect of nutrients on general health, this systematic review aimed at specifically evaluating the role of nutritional supplements on oral health in adults. Methods: PRISMA guidelines were followed in conducting this systematic review where four electronic databases including Scopus, PubMed, EMBASE, and Web of Science were reviewed. Based on the inclusion criteria, four studies exploring the effect of oral nutritional supplements on oral health among the adult population were included in this systematic review. Results: This review generated evidence suggesting a positive effect of nutritional supplements on oral health. These findings were depicted in the form of a reduction in plaque scores, probing depths, gingival inflammation, and greater improvement in periodontal healing among individuals with higher intakes of nutritional supplements within recommended doses. Conclusions: The systematic review outlines the positive impact of consuming nutritional supplements in the recommended dosage on oral health.Additionally, this review stresses the necessity for interventional studies to further investigate the effects of nutritional supplements on oral health, particularly in regard to periodontal healing. PROSPERO registration: CRD42021287797 (27/11/2021).

The Influence of Fixed Dental Prostheses on the Expression of Inflammatory Markers and Periodontal Status-Narrative Review.

A dental prosthesis will only be successful if the restoration lasts for a long period and does not cause any illness. The presence of permanent prosthetic restorations has been linked to an increased risk of periodontal infections, according to a large body of research that has been gathered. When chronic inflammation is brought on by fixed prosthetic constructions, both cellular and noncellular immunity are activated as adaptive immune mechanisms. It has previously been stated that both clinically adequate and inadequate restorations might cause gingival inflammation. Areas surrounding the abutment teeth presented periodontal pockets, attachment loss, congestion, bleeding on probing, and gingival hyperplasia after fixed restorations were removed. The depth of pockets, bleeding on probing, and bone loss are all closely correlated with disease's severity and IL-1β concentration in gingival crevicular fluid; IL-1β shows higher values in disease sites than in healthy ones. hs-CRP and TNF-α blood levels showed a considerable reduction one day after fixed restorations were applied, in comparison with the pre-treatment values. Collaboration between prosthodontists and periodontists is essential for a good treatment outcome since it will increase the restoration's lifespan, enhance periodontal health, and improve the quality of life for dental patients.

The anti-plaque effect of high concentration sodium bicarbonate dentifrice on plaque formation and gingival inflammation, irrespective to individual polishing technique and plaque quality

AimTo assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation, and gingivitis, as compared to a control toothpaste, irrespective of individual brushing technique and plaque quality.MethodsThe experimental gingivitis model, with a split-mouth design was used to assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation. By producing individual fitted trays, the toothpaste was applied in the test quadrant and a control dentifrice in the contralateral. The participants used the individual fitted trays for 1 min every morning and evening, for 21 days. In this period, the participants was only allowed to brush the teeth in the opposite jaw, as usual. Twenty healthy individuals successfully completed the study.ResultsAt 21 days, there was no statistically significant difference between test quadrant and control quadrant with regard to plaque indices, gingival index and number of bleeding sites.ConclusionThis study demonstrated that the high concentration sodium bicarbonate dentifrice used did not produce statistically significant anti-plaque effect compared to the control dentifrice, in terms of Plaque- and Gingival Indices, number of bleeding sites or by Quigely and Hein, the Turesky modification Plaque Index, irrespective of brushing technique and individual plaque quality.Trial registrationRegional Committee for Medical Research and Ethics, South-East Norway in 2021 (REK.2021/370116).Clinical Trial Registration: NCT05441371 (First registered 09/06/2022, First posted 01/07/2022) (http://www.clinicaltrials.gov). (Retrospectively registered).

Is the microbiome the cause of irritable bowel syndrome and inflammatory bowel disease? Lessons to consider from odontology.

A substantial amount of research is pointing to the disrupted microbiome and dysfunctional host-microbiome interaction as potential causes of Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). The true cause of the diseases is still not fully elucidated, and the various treatments used are not truly effective in the long run, especially for IBD, since a true cure is not known to exist. Treatment failure and surgery are common for IBD, many times leading to a perceived lower quality of life, not to mention the enormous cost for society for treatment up until that point and after. Although it is clear that the microbiome has a major role in the disease, it seems the majority of the research and treatments are still focused on treating and understanding the inflammation and not the primary cause of the inflammation in the first place. This was also the case for many decades in the search for the cause of periodontitis (PD) and gingivitis (GV), a destructive and non-destructive inflammatory disorder, respectively, the first resulting in loss of tissue supporting the teeth. There was much uncertainty and confusion until it was fully established that the microbiome was the cause. PD treatments primarily nowadays reflect the cause, i.e. the removal of microbes. There is no doubt, however, that the inflammatory pathways are important in both diseases and the purpose of this text is not to dispute this in respect to gastrointestinal disorders too. However, a different view on inflammation and associated disorders is explored to explain the nature of extraintestinal manifestations. The aim of this report is not to systematically fully review the literature to try to strengthen causality, as there are many reviews that explore the microbial aspects of IBS and IBD. Instead, the objective is to above all reflect on what has been learned in the field of odontology/stomatology and discuss relevant gastrointestinal research in order to propose tentative hypotheses and questions regarding IBS and IBD aetiology. Perhaps it could help soften the confusion regarding the microbial aetiology and dysbiosis concept, while guiding future research and treatments, primarily regarding microbial transplants, antibiotics, and diet.