Gingival Research Articles

Qualitative and quantitative analysis of gingival microvessels by capillaroscopy in healthy subjects

Gingiva is composed by attached gingiva and free gingiva that are separated by free gingival line. Attached gingiva covers the alveolar bone and adheres to the bone and root surface by fibres. Free gingiva ends with the gingival margin and in clinical practice it can be displaced from the tooth surface to locate the prosthetic margin. Capillaroscopy allows to take microphotographs of the microvessels and to observe their abnormalities in autoimmune rheumatic diseases (1). Aim of this study was to analyse microvessels of the attached gingiva, free gingiva line and free gingiva by means of capillaroscopy. In correspondence of upper incisors of 12 young healthy volunteers, after placement of liquid vaseline, microphotographs (x200) were taken at level of the free gingiva and 2-3 mm more apically within the attached gingiva. Capillaries structure and organization were evaluated in the three areas of interest. In 10 randomly selected microphotographs of the attached gingiva, the amount and percentage of microvessels per mm2 were also calculated. For each subject, two analyses were performed at 3 weeks of distance for repeatability assessment. At the observation, in attached gingiva vessels appeared as tortuous capillary loops perpendicular to the epithelial surface. At level of free gingival line vessels get linear and parallel to the arch of gingival margin. In free gingiva capillaries run superficially and parallel to the epithelial surface, toward the margin and fell back with a loop on the tooth side. At the quantitative analysis, the method resulted repeatable (Wilcoxon signed-rank test, p>0.05). A mean of 49.8 (± 9.5) microvessels for mm2 was found. Capillaries represented the 10.3% (±3.5) of the attached gingiva. Capillaroscopy is a non-invasive repeatable method to observe gingival capillaries. This method may be proposed in clinical practice to detect and monitor changes or abnormalities after placement of prosthetic margins.

Influence of continued oral health education on treatment effect of elderly patients with periodontal disease

Objective To explore the influence of continued oral health education on treatment effect of elderly patients with periodontal disease. Methods Totals of 62 elderly patients with age from 60 to 74 years old and with periodontal disease treated in Department of Stomatology from January 2014 to February 2015 were selected and randomly divided into experimental group and control group, each with 31 cases. Patients in the control group were given routine oral hygiene education, while patients in the experimental group were given continued oral health education at home. After 1, 3 and 6 months of treatment, plaque index and gingival index of patients in the two groups were compared. Results For both groups, plaque index and gingival index at first visit and 1 month after treatment showed no significant difference (P>0.05); 3 and 6 months after the treatment, plaque index and gingival index of patients in the experimental group were fewer than those in the control group (P<0.05). 1, 3 and 6 months after the treatment, plaque index and gingival index of patients in the experimental group were relatively stable, yet lower than before the treatment (P<0.05); 1 month after treatment, plaque index and gingival index of patients in the control group were lower than before the treatment (P<0.05), yet 3 and 6 months after the treatment, the number grew gradually to the level before the treatment. Conclusions Positive and effective continued oral health education can help to maintain long-term curative effect of periodontal disease, alleviate gingiva inflammation and thus improve obviously periodontal condition of the patients. Key words: Aged; Health education; Continued nursing; Periodontal disease

Great expectations of patients with missing lateral incisors: when are space opening and space closure appropriate?

On average, 2% of the UK population have agenesis of the permanent maxillary lateral incisors. Reopening the space for restorative replacement or closing the space and subsequent reshaping of the canine depends on a number of factors. Among these are the aesthetics of the canines, level of the smile line, gingival architecture and occlusion. Joint orthodontic and restorative planning to determine the appropriateness of space opening or space closing, with a discussion of these in context with the expectations of the patient/parent, is important before commencing treatment. Despite advances in materials and techniques within both restorative and orthodontic specialties resulting in improvements in the aesthetic outcomes of hypodontia cases, the management of patient/parent expectations is key to overall success. This paper details the contemporary restorative–orthodontic treatment options for the management of missing lateral incisors, the orthodontic biomechanics and restorative approaches involved in treatment.

Clinical observation of 52 patients with acute myeloid leukemia transformed from myelodysplastic syndrome

Objective To investigate the clinical features, efficacy and prognosis factors of acute myeloid leukemia (AML) transformed from myelodysplastic syndrome (MDS). Methods The evolution time, clinical characteristics, subtypes, responses to treatment and the related impact factors of 52 patients with AML transformed from MDS were analyzed retrospectively. Results The median evolution time was 6.75 months. Results of univariate analysis showed age≥46 years old, male, IPSS-R karyotype of poor prognosis were significant risk factors of leukemia free survival (LFS). Results of multivariate analysis by Cox model showed that age≥46 years old and IPSS-R karyotype of poor prognosis were independent risk factors for LFS. The subtypes of AML transformed from MDS included M2 (67.31 %, 35 cases), M5 (11.54 %, 6 cases), M4 (9.62 %, 5 cases), M6 (9.62 % , 5 cases) and M1 (1.92 % , 1 case). 17 patients (32.69 %) developed extramedullary infiltration mainly in liver, spleen, lymph nodes, gingival, alimentary tract and tonsil. White blood cell count and neutrophil count were increased alone with transformation to AML compared with those newly diagnosed MDS. The complete remission rate was only 33.3 % (8/24). Conclusions Elderly and IPSS-R karyotype of poor prognosis can increase the risk of MDS evolution to AML, mainly to M2. Extramedullary infiltration was easy to be found in AML transformed from MDS, with low remission rate, high treatment-related mortality and poor prognosis. Key words: Myelodysplastic syndromes; Evolution; Leukemia, myeloid, acute

Manual versus sonic powered toothbrushing in patients with intellectual disability: a cluster-randomized clinical trial.

To compare the use of sonic powered or manual toothbrush in patients with intellectual disability (ID) in terms of plaque (PlI) and gingival (GI) indices and adverse effects. Subjects with ID were recruited for this cluster-randomized, single blinded (examiner), 6-month clinical trial, comparing powered versus manual toothbrushing. Outcome variables included PlI and GI, evaluated at baseline and 3months after supervised toothbrushing and after 3 additional months of unsupervised used. Clinical outcome variables were analysed by repeated measures ANCOVA considering time and group as factors and respective baseline values as covariates (generalized linear model). Sixty-four patients (34 male, mean age 34.5) in six clusters were included in the study. No statistically significant effect of toothbrushing group was observed for PlI or GI. A significant effect of time was identified (p<0.001) with mean reductions ranging 0.44-0.45 for PlI and 0.30-0.36 for GI from baseline to 3-6months. No relevant adverse effect or technical problems were observed. The tested sonic powered toothbrush was as effective and safe as the manual toothbrush. The use of powered or manual toothbrushes, together with fluoride toothpaste, may improve plaque and gingivitis levels, in patients with mild to limit ID.

Development and validation of a sensitive method for Levofloxacin in Gingival Crevicular Fluid by HPLC using UV - Visible detector

Increased interest in the clinical use of antibiotics for periodontal therapy required the development of a sensitive assay for the quantitation of levofloxacin in gingival crevicular fluid (GCF). The HPLC assay employs a C18 reversed-phase Hypersil BDS column with a mobile phase composed of methanol and phosphate buffer (pH 3.5). The chromatographic separation was monitored by a UV- Visible detector with an excitation wavelength of 290nm. The retention time of Levofloxacin and Ciprofloxacin were 5.55 min and 6.52min respectively. Levofloxacin was extracted from GCF collected on capillary tubes by addition of acetonitrile containing the internal standard ciprofloxacin, and phosphate buffer. The percentage mean extraction recovery of low, mid and high quality control samples was 89.53 0.91 % (Mean SD) for Levofloxacin and it was 91.2 2.2 % for Ciprofloxacin. The lowest limit of quantitation was 50 ng/ml, with a relative standard deviation of 2.56%. The interday and intraday precision at LLOQ was 3.20 0.80 (meanSD) and 3.505 0.84 (meanSD). The typical GCF volumes collected were 0.1-1 ml. The method was validated for the linear concentration range 50-1300 ng/ml of levofloxacin on the capillary tubes. This assay for levofloxacin was shown to be an accurate, precise and rugged method. The proposed method can be used for the estimation of Levofloxacin which was administered as in situ gels in periodontitis.

Dentine hypersensitivity: real or imagined.

Background: Dentine hypersensitivity is a common presentation of cause of pain and or discomfort with mastication which has been shown to affect the quality of life of the affected individual. It is also a common cause of presentation at the dental clinics. However, the cause, diagnosis and possible management to give relief can be a dilemma for the clinician who at times may wonder if the sensation the individual is presenting with, is real or imagined. Aim: The purpose of this paper was to review dentine hypersensitivity in view of causes, diagnosis and management. Methodology: Articles used were found by searching the key words: dentine hypersensitivity, tooth wear lesions, desensitization, gingival recession, treatment of hypersensitivity. Result: There are a variety of causes of dentine hypersensitivity with a variety of ways to manage and provide adequate treatment, but the condition must be well understood. Conclusion: Many options of treatment are now available to eliminate the pain from dentine hypersensitivity and thus improving the quality of life of these patients because the sensitivity they experience is real. Keywords: dentine, hypersensitivity, tooth wear, desensitization, quality of life

Fold anterolateral thigh flap in through-and-through cheek defect reconstruction following oral cancer ablation

Objective To investigate the outcome of fold anterolateral thigh flap in through-and-through defect reconstruction following oral cancer ablation. Methods From January, 2011 to December, 2013, 23 patients were performed through-and-through defect reconstruction following oral cancer ablation with free fold anteorlateral thigh flap including 15 cases of buccal mucosa carcinoma, 2 cases of basal cell carcinoma of buccal skin, 4 cases of gingiva carcinoma, 1 case of recurrent parotid duct carcinoma and 1 case of buccal rhabdomyosarcoma. The defects ranged from 3.5 cm × 7.0 cm~7.0 cm × 12.0 cm and the flaps ranged from 4.0 cm × 12.0 cm-8.0 cm × 20.0 cm in size, and were adjusted to the through-and-through defect of the buccal area. The outcome of reconstruction was evaluated by considering the facial appearance, the swallowing and the speech function, the ranges of mouth opening and patient prognosis. Results All of the 23 cases transplanted flaps survived well, the donor sites were closed directly, without donor-site morbidity. All patients were satisfactory with their facial appearance, occlusion and swallowing and speech function. Fifteen patients performed post-operative radiotherapy. The follow-up period was 8-45 months(average 22 months), 5 patients performed salvage surgery for tumor recurrence and 2 patients died of re-recurrence, 1 patient survival with disease and all other patients were alive without disease. Conclusion The fold anterolateral thigh flap is large and suitable and reliable for the through-and-through defect reconstruction following oral cancer ablation. Key words: Oral cancer; Through-and-through defect; Anterolateral thigh flap; Transplantation

The comparison on pluripotent differentiation between human gingival fibroblasts and humanperiodontal ligament cells in vitro

The comparison on pluripotent differentiation between human gingival fibroblasts and humanperiodontal ligament cells in vitro

Clinical effects and safety of catheter- directed thrombolysis for acute lower extremity deep vein thrombosis in patients aged 70 years and over

Objective To analyze the efficacy and safety of catheter-directed thrombolysis (CDT) for acute lower extremity deep venous thrombosis (DVT) in patients aged 70 years and over . Methods Clinical data of 109 cases who had acute lower extremity DVT and had been treated with CDT from March 2011 to September 2014 were retrospectively analyzed. Results Inferior vena cava filters (IVCF) were implanted in 109 patients. A thrombolytic catheter was inserted from the contralateral femoral vein (21 cases), ipsilateral popliteal vein (44 cases), posterior tibial vein (28 cases) or small saphenous vein (16 cases). The duration of thrombolysis was (5.47±2.13) d. The dosage of urokinase was (3.80±0.56)million units. Forty-two cases underwent balloon dilatation alone, and 67 cases combined balloon dilatation with stent implantation. Gingival bleeding occurred in 7 patients and gross hematuria occurred in 4 patients during thrombolysis, which disappeared after medication adjustment. No symptomatic pulmonary embolism (PE) or other serious complications were found in any patients. There were significant differences in the venous patency score and lower limb circumferences at 10 cm above and below the knee one week after treatment (t=3.874, P=0.031). Ninety-seven cases were followed up for a mean period of (20.7±6.5) months, and the vein patency rate was (77.9±10.5) % and (73.1±9.4) % at 6 and 18 months after treatment, respectively. Recurrence of deep vein thrombosis was found in 6 cases, of which 2 cases had recurrent stent thrombosis, and treatment with CDT again was successful. No severe deep venous thrombosis syndrome (PTS) was found during the follow-up. Conclusions CDT is a minimally invasive procedure and can rapidly resolve limb venous drainage disorders. CDT is safe, has few complications and usually generates satisfactory outcomes. For very-old elderly patients who have no anticoagulation and thrombolytic contraindications, CDT is a useful option for the treatment of acute lower limb DVT. Key words: Venous thrombosis; Catheterization, peripheral; Thrombolytic therapy

Expression of heat shock protein 27 in cigarette smoke extract-induced injury of human gingival fibroblasts

This research aimed to observe the expression of heat shock protein 27 (HSP27) in human gingival fibroblasts (HGFs) cell injury induced by different concentrations of cigarette smoke extract (CSE). The third to eighth generations of cultured HGFs were treated with serially diluted CSE of different concentrations (0, 2.5%, 5.0%, 12.5%, 25.0%, 50.0%). Wound-healing assay was performed to determine the migration of HGFs, and Western blot was used to determine the expression of HSP27. The migration capability of HGFs weakened with the increase of CSE concentration. HSP27 expression was negative in normal HGFs but positive in CSE-intervened HGFs in a concentration-dependent manner. HSP27 concentration increased in the CSE-induced injury of HGFs. This finding suggests that HSP27 plays an important role in CSE-induced epithelial injury.

Treatment of multiple gingival recession with coronally advanced modified tunnel technique combined with connective tissue graft

Treatment of multiple gingival recession with coronally advanced modified tunnel technique combined with connective tissue graft

Free gingival graft plus resin-modified glass ionomer cement restoration for the treatment of gingival recession

Over the last few years, dentistry has evolved in such a way that clinicians are not only required to treat disease and improve function but also to cope with the ever increasing esthetic demands of our patients. Among the esthetic procedures, root coverage by periodontal plastic surgery has attracted the most interest. Gingival recession is an apical shift of the gingival margin with exposure of the root surface. Gingival recession is frequently associated with cervical wear. In these cases, complete coverage by traditional mucogingival surgical techniques might be contraindicated because of the need for extensive root planing, which could compromise the tooth. The combination of an adhesive restorative material and surgical coverage might be a solution. Such a case is presented here, where a perfect blend of the principles of mucogingival surgery and the biocompatible nature of restorative material is effectively utilized.

Factors influencing caries incidence in permanent teeth in children/adolescents under and after anti-neoplastic treatment.

Aim of the studyTo determine reasons for the increase in caries among children/adolescents treated for neoplasms.Material and methodsHealth promoting behaviour, oral hygiene (PLI), gingiva (GI), dentition (DMFt/DMFs), number of teeth with white spot lesions (WSL), and enamel defects (ED) were assessed in three groups of 60 patients each. The three groups were as follows: under chemotherapy (CH), after chemotherapy (PCH), and generally healthy (CG). Medical files supplied information on neoplasm type, chemotherapeutic type and dose, age at treatment start, chemotherapy duration, and complications. Statistical analysis was performed with Mann-Whitney U test and Spearman's rho test.ResultsThe age at which chemotherapy was started/its duration was 5.9 ±4.0/1.3 ±0.5 years in PCH and 9.12 ±4.44/0.8 ±0.3 years in CH; PCH completed treatment 4.9 ±3.4 years ago. Chemotherapy most often included vincristine (VCR), etoposide (VP-16), adriamycin (ADM), cyclophosphamide (CTX), cisplatin (CDDP), and ifosphamide (IF). Mucositis occurrence was 28.33% in PCH and 45.00% in CH; vomiting occurrence was 43.33% and 50.00%, respectively. Nutrition and prophylaxis mistakes occurred more often in CH/PCH than in CG; PLI, GI, caries incidence and severity, and the number of teeth with WSL were higher. Correlation between caries incidence and chemotherapeutic type and dose, age at treatment start and treatment duration, mucositis, emesis, PLI, GI, ED, no fluoride prophylaxis, and nutritional mistakes was established. Ifosphamide and mucositis treatment played a major role in chemotherapy; after chemotherapy – ED and CTX, ADM, IF, and VP-16.ConclusionsCaries in permanent teeth in children/adolescents undergoing chemotherapy result from nutritional mistakes, poor prophylaxis, and indirectly from chemotherapy complications (first mucositis and emesis, and later developmental ED).

In vitro comparison of new bisphosphonic acids and zoledronate effects on human gingival fibroblasts viability, inflammation and matrix turnover

Bisphosphonates (BPs) are well known clinically used drugs, commonly applied to treat osteoclast-mediated bone resorption. Some clinically used BPs were demonstrated to be able to inhibit the activity of matrix metalloproteinases (MMPs) (1), a protease family required to fully degrade all the components of the extracellular matrix during connective tissue remodelling (2). Combining the arylsulfonamide function with the bisphosphonic group, several compounds were synthesized to obtain selective inhibitors of MMPs. The aim of the present work is to compare the effects on cell adhesion, cytotoxicity, inflammatory response occurrence and matrix turnover process in an in vitro model of primary human gingival fibroblasts (HGFs) treated with newly synthesized sulfonamide BPs and with zoledronic acid (ZA), a clinically used drug. Western blot was used to measure Procollagen I, β1 integrin MMP-8 and MMP-9, phase contrast and MTT for cell viability, LDH was performed for toxicity evaluation, ELISA for Prostaglandin E2 (PGE2) secretion assessment. When compared with ZA, the treatment with the newly synthetized compounds shows increasing viability, Procollagen I expression and decreased expression of β1 integrin in HGFs. Higher levels of released LDH, PGE2 and MMP-9 expression are recorded in ZA-treated HGFs. Increased levels of MMP-8 are recorded in newly synthetized compounds-treated samples.These findings imply that new BPs could accelerate the physiological matrix turnover, they are more able to preserve the soft tissue surrounding bone as they have neither inflammatory effects nor toxicity, along with reduced effects on the cell viability, which are instead typical side effects of ZA administration. We can conclude that the newly synthesized compounds are better tolerated, leading to the hypothesis that their use leads to connective tissues side effects reduction compared to clinically used drugs, even though several studies are required to deeply investigate the signaling cascades involved in the mechanism of action of these new BPs.

Effects of methacrilyc thermosets coated with Silver-polysaccharide nanocomposite on HGFs adhesion in a S. mitis co-culture system

Silver based medical products have been proven to be effective in retarding and preventing bacterial growth, being silver reported to control infections since ancient times (1). In the field of dentistry, the use of silver ions/nanoparticles has been explored to counteract bacteria in resins and implants, as silver can destroy bacterial cell walls by reacting with the thiol groups (–SH) of proteins exposed to the extracellular portion of the bacterial membrane. Conversely, eukaryotic cells lack these exterior binding sites, so nanoparticles are supposed to interact with them only upon metal internalization (2). To reduce both bacterial adhesion to dental devices and cytotoxicity against eukaryotic cells, we coated BisGMA/TEGDMA methacrylic thermosets with a new material, Chitlac-nAg, formed by stabilized silver nanoparticles with a polyelectrolyte solution containing Chitlac. Here we analyzed the proliferative and adhesive ability of human gingival fibroblasts (HGFs) on BisGMA/TEGDMA thermosets uncoated and coated with AgNPs in a co-culture model system with Streptococcus mitis. After 48 h, HGFs well adhered onto both surfaces, while S. mitis cytotoxic response was higher in the presence of AgNPs coated thermosets. After 24 h thermosets coated with Chitlac as well as those coated with Chitlac-nAg exerted a minimal cytotoxic effect on HGFs, while after 48 h LDH release rised up to 20%. Moreover, the presence of S. mitis reduced this release mainly when HGFs adhered to Chitlac-nAg coated thermosets. The reduced secretion of collagen type I was significant in the presence of both surfaces even more when saliva is added. Integrin β1 localized closely to cell membranes onto Chitlac-nAg thermosets and PKC α translocated into nuclei. These data confirm that Chitlac-nAg thermosets have a promising utilization in the field of restorative dentistry exerting their antimicrobial activity due to AgNPs without cytotoxicity for eukaryotic cells.This work was supported by grants from MIUR FIRB 2010 and MIUR PRIN-2009.

Periodontal Diagnostik Biyobelirteç Olarak Diş Eti Oluğu Sıvısındaki Konak Kaynaklı Enzimler-Bölüm 1

Bu çalışma, diş eti oluğu sıvısındaki (DOS) periodontal hastalık tanısının konulmasına yardımcı olan konak kaynaklı enzimlere ve onların inhibitörlerine odaklanılan çalışmanın ilk kısmıdır. İnflamatuar bir durum olan periodontit, alveolar kemik rezorpsiyonu, periodontal ataşman kaybı ve bağ dokusunun yıkımı ile karakterizedir. Periodontal cep derinliği, ataşman seviyesi, sondalamada kanama gibi olağan periodontal ölçümler periodontal hastalıkların teşhisi için gereklidir. Ancak hastalığın şiddetinin, prognozunun ve tedaviye verilen yanıtın değerlendirilmesinde yetersiz kalabilirler. DOS, periodontal hastalık ilerlemesi için olası biyolojik belirteç olarak belirtilmiş 65'den fazla bileşenden oluşmaktadır. Bu tür bileşenlerin varlığının incelenmesi, periodontal hastalığın derecesinin ya da periodontal tedavinin sonuçlarının değerlendirilmesinde faydalı olabilir. Bu çalışma, 'Pubmed' veri tabanında periodontal hastalık, diş eti oluğu sıvısı ve enzimler anahtar kelimeleriyle araştırılan, 1970-2015 yılları arasında yayınlanmış makaleler incelenerek hazırlanmıştır. İlk bölümde; aspartat aminotransferazı, alkalen fosfatazı, asit fosfatazı, beta glukuronidazı, nötrofil elastazı, elastaz inhibitörlerini, katepsinleri, tripsin-benzeri enzimleri içeren konak kaynaklı enzimlere ve onların inhibitörlerine odaklanılmıştır. İkinci bölümde de, immünoglobulin parçalayıcı proteazı, glukozidazı, dipeptidil peptidazı, spesifik olmayan nötral proteinazları, metalloproteinazları, metalloproteinaz doku inhibitörünü, miyeloperoksidazı, laktat dehidrogenazı, arilsülfatazı, ß-N-asetil hekzoaminidazı içeren konak kaynaklı enzimlere ve onların inhibitörlerine odaklanılmıştır.

An intriguing relation between periodontal and cardiovascular diseases

Periodontitis is a chronic inflammatory condition promoted by bacterial colonization of the gingiva that causes alveolar bone and tooth loss. Under these conditions, bacteria, as well as bacterial products and inflammatory mediators can move from the gingival pocket to the well vascularised periodontal tissues and into the circulation. In fact, recently a possible connection between oral infection and cardiovascular disease was suggested (1). One of the major pathogens involved in the progression of periodontal disease is the Porphyromonas gingivalis (LPS-G). The aim of the study was to induce endothelial differentiation in human periodontal ligaments stem cells (hPDLSCs) (2) on decellularized pig heart valve as scaffold and evaluate the role of LPS-G on cell cultures in terms of reactive oxygen species (ROS) production and NFKB pathway. Many studies have shown that ROS provoked oxidative stress plays a critical role in the development of cardiovascular disease. Excessive generation of ROS can cause cellular dysfunction and injury by directly oxidizing and damaging proteins, DNA and lipids, which ultimately result in cell death. To induce endothelial differentiation, human periodontal ligament stem cells (hPDLSCs) were cultured with endothelial growth medium (EGM-2MV) supplemented with vascular endothelial growth factor (VEGF) and seeded on decellularized pig heart valve. Valve leaflets were incubated for 30 min with 10 μM DCFH-DA at 37°C in humidified incubator. At the end of loading, the valve leaflets were observed using multiphoton microscope. Results of time lapse experiments revealed that after treatment, with 2,5 mg/ml LPS-G, a rapid sustained increase in ROS generation was observed mainly in differentiated hPDLSCs. Comparing the average response of undifferentiated and differentiated hPDLSCs is clearly evident that the latter showed an six fold increase in ROS production after LPS-G exposure, while on undifferentiated appeared to be negligible. Moreover, in endothelial differentiated cells the NFKB nuclear translocation in presence of LPS-G was evident. A reasonable conclusion could be that the treatment of periodontal disease not only improve dental but presumably also cardiovascular health.

Comparison of the Efficacy and Side Effects of Chlorhexidine Mouthrinses with (Hexidine) and without (Epimax) Alcohol

Introduction: Chlorhexidine mouthrinses have widely been recognized for their contribution in maintaining plaque control. Most of them contain alcohol that makes them impractical for many patients. Alcohol-free mouthwashes may have fewer side effects but may be less efficient. The current study was aimed to compare the effectiveness and side effects of chlorhexidine mouthrinses with and without alcohol. Materials and Methods: In this double-blind clinical trial, 32 patients with moderate and severe gingivitis were recruited. For all patients, full prophylactic procedures, such as removal of plaque, calculus, and stains on the teeth, were performed. Each patient was asked to use 15 mL of the mouthrinse for 60 s twice daily. The patients were divided into two groups, one group used Hexidine (0.12% chlorhexidine and 10% ethanol) mouthwash and the other group used Epimax (0.12% chlorhexidine and 0.05% sodium fluoride) mouthwash. After 14 days, plaque (PI), gingival (GI), and stain indices were analyzed. The obtained data were analyzed by using SPSS 16 using covariance [Analysis of covariance (ANCOVA)] and t-test. Results: Both mouthwashes significantly reduced the mean scores of plaque (P Conclusion: Although Epimax mouthwash did not show any side effects, it was less suitable and caused more dental stain. Ethanol-free Hexidine mouthwash seems to be more proper for gingivitis, but its side effects are required to be taken into consideration.

Effects of QCC on improving the compliance of tooth brushing in adolescent patients with orthodontic treatment of fixed appliance

Objective To explore the methodology and effects of quality control circle (QCC) on improving the compliance of tooth brushing in adolescent patients with orthodontic treatment of fixed appliance. Methods A QCC activity conducted from February to August in 2014, focused on improving the compliance of tooth brushing in adolescent patients with orthodontic treatment of fixed appliance. The study investigated 90 participants and compared their compliance of tooth brushing, plaque index (PLI) and gingival index (GI) before and after QCC. Results After the activity, the score of tooth brushing compliance was (10.68±2.78), PLI (1.29±0.41) and GI (0.86±0.37). All the assessment indexes and the comprehensive quality were significantly improved after QCC (P<0.05). Conclusions QCC is efficient to promote the compliance of tooth brushing and oral hygiene, and to improve the comprehensive ability of adolescent patients with orthodontic treatment of fixed appliance. Key words: Quality control circle; Orthodontic treatment; Youngsters; Oral hygiene; Compliance