Gingivitis Patients Research Articles

Quantitative Assessment of Gingival Inflammation in Patients Undergoing Nonsurgical Periodontal Therapy Using Photometric CIELab Analysis

Visual inspection and gingival indices have been traditionally used for diagnosis of gingival inflammation. These methods are prone for subjective variability. Thus, the study is aimed at evaluating gingival inflammation quantitatively by using CIELab colour space value obtained from digital photographs. An experimental study was conducted with 27 patients each in group A (gingivitis) and group B (chronic periodontitis, CP). Preoperative and postoperative (1 month) photographs of maxillary anterior sextant were recorded to evaluate CIELab coordinate values. Simultaneously, clinical parameters such as bleeding on probing (BOP) and periodontal probing depth (PPD) along with indices such as plaque index (PI), gingival index (GI), and sulcus bleeding index (SBI) were evaluated before and after the nonsurgical periodontal therapy. Data was presented as the mean ± SD , and a paired t -test was used for the testing hypothesis with p < 0.05 considered as significant. Data analysis was carried out with Statistical Package for the Social Sciences (SPSS) version 21. A significant reduction ( p < 0.001 ) is seen in all the clinical parameters and indices before and after the intervention in chronic periodontitis patients. Similar results were seen in gingivitis patients ( p < 0.001 ) except for PPD. A significant ( p < 0.001 ) reduction in postoperative values of the a ∗ and b ∗ coordinates was seen in CP patients; whereas, only the a ∗ coordinate value reported a significant ( p < 0.001 ) reduction in the gingivitis group of patients. The Δ E of the gingivitis and chronic periodontitis groups was 2.25 and 2.96, respectively. Within the confinements of the study, estimating the gingival colour with the help of CIELab values taken via digital photographs can be an excellent valuable tool to assess the gingival colour as a sign of gingival inflammation.

Prevalence of gingivitis in patients with open bite

Prevalence of gingivitis in patients with open bite

Evaluation The Effect of Folic Acid on Some Inflammatory Mediators; IL-6 and TNF-α in Chronic Gingivitis Patients

Evaluation The Effect of Folic Acid on Some Inflammatory Mediators; IL-6 and TNF-α in Chronic Gingivitis Patients

Salivary total protein levels among healthy controls, chronic gingivitis patients and chronic periodontitis patients

Background: Periodontal diseases are one of the most common chronic infectious and inflammatory diseases in the world that can be diagnosed by clinical, radiographic signs and some biomarkers. Saliva contains locally and systemically derived markers that can aid in the diagnosis of periodontal diseases. The aim of the present study was designed to evaluate salivary total protein levels in patients with chronic gingivitis and chronic periodontitis. Materials and Methods: Five milliliters of unstimulated whole saliva samples was collected from a total of 113 individuals; each of the healthy and chronic gingivitis groups was included 39 participants and 35 patients in the chronic periodontitis group. Salivary total protein levels, gingival index (GI), papillary bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level were recorded in the respective groups. Salivary protein estimation was done by direct ultraviolet absorption method, and determination was based on biuret method. Results: The mean salivary total protein levels in the healthy, chronic gingivitis, and chronic periodontitis groups were 1.52, 2.58, and 6.30 g/dl, respectively. The salivary total protein levels of gingivitis and periodontitis patients were 1.6 and 4.2 times higher than healthy controls, which were statistically significant (P < 0.001). In addition, GI (r = 0.476) and PBI (r = 0.490) were significantly correlated with protein levels in gingivitis patients. However, PPD was significantly correlated with protein contents in only periodontitis patients (r = 0.387). Conclusions: Increased total protein levels are related to the severity of periodontal diseases, and it may serve as a biomarker in inflammation of the periodontium.

Clinical and Microbiological Evaluation of Cardamom Extract and Chlorhexidine on Plaque and Gingivitis in Patients Using Orthodontic Appliance

Clinical and Microbiological Evaluation of Cardamom Extract and Chlorhexidine on Plaque and Gingivitis in Patients Using Orthodontic Appliance

Comparison of laser therapy and ozonated water on gingival inflammation in orthodontic patients with fixed appliances

There is an increased prevalence of oral ailments such as dental caries, gingivitis, and periodontitis when orthodontic therapy is administered. Poor oral hygiene in conjunction with the placement of fixed orthodontic appliances is considered a significant factor in raising accumulation of bacterial plaque and its associated inflammatory response. The present study aimed to evaluate and compare laser therapy with subgingival irrigation using ozonated water on gingivitis in patients undergoing fixed orthodontic treatment and to ascertain the presence of the inflammatory marker monocyte chemoattractant protein (MCP-1) in gingival crevicular fluid (GCF). This study was a double-blind clinical study in which a split-mouth design was applied in 30 subjects for 28 days that received fixed orthodontic therapy. In each subject, the upper right quadrant (control side) was irrigated with 0.01 mg/L ozonated water and the upper left quadrant (experimental side) was irradiated with a diode laser on day 0 (baseline) and day 7. The patients were recalled on days 7, 14, and 28 and clinical parameters were recorded at each visit. Biochemical evaluation of gingival inflammation with MCP-1 levels in GCF was obtained at the baseline (day 0) and on day 28. A statistically significant (p < 0.05) reduction of all clinical parameters and MCP-1 activity in GCF was observed on both sides. Low-level laser irradiation showed a significant reduction of clinical parameters and MCP-1 activity compared to subgingival ozone irrigation. Laser therapy can be considered a more effective method than subgingival ozone irrigation in patients undergoing fixed orthodontic treatment as it showed a consistent improvement in gingival inflammation. Fixed orthodontic appliances make oral hygiene maintenance difficult and results in gingivitis. Adjunctive oral hygiene procedures such as subgingival irrigation with ozonated water or laser irradiation are beneficial. The data from this study suggest that irrigation with ozonated water or laser irradiation reduces gingival inflammation, with laser therapy being more effective.

Comparison of the effects of non-surgical periodontal treatment on perceived pain levels in gingivitis and periodontitis patients by gender

Comparison of the effects of non-surgical periodontal treatment on perceived pain levels in gingivitis and periodontitis patients by gender

Assessment of the Plaque-Induced Gingivitis Patient With and Without Hyaluronic acid and Xylitol Toothpaste.

ABSTRACTContext:The traditional manner of treatment of periodontal tissue inflammation includes giving information about the problem to the patient, oral motivation, and mechanical scaling and root planning (SRP).Aims:We aimed at estimating the effect of using toothpaste with hyaluronic acid (Hyaluronan, HA) and xylitol (HAX) as a therapeutic agent in the treatment of plaque-induced gingivitis.Materials and Methods:Sixty male patients who were in the age group of 20 to 35 years participated in this study. All of them endured 4 appointments, who suffered plaque-induced gingivitis, they distributed into 2 groups depending on the toothpaste variety: group 1 (G1): made up of 30 patients who consume toothpaste that contains HAX, while group 2 (G2): made up of 30 patients who consume toothpaste without HAX (placebo type). Clinical periodontal parameters (CPPs) for all of them were recorded, once at the beginning of the treatment besides four times throughout the treatment at weekly interims during all visits.Results:The means of plaque indices (PLI) and gingival indices (GI) decreased along with the sessions for both groups, where the initial means of PLI and GI (baseline) were 2.55 ± 0.14, 2.33 ± 0.15 for the G1, and 2.57 ± 0.13, 2.34 ± 0.16 for G2, respectively; whereas the least means shown at the fourth visit were 0.39 ± 0.05, 0.30 ± 0.06 for G1, and 0.71 ± 0.07, 0.61 ± 0.05 for G2, respectively. There was a reduction in the mean percent of bleeding on probing (BOP) score 1 for all visits in both groups. Finally, an intragroup comparison among dissimilar visits and intergroup comparisons for each visit showed highly significant differences at a P-value of ≤ 0.001 for PLI, GI, and BOP.Conclusions:Using toothpaste with or without HAX can decrease gingival inflammation; it can result in a higher improvement in the periodontal status of patients than toothpaste without HAX.

Effectiveness of metronidazole gel and mobile telephone short-message service reminders on gingivitis in orthodontic patients.

To compare the effectiveness of metronidazole gel and mobile telephone short-message service (SMS) reminders on gingivitis in patients undergoing fixed orthodontic treatment. The trial was double blinded (patient and investigator), and only the clinical trial unit pharmacist was unblinded. Data were collected from patients undergoing fixed orthodontic treatment for at least 6 months. A total of 66 patients were randomly assigned to either 0.8% metronidazole gel (n = 22), SMS reminder and placebo gel (n = 22), or placebo (control) group only (n = 22). Gingival index (GI), bleeding index (BI), and orthodontic plaque index (OPI) were evaluated on several teeth at baseline (T0) and after 4 weeks (T1). Paired-sample t-tests were used to compare mean differences of indexes at T0 and T1 in the groups, and independent-sample t-tests were used to determine the effects of interventions compared with the controls. Data from 64 patients were analyzed; there were 2 dropouts. There were statistically significant (P < .05) reductions in GI, BI, and OPI scores from T0 to T1 for each intervention. However, there were no significant differences between each intervention and the control group. There were no adverse effects. The null hypothesis could not be rejected. There is no difference between interventions (application of 0.8% metronidazole gel and SMS reminder for reinforcing oral hygiene) in reducing gingival inflammation in orthodontic patients.

Effects of Low-Level Diode Laser on the Level of Interleukin 1-Beta in the Gingival Crevicular Fluid and the Incidence of Gingivitis Caused by the Use of Orthodontic Separators: A Randomized Clinical Trial

Background: In recent years, there has been an increased tendency for using dental lasers for the treatment of soft tissue problems. The aim of this study was to evaluate the effect of low-level diode laser (980 nm) on the level of interleukin 1 beta (IL-1β) in the gingival crevicular fluid (GCF) and the incidence of initial gingivitis caused by the use of orthodontic separators. Methods: In this randomized clinical trial, 30 patients, who were beginning a fixed orthodontic treatment without gingivitis, were randomly assigned to control and diode laser radiation (980 nm wavelength, 3 J of energy, a density of 3 J/cm2 , a power of 0.2 W, and at a distance of 1 cm away from the tissue for 15 seconds on the buccal and palatal sides of the tooth) groups. The gingival index (GI) and bleeding on probing (BOP) were measured at the beginning of the study and one week after the treatment. The level of IL-1β was evaluated using an enzyme-linked immunosorbent assay at the beginning of the study and one week after the placement of the separator. Finally, the inter-group and intra-group statistical analyses were performed using independent and paired t tests, and P&lt;0.05 was considered as the significance level. Results: The evaluation of clinical variables in the entire mouth showed a slight clinical improvement in the experimental group although there was no significant difference between the two groups. No significant difference was observed between intra-group and inter-group evaluations of clinical indices in the studied specific teeth. Eventually, no difference was found between the two groups in terms of IL-1β changes. Conclusions: In general, the single-diode laser radiation session is not effective in the treatment of gingivitis in patients undergoing orthodontic treatment. Thus, it is recommended to perform frequent laser radiation sessions in further studies.

Clinical study on the therapeutic effects of Quercus infectoria galls as oral powder in gingivitis and plaque patients

Gingivitis is a nondestructive disease that causes inflammation of the gums and is one of the most commonperiodontal diseases. The cause of inflammation is bacterial bovillomatosis, known as the plaque, on thesurface of the teeth. The plaque is the main cause of periodontal disease; if left untreated, gingivitis candevelop into inflammation of the tooth, where inflammation of the gums destroys the bones, causes tissueerosion around the teeth and can lead to loss of tooth. Q. infectoria were applied topically to ten people aged25-55 who were suffering from gingivitis and plaque. Diagnoses and follow-up treatment were performed ina dental clinic under the supervision of a dentist for a period of two weeks. We noted the great efficacy of theherb against gingivitis and plaque. The progress of plaque measured in terms of mean, population standarddeviation and variance were 0.66 , 0.17, 0.02 before treatment and 0.29, 0.12, 0.01 after treatment. Gingivalprogress before and after treatment were 0.72 , 0.15 , 0.02 and 0.32 , 0.11 , 0.01 , respectively. Accordingto results were due to the fact that Q. infectoria contain large amounts of tannin and other compounds thatconstrict vessels and tissues and are effective against various types of infections. Therefore, we recommendthem as an alternative to antibiotics. Effectiveness of Q. infectoria as an effective substance to inhibit thegrowth of oral bacteria and thus act as an anti-inflammatory and retention of gum tissue where the substancewas tested directly on patients have Plaque and gingivitis and we can recommend them as an alternative toantibiotics

Clinical Manifestations of Periodontal Tissue Diseases in Patients with Rheumatoid Arthritis Who Live in Anthropogenically Loaded Areas

The objective of the study is to clinically assess the condition of periodontal tissues in patients with rheumatoid arthritis, living in anthropogenically loaded and environmentally friendly areas and in people with generalized periodontitis without concomitant somatic diseases.&#x0D; Materials and methods. There were examined 137 patients, including 82 patients with generalized periodontitis of the I degree (subgroups A) and the II degree (subgroups B) with rheumatoid arthritis, living in anthropogenically loaded areas (group I), environmentally friendly areas (group II) and without concomitant somatic diseases living in environmentally friendly areas (group III). Control group – included 18 healthy people.&#x0D; Periodontal tissues were evaluated according to the indices: Greene-Vermillion, PMA, periodontal index offered by Russel and the depth of periodontal pockets. &#x0D; Results. Women (80%) dominated in each group, patients with generalized periodontitis of the II degree of severity dominated, too.&#x0D; The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup and differed significantly from this figure in the IIB subgroup 1.07-fold (pIB-IIB&lt;0.05) and from that in the IIIB subgroup 1.2-fold (pIB-IIIB&lt;0.001). The value of the Greene-Vermilion index in patients with GP of the I degree of development in all subgroups A corresponded to “unsatisfactory”. In patients with GP of the II degree of development, the state of hygiene corresponded to “bad” in subgroups IB, IIB and was 3.04±0.11 points (pIB-IIB˂0.01, pIB-IIIB˂0.001, pIB-K˂0.001); 2,63 ± 0.07 points (pIIB-IB˂0.01, pIIB-IIIB˂0.001, pIIB-K˂0.001), in ІІІB – “unsatisfactory”. According to the indicators of the PMA index in patients with GP of the I degree of severity, we’ve found the average severity degree of gingivitis (within the range of 43.25±2.02 – 48.06±1.46%) and severe degree of gingivitis in patients with the GP of the II degree &gt;50 %. The highest indicator of periodontal index was found in the IB subgroup – 6.16±0.10 points (pIB-IIB˂0.01, pIB-IIIB˂0.001, pIB-K˂0.001), which indicated a severe form of periodontitis.&#x0D; Conclusion. Most often, GP in patients with RA was diagnosed in women, most of whom were patients with GP of the II degree (most in group I – 69.04%). The highest depth of periodontal pockets was 5.02±0.11 mm in the IB subgroup. The performed clinical and index assessment of periodontal tissues in patients of three groups indicates a more severe course of GP of the I and II degree in patients with rheumatoid arthritis living in anthropogenically loaded areas (IA, IB subgroups).

Expert System in Accuracy to Identify Gingivitis in Humans Using the Certainty Factor Method

Gingivitis is a common inflammatory disease of the gums, which is a condition where bacteria develop in the mouth that causes damage to the connective tissue cells that are attached to the teeth. Lack of awareness in caring for teeth will have a negative impact not only on dental health but also on the health of the body. At present many people do not know how to accurately identify gingivitis in humans so that the condition is worsened and can even cause the paralysis of the existing connective tissue. This study aims to determine the level of accuracy in identifying gingivitis by using the Certainty Factor method precisely and accurately. The data processed in this study are fifty data sourced from expert interviews at Rahmatan Lil Alamin Clinic, Padang Indonesia. There are several types Symptoms refer to gingivitis in humans. The data is obtained from the results of medical records of patients who carry out examinations in the clinic. The data will be processed to identify the type of gingivitis based on the direction of the expert. The processing steps are solving rules, determining the weight value of each symptom and calculating the Certainty Factor value. The results of the processing were continued by calculating the level of accuracy. The results of the testing of this method were that 96% of them had gingivitis, the type most often suffered by marginal gingivitis patients. Based on the signs entered by the user. The results of this test have been able to specifically identify gingivitis, using the Certainty Factor method, the results of the accuracy level obtained are quite accurate and can be recommended to help dentists improve their accuracy in identifying gingivitis in humans.

Salivary pH as an improvement parameter in patients with periodontitis: A pilot study

Background: The pH is a chemical parameter of saliva widely studied at present, its normal range is between 6.5 and 7.2. Its alteration has been linked to different oral pathologies, such as periodontal diseases. The purpose of this study was to identify the usefulness of salivary pH measurement as an indicator of improvement in patients with periodontitis and to estimate its possible relationship with the biofilm index and the number of periodontal pockets.&#x0D; Methods: A descriptive-comparative pilot study was conducted on forty adult patients; one group was conformed by twenty patients with gingivitis and the second one by twenty patients with chronic periodontitis. In both groups was determined the biofilm index, was performed periodontal probing and a salivary sample was taken for salivary pH measurement, before and after periodontal treatment.&#x0D; Results: the results showed that of 20 periodontitis patients evaluated, 6 (30%) had an initial alkaline pH greater than 7,6 and a moderate positive relationship with the biofilm index was observed (r=0.5277). After treatment, 15(75%) periodontitis patients and 14 (70%) gingivitis patients presented a decrease in this parameter.&#x0D; Conclusions: there is a variation in the salivary pH after periodontal treatment tending to its restoration, this probably occurs in response to periodontal tissue repair, therefore, pH is a salivary parameter that has potential for monitoring patients with periodontal disease.

Contemporary practices for mechanical oral hygiene to prevent periodontal disease.

It is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.

Local and systemic levels of aMMP-8 in gingivitis and stage 3 grade C periodontitis.

This study aimed to analyze active matrix metalloproteinase (aMMP-8) levels in gingival crevicular fluid (GCF), saliva and serum in the context of new criteria of gingivitis and stage 3 grade C periodontitis. Periodontal disease is an inflammatory process that can result in tooth loss and also is considered a modifying factor for systemic health. Matrix metalloproteinase (MMP)-8 is the major collagenase of periodontal tissue breakdown. Totally 83 systemically healthy and non-smoker individuals consisting of 23 periodontally healthy, 20 gingivitis and 40 stage 3 periodontitis, were recruited to the study. Clinical periodontal examinations of probing depth (PD), clinical attachment loss (CAL), gingival index (GI), plaque index (PI) and bleeding on probing (BOP) were recorded; and GCF, saliva and serum samples were obtained. aMMP-8 was measured by immunofluorometric assay (IFMA). GCF and serum aMMP-8 levels were significantly increased in periodontitis and gingivitis compared to healthy ones (P<.001), whereas gingivitis and periodontitis patients showed similar levels of aMMP-8 in GCF and serum (P>.05). Saliva levels of aMMP-8 were higher in periodontitis patients than both gingivitis and healthy individuals (P<.001). There was no significant difference in salivary aMMP-8 levels between gingivitis group and healthy controls (P>.05). These findings support the involvement of aMMP-8 in periodontal diseases and suggest that its local and systemic levels can reflect stage 3 grade C periodontitis. Moreover, aMMP-8 in GCF and serum seems to have a potential to differentiate between gingivitis and periodontal health.

Effect of mixed chlorhexidine and hydrogen peroxide mouthrinses on developing plaque and stain in gingivitis patients: a randomized clinical trial.

To evaluate the effects of mixed chlorhexidine (CHX)/hydrogen peroxide (H2O2) mouthrinses compared with CHX mouthrinse alone on plaque, tooth stain, and gingivitis. This study was a double-blind, randomized two group parallel experiment, using a 14-day non-brushing half-mouth model. The test group was randomly assigned to the mixed 0.12% CHX and 1.5% H2O2 mouthrinse, whereas the control group used 0.12% CHX. Sixty healthy volunteers were enrolled in the study and received scaling and polishing 2weeks prior to the experiment and then rinsed with the allocated mouthrinses twice daily for 2weeks. The plaque, stain, and gingivitis scores were evaluated and recorded by a calibrated investigator. Fifty-two subjects completed the study (CHX + H2O2n = 25/CHX n = 27). There were significant differences between the control and test groups for plaque index (CHX 0.64 ± 0.41 vs. CHX + H2O2 0.46 ± 0.36, p = 0.035) and stain intensity at proximal areas (CHX 0.26 ± 0.36 vs. CHX + H2O2 0.09 ± 0.14, p = 0.019) at the end of the experimental non-brushing side. However, the gingival indices did not differ significantly (CHX 0.61 ± 0.34 vs. CHX + H2O2 0.62 ± 0.31, p = 0.938) between groups. In the absence of oral hygiene practice, the mixed CHX + H2O2 mouthrinse was slightly superior in reducing plaque scores and stain compared with CHX alone. The clinical effectiveness of CHX + H2O2 is comparable with CHX mouthwash alone. Therefore, the use of the mixed mouthrinse is beneficial compared with CHX for minimizing biofilm and tooth staining.

Orodental, Facial and Clinical Features of Mutation-Positive Noonan Syndrome: A Monocentric Study.

To evaluate orodental, facial, clinical and molecular characteristics of the patients with Noonan Syndrome (NS). The orodental, clinical and molecular characteristics of 29 mutation-positive patients with NS were recorded. Orodental examination was performed in 17 patients. All exons and exonintron boundries of PTPN11 and SOS1 genes were analyzed by Sanger sequencing. A total of 29 patients with NS from 27 unrelated families were included in the study. Seventeen patients were examined by a specialist in oral medicine. The most common orodental findings were high-arched palate (n=13), gingivitis (n=6) and severe caries (n=6). Anterior open bite, posterior cross bite, Class II malocclusion, hypodontia, prognathism (maxillary or mandibular), macroglossia and gingival hyperplasia were also detected. Thirteen different mutations were observed in PTPN11 gene and exon 3 was the hotspot region. Hypodontia was detected in two patients who had the same mutation in PTPN11 gene, c.181G>A, p.D61N. This study indicated a high prevalance of orodental problems including high-arched palate, severe dental caries and gingivitis in patients with mutation-positive NS. The mutation in PTPN11 gene, c.181G>A, p.D61N, may be associated with hypodontia in patients with NS.

Salivary biomarkers of cellular damage and oxidative stress following of lower third molar surgical removal

Salivary biomarkers of cellular damage and oxidative stress following of lower third molar surgical removal

Serum vitamin D concentration is associated with antimicrobial peptide level in periodontal diseases

ObjectiveThe aim of the study was to assess whether or not Vitamin D deficiency was associated with the GCF and gingival tissue antimicrobial peptides (AMP), namely, human beta defensin-2 (hBD-2) and cathelicidin (LL-37) level in chronic periodontitis (CP) and gingivitis patients. DesignA total of 80 volunteers were included in this study. Forty was classified as Vitamin D deficient (25(OH)D <20 ng/mL), and 40 Vitamin D sufficient patients (25(OH)D ≥ 20 ng/mL). Of these, 20 of them were affected by gingivitis and 20 by CP. Following sampling, the hBD-2 and LL-37 concentration in gingival tissues and GCF were determined by the ELISA method. ResultsThe hBD-2 and LL-37 levels were higher in periodontitis compared to gingivitis patients within Vitamin D sufficient and deficient groups. The AMP levels of GCF and gingival tissue in the vitamin D deficient group was lower compared to sufficient serum 25(OH)D within gingivitis and CP groups. Additionally, a non-parametric regression model known as the generalized additive model was used to identify the contribution of diagnosis, Vitamin D status, and other potential clinical variables on the local levels of AMPs. Regression analysis showed that the periodontal disease status, serum vitamin D concentration were independent predictors for elevated GCF AMP levels. Finally, a positive correlation between GCF and tissue levels of both hBD-2 (r = 0.82; <0.0001) and LL-37 (r = 0.65; <0.0001) was detected. ConclusionThis study shows that serum 25(OH)D deficiency is associated with decreased hBD-2 and LL-37 expression of GCF and gingival tissues in both gingivitis and CP patients.