Lower Plaque Scores Research Articles

Plaque Removal and Gingival Bleeding Using Biodegradable Toothbrushes: Salvadora persica, Bamboo, and Nylon: A Comparative Study.

BACKGROUND There is little information available comparing eco-friendly products versus traditional plastic-based oral care implements. Therefore, this study was conducted to compare the plaque removal efficacy and bacterial contamination of biodegradable miswak (S. persica) toothbrushes with bamboo toothbrushes and conventional toothbrushes. MATERIAL AND METHODS This single-blinded, parallel randomized, observational comparative study comprised 30 participants aged 18-35 years. Participants were randomized into 3 groups of 10 participants each: miswak (S. persica) brush, bamboo brush, and regular toothbrush). Participants were trained on proper brushing technique. Plaque and bleeding scores were measured by Loe and Sillness and Ainamo and Bay indices, respectively, at baseline (T0), at 4 weeks (T1), and 8 weeks (T2). Microbial contamination on the bristles of all 3 brushes was also evaluated. Multigroup comparison was done using one-way ANOVA, whereas inter-group comparisons were made using post hoc Bonferroni correction. RESULTS All 3 groups had lower plaque scores at the end of 8 weeks. A statistically significant reduction in the bleeding index in the miswak group was seen from baseline to week 8, with a 16.68% reduction in bleeding sites. Similar reductions were seen in the bamboo brush (21.04%) and conventional brush (22.7%) groups. Regular toothbrushes had almost 4 times more microbial contamination than bamboo brushes and more than double the level of miswak toothbrushes. Significant difference with ANOVA test was seen among the 3 tooth brushes, with P value 0.001. CONCLUSIONS Miswak natural toothbrushes and bamboo toothbrushes can be as effective as a conventional plastic toothbrush.

Evaluation of correlation between compliance of a patient towards orthodontic treatment and plaque accumulation in lower anterior region with fixed orthodontic appliances. A cross-sectional study

BACKGROUND &OBJECTIVE: Using orthodontic appliances can offer new spots for the oral microbiota and dental plaque to attach. Poor oral hygiene can lead to gingivitis and tooth decay resulting in the removal of braces to repair damage and delay treatment. Orthodontic patients who are mindful of their oral health often show greater compliance with their treatment. They tend to miss fewer appointments and avoid losing brackets, demonstrating a strong commitment to their orthodontic care. This study aims to find a correlation between plaque accumulation and patients’ compliance with their orthodontic treatment. METHODOLOGY:50 orthodontic patients (20 males and 30 females, aged 11 to 25 years) were assessed at their 3rd, 4th, or 5th appointments. The plaque index for each patient was calculated on these appointments. Patient compliance like appointment follow-ups and bracket failures was recorded. A correlation was found between the plaque index and compliance of the patient. RESULTS: A statistical analysis revealed a significant, strong negative correlation between the rate of following appointment follow-ups and the plaque scoring index (r = -0.832, P value < 0.001), and a significant, strongly positive correlation between bracket failure rate and plaque scoring index (r = 0.795, P < 0.001). Patients who had good attendance at follow-up appointments and low bracket failure had lower mean plaque score indices. CONCLUSION: Patients with good compliance in terms of low bracket failure rate and attending follow-up appointments regularly tend to have lower plaque scores.

Association between COVID-19 stress, coping mechanisms and stress-related oral conditions among Egyptian adults: a cross-sectional study

The present study investigated the association between COVID-19 stresses and oral conditions including gingivitis, oral hygiene, oral ulcers, and dry mouth. This was a cross-sectional study that collected data from adults in community settings in Alexandria, Egypt, between October 2021, and February 2022. Gingival condition and oral hygiene were assessed using the gingival and plaque indices. Participants were asked if they experienced oral ulcers during the past week and dry mouth during the past year. COVID-19 fears and coping were assessed using the COVID Stress Scale (CSS), and the Brief Resilience Coping Scale (BRCS), respectively. Oral health behaviors were assessed using the World Health Organization questionnaire. Regression analyses were used to assess the association between the dependent variables (clinically assessed gingival and plaque indices, reported presence of oral ulcers, and dry mouth) and explanatory variables (CSS and BRCS) after adjusting for confounders (COVID-19 status, oral health behaviors, smoking, age in years, sex, and highest educational level). The response rate was 88.8% (373/420). The mean (SD) age = 39.26 (11.45) with 74.3% females and 49.3% reporting completing high school or higher education. The mean (SD) plaque and gingival indices were 1.59 (0.66) and 1.39 (0.59), respectively. Only 20.1% reported the presence of oral ulcers and 41.6% reported xerostomia. Lower plaque score was associated with higher COVID-19 contamination fears (B = − 0.03, 95% CI − 0.05, − 0.02) and higher compulsive checking and reassurance-seeking (B = − 0.02, 95% CI − 0.03, − 0.009). Lower gingival score was associated with higher COVID-19 contamination fears (B = − 0.02, 95% CI − 0.03, − 0.002). Higher odds of reporting dry mouth were associated with greater fear of COVID-19 socioeconomic consequences (AOR = 1.05, 95% CI 1.001, 1.09), and lower coping scores (AOR = 0.93, 95% CI 0.88, 0.99). The findings suggest an association between COVID-19 specific stresses and stress-related oral conditions and shed light on the possible link between mental and oral health, emphasizing the importance of integrated planning of care services.

Evaluation of Salivary Components and Dental Plaque in Relation to Dental Caries Status in Type 1 Diabetes Mellitus.

PurposeTo evaluate the dental caries prevalence in Type 1 Diabetes Mellitus (T1DM) as compared to healthy children and, to assess the salivary components (flow rate, glucose, α-Amylase, Streptococcus mutans) and dental plaque in relation to their dental caries status.MethodsDental caries were estimated by using the DMFS index and dental plaque by Sillness and Loe plaque index. The following methods were used to assess the salivary components; draining method to determine the flow rate; glucose oxidase peroxidase method for glucose; substrate method for α-Amylase, Mitis Salivarius Bacitracin agar was used to culture Streptococcus mutans.ResultsCaries prevalence was significantly lower in T1DM. In the diabetic group, a significant positive correlation was found between DMFS value and plaque, DMFS value and salivary glucose, and also with DMFS value and salivary α-Amylase. A significant negative correlation was found between the DMFS value and the unstimulated salivary flow rate. The multivariate regression analysis demonstrated that decrease in the unstimulated salivary flow rate to be significantly associated with increasing DMFS values.ConclusionThe caries prevalence was found to be low in T1DM when compared to the healthy children, the cause for it being related to the low plaque scores. Low caries prevalence could also be due to the restriction of sucrose in their diet.Clinical significanceAs clinicians, along with restoring the smiles of a child patient, we have to retrospectively analyze the factors involved in the causation of dental caries. Educating the parents and the child in regard to this will help prevent the occurrence of any new carious lesion.How to cite this articleManjushree R, Anandakrishna L, Prasad KS K, et al. Evaluation of Salivary Components and Dental Plaque in Relation to Dental Caries Status in Type 1 Diabetes Mellitus. Int J Clin Pediatr Dent 2022;15(S-2):S121-S125.

Plaque Removal Efficacy of Dental floss Compare to Water Jet Following Single Use

Background: Dental plaque (biofilm) is a well-known contributor to the onset and progression of many dental illnesses. Plaque is a natural biofilm that develops on oral surfaces and contains a wide variety of organisms. As a result, it is critical to control plaque formation, particularly in the young population, by implementing effective preventive strategies. Objective: To assess and compare plaque removal efficacy of water flosser and string floss in patients. Study design: Randomized controlled trial Place and Duration of study: Department of Periodontology, Sardar Begum Dental College, Gandhara University from 1st March 2019 to 31st May 2019. Methodology: Seventy patients were enrolled. Patients were randomly allocated to one of two groups, group A (using dental floss) as the control group and group B (using waterpik) as the intervention group, using the lottery technique. Patients were randomly allocated to one of two groups, group A (control group), using dental floss and group B (intervention group), using waterpik utilizing the lottery technique. All participants were taught correct brushing technique utilizing the Modified Bass technique and manufacturer's instructions for using waterpik as well as normal flossing instructions for using Dental floss. Results: The mean age presentation was 34.23±6.78 years. The females were 42 (60%) males were 28 (40%). The mean percentage showed that those using water flosser with tooth brushing had low plaque score than using string floss with tooth brushing. The independent t test showed that water flosser is significantly more effective (p=0.001) in plaque reduction than conventional string floss. Conclusion: A water flosser coupled with hand brushing is more effective in eliminating plaque than string floss. Plaque removal was 20-30% higher in the group that used a water flosser. Key words: Efficacy, Dental floss, Water jet

THE RELATIONSHIP BETWEEN THE EXPRESSION LEVELS OF TISSUE INHIBITOR OF METALLOPROTEINASES-3 (TIMP3) AND SEVERITY OF ATHEROSCLEROSIS

Objective: TIMP3 is one of tissue inhibitors of metalloproteinases (TIMPs), which binds to the components of the extracellular matrix, and has crucial roles in atherosclerogenesis and adipose tissue differentiation. In this study, it was aimed to determine the effects of TIMP3 gene expression levels on severity of atherosclerosis in different tissues. Material and Methods: The first group of the study (evaluated for coronary artery disease) were cases classified as high and low plaque scores according to the degree and location of atherosclerotic lesions. In the second group (post-mortem cases) were male cadavers who died due to coronary heart disease (CHD, n=26) and non-cardiac trauma (T-nonP, n=4). The TIMP3 expression levels were examined in leukocyte and peri-coronary epicardial adipose tissues (EAT) samples (n=69 and n=34, respectively) of the first group and EAT and coronary artery samples (n=12 and n=30, respectively) of the second group using quantitative RT-PCR. In addition, the protein expressions of TIMP3 were analysed on artery sections by immunofluorestaining. Results: In the post-mortem study group, the TIMP3 expression levels were found to increase in no plaque segments of arteries of cases with CHD (CHD-nonP) compared to advanced atherosclerotic arteries (CHD-P) and normal arteries of T-nonP cases (p=0.01 and p=0.05, respectively). The TIMP3 expressions in EATs and leukocytes were not statistically significant between the study groups. In addition, TIMP3 protein was detected in normal arteries, peri-coronary EATs and mostly in macrophages-rich areas in advanced atherosclerotic arteries. Conclusion: TIMP3 expression levels increase in normal coronary arterial segments of cases with CHD, which depict a protective role of TIMP3 in development of atherosclerosis.

Interdental and subgingival microbiota may affect the tongue microbial ecology and oral malodour in health, gingivitis and periodontitis.

Oral malodour is often observed in gingivitis and chronic periodontitis patients, and the tongue microbiota is thought to play a major role in malodorous gas production, including volatile sulphur compounds (VSCs) such as hydrogen sulphide (H2 S) and methanethiol (CH3 SH). This study aimed to examine the link between the presence of VSCs in mouth air (as a marker of oral malodour) and the oral bacterial ecology in the tongue and periodontal niches of healthy, gingivitis and periodontitis patients. Participants were clinically assessed using plaque index, bleeding on probing (BOP) and periodontal probing depths, and VSC concentrations in their oral cavity measured using a portable gas chromatograph. Tongue scrapings, subgingival and interdental plaque were collected from healthy individuals (n=22), and those with gingivitis (n=14) or chronic periodontitis (n=15). The bacterial 16S rRNA gene region V3-V4 in these samples was sequenced, and the sequences were analysed using the minimum entropy decomposition pipeline. Elevated VSC concentrations and CH3 SH:H2 S were observed in periodontitis compared with health. Significant ecological differences were observed in the tongue microbiota of healthy subjects with high plaque scores compared to low plaque scores, suggesting a possible connection between the microbiota of the tongue and the periodontium and that key dysbiotic changes may be initiated in the clinically healthy individuals who have higher dental plaque accumulation. Greater subgingival bacterial diversity was positively associated with H2 S in mouth air. Periodontopathic bacteria known to be prolific VSC producers increased in abundance on the tongue associated with increased bleeding on probing (BOP) and total percentage of periodontal pockets >6mm, supporting the suggestion that the tongue may become a reservoir for periodontopathogens. This study highlights the importance of the periodontal microbiota in malodour and has detected dysbiotic changes in the tongue microbiota in periodontitis.

A randomized controlled trial of manual versus powered tooth brushing during haematopoietic stem cell transplantation.

AimTo compare manual and powered tooth brushing (MT and PT) with respect to patient compliance to brushing frequency advice, plaque removal and severity of oral mucositis (OM) in patients undergoing hematopoietic stem cell transplantation (HSCT) after high‐dose chemotherapy.Materials & methodsA randomized controlled trial was conducted. Forty‐six patients scheduled to receive myeloablative conditioning regimen before autologous HSCT were included and randomly assigned to control (MT, n = 23) or test (PT, n = 23) groups. Starting at day 1 (day of hospital admission for HSCT), brushing frequency (patient recorded diary), plaque scores (Plaque Control Index) and oral mucositis (Oral Mucositis Nursing Index) were recorded daily. Data for days 1 to 17 were analysed using regression analysis and general linear models.ResultsFew patients maintained 4 times per day brushing, but most brushed at least 2 times per day throughout the study. In PT, overall plaque scores were lower by 6.98% (p = .006) as compared to MT. No differences were seen in OM scores between the groups (p = .968). A small but significant positive correlation was found between plaque scores and OM severity: R 2=0.15 (p < .01).ConclusionsPowered tooth brushing resulted in lower plaque scores, but was not associated with reduced OM severity. Individual plaque scores were positively related to OM severity.

Impact of Sensitization of Family Caregivers upon Treatment Compliance among Geriatric Patients Suffering from Elder Abuse and Neglect.

Geriatric patients in various outpatient department (OPDs) have been found to agonize from elder abuse and neglect (EAN). Such suffering imposes depressive states within individuals, which in turn affects treatment compliance. The objective of this study was to evaluate the impact of sensitization (psychotherapeutic) of family caregivers (FCGs) upon two denture treatment parameters (maintenance and treatment satisfaction) among EAN patients and compare the differences in outcome with non-abused patients. A survey of completely edentulous subjects (n = 860, aged 41–80 years) provided a sampling frame of 332 EAN patients from which 150 patients (including FCGs) fulfilling the study criteria were distributed (simple random, convenient) into two groups (Group A—control, Group B—test). FCG sensitization for subjects in Group B was performed by a clinical psychologist in 2–4 short (30 min) sessions. Demographic characteristics (frequency) were measured using a self-reported questionnaire, denture maintenance was measured using a denture hygiene index (scores), and treatment satisfaction was analyzed on a 10-point visual analog scale. Relevant data were calculated for means and absolute/relative frequencies. Any difference between two groups was estimated using an unpaired t-test while the level of relationship was determined by Karl Pearson’s test at a p-value of < 0.05. The results showed highest frequency (38.6%) for neglect, with elder neglect (EN) being most common (38.14% alone and 14% in combination). EN was found more if the FCG was a son (52%), in the age group (21–30 years), and with low education and low income (75%). Patients whose FCGs were counselled (Group B) demonstrated low denture plaque scores (mean = 1.38 ± 0.618), while demonstrating comparatively higher scores in six different parameters of treatment satisfaction. Differences between the two groups for both parameters were also found to be statistically significant. Psychotherapeutic counselling in the form of FCG sensitization brings better results of denture maintenance and treatment satisfaction.

Total plaque score helps to determine follow-up strategy for carotid artery stenosis progression in head and neck cancer patients after radiation therapy.

To identify predictors of carotid artery stenosis (CAS) progression in head and neck cancer (HNC) patients after radiation therapy (RT). We included 217 stroke-naïve HNC patients with mild carotid artery stenosis after RT in our hospital. These patients underwent annual carotid duplex ultrasound (CDU) studies to monitor CAS progression. CAS progression was defined as the presence of ≥50% stenosis of the internal/common carotid artery on follow-up CDU. We recorded total plaque score (TPS) and determined the cut-off TPS to predict CAS progression. We categorized patients into high (HP) and low plaque (LP) score groups based on their TPS at enrolment. We analyzed the cumulative events of CAS progression in the two groups. The TPS of the CDU study at enrolment was a significant predictor for CAS progression (adjusted odds ratio [aOR] = 1.69, p = 0.002). The cut-off TPS was 7 (area under the curve: 0.800), and a TPS ≥ 7 strongly predicted upcoming CAS progression (aOR = 41.106, p = 0.002). The HP group had a higher risk of CAS progression during follow-up (adjusted hazard ratio = 6.15; 95% confident interval: 2.29-16.53) in multivariable Cox analysis, and also a higher trend of upcoming ischemic stroke (HP vs. LP: 8.3% vs. 2.2%, p = 0.09). HNC patients with a TPS ≥ 7 in any CDU study after RT are susceptible to CAS progression and should receive close monitoring within the following 2 years.

"BRUSH UP": AN INNOVATIVE TECHNOLOGICAL AID FOR PARENTS TO KEEP A CHECK OF THEIR CHILDREN'S ORAL HYGIENE BEHAVIOUR.

ABSTRACTObjective: To investigate the impact of “Brush Up” - a mobile application, on oral hygiene behaviours of 4-6-year-old children in Bangalore city.Methods: In this experimental study, 247 children aged 4-6, were randomly divided into three groups. Considering “Brush Up” is a mobile application, parents of the children in Group 1 (n=82) downloaded the application on their smartphones. Children in Group 2 (n=83) and Group 3 (n=82) received tooth brushing instructions by an educative video and manual demonstration, respectively. Effectiveness of tooth brushing was assessed with plaque scores, which were recorded for all the groups at baseline and one month using Visible Biofilm Index.Results: Wilcoxon signed rank test showed a significant improvement in the tooth brushing behaviour for the Brush Up group, which was indicated by a lower plaque score after a follow-up of one month. Kruskal-Wallis test followed by post-hoc test showed that the mean ranks of plaque scores of Brush Up group are consistently lower than those of video demonstration group and manual demonstration group.Conclusions: The lower plaque score in subsequent follow-up in Brush Up group suggests that using a smart system can enhance learning a correct tooth brushing method in young children and can also help in implementing the required reinforcement and motivation to brush and aid in better plaque control.

Comparative Study of Oral Health Education Given by a Dentist and Schoolteachers in Thai Grade 3 Students.

ABSTRACTObjectives:To compare children’s knowledge and attitudes toward oral health (OH) and plaque score after receiving OH education (OHE) from a dentist or trained schoolteachers.Materials and Methods:Third-grade students in Amphoe Meuang, Nakhon Phanom, Thailand (n = 652), were randomly divided into a dentist group (n = 217), a teacher group (n = 216), and a control group (n = 219). The students’ OH knowledge, attitudes, and plaque scores before the intervention were collected as baseline data. The dentist and the teacher groups received additional OH education sessions by a dentist and trained schoolteachers, respectively. Their immediate post-test knowledge was evaluated after each session, and plaque scores were determined after the brushing session. All groups continued a monthly tooth brushing activity for two months. The final assessment was done at the three-month follow-up.Results:The students who received additional OHE by either a dentist or teacher demonstrated improved knowledge and attitudes towards OH, including plaque score. Interestingly, at the three-month follow-up, the knowledge score in the teacher group was significantly higher than in the dentist group. However, the dentist group had a significantly lower plaque score compared with the teacher group.Conclusions:Additional OHE in school significantly improved students’ OH knowledge and positive attitudes regardless of the provider. However, the teacher tends to have a greater impact on their students; thus after appropriate training, schoolteachers can be efficient OH educators, especially in the long term.

Evaluating Cognitive/Emotional and Behavioral Mediators of Oral Health Outcomes in Vulnerable Older Adults.

Inconsistent outcomes of oral hygiene interventions require testable theories combining cognitive and behavioral domains to guide intervention and improve results. This article evaluates the integrated model as a cognitive-behavioral approach to improve oral health clinical outcomes in ethnically diverse low-income older adults. Baseline data from a clinical trial utilizing the integrative model (IM) model evaluated predictors of gingival index (GI) and plaque score (PS). Individual logistic regression was performed for all predictors in relation to GI and PS. Multiple logistic regression was performed with significant predictors of GI and PS only. Greater locus of control and more brushing predicted lower GI; greater locus of control predicted lower PS. Both cognitive and behavioral domains impact GI, requiring more prolonged effort for improvement while locus of control, a cognitive variable, predicts PS, immediately improved by daily brushing/flossing. A streamlined IM including locus of control and tooth brushing should improve oral hygiene of low-income older adults.

Self-reported bleeding on brushing as a predictor of bleeding on probing: Early observations from the deployment of an internet of things network of intelligent power-driven toothbrushes in a supportive periodontal care population.

BackgroundBleeding on brushing (BoB) is an important sign of gingival inflammation. Recently, the use of intelligent toothbrushes and oral health Apps has shown potential to improve oral and periodontal health. In the context of the introduction of an Internet of things network of intelligent power‐driven toothbrushes in a supportive periodontal care programme, the aim of this study was (a) to audit the adoption and retention of this new technology; and (b) to preliminarily assess the feasibility to gather data on BoB and associate them with clinical periodontal parameters.Methods100 subjects with different periodontal case diagnoses participating in supportive periodontal care (SPC) were provided with and instructed on the use of an intelligent power‐driven toothbrush connected with an App (I‐Brush). Brushing sessions and occurrence of BoB were recorded through the App and stored in a data protection compliant backend. Subject retention was audited over time. BoB recorded in the two weeks before the SPC appointment was associated with clinical parameters observed by the clinician blind to App data.Results75% of subjects provided data from using the power toothbrush and the App for a minimum of 10 brushing sessions over an average period of 362 days. Compared with baseline, subjects’ oral hygiene, bleeding on probing and prevalence of residual pockets improved gradually while using the I‐Brush. The number of BoB episodes in the two weeks leading to the SPC appointment and the number of residual pockets predicted BOP (p < .001) detected during the examination. App use in the previous two weeks was associated with lower plaque scores at SPC.ConclusionsThese preliminary observations indicate good adoption and retention of a mobile health system built around an intelligent power toothbrush in a SPC population. The App was able to gather clinically relevant information predicting the observed degree of gingival inflammation. Deployment of mHealth systems seems feasible in dental practice and may bring significant oral health benefits. More investigations are needed in this area.

Metal versus Poly ether-ether ketone (PEEK) framework reinforcements for maxillary palateless ball retained implant overdentures. One year clinical and radiographic outcomes

Objectives: This study aimed to investigate both the clinical and radiographic outcomes of metal and Poly ether-ether ketone (PEEK) framework reinforcement materials for maxillary palateless ball retained implant overdentures after one year follow-up period . Materials and methods: Eight edentulous patients with edentulous maxillary ridges and implant retained mandibular overdentures who complained from lack of retention of their maxillary dentures were classified into 2 groups; group 1 included 4 patients who received palateless maxillary overdentures with cobalt chromium metal reinforcement, group 2 (included 4 patients who received palateless maxillary overdentures with PEEK reinforcement. All patients received 4 implants in canine and second premolar areas of maxilla. After 6 months, overdentures were attached to the fixtures with O/ring attachments. Clinical outcomes included Plaque indices, bleeding indices, depth of probing and implant mobility) and radiographical evaluation included marginal bone resorption. All outcomes were evaluated at prosthesis delivery, 6 months and one year after prosthesis delivery. Results: The survival rate of the implants showed significant difference, as it was 83% and 100% for metal and PEEK groups respectively. Plaque and bleeding scores, as well as pocket depth increased significantly from base line to 12 months. Bone resorption progress significantly from 6 months to 12 months in both groups. PEEK group showed significantly lower plaque scores, bleeding scores, probing depth and bone resorption than metal one. No significant differences in mobility of the implants in-between observation times or groups were noted

Microbial contamination and plaque scores of nanogold-coated toothbrush.

The study aimed to evaluate the microbial contamination and plaque scores of nanogold-coated and uncoated toothbrushes. This study was designed as a single-centre, parallel, examiner-blinded, randomized, two-group clinical trial. Eighty-four participants were enrolled and randomly assigned to receive either a nanogold or uncoated toothbrush. Basic periodontal therapy was performed for all the recruited subjects, and plaque scores of zero were considered baseline values. All participants were instructed to follow a twice-daily brushing regimen without dentifrice and to refrain from other oral hygiene care during the one-week study period. Plaque levels were assessed after oneweek using the Turesky modification of the Quigley-Hein Plaque Index (TMQHPI). The bristles were tested for microbial contamination by viable cell counting. The recorded data were statistically analysed, and a P-value of <.05 was accepted as statistically significant. After oneweek of brushing without using toothpaste, the mean plaque index scores were 0.37±0.07 in the nanogold group and 0.58±0.10 in the uncoated group. A significant difference in the mean plaque scores was observed between the groups (P<.001). The mean colony-forming unit (CFU) was 21±48.8 for the nanogold-coated group and 100±128.4 for the uncoated group. The difference in the mean CFUs observed between the groups was significant (P=.014). The use of a nanogold-coated toothbrush demonstrated significantly lower bristle contamination and lower plaque scores after oneweek compared with uncoated toothbrushes without using dentifrice.

COMPARISON OF PLAQUE SCORE BETWEEN TRADITIONAL BRUSHING TEETH (MISWAK) AND BASS METHOD (Overview of Students of the Pondok Pesantren Darul Hijrah Putera Banjarbaru)

Background: Siwak or miswak is obtained from the branches and stems of the Salvadora persica plant that grows in the Middle Eastern plains and commonly used as a toothbrush to clean teeth and gingival structures. Miswak contains natural antibacterial acids (astringents, abrasives and detergents) which function to kill bacteria, prevent infection and stop bleeding in the gum. Chemical substances such as Chloride, Pottasium, Sodium Bicarbonate, Fluoride, Silica, Sulfur, Vitamin C, Trimethylamine, Salvadorine, and Tannins which function to clean teeth, whiten and nourish teeth and gingiva. How to brush your teeth has an effect on reducing or removing plaque. Efforts to clean plaque can be done by brushing your teeth. Brushing your teeth using a toothbrush is a form of mechanical removal of plaque. It can be done through several methods, including the method of Bass, Stillman, Fones, and adapted to the movements named Vertical and Horizontal. The bass method is a tooth brushing technique that is done by placing a 45-degree toothbrush on the root of the tooth and then gently pressing it while doing a small rotating motion. The tip of the toothbrush is directed to the gingival neck. The bass method is more effective for removing plaque around and below the edge of the gingiva. Controlled movements are used to get rid of plaque and avoid trauma to the gingiva. Objective: The purpose of this study was to analyze the comparison of plaque scores between brushing tooth with traditional (Miswak) and bass methods on students of the Pondok Pesantren Darul Hijrah Putera Banjarbaru. Method: This study used the Quasi experimental research method with Pre and Post-test. Results: The results of statistical tests using the non-parametric test of the Man Whitney test showed a value of p = 0,000 (p ≤ 0,05), the results showed that there were significant differences between the plaque scores before and after the tooth brushing treatment with the miswak and bass method. Conclusion: The bass method group has a lower plaque score than the miswak group.

Comparison of the effects of lanthanum carbonate and calcium carbonate on the progression of cardiac valvular calcification after initiation of hemodialysis

BackgroundAlthough mineral metabolism disorder influences cardiac valvular calcification (CVC), few previous studies have examined the effects of non-calcium-containing and calcium-containing phosphate binders on CVC in maintenance hemodialysis patients. The aim of the present study was to compare the effects of lanthanum carbonate (LC) with calcium carbonate (CC) on the progression of CVC in patients who initiated maintenance hemodialysis and to investigate clinical factors related to CVC.MethodsThe current study included 50 subjects (mean age 65 years, 72% males) from our previous randomized controlled trial (LC group, N = 24; CC group, N = 26). CVC was evaluated as CVC score (CVCS) using echocardiography at baseline and 18 months after initiation of hemodialysis. We compared CVCS and the changes between the two groups. We also analyzed the associations between CVCS and any other clinical factors including arterial plaque score (PS) and serum phosphorus levels.ResultsBaseline characteristics of study participants including CVCS were almost comparable between the two groups. At 18 months, there were no significant differences in mineral metabolic markers or CVCS between the two groups, and CVCS were significantly correlated with PS (r = 0.39, p < 0.01). Furthermore, changes in CVCS were significantly correlated with average phosphorus levels (r = 0.36, p < 0.05), which were significantly higher in high serum phosphorus and high PS group compared to low serum phosphorus and low PS group (p < 0.05).ConclusionsIn the present study, there were no significant differences between LC and CC with regard to progression of CVC. However, serum phosphorus levels and arterial plaque seem to be important for the progression and formation of CVC in hemodialysis patients.

Porphyromonas Gingivalis Load is Balanced by 0.20% Chlorhexidine Gel. A Randomized, Double-Blind, Controlled, Microbiological and Immunohistochemical Human Study

Microbial contamination could compromise the stability of dental implants increasing the risk of inflammatory reactions in the surrounding soft tissues. In this human, randomized, double-blind, clinical study, the presence of Porphyromonas gingivalis on the healing abutment and the inflammatory infiltrate surrounding peri-implant soft tissues were investigated. Experiments were done in order to clarify the effect of 0.20% chlorhexidine (CHX) versus placebo, applied during each rehabilitation stage. Thirty patients (15 per group) were included. The load of adhering P. gingivalis on the healing screw were quantified by quantitative Polymerase Chain Reaction (qPCR) Taq-Man. Immunohistochemical analysis was carried out on the gingival biopsy. Moreover, clinical data were recorded. Analysis of variance and the Holm–Sidak test was used to evaluate differences between groups. The results showed a significant low presence of P. gingivalis load in healing abutments belonging to the 0.20% CHX group. Overall, the differences in terms of P. gingivalis DNA copy number between two groups were statistically significant (p < 0.01). All implants showed very low plaque and bleeding scores, but the placebo group appeared to have the highest expression of inflammation markers for T Lymphocytes, B Lymphocytes and macrophages Cluster definitions (CD3, CD20 and CD68). The use of 0.20% CHX could be recommended in all clinical procedures as it reduces significantly P. gingivalis load and host inflammatory response around implants.

Prevalence of oral hygiene tools amongst hospitalised elders: A cross-sectional survey.

This study aimed to evaluate the prevalence of various oral hygiene tools amongst hospitalised elders and to associate their cognitive status with the prevalence of tools and oral hygiene status. Elderly hospitalised participants were included in the study and underwent a brief clinical intra-oral examination. A semi-structured questionnaire evaluated the awareness and personal possession of the various oral hygiene tools. Participants' personal information and various clinical parameters including DMF (T) index, plaque index, CPITN index, denture plaque and calculus index were collected. Mini-Mental State Examination (MMSE) scores were retrieved from the medical records. Linear regression models were applied for statistical analyses (P<0.05). A total of 100 hospitalised elders (age = 84.5±6.9years; ♀ = 72, age = 84.9±7.2years; ♂ = 28, age = 83.3±5.8years) participated in this study. Awareness was high for manual toothbrush (100%), electric toothbrush (86%), dental floss (79%), interdental brush (44%), interdental stick (55%) and mouthwash (75%), but was low for tongue scraper (9%), while the prevalence of use was 93%, 17%, 27%, 21%, 29%, 39% and 4%, respectively. Linear regression models revealed plaque scores were lower when more hygiene tools were used by the participants (P=0.0059). Participants with high MMSE scores had lower plaque scores (P=0.0004) and possessed more oral hygiene tools (P=0.0203). Poor oral hygiene is often noticed in institutionalised elders and might be related to a lack of knowledge about existing oral hygiene tools. These may help optimising oral hygiene, especially in cognitively impaired elders. Oral hygiene tools should be prescribed according to the patient's need, functional and cognitive status.