Moderate Gingivitis Research Articles

Relationship of Periodontitis in Pregnancy to Premature and Low Birth Weight in a Libyan Women Sample

To assess the relation between periodontitis and the risk of preterm delivery/low birth weight among Libyan women in Benghazi. Methods: A total of 300 Libyan pregnant women attended to the reception of labour department of Al- Jomhuriya Hospital in Benghazi for delivery from May to August 2010 were included in this study. After recording and exclusion of traditional risk factors for premature/low birth weight like; age, weight, smoking, prenatal care, medical history, gestational and obstetric history. They were examined for periodontal status using Plaque Index, Gingival Index and Periodontal Disease Index, all the data obtained were analyzed with the day of delivery and birth‘s weight. Results: The periodontal disease index score (PDI) showed that 47% of the sample had moderate gingivitis, 29% of the sample had mild gingivitis, 10% had severe gingivitis while 11% had mild periodontitis. According to gingival index score, moderate gingivitis had high percentage (60%) which is related to high percentage (51%) in plaque index score. PDI showed insignificant relationship with PLBW at P-value = 0.849. Conclusion: This study suggests that there is no association between periodontitis and premature/low birth weight among Libyan ladies in Benghazi.

β THALASSEMIC PATIENTS;

Introduction Thalassemia is a worldwide disease. 5-8% of Pakistani population (approx. 8 –10 millions) are carrying thalassemia genes. It causes various abnormalities indifferent organs of patients. In Pakistan (to the best of our knowledge) no research work on oral and maxillofacial manifestation had been carried out, therefore present study wasunder taken. Objectives: The aim of this study was to evaluate the frequency ofgingival status Thalassemic patients and correlate with age. Study Design: Cross Sectional, Observational, Non Therapeutic Setting: AbbasiShaheed Hospital Karachi with collaboration of Husaini Institute of Blood Diseases Karachi, Fatimid Foundation and National institute of Oral Diseases Karachi Pakistan.Period: 2 years June 2013 to June 2015.Methods and Materials: 200 diagnosedβ– thalassemia major patients, were randomly selected form the Patients who were registered for their treatment .Their clinical examination and percentage of recorded feature were calculated and cross tabulated with age and GI Index were used for evaluation of Gingivitis and result were deduced.Results:The most prominent features recorded were gingivitis in 83.5normal patients were 16.5, Mild Gingivitis 39% %; Moderate Gingivitis 37 %; Severe Gingivitis in 7.5%.Conclusion: The increase in severity of Gingivitis increases with age and duration, necessitate regular surveillance and counselling in order to reassure the patient,reduce ginigivitis in thalassemia patients and improve the overall condition and life style of Patients.

Occurrence of Gingivitis and Oral Hygiene in Individuals with Down Syndrome

Objective: To determine the frequency distribution of gingivitis and oral hygiene in individuals with Down syndrome. Material and Methods: This study used a cross-sectional descriptive method and the subjects were 174 individuals with Down syndrome aged ≥14 years attending type C (intellectual disability) special needs schools in Jakarta. Gingivitis was measured using the gingival index, and oral hygiene was measured using the Simplified Oral Hygiene Index (OHI-S). The measurement of the two components of plaque and calculus was completed on six teeth on different surfaces, including the facial side of three maxillary teeth, the lingual side of the two posterior mandibular teeth, and the labial side of one anterior mandibular tooth. Descriptive statistics were used to calculate the absolute and relative frequencies. Results: 3.4% had no gingivitis, 47.2% had mild gingivitis, 40.8% had moderate gingivitis, and 8.6% had severe gingivitis. Regarding oral hygiene , 28.2% had good hygiene , 49.4% had fair, and 22.4% had poor hygiene . Conclusion: Individuals with Down syndrome had a frequency distribution of gingivitis mainly in the mild and moderate categories, and a majority of subjects had fair OHI-S.

Evaluation of Topical Application of <i>Azadirachta indica</i> (Neem) in Prevention of Gingivitis: A Randomized Control Trial

Background: The purpose of the present study was to envisage the anti-plaque and anti-inflammatory properties of neem (Azadirachta) in the form of a mouth gel. Materials and Methods: A total of 60 subjects (33 males and 27 females) from age group 19 - 35 years, suffering from mild to moderate gingivitis were randomly divided into two groups. Group A (n = 30) participants were advised experimental (neem) gel and Group B (n = 30) participants were advised 0.2% chlorhexidine gel. All the clinical parameters (the gingival index by Loe and Silness [1], Plaque index by Silness and Loe [2] and sulcus bleeding index by Muhlemann H. R. and Sen S. [3]) were recorded at baseline, on the 14th day and 21st day by the same clinician in both groups. Results: on intragroup comparison the gingival index, plaque index and sulcus bleeding index decrease significantly in both the groups in all assessed periods. On intergroup comparison the indices did not differ significantly at baseline but after 2nd and 3rd week, the indices in Group B decrease more than the group A, which was statistically significant. Conclusion: Based on the observations of our study, it can be concluded that chlorhexidine gluconate as well as neem gel can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. chlorhexidine gluconate gel has been found to be more effective when antiplaque and anti-inflammatory properties were considered. The effect of neem observed maybe because of its anti-inflammatory action. The antiplaque action of chlorhexidine gluconate is due to its substantivity. Substantivity of neem is required to be further studied.

Niveles de Proteina C-Reactiva en Gestantes con Periodontitis y Gingivitis

Objetivos. Determinar si la enfermedad periodontal, específicamente la periodontitis crónica y la gingivitis severa, moderada y leve estimulan el aumento del nivel de Proteína C Reactiva (PC-R) ; y en cual de las enfermedades periodontales se genera un mayor incremento de la PC-R. Materiales y métodos. Estudio correlacional, observacional y retrospectivo. La muestra estuvo constituida por 136 gestantes divididas en 3 grupos: 1) Gestantes con periodontitis crónica; 2) Gestantes con gingivitis severa o moderada; 3) Gestantes con gingivitis leve. A cada gestante se le solicitó un análisis de sangre para detectar los niveles plasmáticos de PC-R. Cada gestante fue registrada en una ficha de recolección de datos, en la cual se indicó el nivel de PC-R en mg/l, IHO-S, IG y el periodontograma. Resultados. El promedio del nivel de PC-R en el grupo con PC fue de 4,53 mg/l, en el grupo con GSM fue de 1,53 mg/l y en el grupo con GL fue de 3,77 mg/l, siendo la diferencia de promedios entre el grupo con PC y GSM estadísticamente significativa (p=0,002); mientras que la diferencia de promedios entre el grupo con PC y GL no tuvo significancia estadística (p=0,371). Conclusiones. La enfermedad periodontal estimula el aumento del nivel de PC-R. La periodontitis crónica estimula un mayor aumento del nivel de PC-R en comparación a la gingivitis severa, moderada y leve.

Effect of Bulgarian propolis on the oral microflora in adolescents with plaque-induced gingivitis

We compared the effect of two therapeutic approaches (marketed toothpaste and addition of Bulgarian propolis extract to the toothpaste) on gingival inflammation, plaque formation and oral microbial flora on Bulgarian adolescents with moderate plaque-induced gingivitis. The participants were divided randomly into two groups of 35 students. The first group was instructed to use marketed toothpaste in their routine oral hygiene. The second group was instructed to add 10 drops of Propolin® to the toothpaste before every brushing. The Gingival index and Plaque index were registered and dental plaque samples were collected on the first visit and on the 20th day of the study. After the treatment, the number of students with Gingival index=1.1–2.0 in the second group was significantly lower than the respective number in the first group. Neisseria spp. and Streptococcus spp. were present in all samples before and after treatment. The addition of propolis resulted in the complete eradication of Streptococcus mutans, Candida albicans, Fusobacterium varium, Gram-negative cocci, Gram-positive rods, Porphyromonas asaccharolyticus, Prevotella bivia, Prevotella intermedia, Prevotella melani and Streptococcus intermedius. The analyses of Propolin® composition revealed it was a black poplar type propolis and is rich in compounds with pronounced antimicrobial activity. In conclusion, the addition of Bulgarian propolis to the toothpaste improved the gingival health in adolescents with moderate plaque-induced gingivitis and resulted in increased activity against potential periodontal and cariogenic pathogens.

PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

Comparing the Effect of Coconut Oil Pulling Practice with Chlorhexidine Mouth Wash in Plaque Induced Gingivitis by Evaluation of Salivary Biochemical Marker � A Comparative Interventional Study

Background: Oil pulling is an oral hygiene practice and is described in the ancient Ayurvedic literature. Materials and Methods: A total of 30 subjects with plaque related mild – moderate gingivitis in the age Group of 18-25 was recruited and they were divided into two Groups as Group A and B, each with 15 subjects. Group A subjects were advised to practice coconut oil pulling therapy and Group B subjects were advised to use Chlorhexidine Gluconate 0.12% solution for 4 weeks as an adjuvant practice along with routine tooth brushing. Estimation of salivary Aspartate Aminotransferase was done at pre and post intervention stage for both the study Groups by using semi auto analyser. Results: Statistically significant reduction in the reduction in the salivary Aspartate Aminotransferase level was seen at post intervention stage in Group A and Group B compared to preintervention stage. Comparison of salivary Aspartate Aminotransferase level between Group A subjects and Group B subjects at pre and post intervention stage revealed no significant difference. Our study results show that oil pulling utilizing coconut oil is effective in reducing the severity of plaque induced mild-moderate gingivitis and the effect is comparable to 0.12% chlorhexidine mouthwash in reducing plaque formation and gingivitis. Conclusion: Oil pulling utilizing coconut oil is an effective adjuvant oral hygiene practice in reducing the severity of plaque induced mild – moderate gingivitis along with the routine oral hygiene measure. Coconut oil pulling practice could be a potential alternative to chlorhexidine mouth wash for long term use.

Características del estado periodontal en gestantes del Hospital Materno Infantil San Pablo de Asunción, Paraguay

Objetivo: Determinar las características del estado periodontal en gestantes que acudieron al Hospital Materno Infantil San Pablo (HMISP) de Asunción, Paraguay en el periodo comprendido entre diciembre del 2015 a febrero del 2016. Métodos: Se realizó un estudio observacional descriptivo de corte transversal a pacientes embarazadas que asistieron a su primera consulta prenatal. Se aplicó una encuesta sobre factores sociodemográficos, hábitos de higiene oral e instrucción de salud bucal por parte del personal de salud. La evaluación del estado periodontal se realizó en una hoja de registro de datos clínicos, que incluyó el índice gingival (IG) de Löe y Silness en dientes del sextante anteroinferior. Resultados: Se evaluaron a 96 pacientes con edades comprendidas entre 15 y 37 años, con una media de 23,8, desviación estándar 5,47. Se evidenció que la gingivitis predominó en las gestantes en un 85,4% (n=82). La gingivitis moderada fue la manifestación más frecuente (49%), tanto en el primer como el tercer trimestre, en tanto que la gingivitis severa se presentó en menor proporción (3,1%). Conclusiones: La gingivitis predominó en las gestantes en un 85,4%, siendo más frecuente la gingivitis moderada en un 49% según lo registrado con el IG de Löe y Silness.

A longitudinal assessment of periodontal health status in 53 Labrador retrievers.

To determine the incidence and rates of progression of gingivitis and periodontitis in Labrador retrievers. Fifty-three dogs, aged 1·1 to 5·9 years, had their periodontal health assessed every 6 months for up to 2 years. The extent of gingivitis and periodontitis was measured around the whole gingival margin of every tooth under general anaesthesia. All dogs had gingivitis at the initial assessment. The majority (64·2%) of tooth aspects had very mild gingivitis. The palatal/lingual aspect of all tooth types was most likely to show bleeding when probed: 63·0% of these aspects had mild or moderate gingivitis. Over 2 years, 56·6% of dogs developed periodontitis and dogs as young as 1·9 years were affected. There was a significant positive correlation between the proportion of teeth with periodontitis and age. In total, 124 teeth (5·7%) developed periodontitis; 88 (71·0%) of these were incisors. The palatal/lingual aspect of the incisors developed the disease first (2·8% of incisor aspects). Periodontitis developed in regions that are difficult to see in conscious dogs implying that detection and treatment of disease requires periodic sedation or anaesthesia.

Prevalence and Severity of Plaque-Induced Gingivitis in Three Latin American Cities: Mexico City-Mexico, Great Metropolitan Area-Costa Rica and Bogota-Colombia

Plaque-induced gingivitis is the most common form of periodontal disease and can affect 100% of the population. Gingivitis prevalence in Latin American population is not well documented, therefore the aim of this study was to determine the prevalence and severity of plaque-induced gingivitis in adult populations of three Latin American cities. Methods: This cross sectional multicenter study included 1650 participants, 550 from the Great Metropolitan Area of Costa Rica (GAM), 550 from Mexico City, Mexico (CDMX) and 550 from Bogota City, Colombia (BC). Subjects completed a questionnaire about their medical history and oral hygiene. Clinical assessment included recording of missing teeth, visible plaque index, calculus recording and gingival index (GI, Loe-Silness index). Results: Average GI was 1.36. No statistical difference was found between GAM (1.45) and BC (1.48); however, GI in CDMX was significantly lower (1.16). Average gingival bleeding on probing was 43%. Total plaque index was 0.76 showing the highest accumulation at interproximal sites (p=0.0001). A positive correlation was found between plaque and gingivitis (r=0.59). Dental calculus was present in at least one of the 18 evaluated sites per subject with no statistical difference between cities. There was no statistical difference in GI between smokers, former smokers and non- smokers. Conclusion: Gingivitis prevalence was 99.6%. Moderate Gingivitis was the predominant form, with no statistically significant difference between cities or gender. Dental plaque accumulation was the most important risk factor associated with the establishment of the disease.

Prevalence and Severity of Plaque-Induced Gingivitis in Three Latin American Cities: Mexico City-Mexico, Great Metropolitan Area-Costa Rica and Bogota-Colombia

Plaque-induced gingivitis is the most common form of periodontal disease and can affect 100% of the population. Gingivitis prevalence in Latin American population is not well documented, therefore the aim of this study was to determine the prevalence and severity of plaque-induced gingivitis in adult populations of three Latin American cities. Methods: This cross sectional multicenter study included 1650 participants, 550 from the Great Metropolitan Area of Costa Rica (GAM), 550 from Mexico City, Mexico (CDMX) and 550 from Bogota City, Colombia (BC). Subjects completed a questionnaire about their medical history and oral hygiene. Clinical assessment included recording of missing teeth, visible plaque index, calculus recording and gingival index (GI, Loe-Silness index). Results: Average GI was 1.36. No statistical difference was found between GAM (1.45) and BC (1.48); however, GI in CDMX was significantly lower (1.16). Average gingival bleeding on probing was 43%. Total plaque index was 0.76 showing the highest accumulation at interproximal sites (p=0.0001). A positive correlation was found between plaque and gingivitis (r=0.59). Dental calculus was present in at least one of the 18 evaluated sites per subject with no statistical difference between cities. There was no statistical difference in GI between smokers, former smokers and non- smokers. Conclusion: Gingivitis prevalence was 99.6%. Moderate Gingivitis was the predominant form, with no statistically significant difference between cities or gender. Dental plaque accumulation was the most important risk factor associated with the establishment of the disease.

Prevalence of Periodontal Diseases among Patients Attending the Outpatient Department at the College of Dentistry, King Khalid University, Abha, Saudi Arabia

Aims: A retrospective study was performed involving 2739 patients who were attending the College of Dentistry outpatient clinic department of King Khalid University (KKU), Abha, Kingdom of Saudi Arabia (KSA) during the period of 1st January to 31st December, 2009. Methods: Random data were collected from the patients record files ofthe College of Dentistry who attended from 1st January to 30th December, 2009. Results: Among 2739 patients mean age 32±13 (range 11~82) years, males 86.5% and females 13.5%, were found sufferers of different types of periodontal diseases i.e., gingivitis and periodontitis. Gingivitis cases were found 1722(63.2%), in which mild gingivitis was 49.8%, moderate gingivitis 45.8%, severe gingivitis 1.97%, acute gingivitis 0.52% and puberty gingivitis 1.80%. Total number of patients affected with various forms of periodontitis was 1009 (36.8%), in which mild periodontitis was 57.4%, moderate periodontitis 36.6%, severe periodontitis 4.95% and aggressive periodontitis 0.89%. The prevalence and severity of gingivitis was found increased with age to a peak in the 21~30 years age group, whereas, periodontitis increased significantly (p<0.001) in subjects above the age of 40 years. Conclusion: Using the research results, a greater effort can be made in providing periodontal health to the population of at or around the city of Abha, KSA. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13835 City Dent. Coll. J Volume-10, Number-1, January-2013

Correlation between interleukin-1β and matrix metalloproteinase-1 levels in crevicular fluid with a proposed periodontal disease index in children.

Background:The crevicular fluid contains biomarkers that allow the identification of periodontal disease, anticipation of its risk, and prediction of its progression.Purpose:The purpose of this study is to correlate interleukin-1β (IL-1β) and matrix metalloproteinase-1 (MMP-1) levels in crevicular fluid with periodontal disease severity in schoolchildren.Methods:A cross-sectional study was conducted in 82 schoolchildren between 9 and 12 years. The biofilm percentage, attachment level, gingival recession, dental calculus, and bleeding on probing were measured in the teeth 16, 26, 36, 41, and 46. These five parameters obtained were considered to propose a disease score between 0 and 10 points. In crevicular fluid from the tooth with the highest score, IL-1β and MMP-1 levels were measured.Results:According to the proposed score, mild gingivitis was identified in 20 schoolchildren, moderate gingivitis in 30, and severe gingivitis in 32. Biofilm percentage, IL-1β, and MMP-1 levels increased as the severity of the disease increase. The mean and 95% confidence interval were 23.2 pg/μl (18.6–27.7), 37.3 pg/μl (27.8–46.9), and 44.6 pg/μl (34.4–58.8) (P = 0.01) for IL-1β and 2.69 mol/min (2.51–2.87), 4.43 mol/min (3.9–4.95), and 5.59 mol/min (4.81–6.38) (P < 0.001) for MMP-1 in each group, respectively. The proposed clinical score correlated with biofilm percentage (r = 0.63), IL-1β (r = 0.50), and MMP-1 (0.45) levels, P < 0.001 in all cases.Conclusions:The proposed clinical score for periodontal disease in children correlated with percentage of biofilm, IL-1β, and MMP-1 levels.

The efficacy of anticalculus mouth rinse in moderate gingivitis patients with and without professional intervention

Aim: Gingivitis has been defined as the reversible dental plaque-induced inflammation of the gingiva without detectable bone loss or clinical attachment loss. It is frequently encountered in dental practice and affected people of all ages and describes the condition of the dental soft tissue. There is always a correlation between the presence of calculus and the prevalence of gingivitis. The aim of this clinical study was to assess the efficacy of anticalculus mouthwash on reduction of plaque and calculus with and without professional intervention. Materials and Methods: A total of 40 volunteers with clinical signs of moderate gingivitis were selected and after a washout period of 2 weeks divided into groups, with and without any professional intervention. The patients were instructed to use anticalculus mouth twice daily. Clinical assessment was carried out using the plaque index based on Silness and Loe method, gingival index based on Loe and Silness method, and calculus index of Oral Hygiene Index-Simplified at baseline, 1 month, and 2-month days of the anticalculus mouthwash use. Statistically analysis was carried out using the Kruskal–Wallis and Mann–Whitney test for comparative analysis. Results: The study proved that anticalculus mouthwash was effective in lowering all the clinical scores both with and without any professional intervention. However, the optimal results were achieved when combined with professional scaling. Conclusion: Anticalculus mouthwash is effective in controlling plaque-induced gingivitis and lowering clinical scores.

Effectiveness of Herbal Mouthwash among Visually Impaired Residential School Students

Visually impaired patients are unable to visualize the plaque on tooth surfaces resulting in inadequate plaque removal and therefore the progression of dental caries and inflammatory disease of the periodontium. The objective of the study was to assess the effectiveness of herbal mouth wash in reduction of plaque and gingivitis among visually impaired children. Randomized controlled clinical trial was conducted with parallel groups study, comprising 6 to 20 year old visually impaired children, 20 in each group (herbal mouth wash or chlorhexidine mouthwash or placebo mouthwash). Plaque and gingival index were recorded at baseline and at the end of the study. Children were asked to use the mouth wash twice daily for two weeks. Analysis was done using Chi-square test for categorical data and Mann-Whitney U test/independent t-test and one way analysis of variance/Kruskal-wallis H test for quantitative data. The level of significance was set at P<0.05. Participants showed fair oral hygiene (mean plaque scores of 1.14±0.53) and moderate gingivitis (mean gingival scores of 1.12±0.45) with no significant difference between three groups (P=0.47 and 0.84, respectively). Significant reduction of plaque and gingivitis was seen at follow-up with no significant difference between herbal and chlorhexidine mouthwash. However, significant difference was found between placebo and herbal/chlorhexidine mouthwash. Herbal mouthwash showed significant effect on reducing plaque formation and gingivitis in visually impaired students. The effectiveness of herbal mouthwash was analogous to the gold standard chlorhexidine.

Anti–Plaque Efficacy of cure next Gel, Hoira-sa gel in Comparison with Chlorhexidine Gel. A Randomised Control trial Study

AIM: To compare anti plaque efficacy of Cure next gel, Hoira-SA gel (Natural Herb Extracts) with Chlorhexidine gel among patients with mild to moderate gingivitis. OBJECTIVE: The objective of the study is to compare the anti-plaque efficacy of Natural Herb Extract Gels (Cure Next gel and Hoira-SA Gel) with Chlorhexidine gel in reducing plaque accumulation, gingival inflammation among patients with mild to moderate gingivitis. MATERIALS AND METHOD: 45 systemically healthy mild to moderate gingivitis patients are to be selected from the outpatient department of Saveetha Dental College. Patients were divided into three groups where in Group 1 (GP1) included 15 patients provided with Cure Next Sample, Group 2 (GP2) included 15 patients provided with Chlorhexidine sample; Group 3 (GP3) included 15 patients with Hoira-SA gel sample. Following randomization, the baseline values were recorded and supra gingival scaling and polishing was done. Patient was allotted in one of the three groups and instructions about usage of gel were given. Postoperative assessment was done after two weeks using Plaque Index and Bleeding Index. RESULT: There was a significant reduction found in the levels of mean plaque and bleeding scores assessed post operatively after two weeks of administration of gel samples in all the three groups. The plaque and bleeding scores were compared between the groups to assess the anti-plaque efficacy of the gel samples in comparison with chlorhexidine gel. CONCLUSION: This study revealed that all the three gels (Cure next gel, Chlorhexidine gel and Hoira gel) can be effectively used in plaque control for mild to moderate gingivitis patients. But while comparing Cure Next gel with Hoira gel, Cure next gel administration showed significant reduction in plaque accumulation similar to that of Chlorhexidine gel.

Effect of tablets containing probiotic candidate strains on gingival inflammation and composition of the salivary microbiome: a randomised controlled trial.

The aim of the study was to investigate clinical and microbial effects of probiotic candidate strains in patients with moderate gingivitis. The null hypothesis was that the clinical measurements with treatment would not differ from placebo. 47 adult patients were enrolled in a randomised placebo-controlled trial with a 4-week intervention of tablets containing a mix of Lactobacillus rhamnosus PB01, DSM 14869 and Lactobacillus curvatus EB10, DSM 32307 or placebo. Clinical examinations and samplings were done at baseline and after 2, 4 and 6 weeks. The clinical endpoints were general bleeding on probing (BOP), general plaque index (PI) and flow of gingival crevicular fluid (GCF). In addition, the concentration of selected cytokines (interleukin (IL)-1β, IL-6, IL-8, IL-10, tumour necrosis factor alpha (TNF-α)) in GCF was determined with multiplex immunoassays. The profiles of the salivary microbiome were analysed with Next Generation Sequencing (NGS) and qPCR. In contrast to the placebo group, there was a significant reduction in BOP and amount of GCF (P<0.05) after 4 weeks in the probiotic test group when compared with baseline. The general PI was less affected although there was a tendency of decreased plaque levels in the probiotic group (P=0.05-0.09). The cytokines were unaffected by the intervention as well as the salivary microbiome. The Shannon index showed no significant differences between the groups or alterations over time. The occurrence of both probiotic strains increased in saliva of the test subjects during the intervention but returned to baseline levels within 2 weeks. Although a marked improvement in gingival health was recorded in the probiotic group, the null hypothesis could not be rejected.

Triphala - An Indigenous Ayurvedic Mouthwash As An Anti-Inflammatory Agent - A Clinical Study

Background: An antiplaque agent with minimal side effects that can be used as an effective adjunct to mechanical plaque control is needed. Mouthwash has been used for centuries for medicinal and cosmetic purposes, but in recent years, the rationale behind the use of chemical ingredients has been subjected to scientific research and clinical trials. Herbal medicines are in great demand in the developed as well as in developing countries for primary health care because of their wide biological and medicinal activities, higher safety margin, and lower costs. Triphala mouthwash used in Ayurveda since ancient times, is well-known for its anti-plaque, anti-gingivitis and anti-microbial properties.&#x0D; Aim: To evaluate and compare the effects of an indigenously prepared 0.6% triphala mouthwash on dental plaque and gingival inflammation with a commercially available chlorhexidine mouthwash.&#x0D; Materials and Methods: 20 subjects in the age group of 20-40 years with mild to moderate gingivitis were selected and divided into two equal groups in the study. Following oral prophylaxis, Group I (n=10) subjects were instructed to rinse with 10 ml of 0.2% chlorhexidine mouthwash, Group II (n=10) subjects with 10 ml of 0.6% triphala mouthwash twice daily for 14 days. Oral Hygiene Index-Simplified, Turesky- Gilmore-Glickman modification of Quigley-Hein-Plaque index and Gingival Index were recorded at baseline, 7 and 14 days respectively.&#x0D; Results: Group I and Group II subjects showed statistically significant results in the reduction of the clinical parameters (p &lt; 0.001). Group I subjects showed statistically significant results in reduction of the plaque status (p &lt; 0.05) whereas; Group II subjects showed significant reduction in the gingival inflammation (p &lt; 0.05).&#x0D; Conclusion: Although, 0.2% chlorhexidine mouthwash yielded better results, 0.6%Triphala mouthwash may be used for short duration of time without any potential side-effects as an alternative to chlorhexidine mouthwash in reducing gingival inflammation.

Anti-Inflammatory Effects of Prepared Punica Granatum Mouthwash on Patients with Moderate Gingivitis

Objective: Punica granatum is a herbal product used in the field of dentistry which has many potential effects including bactericidal, antifungal, antiviral, and immune modulation. This study aimed to evaluate the effect of prepared Punica granatum as an antiplaque and anti-inflammatory agent in the treatment of gingival inflammation. &#x0D; Methods: Sixty patients were enrolled in this study. Fourty five patients with moderate gingivitis were divided randomly into 3 groups; chlorhexidine group included 15 patients received once-daily dose of chlorhexidine mouthwash for 1 day, Punica I group included 15 patients received once-daily dose of Punica mouthwash for 1 day, and Punica II group included 15 patients received once-daily dose of Punica mouthwash for 2 consecutive days. Plaque index, gingival index, and bleeding on probing were assessed before rinsing and after 3 and 7 days of rinsing, also saliva were collected before rinsing and after 1 hour, 2 hrs, 1 and three days of rinsing to estimate the level of interleukine-1β. The rest 15 subjects were with clinically healthy gingiva. &#x0D; Results: Punica II group resulted in significant reduction of plaque index, gingival index, and bleeding on probing after 3 and 7 days of rinsing (p≤0.05) but with non-significant differences with chlorhexidine group (p&gt;0.05). It had significant effect in reduction of interleukine-1β which begin after one day of rinsing and continued into three days (p≤0.05).&#x0D; Conclusions: Punica like chlorhexidine has a positive effect on reduction of plaque accumulation and improvement of gingival inflammation so can be used as an anti-plaque and anti-inflammatory agent in the treatment of gingival inflammation.