Modified Gingival Index Research Articles

Analyses of gingival papilla blood flow via color doppler flow imaging and micro-flow imaging in patients with advanced periodontitis: a clinical pilot study

BackgroundResearch investigating the potential link between gingival microvascular blood flow and inflammatory status is scarce. This study aims to assess color doppler flow imaging (CDFI) and micro-flow imaging (MFI) as tools for the assessment of gingival papilla blood flow (GPBF) and to examine their diagnostic utility as a noninvasive means of detecting gingival bleeding.MethodsCDFI and MFI were used to assess the GPBF grade (0–4) of 140 anterior gingival papilla sites in advanced periodontitis patients. Correlations between GPBF grades and periodontal characteristics were examined, and diagnostic performance as a means of predicting bleeding on probing (BOP) was examined using receiver operating characteristic curves.ResultsGPBF grades 0 and 1 assessed by the MFI were 14.29% and 15.71% respectively, lower than the 28.57% and 24.29% assessed by the CDFI. In contrast, MFI detected a higher frequency of GPBF grade 2 sites (40.71%) relative to CDFI (22.14%). The CDFI and MFI provided consistent results in 62.14% of the sites, while the MFI demonstrated higher ratings in rest 37.86% of the sites. A significant positive correlation was detected between GPBF grade and the modified gingival index (MGI), bleeding index (BI), BOP, and probing depth (PD). It showed high accuracy for CDFI or MFI to diagnosing BOP with a sensitivity of 80.51% and 96.43% and a specificity of 77.27% and 57.14%, respectively. Area under the receiver operator characteristic curve values when predicting BOP based on the GPBF grade determined using CDFI and MFI approaches 0.887 (95% CI 0.833–0.942) and 0.917 (95% CI 0.862–0.972), respectively, and there were no significant differences between these values (Z = − 1.502, p = 0.133).ConclusionsBoth MFI and CDFI can be employed for the evaluation of GPBF, and MFI is better suited to detecting mild inflammation.Trial registration ChiCTR2200066021 (Date of registration: 22/11/2022).

Use of intraoral mobile photography for screening of oral health in children

Abstract Background The aim of the study is to evaluate the diagnostic accuracy of intraoral mobile photography to assess caries intensity (DMFT/deft), simplified oral hygiene index (S-OHI) and modified gingival index (MGI). Methods Children aged 7-12 were included in the study. The clinical doctor evaluated the oral health indicators by visual examination: DMFT, deft, S-OHI, MGI were calculated. Dental students independently captured photos with a mobile phone (iPhone-11) in 8 predetermined projections. Dental images were kept in coded folders for research anonymity. Another professional calculated index based on the photos. Variables were used with binary values (DMFT/deft = 0/≥1; MGI=0/≥1; S-OHI≤1.2/>1.2). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of dental photography were evaluated and Cohen’s Kappa was calculated to measure the level of agreement between two independent observers. Results 2864 photographs were evaluated for 358 participants. The sensitivity and specificity of intraoral mobile photography for DMFT index is 95.8 (95% CI: 93.4-98.3) and 89.2 (95% CI: 83-95.5); For deft index: 100.0 (95% CI: 100-100) and 88.6 (95% CI: 79.3-98); For MGI: 89.7 (95% CI: 85.8-93.5) and 91.4 (95% CI: 86.3-96.5); For S-OHI: 77.6 (95% CI: 67.6-87.6) and 93.8 (95% CI: 91-96.6); The PPV value for DMFT, deft, MGI and S-OHI is 96.2; 97.7; 95.6 and 74.3 and the NPV value is 88.3; 100.0; 80.9 and 94.8 respectively. It was achieved substantial and perfect agreement between two independent raters: For DMFT, deft, MGI, S-OHI indices Cohen’s Kappa =0.85; 0.93; 0.78; 0.70 correspondingly. Conclusions Intraoral mobile photography, if applied within appropriate guidelines is reliable for assessing caries intensity, simplified hygiene index and modified gingival index as well as visual screening and may become a priority for dental public health. The involvement of dental students in studies of similar design is appropriate. Key messages • Intraoral mobile photography can be used for oral health screening in children. • The involvement of dental program students in screening studies conducted with intraoral mobile photography is appropriate.

Clinical and dental predictors of preterm birth using machine learning methods: the MOHEPI study.

Preterm birth (PTB) is one of the most common and serious complications of pregnancy, leading to mortality and severe morbidities that can impact lifelong health. PTB could be associated with various maternal medical condition and dental status including periodontitis. The purpose of this study was to identify major predictors of PTB among clinical and dental variables using machine learning methods. Prospective cohort data were obtained from 60 women who delivered singleton births via cesarean section (30 PTB, 30 full-term birth [FTB]). Dependent variables were PTB and spontaneous PTB (SPTB). 15 independent variables (10 clinical and 5 dental factors) were selected for inclusion in the machine learning analysis. Random forest (RF) variable importance was used to identify the major predictors of PTB and SPTB. Shapley additive explanation (SHAP) values were calculated to analyze the directions of the associations between the predictors and PTB/SPTB. Major predictors of PTB identified by RF variable importance included pre-pregnancy body mass index (BMI), modified gingival index (MGI), preeclampsia, decayed missing filled teeth (DMFT) index, and maternal age as in top five rankings. SHAP values revealed positive correlations between PTB/SPTB and its major predictors such as premature rupture of the membranes, pre-pregnancy BMI, maternal age, and MGI. The positive correlations between these predictors and PTB emphasize the need for integrated medical and dental care during pregnancy. Future research should focus on validating these predictors in larger populations and exploring interventions to mitigate these risk factors.

Effects of stannous fluoride dentifrice on gingival health and oxidative stress markers: a prospective clinical trial

BackgroundPeriodontal disease results in oral dysbiosis, increasing plaque virulence and oxidative stress. Stannous fluoride (SnF2) binds lipopolysaccharides to reduce plaque virulence. This study prospectively assessed SnF2 effects on oxidative stress in adults with gingivitis.MethodsThis was a 2-month, single-center, single-treatment clinical trial. Twenty “disease” (> 20 bleeding sites with ≥ 3 pockets 3 mm-4 mm deep) and 20 “healthy” (≤ 3 bleeding sites with pockets ≤ 2 mm deep) adults were enrolled. All participants were instructed to use SnF2 dentifrice twice daily for 2 months. An oral examination, Modified Gingival Index (MGI) examination and Gingival Bleeding Index (GBI) examination were conducted at baseline, 1 month and 2 months. Gingival crevicular fluid (GCF), saliva, oral lavage and supragingival plaque were collected at each visit to evaluate: Endotoxins, Protein Carbonyls, L-lactate dehydrogenase (LDH), Ferric reducing antioxidant power (FRAP), Oxidized low density lipoproteins (oxi-LDL), IL-6 and C-reactive protein (CRP). A subset-analysis examined participants considered at higher risk of cardiovascular disease. Change-from-baseline analyses within each group were of primary interest.ResultsThe disease group showed statistically significant reductions in GBI at Month 1 (67%) and Month 2 (85%) and in MGI at Month 1 (36%) and Month 2 (51%) versus baseline (p < 0.001). At baseline, the disease group showed greater LDH in GCF and oxi-LDL levels in saliva versus the healthy group (p ≤ 0.01). Total antioxidant capacity (FRAP) in saliva increased versus baseline for the disease group at Months 1 and 2 (p < 0.05), and levels for the disease group were greater than the healthy group at both timepoints (p < 0.05). SnF2 treatment reduced endotoxins (lavage) for both disease and healthy groups at Month 2 (p ≤ 0.021) versus baseline. There was a reduction in oxidative stress markers, namely protein carbonyl in saliva, at Months 1 and 2 (p < 0.001) for both groups and a reduction in cytokine IL-6 (lavage) in the disease group at Month 2 (p = 0.005). A subset analysis of participants at higher coronary disease risk showed reductions in endotoxins in lavage, oxi-LDL, and CRP in saliva at Month 2 (p ≤ 0.04).ConclusionSnF2 dentifrice use reversed gingival inflammation, suppressed endotoxins and reduced some harmful oxidant products in saliva and gingiva.Clinical trial registrationClinicaltrials.gov NCT05326373, registered on 13/04/2022.

Oral health status of Egyptian children with lysosomal storage diseases: An evaluation of dental indices, salivary cytokines level, and bacterial bioburden.

Lysosomal storage diseases (LSDs), a group of inborn errors of metabolism, include various subtypes, for example, mucopolysaccharidosis (MPS) and Gaucher disease (GD). Besides the physical/mental disabilities, they suffer from several oral deteriorations. To evaluate the oral health status of Egyptian children with LSD. Thirty LSD children and thirty non-LSD children were enrolled for this study according to the inclusion and exclusion criteria. Dental indices were used to assess caries prevalence and periodontal status. Saliva samples were collected from all enrolled children to estimate interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and protein levels as well as Streptococcus mutans and Lactobacilli colony counts. Children with MPS and GD showed non-significant differences in decayed, missing, or filled teeth (DMFT) scores (p = .115). Scores of dmft showed a significant increase in MPS, but not in GD children (p = .020, p = .127). Children with LSD showed significantly increased Modified Gingival Index (MGI), Plaque Index (PI), Oral Hygiene Index (OHI-s) scores (p < .001) and salivary IL-6 and TNF-α (p = .007, p = .001, p < .0001, p = .002, respectively) and salivary total proteins (p = .001) levels. Unexpectedly, non-significant differences were observed in salivary Streptococcus mutans or Lactobacilli counts in children with MPS and GD (p = .058, p = .420, p = .502, p = .053, respectively). To our knowledge, this is the first article that evaluates Egyptian children with LSD. We demonstrated high caries prevalence in primary teeth, not permanent teeth, in children with MPS and poor gingival/hygiene status in children with MPS and GD, which triggered a state of inflammation. The daily supplement intake prevented oral bacterial growth. The most probable cause of oral alterations is decreased salivary flow rate, as deduced from a significantly increased salivary protein.

Effect of erbium, chromium-doped: yttrium, scandium, gallium, and garnet laser-assisted periodontal therapy using radial firing tip during early healing period: a randomized controlled split-mouth clinical trial

BackgroundThis study aimed to demonstrate the efficacy of erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser-assisted nonsurgical periodontal therapy in periodontitis patients during 8 weeks of healing.MethodsA split-mouth, single-blinded, randomized controlled clinical trial was conducted on 12 patients diagnosed with stage III/IV periodontitis and had a minimum of two teeth with probing pocket depth (PPD) > 5 mm in at least two quadrants. Upon randomization, each quadrant was assigned for conventional scaling and root planing (SRP) procedure or laser-assisted therapy (SRP + laser) using radial firing tip (RFPT 5, Biolase). Clinical measurements and gingival crevicular fluid collection were performed for statistical analysis.ResultsIn the initial statistical analysis on the whole subject teeth, modified gingival index (MGI) reduction was greater in test group at 1(P = 0.0153), 4 (P = 0.0318), and 8 weeks (P = 0.0047) compared to the control in the same period. PPD reduction at 4 weeks in test group was -1.67 ± 0.59 showing significant difference compared to the control (-1.37 ± 0.63, P = 0.0253). When teeth with mean PPD ≥5 mm were sorted, MGI decrease was significantly greater in test group at 1 (P=0.003) and 8 week (P=0.0102) follow-ups. PPD reduction was also significantly greater in test group at 4 week period (-1.98 ± 0.55 vs -1.58 ± 0.56, test vs control, P=0.0224). ConclusionsEr,Cr:YSGG-assisted periodontal therapy is beneficial in MGI and PPD reductions during early healing period.

CLINICAL AND RADIOGRAPHIC ASSESSMENT OF BOND APATITE IN HORIZONTAL BONE AUGMENTATION AROUND DENTAL IMPLANTS: A RANDOMIZED CONTROLLED TRIAL

Background:Bond apatite is a composite graft, composed of two-thirds biphasic calcium sulfate and one-third hydroxyapatite granules of various sizes and shapes. Oral implants are used to secure dental prostheses in cases of partial or total edentulism. The outcomes of correctly completed dental-implant procedures result in high rates of success and survival of dental prostheses. Objective:The aim of this study was to assess Bond Apatite use in horizontal bone augmentation around dental implants, clinically and radiographically. Materials and Methods:This research included sixteen patients, six men and ten women, with an average age of thirty years having missing maxillary anterior or premolar teeth with insufficient horizontal bone. The patients were divided into two groups: group I patients (N=8) received dental implants with Bond apatite, while group II patients (N=8) received dental implants with Bio-Oss bone graft material and pericardium bioresorbable membranes. All patients were evaluated clinically usingthe modified plaque index (MPI), modified gingival index (MGI) and probing depth (PD) and radiographically to assess bone width dimensions. Results: There was a statistically significant difference between groups regarding MGI(p = 0.038)andperi-implant buccal PD [mm](p = 0.026). There was no statistically significant difference between the tested groups regarding age(p = 0.608), sex(p = 0.123), MPI(p = 0.608),orperi-implant palatalPD [mm](p = 0.118). There was no statistically significant difference between the two groups regarding postoperative bone width (p = 0.187). Conclusion:Bond apatitemay be used as one of the materials of choice for horizontal bone augmentation around dental implants with similar promising results compared to Bio-Oss. Finally, the use of Bond apatite preparation is a straightforward, affordable, and considered successful bone graft material that could be used in osseous defect reconstruction procedure. Trial registration:The study is listed on www.clinicaltrials.gov with registration number (NCT06043258) 22/09/2023. The study was conducted in accordance with the seventh revision of the Helsinki Declaration in 2013 and approved by the Institutional Review Board (IRB) (M07061119) of the Faculty of Dentistry, Mansoura University, Egypt.

A Comparison of the Effect of Zirconia Crown on Periodontal Tissues: A Nonrandomized Clinical Trial

Background: Dental crowns are effective on the gingival tissue around the teeth. However, using zirconia as crowns due to the method and type of material can effectively improve this effect. Methods: This is a pre-post clinical trial conducted on 35 teeth with metal-ceramic crowns and 35 teeth with zirconia crowns. Teeth were prepared for fabricating metal-ceramic and zirconia crowns. Plaque index (PI), modified gingival index (MGI), pocket probing depth (PPD), papilla bleeding index (PBI), and gingival level (GL) were measured before and six months after getting the dental crown. The data were analyzed using the Mann–Whitney test. Results: In both groups, the GL remained the same after six months of crown placement (P&gt;0.05). In the metal-ceramic group, the PI decreased significantly (P=0.000), but MGI and PBI significantly increased (P=0.000 and P=0.000, respectively) six months after crown placement. Based on the results, PPD increased significantly only on the midlingual surface (P=0.02). The PI significantly decreased in the zirconia group (P=0.000). Nevertheless, PPD represented no change (P&gt;0.050). The comparison between the two groups six months after crown placement indicated that the PI, MGI, and PBI were significantly higher in the metal-ceramic group (P=0.010, P=0.011, and P=0.044, respectively). The metal-ceramic group showed a significantly greater increase in PPD on the midlingual surface (P=0.043). Conclusion: Both crown types on teeth could significantly increase the incidence of gingivitis, and compared with zirconia crowns, metal-ceramic crowns demonstrated significantly more inflammation.

Closed sinus lift and fixed prostheses versus implant-assisted overdentures in management of atrophied distal extension maxillary ridges: A one-year randomized clinical trial

Rehabilitation of elderly or medically compromised patients with an atrophied unilateral posterior maxillary ridge by an implant-supported prosthesis may be complicated by maxillary sinus pneumatization with insufficient bone for implant placement. This short-term clinical trial assessed clinical results of closed sinus lift and fixed prosthesis versus implant-assisted overdentures in the management of participants with atrophied distal extension maxillary ridges. Forty participants with unilateral atrophying distal extension maxillary ridges were randomly assigned into 2 groups. The CSL group (n=20) participants received fixed prostheses supported by 3 implants following a closed sinus lift. The IOD group (n=20) participants received removable partial overdentures assisted by a single implant that was positioned mesially to the maxillary sinus. The modified plaque index (MPI), modified gingival index (MGI), pocket depth (PD), implant stability (IS), and vertical bone loss (VBL) were measured at prosthesis delivery (T0), and 6 (T6) and 12 months (T12) after delivery. The oral health impact profile (OHIP-14) questionnaire was used to assess oral health-related quality of life (OHRQoL) at T12. Significant differences between observation times were performed using Friedman and Wilcoxon signed-rank tests for MPI and MGI and using repeated measures ANOVA with Bonferroni correction of P values for PD, IS, VBL, and OHIP. Between-group comparison of MPI and MGI the Mann-Whitney test was used, while for PD, IS, VBL, and OHIP comparison was made using independent samples t test (α=.05 for all tests). The implant survival rates were 100% for both groups. MPI and PD significantly increased with time for both groups. MGI significantly increased with time for the CSL group only (P=.049). The IS significantly decreased with time for the IOD group. VBL increased significantly from T6 to T12 for the CSL (P=.042) and the IOD (P=.002) groups. The CSL group recorded higher MPI, MGI, PD, and IS values than the IOD group (P<.05). The IOD group recorded higher VBL than the CSL group (P<.001). The CSL group scored significantly lower OHIP-14 values (better OHRQoL) than the IOD group for all values (P<.05). In comparison with implant-assisted partial overdentures, closed sinus lift with fixed prostheses had higher implant stability, reduced bone loss, and higher participant OHRQoL. However, peri-implant soft tissue health was found to be better with implant overdentures.

Comparative evaluation of novel tooth brushing with reminder therapy with conventional brushing techniques in children

Background: Dental caries and periodontal diseases are the most prevalent oral diseases in the children. Dental plaque is the main contributing agent for these oral diseases. Tooth brushing is considered to be one of the most efficient ways of maintaining the oral hygiene. Often, it is noted that certain areas of oral cavity and surfaces of the teeth are brushed more, while the other areas are neglected. With this background, we have designed a novel technique of tooth brushing with reminder therapy. Methods: Oral examination of 180 children aged between 6-12 years was done and Oral Hygiene Index Simplified, Turesky-Gilmore-Glickman modification of Quigley-Hein Plaque Index, Modified Gingival Index were recorded. The children were randomly divided into three groups; Control group; Tooth brushing using Fones technique; Tooth brushing along with a reminder therapy (dantharaag: the tooth tune). Each group was taught their respective techniques and follow up was done at 15 and 45 days interval and all the indices were recorded. The data, thus collected was tabulated and subjected to analysis. Results: The results showed a reduction in the scores of OHI-S, TMQH and MGI in all the three groups during follow up visits. However, this difference was statistically significantly between the groups where, Group 2 was better than Group 1 and Group 3 was better than Group 1 and 2 by 45 days. Conclusions: In conclusion, Dantharaag: the tooth tune was readily accepted by children and showed better results in plaque reduction and oral hygiene improvement.

A two-year prospective study to compare the peri-implant parameters of posterior implant-supported single crowns with and without mesial proximal contact loss

Background/purposeInterproximal contact loss may lead to food impaction and result in subsequently periodontal complications. The purpose of this prospective study was to investigate the peri-implant parameters of posterior implant-supported single crowns (SCs) with and without mesial proximal contact loss after 2 years of follow-up. Material and methodsTwenty-six patients with a total of 40 posterior implant-supported SCs with mesial adjacent natural teeth were observed for 24 months after crown insertion. The mesial proximal contacts were assessed by dental floss, then were classified as tight, weak, and open contacts. The following peri-implant parameters were evaluated, including modified plaque index (MPI), modified gingival index (MGI), and probing depth (PD) were conducted at six sites per tooth (mesiofacail, midfacial, distofacial, mesiolingual, mid-lingual and distolingual) in the 6-, 12-, 18- and 24-month following visits. Furthermore, radiographs were taken regularly in 12- and 24-month recall sections for measuring the marginal bone loss (MBL). ResultsAt 12-month observation, the incidence rates of weak and open contacts were 22.5 % and 12.5 %; whereas after 24 months of clinical service, the rates came up with 12.9 % and 25.6 %, respectively. No significant differences were found between the tight, weak, and open contact groups in the parameters of MPI, MGI, or PD (P > 0.05) at 12- and 24-month follow-up. None of the mean differences of the peri-implant parameters: MPI, MGI, PD and MBL had significant differences between the tight, weak, and open contact groups after 1 and 2 years of clinical service (P > 0.05). ConclusionThe presence of open, weak, and tight mesial proximal contacts had no significant effects on the peri-implant tissue conditions.

The effect of secondhand smoke exposure on dental caries and gingival health among schoolchildren in Damascus, Syria: a cross-sectional study

ObjectiveThis study aimed to evaluate the effect of secondhand smoke on dental caries and gingival health among schoolchildren in Damascus, Syria.Materials and methodsThis was a cross-sectional study. It was carried out at government schools in Damascus, Syria. This study included healthy children aged 10 to 13 years old. Schoolchildren were interviewed to answer the researcher-administered questionnaire to obtain answers regarding demographic information and family smoking behavior. A dental examination was performed by a dentist, and the number of decayed (D), missing (M), and filled (F) permanent teeth (DMFT) was scored based on the World Health Organization (WHO) 1997. A gingival examination was performed using the modified gingival index (MGI) and Silness-Leo plaque index (PI) to assess gingival inflammation and plaque accumulation, respectively.ResultsA total of 284 schoolchildren participated. More than half (61.26%) of them were exposed to secondhand smoke (SHS), and about half of them (52.11%) resided in a house with at least one cigarette smoked in a day. About one-third of the passive smokers (33.30%) had poor plaque control, with a statistically significant difference from non-passive smokers (p < 0.05). The multivariate regression model showed that the number of smokers at home was significantly associated with the DMFT score, dental plaque accumulation, and gingival inflammation (p < 0.1). However, the number of cigarettes smoked at home in a day was not a predictor for dental caries and gingival status (p = 1.000).ConclusionsWithin the limitations of this study, the number of smokers at home appears to have more adverse effects on children’s oral health compared to the quantity of smoke inhaled. In addition, SHSe was associated with more dental plaque accumulation among schoolchildren.

Correlation of Serum and Gingival Crevicular Fluid Levels of Caspase-3 and Milk Fat Globule-Epidermal Growth Factor 8 on Gingival Health.

This study aimed to estimate and correlate the serum and gingival crevicular fluid (GCF) levels of caspase-3 and milk fat globule-epidermal growth factor 8 (MFG-E8) in healthy, gingivitis and generalised chronic periodontitis subjects. A total of 24 subjects were selected and divided into three groups. After recording the periodontal parameters (plaque index (PI), modified gingival index (MGI), probing depth (PD) and clinical attachment level (CAL)), the serum and GCF samples were collected and the levels of caspase-3 and MFG-E8 were estimated using enzyme-linked immunoassay (ELISA). The mean values of PI, MGI, PD and CALs were significantly higher in group III when compared to group II and group I. The mean value of serum and GCF caspase-3 increased with increasing disease severity, whereas the mean serum and GCF values of MFG-E8 decreased with increasing severity of disease. Spearman's correlation showed a strong positive correlation between the serum and GCF levels of caspase-3 and periodontal parameters, whereas serum and GCF levels of MFG-E8 showed a strong negative correlation with the periodontal parameters. The findings of this study are suggestive that the serum and GCF levels of caspase-3 and MFG-E8 could serve as a potential biomarker for the role of apoptosis in periodontal disease. However, further studies are required to explore the mechanism and understand the relationship between these apoptotic markers and periodontitis.

Efficacy of amobile phone application for the improvement of oral hygiene of patients undergoing fixed orthodontic treatment : Arandomized controlled clinical trial.

This study aimed to assess the efficacy of amobile phone application (app) to improve oral hygiene of patients undergoing fixed orthodontic treatment. This randomized controlled clinical trial was conducted with atotal of 60patients undergoing fixed orthodontic treatment in two groups: intervention and control (n = 30 each). Apreviously designed mobile app (Labkhand) was used by patients in the intervention group. Orthodontic plaque index (OPI) and modified gingival index (MGI) were recorded in the two groups at baseline (first session or T0), and after 1 (T1) and 3 (T2) months. The number of debonded/broken brackets was also recorded, and pain score of the patients was assessed at nine time points. Data were analyzed using the χ2 test, paired t‑test, and repeated measures analysis of variance (ANOVA; α = 0.05). The two groups demonstrated no significant difference in OPI and MGI at T0 (P > 0.05). OPI and MGI at T1 and T2 were significantly lower in the intervention group than in the control group (P < 0.05). The number of patients with broken brackets in the intervention group was significantly lower than that in the control group (P = 0.017). The two groups reported no significant difference in pain score (P > 0.05). The Labkhand mobile app successfully improved oral hygiene indices of patients undergoing fixed orthodontic treatment, and decreased the frequency of broken brackets after 1 and 3months of use.

Frequency tongue coating in patients referred to Kerman Dental School and its relationship with relative factors

ObjectiveThere has been shown a relationship between “tongue coating” and “Simplified Oral Health Index, periodontal status, modified mallampati classification (MMC) of the oropharynx and oral malodor”. The purpose of this study is to assess the frequency of tongue coating and relative factors (sex, age, smoking, systemic disease and oral health indices) among patients referred to Dental School of Kerman University.MethodsIn this cross sectional study 250 patients referred to dental school of Kerman university of medical sciences were examined. The data collection form was included demographic data (gender, age, history of systemic disease and smoking) and Oral health indices such as TCI (Tongue coating index), OHI-S (Simplified Oral Hygiene Index), MGI (Modified Gingival Index), MMC and lost teeth. The analysis have been done using SPSS21, T-test, Pearson correlation coefficient and linear regression analysis (significance level was set at less than 0.05).ResultsTongue coating has been shown in 96% of patients with the mean percent of 45.83 ± 19.16%. Men had higher percent of TCI though it was not statistically significant. Smoking was the strongest determinant factor in people with higher TCI scores (P = 0.013). There was a positive significant correlation between OHI-S and TCI [(Pearson’s coefficient(r) = 0.134, P = 0.034)].ConclusionTCI appears to be related to smoking and Simplified Oral Health Index. The evaluation of tongue coating is necessary to assess its impact on oral health status and also to motivate patients to clean their tongue as a part of their oral health care routine.

Evaluation and comparison of the efficacy of autologous fibrin glue with 4-0 silk sutures in periodontal flap closure and wound healing - A split mouth randomized controlled trial.

Fibrin glue has shown to be a pioneering remedy to overcome the inconvenience of suturing. Autologous products reduce the risk of contamination and immunological responses compared to commercial fibrin glue. Hence using autologous fibrin glue (AFG) as a tissue sealant in periodontal flap closure would be of added value for a predictable outcome. To evaluate and compare the efficacy of AFG with 4-0 silk sutures in periodontal flap closure and healing. Total of 17 patients diagnosed with generalized periodontitis in the age group of 18 to 60years with probing pocket depth of ≥ 6mm and clinical attachment level of ≥5mm in at least two quadrants were categorized into test group (AFG) and control group (4-0 silk sutures). Primary outcome measures [modified gingival index (MGI), early wound index (EHI) and interleukin 1 beta (IL-1ß) and secondary outcome measures (oral hygiene index, plaque index and visual analog scale (VAS) were recorded at baseline, 1, 2, 3 and 4 weeks. A statistically significant reduction of IL-1ß value (p =.005); MGI (p = .02); EHI (p = .004), VAS scores (p < .001) and a positive Spearman's correlation (rho = 0.15) was seen between EHI scores & IL-1ß levels in test group at 1week period in comparison to control group. AFG showed promising results as an alternative to sutures. The use of AFG significantly improved clinical parameters and reduced the levels of pro-inflammatory cytokines making it an effective adhesive with healing properties in the era of suture-less periodontal flap surgery.

Effectiveness of AI-driven remote monitoring technology in improving oral hygiene during orthodontic treatment.

This study aimed to evaluate the effectiveness of Dental Monitoring™ (DM™) Artificial Intelligence Driven Remote Monitoring Technology (AIDRM) technology in improving the patient's oral hygiene during orthodontic treatment through AI-based personalized active notifications. A prospective clinical study was conducted on two groups of orthodontic patients. DM Group: (n = 24) monitored by DM weekly scans and received personalized notifications on the DM smartphone application regarding their oral hygiene status. Control Group (n = 25) not monitored by DM. Both groups were clinically assessed using Plaque Index (OPI) and the Modified Gingival Index (MGI). DM Group was followed for 13 months and the Control Group was followed for 5 months. Student-independent t test and paired t tests were used to investigate the mean differences between study groups and between time points for each group respectively. At all time points, the mean differences indicated that the DM group had lower OPI and MGI values than the control group. The mean value for OPI and MGI were statistically significantly lower in the DM group (OPI = 1.96, MGI = 1.56) than in the control group (OPI = 2.41, MGI = 2.17) after 5 months. A rapid increase in mean OPI and MGI values was found between T0 and T1 for both study groups. A plateau effect for OPI scores appeared to occur from T1 to T5 for both study groups, but the plateau effect seemed to be more pronounced for the DM group than the study group. The MGI values for both study groups also increased dramatically from baseline to T5, however, a plateau effect was not observed. The oral hygiene of orthodontic patients rapidly worsens over the first 3 months and plateaus after about 5 months of treatment. AIDRM by weekly DM scans and personalized active notifications may improve oral hygiene over time in orthodontic patients.

A hospital-based oral health education program impacts in pediatric cancer patients-A pilot study.

To assess the impact of an oral health education and preventive program (OHEPP) for pediatric cancer patients. This was a single-arm study with 27 children and adolescents undergoing antineoplastic treatments. Patients were followed up for 10 weeks, and their oral health conditions were evaluated using the Modified Gingival Index (MGI), Visible Plaque Index (VPI), and the modified Oral Assessment Guide (OAG). Audiovisual resources, storytelling, and ludic instruments were used to provide oral health education to patients and parents/caregivers. The patients' mean age was 9.41(±4.49) years, and acute lymphoblastic leukemia was the most prevalent diagnosis (22.2%). Mean MGI and VPI values were 0.82(±0.59) and 54.11%(±19.92%) at baseline and 0.33 (±0.29) and 19.83% (±11.47%) after 10weeks, respectively (p<.05). The mean OAG score was 9.51 (±2.54) and 36 cases (19.8%) of severe oral mucositis (SOM) were documented. Patients with higher MGI were more likely to develop SOM. The OHEPP had a positive impact on pediatric patients undergoing cancer therapy by improving their periodontal health, reducing biofilm accumulation, and preventing the development of OM lesions.

The Efficacy and Safety of Oral Irrigator on the Control of Dental Plaque and Gingivitis: A Randomized, Single-Blind, Parallel-Group Clinical Trial.

To evaluate the efficacy and safety of oral irrigator (OI) in controlling dental plaque and gingivitis. Ninety participants diagnosed with gingivitis were randomly assigned to two groups, given a toothbrush combined with OI (WaterPik®) (test) or a toothbrush alone (control). The Turesky-Modified Quigley-Hein Plaque Index (T-QH), Modified Gingival Index (MGI), Bleeding Index (BI), and percentage of sites with bleeding on probing (BOP%) were evaluated at baseline, 4 weeks, 8 weeks, and 12 weeks. The full analysis set (FAS) and per-protocol set (PPS) were analyzed. Adverse events were recorded through electronic diaries and examinations. Of the 90 participants, the efficacy was assessed in the following numbers (FAS/PPS): test (45/33) and control (43/38). Compared with the control, MGI, BI, and BOP% were significantly lower in the test group after 4 weeks (4 weeks: p = 0.017, p = 0.001, and p = 0.001, respectively; 8 weeks and 12 weeks: p < 0.001 for all, FAS); T-QH was significantly lower after 8 weeks (8 weeks: p = 0.033; 12 weeks: p = 0.006, FAS). Transient gingival bleeding may be associated with OI. Self-reported pain and dentin hypersensitivity symptoms were similar between groups. As adjuncts to toothbrushing, OI demonstrated significantly better efficacy in controlling dental plaque and gingival inflammation with no substantial safety hazards.

Effectiveness of Tooth Brushes on Gingival Health in Patients undergoing Orthodontic Treatment

Aim: To evaluate and compare the effectiveness of two different manual toothbrushes on gingival health among patients undergoing orthodontic treatment. Methodology: In the present randomized cross-over controlled trial, 60 subjects were recruited, to receive either crisscross or multilevel bristle design. Modified Gingival Index (MGI), Modified Silness and Loe Plaque Index, and Gingival Bleeding Index (GBI) and were assessed for 120 days. Statistical analysis was done using SPSS version 21 (SPSS; Chicago, IL, USA). Owing to the ordinal nature of the indices, non-parametric tests of significance were used. Results: The efficacy of the two-bristle design brush showed an overall reduction in the mean score. Overall significant differences were seen in the efficacy of the two different bristle designs. Both the study groups showed a reduction in the mean MGI, PL, and GBI with a P value less than 0.001 which was statistically significant. Conclusion: In the present study, the criss-cross bristle design was found to be significantly more effective as compared to the multilevel toothbrush design for reducing MGI, PL, and GBI scores.