Papilla Bleeding Index Research Articles

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>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>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.

The effect of body weight and psychological characteristics on periodontal disease development.

The aim of the study was to examine the association between periodontal health in young patients with various body mass indexes and psychological traits such as temperament, level of anxiety, and autonomic nervous system tone.

Infective endocarditis: prevention strategy and risk factors in an animal model.

Infective endocarditis is a serious infection of the endocardium, especially the heart valves, which is associated with a high mortality rate. It generally occurs in patients with altered and abnormal cardiac architecture combined with exposure to bacteria from trauma and other potentially high-risk activities with transient bacteremia.

Evaluation of oral biotics’ effectiveness for home oral care

Relevance. The incidence of oral mucosal diseases is nowadays increasing. Inflammatory periodontal diseases are common in dental practice and occupy second place worldwide among oral diseases.Purpose. The study aimed to analyze ‘Denta Balance’, an oral synbiotic complex, and ‘Lesnoy balsam’, a mouthwash, as home care products treating inflammatory periodontal diseases and halitosis.Material and methods. The study included 40 patients aged 18 to 28 y.o., of which 10 were males (25%) and 30 females (75%). They randomly formed two groups. The age in Group 1 was 23.0 ± 2.5 years and in Group 2 – 24.0 ± 3.2 years. In all patients, we assessed the Fedorov-Volodkina hygiene index and papilla bleeding index (PBI, Saxer & Mühlemann, 1975) before and after oral care product use. All patients formed two groups, 20 patients in each group. The fi group used a spray and powder for oral administration containing synbiotic complex; Group 2 used a natural-phytoncide mouthwash as an oral care product. Besides dental status assessment, we conducted a survey where we collected dental history. The main survey criteria were tooth sensitivity, halitosis, dry mouth, tenderness around the gums, bleeding on brushing, eating or spontaneous bleeding. We also asked the patients to assess the one-month effect of synbiotic-complex products and natural-phytoncide mouthwash.Results. The use of products showed a positive effect in both groups, i.e., tenderness around the gums, tooth sensitivity, and halitosis disappeared; bleeding on brushing and spontaneous bleeding significantly decreased; the gum colour returned to normal. The dental status index assessment confirmed the effectiveness of the treatment: the hygiene index insignificantly improved after the treatment; periodontal indices changed for the better.Conclusion. The study noticed a positive effect of Denta balance, a spray with a probiotic for bleeding gums, and Denta balance FRESHeffect, a probiotic for fresh breath, included in the protocol of inflammatory periodontal disease and halitosis treatment.

Effect of Nonsurgical Periodontal Treatment on Salivary and Plasma Superoxide Dismutase Levels of Patients Suffering from Periodontitis.

Antioxidant capacity is frequently measured by evaluating superoxide dismutase (SOD) concentration in body fluids. The aim of this study was to compare SOD concentrations in the saliva and plasma of patients with periodontitis to those measured in a group of patients with healthy periodontium, as well as to evaluate the influence of nonsurgical periodontal therapy on salivary and plasma SOD in periodontitis patients. For this purpose, 40 systemically healthy patients aged 30-70 years who had at least 20 teeth were recruited, 20 of whom had periodontitis, and 20 served as healthy periodontitis-free controls. In all participants, periodontal status was assessed via the plaque index (PI), gingival index (GI), papilla bleeding index (PIB), probing depth (PD), and clinical attachment level (CAL), and the SOD concentration in both saliva and plasma was determined by conducting a commercial immunoenzymatic ELISA test. In periodontitis patients, periodontal indices and saliva and blood samples were taken at the beginning of the study, as well as 3 months after periodontal therapy, while in the control group, these data were gathered at the beginning of the study only. SOD values in the saliva of patients with periodontitis (0.244 U/µL) were statistically significantly higher compared with patients with healthy periodontium (0.017 U/µL). Moreover, periodontal therapy led to a statistically significant decrease in this marker in the saliva of patients with periodontitis (p = 0.023), which was comparable with that measured in the control group. On the other hand, no statistically significant differences were noted in plasma SOD values either between the two groups or at follow-up compared with baseline in the group with periodontitis. These findings suggest that the elevated salivary SOD in patients with periodontal disease may represent a mechanism of tissue protection against oxidative stress that occurs in response to periodontal disease.

The effect of surface-modified silver nanoparticles on the inflammatory component of the intragingival peri-implant area

Aim: to evaluate the intensity of the gingival inflammatory component in the peri-implant area by studying the mucous membrane bleeding in the implant area according to the papilla bleeding index (PBI), when using healing abutments with a surface modified with silver nanoparticles (AgNP). Materials and methods. 40 patients undergoing rehabilitation for secondary partial adentia by the method of dental implantation were enrolled in the study and divided into 2 groups: Group 1 (20 patients) – healing abutments with the surface modified by the method of plasma electrooxidation and AgNP-doped were fixed; Group 2 (20 patients) – standard healing abutments of the implant system used with a polished surface were fixed. The control group (20 patients) – to determine reference values. A total of 60 patients were involved in the study. The degree of bleeding was measured according to the PBI. The mucous membrane thickness was assessed using an endodontic reamer. Results. There was no statistically significant difference in bleeding level 0 between Groups 1 and 2, but the study group was significantly different from the control group (p < 0.001). According to the bleeding level 3, there was a statistically significant difference between Groups 1 and 2, the study group was (12.7 %) versus 48.5 % (p < 0.001). In addition, the study group was significantly different from the control group (p = 0.019), but this was due to the fact that the measurements were taken directly from the wound surface and the comparison was made to understand inflammatory manifestations as a whole. According to bleeding level 4, there were no patients with this level in the study group, but in the comparison group there were 19.2 % of those (p < 0.001). Based on the results of the data obtained, it is advisable to consider effective use of the antibacterial effect of silver nanoparticles to reduce the gingival inflammatory component in the peri-implant area. Conclusions. The use of the bleeding index (PBI) is appropriate in the clinical diagnosis of inflammatory processes in the peri-implant area. Reduction of levels 3, 4 bleeding in the peri-implant area by 35.8 % and 19.2 %, respectively, in patients using healing abutments coated with AgNP compared to polished ones, indicates a pronounced anti-inflammatory effect of the proposed AgNP-doped surface. The absence of a statistical difference in the mucous membrane thickness of the studied areas between the groups allows us to consider the obtained results as consequences of the silver nanoparticle impact with an antibacterial effect. The result of this study allows recommending the proposed AgNP-doped surface for use in clinical practice.

Changes in Interleukin-1β, Tumor Necrosis Factor-α, and Interleukin-10 Cytokines in Older People with Periodontitis.

Aging can change the ability to respond to various stimuli and physical conditions. A decreased immune response is a form of deterioration of function in older people, who then become more vulnerable when exposed to pathogens. Periodontitis is an inflammatory disease of the periodontal tissues that often occurs in older people. This study aimed to clinically analyze the periodontal status and cytokine levels of IL-1β, TNF-α, and IL-10 in older people and adults with periodontitis. This clinical study examined 20 persons in a group of older people and 20 persons in a group of adults. The clinical measurements of periodontal status included the Simplified Oral Hygiene Index (OHI-S), Plaque Index (PlI), and Papilla Bleeding Index (PBI). The cytokine levels in gingival crevicular fluid (GCF) were quantified by using ELISA kits. The OHI-S, PlI, and PBI were found to be higher in the older group. The mean values of cytokines were higher in the older group than in adults, although no statistically significant differences were found. A strong correlation was found between the clinical measurements and the cytokine levels in the GCF. There was an increasing tendency of pro-inflammatory and anti-inflammatory cytokines in the older group compared to the adult group.

THE EFFECT OF THE TREATMENT AND PREVENTION COMPLEX ON THE CONDITION OF PERIODONTAL TISSUES AND LOCAL IMMUNITY IN CHILDREN WITH CHRONIC

Introduction.Chronic catarrhal gingivitis remains a prevalent dental condition in children, which may subsequently lead to the development of periodontitis and tooth loss. The issue of selecting appropriate medications for the comprehensive treatment and prevention of inflammatory periodontal diseases in children with chronic gastroduodenitis remains relevant. Objective.To study the effectiveness of the proposed treatment and prevention complex for chronic catarrhal gingivitis in children with gastroduodenitis. Materials and Methods.Three groups of children were formed for the study: the first group comprised 10 somatically healthy children without signs of periodontal tissue inflammation, the second group included 20 somatically healthy children with chronic catarrhal gingivitis, and the third, main group, consisted of 20 children diagnosed with chronic gastroduodenitis and chronic catarrhal gingivitis. Results.Before treatment, all children were instructed in oral hygiene and underwent controlled tooth cleaning. Children in the third group were prescribed the treatment and prevention complex developed by our research team. The complex included brushing teeth twice a day after meals with Splat "Medicinal Herbs" toothpaste, mouth rinsing with Decasan solution, application of Cholisal on the gums, and Euro-Biotic Germina – 1 capsule twice a day after meals. Treatment of children in the second group was conducted according to protocols for 14 days. The dynamic observation was conducted before treatment and after 1, 3, 6, and 12 months by assessing Silness-Loe and Fedorova-Volodkina indices, PMA (papillary-marginal-alveolar), and PBI (papilla bleeding index) bleeding. Following the course of treatment and prevention complexes, children in the second and third groups exhibited improved oral cavity hygiene and periodontal indices; PBI (papilla bleeding index) and PMA (papillary-marginal-alveolar). Conclusion. The results of the study demonstrate that the treatment and prevention complex has a consistently positive impact on oral hygiene and the degree of periodontal inflammation, and after a year, the indicators remain better than the initial ones. We recommend prescribing the treatment and prevention complex developed by our research team for children with chronic gastroduodenitis once every six months.

A Comparative Evaluation of Soft and Hard Tissue Changes Around Dental Implants Placed With and Without Platelet-Rich Fibrin.

A patient's ability to maintain a healthy bone-implant interface seems to be a major predictor of implant longevity over the long term. The implant surface is protected from the oral environment, the bone, and the implant itself by the peri-implant tissues. Platelet-rich fibrin (PRF) has been shown to help in the regeneration of bone and other connective tissues. Since there has been inadequate information on the role of PRF in maintaining soft tissue integrity and crestal bone changes, the present study aimed to evaluate these challenges clinically and radiographically in human patients who had dental implants placed with PRF. There were a total of 15 patients who were recalled for the analysis, and they were split into two groups. PRF was used to complete the implant procedure in the experimental group, but PRF was not used in the control group. Cone beam computed tomography (CBCT)was used to evaluate the amount of alveolar bone prior to dental implant placement and intra-oral periapical radiograph (IOPAR) for postoperativeassessment. Gingival index, plaque index, probing depths, papilla bleeding index, and crestal bone changes were used to document clinical limits. IOPAR using a similar approach was used to evaluate the crestal bone level alterations. Patients were evaluated clinically and radiographically for changes in the peri-implant soft tissue and crestal bone during implant placement, sixand nine monthspostoperatively. From baseline (p=0.02) to six months (p=0.04) and nine months (p=0.04), both groups showed changes in crestal bone loss and soft tissue although the changes in the test group were smaller. Soft tissue changes showed significant differences for probing depth and papilla index score at baseline and at the end of the six and nine months (p<0.05), whereas no significant difference was noted with bleeding index and plaque index score during the follow-up (p>0.05). To conclude, the provided data demonstrated that the local injection of PRF during implant placement has the potential to favorably stimulatebone formation, and may be used as a therapeutic adjuvant in the clinical setting of implant placement.

Оцінка стану тканин пародонта у хворих із соматичною патологією

The purpose of the study was to investigate the influence of concomitant somatic pathology on periodontal tissues. Materials and methods. 104 patients, aged 28–46 years, with diseases of periodontal tissues, who had somatic pathology, were involved in the study. The examined persons were divided into groups: 35 persons (group 1) with pathology of the hepatobiliary system, 37 persons (group 2) with pathology of the gastrointestinal tract, and 32 persons (group 3) with pathology of the cardiovascular system. The comparison group included 30 people with periodontal tissue diseases without somatic pathology. To determine the depth and prevalence of the inflammatory process of the gums the Svrakov’s number indicator was used. Oral hygiene was assessed according to the Silness-Loe and Stallard indices. The papillary-marginal-alveolar index (C. Parma, 1960) was determined to assess the severity of gum inflammation. Bleeding gums were assessed by the gum's papilla bleeding index according to Muhllemann. Statistical processing of the research results was carried out with a computer program for variational and statistical analysis of medical and biological research data “GraphPad Prism 5”. Results and discussion. Patients with diseases of periodontal tissues against the background of somatic pathology had the highest percentage of chronic generalized periodontitis of the II degree, in contrast patients of the comparison group had the highest percentage of chronic generalized periodontitis of the initial – I degree. Svrakov's number in patients with periodontal disease against the background of somatic pathology significantly (р ˂0.05) exceeded the indicators of patients of the comparison group. At the same time, there is no significant difference between the results of groups 1, 2 and 3. The highest values of the indexes of Silness-Loe and Stallard were recorded in patients with the cardiovascular system pathology, which significantly (p&lt;0.05) exceeded the data in the comparison group, but did not significantly differ from the results of patients with pathology of hepatobiliary system and gastrointestinal tract. The papillary-marginal-alveolar index data were the highest in patients with hepatobiliary system pathology (64.25 ± 8.19%), which significantly (p&lt;0.05) exceeded the results of the comparison group and in individuals of groups 2 and 3. The highest indicator of the bleeding index is 1.98 ± 0.22 points in patients of the 1st group, which significantly exceeds the indicators in the group of people without somatic pathology and in the group of patients with pathology of gastrointestinal tract and cardiovascular system. Conclusion. The conducted studies show that the presence of somatic pathology contributes to the development of periodontal tissue diseases, and certainly aggravates their course, which is proven by the results of the index assessment

Analysis of clinical parameter and tumor necrosis factor-alpha levels on keratinized tissue around implant and tooth.

Studies have shown the importance of keratinized tissue around implants to prevent peri-implant diseases. This study aims to analyze the correlation of keratinized tissue around implants and teeth with clinical parameter scores and tumor necrosis factor-alpha (TNF-α) levels. A cross-sectional study of 20 adults with 20 dental implants and 20 contralateral teeth that have functioned suprastructurally for more than 3 months without any systemic diseases. Keratinized tissue around implant and tooth was measured. The clinical examinations included the plaque index (PI), papilla bleeding index (PBI), and pocket depth (PD). Peri-implant sulcus fluid (PISF) and gingival crevicular fluid were collected to measure TNF-α levels. Spearman's test was used to analyze the correlation. Significant differences were found between keratinized tissue around the implant in PI, PBI, and PD (P < 0.05). Differences were found between wide and narrow keratinized tissue around contralateral teeth in PI and PBI (P < 0.05) but not in PD. TNF-α levels were not correlate to keratinized tissue width around implant and contralateral tooth (P > 0.05). Strong correlations were found between each clinical parameter score and the keratinized tissue width of peri-implant tissue in PI, PBI, and PD. The clinical parameter score between wide and narrow keratinized tissue around implant showed strong correlation, particularly in PBI. This shows the importance of adequate keratinized tissue around implant to maintain implant stability.

Evaluation of Lipid Peroxidation in the Saliva of Diabetes Mellitus Type 2 Patients with Periodontal Disease.

As oxidative stress has been implicated in the pathogenesis of diabetes mellitus and periodontitis, it may serve as a link between these conditions. Therefore, as a part of the present study, salivary lipid peroxidation (LP) in periodontitis patients with and without diabetes mellitus type 2 (DM2) was evaluated, along with the periodontal therapy effectiveness. The study sample comprised of 71 DM2 patients with periodontitis and 31 systemically healthy controls suffering from periodontitis of comparable severity. In all participants, periodontal indices-plaque index (PI), gingival index (GI), papilla bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level (CAL)-were recorded, and salivary LP was measured using a spectrophotometric method prior to treatment initiation and three months post-treatment. At baseline, mean salivary LP in DM2 patients was higher than that measured for the control group, but the difference did not reach statistical significance (p &gt; 0.05), whereas a positive significant correlation was found between PPD and LP in both groups. Three months after nonsurgical periodontal therapy, clinical periodontal parameters and salivary LP levels were significantly reduced in both groups (p &lt; 0.05). These findings indicate that the improvement in clinical periodontal status following nonsurgical periodontal therapy is accompanied by a significant decrease in salivary LP in DM2 patients, suggesting that periodontitis, rather than diabetes, is the primary driver of the elevated salivary LP in this group.

Effects of Nonsurgical Periodontal Therapy on Salivary 8-Hydroxy-Deoxyguanosine Levels and Glycemic Control in Diabetes Mellitus Type 2 Patients.

Diabetes and periodontitis are complex chronic diseases that are potentially interrelated, as well as associated with oxidative stress. Thus, the aim of the present study was to evaluate the influence of nonsurgical periodontal treatment on salivary 8-hydroxy-deoxyguanosine (8-OHdG) levels and glycemic control in patients suffering from both diabetes mellitus type 2 (DM2) and periodontitis. The study sample included 53 DM2 patients, while 31 systemically healthy patients served as controls. Participants in both groups suffered from periodontitis of comparable severity. Periodontal clinical parameters, namely plaque index (PI), gingival index (GI), papilla bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded, along with salivary 8-OHdG levels and glycated hemoglobin (HbA1c). Levels of 8-OHdG were analyzed by ELISA. All aforementioned parameters were evaluated prior to commencing the study and at 90-day follow-up upon nonsurgical periodontal therapy completion. At baseline, salivary levels of 8-OHdG in DM2 patients were significantly higher (1.17 ng/mL) than those measured for the control group (0.75 ng/mL) and showed significant positive correlation with GI and PPD (p < 0.05). Three months after nonsurgical periodontal therapy, the salivary 8-OHdG levels were significantly reduced in DM2 patients (p < 0.05). Analysis results also revealed statistically significant changes in all measured clinical parameters between baseline and three-month follow-up in both groups (p < 0.05). Upon treatment completion, a decline in the HbA1c level was noted in DM group, but it did not reach statistical significance (p > 0.05). It can be concluded that DM2 patients benefit from non-surgical periodontal therapy, as indicated by a marked reduction in their salivary 8-OHdG level and a modest improvement in glycemic control. Short-term clinical benefits noted in the DM group were similar to those observed in the non-diabetic periodontal patients.

Minimal periodontal basic care - no surgery, no antibiotics, low adherence. What can be expected? A retrospective data analysis.

This retrospective study aimed to evaluate tooth loss and the evolution of periodontal inflammatory parameters within a strict nonsurgically treated patient cohort with < 2 supportive periodontal care visits per year, defined as minimal periodontal basic care, of 2.5 to 10.7 years. Data for nonsurgically treated patients were checked for: complete periodontal examination data at baseline (T0), after active periodontal therapy (T1), and after ≥ 2.5 years of supportive periodontal care (T2); smoking, diabetes mellitus, age (at least 18 years), plaque and gingival indices, bleeding on probing, percentage of residual pockets, supportive periodontal care adherence, and number of supportive periodontal care visits were assessed as risk factors for tooth loss. In total, 132 patients were included (76 female, mean age 56.7 ± 10.3 years), mean T1-T2: 4.5 ± 1.6 years. 26.5% of all patients lost 118 teeth (0.5 teeth/patient, 0.12 teeth/patient/year). Plaque and bleeding parameters were: mean plaque control record, 59.77 ± 28.07%; mean Papilla Bleeding Index, 47.46 ± 34.12%; mean bleeding on probing, 33.46 ± 21.52%. Supportive periodontal care duration (P = .013) and T2 bleeding on probing (P = .048) were identified as patient-related risk factors for tooth loss. Minimal periodontal basic care was characterized by elevated bleeding on probing, Papilla Bleeding Index, and plaque control record scores. This possibly highlights a lack of consequent applied surgical intervention (if needed) transitioning into regular supportive periodontal care, including insufficient patient behavioral changes regarding domestic oral hygiene procedures and possibly nonaddressed proinflammatory dietary habits as a negative effect. An apparently low tooth loss rate could be observed. The duration of supportive periodontal care was identified as a risk factor for tooth loss.

Enzymatic antioxidants activity in gingival crevicular fluid and saliva in advanced periodontitis.

Enzymatic antioxidants are the primary line of defense against oxidative and nitrosative stress. However, their involvement in the progression of periodontitis is still not well understood. The study aimed to determine the activity of enzymatic antioxidants in the gingival crevicular fluid (GCF) and saliva of patients with periodontitis. The study group of 56 patients with periodontitis (stage III and IV) and 28 healthy controls were involved. The modified plaque index, probing depth, the clinical attachment level, the percentage of sites with bleeding on probing, papilla bleeding index, and maximum value of tooth mobility (Periotest®) were tested. Saliva (stimulated and non-stimulated) and GCF were collected from the participants, and activity of peroxidase, catalase, superoxide dismutase, and glutathione reductase were determined colorimetrically. Lower activity of peroxidase (p < 0.0001), catalase (p < 0.0001), superoxide dismutase (p=0.0188), and glutathione reductase (p < 0.0001) was noted in non-stimulated saliva of patients with periodontitis compared to healthy subjects. Peroxidase (p < 0.0001), catalase (p < 0.0001) and superoxide dismutase (p < 0.0001) showed lower activity in stimulated saliva of patients with periodontitis compared to healthy subjects. The peroxidase (p < 0.0029), catalase (p < 0.0001), and glutathione reductase (p=0.0028) activity in GCF of stage III + IV were significantly higher compared to healthy controls. Superoxide dismutase (p < 0.0001) showed lower activity in GCF of patients with periodontitis. The demonstrated decrease in activity of all analyzed enzymatic antioxidants in non-stimulated saliva may result from long-lasting periodontitis and exhaustion of the safeguard mechanism against reactive oxygen species.

Lipid Peroxidation Levels in Saliva and Plasma of Patients Suffering from Periodontitis.

Lipid peroxidation (LPO) participates in the development of various diseases, including periodontitis, and malondialdehyde (MDA) is its terminal product. Therefore, in the present study, salivary and plasma MDA levels in 30 periodontitis patients were compared to those in 20 healthy controls, as well as in relation to periodontal therapy in order to assess its effectiveness. Periodontal status was assessed via plaque index, gingival index, papilla bleeding index, probing depth and clinical attachment level, while salivary and plasma MDA levels were determined by the ELISA method. The periodontitis group had a significantly greater salivary (2.99 pmol/µL) and plasma (0.50 pmol/µL) MDA levels relative to the healthy controls (1.33 pmol/µL and 0.40 pmol/µL, respectively). Three months after the periodontal therapy completion, although salivary MDA levels were significantly lower than those measured at the baseline (p < 0.001), the reduction in plasma MDA was not statistically significant (p > 0.05). These findings indicate that, while inflammatory processes in periodontium may increase local and systemic lipid peroxidation, periodontal therapy can result in a significant decrease in salivary, but not plasma, MDA levels.

Effect of different enamel pretreating agents on bonding efficacy and survival rates of orthodontic brackets: In vitro study and split-mouth randomized clinical trial

This double invitro study and randomized clinical trial aimed to investigate the bonding failure rates of orthodontic brackets after enamel pretreatment with agents showing different particle sizes. For the invitro study, 80 bovine teeth were randomly divided into 4 groups according to the pretreating method used and their particle sizes: erythritol (14 μm), glycine (18-22 μm), sodium bicarbonate (70 μm), and no pretreatment. Scanning electron microscopy microphotographs were performed after pretreatment. Then, brackets were bonded, and shear bond strength was calculated. For the clinical study, agents with low (erythritol) and high (sodium bicarbonate) particle sizes were chosen. Twenty consecutive patients willing to start fixed orthodontic treatment with vestibular stainless steel brackets were enrolled. Patients were randomly divided into 2 groups following a split-mouth design. Group A underwent a 5-second enamel pretreatment procedure with erythritol for teeth belonging to maxillary left and mandibular right quadrants, whereas the remaining quadrants were pretreated for 5 seconds with sodium bicarbonate powder. In group B, quadrants were inverted. Then, brackets were bonded on the vestibular surfaces of teeth, and patients were visited monthly for 12 months to assess bond failures. Periodontal evaluation of probing pocket depth, bleeding on probing, plaque index, and papilla bleeding index was conducted before bonding and after 1, 3, 6, and 12 months. The invitro study showed that erythritol and control presented significantly higher shear bond strength values for other agents. Bicarbonate showed the lowest values. In the clinical study, 20 patients (aged 16.4 ± 3.9 years) were enrolled, and all completed the study. Erythritol showed a significantly lower failure rate (3%) than sodium bicarbonate (7.5%). Kaplan-Meier survival plots showed statistically significant differences in risk of failure between the 2 groups during the 12-month follow-up. Enamel pretreatment with erythritol can be a viable technique to reduce failure rates of orthodontic brackets. The trial was not registered. The protocol was not published before trial commencement. No funding or grant was received for this research.

Short- term effect of probiotic Lactobacillus reuteri consumption on the salivary microbiome profile of subjects undergoing orthodontic treatment with fixed appliances

ABSTRACT Objective This prospective clinical study aim was to analyze the effect of the probiotic Lactobacillus reuteri Prodentis lozenges on salivary microbiome of subjects wearing fixed orthodontic appliances. Methods Saliva samples were collected prior to consumption and 14th-day post probiotic lozenges consumption (n=40, age 18–23). Oral hygiene index-score (OHI-S) and papilla bleeding index (PBI) were recorded. The salivary microbiome was profiled by next-generation sequencing using the V3-V4 region of 16S-rRNA. Microbial composition, diversity and taxonomic biomarkers were analysed in comparison to probiotic intervention and the clinical characteristics of the cohort using standard bioinformatics tools. Results The diversity and bacterial community structures did not change significantly in salivary microbiome of periodontally healthy subjects during short-term probiotic intervention. Probiotic consumption correlated with reduction of OHI and PBI scores (50% reduction of scores, P<0.001). The reduction of clinical indices was evident in conjunction with significantly reduced abundance of oral pathogens, such as Porphyromonas pasteri, Treponema sp., Fretibacterium fastidiosum, Kingella oralis and Propionibacterium acnes. Conclusion Short-term probiotic intervention helped maintaining good oral health in patients undergoing fixed orthodontic therapy. Although overall oral microbiome structure remained largely unchanged, a significant alteration in the abundance of health and disease-associated species highlighted the beneficial effect of probiotic.

Effects of different immunosuppressive drugs on the periodontal status and changes in periodontal pathogenic bacterial flora in rheumatoid arthritis patients

Purpose: To investigate the prevalence of periodontal disease(s) and the associated bacteria among rheumatoid arthritis (RA) patients treated with different immunosuppressive drugs.Methods: Patients aged 18 – 65 years who had a 6-month history of RA, and were diagnosed as per the American College of Rheumatology and European League against Rheumatism, were included in the study. Supragingival plaque was removed by dentists. Using sterile paper strips, sub-gingival biofilm samples were collected from 5 of the deepest periodontal pockets. The samples were sent to pathologists for assessment. Polymerase chain reaction was carried out on them. Detection thresholds were &gt;102 for Aggregatibacter actinomycetemcomitans, while the detection threshold for Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenellacorrodens, and Capnocytophaga species was 103.Results: There was a higher number of patients with bleeding-on-probing amongst cohorts who received a combination of methotrexate and tumor necrosis factor-α antagonist than in those given leflunomide only (52 vs. 29, p = 0.041, q = 3.064), or methotrexate + rituximab (52 vs. 30, p = 0.041, q = 3.131, Fig. 1). Papilla bleeding index was lowest in patients who were treated with leflunomide. Almost all patients had dental infection with Fusobacterium nucleatum.Conclusion: These results indicate that treatment of RA with methotrexate results in periodontal inflammation.

Interferon-Gamma (IFNg) +874A/T Polymorphism Does Not Significantly Affect the Severity of Periodontitis.

Objectives Interferon-gamma (IFNg) is an immune-regulatory cytokine with a role in host responses to periodontitis. Genetic factors have been reported to modify the corresponding protein expression. The objective of this study was to evaluate the association and role of IFNg polymorphisms, such as IFNg +874 A/T, and the susceptibility to periodontitis. Materials and Methods A total of 100 unrelated subjects were included in the present study. Genomic deoxyribonucleic acid (DNA) was obtained from peripheral blood of 43 patients with mild periodontitis and 57 patients with severe periodontitis. The determined clinical parameters of periodontitis included probing depth, clinical attachment loss, and papilla bleeding index. The oral hygiene indicators were also assessed. The level of IFNg was determined from the gingival crevicular fluid by enzyme-linked immunosorbent assay technique. The IFNg +874 A/T polymorphisms were analyzed from peripheral blood by the method of restriction fragment length polymorphism-polymerase chain reaction. Statistical Analysis Statistical analysis of the results was conducted using chi-squared testing for categorical data. Independent t -tests and Mann–Whitney U tests were used for numeric data. Kruskal–Wallis testing was used to compare genotypes concerning for IFNg +874 A/T polymorphism. A p -value < 0.05 was assumed for statistical significance. Results Analysis of the IFNg +874 A/T polymorphism showed no significant differences with the level of IFNg. No significant differences were observed either in IFNg +874 A/T polymorphism between the subjects with mild periodontitis and those with severe periodontitis ( p > 0.05). The subjects with severe periodontitis showed marginally but not significantly higher levels of IFNg compared with subjects with mild periodontitis ( p > 0.05). Conclusion The polymorphism of IFNg +874 A/T was not associated with the level of IFNg nor with the risk of periodontitis in this study.