Professional Mechanical Tooth Cleaning Research Articles

An Observational Study on Changes in the Oral and Gut Microbiota through Professional Mechanical Tooth Cleaning, including Tooth-Brushing Instructions in Patients with Multi-Bracket Appliances

Multi-bracket appliances have long been established as tools for treating malocclusions. However, the complex construction and difficulty in cleaning due to their long-term intraoral retention have hindered the prevention of caries and periodontitis. In this study, professional mechanical tooth cleaning (PMTC), including tooth-brushing instructions, was continuously performed for 3 months in 24 patients who had worn multi-bracket appliances for more than 6 months, and changes in the oral and gut microbiota were examined using one-way repeated-measures analysis of variance. Additionally, changes in bacterial flora associated with different treatment durations were verified using the Pearson correlation coefficient. The results showed that continuous PMTC significantly reduced the amount of plaque in the oral cavity. No significant changes were observed in the oral or gut microbiota and no significant increase in pathogenic bacteria was observed. Therefore, our results suggest that continuous PMTC during orthodontic treatment with multi-brackets may inhibit the growth of pathogenic bacteria by maintaining a clean oral environment and avoiding dysbiosis in both the oral and gut microbiota. Significant changes in the gut microbiota with different treatment durations suggested that differences in food intake and food choices at each treatment stage of orthodontic treatment may affect the gut microbiota.

Professional Mechanical Tooth Cleaning Method for Dental Implant Surface by Agar Particle Blasting.

Oral dysfunction due to peri-implantitis and shortened life of implants has become a major concern. Self-care and removal of oral biofilms by professional mechanical tooth cleaning (PMTC) are indispensable for its prevention. However, if the surface roughness of the implant is increased, it may result in the adhesion of biofilm in the oral cavity. Therefore, the PMTC method can serve for long-term implant management. Calcium carbonate (CaCO3) has been used as a cleaning method for implant surfaces; however, there is concern that the implant surface roughness could increase due to particle collision. Therefore, in this study, to establish a blasting cleaning method that does not adversely affect the implant surface, a new blasting cleaning method using agar particles was devised and its practical application examined. When the simulated stains were blasted with white alumina (WA) abrasive grains and CaCO3 particles, the simulated stains were almost removed, the surface roughness changed to a satin-finished surface—which was thought to be due to fine scratches—and the surface roughness increased. Most of the simulated stains were removed on the surface of the sample blasted with glycine particles and agar particles. Conversely, the gloss of the sample surface was maintained after cleaning, and the increase in surface roughness was slight.

Oral care and oral assessment guide in breast cancer patients receiving everolimus and exemestane: subanalysis of a randomized controlled trial (Oral Care-BC).

Oral mucositis is a clinically significant adverse event linked to cancer therapy; it reduces the quality of life of patients and may result in the discontinuation of treatment and a poorer prognosis. Based on level 3 evidence, the Mucositis Study Group of Multinational Association for Supportive Care in Cancer and the International Society of Oral Oncology recommend oral care for all patients receiving cancer chemotherapy and radiotherapy, although no data from large-scaled randomized controlled trials support the efficacy of oral care in preventing oral mucositis. Therefore, this randomized, controlled, multicenter, open-label, phase III study sought to determine whether professional oral care reduces oral mucositis in everolimus and exemestane-treated estrogen receptor-positive metastatic breast cancer patients. Altogether, 169 patients were randomized into the professional oral care (n=82) and control (n=87) groups. The professional oral care group received oral health instruction, professional mechanical tooth and tongue cleaning, gargling with a benzethonium chloride mouthwash, and dexamethasone ointment when grade 1 mucositis manifested. The control group received oral health instruction and gargling. Eight weeks after the everolimus and exemestane administration, the oral status (Oral Assessment Guide criteria) and oral mucositis status (Common Terminology Criteria for Adverse Events functional and clinical examinations) were evaluated. The incidence of oral mucositis of any grade and grade 2 severe mucositis was significantly lower in the professional oral care group, based on the Common Terminology Criteria for Adverse Events functional and clinical examinations. The total Oral Assessment Guide score, total Oral Assessment Guide grade, and Oral Assessment Guide score of teeth/dentures and mucous membranes were significantly different between the two groups. The Oral Assessment Guide grade for swallow, lip, teeth/dentures, mucous membrane, tongue, and saliva significantly correlated to oral mucositis severity. Professional oral care may prevent oral mucositis and improve teeth/denture conditions in patients receiving everolimus and exemestane.

Influence of one-step professional mechanical tooth cleaning pastes on surface roughness and morphological features of tooth substrates and restoratives.

This study investigated the influence of professional mechanical tooth cleaning (PMTC) pastes on the surface texture of different subject materials. Two one-step PMTC pastes, Clinpro Cleaning Paste for PMTC (CP) and PRG Pro-Care Gel (PG), and multiple-step PMTC pastes, Merssage Regular (MR), Merssagge Fine (MF), and Merssage Plus (MP), were used. For comparison, PMTC was performed using distilled water without paste (DW). The subjected materials used were bovine enamel (ENA) and dentin (DEN), a resin composite (FSU), and lithium disilicate (IEC). The prepared specimens were polished using a #2000-grit silicon carbide paper. PMTC was performed using a brush at 1,000 rpm for 15 s. The surface roughness (Ra) values of the specimens before and after PMTC were measured by laser scanning microscopy. The Knoop hardness number (KHN) of the subjected material was obtained. The types of PMTC pastes and subject materials had a significant influence on the Ra values and KHN. For the majority of subject materials, the descending order of Ra values after PMTC was MR > MF > CP > PG > MP > DW. The descending order of KHN of the materials was IEC > ENA > FSU > DEN. Although one-step PMTC pastes appeared to be effective, it is important to consider the subject material during PMTC.

The Effectiveness Focused on Professional Mechanical Tooth Cleaning for Implant Patients Management

The Effectiveness Focused on Professional Mechanical Tooth Cleaning for Implant Patients Management

Use of ATP bioluminescence to survey the spread of aerosol and splatter during dental treatments

Aerosol and splatter produced during dental treatments (ultrasonic scaling and professional mechanical tooth cleaning) are potential sources of infection. Contamination patterns on the mask, goggles, chest and gowned right arm of operators, and on the goggles of patients before and after dental treatments were investigated using ATP bioluminescence analysis. Contamination on every surface tested increased significantly after dental treatment. Maximum contamination was found on the goggles of patients. Aerosol and splatter produced during dental treatments therefore have the potential to spread infection to operators and patients. ATP bioluminescence is a useful tool for monitoring surface contamination.

Effective Management Interval Focused on Professional Mechanical Tooth Cleaning

Effective Management Interval Focused on Professional Mechanical Tooth Cleaning

White Blood Cell Signaling and Defense Mechanisms in Patients with Diabetes Mellitus Type 2 and Periodontitis

White blood cell membrane and surface structures are affected by the metabolic disorders and complications found in diabetes mellitus. Therefore, cellular activation, signal propagation, intracellular signaling as well as bactericidal effector functions are altered. Most likely diabetic symptoms can be corrected by the systemic intervention and treatment of the patients (Antidiabetic Therapy/ADT, i.e. anti-diabetic medication, diet and dietetic supervision, physiotherapy and physical exercises). We hypothesize that simultaneously blood cell functions will improve. Gum diseases like periodontitis have long been associated with and termed complications of uncontrolled diabetes mellitus. Vice versa, after diabetic conditions are corrected, periodontitis treatment will be proven effective, when oral hygiene regimen, full mouth decontamination (FD, i.e. the oral use of topical antiseptics prior and after professional mechanical tooth cleaning, tooth as well as root surface planing, polishing as well as gum and soft tissue decontamination in combination with systemic antibiotics) are performed. To reinforce gum healing, reinfection prevention (RP) as well as supportive periodontal therapy (SPT) will be administered by dental professionals on an individual basis and a detailed schedule. If periodontal pockets critical for participant's self care are not eliminated by FD including RP and SPT, and niches > 5mm after 6 month persist, patients are informed and offered surgical intervention as indicated for gum disease elimination.

Pyogenic Liver Abscess Related to Dental Disease in an Immunocompetent Host

A 59-year-old man with poor oral hygiene presented to our hospital because of fever and chills. Abdominal ultrasonography and enhanced computed tomography (CT) revealed a liver abscess. The patient had no history of immunodeficiency and we confirmed the patient had no immunologic abnormalities. Blood culture revealed Fusobacterium nucleatum, a bacterium commonly found in the oral cavity. Even if a patient is immunocompetent, poor oral hygiene might be an independent risk factor for a pyogenic liver abscess. Professional mechanical tooth cleaning (PMTC) and appropriate self-care are recommended as a prophylaxis against not only dental, but also systemic diseases.

Study of the clinical usefulness of a dental drug system for selective reduction of mutans streptococci using a case series

The aim of this study was to evaluate the clinical efficacy and safety of a dental drug delivery system (3DS) for the selective reduction of mutans streptococci. Twenty patients with high levels of mutans streptococci in saliva participated. The efficacy of 0.2% chlorhexidine (CHX) delivered by 3DS in reducing the salivary levels of mutans streptococci compared with total streptococci and lactobacilli was investigated. Each subject was treated by professional mechanical tooth cleaning (PMTC) and subsequently individual trays with CHX for 5 min. Salivary bacterial samples were taken at the baseline and weeks 1-12. A significant reduction in the colony count of mutans streptococci was observed during the first 4 weeks compared with the baseline count, while no significant decrease in the count of total streptococci or lactobacilli was found during 12 weeks. In particular, the proportion of mutans streptococci in total streptococci remained low after 12 weeks. Our results indicate that the new 3DS used in combination with PMTC appears to be a promising intraoral drug delivery system which, when used with a low CHX concentration selectively, effectively reduces mutans streptococci in the oral cavity with no adverse effects.

The effect of a mouth rinse containing phenolic compounds on plaque formation and developing gingivitis

The clinical effect of Listerine, a mouth rinse containing a mixture of phenolic compounds, is ascribed to its bactericidal properties. However, phenolic compounds are also known to interfere with the inflammatory process. The purpose of this clinical trial was to evaluate the effect of regular mouth rinsing with Listerine on plaque and gingivitis during a 2-week period of no mechanical oral hygiene. Twenty-one subjects were recruited for the study. On Day 0 of each 2-week experimental period, the participants were told to abstain from all mechanical plaque-control measures but to rinse twice a day with 10 ml of the assigned solution (test: Listerine, positive control:0.1% chlorhexidine (CHX), negative control: saline) for 60 s. Each experimental period was preceded by a 2-week period including oral hygiene instruction, scaling and professional mechanical tooth cleaning. Examinations included assessments of plaque and gingivitis (Days 0 and 14), sampling of plaque and collection of gingival crevicular fluid (GCF) (Days 0, 7 and 14). From the supragingival plaque samples, six different morphotypes of bacteria were counted using dark-field microscopy. The GCF collected was analysed with respect to the content of lactoferrin and albumin. During the experimental periods, it was observed that significantly less plaque formed and less gingivitis developed when the participants rinsed with the Listerine mouthwash than with saline solution. However, significantly more plaque formed during the Listerine than during the CHX rinse period, while there was no significant difference in the development of gingival bleeding between the Listerine and the CHX rinse regimens. Significantly smaller proportions of motile rods and fusiforms were found in the List and CHX groups than in the control (Ctrl) group. The increase of the lactoferrin/albumin ratio in the List group was significantly smaller than that in the Ctrl group but significantly larger than in the CHX group. It was suggested that the effect of Listerine on gingivitis is more pronounced than on plaque formation. This indicates that the phenolic compound may have anti-inflammatory effects.

The effect of systemic administration of ibuprofen in the experimental gingivitis model

Studies in humans have indicated that systemically administered flurbiprofen and ibuprofen may reduce gingivitis. De novo plaque formation is enhanced at tooth surfaces adjacent to inflamed gingivae. The aim of the present clinical trial was to evaluate the effect of systemic administration of ibuprofen on gingivitis and plaque build-up. Eleven subjects were recruited for the study and were given oral hygiene instruction, scaling and professional mechanical tooth cleaning (PTC). At the end of a preparatory period (Day 0), the participants were told to abstain from all mechanical plaque control measures during a 2-week experimental period but to rinse with an assigned mouth rinse (positive control: 0.1% chlorhexidine digluconate; negative control: saline) or administer ibuprofen (tablets of 200 mg twice daily). Mouth rinsing was performed twice a day (after breakfast and in the evening), for 60 s with 10 ml. Re-examination was performed after 14 days of experiment. After a 2-week "wash-out" period, the participants received a new PTC and a second 14-day experimental period was initiated. The experimental and "wash-out" periods were repeated until all volunteers had been involved in all three regimens. Dental plaque was scored using the Quigley & Hein Plaque Index system and gingivitis according to the Gingival Index (GI) system. Supragingival plaque was collected and prepared for dark-field microscopy. One hundred bacterial cells were counted and classified into six different groups: coccoid cells, straight rods, filaments, fusiforms, spirochetes and motile rods. Gingival crevicular fluid (GCF) was collected from the same sites that were sampled for plaque. The volume of GCF collected in each strip was measured and analysed regarding content of lactoferrin and albumin. During the period when the panelists rinsed with saline they accumulated large amounts of plaque and developed marked signs of gingivitis. When they rinsed with chlorhexidine digluconate, small amounts of plaque formed and few sites received GI score > or =2. After the 2 weeks of ibuprofen administration, the panelists presented with significantly fewer sites that scored GI > or =2 but had formed similar amounts of plaque as during the negative control period. It is suggested that ibuprofen administered via the systemic route has an effect on gingivitis but not on de novo plaque formation.

Feasibility of eradication of mutans streptococci from oral cavities

Dental caries prevention programs using chlorhexidine (CHX) have been proposed, but CHX's effect in reducing levels of mutans streptococci (S. mutans and S. sobrinus) appears to last for only a few months. The aim of this study was to attempt to eradicate mutans streptococci from the oral cavity using intensive professional mechanical tooth cleaning (PMTC) and topical application of CHX in custom-made trays. Seven adult dentate subjects participated in this study (mean age 53.7+/-5.6, age range 46 to 62, mean DMFT, 9.1+/-4.2). For each subject, PMTC was carried out eight times within ten days. After each PMTC, 1% CHX was applied twice to the tooth surface using custom-made trays. In addition, as home treatment, subjects were required to carry out tooth brushing three times a day, and apply 0.2% CHX in custom trays after brushing in the morning and evening. In addition, subjects rinsed with 0.2% CHX solution after lunch. Salivary levels of mutans streptococci were evaluated using Dentocult-SM at baseline and on days 9, 20, 70, 120. Mutans streptococci were eradicated by day 120 from 4 of the 7 seven subjects participating in this study. Those 3 subjects still harboring mutans streptococci exhibited deep periodontal pocketing. Eradication of mutans streptococci from the oral cavity is feasible using a combination of CHX application in custom-made trays and intensive PMTC.

How Swedish dental hygienists apply their training program in the field

The purpose of this study was to evaluate how clinical practice by Swedish dental hygienists was related to type of dental delivery system, period of training, educational institution attended and patient category. Dental hygienists from 14 different dental hygiene schools were represented. Of these schools, 11 are still in operation. A specially designed questionnaire was posted to all dental hygienists in Sweden (n = 1857). A total of 1399 questionnaire (75.3%) were completed and returned, providing data on 15,546 dental appointments. 37.2% of the Swedish dental hygienists are presently working in private practices, 45.8% in the public dental health service and 6.2% in both. Of the patients treated by hygienists, 88.7% were adults: 99.5% in private practice and 78.4% in the public dental health service. 42.0% of all dental hygienists were trained in 1980-84. The mean treatment time per appointment in private practice was 49.7 min and 45 min in the public dental health service. Scaling, root-planning and removal of overhangs took 27 min per visit in private practice and 22 min in the public dental health service. However, there were no significant differences in methods in the two delivery systems with respect to examinations, self-care training, professional mechanical toothcleaning (PMTC), topical fluoride application, or salivary and oral microbiology tests. The adult patient categories were periodontal risk (45.1%), caries risk (9.1%) and hygiene (34.6%). In periodontal risk patients, scaling, root-planning and removal of overhangs took 28 min per appointment and 14 min in caries risk patients.

Effect of monthly professional mechanical tooth cleaning on periodontal health in adults

The beneficial effects of comprehensive dental prophylaxis programs are well recognized. In order to study the factors determining the effectiveness of these programs, 28 periodontal recall patients were subjected to monthly professional mechanical tooth cleanings. Experimental and control teeth were randomly selected according to a splitmouth cross-over method. The Plaque and Gingival indices were recorded 1 month prior to the study, at the start, and at 4, 8, and 12 months. One month prior to the study calculus and bacterial plaque were thoroughly removed from all teeth. During the study period only the experimental teeth were cleaned. Efforts were made not to influence the oral hygiene of the participants by any other means. Following the initial tooth cleaning and during the preexperimental period the Plaque and Gingival indices decreased to a low level on both the experimental and control teeth (mean P1I = 0.4, mean GI = 0.3). This high standard of oral hygiene and gingival health was maintained throughout the study period, and no differences could be observed between experimental and control teeth. This indicates that factors other than the mechanical professional cleaning were responsible for the maintenance of gingival health. It is suggested that participation in the program in itself may have motivated the patients to improve their oral home care.