Professional Oral Hygiene Procedures Research Articles

Aerosols Contamination in the Dental Practice Following Everyday Procedures: An Observational Study.

The purpose of the present observational study was to evaluate the bacterial load in the air following various dental procedures. Air contamination following seven aerosol-generating dental procedures was assessed. The air volume was sampled by a wet cyclone collector for 10 min during 10 sessions of the following procedures: air-polishing, ultrasonic instrumentation, manual instrumentation, rubber cup polishing, cavity preparation with a 1:5 red contra-angle, cavity preparation with turbine and Low Volume Evacuator (LVE), and cavity preparation with turbine and High Volume Evacuator (HVE). Contamination of the sampled solution was determined using ATP (Adenosine TriPhosphate) quantification of the viable bacterial count, and compared to baseline measurements. The baseline air contamination was 1.45 (0.85-2.04) CFUs/L of air. The highest increase in air contamination was observed after the use of a turbine with LVE, with an average of 7.38 (95% CI 3.87-10.89) CFUs/L of air (p < 0.01). The use of the turbine with HVE and the use of the red hand-piece resulted in non-significant increases in bacterial counts compared to baseline (2.98 [1.34-4.63] and 2.70 [0.18-4.22] CFUs/L of air respectively). The application of air polishing, ultrasonic instrumentation, hand instrumentation and rubber cups did not result in a higher bacterial count than the baseline. Routine professional oral hygiene procedures do not increase air contamination. However, cavity excavation with LVE creates a significantly higher bacterial count in the air.

The influence of professional oral hygiene on the indicators of local immunity

Professional oral hygiene is an important part of measures aimed at preventing and maintaining the patient’s health. Local immune response is the first barrier of immune protection capable of preventing infection diseases. The aim of the study - the influence of professional hygiene on the indicators of local immunity has been studied. The study involved two groups of patients: the first group included 19 individuals with chronic caries of varying depths (class I), and the second group comprised 15 individuals with moderate periodontal disease. To evaluate nonspecific oral protection, the index of natural colonization of the buccal epithelium and the activity of microbial adsorption by oral mucosal cells were assessed. Specific immunity was evaluated by measuring the concentration of immunoglobulins in unstimulated saliva. All indicators were recorded both before and after professional oral hygiene procedures. When studying the index of natural colonization of the buccal epithelium, it was found that professional cleaning in both groups led to normalization of the spectrum of bacteria adhered to the epithelium: there was a decrease in the amount of gram-negative microflora, atypical for this biotope, while maintaining a high adhesion index of gram-positive cocci. In persons with caries, before sanation, “unsatisfactory” resistance of oral mucosa was revealed in a third of the examined, after sanation, the number of such patients decreased by 3 times, with “satisfactory” resistance increased by 2 times. In the group with periodontal disease, all patients exhibited “unsatisfactory” mucosal resistance before the hygiene procedures. After sanitation, 20 % “unsatisfactory” resistance persisted. In the majority of patients (80 %), the resistance of the oral mucosa improved to “satisfactory”. The concentration of all classes of immunoglobulins in both groups before sanitation was significantly below the norm, after the measures taken, the indicators increased significantly and reached the level typical for healthy individuals. Carrying out professional cleaning of the teeth leads to the normalization of local immune status even without additional medical immunocorrection.

Hygiene and Care Protocols for Implant-supported Dental Prostheses in Patients with Diabetes

Background: Prophylactic dental procedures following implant placement are critical to the long-term success of implants and are also dependent on the patient maintaining effective home care. Purpose: Evaluation of the effectiveness of preventive measures in patients with diabetes during long periods after prosthetic treatment with implants. Materials and methods: The study included 62 patients with diabetes with edentulism using 146 dental implants. Patients underwent constant monitoring, including regular occupational hygiene during follow-up examinations. Their frequency was set individually from 2 to 4 times A clinical index including Bleeding on Probing (BOP), Probing Depth (PD), and Marginal Bone Loss (MBL). Results: In patients included in the preventive protocol after 12 months, the mean BOP was 1.4 ± 0.15, and PPD was 2.46 ± 0.42. After 12 months in patients mean MBL was 0.72 ± 0.6 mm, after 3 years MBL was 1.24 ± 0.25 mm. For patients who were excluded from preventive services after 12 months, the mean BOP 1.9 ± 0.25, and the mean PPD was 3.56 ± 0.28). After 12 months in patients mean MBL was 0.87 ± 0.7 mm, after 3 years MBL was 1.52 ± 0.32 mm (p &gt; 05). Compared to persons enrolled in the preventive protocol, those in the group without services were more likely to develop peri-implantitis (42.4% vs. 12,6%). The survival rate of implants after 3 years was 98.4%. The survival rate of implants in those patients who were excluded from preventive services after 3 years was 95.4%. Conclusion: For patients with diabetes, regular medical examinations, accompanied by professional oral hygiene procedures, prevent the development of negative reactions of the soft tissues surrounding the implant.

Analysis of a Combination Therapy Protocol for the Treatment of Oral Mucous Membrane Pemphigoid: A Retrospective Case Series Study.

Mucous membrane pemphigoid (MMP) is an autoimmune-based bullous disease affecting the mucous membranes, mainly oral and ocular. One of the most common clinical manifestations is desquamative gingivitis (DG), characterized by intense symptoms and functional limitations. The dentist is among the first specialists to observe DG and, therefore, must be able to diagnose it. In this regard, the purpose of the present study was to evaluate the efficacy and safety of a clinical protocol for the topical management of patients with DG and MMP buccal lesions. Thirteen patients with clinical and histologic diagnoses of MMP-localized DG in the oral cavity were retrospectively enrolled. Each patient received topical treatment with clobetasol propionate oral gel 0.05%; nicotinamide; oral probiotic (contains Bifidobacterium lactis HN019, Kluyveromyces marxianus fragilis B0399, colostrum, and biotin); and doxycycline. Before and after 3 months of therapy, clinic records were collected for each patient. Seven patients (53.8%) had a complete response to treatment; four patients (30.8%) had a partial response to treatment; and, finally, two patients (15.4%) had no benefit from therapy. Dental management of patients presenting solely with oral manifestations of MMP may involve the use of topical corticosteroids, doxycycline, vitamin supplements, and probiotics and associating professional oral hygiene procedures.

Biofilm Adhesion and Micromorphology Analysis after Professional Oral Hygiene Procedures on CAD/CAM Milled and Veneered Zirconia Restorations: In Vitro Study

Biofilm Adhesion and Micromorphology Analysis after Professional Oral Hygiene Procedures on CAD/CAM Milled and Veneered Zirconia Restorations: In Vitro Study

Clinical effectiveness of an immunomodulatory drug based on a muramylpeptide composition in the treatment of patients with chronic generalized periodontitis

To assess the efficacy of an immunomodulatory drug based on a muramylpeptide composition in the treatment of patients with chronic generalized periodontitis. The study comprised 40 patients with chronic generalized periodontitis. In controls the treatment consisted in oral hygiene instructions, professional oral hygiene procedures and root scalling while in main study group the conventional treatment protocol was combined with intramuscular injections of muramylpeptide composition. The study showed significant reduction of inflammatory symptoms in periodontal tissues in muramylpeptide composition group. Muramylpeptide composition increases the threshold of tissue protection against constantly present microbial accumulations in periodontal disease patients thus providing opportunity for excluding toxic antimicrobial agents and/or antibiotics (or reducing their dosages).

Hirudotherapy in treatment of chronic generalised periodontitis

Chronic generalized periodontitis (CGP) is a disease associated with low susceptibility to the therapeutic protocols applied; practitioners tend to characterize it as a disease presenting certain difficulties. Therefore, the search for drugs and methods capable of increasing the efficacy of CGP therapy is an ongoing process. Additional problems, which have to do with either with antibiotic resistance or increased sensitivity to drugs, also occur quite often. This study aimed to assess the possibility of applying hirudotherapy in the context of conservative treatment of CGP. 50 patients with CGP without somatic pathology were examined and treated. The participants were divided into two groups (n = 25), all group members of about the same age. At the first stage, the treatment followed the accepted standard: professional oral hygiene procedures, antimicrobial and anti-inflammatory drugs, demonstration of proper personal oral hygiene routines. Then, first group went through a monthlong hirudotherapy course that consisted of 6 to 8 individual procedures. Second group was observed throughout this period with the aim to control the level of their compliance with the oral hygiene routines they were trained. Having analyzed the results, we found that hirudotherapy was more effective than what was prescribed to the second (control) group. The papillary marginal alveolar index (PMA), which reflects the severity of inflammation and gum bleeding, decreased significantly in the first group, where medicinal leeches were used: in the patients with severe CGP it went down by 6%, in those with moderately severe CGP the index decreased by 24% and the participants whose CGP was only light had the PMA go down by 2%. Thus, we have demonstrated the efficacy of hirudotherapy in the context of conservative CGP treatment, which allows recommending this method for inclusion into clinical practice.

Report of the use of topical ozone together with professional oral hygiene procedures in patient with gingival mucous membrane pemphigoid

Event Abstract Back to Event Report of the use of topical ozone together with professional oral hygiene procedures in patient with gingival mucous membrane pemphigoid Paola Carcieri1*, Roberto Broccoletti1, Alessio Gambino1, Davide Conrotto1, Mario Carbone1 and Paolo Giacomo Arduino1 1 University of Turin, Department of Surgical Sciences, Oral Medicine Section, Italy Aim. Mucous membrane pemphigoid (MMP) is a heterogeneous group of autoimmune chronic inflammatory, subepithelial blistering disorder, predominantly involving the mucous membranes. It has a female predilection and commonly occurring after the fifth decade of life. The oral mucosa is affected in more than 90% of cases. Even if this condition has been reported as non-plaque induced, effective dento-gingival plaque control sometimes could resolve the gingival inflammation. Ozone is naturally produced by the photo dissociation of molecular oxygen into activated oxygen atoms which then react with further oxygen molecules. This transient radical anion rapidly becomes protonated, which in turn decomposes to an even powerful oxidant, the hydroxyl radical OH. Application of ozone in periodontics comes as a result of its physic-chemical properties. Ozone therapy has a wide range of applications in treating various diseases owing to its unique properties including antimicrobial, immunostimulant, analgesic, detoxicating, bioenergetic and biosynthetic actions. Materials and Methods. A 70-year-old female patient presented with 1-year history of intact blisters in her mouth, which ruptured leaving throbbing ulcers and peeling of the gingiva; she also reported pain and burning sensation while taking hot and spicy foods. A biopsy was performed with MMP evidence. A professional oral hygiene regimen was started to deal with the gingival status associated together with the use of local ozone applications. Severity of pain was detailed using a Visual Analogue Scale (VAS). Patient received non-surgical periodontal therapy, including personalized oral hygiene instructions, and thorough supragingival scaling and polishing with the removal of all deposits and staining. Clinical outcome variables were recorded at baseline and after the intervention and included full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), and the clinical extension of gingival involvement. Results. After finishing the proposed protocol, a significant and statistical reduction was observed for FMPS, FMBS, and clinical gingival involvement, without using any topical or systemic immunosuppressant. Discussion. Professional oral hygiene procedures and non-surgical periodontal therapy, including topical use of ozone therapy, were associated with a prominent improvement of gingival clinical outcomes in this female with exclusive MMP related gingivitis.

Oral Health Status in Alzheimer\'s Disease Patients: A Descriptive Study in an Italian Population

To evaluate the oral health status in Alzheimer's disease (AD) patients. A descriptive study was performed on 120 AD patients (60 institutionalized in a public institute and 60 attended a daytime center), from September 2013 to January 2014. About 103 subjects formed the control group. The following medical and dental data were collected: dementia severity, pharmacological therapy, physical status (American Society of Anesthesiologists [ASA]), decayed (D), filled (F), and remaining natural teeth (T), DF/T ratio, community periodontal index (CPI), and gingival index (GI). A t-test for independent samples and the Spearman's correlation test were used to evaluate all variables. The significance level was set at 0.05. Statistically more AD patients (91.7%) were under pharmacological therapy and their physical status was more severe (ASA 2, ASA 3) compared with control subjects (p < 0.001). Moreover, they presented numbers of D, CPI, and GI significantly higher (p ≤ 0.005). In the institutionalized subgroup, statistically more moderate and severe AD cases were detected and more patients were edentulous (p < 0.001). Noninstitutionalized patients presented DF/T ratio, CPI, and GI significantly lower (p ≤ 0.024). A significant weak negative correlation (r = -0.121 to -0.372) between epidemiologic indices and AD severity was observed. Alzheimer's disease patients show a low oral health status that decreases progressively as the disease severity aggravates. Therefore, further studies are necessary to investigate oral health care interventions for AD patients. It would be beneficial to introduce trained professional figures in specialized elderly institutions for regular follow-up visits and professional oral hygiene procedures. This task has to be coordinated with the treating physician, family members, and/or caregivers. Knowing that the severity of AD has a negative effect on the oral health status and the type of institutionalization exacerbates it.

Impact of a sodium carbonate spray combined with professional oral hygiene procedures in patients with Sjögren's syndrome: an explorative study.

The aim of this study was to make an initial estimation on the effects of a sodium bicarbonate and xylitol spray (Cariex® ), associated with non-surgical periodontal therapy, in participants with primary Sjögren's syndrome. Sjögren's syndrome (SS) is a multisystem autoimmune disease that predominantly involves salivary and lachrymal glands, with the clinical effect of dry eyes and mouth. A prospective cohort of 22 women and two men has been evaluated. They were randomized into three groups (eight patients each): Group A) those treated once with non-surgical periodontal therapy, education and motivation to oral hygiene, associated with the use of Cariex® ; Group B) treated only with Cariex® ; Group C) treated only with non-surgical periodontal therapy, education and motivation to oral hygiene. Clinical variables described after treatment were unstimulated whole salivary flow, stimulated whole salivary flow, salivary pH, reported pain (using Visual Analogue Scale) and the Periodontal Screening and Recording index. Salivary flow rate improved in all groups, but the difference was statistically significant only in those treated with Cariex® , alone or in combination with periodontal therapy. Gingival status improved in participants who underwent periodontal non-surgical therapy while remained unchanged in those only treated with Cariex® . Reported pain decreased in all groups, showing the best result in participants treated with periodontal therapy together with Cariex® . We propose a practical approach for improving gingival conditions and alleviating oral symptoms in patients with SS. Future randomized and controlled trials are however required to confirm these results as well as larger population, and also assessing other parameters due to oral dryness, possible oral infections and more comprehensive periodontal indices.

Influence of Professional Oral Hygiene Procedures on Plasma Glucose Levels of systemically Healthy Individuals: A Short-term Study

ABSTRACT Aims The treatment of gingival inflammation is associated with improved glycemic control in diabetic patients. The aim of this study was to test the short-term effects of professional oral hygiene procedures on plasma glucose levels in systemically healthy individuals with periodontal diseases. Materials and methods Forty-five systemically healthy individuals visiting the RajaRajeswari Dental College &amp; Hospital were randomly allocated into three groups, group I (gingivitis), group II (periodontitis), and group III (healthy control). The subjects of groups I and II were treated by scaling and root planning whereas the healthy control group did not receive any treatment. The plasma glucose levels were estimated at baseline for all the three groups. Plasma glucose levels were again assessed immediately following the oral hygiene procedures and at 1 week recall visit for groups I and II. Results All 45 patients completed the study. There were no dropouts. There was no statistically significant change in random blood sugar (RBS) level in group I (gingivitis) from baseline to postoperative whereas there was a statistically significant reduction in the mean RBS levels from postoperative to 1 week. In group II (periodontitis), there was a significant reduction in the mean values of RBS from baseline to postoperative and baseline to 1 week. Conclusion This short-term study showed that professional oral hygiene procedures are effective in improving the glycemic status of systemically healthy patients with periodontal diseases. How to cite this article Kulal R, Paul S, Sambhashivaiah S, Shivanand S. Influence of Professional Oral Hygiene Procedures on Plasma Glucose Levels of systemically Healthy Individuals: A Short-term Study. J Health Sci Res 2015;6(2):29-32.

Effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength and bond failure mode of metallic orthodontic brackets

ObjectiveTo evaluate the effects of ultrasonic instrumentation with different scaler-tip angulations on the shear bond strength (SBS) and bond failure mode of metallic orthodontic brackets.MethodsAdhesive pre-coated metallic brackets were bonded to 72 extracted human premolars embedded in autopolymerizing acrylic resin. The teeth were randomly divided into 3 groups (n = 24 each) to undergo no treatment (control group) or ultrasonic instrumentation with a scaler-tip angulation of 45° (45°-angulation group) or 0° (0°-angulation group). SBS was tested in a universal testing machine, and adhesive remnant index (ARI) scores were recorded. The Kruskal-Wallis test and Mann-Whitney U-test were used for statistical analysis.ResultsThe control group had a significantly higher mean SBS value than the treated groups, which showed no significant differences in their mean SBS values. The ARI scores were not significantly different among the groups.ConclusionsUltrasonic instrumentation around the bracket base reduces the SBS of metallic orthodontic brackets, emphasizing the need for caution during professional oral hygiene procedures in orthodontic patients. The scaler-tip angulation does not influence the SBS reduction and bond failure mode of such brackets.

Conservative Approach in Patients with Pemphigus Gingival Vulgaris: A Pilot Study of Five Cases

Objectives. The aim of this pilot study was to describe the clinical efficacy of a conservative oral hygiene protocol in patients affected by gingival pemphigus vulgaris (PV) applied in a case series. Methods. Subjects suffering from PV with gingival localisation and slightly responsive to conventional treatment with systemic corticosteroids and immunosuppressive drugs were selected among individuals treated in the Unit of Oral Medicine Section of the University of Turin. Five subjects received nonsurgical periodontal therapy, over a 7-day period, including oral hygiene instructions; patients were instructed about domiciliary oral hygiene maintenance and instructions were reinforced at each visit and personalised if necessary. Clinical outcome variables were recorded at baseline (before starting) and 16 weeks after intervention, including full mouth plaque score (FMPS), bleeding scores (FMBS), probing pocket depth (PPD), oral pemphigus clinical score (OPCS), and patient related outcomes (visual analogue score of pain). Results. Five patients were treated and, after finishing the proposed therapy protocol, a statistical significant reduction was observed for FMBS (P = 0.043) and OPCS (P = 0.038). Conclusions. Professional oral hygiene procedures with nonsurgical therapy are related to an improvement of gingival status and a decrease of gingival bleeding in patients affected by PV with specific gingival localization.

Professional Oral Hygiene as a Therapeutic Option for Pediatric Patients With Plasma Cell Gingivitis: Preliminary Results of a Prospective Case Series

Plasma cell gingivitis (PCG) is a rare, benign inflammatory condition of unclear etiology with no definitive standard of care ever reported to our knowledge. The aim of this case series is to ascertain the clinical efficacy of professional oral hygiene and periodontal therapy in younger individuals with a histologically confirmed diagnosis of PCG. All patients received non-surgical periodontal therapy, including oral hygiene instructions, and thorough supragingival scaling and polishing with the removal of all deposits and staining combined with the use of antimicrobials in a 9-week cohort study. Clinical outcome variables were recorded at baseline and 4 weeks after the intervention and included, as periodontal parameters, full-mouth plaque scores (FMPS), full-mouth bleeding scores (FMBS), the clinical extension of gingival involvement, and patient-related outcomes (visual analog score of pain). A total of 11 patients (six males and five females; mean age: 11 ± 0.86 years) were recruited. Four weeks after finishing the oral hygiene and periodontal therapy protocol, a statistically significant reduction was observed for FMPS (P = 0.000), FMBS (P = 0.000), reported pain (P = 0.003) and clinical gingival involvement (P = 0.003). Standard, professional oral hygiene procedures and non-surgical periodontal therapy including antimicrobials were associated with a marked improvement of clinical and patient-related outcomes in pediatric cases of PCG.

Professional oral hygiene treatment and detailed oral hygiene instructions in patients affected by mucous membrane pemphigoid with specific gingival localization: a pilot study in 12 patients

The aim of this prospective case series was to assess the clinical efficiency of an oral hygiene protocol in patients affected by mucous membrane pemphigoid (MMP) with specific gingival localization, before starting any medical treatment. Patients received oral hygiene instruction followed by non-surgical periodontal therapy including oral hygiene instructions in a 3-week cohort study. Clinical outcome variables were recorded at baseline and 5 weeks after intervention and included, as periodontal parameters, full mouth plaque (FMPS) and bleeding (FMBS) scores and patient-related outcomes (visual analogue score of pain). A total of 12 patients were recruited. The mean age at presentation was 59.5 ± 14.52 years. Five weeks after finishing the oral hygiene and periodontal therapy protocol, a statistical significant reduction was observed for FMPS (P = 0.001), FMBS (P = 0.022) and reported pain (P = 0.0028). Professional oral hygiene procedures and non-surgical periodontal therapy are connected with improvement of gingival status and decrease in gingival-related pain, in female patients affected by MMP with specific gingival localization.

Clinical and microbiological evaluations of acute periodontitis in areas of teeth applied with orthodontic bands

Two cases with severe periodontal inflammation in areas of teeth applied with orthodontic bands are presented. Both were diagnosed as acute periodontitis, and removal of the orthodontic bands followed by professional oral hygiene procedures resulted in the recovery to the normal level of periodontal condition. The presence of 10 targeted species of Gram-negative periodontal bacteria in subgingival plaque samples taken from the corresponding teeth, which were not detected in either patient during the period of severe periodontal inflammation, was assessed several times using a polymerase chain reaction method. As the periodontal conditions of the patients improved, these bacteria were identified during the follow-up examination periods. Our results suggest that none of the 10 Gram-negative periodontal bacteria were associated the acute periodontitis at the teeth applied with orthodontic bands.