Professional Oral Hygiene Research Articles

Morphological and chemical characteristics of different titanium surfaces treated by bicarbonate and glycine powder air abrasive systems.

This in vitro study investigated possible morphological and chemical changes induced by glycine or sodium bicarbonate powder air polishing on machined and acid-etched titanium surfaces. The glycine powder (granulometry <65 μm) and sodium bicarbonate powder (granulometry <150 μm) were applied on 2 machined healing abutments and on 2 acid-etched healing abutments. The samples were characterized by scanning electron microscopy coupled with energy dispersive x-ray spectroscopy. The analyses were performed at different steps: (1) as received, right after opening the abutment packaging; (2) after 20 minutes air exposure; (3) after aging in artificial saliva; (4) after glycine or sodium bicarbonate powder air polishing for 5 seconds; (5) after repetition of steps 3 and 4 with longer time of polishing (20 seconds). Air polishing using glycine and sodium bicarbonate powder seemed to be safe for professional oral hygiene of titanium dental implants, although acid-etched abutments and abutments treated with bicarbonate harbored more salts. This might indicate a greater plaque accumulation in a clinical situation. However, this result has to be investigated in vivo to understand its clinical relevance.

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.

The Effect of AcceleDent® Device on Both Gingival Health Condition and Levels of Salivary Interleukin-1-βEta and Tumor Necrosis Factors-Alpha in Patients under Fixed Orthodontic Treatment

Traditional orthodontic treatment takes a long time and this may lead to several disadvantages like higher predisposition to periodontal diseases and dental caries. Recently, many researchers focus on shorter orthodontic treatment time through different methods like the use of: vibration, surgical approach, adjunctive medicine, laser and others. This study aimed to determine the effect of Acceledent vibration device on the gingival health condition and the changes in levels of salivary IL-1β and TNF- α among patients under fixed orthodontic appliance during orthodontic treatment. Material and Methods: A total of 32 adult patients with an age ranged between 19-23 years were participated in this study. They were divided into two groups: 14 patients under fixed orthodontic appliance with the use of Acceledent vibration device as study group and 18 patients under fixed orthodontic appliance only as control group. All patients were with Class I and /or Class II malocclusion cases requiring bilateral extraction of their maxillary first premolar teeth, underwent a session of professional oral hygiene and received oral hygiene instructions before and during the period of study. The collection of the unstimulated salivary samples from the individuals was performed at different times after placement of the fixed orthodontic appliance; base line (T0), after 1 hour (T1), after one week (T2), after two week (T3). The levels of salivary IL-1β and TNF-α were estimated by using commercially available ELISA kits. Oral cleanliness were determined by using of gingival index (GI) and plaque index (PI). Results: For both study and control groups, results reported that the mean value of salivary IL-1-β (pg/ml) and TNF-α (pg/ml) were highest at T1, followed by T2, then T3 and lowest T0 with highly statistically significant difference (P<0.01).The mean value of both salivary IL-1-β (pg/ml) and TNF-α (pg/ml) among study group were higher than control group at T1, followed by T2, then T3 with statistically significant difference (P<0.05). Among study group only, results of this study recorded a negative direction correlation between both IL-1-β (pg/ml) and TNF-α (pg/ml) and gingivitis at the (T2 and T3) and (T3) with statistically highly significant and significant respectively. Conclusion: The application of Acceledent device play important role in improving the gingival health condition and increasing the levels of salivary IL-1β and TNF-α secretion among patients under fixed orthodontic appliance in comparison to other under fixed orthodontic appliance.

Dental care protocol based on visual supports for children with autism spectrum disorders.

BackgroundSubjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments.Material and Methods83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in order to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and, if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a psychologist (stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender, intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate.ResultsSeventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44 subjects who need restorative treatments, only three refused it. The acceptance rate at each stage was statistically significant associated to the verbal fluency (p=0.02; p=0.04; p=0.01, respectively for stage 1, 3 and 4). In stage 2 all subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically associated to the acceptance rate (p<0.01).ConclusionsThe use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used as the first strategy to treat patients with ASDs in dental setting. Key words:Autism spectrum disorders, behaviour management, paediatric dentistry, visual learning methods.

Long-term Management of a Gingival Fibromatosis Patient with the Primary Dentition

Gingival fibromatosis is a rare oral condition that is characterized by proliferative fibrous overgrowth of the attached gingiva, the marginal gingiva, and the interdental papilla, typically presenting in the growth period. A case of a 27-month-old girl with a generalized severe gingival overgrowth is described herein. The patient had no known systemic disease, but enlarged gingival tissue had gradually covered her teeth. The excess gingival tissue was removed by conventional gingivectomy, which involved extraction of the retentive primary teeth under general anesthesia when she was 5 years old. Post surgical follow-up at 18 months after the surgery demonstrated no recurrence. Resectional surgery of the enlarged gingival tissue is the treatment choice for gingival fibromatosis, although there is a high risk of recurrence. More frequent professional follow-ups and oral hygiene instruction might be required. A delay in the surgical treatment may have significant consequences for the patient, such as primary dentition retention and consequent delay in the eruption of the permanent teeth, difficulties in mastication and phonation, malpositioning of the teeth, and psychological problems. Early surgical treatment should be performed according to the severity of enlargement.

Topical Tacrolimus and Periodontal Therapy in the Management of a Case of Oral Chronic GVHD Characterized by Specific Gingival Localization

Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

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.

Implant Tooth‐Supported Removable Partial Denture with at Least 15‐Year Long‐Term Follow‐Up

The aim of the present report is to describe the long-term follow-up of cases treated with implant tooth-supported removable partial denture (ITSRPD) after at least 15 years. The study sample comprised 20 consecutively partially edentulous patients treated with ITSRPD. Implants were placed in order to improve unfavorable removable partial denture design resulting from unfavorable teeth distribution and biomechanical considerations, esthetic, or periodontal challenges. All patients were followed up every 6 months for the first 2 years and annually thereafter for at least 15 years. Recall visits for professional cleaning and oral hygiene re-enforcement were scheduled every 3 to 6 mounts. A total of 42 implants were placed in 20 patients and restored with ITSRPD. All implants and prosthetic devices functioned successfully throughout the 15 years of follow-up. Three patients had gone through further implant placement several years after ITSRPD was provided, and a fixed implant-supported restoration was provided on the original and new implants. No implant failure was noted during follow-up, resulting in a rate for implant survival of 100% for the study. Marginal bone loss around implants ranged between 0 and 2 mm (mean 0.64 ± 0.6 mm). During the follow-up period, prosthetic complications were minor and included one rest rupture. All patients answered a questionnaire and were satisfied with the prosthesis. They reported good chewing ability and stability of the prosthetic devices. ITSRPD can be used with predictable long-term results in carefully selected and well-maintained population. Patients should be advised of their role in maintenance, and a comprehensive recall system is mandatory to obtain satisfactory long-term results.

Evaluation of a Hydrophilic Gingival Dental Sealant in Beagle Dogs

A liquid solution, gingival sealant containing polymers that form a barrier film upon application was evaluated in dogs. It is a non-toxic, low viscosity, hydrophilic barrier sealant that dries in approximately 10 to 15-seconds after subgingival application. It was designed as a preventative to be applied immediately following a professional oral hygiene procedure in order to block plaque and calculus formation in the sulcus and aid in the prevention of periodontal disease in companion animals. Additionally, the polymer was designed to promote an aerobic environment in the sulcus by oxygen and water transport through engineered pores within the polymer. A 30-day split-mouth, blinded study in two groups of 15 beagle dogs was used. Plaque was significantly (p < 0.05) reduced on the side receiving the sealant by 30.0% and 50.5% (average = 40.3%) in groups 1 and 2, respectively. Calculus was significantly (p < 0.05) reduced on the side receiving the sealant by 27.2% and 20.0% (average = 23.6%) in groups 1 and 2, respectively. Gingival inflammation was monitored to assess product safety. Sides receiving sealant showed no statistically significant differences in gingival index score. No adverse events were observed in the study. This study demonstrates that this gingival sealant can be used as another valuable tool for aiding in the prevention of periodontal disease in dogs.

Influence of Cervitec gel on periodontal health of patients wearing fixed orthodontic appliances

Background/purposeThis double-blinded randomized placebo-controlled study aimed to evaluate the efficacy of 0.2% chlorhexidine containing Cervitec gel on periodontal health during orthodontic treatment. Materials and methodsTwenty-five patients undergoing fixed orthodontic treatment were randomly assigned to the Cervitec (n = 13) or control (n = 12) groups. After clinical examination at first visit, all patients received professional prophylaxis, and 2 weeks later baseline (B) evaluations are performed. Later, oral hygiene procedures were refrained for 3 days until Day 0, during which the participants in the Cervitec group were instructed to brush with standard toothpaste (ST) (1 × 1) and Cervitec (1 × 1), whereas the control group received placebo (1 × 1) until Day 14. Between Day 14 and Day 28, patients returned to brushing with ST (2 × 1). The clinical measurements were recorded and subgingival plaque samples were collected at first visit, B, Day 0, Day 14, and Day 28. Subgingival plaque samples were analyzed for total bacteria, Porphyromonas gingivalis (P.g.), and Treponema denticola (T.d.) using real-time polymerase chain reaction. The data were statistically analyzed. ResultsAfter receiving professional prophylaxis and oral hygiene instructions, remarkable improvements was seen in clinical and microbiological variables of the study. Although there was a significant reduction in the Quigley–Hein Plaque Index (mQHI) score at Day 14 in only the Cervitec group (P < 0.01), both the Cervitec group and the control group revealed significant reductions in the mQHI score at Day 28 compared with Day 0 (P < 0.001 and P < 0.01, respectively). Intragroup and intergroup evaluations revealed no statistically significant alterations for P.g. and T.d. ConclusionThe present data suggested that brushing with Cervitec gel once a day has the potential to reduce bacterial accumulation around teeth and fixed appliances in patients undergoing orthodontic treatment. However, within the limits of this study, Cervitec seems to have no significant effect on total bacteria, P.g., and T.d. levels of subgingival dental plaque.

Use of Oral Chroma™ in the Assessment of Volatile Sulfur Compounds in Patients with Fixed Prostheses

Prosthetic rehabilitation improves the patient's quality of life and oral health. The purpose of the present study was to assess the production of volatile sulfur compounds (VSCs) using Oral Chroma™ in patients wearing provisional and permanent fixed prosthesis, who were treated or not, with supportive non-surgical periodontal therapy. A total of 10 healthy patients not affected by periodontal disease and who needed the restoration of at least two edentulous single sites were included in the present study. Registrations of VSCs were carried out with a Gas Chromatograph OralChroma™ (Oral Chroma™, Abimedical, Abilit Corp., Osaka, Japan) one month after placement of the provisional restoration (group 1) and one month after placement of the final restoration (group 3). After each measurement, professional oral hygiene was carried out both on patients with provisional (group 2) and permanent prostheses (group 4) and VSC values were registered. The results showed that there were no statistical significant differences in the VSC quantity between groups with temporary or permanent prostheses. Meanwhile, statistically significant differences were found in VCS values between groups before and after the professional health care session (p less than 0.05). Also it was observed that dimethyl sulphide (CH3)2S was present in all the study groups. The present preliminary study suggests that OralChroma™ produce a comprehensive assessment of VSC in the clinical diagnosis of halitosis and that professional oral hygiene seems to influence VSC production. However, further clinical long-term studies with a larger sample size are necessary for a better understanding of halitosis manifestation in patients wearing provisional and permanent fixed prosthesis.

Effect of orthodontic tooth movement on salivary levels of Interleukin-1beta, Tumor Necrosis Factor-alpha, and C- reactive protein

Orthodontic force is considered to stimulate cells in the periodontium to release many mediators such as cytokines which play a responsible role for periodontal and alveolar bone remodeling, bone resorption and new bone deposition. Aim of this study was carried out to estimate changes of the (interleukin-one beta, tumor necrosis factor - alpha and C-reactive protein) levels in unstimulated whole saliva during the leveling stage of orthodontic tooth movement. Materials and methods: The sample consisted of thirty adult patients (12 males and 18 females) with ages ranges (19- 23) years. Each sample had Class I and Class II malocclusion dental classification and required bilateral extraction of their maxillary first premolars, underwent a session of professional oral hygiene and received oral hygiene instructions before and during the period of study, one month later fixed orthodontic appliance were placed in the upper arch by using 0.014 nickel titanium arch wire. The unstimulated whole saliva was taken from each sample immediately before placement of the appliance (baseline), and at (after1hour, after one week and after two week) following placement of the fixed orthodontic appliance. In addition the plaque index and gingival index were recorded during the interval periods of this study to assess oral cleanliness. The interleukin - one beta and tumor necrosis factor- alpha were determined by enzyme linked immunosorbent assay, while the C-reactive protein was determined by latex agglutination. Results: The results of the present study found the mean value of both salivary (interleukin-one beta and tumor necrosis factor -alpha) were highest at (after1hour) followed by at (after one week) then at (after two week) than the baseline with highly statistical significant differences (P 0.05). While the mean values of C-reactive protein were higher at (after 1hour) only with highly significant differences (P< 0.01) among females and total samples while only significant difference (P<0.05) for males, in addition there were no statistical significant differences between males and females. Regarding the correlation between salivary (interleukin - one beta and tumor necrosis factor -alpha), there were positive correlation between them at all periods of study. Moreover there were positive correlation between salivary (interleukin - one beta and tumor necrosis factor -alpha) and salivary C- reactive protein. On the other hand there were no association between the salivary (interleukin - one beta and tumor necrosis factor -alpha and C-reactive protein) and clinical parameter (plaque index and gingival index). Conclusion: From this clinical study we conclude that orthodontic force induces increasing the levels of (interleukin - one beta, tumor necrosis factor -alpha, C-reactive protein) in unstimulated whole saliva during orthodontic tooth

Regular Use of Antimicrobial Mouthrinses Can Effectively Augment the Benefits of Oral Prophylaxis and Oral Hygiene Instructions at 6-Month Recall Intervals in Reducing the Occurrence of Dental Plaque and Gingivitis

Clinical efficacy of antimicrobial mouthrinses. Gunsolley JC. J Dent 2010;38(Suppl):S6-10. Philip A. Swango, DDS, MPH, Diplomate ABDPH Are antimicrobial oral rinses clinically beneficial in reducing the occurrence of dental plaque and gingivitis, and how do benefits after 6 months of use compare with those obtained from professional dental prophylaxis and oral hygiene instructions? Johnson & Johnson provided an honorarium to the author (J.C.G.) to conduct the review Systematic review Level 1: Good quality patient-oriented evidence Grade A: Consistent good quality patient-oriented evidence

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.

A prospective clinical trial for assessing the efficacy of a minimally invasive protocol in patients with bisphosphonate-associated osteonecrosis of the jaws

The objective of this study was to assess whether a minimally invasive protocol can be effective in the long-term control of necrotic areas and pain in patients suffering osteonecrosis of the jaw associated with the use of bisphosphonate drugs (BRONJ). Thirty-four consecutive patients (14 male, 20 female) with BRONJ under treatment with zoledronate, pamidronate, or alendronate were enrolled. All of the patients received professional oral hygiene treatment and antiseptic oral rinses, and if in pain they assumed an antibiotic therapy with amoxicillin/clavulanate potassium and metronidazole for ten days. At the baseline visit, as well as at each 3-month recall, the size of the osteonecrotic lesions were measured and the pain level assessed with a visual analog scale. The results from the general linear model showed a statistically significant (F = 16.1; P < .01; r(2) = 0.95) time-related decrease in the size of exposed bone areas during the nonsurgical therapy (from 12.5 ± 12.0 mm to 8.8 ± 10.3 mm). This conservative protocol seems to provide successful treatment in the vast majority of patients.

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.

Halitosis and oral health‐related quality of life: a case report

This is a clinical case of a 36-year-old Dutch male, patient in the Dr. S. van Mesdag Forensic Psychiatric Centre in Groningen. It demonstrates a short-time effect of a tailored oral hygiene self-care intervention in three sessions over a period of 3 months on halitosis and a patient's oral health-related quality of life (OH-QoL). In addition to a dental screening and professional oral hygiene care, a semi-structured interview was conducted by the dental hygienist, and questionnaires were administered. The questionnaires included were; the Dutch version of the Oral Health Impact Profile-14 (OHIP-14-NL; used as a measurement of OH-QoL), scales for expected social outcomes for having healthy teeth, attitudes towards oral hygiene behaviour (OHB) and dental anxiety. Clinical observations showed an improvement in patient's OHB, while the extreme foetor-ex-ore was reduced to an acceptable level. A retrospective assessment showed that patient's attitude towards the recommended OHB together with his self-perceived OH-QoL had positively increased. This case highlights the value of professional individual oral hygiene instructions performed by a dental hygienist. It also illustrates that a patient's effective OHB may play an important role in the reduction in halitosis and self-perceived OH-QoL. Finally, the retrospective version of the OHIP-14-NL may be an adequate method to assess self-perceived OH-QoL within a relative short period of time.

Clinical evaluation of an implant maintenance protocol for the prevention of peri-implant diseases in patients treated with immediately loaded full-arch rehabilitations

The aim of this prospective study was to assess the outcomes of an implant maintenance protocol for implants supporting a full-arch rehabilitation. Sixty-one patients (28 women and 33 men) treated with immediately loaded full-arch rehabilitation, both mandibular and maxillary, supported by a combination of two tilted and two axial implants, were included in the study. Patients were scheduled for follow-up visits every 6 months for +2 years, then yearly up to 4 years. Each patient received professional oral hygiene treatment and detailed oral hygiene instructions. During each visit, modified plaque index, bleeding index and probing depth were assessed. The presence of peri-implant tissue inflammation was also evaluated. Mean observation time, considering both mandible and maxilla, was 18.3 months ranging from 6 months to 5 years. Both plaque and bleeding indexes frequency decreased over time. Probing depth was stable (2.46 ± 0.5 mm at 4 years). Only three implants were lost due to peri-implantitis (1.4% at 12 months), whereas the incidence of peri-implant mucositis was less than 10% in each considered period. The adoption of a systematic hygienic protocol is effective in keeping low the incidence of peri-implant mucositis as well as in controlling plaque accumulation and clinical attachment loss.

Effects of mucosal care on oral pathogens in professional oral hygiene to the elderly

To elucidate the effects of mucosal care on colonization of mutans streptococci and infection of Candida species, we randomized 50 functionally dependent nursing home residents, mean age 76.1 (±7.8 years), 76% females, to receive oral professional care with or without mucosal care. During 12 months of follow-up, significant reduction in the numbers of mutans streptococci in saliva and dental plaque samples were observed in both treatment groups. However, there was no reduction in the numbers of mutans streptococci in tongue samples in the non-mucosal group ( p = 0.150). In the comparison between the treatment with and without mucosal care, the treatment with mucosal care showed a significant inhibition effects on numbers of nutans streptococci on the tongue surface at 6 months after the treatment as compared with the treatment without mucosal care ( p = 0.043). Mucosal care was not associated with any significant reduction in the rate of opportunistic infection with Candida species in any of the three sites. However, more subjects without mucosal care had Candida infection in dental plaque during the follow-up ( p = 0.046). Professional dental care with (versus without) mucosal care had no effect on mutans streptococci colonization in saliva or plaque. Lack of mucosal care seemed to be associated with higher rates opportunistic infections with Candida species.