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Park SH, Cho SH, Han JY. Effective professional intraoral tooth brushing instruction using the modified plaque score: a randomized clinical trial. J Periodontal Implant Sci 2018. [PMID: 29535888 PMCID: PMC5841264 DOI: 10.5051/jpis.2018.48.1.22] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods A total of 116 patients were included in this study. After evaluation of the Löe and Silness gingival index (GI), Silness and Löe plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. Results After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was 2.76±0.71 times longer than that for MPS measurement after 2 weeks of training. Conclusions MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health.
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Affiliation(s)
- Se-Ho Park
- Department of Dentistry and Periodontology, Hanyang University College of Medicine, Seoul, Korea
| | - Sung-Hee Cho
- Department of Dentistry and Periodontology, Hanyang University College of Medicine, Seoul, Korea
| | - Ji-Young Han
- Department of Dentistry and Periodontology, Hanyang University College of Medicine, Seoul, Korea
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Sparabombe S, Roncati M, Monterubbianesi R, Catellani A, Manzoli L, Bambini F, Procaccini M, Putignano A, Orsini G. Assessment of antiplaque effectiveness of chlorhexidine-soaked gauze compared to chlorhexidine mouth rinse: Randomized clinical trial. JOURNAL OF INVESTIGATIVE AND CLINICAL DENTISTRY 2018; 9:e12328. [PMID: 29453785 DOI: 10.1111/jicd.12328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/24/2017] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present study was to compare the efficacy of a disposable gauze soaked with chlorhexidine and rolled up on the finger vs chlorhexidine mouth rinse (CM) to maintain oral hygiene. METHODS In this single-blind, randomized trial, both groups were instructed to brush their teeth and use the 0.12% chlorhexidine intervention twice per day (experimental group: toothbrushing + chlorhexidine-soaked gauze; control group: toothbrushing + mouth rinse). The main outcome was the change in full mouth plaque index scores from baseline to 2 weeks. Secondary outcomes were the patient's appreciation (visual analog scale) and the bleeding index. RESULTS The final sample consisted of 60 young patients: 31 in the experimental group and 29 in the control group. After 2 weeks, both interventions were effective in reducing plaque index. The percentage of score reduction was 33% in the experimental group and 30% for the controls, with no significant difference between groups. Both interventions reduced the bleeding index, but this reduction was significant only in the experimental group (P < .001). CONCLUSIONS There is no difference between chlorhexidine-soaked gauze and CM regarding plaque control. In addition, gauze soaked with chlorhexidine was significantly more effective in reducing the bleeding index score and was appreciated by the patients.
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Affiliation(s)
- Scilla Sparabombe
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Marisa Roncati
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Alberto Catellani
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Lamberto Manzoli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fabrizio Bambini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Maurizio Procaccini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Ancona, Italy
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Arweiler NB, Auschill TM, Sculean A. Patient self-care of periodontal pocket infections. Periodontol 2000 2017; 76:164-179. [DOI: 10.1111/prd.12152] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2016] [Indexed: 01/22/2023]
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Schmalz G, Kiehl K, Schmickler J, Rinke S, Schmidt J, Krause F, Haak R, Ziebolz D. No difference between manual and different power toothbrushes with and without specific instructions in young, oral healthy adults—results of a randomized clinical trial. Clin Oral Investig 2017; 22:1147-1155. [DOI: 10.1007/s00784-017-2200-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 09/04/2017] [Indexed: 11/30/2022]
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Vernon LT, Da Silva APB, Seacat JD. In Defense of Flossing: Part II-Can We Agree It's Premature to Claim Flossing Is Ineffective to Help Prevent Periodontal Diseases? J Evid Based Dent Pract 2017; 17:149-158. [PMID: 28865811 DOI: 10.1016/j.jebdp.2017.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/16/2017] [Accepted: 06/17/2017] [Indexed: 01/14/2023]
Abstract
Periodontal diseases are complex, multifactorial disorders. Effective daily plaque control promotes gingival/periodontal health. Recent meta-analyses and other reviews have found inconclusive evidence to support that tooth flossing promotes gingival/periodontal health. Ideally, the claim should have been that, "at present, we do not have high-quality evidence from well-designed randomized clinical trials to determine whether flossing lowers the risk for periodontal diseases." Rather than "not proven to be effective," the lay public may now think that flossing is "almost entirely unhelpful and/or unnecessary." How does the dental community communicate the nuances of this topic? Herein, we examine the key structural issues underlying this area of research. We assert that effective flossing between specific teeth can promote gingival/periodontal health. Furthermore, we explore the nuances for whom this may be true and untrue, why our evidence is lacking, and what can be done to clarify the effectiveness of flossing on clinical outcomes.
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Affiliation(s)
- Lance T Vernon
- Department of Pediatric Dentistry and Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA.
| | - Andre Paes B Da Silva
- Department of Periodontology, Case Western Reserve University School of Dental Medicine, Cleveland, OH, USA
| | - Jason D Seacat
- Department of Psychology, Western New England University, Springfield, MA, USA
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Sälzer S, Alkilzy M, Slot DE, Dörfer CE, Schmoeckel J, Splieth CH. Socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level. J Clin Periodontol 2017; 44 Suppl 18:S106-S115. [DOI: 10.1111/jcpe.12673] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Mohammad Alkilzy
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Julian Schmoeckel
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Christian H. Splieth
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
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Validity of a New Kit Measuring Salivary Lactate Dehydrogenase Level for Screening Gingivitis. DISEASE MARKERS 2017; 2017:9547956. [PMID: 28337048 PMCID: PMC5346391 DOI: 10.1155/2017/9547956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 01/27/2023]
Abstract
Aim. The aim of this study was to determine the usefulness of a new kit that can evaluate salivary lactate dehydrogenase (LD) level in real time for screening gingivitis. Materials and Methods. The study included 70 systemic healthy volunteers [29 males and 41 females; mean age ± SD: 24.1 ± 2.6 years]. Resting saliva was collected from each participant and LD level was evaluated in real time using the kit (a color-changing sheet with an integer scale ranging from 1 to 10). A dentist measured probing pocket depth, clinical attachment level, and the proportion of sites with bleeding on probing (% BOP) at six sites on all teeth. Gingivitis was diagnosed when the BOP value was ≥20%. Results. Salivary LD level was positively correlated with mean % BOP (odds ratio: 1.47, 95% confidence interval: 1.132–1.916, and P < 0.001) in a logistic regression model. The sensitivity and specificity of the kit were 0.89 and 0.98, respectively, at a cut-off value of 8.0 for LD level. Conclusions. The new kit for measurement of salivary LD level may be a useful tool to screen for gingivitis in young adults, which contributes to early detection of future periodontitis.
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108
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Bizhang M, Schmidt I, Chun YHP, Arnold WH, Zimmer S. Toothbrush abrasivity in a long-term simulation on human dentin depends on brushing mode and bristle arrangement. PLoS One 2017; 12:e0172060. [PMID: 28222156 PMCID: PMC5319671 DOI: 10.1371/journal.pone.0172060] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/09/2017] [Indexed: 11/18/2022] Open
Abstract
Objective The aim of this study was to evaluate the susceptibility of dentin to brushing abrasion using four different toothbrushes (rotating-oscillating, sonic and two types of manual toothbrushes) with the same brushing forces. Methods Dentin samples (n = 72) were selected from 72 impacted third molars. Half of the surface of dentin samples was covered with an adhesive tape, creating a protected and a freely exposed area in the same specimen. Brushing was performed with either a: sonic (Sonicare PowerUp, Philips GmbH, Hamburg, Germany), b: oscillating-rotating (Oral B Vitality Precisions Clean, Procter & Gamble, Schwalbach am Taunus, Germany) or two different manual toothbrushes c: flat trim brush head toothbrush (Dr. Best: Original, Glaxo-Smith-Kline, Bühl, Germany) and d: rippled-shaped brush head toothbrush (Blend-a-Dent, Complete V-Interdental, Blend-a-med, Schwalbach, Germany) in a custom made automatic brushing machine. The brushing force was set to 2 N and a whitening toothpaste (RDA = 150) was used. The simulation period was performed over a calculated period to mimic a brushing behavior of two times a day brushing for eight years and six months. Dentin loss was quantitatively determined by profilometry and statistically analyzed by Wilcoxon and Mann-Whitney-U Test (p < 0.05). Results The mean (standard deviation) surface loss was 21.03 (±1.26) μm for the sonic toothbrush, 15.71 (±0.85) μm for the oscillating-rotating toothbrush, 6.13 (±1.24) μm for the manual toothbrush with flat trim brush head and 2.50 (±0.43) μm for the manual toothbrush with rippled-shaped brush head. Differences between all groups were statistically significant at p<0.05. Conclusion Using the same brushing force and a highly abrasive toothpaste, manual toothbrushes are significantly less abrasive compared to power toothbrushes for an 8.5—year simulation.
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Affiliation(s)
- Mozhgan Bizhang
- Faculty of Health, School of Dentistry, Department of Operative and Preventive Dentistry, Witten/Herdecke University, Witten, Germany
- * E-mail:
| | - Ilka Schmidt
- Faculty of Health, School of Dentistry, Department of Operative and Preventive Dentistry, Witten/Herdecke University, Witten, Germany
| | - Yong-Hee Patricia Chun
- Department of Periodontics, Department of Cellular Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Wolfgang H. Arnold
- Department of Biological and Material Sciences in Dentistry, Witten/Herdecke University, Witten, Germany
| | - Stefan Zimmer
- Faculty of Health, School of Dentistry, Department of Operative and Preventive Dentistry, Witten/Herdecke University, Witten, Germany
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109
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Hoogteijling FCR, Hennequin-Hoenderdos NL, Van der Weijden GA, Slot DE. The effect of tapered toothbrush filaments compared to end-rounded filaments on dental plaque, gingivitis and gingival abrasion: a systematic review and meta-analysis. Int J Dent Hyg 2017; 16:3-12. [DOI: 10.1111/idh.12272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - NL Hennequin-Hoenderdos
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - GA Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
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Han K, Park JB. Association between oral health behavior and periodontal disease among Korean adults: The Korea national health and nutrition examination survey. Medicine (Baltimore) 2017; 96:e6176. [PMID: 28207558 PMCID: PMC5319547 DOI: 10.1097/md.0000000000006176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study was performed to assess the association between oral health behavior and periodontal disease using nationally representative data.This study involved a cross-sectional analysis and multivariable logistic regression analysis models using the data from the Korean National Health and Nutrition Examination Survey. A community periodontal index greater than or equal to code 3 was used to define periodontal disease.Adjusted odds ratios and their 95% confidence intervals of periodontitis for the toothbrushing after lunch group and the toothbrushing before bedtime group were 0.842 (0.758, 0.936) and 0.814 (0.728, 0.911), respectively, after adjustments for age, sex, body mass index, drinking, exercise, education, income, white blood cell count, and metabolic syndrome. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the floss group and the powered toothbrush group after adjustment were 0.678 (0.588, 0.781) and 0.771 (0.610, 0.974), respectively.The association between oral health behavior and periodontitis was proven by multiple logistic regression analyses after adjusting for confounding factors among Korean adults. Brushing after lunch and before bedtime as well as the use of floss and a powered toothbrush may be considered independent risk indicators of periodontal disease among Korean adults.
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Affiliation(s)
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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111
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Valkenburg C, Slot DE, Bakker EWP, Van der Weijden FA. Does dentifrice use help to remove plaque? A systematic review. J Clin Periodontol 2016; 43:1050-1058. [PMID: 27513809 DOI: 10.1111/jcpe.12615] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 11/30/2022]
Abstract
AIMS The aim of this systematic review was to establish the efficacy of brushing with and without a dentifrice for dental plaque removal. MATERIALS AND METHODS MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched. The inclusion criteria were randomized controlled trials and controlled clinical trials and subjects ≥18 years of age with good general health. Studies that evaluated the effect of toothbrushing with a dentifrice compared to brushing without a dentifrice were included. Data were extracted from the eligible studies, and a meta-analysis was performed where feasible. RESULT The search was conducted until June 2016 and retrieved 10 eligible publications that included 20 comparisons. On average, 49.2% of plaque was removed when brushing was performed with a dentifrice, and 50.3% of plaque was removed when toothbrushing was performed without a dentifrice. The descriptive analysis indicated that the majority of the comparisons did not show an additional effect of dentifrice use. Regarding the meta-analysis of post-brushing scores, no significant difference was observed between toothbrushing with and without a dentifrice (DiffM 0.00, 95%CI [-0.05: 0.05], p = 0.91). The meta-analysis of incremental data (as means or percentages) supported and strengthened these findings. CONCLUSION The cumulative evidence for this systematic review demonstrates that there is moderate certainty that toothbrushing with a dentifrice does not provide an added effect for the mechanical removal of dental plaque.
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Affiliation(s)
| | - Dagmar E Slot
- Department of Periodontology Academic Centre for Dentistry, Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eric W P Bakker
- Division of Clinical Methods and Public Health, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Fridus A Van der Weijden
- Department of Periodontology Academic Centre for Dentistry, Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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112
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Acunzo R, Limiroli E, Pagni G, Dudaite A, Consonni D, Rasperini G. Gingival Margin Stability After Mucogingival Plastic Surgery. The Effect of Manual Versus Powered Toothbrushing: A Randomized Clinical Trial. J Periodontol 2016; 87:1186-94. [PMID: 27677810 DOI: 10.1902/jop.2016.150528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Oscillating-rotating power toothbrushes have been proven to be clinically efficacious. To the best of the authors' knowledge, a clinical evaluation of the safety of these toothbrushes after surgical root coverage procedures has not been published. The aim of this study is to evaluate the gingival margin (GM) stability with the use of an oscillating-rotating toothbrush compared with a manual toothbrush. METHODS Sixty healthy individuals with at least one Miller Class I or II gingival recession underwent a surgical root coverage procedure. Soft-bristle manual and powered toothbrushes were given to participants randomly assigned to control and test groups, respectively. Full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depth (PD), and recession depth (RD) were recorded at baseline and 1, 3, and 6 months after completion of the surgical procedure. Data analyses were performed using linear random-intercept models to take into account within-participant correlations over time. Temporal trend differences across treatments by including treatment-time interaction terms were then tested using a global Wald test. RESULTS Use of a powered toothbrush resulted in a significantly greater reduction of recorded periodontal clinical indices compared with a manual device (FMPS, P = 0.05; FMBS, P = 0.005; RD, P = 0.004). No significant differences were noticed between the two experimental groups both for PD (P = 0.03) and clinical attachment level (P = 0.11). Complete root coverage was significantly higher in participants who used the powered toothbrush compared with the manual toothbrush at 6 months (control, 66.67%; test, 96.67%; P = 0.002). CONCLUSION Use of an oscillating-rotating powered toothbrush with a soft-bristle head resulted in higher GM stability after root coverage procedures compared with the use of a manual soft-bristled toothbrush.
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Affiliation(s)
- Raffaele Acunzo
- Department of Biomedical, Surgical, and Dental Sciences; University of Milan; Milan, Italy.,Foundation Institute for Inpatient Treatment and Scientific Studies (IRCCS) Ca' Granda Policlinic, Milan, Italy
| | - Enrico Limiroli
- Department of Biomedical, Surgical, and Dental Sciences; University of Milan; Milan, Italy.,Foundation Institute for Inpatient Treatment and Scientific Studies (IRCCS) Ca' Granda Policlinic, Milan, Italy
| | - Giorgio Pagni
- Department of Biomedical, Surgical, and Dental Sciences; University of Milan; Milan, Italy.,Foundation Institute for Inpatient Treatment and Scientific Studies (IRCCS) Ca' Granda Policlinic, Milan, Italy
| | - Adele Dudaite
- Department of Periodontology, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Dario Consonni
- Foundation Institute for Inpatient Treatment and Scientific Studies (IRCCS) Ca' Granda Policlinic, Milan, Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical, and Dental Sciences; University of Milan; Milan, Italy.,Foundation Institute for Inpatient Treatment and Scientific Studies (IRCCS) Ca' Granda Policlinic, Milan, Italy
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Chapple ILC, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, Madianos P, Louropoulou A, Machtei E, Donos N, Greenwell H, Van Winkelhoff AJ, Eren Kuru B, Arweiler N, Teughels W, Aimetti M, Molina A, Montero E, Graziani F. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol 2016; 42 Suppl 16:S71-6. [PMID: 25639826 DOI: 10.1111/jcpe.12366] [Citation(s) in RCA: 334] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2014] [Indexed: 11/28/2022]
Abstract
UNLABELLED Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis. AIM The aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches. METHODS Two meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus. RESULTS Data support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.
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Affiliation(s)
- Iain L C Chapple
- Periodontal Research Group & MRC Centre for Immune Regulation Birmingham Dental School, Birmingham, UK
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114
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Rodríguez NI, Moral J. Design and content validation of the Oral Hygiene Habits Scale. JOURNAL OF ORAL RESEARCH 2016. [DOI: 10.17126/joralres.2016.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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115
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Effect of mouthwashes on the composition and metabolic activity of oral biofilms grown in vitro. Clin Oral Investig 2016; 21:1221-1230. [PMID: 27337976 PMCID: PMC5399055 DOI: 10.1007/s00784-016-1876-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 06/06/2016] [Indexed: 11/26/2022]
Abstract
Objective The aim of this study was to determine the effect of an oxygenating mouthwash compared to two other established mouthwash products on bacterial composition and metabolic activity of oral biofilms in vitro. Material and methods Twelve healthy subjects participated as donors. Plaque-saliva mixture inoculated biofilms were grown and treated with 3 different chemotherapeutic mouthwashes [amine fluoride/stannous fluoride (MD), oxygenating agent (AX), chlorhexidine 0.12 % (PA), and water (W)]. Effects of treatments were assessed on biofilm composition (16S rRNA gene amplicon sequencing), production of organic acids (formate, acetate, lactate, propionate, butyrate using capillary electrophoresis), and viability of the remaining biofilm (CFUs). Results Microbial profiles of biofilms clustered per inoculum donor and were dominated by the genera Veillonella, Streptococcus, and Prevotella. Microbial diversity was only reduced after PA treatment. Significant changes in composition occurred after treatment with AX, resulting in lower proportions of Veillonella and higher proportions of non-mutans streptococci. Production of all organic acids after PA and lactate after MD was significantly lower as compared to W. AX resulted in reduction of acetate, butyrate, and propionate and increase in lactate production (p < 0.05). Viable counts were significantly lower after PA and AX treatments compared to W, while no significant reduction was observed after MD. Conclusions All studied mouthwashes affected the in vitro biofilms differently. The effects of the AX treatment were the most prominent which resulted in changes of the bacterial composition and metabolism. Clinical implications Awareness by the dental team that mouthwashes can change the bacterial composition and metabolism is important when advising its use.
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116
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Dörfer CE, Staehle HJ, Wolff D. Three-year randomized study of manual and power toothbrush effects on pre-existing gingival recession. J Clin Periodontol 2016; 43:512-9. [PMID: 26810391 PMCID: PMC5084749 DOI: 10.1111/jcpe.12518] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 11/30/2022]
Abstract
AIM To compare long-term effects of brushing with an oscillating-rotating power toothbrush or an ADA reference manual toothbrush on pre-existing gingival recession. MATERIALS AND METHODS In this controlled, prospective, single-blind, parallel-group study, healthy subjects with pre-existing recession were randomized and brushed with a power toothbrush (n = 55) or an ADA reference manual toothbrush (n = 54) for a 3-year study period. Subjects were required to brush their teeth twice daily for 2 min. using a standard fluoride toothpaste. During the study, subjects were assessed for clinical attachment loss and probing pocket depths to the nearest mm at six sites per tooth by the same calibrated examiner. Gingival recession was calculated at pre-existing sites as the difference between clinical attachment loss and probing pocket depths. Hard and soft oral tissues were examined to assess safety. RESULTS After 35 ± 2 months, mean gingival recession did not differ significantly between groups, but was significantly reduced from baseline (p < 0.001), from 2.35 ± 0.35 mm to 1.90 ± 0.58 mm in the power and from 2.26 ± 0.31 mm to 1.81 ± 0.66 mm in the manual group. CONCLUSIONS Gingival recession in subjects with pre-existing recession was significantly reduced after 3 years of brushing with either a power or manual toothbrush.
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Affiliation(s)
- Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Oral Medicine, Christian-Albrechts-University at Kiel, Kiel, Germany
| | - Hans Jörg Staehle
- Department of Conservative Dentistry, Dental School, University of Heidelberg, Heidelberg, Germany
| | - Diana Wolff
- Department of Conservative Dentistry, Dental School, University of Heidelberg, Heidelberg, Germany
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de Freitas GC, Pinto TMP, Grellmann AP, Dutra DAM, Susin C, Kantorski KZ, Moreira CHC. Effect of self-performed mechanical plaque control frequency on gingival inflammation revisited: a randomized clinical trial. J Clin Periodontol 2016; 43:354-8. [DOI: 10.1111/jcpe.12520] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Guilherme Camponogara de Freitas
- Division of Periodontology; Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - Tatiana Militz Perrone Pinto
- Division of Periodontology; Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - Alessandra Pascotini Grellmann
- Division of Periodontology; Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - Danilo Antonio Milbradt Dutra
- Division of Periodontology; Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - Cristiano Susin
- Department of Periodontics; College of Dental Medicine; Georgia Regents University; Augusta GA USA
| | - Karla Zanini Kantorski
- Division of Periodontology; Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Brazil
| | - Carlos Heitor Cunha Moreira
- Division of Periodontology; Department of Stomatology; School of Dentistry; Federal University of Santa Maria; Santa Maria Brazil
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118
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Hennequin-Hoenderdos NL, Slot DE, Van der Sluijs E, Adam R, Grender JM, Van der Weijden GA. The effects of different levels of brush end rounding on gingival abrasion: a double-blind randomized clinical trial. Int J Dent Hyg 2016; 15:335-344. [DOI: 10.1111/idh.12212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- NL Hennequin-Hoenderdos
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - E Van der Sluijs
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
| | - R Adam
- Procter & Gamble Service GmbH; Kronberg Germany
| | | | - GA Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam; Amsterdam and Vrije Universiteit; Amsterdam The Netherlands
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119
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Harnacke D, Stein K, Stein P, Margraf-Stiksrud J, Deinzer R. Training in different brushing techniques in relation to efficacy of oral hygiene in young adults: a randomized controlled trial. J Clin Periodontol 2016; 43:46-52. [PMID: 26660396 DOI: 10.1111/jcpe.12489] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2015] [Indexed: 11/28/2022]
Abstract
AIM This study aims to assess plaque scores after oral hygiene in an unselected sample of young German adults and to compare the effects of computer-based training of the Fones versus the modified Bass technique on these scores. MATERIAL AND METHODS Seventy 18- to 19-year olds received computer-based training of the Fones technique, the modified Bass technique or basic instructions of oral hygiene alone (control group). The marginal plaque index (MPI; percentage of sections adjacent to the gingiva showing plaque) and BOP were assessed at baseline and after 6, 12 and 28 weeks. MPI was assessed immediately after participants had been asked to perform oral hygiene to the best of their abilities. RESULTS At baseline, MPI levels of 83.3% ± 12.5 (mean ± SD) were observed. After 12 weeks, groups differed significantly (p < 0.05) with respect to MPI: Fones group: 70.3% ± 14.7; Bass group: 77.91 ± 14.37; control group: 79.3% ± 9.2. No differences in BOP were found. CONCLUSIONS High plaque levels at gingival margins after oral hygiene were observed in an unselected sample of young German adults. After 12 weeks, plaque levels after oral hygiene were slightly reduced in the group who had received training of the Fones technique but effects trailed off afterwards. The study failed to prove effects of the training on signs of gingival inflammation.
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Affiliation(s)
- Daniela Harnacke
- Institute of Medical Psychology, Justus-Liebig-University, Giessen, Germany
| | - Kathrin Stein
- Institute of Medical Psychology, Justus-Liebig-University, Giessen, Germany
| | - Patrick Stein
- Institute of Medical Psychology, Justus-Liebig-University, Giessen, Germany
| | | | - Renate Deinzer
- Institute of Medical Psychology, Justus-Liebig-University, Giessen, Germany
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Van der Weijden FA, Van der Sluijs E, Ciancio SG, Slot DE. Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control? Dent Clin North Am 2015; 59:799-829. [PMID: 26427569 DOI: 10.1016/j.cden.2015.06.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Also note that structured abstracts are not allowed per journal style: What is the effect of a mouthwash containing various active chemical ingredients on plaque control and managing gingivitis in adults based on evidence gathered from existing systematic reviews? The summarized evidence suggests that mouthwashes containing chlorhexidine(CHX) and essential oils (EO) had a large effect supported by a strong body of evidence. Also there was strong evidence for a moderate effect of cetylpyridinium chloride(CPC). Evidence suggests that a CHX mouthwash is the first choice, the most reliable alternative is EO. No difference between CHX and EO with respect to gingivitis was observed.
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Affiliation(s)
- Fridus A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands.
| | - Eveline Van der Sluijs
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sebastian G Ciancio
- Department of Periodontics and Endodontics, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands
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