1
|
Mitani A, Matsuura T, Aino M, Hayashi JI, Nishida E, Hori M, Kikuchi T. Effectiveness of novel oral hygiene instruction avoiding inattentional blindness using an application for unique plaque control record calculation: A randomized clinical trial. J Periodontal Res 2024; 59:458-467. [PMID: 38186286 DOI: 10.1111/jre.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE This study was performed to estimate the effectiveness of novel oral hygiene instruction (OHI) focusing on areas with deep periodontal pockets for reduction of periodontal inflammation. BACKGROUND DATA DISCUSSING THE PRESENT STATUS OF THE FIELD Because stained areas on the plaque chart do not always correspond to the areas with deep periodontal pockets, conventional OHI based on O'Leary's plaque control record (PCR) often provides guidance inconsistent with the target area. METHODS This randomized clinical trial involved two groups: (1) OHI based on the PCR limited in deep pocket sites (novel OHI group) and (2) OHI based on O'Leary's PCR (conventional OHI group). The unique PCR (aggressive target for PCR [agPCR]; only counting the plaque-stained areas with PD at ≥4 mm sites) for the novel OHI was calculate by dedicated expression program. The probing depth (PD), bleeding on probing (BOP), and periodontal inflamed surface area (PISA) were obtained at the baseline and 5 to 6 months later. RESULTS The approximation curve with PISA before and after instruction indicated that the PISA converged to a lower value after instruction in the novel OHI group. The approximation curve with the improvement rate of the PISA and agPCR showed a positive correlation in the novel OHI group but no correlation in the conventional OHI group. CONCLUSION Control of inflammation was more effective in the novel OHI group. These results suggest that this novel OHI technique using our developed application could be used as a strategy to improve the effectiveness of brushing instruction.
Collapse
Affiliation(s)
- Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Takato Matsuura
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Makoto Aino
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Jun-Ichiro Hayashi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Eisaku Nishida
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Miki Hori
- Department of Dental Materials Science, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Takeshi Kikuchi
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| |
Collapse
|
2
|
D'Elia G, Floris W, Marini L, Corridore D, Rojas MA, Ottolenghi L, Pilloni A. Methods for Evaluating the Effectiveness of Home Oral Hygiene Measures-A Narrative Review of Dental Biofilm Indices. Dent J (Basel) 2023; 11:172. [PMID: 37504238 PMCID: PMC10378657 DOI: 10.3390/dj11070172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/09/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
Dental plaque is a biofilm structured in an extracellular matrix of polymers of host and microbial origin; the microorganisms can coexist in harmony with the host, thus guarantying oral health. Environmental modifications can lead to dysbiosis and onset of oral diseases; in fact, plaque is the etiological agent both of periodontal disease and dental decay. The use of an effective oral hygiene index should be considered as a relevant goal for the clinicians and the researchers, and consequently, numerous plaque indices have been proposed during the years. The present literature review aims primarily to obtain a complete summary of these scores to assess plaque deposits. It is useful because the clinician/researcher will select the right scoring method for the specific situation only if he knows the available options and if he is aware of both their strengths and weaknesses. This review applies a basic classification of plaque indices that distinguishes the ones that use non-quantitative methods from the ones that use quantitative methods. Non-quantitative methods are more subjective because they are based on the ability of the clinician to point out the presence or the entity of deposits, while quantitative methods introduce objectifiable means to measure plaque deposits.
Collapse
Affiliation(s)
- Gerarda D'Elia
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| | - William Floris
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| | - Lorenzo Marini
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| | - Denise Corridore
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| | - Mariana Andrea Rojas
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| | - Livia Ottolenghi
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| | - Andrea Pilloni
- Section of Periodontics, Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, #6 Via Caserta, 00161 Rome, Italy
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Sreenivasan PK, Prasad KV. Distribution of dental plaque and gingivitis within the dental arches. J Int Med Res 2017; 45:1585-1596. [PMID: 28795618 PMCID: PMC5718714 DOI: 10.1177/0300060517705476] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 05/27/2017] [Indexed: 11/21/2022] Open
Abstract
Objective The natural accumulation of supragingival plaque on surfaces of human teeth is associated with gingival inflammation and the initiation of common oral diseases. This study evaluated the distribution of dental plaque and gingivitis scores within the dental arches after prophylaxis. Methods Adult subjects from the Dharwad, India area representing the general population who provided written informed consent were scheduled for screening. Healthy subjects over the age of 18 years, not currently requiring any medical or dental care, and presenting with a complement of at least 20 natural teeth were recruited for this parallel design study. Enrolled subjects (n = 41) underwent oral examinations for dental plaque (PI) and gingivitis (GI) using the Turesky modification of the Quigley-Hein and the Löe-Silness Index, respectively, at the baseline visit, followed by a whole mouth dental prophylaxis. Subjects were given fluoride toothpaste for twice daily oral hygiene for the next 30 days. Subjects were recalled on days 15 and 30 for PI and GI examinations identical to baseline. Results Analyses indicated that mean scores for PI and GI on either arch and the whole mouth were higher than 2 and 1, respectively, during all examinations. Anterior surfaces consistently exhibited lower PI scores than posterior regions of either arch, or the entire dentition. Regional GI differences within the dentition were similar to PI scores, with lower scores on anterior than posterior teeth. Prophylaxis reduced both the frequency and mean scores of both PI and GI, irrespective of arch, with lower scores observed on anterior than posterior regions during all recall visits. Molar and lingual regions consistently exhibited higher PI and GI scores compared with anterior surfaces. At all examinations, mean scores for both plaque and gingivitis were higher on approximal vestibular than mid-vestibular surfaces. Conclusions Differences observed in PI and GI within the dentition have several practical implications: (a) there are advantages of whole mouth assessments for oral health (b) a need for oral hygiene formulations to reduce the larger deposits of dental plaque in the posterior region and resultant gingival inflammation, and
Collapse
Affiliation(s)
| | - Kakarla V.V. Prasad
- Department of Community Dentistry, SDM College of Dental Sciences, Dharwad, India
| |
Collapse
|
5
|
Han SY, Kim BR, Ko HY, Kwon HK, Kim BI. Validity and reliability of autofluorescence-based quantification method of dental plaque. Photodiagnosis Photodyn Ther 2015; 12:587-91. [DOI: 10.1016/j.pdpdt.2015.10.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/10/2015] [Accepted: 10/08/2015] [Indexed: 11/27/2022]
|
6
|
Deinzer R, Jahns S, Harnacke D. Establishment of a new marginal plaque index with high sensitivity for changes in oral hygiene. J Periodontol 2015; 85:1730-8. [PMID: 25079399 DOI: 10.1902/jop.2014.140285] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Although several plaque indices exist, they rarely assess in detail the plaque adjacent to the gingival margin, an area most important for periodontal health. This study aims to develop a new marginal plaque index (MPI) and to assess its validity and treatment sensitivity compared to the internationally accepted Turesky modification of the Quigley and Hein Index (TQHI). METHODS Data from two studies with n = 64 and n = 67 participants, respectively, are reported here. Convergence of MPI with TQHI and concurrent and predictive validity with papillary bleeding index were assessed, as was treatment sensitivity to a treatment of proximal hygiene (study 1) or toothbrushing (study 2), respectively. RESULTS Convergent validity with TQHI is very good. Concurrent and predictive validity parameters of the MPI are similar to the TQHI. The treatment sensitivity of MPI exceeds TQHI by far. This results in a reduction by >70% of the sample size needed to discover significant treatment effects. As expected, the largest treatment sensitivity was observed for proximal MPI measures in study 1, whereas study 2 showed largest effects for cervical measures. CONCLUSIONS MPI appears to be a valid plaque-scoring system that assesses plaque at the gingival margin. It responds with high sensitivity to treatments aimed at plaque reduction at the gingival margin. Its treatment sensitivity and capacity to differentiate between proximal and cervical plaque make it a promising tool for periodontal research.
Collapse
Affiliation(s)
- Renate Deinzer
- Institute of Medical Psychology, Justus Liebig University of Giessen, Giessen, Germany
| | | | | |
Collapse
|
7
|
Raggio DP, Braga MM, Rodrigues JA, Freitas PM, Imparato JCP, Mendes FM. Reliability and discriminatory power of methods for dental plaque quantification. J Appl Oral Sci 2010; 18:186-93. [PMID: 20485931 PMCID: PMC5349756 DOI: 10.1590/s1678-77572010000200014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 09/28/2009] [Indexed: 12/02/2022] Open
Abstract
Objective This in situ study evaluated the discriminatory power and
reliability of methods of dental plaque quantification and the relationship
between visual indices (VI) and fluorescence camera (FC) to detect plaque. Material and Methods Six volunteers used palatal appliances with six bovine enamel blocks presenting
different stages of plaque accumulation. The presence of plaque with and without
disclosing was assessed using VI. Images were obtained with FC and digital camera
in both conditions. The area covered by plaque was assessed. Examinations were
done by two independent examiners. Data were analyzed by Kruskal-Wallis and Kappa
tests to compare different conditions of samples and to assess the inter-examiner
reproducibility. Results Some methods presented adequate reproducibility. The Turesky index and the
assessment of area covered by disclosed plaque in the FC images presented the
highest discriminatory powers. Conclusions The Turesky index and images with FC with disclosing present good reliability and
discriminatory power in quantifying dental plaque.
Collapse
Affiliation(s)
- Daniela Prócida Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | | | | | | | | | | |
Collapse
|
8
|
Tacken MPE, Cosyn J, De Wilde P, Aerts J, Govaerts E, Vannet BV. Glass fibre reinforced versus multistranded bonded orthodontic retainers: a 2 year prospective multi-centre study. Eur J Orthod 2009; 32:117-23. [PMID: 19837746 DOI: 10.1093/ejo/cjp100] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objective of this study was to compare glass fibre reinforced (GFR) with multistranded bonded orthodontic retainers in terms of success rate and periodontal implications. A 2 year parallel study was conducted of 184 patients scheduled to receive bonded retainers in the upper and lower anterior segments. In three centres, the patients (mean age 14 years; 90 males and 94 females) were sequentially assigned to receive GFR retainers containing 500 unidirectional glass fibres (GFR500), 1000 unidirectional glass fibres (GFR1000), or multistranded retainers (gold standard). Retainer failures and periodontal conditions were monitored every 6 months. In a control group of 90 subjects without retainers, periodontal conditions were examined (negative control). Of the 274 recruited patients, 15 dropped out during the 2 year study period. Kaplan-Meier plots were drawn to assess survival of the different retainers. The Mantel-Cox log-rank test was used to identify significant differences in survival functions among the groups. Repeated measures analysis of variance and appropriate post hoc tests were adopted to evaluate periodontal conditions over time. GFR retainers showed unacceptably high failure rates in comparison with multistranded retainers (51 versus 12 per cent). The most significant periodontal conditions were found in patients with GFR retainers with no significant differences between the GFR500 and the GFR1000 group for any parameter at any time point. Subjects without retainers showed significantly lower levels of gingival inflammation and plaque accumulation when compared with patients in any retainer group. Multistranded retainers should remain the gold standard for orthodontic retention, although periodontal complications are common. The use of GFR retainers should be discouraged in daily practice.
Collapse
Affiliation(s)
- Michel P E Tacken
- Department of Orthodontics, Dental Medicine, Free University of Brussels (VUB), Belgium
| | | | | | | | | | | |
Collapse
|
9
|
Aleksejūniene J, Scheie AA, Holst D. Inter-individual variation in the plaque formation rate of young individuals. Int J Dent Hyg 2006; 4:35-40. [PMID: 16451438 DOI: 10.1111/j.1601-5037.2006.00167.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of the present study was to describe the inter-individual variation in the plaque formation rate of 38 young adults. METHODS The plaque formation rate was estimated by employing a quantitative plaque percent index (P% index). A substantial inter-individual variation in the plaque formation rate was observed. The possible contributions of stimulated salivary flow rate, buffer capacity, diet and smoking to the variation in plaque formation were estimated by regression analysis. RESULTS The control variables explained only 2.5% of the variance in the plaque formation rate. Neither associations nor the total model were significant. The present method of measuring plaque presented as a simple and time-effective procedure. CONCLUSIONS It is suggested that the observed variation in the plague formation rate between the young individuals can be regarded as a biological function which is possibly an inherent individual characteristic. Studies with larger sample sizes are required to confirm the findings of the present study.
Collapse
Affiliation(s)
- J Aleksejūniene
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Canada.
| | | | | |
Collapse
|
10
|
Dombret B, Matthijs S, Sabzevar MM. Interexaminer reproducibility of ordinal and interval-scaled plaque indices. J Clin Periodontol 2003; 30:630-5. [PMID: 12834501 DOI: 10.1034/j.1600-051x.2003.00281.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although many plaque scoring indices have been proposed for clinical or research purposes, only few of them are commonly used in the dental literature. Owing to the ordinal nature of these established indices, only nonparametric tests can be performed, while statistical analysts usually prefer parametric methodologies. Furthermore, these indices do not discriminate between the proximal and the broad surfaces of the teeth. AIMS The aim of this study was to assess the interexaminer reproducibility for one established ordinal plaque index and two recently proposed interval-scaled indices. METHOD Six subjects received a professional tooth cleaning and stopped all oral hygiene measures during 48-62 h. Accumulated plaque was disclosed and separately scored on all teeth except third molars by two examiners using the visual plaque index (VPI), the axial plaque extension index (APEI) and the proximal plaque extension index (PPEI). In total, 168 teeth (48 molars, 48 premolars, 24 canines and 48 incisors) were scored. RESULTS Statistically significant differences were found between the means of buccal VPI (p<0.05, Wilcoxon test), mesiobuccal, mesiolingual and distolingual APEI, and distobuccal, mesiolingual and distolingual PPEI (p<0.05, t-test). Spearman correlation values between the duplicate VPI measurements were 0.84 for buccal and 0.64 for lingual VPI, while Pearson correlation values varied between 0.51 and 0.83 for APEI and between 0.48 and 0.74 for PPEI. For VPI, 71% of the buccal (kappa=0.60) and 74% of the lingual (kappa=0.53) scores were identical. For APEI and PPEI scores, a linear regression was found with slopes ranging between 0.50 and 0.80. Mean measurement errors were 7.7% for buccal and 0.4% for lingual VPI, and ranged between 0.9% and 46.1% for APEI and PPEI. CONCLUSION The interexaminer reproducibility of all three indices showed fair to good agreement. Buccal VPI and buccal APEI in particular showed good agreement.
Collapse
Affiliation(s)
- B Dombret
- Free University of Brussels, School of Dental Medicine, Department of Periodontology, Laarbeeklaan 103, B-1090 Brusssels, Belgium
| | | | | |
Collapse
|