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Rius-Bonet O, Roca-Obis P, Zamora-Olave C, Willaert E, Martinez-Gomis J. Diagnostic accuracy of clinical signs to detect erosive tooth wear in its early phase. J Oral Rehabil 2024; 51:861-869. [PMID: 38186266 DOI: 10.1111/joor.13653] [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: 04/17/2023] [Revised: 08/19/2023] [Accepted: 12/28/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Agreement exists about most of the clinical features of erosive tooth wear, though no evidence supports their validity in diagnosing the condition. OBJECTIVE This study aimed to determine the accuracy of clinical signs for diagnosing erosive tooth wear in a young adult general population. METHODS We conducted a cross-sectional study of dental students. In the first session, two examiners independently determined the presence of erosive tooth wear based on glazed enamel surfaces, morphological changes on non-occlusal surfaces, flattening of convex areas, or any type of concavity. In the second session, one examiner recorded the presence of clinical signs according to the Tooth Wear Evaluation System. The diagnostic accuracy of each clinical sign, both alone and combined, was assessed by calculating their sensitivity and specificity for detecting erosive tooth wear and performing multivariate logistic regression models. RESULTS Of the 147 participants (78 women and 69 men; median age, 22 years) we included, 76.2% had erosive tooth wear. The single clinical signs with greatest balance between the sensitivity and specificity were 'convex areas flatten' (63% and 71%, respectively) and 'dull surface' (47% and 89%, respectively). Multivariate logistic regression revealed that 'preservation of the enamel cuff' (odds ratio, 22) and the combination of 'smooth silky shining, silky glazed appearance, and dull surface' (odds ratio, 68) had the best predictive values. CONCLUSIONS The most accurate clinical signs for detecting early erosive tooth wear were dull surface, flattened convex areas and preservation of the enamel cuff.
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Affiliation(s)
- Ona Rius-Bonet
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Paula Roca-Obis
- Department of Oral Medicine, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
| | - Carla Zamora-Olave
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
| | - Eva Willaert
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
| | - Jordi Martinez-Gomis
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Catalonia, Spain
- Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Catalonia, Spain
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Wang W, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Si Y. Epidemiology of plaque-induced gingivitis among 12-15-year-old Chinese schoolchildren: A study based on the 2018 case definition. J Clin Periodontol 2024; 51:299-308. [PMID: 38037239 DOI: 10.1111/jcpe.13904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/11/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
AIM To explore the epidemiology of plaque-induced gingivitis and related factors among Chinese adolescents. MATERIALS AND METHODS This cross-sectional survey comprised 118,601 schoolchildren in the 12-15-year age group. Data came from the National Oral Health Survey in mainland China. The field investigation was conducted according to the World Health Organization guidelines. The new 2018 case definition for plaque-induced gingivitis was used. Participants underwent clinical examinations and completed a structured questionnaire. Bleeding on probing (BOP) was performed on all teeth. Multinomial logistic regression was used to explore the factors related to the extent of gingivitis. RESULTS Nearly half of the study population (47.3%) had plaque-induced gingivitis; 23.9% and 23.3% presented with localised and generalised gingivitis, respectively. The first molars were the most affected by BOP. Well-established factors, such as demographic characteristics, socioeconomic status, local factors and smoking habits, were significantly associated with the extent of gingivitis. Odds ratios for localised and generalised gingivitis increased with the decrease in frequency of toothbrushing with a fluoride dentifrice. CONCLUSIONS The study population had high plaque-induced gingivitis prevalence. The extent of gingivitis appeared to have a dose-response relationship with the frequency of toothbrushing with a fluoride dentifrice.
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Affiliation(s)
- Wenhui Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Xuenan Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Wensheng Rong
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Weijian Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yan Si
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Liu X, Xu J, Li S, Wang X, Liu J, Li X. The prevalence of gingivitis and related risk factors in schoolchildren aged 6-12 years old. BMC Oral Health 2022; 22:623. [PMID: 36544102 PMCID: PMC9768968 DOI: 10.1186/s12903-022-02670-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND According to epidemiological studies, gingivitis is a common disease. However, its morbidity, considerably varies among individual. This study aimed to investigate the epidemiological characteristics of gingivitis, including prevalence, severity, intraoral distribution, and associated risk factors, in children aged 6-12 years in Jinzhou, China. METHODS A multistage, whole-group, randomized sample of 2880 children aged 6-12 years in Jinzhou City, China, was selected and clinically examined. Each selected child completed a questionnaire on sociodemographic factors and oral health behaviors in cooperation with the investigator and teacher. Gingival bleeding refers to the bleeding of 10% or more teeth under the condition of ingivitis. Gingivitis was further categorized into localized gingivitis (30% ≥ number of teeth positive for gingival bleeding ≥ 10%) and generalized gingivitis (number of positive for gingival bleeding > 30%). The score of gingival bleeding was recorded using the Gingival Index. RESULTS The prevalence of gingivitis in children aged 6-12 years in Jinzhou was 28.58%, including 701 cases of localized gingivitis (24.3%) and 122 cases of generalized gingivitis (4.2%). There were 429 cases (28.3%) of gingivitis in males and 394 cases (28.9%) in females, with no statistically significant difference in prevalence between males and females (P > 0.05). Chi-square tests and binary logistic regression analysis showed that aging, dental calculus, plaque, and dental crowding were significantly associated with a high prevalence of gingivitis. CONCLUSIONS Our study showed that dental calculus, large amount dental plaque, poor oral health behavior, and oral health awareness are associated with the prevalence of gingivitis and maintaining children's oral health requires professional guidance and regular preventive care.
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Affiliation(s)
- Xiaoyu Liu
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Jianhui Xu
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Siwei Li
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xueqin Wang
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Jin Liu
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xin Li
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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Grover V, Kumar A, Jain A, Chatterjee A, Grover HS, Pandit N, Satpathy A, Madhavan Pillai BR, Melath A, Dhruvakumar D, Thakur R, Joshi NV, Deshpande N, Dadlani H, Meenakshi AA, Ashok KP, Reddy KV, Bhasin MT, Salaria SK, Verma A, Gaikwad RP, Darekar H, Amirisetty R, Phadnaik M, Karemore V, Dhulipalla R, Mody D, Rao TS, Chakarpani S, Ranganath V. ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity. J Indian Soc Periodontol 2022; 26:307-333. [PMID: 35959314 PMCID: PMC9362809 DOI: 10.4103/jisp.jisp_233_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 11/24/2022] Open
Abstract
Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.
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Affiliation(s)
- Vishakha Grover
- Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Ashish Kumar
- Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ashish Jain
- Department of Periodontology, Dental Institute, Regional Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Anirban Chatterjee
- Department of Periodontology, Renupriya Dental Health Care, Bengaluru, Karnataka, India
| | | | - Nymphea Pandit
- Department of Periodontology, D. A. V Dental College and Hospital, Yamunanagar, Haryana, India
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha "O" Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | | | - Anil Melath
- Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India
| | - Deepa Dhruvakumar
- Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Roshani Thakur
- Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, India
| | - Nilesh V Joshi
- Department of Periodontology, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be) University, Navi Mumbai, India
| | - Neeraj Deshpande
- Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Himanshu Dadlani
- Department of Periodontology, Kalka Dental College, Meerut, Uttar Pradesh, India
| | - A Archana Meenakshi
- Department of Periodontology, Ragas Dental College and Hospitals, Chennai, Tamil Nadu, India
| | - K P Ashok
- Department of Periodontics, GSL Dental College, Rajahmundry, India
| | - K Vinathi Reddy
- Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
| | - Meenu Taneja Bhasin
- Department of Periodontics, Sudha Rustagi Dental College, Faridabad, Haryana, India
| | | | - Abhishek Verma
- Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
| | | | | | - Ramesh Amirisetty
- Department of Periodontology, G. Pulla Reddy Dental College and Hospital, Dr. NTR University of Health Sciences, Kurnool, Andhra Pradesh, India
| | - Mangesh Phadnaik
- Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Vaibhav Karemore
- Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
| | - Ravindranath Dhulipalla
- Department of Periodontology, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
| | - Dhawal Mody
- VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Tushar Shri Rao
- Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Swarna Chakarpani
- Department of Periodontics, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
| | - V Ranganath
- Department of Periodontics, AECS Maaruti Dental College and Research Center, Bengaluru, Karnataka, India
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Boes H, Brüstle S, Danesh G, Zimmer S, Bizhang M. Comparative in vitro study of the cleaning efficacy of AirFloss ultra and I-Prox Sulcus brushes in an orthodontic phantom model. Sci Rep 2021; 11:1921. [PMID: 33479418 PMCID: PMC7820349 DOI: 10.1038/s41598-021-81603-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 01/07/2021] [Indexed: 11/09/2022] Open
Abstract
Preventing biofilm-related risks such as gingivitis and white spot lesions during orthodontic treatments is very challenging. The cleaning efficiencies of AirFloss Ultra and I-Prox P sulcus brushes were evaluated using an orthodontic phantom model. After attaching brackets onto black-coated maxillary KaVo teeth, a plaque substitute was applied. The evaluated tooth surfaces were divided into two areas. Cleaning was performed with an AirFloss Ultra with two (A-2) or four (A-4) sprays or an I-Prox P for two (I-2) or four (I-4) seconds. Images before and after cleaning were digitally subtracted, and the percentage of fully cleaned surfaces was determined (Adobe Photoshop CS5, ImageJ). Statistical analysis was performed by ANOVA and post hoc tests with Bonferroni correction (SPSS 25, p < 0.05). The mean values of total cleaning efficacy were 26.87% for I-2, 43.73% for I-4, 34.93%, for A-2 and 56.78% for A-4. The efficacy was significantly higher for A-4 than for A-2, I-4, and I-2. There were significant differences between the four groups. Repeated cleaning led to an improved result. Within the study limitations, the AirFloss Ultra with four sprays proved to be more efficient than the sulcus brush I-Prox P for cleaning.
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Affiliation(s)
- Hanna Boes
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany.
| | - Sören Brüstle
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
| | - Gholamreza Danesh
- Department of Orthodontics, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
| | - Mozhgan Bizhang
- Department of Operative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455, Witten, Germany
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Corbella S, Tramontano F, Zotti B, Muzzarelli M, Alberti A, Francetti L. Influence of teeth anatomical characteristics on the efficacy of manual toothbrushing manoeuvres. Saudi Dent J 2020; 32:337-342. [PMID: 33132661 PMCID: PMC7588504 DOI: 10.1016/j.sdentj.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/23/2019] [Accepted: 10/24/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of the study was to investigate the efficacy of two toothbrushing techniques on the amount of plaque accumulation and to evaluate how the changes were correlated to the anatomical characteristics of the anterior maxillary arch. Methods Thirty subjects of both genders were included, they were asked not to brush for 12 h. Afterwards, they were asked to manually brush the left side of their maxillary arch with the modified Bass technique and the right side adopting the roll technique. The comparison of photographs taken before and after the manoeuvres, using a plaque disclosing agent, allowed the researchers to measure the changes in plaque accumulation measured using the Quigley and Hein plaque scoring classification. Linear regression analysis was used to evaluate the correlation between such changes and the teeth and arch anatomical characteristics. Results A mean reduction of 9.6 ± 5.2% considering both arches after brushing was observed. The changes in plaque accumulation were not different between the two techniques. The length of the line obtained joining the contact point between the central incisors and the contact point between the second premolar and the first molar on the left side and the distance between that line and the lateral incisor on the same side positively correlated to the decrease in the plaque scores (P = 0.046 and P = 0.044, respectively). Conclusion Both tested techniques were effective in plaque removal in the anterior maxillary arches. However, the research for the anatomical factors influencing the amount of efficacy of the toothbrushing manoeuvres was inconclusive. We can hypothesise that the adoption of one adequate technique could be more important than the teeth characteristics.
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Affiliation(s)
- Stefano Corbella
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Oral Surgery, Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Beatrice Zotti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Martina Muzzarelli
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Fan KA, Zhong JS, Ouyang XY, Xie Y, Chen ZY, Zhou SY, Zhang Y. [Vestibular incision subperiosteal tunnel access with connective tissue graft for the treatment of Miller classI and II gingival recession]. JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:80-85. [PMID: 30773549 DOI: 10.19723/j.issn.1671-167x.2019.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the clinical outcomes of vestibular incision subperiosteal tunnel access (VISTA) with connective tissue graft (CTG) in the treatment of Miller classes I and II localized gingival recession. METHODS Ten patients with 10 Miller classes I and II localized gingival recessions were enrolled in the study. All defects were equal to or above 2 mm in recession depth. All the patients received treatment with VISTA+CTG. Their clinical parameters, including recession depth (Rec), recession width (RW), keratinized tissue width (KT), clinical attachment loss (CAL), probing depth (PD) were recorded and compared before surgery and 6 months later. The mean root coverage (MRC) and complete root coverage (CRC) were calculated at the end of 6 months. A visual analogue scale (VAS) was used to estimate the patients' discomfort during the operation and during the 2 weeks post-operation. Patient-based aesthetic satisfaction 6 months after surgery was evaluated by a VAS. RESULTS The mean Rec was (2.65±0.82) mm at baseline, and (0.35±0.58) mm after 6 months. The VISTA+CTG treatment resulted in an improvement of (2.30±0.98) mm in recession depth (P<0.001). MRC was 86.67%±21.94% and CRC reached 70% at the end of 6 months. KT increased (0.90±1.22) mm (P<0.05). Aesthetic satisfaction on the patients' level was 8.30 based on VAS (0=unsatisfied, 10=extremely satisfied). The patients' discomfort during the operation and 2 weeks post operation were 2.40 and 4.30 (0=no pain, 10=extreme pain). Furthermore, clinical outcomes showed no statistically significant difference between the gingival biotypes, and between the teeth positioned in maxillary and in mandibular. CONCLUSION VISTA+CTG could be an effective treatment for Miller classes I and II localized gingival recession. Clinical outcomes indicated decrease in recession depth and width, and increase in width of keratinized tissue. Patients suffered little pain during the operation and 2 weeks post-operation of healing and accessed good aesthetic satisfaction. VISTA+CTG could be an option for the treatment of Miller classes I and II localized gingival recession.
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Affiliation(s)
- K A Fan
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - J S Zhong
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X Y Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Xie
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Z Y Chen
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - S Y Zhou
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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8
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Jalaluddin M, Rajasekaran UB, Paul S, Dhanya RS, Sudeep CB, Adarsh VJ. Comparative Evaluation of Neem Mouthwash on Plaque and Gingivitis: A Double-blind Crossover Study. J Contemp Dent Pract 2017; 18:567-571. [PMID: 28713109 DOI: 10.5005/jp-journals-10024-2085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The present study aimed at evaluating the impact of neem-containing mouthwash on plaque and gingivitis. MATERIALS AND METHODS This randomized, double-blinded, crossover clinical trial included 40 participants aged 18 to 35 years with washout period of 1 week between the crossover phases. A total of 20 participants, each randomly allocated into groups I and II, wherein in the first phase, group I was provided with 0.2% chlorhexidine gluconate and group II with 2% neem mouthwash. After the scores were recorded, 1-week time period was given to the participants to carry over the effects of the mouthwashes and then the second phase of the test was performed. The participants were instructed to use the other mouthwash through the second test phase. RESULTS There was a slight reduction of plaque level in the first phase as well as in the second phase. When comparison was made between the groups, no statistically significant difference was seen. Both the groups showed reduction in the gingival index (GI) scores in the first phase, and there was a statistically significant difference in both groups at baseline and after intervention (0.005 and 0.01 respectively). In the second phase, GI scores were reduced in both groups, but there was a statistically significant difference between the groups only at baseline scores (0.01). CONCLUSION In the present study, it has been concluded that neem mouthwash can be used as an alternative to chlorhexidine mouthwash based on the reduced scores in both the groups. CLINICAL SIGNIFICANCE Using neem mouthwash in maintaining oral hygiene might have a better impact in prevention as well as pervasiveness of oral diseases as it is cost-effective and easily available.
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Affiliation(s)
- Md Jalaluddin
- Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology University, Bhubaneswar, Odisha, India, e-mail:
| | - U B Rajasekaran
- Department of Orthodontics and Dentofacial Orthopedics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Sam Paul
- Department of Orthodontics and Dentofacial Orthopedics Educare Institute of Dental Sciences, Malappuram, Kerala, India
| | - R S Dhanya
- Department of Public Health Dentistry, PSM College of Dental Science & Research, Thrissur, Kerala, India
| | - C B Sudeep
- Department of Public Health Dentistry, Sree Anjaneya Institute of Dental Sciences, Kozhikode, Kerala, India
| | - V J Adarsh
- Department of Conservative Dentistry and Endodontics, Mahe Institute of Dental Sciences, Mahe, Puducherry, India
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Gupta D, Gupta RK, Jain A, Bindhumadhav S, Sangeeta, Garg P, Chaturvedi S, Chattu VK. Assessment of Effectiveness of Barleria prionitis on Oral Health. Pharmacognosy Res 2016; 8:169-72. [PMID: 27365983 PMCID: PMC4908843 DOI: 10.4103/0974-8490.181456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM To evaluate the efficacy of Barleria prionitis extract mouthwash in comparison with gold standard chlorhexidine (CHX) mouthwash on the oral health. MATERIALS AND METHODS A total of 30 subjects were randomly divided into two groups, B. prionitis group and the CHX gluconate mouthwash group. The data were collected at the baseline and 3 days. The plaque was disclosed using erythrosine disclosing agent and their scores were recorded using the Quigley and Hein plaque index modified by Turesky-Gilmore-Glickman. Statistical analysis was performed to compare the effect of the two drug regime. RESULTS Our result showed that the CHX and the B. prionitis were statistically equally effective against dental plaque. Although the action of CHX was more pronounced. CONCLUSIONS This study has confirmed antimicrobial potential of the plant B. prionitis, thus supporting its folklore application as preventive remedy against oral microbial diseases. SUMMARY Within the limitation of this trial, herbal mouthwash has been shown to demonstrate similar effects on plaque as compared to the standard drug CHX. Further long term research needs to be done to check the efficacy and effectiveness of herbal products over standard drug regime.
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Affiliation(s)
- Devanand Gupta
- Department of Public Health Dentistry, Institute of Dental Science, Bareilly, Uttar Pradesh, and General Secretory, International Society for Holistic Dentistry, India
| | | | - Ankita Jain
- Department of Public Health Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | | | - Sangeeta
- Consultant Dental Surgeon, Patna, Bihar, India
| | - Purnima Garg
- Consultant Stomatologist, Dehradoon, Uttrakhand, India
| | | | - Vijay Kumar Chattu
- Faculty of Medical Sciences, The University of the West Indies, Trinidad and Tobago
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Funieru C, Klinger A, Băicuș C, Funieru E, Dumitriu HT, Dumitriu A. Epidemiology of gingivitis in schoolchildren in Bucharest, Romania: a cross-sectional study. J Periodontal Res 2016; 52:225-232. [PMID: 27093564 DOI: 10.1111/jre.12385] [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: 03/04/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Gingivitis is the most prevalent oral disease in children, being strongly associated to social gradients. Many studies have reported different results concerning the extent and intra-oral distribution of gingivitis in children. The aim of this study was to investigate the epidemiologic parameters and socio-related risk factors of gingivitis in the 10-17-year-old Bucharest schoolchildren population and to analyze its intra-oral distribution. MATERIAL AND METHODS Cross-sectional data were obtained from 1595 schoolchildren, social condition being assigned using a simple questionnaire. Classes of students were used as clusters in a single-stage cluster sampling method. An intra-oral exam was performed for all the children included in this study. Silness and Löe scores, prevalence and the extent of gingivitis were calculated. RESULTS The gingival scores showed a mild inflammation and the prevalence of gingivitis was 91%. Boys had a higher gingival (0.19 vs. 0.18; p < 0.05) and plaque scores (0.71 vs. 0.59; p < 0.01) than girls. Children who did not live in overcrowded households, whose parents had a better education and those who had direct access to school dental services displayed better gingival conditions (p < 0.05). Gingivitis was more severe on the upper teeth, with the maximum score being reached at the right upper lateral incisor (0.63 on distal surface). CONCLUSIONS Gingival condition in Bucharest schoolchildren population was associated to social gradients. School dental services are also another factor that seems to be related with gingivitis.
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Affiliation(s)
- C Funieru
- Department of Preventive Dentistry, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,RECIF (Réseau d' Epidémiologie Clinique International Francophone), Bucharest, Romania
| | - A Klinger
- Department of Periodontology, Faculty of Dental Medicine, Hadassah and Hebrew University Medical Center, Jerusalem, Israel
| | - C Băicuș
- RECIF (Réseau d' Epidémiologie Clinique International Francophone), Bucharest, Romania.,Department of Internal Medicine, Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | - H T Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - A Dumitriu
- Department of Periodontology, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Zucchelli G, Mounssif I. Periodontal plastic surgery. Periodontol 2000 2015; 68:333-68. [DOI: 10.1111/prd.12059] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2013] [Indexed: 11/29/2022]
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12
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The relationship between incisal/occlusal wear, dentine hypersensitivity and time after the last acid exposure in vivo. J Dent 2015; 43:248-52. [DOI: 10.1016/j.jdent.2014.11.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/04/2014] [Accepted: 11/07/2014] [Indexed: 11/24/2022] Open
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Sharma R, Hebbal M, Ankola AV, Murugaboopathy V, Shetty SJ. Effect of two herbal mouthwashes on gingival health of school children. J Tradit Complement Med 2014; 4:272-8. [PMID: 25379471 PMCID: PMC4220507 DOI: 10.4103/2225-4110.131373] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed at determining the effect of indigenously prepared neem and mango chewing stick mouthwashes on plaque and gingival indices. A sample of 105 children aged 12-15 years was randomized into three groups, namely neem, mango, and chlorhexidine mouthwash groups. All the children were examined at baseline and gingival and plaque indices were recorded. Baseline scores for plaque and gingivitis were fair and moderate, respectively, in all the three groups and there existed no statistically significant difference among them. Ten millilitres each of herbal and chlorhexidine mouthwashes (0.2%) were administered according to the group allocation twice daily for 21 days. Indices were reassessed at 21 days (immediately after intervention) and at 1 month, 2 months, and 3 months after discontinuing the mouthwashes. Statistically significant reduction (P < 0.001) in plaque index was found in all the three mouthwash groups at 21 days and at 1 month from discontinuing the mouthwash. Chlorhexidine additionally showed statistically significant reduction in plaque index at 2 months from discontinuing the mouthwash. Statistically significant reduction (P < 0.001) in gingival index was found in all the three mouthwash groups at 21 days (immediately after discontinuing the mouthwash) and at 1 and 2 months from discontinuing the mouthwash. To conclude, all the three mouthwashes were effective antiplaque and antigingivitis agents. Chlorhexidine and neem possess equivalent efficacy in reducing plaque, while chlorhexidine has superior antigingivitis properties.
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Affiliation(s)
- Ratika Sharma
- Department of Public Health Dentistry, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
| | - Mamata Hebbal
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Anil V Ankola
- Department of Public Health Dentistry, KLE VK Institute of Dental Sciences, Belgaum, Karnataka, India
| | - Vikneshan Murugaboopathy
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
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Hayasaki H, Saitoh I, Nakakura-Ohshima K, Hanasaki M, Nogami Y, Nakajima T, Inada E, Iwasaki T, Iwase Y, Sawami T, Kawasaki K, Murakami N, Murakami T, Kurosawa M, Kimi M, Kagoshima A, Soda M, Yamasaki Y. Tooth brushing for oral prophylaxis. JAPANESE DENTAL SCIENCE REVIEW 2014. [DOI: 10.1016/j.jdsr.2014.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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West NX, Lussi A, Seong J, Hellwig E. Scaffold-free microtissues: differences from monolayer cultures and their potential in bone tissue engineering. Clin Oral Investig 2013; 17:9-17. [PMID: 22695872 PMCID: PMC3585766 DOI: 10.1007/s00784-012-0763-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Accepted: 05/23/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Cell-based therapies for bone augmentation after tooth loss and for the treatment of periodontal defects improve healing defects. Usually, osteogenic cells or stem cells are cultivated in 2D primary cultures, before they are combined with scaffold materials, even though this means a loss of the endogenous 3D microenvironment for the cells. Moreover, the use of single-cell suspensions for the inoculation of scaffolds or for the direct application into an area of interest has the disadvantages of low initial cell numbers and susceptibility to unwanted cellular distribution, respectively. MATERIALS AND METHODS We addressed the question whether an alternative to monolayer cultures, namely 3D microtissues, has the potential to improve osteogenic tissue engineering and its clinical outcome. RESULTS By contrast, to monolayer cultures, osteogenic differentiation of 3D microtissues is enhanced by mimicking in vivo conditions. It seems that the osteogenic differentiation in microtissues is enhanced by strong integrin-extracellular matrix interaction and by stronger autocrine BMP2 signaling. Moreover, microtissues are less prone to wash out by body fluids and allow the precise administration of large cell numbers. CONCLUSION Microtissue cultures have closer characteristics with cells in vivo and their enhanced osteogenic differentiation makes scaffold-free microtissues a promising concept in osteogenic tissue engineering. CLINICAL RELEVANCE Microtissues are particularly suitable for tissue engineering because they improve seeding efficiency of biomaterials by increasing the cell load of a scaffold. This results in accelerated osteogenic tissue formation and could contribute to earlier implant stability in mandibular bone augmentation.
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Affiliation(s)
- N. X. West
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - A. Lussi
- />Department of Operative Dentistry, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - J. Seong
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - E. Hellwig
- />Department of Operative Dentistry and Periodontology, Dental School and Hospital Dentistry, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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Lam OL, McMillan AS, Samaranayake LP, Li LS, McGrath C. Randomized clinical trial of oral health promotion interventions among patients following stroke. Arch Phys Med Rehabil 2012; 94:435-43. [PMID: 23127306 DOI: 10.1016/j.apmr.2012.10.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 10/04/2012] [Accepted: 10/20/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of oral health promotion interventions on clinical oral health. DESIGN Single-blind randomized controlled trial conducted over 3 weeks of in-hospital rehabilitation. SETTING Stroke rehabilitation ward in Hong Kong. PARTICIPANTS Patients with stroke (N=102) admitted to the rehabilitation ward. INTERVENTIONS Patients were randomly assigned either: (1) oral hygiene instruction, (2) oral hygiene instruction and chlorhexidine mouthrinse, or (3) oral hygiene instruction, chlorhexidine mouthrinse, and assisted brushing. MAIN OUTCOME MEASURES Dental plaque, gingival bleeding, and oral functional status were assessed at baseline and review. Development of infectious complications were also monitored during the clinical trial. RESULTS Poor oral hygiene and an overall neglect of oral hygiene practices were observed at baseline. Reductions in dental plaque were significantly greater in the 2 groups receiving chlorhexidine compared with the group receiving oral hygiene instruction alone (P<.001). Reductions in gingival bleeding scores were 3- to 4-fold greater in groups receiving chlorhexidine. No cases of pneumonia were observed during the course of the clinical trial. CONCLUSIONS The oral health condition of patients may be safeguarded after acute stroke with the use of chlorhexidine mouthrinse in conjunction with a standard mechanical plaque removal tool, such as an electric toothbrush. These interventions are acceptable to the majority of patients, and their administration poses a minimal burden to rehabilitation ward staff.
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Affiliation(s)
- Otto L Lam
- Oral Rehabilitation, Faculty of Dentistry, University of Hong Kong, Hong Kong, China
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17
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West NX, Lussi A, Seong J, Hellwig E. Scaffold-free microtissues: differences from monolayer cultures and their potential in bone tissue engineering. Clin Oral Investig 2012; 17 Suppl 1:S9-19. [PMID: 22695872 PMCID: PMC3585766 DOI: 10.1007/s00784-012-0887-x] [Citation(s) in RCA: 133] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 11/21/2012] [Indexed: 12/13/2022]
Abstract
Objectives The paper’s aim is to review dentin hypersensitivity (DHS), discussing pain mechanisms and aetiology. Materials and methods Literature was reviewed using search engines with MESH terms, DH pain mechanisms and aetiology (including abrasion, erosion and periodontal disease). Results The many hypotheses proposed for DHS attest to our lack of knowledge in understanding neurophysiologic mechanisms, the most widely accepted being the hydrodynamic theory. Dentin tubules must be patent from the oral environment to the pulp. Dentin exposure, usually at the cervical margin, is due to a variety of processes involving gingival recession or loss of enamel, predisposing factors being periodontal disease and treatment, limited alveolar bone, thin biotype, erosion and abrasion. Conclusions The current pain mechanism of DHS is thought to be the hydrodynamic theory. The initiation and progression of DHS are influenced by characteristics of the teeth and periodontium as well as the oral environment and external influences. Risk factors are numerous often acting synergistically and always influenced by individual susceptibility. Clinical relevance Whilst the pain mechanism of DHS is not well understood, clinicians need to be mindful of the aetiology and risk factors in order to manage patients’ pain and expectations and prevent further dentin exposure with subsequent sensitivity.
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Affiliation(s)
- N. X. West
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - A. Lussi
- />Department of Operative Dentistry, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - J. Seong
- />Clinical Trials Unit, Department of Oral and Dental Sciences, Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY UK
| | - E. Hellwig
- />Department of Operative Dentistry and Periodontology, Dental School and Hospital Dentistry, University Medical Center Freiburg, Freiburg im Breisgau, Germany
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Longitudinal changes in gingival crevicular fluid after placement of fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2011; 139:735-44. [PMID: 21640879 DOI: 10.1016/j.ajodo.2009.10.043] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Revised: 10/01/2009] [Accepted: 10/01/2009] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Bacterial plaque is an etiologic factor in the development of gingival inflammation and periodontitis. The presence of orthodontic bands and brackets influences plaque growth and maturation. The purposes of this research were to monitor microbiologic and periodontal changes after placement of orthodontic attachments over a 1-year period and to link these changes to alterations in cytokine concentrations in the gingival crevicular fluid (GCF). METHODS This longitudinal split-mouth trial included 24 patients. Supragingival and subgingival plaque composition, probing depth, bleeding on probing, and GCF flow and composition were assessed at baseline (Tb) and after 1 year (T52). A statistical comparison was made over time and between the banded and bonded sites. Prognostic factors for the clinical reaction at T52 in the GCF at Tb were determined. RESULTS Between Tb and T52, the pathogenicity of the plaque and all periodontal parameters increased significantly, but intersite differences were not seen, except for bleeding on probing. The cytokine concentrations in the GCF did not differ significantly between the sites or between Tb and T52. The interleukin-6 concentration in the GCF at Tb was a significant predictive value for the GCF flow at T52 (P <0.05). The same relationship was found between the interleukin-8 concentration at Tb and the increase in probing depth at T52 (P <0.05). CONCLUSIONS Interleukin-6 and interleukin-8 concentrations before orthodontic treatment were shown to be significant predictive factors for some potential inflammatory parameters during treatment.
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van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. Longitudinal changes in microbiology and clinical periodontal parameters after removal of fixed orthodontic appliances. Eur J Orthod 2010; 33:15-21. [PMID: 20671070 DOI: 10.1093/ejo/cjq032] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this longitudinal study was to monitor patients' microbiological and clinical parameters from bracket placement up to 3 months post-treatment. Twenty-four patients (10 males and 14 females, aged 14.6 ± 1.0 years) were included in this investigation. Microbiology (sub- and supragingival), periodontal probing depth (PPD), bleeding on probing (BOP), and gingival crevicular fluid (GCF) flow were assessed at baseline (T1), at bracket removal (T2), and 3 months post-treatment (T3). A statistical comparison was made over time and between the banded, bonded, and control sites. Repeated measurements on patients were taken into account by modelling the patients as a random factor. Except for PPD and BOP, values were log-transformed before analysis. Corrections for simultaneous hypothesis testing were performed via simulation. The results demonstrated that sub- and supragingival colony-forming units ratio (CFU ratio aerobe/anaerobe) decreased significantly (relatively more anaerobes) at T2 compared with T1. Between T2 and T3 no significant increase in CFU ratio was seen, resulting in a significantly lower CFU ratio at T3 compared with T1 for subgingival plaque. The difference concerning supragingival plaque between T3 and T1 was not significant. Clinical parameters PPD, POB, and GCF flow showed a significant increase between T1 and T2. Between T2 and T3 these variables decreased significantly but remained significantly higher than at T1 [except for BOP values at the bonded sites (P = 0.0646)]. Placement of fixed orthodontic appliances has an influence both on microbial and clinical periodontal parameters, which were only partly normalized, 3 months following the removal of the appliances.
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Affiliation(s)
- Jan van Gastel
- Department of Orthodontics, Catholic University Leuven, Belgium.
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20
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Ngom PI, Benoist HM, Soulier-Peigue D, Niang A. [Reciprocal relationships between orthodontics and periodontics: relevance of a synergistic action]. Orthod Fr 2010; 81:41-58. [PMID: 20359448 DOI: 10.1051/orthodfr/2010002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The aim of this article is to review evidence on the reciprocal relationships between orthodontics and periodontics. Normal intra-arch and inter-arch relationships have long been considered as an anatomic prerequisite for the preservation of dental health and function. Certain malocclusion traits are associated with difficulties in maintaining good oral hygiene and as a consequence to poor periodontal condition. Therefore, proper alignment of the teeth provided by orthodontic treatment may promote good control of soft deposit and calculus and subsequent periodontal inflammation. The tendency of orthodontic appliances, particularly the brackets and bands to promote the accumulation of plaque and thus increasing the risk of developing localized periodontal disease must however be constantly emphasized. Periodontitis involves progressive loss of the alveolar bone around the teeth, pathological tooth migration and gingival recession with pathological tooth migration and gingival recession as a possible outcome. The effectiveness of orthodontics in conjunction with periodontics in the management of these esthetic and functional defects is highlighted in this review.
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Affiliation(s)
- Papa Ibrahima Ngom
- Département d'Odontologie, Faculté de Médecine, Pharmacie et Odontologie, Université Cheikh Anta Diop Dakar, Sénégal.
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van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. Longitudinal Changes in Microbiology and Clinical Periodontal Variables After Placement of Fixed Orthodontic Appliances. J Periodontol 2008; 79:2078-86. [DOI: 10.1902/jop.2008.080153] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Söder B, Johannsen A, Lagerlöf F. Percent of plaque on individual tooth surfaces and differences in plaque area between adjacent teeth in healthy adults. Int J Dent Hyg 2004; 1:23-8. [PMID: 16451543 DOI: 10.1034/j.1601-5037.2003.00003.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To apply a planimetric method to determine the percentage of the tooth area covered by plaque on individual tooth surfaces and to compare the percentage of plaque between adjacent tooth surfaces. METHODS Forty-three adults, mean age 43.0 years, with no signs of periodontal disease, participated. The subjects underwent comprehensive professional cleaning of all teeth. The subjects were then instructed to maintain their ordinary oral hygiene habits. Plaque was registered after 1 month, on each individual tooth surface by use of P%I. RESULTS The pattern of plaque accumulation was in large symmetrical, with differences in mean P%I between several adjacent tooth surfaces, e.g. for the maxillary buccal and lingual tooth surfaces between the first and second molars (P<0.001) and for the lingual tooth surfaces between the canines and the first premolars (P<0.01). CONCLUSION In the present study, it was possible to identify and describe adjacent tooth surfaces with the most pronounced plaque accumulation, to make further improvements of oral hygiene possible.
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Affiliation(s)
- Birgitta Söder
- Karolinska Institute, Institute of Odontology, Huddinge, Sweden.
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Abstract
OBJECTIVE To investigate the effect of fluoridated elastomers on the quantity of disclosed dental plaque surrounding an orthodontic bracket in vivo. DESIGN A randomized, prospective, longitudinal clinical trial, employing a split mouth, crossover design. SETTING The Orthodontic Departments of Liverpool and Sheffield Dental Hospitals. SUBJECTS AND METHODS The subjects were 30 individuals about to start fixed orthodontic treatment. The study consisted of two experimental periods of 6 weeks with a washout period between. Fluoridated elastomers were randomly assigned at the first visit to be placed around brackets on 12, 11, 33 or 22, 21, 43. Non-fluoridated elastomers were placed on the contra-lateral teeth. After 6 weeks (visit 2) the elastomers were removed, the teeth disclosed and a photograph taken. Non-fluoridated elastomers were placed on all brackets for one visit to allow for a washout period. At visit 3, fluoridated elastomers were placed on the contra-lateral teeth to visit 1. At visit 4, the procedures at visit 2 were repeated. The photographs were scanned, then the area and proportion of the buccal surface covered with disclosed plaque was measured using computerized image analysis. A mixed-effects ANOVA was carried out with the dependent variable being the area or percentage area of disclosed plaque. RESULTS There was no evidence of a systematic error and substantial agreement for the repeat readings of the same images. The only significant independent variable for the area of disclosed plaque was the subject (p < 0.001). The significant independent variables for the proportion of disclosed plaque were the subject (p < 0.001) and the tooth type (p = 0.002). The independent variable describing the use of fluoridated or non-fluoridated elastomers was not significant for either the area or the proportion of disclosed plaque. CONCLUSION Fluoridated elastomers do not affect the quantity of disclosed plaque around an orthodontic bracket.
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Affiliation(s)
- P E Benson
- Department of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, UK.
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Trombelli L, Tatakis DN. Periodontal diseases: current and future indications for local antimicrobial therapy. Oral Dis 2003; 9 Suppl 1:11-5. [PMID: 12974525 DOI: 10.1034/j.1601-0825.9.s1.3.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The microbial etiology of gingivitis and periodontitis provides the rationale for use of adjunctive antimicrobial agents in the prevention and treatment of periodontal diseases. Although mechanical removal of supra- and subgingival calcified and non-calcified plaque deposits has been proved effective to control the gingival inflammatory lesions as well as to halt the progression of periodontal attachment loss, some patients may experience additional benefits from the use of systemic or topical antimicrobial agents. Such agents are able to significantly affect supra- and subgingival plaque accumulation and/or suppress or eradicate periodontal pathogenic microflora. Currently, properly selected local antiseptic and systemic antibiotic therapies can provide periodontal treatment that is generally effective, low-risk and affordable. This paper will briefly review the host-related conditions in which the periodontal preventive and therapeutic approaches may be effectively assisted by a local antimicrobial regimen. Potential future indications for adjunctive local antimicrobial therapy will also be discussed.
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Affiliation(s)
- L Trombelli
- Research Center for the Study of Periodontal Diseases, University of Ferrara, Ferrara, Italy.
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Abstract
Circumstantial evidence based on anecdote, case reports, epidemiological data and studies in vitro and in situ implicate tooth brushing with toothpaste with tooth wear, gingival recession and dentine hypersensitivity. This review attempts to assess the clinical significance of the potential harm produced by this most common oral hygiene habit. The toothbrush alone appears to have no effect on enamel and very little on dentine. Most toothpaste also has very little effect on enamel and in normal use would not cause significant wear of dentine in a lifetime of use. Wear of enamel and dentine can be dramatically increased if tooth brushing follows an erosive challenge. Gingival recession has a multi-factorial aetiology and certain individuals and specific teeth may be predisposed to trauma from tooth brushing. Tooth brushing is known to cause gingival abrasions but how these relate to gingival recession is not known. The role of toothpaste in gingival abrasion and recession surprisingly has received little if any attention. Gingival recession most commonly exposes dentine and localises sites for dentine hypersensitivity. Some toothpaste products can expose dentinal tubules but erosion is probably the more dominant factor in dentine hypersensitivity. There is no evidence to indicate that electric and manual toothbrushes differ in effects on soft and hard tissues. It is only under, over or abusive use or when combined with erosion that significant harm may be thus caused. In normal use it must be concluded that the benefits of tooth brushing far out-way the potential harm.
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Affiliation(s)
- M Addy
- Division of Restorative Dentistry, Bristol, UK.
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Abstract
OBJECTIVE In a previous study, we screened 149 subjects and established four groups high or low for salivary killing of oral bacteria, and for aggregation and live and dead adherence of oral bacteria (as a combined factor). Caries scores were significantly lower in both High Aggregation-Adherence groups. In this study we looked at the effects of those differences in salivary function on the quantity and diversity of oral biofilm streptococci. DESIGN Subjects from those four groups were recalled for collection of overnight oral biofilm from buccal upper central incisors, lingual lower central incisors, buccal upper and lower first molars, and lingual upper and lower first molars. At each site, groups were compared for total biofilm (by DNA concentration), total streptococci (by quantitative PCR), and streptococcal diversity (by Streptococcus-specific denaturing gradient gel electrophoresis). RESULTS Total biofilm DNA and total streptococci were correlated. Both were highest on buccal molar surfaces and lowest on lingual lower central incisors, and both were significantly lower in the High Aggregation-Adherence groups (particularly at the buccal molar site). Fifty distinct bands were observed in denaturing gradient gels. There was great diversity within and between sites. Three major bands were present in almost every person at every site. Densities for two of those bands were significantly lower in both High Aggregation-Adherence groups. Other less-prevalent bands also showed the same pattern. CONCLUSION These findings are consistent with our caries results in suggesting that differences in salivary function can influence the quantity and composition of streptococci in oral biofilms.
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Affiliation(s)
- J D Rudney
- Department of Oral Science, School of Dentistry, University of Minnesota, 17-252 Moos Tower, 515 Delaware Street SE, Minneapolis, MN 55455, USA.
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Sheen S, Eisenburger M, Addy M. Effect of toothpaste on the plaque inhibitory properties of a cetylpyridinium chloride mouth rinse. J Clin Periodontol 2003; 30:255-60. [PMID: 12631184 DOI: 10.1034/j.1600-051x.2003.300312.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Cetylpyridinium chloride (CPC) mouth rinses have moderate plaque inhibitory activity when used alone but rarely have shown adjunctive benefits to tooth brushing with toothpaste. Several explanations for this apparent anomaly can be proferred, including loss of antiseptic activity due to interactions with toothpaste ingredients. The aim of this study was to measure the effect of toothpaste on the plaque inhibitory properties of a CPC mouth rinse using paired rinses of CPC, toothpaste slurry (TP) and water (W). METHODS The study was a single blind, randomised, seven-treatment, cross over design balanced for residual effects, involving 21 healthy, dentate subjects. The paired rinses were: W-CPC, CPC-W, TP-CPC, CPC-TP, W-TP, TP-W and W-W. Rinsing with solutions or slurries was done for 60 s twice per day. On day 1, subjects were rendered plaque free, suspended tooth cleaning and commenced the allocated rinse regimen. On day 5, plaque was scored by index. A 2(1/2) day wash out of normal oral hygiene was allowed between each regimen. RESULTS The order from lowest to highest plaque scores was as follows: W-CPC = CPC-W < CPC-TP < TP-CPC < or = W-TP < TP-W < W-W. Several differences in pairs of treatments were statistically significant, the most relevant of which were significantly less plaque with W-CPC compared to TP-CPC, TP-W and W-TP, and significantly more plaque with W-W compared to all other regimens except TP-W. CONCLUSIONS Toothpaste, whilst possessing some plaque inhibitory activity, when used immediately before a CPC mouth rinse adversely affected the plaque inhibitory action of this antiseptic. This in part may explain the reported lack of adjunctive benefits of CPC rinses to normal oral hygiene practices and supports the suggestion, made for chlorhexidine rinses, that their use should follow toothpaste by at least 60 min.
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Affiliation(s)
- S Sheen
- Division of Restorative Dentistry, Dental School, Bristol, UK
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Sheen S, Addy M. An in vitro evaluation of the availability of cetylpyridinium chloride and chlorhexidine in some commercially available mouthrinse products. Br Dent J 2003; 194:207-10; discussion 203. [PMID: 12627199 DOI: 10.1038/sj.bdj.4809913] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2001] [Accepted: 09/23/2002] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To assess the comparative activity of mouthrinses containing cetylpyridinium chloride (CPC) and chlorhexidine using the propensity to cause extrinsic staining in vitro as the outcome variable. METHODS Saliva-coated clear acrylic specimens were exposed to cyclical staining regimens of either CPC or chlorhexidine followed by tea. Water and 0.2% chlorhexidine were used as negative and positive controls respectively. Staining cycles were repeated until an optical density of > 2 was reached by one of the products. RESULTS For CPC there was a highly significant difference in staining between the products. Two CPC products performed numerically little better than water. For the chlorhexidine products the 0.2% formulation produced the most staining although little more than the UK version of the 0.1% rinse. The French 0.1% rinse produced by the same manufacturer as the UK formulation showed markedly reduced staining potential although significantly greater than water. CONCLUSION This study, supported by previous in vitro and in vivo studies, indicates discrepancies in the availability of CPC and chlorhexidine in some mouthrinse products. Importantly, this may have an effect on the potential of some rinses to provide the expected plaque inhibitory activity.
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Affiliation(s)
- S Sheen
- Division of Restorative Dentistry, Dental School, Bristol
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Abstract
BACKGROUND Gingival recession in its localized or generalized form is an undesirable condition resulting in root exposure. The result often is not esthetic and may lead to sensitivity and root caries. Exposed root surfaces also are prone to abrasion. The purpose of this article is to describe the prevalence, etiology and factors associated with gingival recession. TYPES OF STUDIES REVIEWED The authors reviewed cross-sectional epidemiologic studies of gingival recession and found that they correlated the prevalence of recession to trauma, sex, malpositioned teeth, inflammation and tobacco consumption. The recent surveys they reviewed revealed that 88 percent of people 65 years of age and older and 50 percent of people 18 to 64 years of age have one or more sites with recession. The presence and extent of gingival recession also increased with age. RESULTS More than 50 percent of the population has one or more sites with gingival recession of 1 mm or more. The prevalence of gingival recession was found in patients with both good and poor oral hygiene. It has been proposed that recession is multifactorial, with one type being associated with anatomical factors and another type with physiological or pathological factors. Recession has been found more frequently on buccal surfaces than on other aspects of the teeth. CLINICAL IMPLICATIONS Dentists should be knowledgeable about the etiology, prevalence and associating factors of gingival recession, as well as treatment options, so that appropriate treatment modalities can be offered to patients. Treatments for gingival recession include gingival grafting, guided tissue regeneration and orthodontic therapy. Such treatments typically result in esthetic improvement, elimination of sensitivity and a decreased risk of developing root caries.
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Affiliation(s)
- Moawia M Kassab
- Department of Periodontics and Endodontics, School of Dental Medicine, State University of New York at Buffalo, USA.
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Tezel A, Canakçi V, Ciçek Y, Demir T. Evaluation of gingival recession in left- and right-handed adults. Int J Neurosci 2002; 110:135-46. [PMID: 11912864 DOI: 10.3109/00207450108986541] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recession is the exposure of the root surface by an apical shift in the position of the gingiva. Several factors have been implicated in the etiology of gingival recession. The aim of this study was to assess the relationship between gingival recession and the hand, right or left, duration, frequency, and technique of tooth brushing in left- and right-handed adults in Erzurum, Turkey. Fifty five left-handed (35 female and 20 male) and 55 right-handed (35 female and 25 male) subjects were included in the study. The left and right hand positions of the subjects were determined by using Oldfield's Edinburg Inventory Index, and they were divided into two groups as left-handed and right-handed. The amount of gingival recession and localization, oral hygiene situations, gingival bleeding, toothbrushing duration, frequency, and techniques of subjects were evaluated. The relationship between the amount of gingival recession and localization and the subjects' hand, duration, frequency and technique of tooth brushing were examined. The data were evaluated with variance analysis and student's t test. The oral hygiene situations in right- and left-handed subjects were determined. On comparing the left-handed subjects with the right-handed ones, it was observed that the left-handed subjects had better oral hygiene than the right-handed. But, this case was not statistically significant (p > .05). In both right-handed and left-handed subjects, women had better oral hygiene than men (p < .01). The rate of gingival recession was found more in the left-handed than in the right-handed (p < .05). In the right-handed subjects, gingival recession was found in the premolar and canine regions of upper right and lower right jaw. A similar result was also observed in the left-handed subjects, because gingival recession was seen on their upper left and lower left jaw. Incisive teeth were affected at the same rate in the left-handed and right-handed. The gingival recession was seen more in maxillary jaw than in mandibular jaw in both groups. A statistically significant relationship between gingival recession and frequency duration, and technique of tooth brushing was found. While the greatest amount of gingival recession was found in horizontal scrub technique, gingival recession increased with increasing tooth brushing duration and frequency. The relationship between gingival recession and hand using in tooth brushing was determined.
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Affiliation(s)
- A Tezel
- Department of Periodontology, Atatürk University, Faculty of Dentistry Erzurum, Turkey.
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34
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Thienpont V, Dermaut LR, Van Maele G. Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop 2001; 120:353-60. [PMID: 11606959 DOI: 10.1067/mod.2001.116402] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this prospective single-blind crossover clinical trial was to evaluate the efficacy of 4 toothbrushes in 33 children undergoing fixed appliance orthodontic therapy. The toothbrushes included in this study were the Braun Oral-B 3D Plaque Remover (Kronberg, Germany), the Philips-Jordan HP 510 (Philips Domestic Appliances, Groningen, The Netherlands), the Lactona orthodontic toothbrush (Bergen op Zoom, The Netherlands), and the Oral-B Advantage Control Grip (Braun); the first 2 are electric, and the last 2 are manual. Every patient tested each type of toothbrush in a randomly designed sequence. Plaque and gingival scores were recorded at baseline and after every 4-week test period. All patients received professional prophylaxis after each clinical evaluation. The data were analyzed with the Friedman test, which showed no significant differences among the 4 brushes for any of the parameters measured. The Wilcoxon signed rank test, comparing the plaque and the gingival scores between the upper and lower jaw for each brush, indicated that plaque removal was more efficient in the lower jaw than in the upper.
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Affiliation(s)
- V Thienpont
- Department of Orthodontics, University of Ghent, Dental School, Belgium.
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Abstract
OBJECTIVES To review the prevalence and current concepts of the mechanisms and aetiology of gingival recession and present the principles of assessment and management of the patient with gingival recession. DATA AND SOURCES The literature was searched for review and original research papers relating prevalence, mechanisms, aetiology, assessment, and treatment of gingival recession using Medline and manual tracing of references cited in key papers otherwise not elicited. STUDY SELECTION Studies with gingival recession as focus and pertinent to key aspects of review. RESULTS Gingival recession is a common condition and its extent and prevalence increase with age. Many factors including trauma and periodontal disease have a role in its aetiology. The patient may develop signs and symptoms including pain from exposed dentine, root caries and aesthetic concerns. Management of gingival recession requires thorough patient assessment, identification of aetiological factors, and recording and monitoring of the extent and severity of the condition. Treatment should be directed at prevention of further progression and the control of symptoms and disease. The patient's aesthetic concerns should be appreciated. Surgical treatment of recession may be indicated to cover exposed root surfaces. Many surgical techniques have been described with varied reported clinical effectiveness. CONCLUSIONS Gingival recession should be thoroughly assessed and evaluated in order to offer the most suitable management.
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Affiliation(s)
- A Tugnait
- Department of Periodontology, Division of Restorative Dentistry, Leeds Dental Institute, Clarendon Way, LS2 9LU, Leeds, UK.
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36
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Renton-Harper P, Addy M, Newcombe RG. Plaque removal with the uninstructed use of electric toothbrushes: comparison with a manual brush and toothpaste slurry. J Clin Periodontol 2001; 28:325-30. [PMID: 11314888 DOI: 10.1034/j.1600-051x.2001.028004325.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Individuals purchasing electric toothbrushes for the 1st time will mostly only have the manufacturer's instructional leaflet for information of usage. AIMS This study was designed to simulate the 1st-time purchase and early use of an electric toothbrush with the aim of comparing plaque removal with a manual toothbrush. Secondary aims were to assess chemical plaque removal effects of a toothpaste slurry and to compare between 2 electric brushes which differed only in head speed. METHODS A group of 16 dentate subjects participated in this single-examiner blind, randomised, crossover design balanced for residual effects. Subjects had "average" oral hygiene and had never used an electric toothbrush previously. 7 days prior to the study, all subjects received the slower oscillating rotating toothbrush under test to use at home as they wished. The test treatments were brushing with 2 oscillating rotating electric toothbrushes, a manual toothbrush and a rinse with a toothpaste slurry (3 g/10 ml water). On day 1 of each study period, subjects were rendered plaque-free, suspended oral hygiene and returned on day 5. Plaque was scored at baseline by index and area and after 30 s, 30 s (total 60 s) and 60 s (total 120 s) of the cleaning treatments. Washout periods were at least 2 1/2 days. RESULTS Highly significant treatment differences were found between the 4 treatments because the toothpaste slurry was totally without effect. Analyses between the 3 brush treatments overall revealed no consistent significant differences. The data suggest that in the early days of electric toothbrush use, subjects perform no better than using a manual brush. CONCLUSIONS The present study, taken with results from others showing greater benefits from the use of electric brushes, supports the idea that dental professionals should, where possible, provide advice and instruction in the use of such devices.
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Affiliation(s)
- P Renton-Harper
- Division of Restorative Dentistry, Dental School, Bristol, England
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Dababneh RH, Khouri AT, Addy M. Dentine hypersensitivity — an enigma? a review of terminology, mechanisms, aetiology and management. Br Dent J 1999; 187:606-11; discussion 603. [PMID: 16163281 DOI: 10.1038/sj.bdj.4800345] [Citation(s) in RCA: 158] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/1999] [Accepted: 09/24/1999] [Indexed: 11/09/2022]
Abstract
Dentine hypersensitivity is a relatively common problem experienced in clinical dental practice. This condition may disturb the patient during eating, drinking, brushing and sometimes even breathing. Therapeutic intervention by desensitising agents may provide only partial pain relief and recurrence is common. Much remains unknown about dentine hypersensitivity, even the terminology can be questioned. Most of the literature over decades has been concerned with reporting clinical trials proving the efficacy of numerous treatments for dentine hypersensitivity. Indeed, besides haemorrhoids, there can be few other diseases or conditions known to man that can apparently be successfully treated by so many and extremely varied agents and formulations applied topically. This paper will discuss the epidemiology, mechanisms of pain production and aetiological factors for the condition in the hope of developing ideas for more realistic prevention and management strategies.
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Affiliation(s)
- R H Dababneh
- Jordanian Royal Medical Services, Queen Alia Military Hospital, Jordan
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38
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39
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Affiliation(s)
- J M Moran
- Division of Restorative Dentistry, Dental School, Bristol, United Kingdom
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40
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Abstract
Gingival recession (GR) is an intriguing condition. This brief communication, after proposing a definition for GR, considers the possible relevance of anatomical, physiological, pathological and traumatic factors in its etiology. It is probable that no one factor in isolation leads to the development of GR. Because of the possible influence of several factors, not necessarily acting synchronously, the occurrence of GR at a given site may be difficult to explain fully, and any subsequent changes may be hard to predict. The importance of the CEJ (or other fixed point) in assessment of GR severity is discussed. A new two-figure Index of Recession (IR) (e.g., F2-4asterisk) is also described, in which the 1st digit relates to the proportional evaluation of the horizontal extent of GR at the level of CEJ, and the 2nd digit is the vertical extent of GR from CEJ in millimetres; the asterisk denotes involvement of the MGJ. The prefixed F (or L) denotes whether GR is facial (or lingual) to the involved root.
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Affiliation(s)
- R G Smith
- Department of Oral & Dental Science, Dental School, Bristol, UK
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41
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Lancashire P, Janzen J, Zach GA, Addy M. The oral hygiene and gingival health of paraplegic inpatients--a cross-sectional survey. J Clin Periodontol 1997; 24:198-200. [PMID: 9083905 DOI: 10.1111/j.1600-051x.1997.tb00491.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Physical and/or mental handicaps are known to directly or indirectly compromise hygiene habits including oral hygiene. It is recommended that handicapped patients, their parents or care workers require from an early stage dental health education and active involvement in preventive programmes. This study surveyed the oral hygiene of paraplegic patients in a specialised centre to determine their oral hygiene needs. Most patients had moderate to poor oral hygiene and gingivitis was prevalent and severe. Plaque and gingivitis was increased in quadriplegic compared to hemiplegic patients. The data indicate that as part of rehabilitation of paraplegic patients there is a need for oral hygiene programmes to be established.
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Affiliation(s)
- P Lancashire
- Division of Restorative Dentistry, Dental School, Bristol, England
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42
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Radford JR, Beighton D, Nugent Z, Jackson RJ. Effect of use of 0.05% cetylpyridinium chloride mouthwash on normal oral flora. J Dent 1997; 25:35-40. [PMID: 9080738 DOI: 10.1016/s0300-5712(95)00116-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The aims of this study were to examine the effect of the use of a mouthwash containing 0.05% cetylpyridinium chloride (CPC) on (1) the composition of the normal oral microbial flora and (2) the establishment of non-oral bacterial species in the mouth. METHOD In a double-blind study, 129 subjects used, twice daily for 6 weeks, either a randomly assigned test or placebo mouthwash. At baseline and at the completion of the study, a sample of the oral flora was obtained by asking each subject to "swish" around the mouth for 30 s, 10 ml of distilled water. The numbers of total colony forming units (CFU), facultative bacteria, streptococci, mutans streptococci, lactobacilli, staphylococci, yeasts and enterococci were enumerated after culture on eight non-selective and selective media. RESULTS After 6 weeks use of either the test or placebo mouthwashes, there were no significant differences (analysis of variance) between the counts (CFU/ml of sample) for any of the microbial taxa. CONCLUSIONS These data indicate that the use of a CPC-containing mouthwash does not alter the composition of the normal oral flora or result in the establishment of non-oral and potentially pathogenic bacteria in the mouth.
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Affiliation(s)
- J R Radford
- Department of Conservative Dentistry, Dundee Dental Hospital and School, University of Dundee, UK
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43
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Lancashire P, Janzen J, Zach GA, Addy M. Plaque and gingivitis in spinal paralysed individuals. Spinal Cord 1996; 34:498-9. [PMID: 8856860 DOI: 10.1038/sc.1996.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Moran J, Addy M, Newcombe R, Warren P. The comparative effects on plaque regrowth of phenolic chlorhexidine and anti-adhesive mouthrinses. J Clin Periodontol 1995; 22:929-34. [PMID: 8613561 DOI: 10.1111/j.1600-051x.1995.tb01797.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The inhibition of bacterial attachment to the tooth surface is one possible approach to plaque control. This study evaluated in vivo the plaque inhibitory action of a novel copolymer reported to have considerable antiadhesive properties in vitro. The study was a single blind, 5-treatment, randomised Latin square crossover design, incorporating balance for carry-over effects. The rinses were the antiadhesive (1%), the antiadhesive with 0.02% chlorhexidine, a 0.2% chlorhexidine rinse product, an essential oil/phenolic rinse product and water. 15 volunteers participated and on day 1 of each study period were rendered plaque-free, ceased toothcleaning and rinsed 2 x daily, under supervision, with the allocated formulation. On day 5, plaque was scored by index and area. Washout periods were 2 1/2 days. Alone or combined with chlorhexidine, the antiadhesive agent showed no effects greater than water. The chlorhexidine rinse was significantly more effective than the essential oil/phenolic rinse which in turn was significantly more effective than the other rinses.
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Affiliation(s)
- J Moran
- Department of Prosthodontics, Dental School, Bristol, England
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45
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Claydon N, Addy M. The use of planimetry to record and score the modified Navy index and other area-based plaque indices. A comparative toothbrush study. J Clin Periodontol 1995; 22:670-3. [PMID: 7593695 DOI: 10.1111/j.1600-051x.1995.tb00824.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Many plaque-scoring methods are based on a subjective assessment of the amount of tooth surface covered by plaque or the presence or absence of plaque at specific sites. The 2x modified Navy plaque index is an example of the latter and requires chairside decisions from 9 zones of all buccal and lingual tooth surfaces, i.e., up to 576 for a complete dentition. The present study describes a procedural modification to the index, whereby plaque is recorded using an established planimetric plaque area method. Scoring is then performed using an overlay away from the clinic. To test the method, plaque-area measurements were made during a 30-subject, crossover study to compare plaque removal following single toothbrushings with 3 different types of manual toothbrush. Consistent with many such studies, no significant differences in plaque removal were noted between the brushes. The method was found quick and simple at the chairside, provided a permanent record of plaque distribution and could be analysed by clinical or nonclinical personnel under ideal conditions. The same method could be employed for other plaque indices based on area or site subjective decisions.
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Affiliation(s)
- N Claydon
- Department of Oral and Dental Science, University of Bristol, Dental School, UK
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46
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Cancro LP, Fischman SL. The expected effect on oral health of dental plaque control through mechanical removal. Periodontol 2000 1995; 8:60-74. [PMID: 9567946 DOI: 10.1111/j.1600-0757.1995.tb00045.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- L P Cancro
- Institute of Applied Pharmaceutical Research, Ltd., Merion, Pennsylvania, USA
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47
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Addy M, Koltai R. Control of supragingival calculus. Scaling and polishing and anticalculus toothpastes: an opinion. J Clin Periodontol 1994; 21:342-6. [PMID: 8034779 DOI: 10.1111/j.1600-051x.1994.tb00723.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The removal of supragingival calculus by scaling and polishing of the teeth is only one aspect of a dental prophylaxis. However in many countries, a large number of individuals only require and receive, at regular intervals, a supragingival scale and polish. The association of supragingival calculus to gingival and periodontal disease is unclear, however, it is logical to assume a plaque retention role. Moreover, for the individual, supragingival calculus may pose cosmetic problems. Regular calculus removal is both time consuming and exacting for dental professionals and has important financial implications to patients and/or health schemes. The benefits of regular supragingival calculus removal are not established, yet potential detrimental effects for the patient are known, and certain groups are susceptible to systemic disease consequent on scaling and polishing of the teeth. The oral hygiene habits of most individuals appear insufficient to prevent the reformation of supragingival calculus once removed and for this reason chemical inhibition is an attractive proposition. Most success to date has been with agents which inhibit crystal growth, notably pyrophosphates, and toothpaste products are available containing such agents. Clinical studies support efficacy for some products and indicate that the magnitude of calculus inhibition would reduce the need for or frequency of scaling and polishing of teeth in a proportion of individuals. Anticalculus toothpastes would appear to be proven worthy of recommendation for those individuals in whom supragingival calculus formation is a problem.
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Affiliation(s)
- M Addy
- Department of Prosthodontics and Periodontology, Dental School, Bristol, England
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48
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Addy M, Pearce N. Aetiological, predisposing and environmental factors in dentine hypersensitivity. Arch Oral Biol 1994; 39 Suppl:33S-38S. [PMID: 7702465 DOI: 10.1016/0003-9969(94)90186-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
If the hydrodynamic theory of stimulus transmission across dentine is valid, sensitive dentine has tubules open at the surface and patent to the pulp. Direct and indirect evidence supports this supposition. Factors that result in dentine exposure remove the covering enamel or periodontal tissues (gingival recession). Epidemiological and clinical data for the distribution of exposed cervical dentine indicate that chronic trauma from physical and chemical factors is the most significant aetiological factor. Brushing with a toothpaste may not open dentinal tubules. It is more likely that toothpaste ingredients, when brushed on dentine, would create a smear layer. Exposure of tubules by erosion is probably the major initiator of sensitivity. An increase in our understanding of the aetiological factors involved in dentine hypersensitivity is essential if a sound approach to its management is to evolve. Such information could emanate from epidemiological studies, clinical investigations and laboratory experiments.
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Affiliation(s)
- M Addy
- Department of Periodontology, Dental School, University of Wales College of Medicine, Cardiff
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49
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Abstract
Chemical plaque removal is one mechanism whereby an agent could improve oral hygiene and gingival health. As with toothpastes most agents, when delivered as rinses, would be considered adjunctive to mechanical tooth cleaning procedures. The aim of this study was to determine whether selected commercial rinses exhibited clinically significant plaque removal properties alone or when combined with toothbrushing with water or a toothpaste. A group of 12 volunteers took part in this single blind, randomized placebo-controlled, 12 cell cross-over study, employing 6 rinses. During each regimen subjects accumulated plaque from a zero baseline over 72 hours. Plaque removal was then measured by index and area after first a single rinse of product and second a subsequent brushing with water or toothpaste. Prebrushing rinsing removed less than 5% of the plaque with little difference between agents. No rinse was more adjunctive than water to postrinse brushings. Most statistically significant differences arose with the chlorhexidine rinse being apparently less effective. However, the possibility of a disclosing dye interaction cannot be discounted as explaining this anomalous result. This study could not support any claim of a direct prebrushing rinse benefit greater than that provided by water to mechanical plaque removal by any of the products tested.
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Affiliation(s)
- A Binney
- Department of Periodontology, Dental School, University of Wales College of Medicine, Cardiff, UK
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Addy M, Slayne MA, Wade WG. The formation and control of dental plaque--an overview. THE JOURNAL OF APPLIED BACTERIOLOGY 1992; 73:269-78. [PMID: 1429304 DOI: 10.1111/j.1365-2672.1992.tb04977.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Addy
- Department of Periodontology, Dental School, University of Wales College of Medicine, Heath Park, Cardiff, UK
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