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Bevilacqua L, Lorenzon MG, Bjedov M, Costantinides F, Angerame D, Maglione M. Evaluation of the efficacy of inter-dental brush and dental floss for peri-implant mucositis: A crossover randomized clinical trial. Int J Dent Hyg 2024; 22:779-788. [PMID: 38487950 DOI: 10.1111/idh.12793] [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: 12/17/2021] [Revised: 09/15/2023] [Accepted: 02/25/2024] [Indexed: 07/23/2024]
Abstract
OBJECTIVES To evaluate the most effective method for mechanical inter-dental plaque removal between inter-dental brushes (IDB) and dental floss (DF), in addition to toothbrushing in patients affected by peri-implant mucositis (PIM); to identify possible factors related to the patient or to the single implant-supported element that could influence plaque accumulation and inflammation of peri-implant tissues. METHODS Forty patients with PIM were recruited. They were randomly assigned to two different groups depending on inter-dental device used (IDB or DF). At baseline (T0), interproximal area (IA), interproximal emergence angle of the implant crown (A°) and manual dexterity (evaluated with Purdue Pegboard) have been recorded. At 14 days (T1), the inter-dental cleaning devices have been inverted between groups. After 14 days (T2), the Plaque Index (PI) and Gingival Index (GI) have been recorded. A questionnaire has been submitted to a patient for the analysis of preferences at T0, T1 and T2. RESULTS Both inter-dental cleaning devices were effective in reducing PI and GI in the inter-dental area after 14 days of use. GI reduction was influenced by manual dexterity of the dominant hand. No significant differences were found for PI and GI at the variation of IA and A°. CONCLUSION IDB was the most effective method for inter-dental plaque removal in all subjects regardless of their manual dexterity. DF seems to be more effective than IDB only in subjects with good dexterity.
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Affiliation(s)
- Lorenzo Bevilacqua
- Clinical Department of Medical Sciences, Surgery and Health, University of Trieste, Trieste, Italy
| | - Maria Giulia Lorenzon
- Clinical Department of Medical Sciences, Surgery and Health, University of Trieste, Trieste, Italy
| | - Marianna Bjedov
- Clinical Department of Medical Sciences, Surgery and Health, University of Trieste, Trieste, Italy
| | - Fulvia Costantinides
- Clinical Department of Medical Sciences, Surgery and Health, University of Trieste, Trieste, Italy
| | - Daniele Angerame
- Clinical Department of Medical Sciences, Surgery and Health, University of Trieste, Trieste, Italy
| | - Michele Maglione
- Clinical Department of Medical Sciences, Surgery and Health, University of Trieste, Trieste, Italy
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Mohapatra S, Mohandas R. Plaque cleaning efficacy of waist-shaped interdental brushes among individuals with open interproximal spaces: a systematic review. Evid Based Dent 2024:10.1038/s41432-024-01036-0. [PMID: 39020080 DOI: 10.1038/s41432-024-01036-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/01/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND The shape and design of interdental brushes are crucial for appropriate adaptation to the interproximal areas, despite their excellent cleaning efficacy. The aim of this review is to assess and compare the available data on the plaque cleaning efficacy of waist-shaped interdental brushes with any other shaped-interdental brushes among patients with wide interdental spaces. METHODS Scopus, PubMed, Cochrane, Science Direct, EBSCO Host, Lilacs, Science Direct, Web of Science, and Google Scholar were searched from the earliest available year (2011) till May 15, 2024. PICO Strategy: P: Individuals with open interproximal spaces; I: Waist-shaped interdental brushes; C: Any other shaped interdental brushes; O: Interproximal plaque cleaning efficacy. The review only comprised randomized controlled trials. The risk of bias assessment and quality of evidence was assessed using the RoB-2 Tool and GRADE Tool respectively. RESULTS Three full-text publications that met the requirements for eligibility underwent additional processing for data extraction. The overall results of the review suggest that the plaque cleaning efficacy of waist-shaped interdental brushes is better than straight/cylindrical-shaped interdental brushes in patients with open interdental spaces; especially on the buccal and lingual line angles. However, the pooling of data was not possible due to the high heterogeneity between the studies. CONCLUSION The current review suggests that the plaque cleaning efficacy of waist-shaped interdental brushes could be better than straight or cylindrical shaped-interdental brushes in patients with open interproximal spaces, especially in buccal and lingual line angles. However, further research should focus on appropriate methodological techniques to increase overall reporting quality and limit the possibility of bias.
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Affiliation(s)
- Subhashree Mohapatra
- Department of Public Health Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India
| | - Rahul Mohandas
- Department of Oral Pathology and Microbiology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
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Son JY, Kim EJ. Interdental cleaning and periodontal status among older Koreans: Findings from KNHANES VII. Gerodontology 2024; 41:295-304. [PMID: 37927103 DOI: 10.1111/ger.12725] [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] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To assess the association between the usage of interdental cleaning and periodontal status among older people in Korea. BACKGROUND In order to maintain oral health in older people, it is very important to use interdental cleaning devices. However, there is a lack of research on periodontal status and interdental cleaning device use in older people. METHODS This study used data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016-2018). A total of 3426 older people adults aged 65 years or older were selected from 16 489 participants. Data on sociodemographic status (sex, age, level of education, income, residential area), personal health practice (subjective health status, smoking, physical activity, hypertension, and diabetes mellitus), oral health practice (subjective oral health status, tooth brushing frequency, dental visits, and chewing problem), the number of teeth and periodontitis were collected. Periodontitis was defined as having a World Health Organisation community periodontal index (CPI) code greater than or equal to three, and severe periodontitis was defined as a CPI code 4. Participants having a CPI code of 3 or 4 were considered to have periodontal disease in this study. Logistic regression analysis investigated the association between interdental cleaning devices usage and periodontitis controlling the confounding factors. RESULTS Those who do not use dental floss had a higher rate of periodontal disease (AOR = 1.47, 95% confidence interval [CI]: 1.05 to 2.1). However, there were no significant differences by interdental brush use. In those with 20 or more teeth, non-users of dental floss had a higher risk of periodontitis in all models. Conversely, in those with fewer than 20 teeth, no significant differences were observed. CONCLUSIONS Older people with mostly intact dentitions have better periodontal health if they clean between their teeth.
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Affiliation(s)
- Ji-Young Son
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
- Department of Preventive Dentistry & Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Eun-Jeong Kim
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
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Sarkisova F, Morse Z, Lee K, Bostanci N. Oral Irrigation Devices: A Scoping Review. Clin Exp Dent Res 2024; 10:e912. [PMID: 38881230 PMCID: PMC11180943 DOI: 10.1002/cre2.912] [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: 03/17/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVES Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that may benefit oral health. However, the effects of oral irrigation on oral health, its role in oral home care, and its mechanism of action are not fully understood. A comprehensive search of the literature revealed no existing broad scoping reviews on oral irrigators. Therefore, this study aimed to provide a comprehensive systematic review of the literature on oral irrigation devices and identify evidence gaps. METHODS The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were utilized to prepare the review. Four databases and eight gray literature sources were searched for English publications across any geographical location or setting. RESULTS Two hundred and seventy-five sources were included, predominantly from scientific journals and academic settings. Most studies originated from North America. Research primarily involved adults, with limited studies in children and adolescents. Oral irrigation was safe and well-accepted when used appropriately. It reduced periodontal inflammation, potentially by modulating the oral microbiota, but further research needs to clarify its mechanism of action. Promising results were reported in populations with dental implants and special needs. Patient acceptance appeared high, but standardized patient-reported outcome measures were rarely used. Anti-inflammatory benefits occurred consistently across populations and irrigant solutions. Plaque reduction findings were mixed, potentially reflecting differences in study designs and devices. CONCLUSIONS Oral irrigators reduce periodontal inflammation, but their impact on plaque removal remains unclear. Well-designed, sufficiently powered trials of appropriate duration need to assess the clinical, microbiological, and inflammatory responses of the periodontium to oral irrigation, particularly those with periodontitis, dental implants, and special needs. Patient-reported outcome measures, costs, caries prevention, and environmental impact of oral irrigation need to be compared to other oral hygiene aids.
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Affiliation(s)
- Farzana Sarkisova
- Department of Oral HealthAuckland University of TechnologyAucklandNew Zealand
| | - Zac Morse
- Department of Oral HealthAuckland University of TechnologyAucklandNew Zealand
| | - Kevin Lee
- Department of Food Science and MicrobiologyAuckland University of TechnologyAucklandNew Zealand
| | - Nagihan Bostanci
- Department of Dental Medicine, Division of Oral Health and PeriodontologyKarolinska InstitutetStockholmSweden
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Reiniger APP, Cr Tavares R, Ortigara GB, Tatsch KF, Uliana JC, Wikesjö UM, Moreira CHC, Kantorski KZ. Effectiveness of dental floss in the management of gingival health: A 6-month follow-up of a randomized controlled clinical trial. Clin Oral Investig 2024; 28:319. [PMID: 38750375 DOI: 10.1007/s00784-024-05693-4] [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: 11/10/2023] [Accepted: 04/24/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVES To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health. MATERIALS AND METHODS Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (p < 0.05). RESULTS 68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone. CONCLUSIONS OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae. CLINICAL RELEVANCE Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health. CLINICALTRIALS GOV : (53831716.5.0000.5346). TRIAL REGISTRATION The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration.
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Affiliation(s)
- Ana Paula P Reiniger
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil
| | - Rodrigo Cr Tavares
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil
| | - Gabriela B Ortigara
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil
| | - Karen F Tatsch
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil
| | - Jaine C Uliana
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil
| | - Ulf Me Wikesjö
- Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Carlos Heitor Cunha Moreira
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil
| | - Karla Z Kantorski
- Post-Graduate Program in Oral Sciences, Federal University of Santa Maria, Avenida Roraima n. 1000, Prédio 26F, Santa Maria, RS, 97015-900, Brasil.
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Ju X, Hedges J, Sethi S, Jamieson LM. Poor Self-Rated Sleep Quality and Quantity Associated with Poor Oral Health-Related Quality of Life among Indigenous Australian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:453. [PMID: 38673364 PMCID: PMC11050505 DOI: 10.3390/ijerph21040453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/31/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Indigenous Australians score worse on both sleep and oral health. This study aimed to evaluate sleep quality and quantity associated with oral health-related quality of life (OHRQoL) among Indigenous Australian adults. METHODS A cross-sectional study involving 728 Indigenous Australian adults aged 18+ years was conducted. Exposure variables were sleep quality and quantity. The primary outcome variable was Oral Health Impact Profile-14 (OHIP14), which has been used to assess OHRQoL. Multivariable log-Poisson regression models were applied to estimate the mean ratios (MRs) for mean OHIP14 scores. RESULTS The average OHIP14 score was 14.9, and the average amount of sleep was 6.8 h/night. After adjusting for all covariates, self-rated very bad sleep quality was associated with 2.2 times (MR = 2.17, 95% CI: 1.97-2.37) higher OHIP14 scores than those who rated their sleep quality as very good. Participants who self-reported sleeping 7-8 h/night had 0.9 times (MR = 0.89, 95%CI: 0.83-0.95) lower OHIP14 scores than those sleeping more than 8 h. CONCLUSIONS The average number of sleep hours for Indigenous participants were lower than recommended (7-8 h/night). Our findings indicate that poor sleep quality and quantity, and oral health-related behaviours associated with sleep deprivation were positively associated with poor oral health related quality of life among Indigenous Australian adults.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre of Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (S.S.); (L.M.J.)
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Härdter AK, Nordloh A, Cyris M, Straßburger M, Rinder T, Dörfer CE, Sälzer S, Graetz C. New design of interdental rubber picks - does the archimedean screw design bring an improvement for experimental cleaning efficacy and force? BMC Oral Health 2024; 24:404. [PMID: 38553668 PMCID: PMC10981285 DOI: 10.1186/s12903-024-04162-4] [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: 09/27/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Up to date, interdental brushes (IDB) are the first choice for interdental cleaning because of their cleaning efficacy. Cylindrical ones must be selected individually according to the size/morphology of the interdental area (IDR), whereas conical ones cover a larger variability of IDR. However, there is a trend on the part of patients towards interdental rubber picks (IRP) which are in general conically shaped, and which seem to be linked with lower cleaning efficacy. A new IRP with an Archimedes´ screw design was developed to overcome this limitation. Therefore, the in vitro study aimed to measure the experimental cleaning efficacy (ECE) and force (ECF) during interdental use of IDBs versus the new IRP type. METHODS Three IRPs with different tapers (PHB angled: 0.039, PHB straight S: 0.027, Vitis straight M: 0.045; all Flexipicks, Dentaid, Cerdanyola del Vallès, Spain) were compared to one IDB (Interprox micro PHD 0.9, Dentaid, Cerdanyola del Vallès, Spain). IDR were reproduced by a 3D-printer (Form2, Formlabs Sommerville, MA, USA) according to human teeth and matched to equivalent pairs (isosceles triangle, concave, convex) in three different diameters (1.0 mm,1.1 mm,1.3 mm). Covered with simulated biofilm, pre-/ post-brushing situations of IDR (standardized, computer-aided ten cycles) were photographed and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. Statistically significant differences were detected using the Mann-Whitney-U-test and the Kruskal-Wallis-test with Bonferroni correction for multiple testing. RESULTS Overall, the ECE (mean ± SD) was higher for IDB micro 0.9 (45.95 ± 11.34%, p < 0.001) compared to all IRPs (PHB angled: 25.37 ± 15.29%; PHB straight: 22.28 ± 16.75%; Vitis straight: 25.24 ± 12.21%; p ≤ 0.001), whereat best ECE was achieved in isosceles triangle IDR of 1.0-1.1 mm (IDB micro 0.9: 70.7 ± 7.7%; PHB angled S: 57.30 ± 4.43%; p < 0.001). The highest ECF occurred for Vitis straight M with 2.11 ± 0.46 N, while IDB micro 0.9 showed lowest ECF values (0.64 ± 0.14 N; p < 0.001). CONCLUSIONS IRP with an Archimedes´ screw design and a higher taper were associated with advanced ECE but also higher ECF, nevertheless, ECE didn't reach the cleaning efficacy of conventional IDBs.
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Affiliation(s)
- Ann-Kristin Härdter
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anna Nordloh
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Cyris
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Martin Straßburger
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
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Holtfreter B, Conrad E, Kocher T, Baumeister SE, Völzke H, Welk A. Interdental cleaning aids are beneficial for oral health at 7-year follow-up: Results from the Study of Health in Pomerania (SHIP-TREND). J Clin Periodontol 2024; 51:252-264. [PMID: 38116705 DOI: 10.1111/jcpe.13936] [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: 06/29/2023] [Revised: 11/14/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
AIM To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study. MATERIALS AND METHODS We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation. RESULTS Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs. CONCLUSIONS Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.
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Affiliation(s)
- Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Elena Conrad
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alexander Welk
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Ge Y, Bamashmous S, Mancinelli-Lyle D, Zadeh M, Mohamadzadeh M, Kotsakis GA. Interdental oral hygiene interventions elicit varying compositional microbiome changes in naturally occurring gingivitis: Secondary data analysis from a clinical trial. J Clin Periodontol 2024; 51:309-318. [PMID: 38088457 DOI: 10.1111/jcpe.13899] [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: 05/28/2023] [Revised: 09/27/2023] [Accepted: 10/22/2023] [Indexed: 02/17/2024]
Abstract
AIM To evaluate the effect of different oral irrigators on the sub-gingival microbiome composition in patients with naturally occurring plaque-induced gingivitis. MATERIALS AND METHODS Sub-gingival plaque was collected from adults participating in a clinical trial assessing the efficacy of oral hygiene with two different oral irrigators (Waterpik Water Flosser [Group 1] and Oral-B Water Flosser [Group 2]) versus dental flossing (Group 3) for microbiome analysis. Plaque samples were reflective of naturally occurring plaque-induced gingivitis at baseline and of gingival health at the endpoint (4 weeks). Clinical measures of gingival inflammation were collected, and the sub-gingival microbiome was analysed by 16S rRNA sequencing to identify amplicon sequence variants. RESULTS Oral hygiene instruction with self-performed manual toothbrushing and water-jet irrigation led to significant reductions in inflammation for all groups; both oral irrigators outperformed flossing in bleeding-on-probing reduction (p < .001). Microbiome diversity of sub-gingival plaque remained relatively stable over time, but significant changes were noted in certain taxa, consistent with increases in the relative abundance of commensals and reductions in late colonizers and periodontal pathogens in the water-jet groups. CONCLUSIONS Reduction in gingival inflammation at 4 weeks within the water-jet groups is accompanied by slight but critical changes in microbiome composition. Although biodiversity does not substantially change within 4 weeks during the resolution of naturally induced gingivitis, significant relative increases in commensal early colonizers such as Streptococcus, Veillonella and Fusobacterium were accompanied by a shift towards a less anaerobic microbiota associated with return to health. These changes were contingent upon the type of interdental hygiene, with Group 1 exhibiting more significant alterations in microbiome composition towards a periodontal-health-compatible community.
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Affiliation(s)
- Yong Ge
- Department of Microbiology, Immunology & Molecular Genetics, University of Texas Health, San Antonio, Texas, USA
| | - Shatha Bamashmous
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Deborah Mancinelli-Lyle
- Department of Periodontology, Academic Center for Dentistry, University of Amsterdam, Amsterdam, The Netherlands
| | - Mojgan Zadeh
- Department of Microbiology, Immunology & Molecular Genetics, University of Texas Health, San Antonio, Texas, USA
| | - Mansour Mohamadzadeh
- Department of Microbiology, Immunology & Molecular Genetics, University of Texas Health, San Antonio, Texas, USA
| | - Georgios A Kotsakis
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, New Jersey, USA
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Van der Weijden GAF, van Loveren C. Mechanical plaque removal in step-1 of care. Periodontol 2000 2023. [PMID: 38148481 DOI: 10.1111/prd.12541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 12/28/2023]
Abstract
Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. Patient education on oral hygiene is an important component of their overall treatment. Firstly, patients should be informed about the direct connection between bacteria in dental plaque and oral diseases. It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. This journey begins by selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. These aids are particularly beneficial for eliminating dental plaque from hard-to-reach areas. Moreover, tongue brushing or tongue scraping can effectively reduce breath odor and tongue coating. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Evidence-based recommendations are derived from comprehensive systematic evaluation of various oral hygiene aids.
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Affiliation(s)
- G A Fridus Van der Weijden
- Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Clinic for Periodontology Utrecht, Utrecht, The Netherlands
| | - Cor van Loveren
- Academic Centre for Dentistry Amsterdam (ACTA), A Joint Venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Mancinelli-Lyle D, Qaqish JG, Goyal CR, Schuller R. Efficacy of water flossing on clinical parameters of inflammation and plaque: A 4-week randomized controlled trial. Int J Dent Hyg 2023; 21:659-668. [PMID: 37753575 DOI: 10.1111/idh.12770] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND The primary prevention of periodontitis is controlling gingivitis daily. The study objective was to compare the efficacy of a pulsating water flosser to a pulsating water flosser infused with air microbubbles on clinical signs of inflammation and plaque. METHODS One hundred and five participants were enrolled in this single-blind, single-centre, parallel, 4-week, IRB/IEC-approved clinical trial. Participants were randomly assigned to one of three groups: water flosser (WF) plus manual toothbrush, water flosser infused with microbubbles of air (MBWF) plus manual toothbrush, or dental floss (DF) plus manual toothbrush. Bleeding on probing (BOP), Modified Gingival Index (MGI) and Rustogi Modification Navy Plaque Index (RMNPI) scores were recorded at baseline, 2 and 4 weeks. RESULTS All participants completed the study (n = 105). All groups showed a statistically significant reduction for BOP, MGI and RMNPI at 4 weeks (p < 0.05, except DF marginal RMNPI). The WF group showed a statistically significant greater reduction in whole mouth BOP (0.41) compared to MBWF (0.32) and DF (0.19). This was also true for MGI (0.37, 0.30 and 0.20, respectively) and RMNPI (0.13, 0.11 and 0.06, respectively; p < 0.05 for all comparisons). No adverse events were reported. CONCLUSION This study demonstrates that a manual toothbrush and water flosser, with or without microbubbles, is an effective oral care regimen for controlling gingivitis over 4 weeks.
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Affiliation(s)
- Deborah Mancinelli-Lyle
- Department of Periodontology, Academic Center for Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jimmy G Qaqish
- All Sum Research Center, Ltd, Mississauga, Ontario, Canada
| | - C Ram Goyal
- All Sum Research Center, Ltd, Mississauga, Ontario, Canada
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12
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van Gennip LLA, Bulthuis MS, Blijlevens NMA, Huysmans MCDNJM, van Leeuwen SJM, Thomas RZ. Caries, periodontitis and tooth loss after haematopoietic stem cell transplantation: A systematic review. Oral Dis 2023; 29:2578-2591. [PMID: 36004454 DOI: 10.1111/odi.14358] [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: 11/11/2021] [Revised: 08/12/2022] [Accepted: 08/13/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE A systematic review was conducted to assess scientific knowledge concerning the effect of haematopoietic stem cell transplantation (HSCT) on the occurrence of caries, periodontal conditions and tooth loss, and to evaluate the prevalence of these diseases in adult HSCT survivors (PROSPERO 152906). METHODS PubMed and Embase were searched for papers, published from January 2000 until November 2020 without language restriction, assessing prevalence, incidence or parameters of caries, periodontal conditions and tooth loss in HSCT recipients (≥80% transplanted in adulthood). Bias risk was assessed with checklists from Joanna Briggs Institute, and data synthesis was performed by narrative summary. RESULTS Eighteen papers were included (1618 subjects). Half were considered at high risk of bias. Longitudinal studies did not show caries progression, decline in periodontal health or tooth loss after HSCT. The prevalence in HSCT survivors ranged from 19% to 43% for caries, 11% to 67% for periodontitis, and 2% to 5% for edentulism. Certainty in the body of evidence was very low. CONCLUSIONS Haematopoietic stem cell transplantation, on the short term, may have little to no effect on caries, periodontal conditions and tooth loss. Caries and periodontitis may be more common in HSCT survivors compared with the general population, whereas edentulism may be comparable. However, the evidence for all conclusions is very uncertain.
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Affiliation(s)
- Lucky L A van Gennip
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein S Bulthuis
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Stephanie J M van Leeuwen
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Renske Z Thomas
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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13
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Sirinirund B, Siqueira R, Li J, Mendonça G, Zalucha J, Wang HL. Effects of crown contour on artificial biofilm removal efficacy with interdental cleaning aids: An in vitro study. Clin Oral Implants Res 2023; 34:783-792. [PMID: 37269176 DOI: 10.1111/clr.14105] [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: 11/20/2022] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the efficacy of various interdental cleaning aids for artificial biofilm removal on different implant-supported crown designs. METHODS Mandibular models with missing first molar were fabricated and installed with single implant analogs and loaded with crowns of different designs (concave, straight, and convex). Artificial biofilm was made with occlusion spray. Thirty volunteers (periodontists, dental hygienists, and laypersons) were asked to clean the interproximal areas. The crowns were unscrewed and photographed in a standardized setting. The outcome was measured by the cleaning ratio which represents the cleaned surfaces in relation to the area of the tested surface. RESULTS A significant difference in favor of concave crown (p < .001) on the basal surface was cleaned by all tools, except the water flosser. There was evidence of an overall effect of "cleaning tool," "surface," and "crown design" (p < .0001) except for the "participant" factor. The mean cleaning ratio for each cleaning tool and overall combined surfaces were (in%): dental floss: 43.02 ± 23.93, superfloss: 42.51 ± 25.92, electric interspace brush: 36.21 ± 18.78, interdental brush: 29.10 ± 15.95, and electric water flosser: 9.72 ± 8.14. Dental floss and superfloss were significantly better (p < .05) than other tools in removing plaque. CONCLUSIONS Concave crown contour had the greatest artificial biofilm removal, followed by straight and convex crowns at the basal surface. Dental floss and superfloss were the most effective interdental cleaning devices for artificial biofilm removal. None of the tested cleaning devices were able to completely remove the artificial biofilm from the interproximal/basal surfaces.
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Affiliation(s)
- Benyapha Sirinirund
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Rafael Siqueira
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Junying Li
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Gustavo Mendonça
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Janet Zalucha
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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14
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Alves Dos Santos GN, Sousa-Neto MD, Assis HC, Lopes-Olhê FC, Faria-E-Silva AL, Oliveira ML, Mazzi-Chaves JF, Candemil AP. Prevalence and morphological analysis of dens invaginatus in anterior teeth using cone beam computed tomography: A systematic review and meta-analysis. Arch Oral Biol 2023; 151:105715. [PMID: 37146389 DOI: 10.1016/j.archoralbio.2023.105715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES To evaluate the prevalence and morphological characteristics of DI using CBCT. METHODS A literature search was performed in PubMed, Embase, Scopus, and Web of Science. Inclusion criteria were randomized clinical trials, cross-sectional studies, and prospective and retrospective cohort studies evaluating the morphological characteristics of DI in anterior teeth using CBCT. Three reviewer authors independently screened the studies, applied the eligibility criteria, assessed the risk of bias, and extracted until September (2022). The risk of bias was evaluated using the Joanna Briggs Institute criteria. Meta-analyses of proportions were used for estimate the prevalence DI according to factors at participant and tooth levels. RESULTS Six studies were included in the meta-analysis. Among 7373 individuals, a prevalence of 7.45 % of DI was observed (n = 258; τ2 = 0.0096; CI of 4.51-11.3; p < 0.05), with no significant influence of sex. Regarding laterality, unilateral DI showed higher mean prevalence (4.30 %; CI of 2.03-7.33). Among the 382 anterior teeth with DI (0.72 %), the most affected tooth was the upper lateral incisor (5.12 %; n = 329; CI of 2.35-8.86; p < 0.001), type I was the most prevalent (0.59 %; CI of 0.24-1.08) and the presence of open apex and periradicular pathology ranged from 4.3 % to 22.72 % and 3.5-77.92 %, respectively. CONCLUSIONS The prevalence of individuals with dens invaginatus was 7.45 %, the most affect tooth was the upper lateral incisor with a prevalence of 5.12 % unilaterally and type I was the most prevalent morphology.
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Affiliation(s)
- Guilherme Nilson Alves Dos Santos
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Helena Cristina Assis
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | | | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Jardel Francisco Mazzi-Chaves
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Amanda Pelegrin Candemil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
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15
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Wiesmüller V, Kasslatter M, Zengin B, Zotz D, Offermanns V, Steiner R, Crismani A, Kapferer-Seebacher I. Cleansing efficacy of an oral irrigator with microburst technology in orthodontic patients-a randomized-controlled crossover study. Clin Oral Investig 2023; 27:2089-2095. [PMID: 37022527 PMCID: PMC10160186 DOI: 10.1007/s00784-023-05003-4] [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: 12/09/2022] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES Orthodontic patients struggle with interdental cleaning calling for simpler mechanical devices to reduce the high plaque levels. The present study aimed to compare the cleansing efficacy of an oral irrigator with that of dental flossing in patients with fixed braces after 4 weeks of home-use. MATERIALS AND METHODS The study design is a randomized and single-blinded cross-over study. After 28 days using the products at home, hygiene indices (Rustogi Modified Navy Plaque Index (RMNPI); gingival bleeding index (GBI)) were compared between test (oral irrigator) and control product (dental floss). RESULTS Seventeen adult individuals finalized the study. After 28 days of cleaning with the oral irrigator, RMNPI was 54.96% (46.91-66.05) compared to 52.98% (42.75-65.60) with dental floss (p = 0.029). Subgroup analysis revealed that the higher cleansing efficacy of the dental floss is attributable to buccal and marginal areas. GBI after the test phase with the oral irrigator was 12.96% (7.14-24.31) and statistically significantly higher compared to 8.33% (5.84-15.33) with dental floss (p = 0.030) which could be seen in all subgroups. CONCLUSIONS Oral irrigators do not remove plaque and reduce gingival bleeding as efficiently as dental floss in easily accessible regions. However, in posterior regions, where the patients struggled with the application of dental floss, the oral irrigator showed similar results. CLINICAL RELEVANCE Oral irrigators should only be recommended to orthodontic patients who cannot use interdental brushes and are not compliant with dental flossing.
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Affiliation(s)
- Vera Wiesmüller
- Department of Conservative Dentistry and Periodontology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Manuel Kasslatter
- Department of Orthodontic Dentistry, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Baran Zengin
- Department of Conservative Dentistry and Periodontology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Desiree Zotz
- Department of Conservative Dentistry and Periodontology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | | | - René Steiner
- Department of Prosthetic Dentistry, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Adriano Crismani
- Department of Orthodontic Dentistry, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Ines Kapferer-Seebacher
- Department of Conservative Dentistry and Periodontology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
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16
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Nakajima M, Nakajima N, Guo J, Mitragotri S. Engineering of bioactive nanocomplexes on dental floss for targeted gingival therapy. Bioeng Transl Med 2023; 8:e10452. [PMID: 36925712 PMCID: PMC10013826 DOI: 10.1002/btm2.10452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022] Open
Abstract
Periodontitis induced by chronic subgingival infection is a ubiquitous disease that causes systemic inflammatory consequences and poses a negative impact on quality of life. The disease is treated and potentially prevented by patient's self-care aimed at eliminating the oral pathogens from the region. Currently available products for interdental self-care, including dental floss and interdental brush, have limited ability to prevent the disease. Here, we report a coated dental floss thread, termed "nanofloss," which uses polyphenol-based nanocoating to functionalize the floss thread with therapeutic agents. Multiple therapeutics can be integrated into the nanofloss including antibacterial small molecules and proteins. Flossing with nanofloss-delivered therapeutic agents to the challenging subgingival region with long-term retention even against the flushing action of the oral fluid in vivo. Our in vitro and in vivo studies demonstrate that chlorhexidine gluconate-loaded nanofloss effectively treats the subgingival infection by Porphyromonas gingivalis. Collectively, the nanofloss offers a promising and easily usable tool for targeted self-care of subgingival infection against periodontitis.
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Affiliation(s)
- Mayuka Nakajima
- John A. Paulson School of Engineering and Applied Sciences, Harvard University Cambridge Massachusetts USA.,Wyss Institute of biologically Inspired Engineering Boston Massachusetts USA.,Present address: Division of Periodontology, Department of Oral Biological Science Niigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Nao Nakajima
- John A. Paulson School of Engineering and Applied Sciences, Harvard University Cambridge Massachusetts USA.,Wyss Institute of biologically Inspired Engineering Boston Massachusetts USA.,Present address: Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences Niigata University Niigata Japan
| | - Junling Guo
- John A. Paulson School of Engineering and Applied Sciences, Harvard University Cambridge Massachusetts USA.,Wyss Institute of biologically Inspired Engineering Boston Massachusetts USA.,Present address: BMI Center for Biomass Materials and Nanointerfaces, College of Biomass Science and Engineering, College of Materials Science and Engineering Sichuan University Chengdu Sichuan China
| | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied Sciences, Harvard University Cambridge Massachusetts USA.,Wyss Institute of biologically Inspired Engineering Boston Massachusetts USA
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17
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Ren X, He J, Cheng R, Chen Y, Xiang Y, Zhang Y, Jiang S, Li J, Cheng L, Hu T. The Efficacy and Safety of Oral Irrigator on the Control of Dental Plaque and Gingivitis: A Randomized, Single-Blind, Parallel-Group Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3726. [PMID: 36834421 PMCID: PMC9965011 DOI: 10.3390/ijerph20043726] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND To evaluate the efficacy and safety of oral irrigator (OI) in controlling dental plaque and gingivitis. METHODS Ninety participants diagnosed with gingivitis were randomly assigned to two groups, given a toothbrush combined with OI (WaterPik®) (test) or a toothbrush alone (control). The Turesky-Modified Quigley-Hein Plaque Index (T-QH), Modified Gingival Index (MGI), Bleeding Index (BI), and percentage of sites with bleeding on probing (BOP%) were evaluated at baseline, 4 weeks, 8 weeks, and 12 weeks. The full analysis set (FAS) and per-protocol set (PPS) were analyzed. Adverse events were recorded through electronic diaries and examinations. RESULTS Of the 90 participants, the efficacy was assessed in the following numbers (FAS/PPS): test (45/33) and control (43/38). Compared with the control, MGI, BI, and BOP% were significantly lower in the test group after 4 weeks (4 weeks: p = 0.017, p = 0.001, and p = 0.001, respectively; 8 weeks and 12 weeks: p < 0.001 for all, FAS); T-QH was significantly lower after 8 weeks (8 weeks: p = 0.033; 12 weeks: p = 0.006, FAS). Transient gingival bleeding may be associated with OI. Self-reported pain and dentin hypersensitivity symptoms were similar between groups. CONCLUSIONS As adjuncts to toothbrushing, OI demonstrated significantly better efficacy in controlling dental plaque and gingival inflammation with no substantial safety hazards.
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Affiliation(s)
- Xiaolin Ren
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jing He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ran Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yulun Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yong Xiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuhan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Sulan Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jia Li
- State Institute of Drug Clinical Trial, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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18
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Moore GC, Smith KT, Christiansen MM, Anderson L, Moravec LJ, Okano DK, Samson KK, Ramer-Tait A, Beede K, Reinhardt RA, Killeen AC. Effect of interproximal home oral hygiene on clinical parameters and inflammatory biomarkers in patients receiving periodontal maintenance. J Periodontol 2023. [PMID: 36799307 DOI: 10.1002/jper.22-0631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The purpose of this 6-week, single-blinded, randomized clinical trial was to determine if the use of an interproximal brush, with or without a tracking device, is more effective than an oral irrigator in improving interproximal probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), bleeding on probing (BOP), and inflammatory markers. METHODS Seventy-six patients with Stages III-IV, Grade B periodontitis and a 5-7 mm posterior interproximal PD with BOP were randomized: (1) interproximal brush alone (IB; n = 26), (2) interproximal brush with tracking device (TD; n = 23), (3) oral irrigator (OI; n = 27). Participants used devices once daily for 6 weeks. Clinical measurements (PD, CAL, PI, BOP, GI) and gingival crevicular fluid (GCF) samples were collected at baseline and 6 weeks. RESULTS All groups showed a significant reduction in PD and CAL (≥1.1 mm, p < 0.0001) and improvement in BOP (≥56%, p < 0.0001) and GI (≥82%, p < 0.001) at the experimental site with no differences among groups. The IB and IB+TD groups showed a significant reduction in PI (≥0.9, p ≤ 0.01). Interleukin (IL)-1β was reduced in all groups (p = 0.006), but IB+TB more than OI (p ≤ 0.05). IL-10 was reduced among all groups (p = 0.01), while interferon-gamma significantly increased (p = 0.01) in all groups. CONCLUSIONS IB and OI improved clinical parameters of PD and CAL and reduced inflammatory markers (BOP, GI, GCF IL-1β). IB had better interproximal plaque reduction. Tracking did not significantly improve clinical parameters compared with the IB and OI groups, suggesting future modifications are needed.
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Affiliation(s)
- Grace C Moore
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Kevin T Smith
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Mary M Christiansen
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Laura Anderson
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Lisa J Moravec
- Department of Dental Hygiene, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - David K Okano
- Department of Periodontics, University of Utah School of Dentistry, Salt Lake City, Utah, USA
| | - Kaeli K Samson
- Department of Biostatistics, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska, USA
| | - Amanda Ramer-Tait
- Department of Food Science and Technology, University of Nebraska, Lincoln, Nebraska, USA
| | - Kristin Beede
- Department of Food Science and Technology, University of Nebraska, Lincoln, Nebraska, USA
| | - Richard A Reinhardt
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
| | - Amy C Killeen
- Department of Surgical Specialties, University of Nebraska Medical Center College of Dentistry, Lincoln, Nebraska, USA
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19
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Edlund P, Bertl K, Pandis N, Stavropoulos A. Efficacy of power-driven interdental cleaning tools: A systematic review and meta-analysis. Clin Exp Dent Res 2023; 9:3-16. [PMID: 36562267 PMCID: PMC9932241 DOI: 10.1002/cre2.691] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone or tooth brushing combined with any other non-PDICT in terms of interproximal plaque and gingival bleeding reduction in gingivitis patients. MATERIAL AND METHODS A systematic literature search was performed in three databases until March 20, 2022 with the following main eligibility criteria: (1) randomized controlled clinical trials (RCTs) with (2) at least 28 days of follow-up in (3) gingivitis patients. Interproximal plaque and bleeding values were defined as the primary outcome variables and used for pair-wise meta-analyses. RESULTS Sixteen RCTs were identified including data from 1258 participants at the final evaluation. Eight studies each investigated the effect of either a liquid-based or mechanical PDICT; one of these studies tested additionally a combined liquid-based and mechanical PDICT. Tooth brushing combined with a liquid-based PDICT compared to tooth brushing alone did not result in better interproximal plaque values but in significantly lower interproximal bleeding values. Tooth brushing combined with either a liquid-based PDICT or with a mechanical PDICT compared to tooth brushing and flossing achieved comparable interproximal plaque and bleeding values. The majority of studies reporting on patient compliance/preference favored the use of a PDICT, and except for a single study, which was reporting soft tissue trauma in two subjects from improper use of a mechanical PDICT, none of the studies reported adverse events. CONCLUSIONS Daily use of PDICT as an adjunct to tooth brushing significantly reduces interproximal bleeding. This effect appears comparable to that of flossing, while PDICT may achieve higher patient acceptance/compliance.
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Affiliation(s)
- Pia Edlund
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
| | - Kristina Bertl
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
- Division of Oral Surgery, University Clinic of DentistryMedical University of ViennaViennaAustria
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental MedicineUniversity of BernBernSwitzerland
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologyUniversity of MalmöMalmöSweden
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20
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Elkerbout TA, Slot DE, Rijnen ME, van der Weijden GAF. Change in oral hygiene behaviour after non-surgical periodontal therapy - A retrospective analyses. Int J Dent Hyg 2023; 21:259-271. [PMID: 35286771 PMCID: PMC10083970 DOI: 10.1111/idh.12593] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/17/2021] [Accepted: 01/10/2022] [Indexed: 01/12/2023]
Abstract
AIM This retrospective analysis investigates changes in daily oral hygiene behaviour after the initial phase of non-surgical periodontal therapy (NSPT). MATERIALS AND METHODS This retrospective study includes 189 consecutive periodontitis patients treated for moderate to severe periodontitis. The authors used the oral hygiene behaviour questionnaire (OHB-9) to assess and evaluate the oral hygiene self-care practices at both intake and evaluation after an active phase of NSPT which consisted of repeated oral hygiene instruction (OHI), supra- and subgingival debridement and polishing. In addition, data on pocket probing depth and bleeding upon pocket probing (BOP) were extracted and PISA and PESA scores were collected. All these parameters are descriptive of the periodontal status at intake and the clinical response to NSPT. RESULTS The OHB-9 showed an increased oral hygiene self-care level after the active phase of NSPT. At the evaluation, 85% of patients used a power toothbrush (PTB), representing an increase of 26% as compared with the intake. In addition, 64% reported brushing 3 min or longer, representing an increase of 33%. The use of woodsticks (WS) and interdental brushes (IDB) at least once a day increased with 15% and 40% respectively. The distribution changes on the answering scale were significant for IDB, WS and brushing duration. However, no significant relationship was found between oral hygiene behaviour at the evaluation and the improvement of the gingival inflammation evaluated by BOP percentage. CONCLUSION The finding of the OHB-9 questionnaire reported was an increase of patients who brushed longer and used the PTB, WS and IDB on a daily basis. The observed improvements in gingival inflammation assessed as bleeding on probing tendency were not significantly associated with oral hygiene behaviour at the evaluation of NSPT.
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Affiliation(s)
- Therese A Elkerbout
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - G A Fridus van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and the Faculty of Dentistry of the Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Clinic for Periodontology Utrecht, Utrecht, The Netherlands
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21
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van der Sluijs E, Slot DE, Hennequin-Hoenderdos NL, Valkenburg C, van der Weijden FGA. The efficacy of an oscillating-rotating power toothbrush compared to a high-frequency sonic power toothbrush on parameters of dental plaque and gingival inflammation: A systematic review and meta-analysis. Int J Dent Hyg 2023; 21:77-94. [PMID: 35535635 PMCID: PMC10084121 DOI: 10.1111/idh.12597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/22/2022] [Accepted: 05/08/2022] [Indexed: 01/12/2023]
Abstract
AIM To establish the efficacy of oscillating-rotating power toothbrush (OR-PTB) compared to high-frequency sonic power toothbrush (HFS-PTB) on improving parameters of plaque and gingival inflammation. Safety and participants' preference were secondary interests. MATERIALS AND METHODS MEDLINE-PubMed and Cochrane-CENTRAL databases were searched, up to April 2021. Inclusion criteria were (randomized)controlled clinical trials that evaluated healthy humans brushing with an OR-PTB compared to a HFS-PTB. Evaluation for a minimum of 4 weeks, of one or more of the following parameters: plaque index scores (PI), bleeding scores (BS), number of bleeding sites (NoB) and gingival index scores (GI). RESULTS Thirty two publications involving 38 comparisons were included after the independent screening. The descriptive analysis showed that in 54% of the comparisons, a significant difference in favour of the OR-PTB was found for PI, BS and GI scores. The Quigley and Hein index showed a significant difference of means (DiffM) between the end scores (DiffM 0.13, 95% CI [0.05;0.21] p < 0.001), as well as for the Rustogi-modified Navy index (DiffM 0.01, 95% CI [0.01;0.03] p = 0.002). This is in line with the meta-analysis for BS (DiffM 0.09, 95% CI [0.03;0.14] p = 0.003), for which the results were in favour of the OR-PTB and considered potentially clinically relevant. NoB showed a significant difference in favour of the OR-PTB for the end scores (DiffM 3.61, 95% CI [2.63;4.58] p < 0.00001). No difference in safety was indicated, 78% of participants preferred the OR-PTB. CONCLUSION For patients to maintain good plaque control and improve gingival health, there is a small but significant difference based on longer-term studies between OR-PTB and HFS-PTB. This difference is potentially clinically relevant.
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Affiliation(s)
- Eveline van der Sluijs
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Nienke Lisette Hennequin-Hoenderdos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Cees Valkenburg
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Fridus G A van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), a joint venture between the Faculty of Dentistry of the University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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22
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van Nes KA, van Loveren C, Luteijn MF, Slot DE. Health action process approach in oral health behaviour: Target interventions, constructs and groups-A systematic review. Int J Dent Hyg 2023; 21:59-76. [PMID: 36208281 PMCID: PMC10092238 DOI: 10.1111/idh.12628] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/18/2022] [Accepted: 10/02/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of this study was to systematically map the Health Action Process Approach (HAPA)-based interventions in dentistry in relation to the type of intervention, the target groups and the constructs of the HAPA model that are used in the study and to assess the clinical relevance of the studies. METHODS A search in the databases of the National Library of Medicine (MEDLINE-PubMed), PsychINFO and Cochrane-CENTRAL was conducted. A quality assessment to estimate the risk of bias and a qualitative descriptive analysis were performed. The overall gathered evidence was graded. RESULTS Ten randomized controlled trials and three observational studies thus in total 13 studies were included. Flossing was the targeted behaviour in ten studies. The target groups consisted of students, adolescents and dental patients. Overall, all nine HAPA constructs were used, but only one study used all HAPA constructs. Six studies presented the used behavioural change techniques according to the BCT taxonomy. Based on the number of the used constructs, only two studies were classified as HAPA intervention studies. The most frequently used constructs were action control as an intervention and behaviour as an outcome measure. The overall evidence was graded with moderate certainty. CONCLUSION In the majority of the studies, the targeted intervention was flossing and the population consisted of students, adolescents and dental patients. All studies used only a selection of the HAPA constructs. Therefore, only a minority of the studies can be considered real HAPA intervention studies.
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Affiliation(s)
- Karin Alexandra van Nes
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Cor van Loveren
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Michiel Fridthjof Luteijn
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
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23
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Hamilton A, Putra A, Nakapaksin P, Kamolroongwarakul P, Gallucci GO. Implant prosthodontic design as a predisposing or precipitating factor for peri-implant disease: A review. Clin Implant Dent Relat Res 2023. [PMID: 36691784 DOI: 10.1111/cid.13183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Putra
- Private Practice, Perth, Western Australia, Australia.,Department of Graduate Prosthodontic, University of Washington, Seattle, Washington, USA
| | - Pranai Nakapaksin
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pongrapee Kamolroongwarakul
- Dental Center, Private Hospital, Bangkok, Thailand.,Department of Graduate Prosthodontic, Mahidol University, Bangkok, Thailand
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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24
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The use of interdental cleaning devices and periodontal disease contingent on the number of remaining teeth in Korean adults. Sci Rep 2022; 12:13853. [PMID: 35974036 PMCID: PMC9381548 DOI: 10.1038/s41598-022-17885-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/02/2022] [Indexed: 11/08/2022] Open
Abstract
This study aimed to investigate the effect of interdental brushes and dental floss on the prevention of periodontitis in participants with ≥ 20 or < 20 remaining teeth by using the Korea National Health and Nutrition Examination Survey 2016-2018. Data from 11,614 participants were analysed using multivariate logistic regression after adjusting for sociodemographic factors (age and sex), socioeconomic factors (level of education and individual income), oral health-related variables (daily toothbrushing), and systemic health-related variables (smoking, diabetes, and obesity). The adjusted odds ratio (AOR) showed statistically significant results for both floss (AOR, 1.41; 95% confidence interval (CI) 1.22-1.64) and interdental brushes (AOR, 1.16; 95% CI 1.01-1.34). However, no significant difference was found in the subjects with fewer than 20 teeth. The subgroup analysis showed that interdental brushes had a significant preventive effect on women who had more than 20 teeth. Among participants with fewer than 20 teeth, interdental brush users had more periodontitis in men. Regarding those with more than 20 teeth, health inequality was alleviated when floss and interdental brushes were used. The bottom line is that the effect of preventing periodontitis in interdental brushes and dental floss was more evident in participants with ≥ 20 remaining teeth rather than in participants with < 20 remaining teeth.
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25
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Han SJ. The Use of Interdental Care Products in Korean Adults Aged 30 Years and Older and Factors Affecting Their Use: 4th to 7th Korean National Health and Nutrition Examination Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148639. [PMID: 35886497 PMCID: PMC9323650 DOI: 10.3390/ijerph19148639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to review the use of interdental care products (ICPs) among adults in Korea, reconfirm their relevance to periodontal health, and identify factors affecting the use of ICPs. Data from 2007 to 2018 from the National Health Nutrition Survey (KNHANES) were used, and 43,069 adults (18,412 men, 24,657 women) aged 30 years or older were included. The frequency and percentage of ICP use according to the characteristics of the subjects are presented. In addition, multivariate logistic regression analysis identified the factors affecting ICP use. The ICP usage rate of participants in the KNHANES phase gradually increased to 22.8% in the 4th, 26.4% in the 5th, and 38.0% in the 6th phase and then decreased to 36.3% in the 7th phase. The adjusted OR values for periodontal health in ICP users were 0.721 for gingivitis and 0.642 for periodontitis, confirming that ICP was associated with a lower prevalence of these conditions. Sex, age, educational level, household income, toothbrushing, and dental check-ups were related to ICP use in all phases. ICP was associated with improved periodontal health, but its use rate was very low. Therefore, oral health professionals should educate adults on the use of ICP, particularly interdental brushing.
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Affiliation(s)
- Su-Jin Han
- Department of Dental Hygiene, College of Health Science, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon 21936, Korea
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26
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Oral Hygiene in Adolescence: A Questionnaire-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127381. [PMID: 35742630 PMCID: PMC9223832 DOI: 10.3390/ijerph19127381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/01/2022] [Accepted: 06/04/2022] [Indexed: 02/05/2023]
Abstract
Oral health is fundamental to our well-being, especially in adolescence. The aim of this study is to investigate oral hygiene knowledge through a questionnaire in a sample of adolescents, paying particular attention to those wearing orthodontic braces. The study was designed as a descriptive report of a local survey. An anonymous questionnaire was distributed to individuals born between 2000 and 2005, both on paper and online. Among 213 adolescents answering the questionnaire, 206 went to the dentist at least once (most of them between 5 and 9 years old), and 144 experienced at least one session of professional oral hygiene. Approximately 83% of the sample brushed their teeth at least twice a day, while only 7% used dental floss daily. Only 54% of respondents wearing orthodontic braces were advised to undergo professional oral hygiene during their orthodontic treatment. Education on oral hygiene at home came only from their parents for 61% of the whole sample. Most respondents had their first visit to the dentist apparently too late. Flossing was rare, whether the adolescents wore orthodontic braces or not. In many cases, professional oral hygiene was not common during orthodontic treatment. Adolescents did not learn about oral hygiene from a dental specialist.
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Influence on the patient's oral hygiene depending on the treatment performed by either one or different pre-graduate practitioners - a randomized, controlled, clinical short-term trial. Clin Oral Investig 2022; 26:5339-5350. [PMID: 35486196 PMCID: PMC9381624 DOI: 10.1007/s00784-022-04501-1] [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: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
Objectives Plaque control by improved domestic oral hygiene is essential in periodontal treatment. However, changing treatment providers may interfere with building a dentist-patient relationship and in turn affect treatment success. The aim of this randomized, controlled, prospective short-term study was to determine the influence of either one or four different pre-graduate practitioners on patients’ oral hygiene parameters during active periodontal therapy. Material and Methods A total of 55 patients with periodontitis were allocated to two groups. Within the group “continuous treatment” (CT, n = 27), each patient was treated by one individual practitioner over the treatment period. For patients of the group “discontinuous treatment” (DT, n = 28), treatment in each session was performed by a different practitioner. Periodontal parameters (BOP, PBI, and PCR) were assessed at two timepoints: T1 (baseline) and T2 (end of active therapy). Results With CT, the PBI improved in 93% of the patients, compared to 71% with DT (p = 0.048). T1-T2 intragroup analysis showed a statistically significant improvement of all observed clinical parameters with no differences in ∆PBI, ∆BOP, and ∆PCR. Spearman’s correlation analysis revealed a weak correlation between PCR and BOP of CT only. Conclusions In the present study, improvement of all parameters was comparable between the groups. PBI, as a parameter displaying patient’s domestic plaque control compliance, improved in more patients from CT than DT. This is possibly indicating an advantage of continuous treatment by one single practitioner. Clinical relevance Treatment by either a single practitioner or by multiple, constantly changing practitioners might influence patients’ compliance to modify their behaviour when medically necessary.
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Efficacy of dental floss in the management of gingival health: a randomized controlled clinical trial. Clin Oral Investig 2022; 26:5273-5280. [PMID: 35451656 DOI: 10.1007/s00784-022-04495-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/13/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This randomized controlled clinical trial evaluated the efficacy of dental floss as a supplement to toothbrushing in support of gingival health in adults. MATERIALS AND METHODS Seventy-five systemically healthy subjects, non-smokers, without loss of interproximal periodontal attachment and with more than 15% of the interproximal sites presenting with gingival bleeding were randomized into two groups either performing toothbrushing supplemented by dental floss (TB + DF) or toothbrushing (TB) alone. Over a 60-day period, participating subjects weekly received oral hygiene instruction and supervised personal and professional plaque removal by applying the devices assigned for the group. Study subjects were instructed to perform toothbrushing twice daily (group TB + DF and TB) and use dental floss once daily (group TB + DF). Gingival Index (GI) and Plaque Index (PlI) were evaluated at baseline, and at 30 and 60 days. Linear mixed models were used to compare PlI and GI intra- and intergroup means. RESULTS Interproximal gingival inflammation (GI = 2 and mean GI) was significantly reduced in both groups by day 30, reduction in inflammation being significantly greater in the TB + DF compared with the TB alone group. No further significant alterations were observed by day 60. Moreover, reduction in gingival inflammation (GI = 2) was greater in the anterior compared with the posterior dentition. CONCLUSIONS Interproximal gingival inflammation may be significantly reduced by toothbrushing alone, the effect being significantly enhanced when toothbrushing is combined with dental floss. TRIAL REGISTRATION The protocol registration was filed on May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov and after complete registration, a NCT number was generated (NCT04909840). Since the date in May 2018 when the protocol preregistration was filed, no change in methodology, primary outcome, and data analysis has occurred. CLINICAL RELEVANCE Optimized personal oral hygiene routines in individuals without loss clinical attachment interproximal should include dental floss as a supplement to toothbrushing in support of gingival health.
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Multicenter Randomized Controlled Trial Comparing the Contribution of Proxabrushes with Regular Toothbrushes and Only Regular Toothbrushes to the Oral Health of Thai Elderly. Int J Dent 2022; 2022:5323092. [PMID: 35401752 PMCID: PMC8989556 DOI: 10.1155/2022/5323092] [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: 09/11/2021] [Revised: 01/30/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of this two-group experimental study was to explore the effects of proxabrush on Thai elderly oral health. Design and Setting. Multicenter randomized controlled trial, parallel grouped, open label, blocked randomization was used at each province to allocate treatment. The study was conducted at public hospitals in 16 provinces in Thailand between November 2019 and January 2020. Methods Participants in the test group used proxabrushes and regular toothbrushes, and participants in the control group used only regular toothbrushes for 6 weeks. Plaque accumulation, gingival status, and oral healthcare data were collected at baseline and at 6-week follow-up. Clinical oral health examiner was blinded to group assignment. Randomization was computer-generated, with allocation concealment by opaque sequentially number sealed envelopes. Data analysis compared plaque and gingival indices between the test and control groups. Results A total of 510 elderly with at least 20 natural teeth and interdental spaces were randomized (test n = 255; control n = 255), and 35 were excluded from analysis because of early drop out leaving 239 in the test group and 236 in the control group. A sample of 475 aged between 60 and 91 years participated in the study; 158 (33.3%) were males and 317 (66.7%) were females. The results revealed that, compared to baseline knowledge, attitude and practice were improved at follow-up for both the test and control groups (p < 0.05). At follow-up, the independent-samples t-test compares the test group plaque index mean of 0.49 (SD 0.44) to the control group mean of 0.60 (SD 0.56); a mean difference of 0.11 (95% CI 0.02 to 0.20) obtained demonstrated statistical significance (p = 0.014), and comparing the test group gingival index mean of 0.52 (SD 0.50) to the control group mean of 0.65 (SD 0.60), a mean difference of 0.13 (95% CI 0.03 to 0.23) obtained demonstrated statistical significance (p = 012). At follow-up, the test group had lower plaque accumulation and better gingival status than the control group. Gender, medical problems, educational level, occupation, and age were not different between the test and control groups. A combination of daily proxabrush and regular toothbrush use yielded significant benefits over regular tooth-brushing alone. Conclusions In conclusion, proxabrush has been found to be an effective interdental cleaning aid among Thai elderly. This trial is registered with TCTR20220127004.
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Stavrakis AK, Kojić S, Petrović B, Nešković I, Stojanović GM. Performance Evaluation of Dental Flosses Pre- and Post-Utilization. MATERIALS 2022; 15:ma15041522. [PMID: 35208062 PMCID: PMC8879268 DOI: 10.3390/ma15041522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
Dental floss is an oral hygiene product used to remove food and plaque in places where toothbrushes cannot reach. Even though over the years since its introduction some research in suitable materials has been performed, thread cracking and wear can still compromise efficiency. The aim of this study was to examine the morphological properties of four different commercially available dental floss types before and after use. For that purpose, scanning electron microscopy and optical microscopy were used to assess the flosses before and after use, and tension testing was performed to determine any degradation in the floss performance after utilization. The analyzed floss samples verify the hypothesis that the properties of the floss need to be known in depth, before recommending a specific type to patients for daily use in all clinical indications.
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Affiliation(s)
- Adrian K. Stavrakis
- Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia; (S.K.); (G.M.S.)
- Correspondence:
| | - Sanja Kojić
- Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia; (S.K.); (G.M.S.)
| | - Bojan Petrović
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, Dentistry Clinic of Vojvodina, University of Novi Sad, 21000 Novi Sad, Serbia; (B.P.); (I.N.)
| | - Isidora Nešković
- Department of Pediatric and Preventive Dentistry, Faculty of Medicine, Dentistry Clinic of Vojvodina, University of Novi Sad, 21000 Novi Sad, Serbia; (B.P.); (I.N.)
| | - Goran M. Stojanović
- Faculty of Technical Sciences, University of Novi Sad, 21000 Novi Sad, Serbia; (S.K.); (G.M.S.)
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Suzuki H, Sugimoto K, Kubota-Miyazawa A, Noritake K, Umemori S, Araki K, Adachi N, Otsuka H, Yoshida N. A survey of oral health status, subjective oral symptoms and oral health behaviors among first-year dental students at a Japanese university. J Oral Sci 2022; 64:85-90. [PMID: 34980826 DOI: 10.2334/josnusd.21-0420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE The rapid deterioration of oral health in young adults is an alarming problem in Japan. The aim of the present study is to investigate the oral health status, subjective oral symptoms and oral health behaviors of dental students. METHODS Participants were 108 first-year students attending dental school in 2018-2019. Oral examinations were performed to assess dental caries indices, oral hygiene status, gingival bleeding on probing (BOP) and pocket depth. A self-administered questionnaire was used to assess subjective oral symptoms and oral health behaviors. RESULTS The prevalence of decayed teeth (DT) and gingivitis (BOP ≥ 10%) were 43.5% and 50.0%, respectively. Having DT and gingivitis were significantly associated with poorer oral hygiene. No association was observed between DT and subjective symptoms. Having gingivitis was significantly associated with xerostomia, mouth-breathing and less use of interdental cleaning tools. Multiple logistic regression analysis for gingivitis yielded an odds ratio of 1.41 (95% confidence interval: 1.19-1.67) for plaque score, and 2.75 (1.27-5.98) for xerostomia. CONCLUSION Since a relatively high ratio of students had DT and gingivitis without clear subjective symptoms, they require regular dental visits for early treatment and oral hygiene maintenance from the start of their time at university.
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Affiliation(s)
- Hitomi Suzuki
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Kumiko Sugimoto
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Ayako Kubota-Miyazawa
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Kanako Noritake
- Oral Diagnosis and General Dentistry, Dental Hospital, Tokyo Medical and Dental University
| | - Sachi Umemori
- Oral Diagnosis and General Dentistry, Dental Hospital, Tokyo Medical and Dental University
| | - Kouji Araki
- Oral Diagnosis and General Dentistry, Dental Hospital, Tokyo Medical and Dental University
| | - Naoko Adachi
- Department of Preventive Oral Health Care Sciences, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Hiromi Otsuka
- Department of Oral Health Sciences, School of Health Sciences, Meikai University
| | - Naomi Yoshida
- Department of Oral Health Care Education, Health Sciences and Biomedical Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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Cota LOM, Villar CC, Vettore MV, Campos JR, Amaral GCLSD, Cortelli JR, Cortelli SC. Periodontal diseases: is it possible to prevent them? A populational and individual approach. Braz Oral Res 2021; 35:e098. [PMID: 34586212 DOI: 10.1590/1807-3107bor-2021.vol35.0098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
Periodontal diseases are infectious inflammatory chronic diseases of a multifactorial nature. They are primarily caused by dysbiotic ecological changes in dental biofilm, which may be influenced by risk factors. The prevention of periodontal diseases may involve different strategies focused on reducing distal, intermediate, and proximal risk factors at both the population and individual levels. Effective prevention depends on interdisciplinary and common risk factor approaches. Also, patient-centered preventive models are more effective than professional-centered models in the management of periodontal diseases. Regular and periodic control of dental biofilm is an essential measure for the different levels of prevention of periodontal diseases. The effectiveness of periodontal disease prevention largely depends on positive modifications of behavior, knowledge, health literacy, patient empowerment, motivation, and compliance.
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Affiliation(s)
- Luís Otávio Miranda Cota
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Mario Vianna Vettore
- University of Agder - UiA, Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, Kristiansand, Norway
| | - Julya Ribeiro Campos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
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Effect of Triweekly Interdental Brushing on Bleeding Reduction in Adults: A Six-Month Retrospective Study. Healthcare (Basel) 2021; 9:healthcare9091239. [PMID: 34575013 PMCID: PMC8468610 DOI: 10.3390/healthcare9091239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
This study assessed the effect of triweekly interdental brushing for a period of 6 months using the bleeding on full-mouth interdental brushing (BOFIB) index. All participants answered questionnaires and were instructed to clean all interdental areas using an interdental brush at least every second day. A dentist assessed the BOFIB index of 28 participants at baseline and at 3- and 6-month follow-up visits. We stratified the participants into three groups: IB-NN, those who used the interdental brush less than three times per week both before and after this program; IB-NY, those who used the interdental brush less than three times per week before the program but at least three times per week after the program; and IB-YY, those who used it at least three times per week both before and after the program. Owing to the weekly number of interdental brushings, the IB-YY and the other two groups showed a significant difference at baseline. At the 6-month follow-up, the weekly number of interdental brushings led to a significant difference between the IB-NN and the other two groups. The BOFIB index was lower among the compliant participants than among the noncompliant participants after 3 and 6 months of triweekly interdental brushing.
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The Potential of Aloe vera as an Active Ingredient in Toothpaste Formulations: A Narrative Review. Jundishapur J Nat Pharm Prod 2021. [DOI: 10.5812/jjnpp.117500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Context: Tooth brushing is a primary method to prevent the onset of oral diseases. Aloe vera is commonly used in dentistry as an herbal alternative due to its anti-inflammatory and anti-microbial actions; recently, it has been used in toothpaste formulations as an active agent. This review aimed to investigate the clinical effects of A. vera as an active ingredient in toothpaste formulations. Materials and Methods: The data used in this review was extracted from articles published until 2020. We searched official databases, including Scopus, PubMed, Google Scholar, Embase, and Science Direct, using the “Aloe vera”, “dentifrice”, and “toothpaste” keywords. After screening titles and abstracts, relevant studies were used for full-text review. Results: Although conflicting results have been reported on the usage of A. vera toothpaste in different studies, the majority of findings suggest that A. vera effectively reduces periodontal indices and removes different organisms, including Streptococcus mutans. However, the overall effects of this herbal toothpaste were found to be equal to those of other commercial toothpaste. Conclusions: Aloe vera toothpaste is as beneficial as other kinds of toothpaste. Therefore, it can be used as an adjunct agent in toothpaste due to its established effects on improving periodontal problems and reducing different oral cavity micro-organisms.
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Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented? Clin Oral Investig 2021; 26:1903-1913. [PMID: 34537880 PMCID: PMC8816322 DOI: 10.1007/s00784-021-04167-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/24/2021] [Indexed: 11/14/2022]
Abstract
Objective To assess whether bacterial colonisation in a power-driven water flosser can be prevented. Materials and methods Twenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp. Results Contamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19–56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans. Conclusion Neither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU. Clinical relevance Bacterial colonisation in a power-driven water flosser seems impossible to prevent; to restrict the risk of cross-contamination within a household, one device per person should be recommended. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04167-1.
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Silva C, Albuquerque P, de Assis P, Lopes C, Anníbal H, Lago MCA, Braz R. Does flossing before or after brushing influence the reduction in the plaque index? A systematic review and meta-analysis. Int J Dent Hyg 2021; 20:18-25. [PMID: 34402188 DOI: 10.1111/idh.12546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of this systematic review was to assess whether flossing before or after influences plaque index reduction. METHODS This systematic review was conducted according to the guidelines of the preferred reporting items for systematic reviews and meta-analyses and registered with the International prospective register of systematic reviews under number CRD42019126239. The PICO question was, 'does flossing before or after brushing have any effect on reducing dental plaque?'. An electronic search was performed until April 2020 in the following databases: PubMed/MEDLINE, Scopus Web of Science and Cochrane Library. The initial database search resulted in 9679 references, and after detailed analysis of the titles and abstracts of the selected studies, the inclusion/exclusion criteria were applied, and 06 complete articles were downloaded and selected for further analysis. After the complete 02 articles were selected, 60 patients with a mean age of 23.1 years were studied and compared dental flossing before or after dental brushing. RESULTS The results showed that there was no statistical difference between brush-floss and floss-brush in reducing plaque index (p = 0.91, RR: 0.01, 95% CI: -0.16, 0.18). CONCLUSIONS Flossing before or after brushing has no significant effect on reducing dental plaque index. However, more clinical studies should be conducted.
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Affiliation(s)
- Cláudia Silva
- Department of Restorative Dentistry, Universidade de Pernambuco FOP/UPE, Camaragibe, Pernambuco, Brazil
| | - Pauliane Albuquerque
- Department of Restorative Dentistry, Universidade de Pernambuco FOP/UPE, Camaragibe, Pernambuco, Brazil
| | - Paulo de Assis
- Department of Restorative Dentistry, Universidade de Pernambuco FOP/UPE, Camaragibe, Pernambuco, Brazil
| | - Cacio Lopes
- Department of Restorative Dentistry, Universidade de Pernambuco FOP/UPE, Camaragibe, Pernambuco, Brazil
| | - Hermínia Anníbal
- Department of Restorative Dentistry, Universidade de Pernambuco FOP/UPE, Camaragibe, Pernambuco, Brazil
| | | | - Rodivan Braz
- Universidade de Pernambuco FOP/UPE, Camaragibe, Pernambuco, Brazil
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Kim SJ, Lee JY, Kim SH, Cho HJ. Effect of interdental cleaning devices on proximal caries. Community Dent Oral Epidemiol 2021; 50:414-420. [PMID: 34369614 DOI: 10.1111/cdoe.12690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 07/20/2021] [Accepted: 07/29/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To estimate the association between the use of interdental cleaning devices and proximal caries experience. METHODS This study used a cross-sectional data from the Sixth Korea National Health and Nutrition Examination Survey (2013-2015). A total of 13 525 adults aged 19-64 years who participated in both the nutrition survey and the health examination survey were included. Data on sociodemographic factors (age and sex), socioeconomic factors (level of education and household income) and personal health practices (frequency of toothbrushing, visits to dental clinic, frequency of snacking and self-rated oral health status), and number of proximal caries were collected. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were calculated using the multivariable Poisson generalized linear model according to use of dental floss or an interdental brush. The risk of proximal caries for dental floss following the stratification of participants into various subgroups related to oral health was assessed. RESULTS While nonflossers had 1.46 times (PR 1.46, 95% CI: 1.16-1.84) higher risk for proximal caries than flossers, the use of an interdental brush was not associated with proximal caries. In the nonflossers, the association for proximal caries was the strongest in those in their 40s (PR 2.28, 95% CI: 1.29-4.03), followed by those in their 30s (PR 1.85, 95% CI: 1.18-2.90). Although nonflossers with middle-low household income had a 59% higher risk (PR 1.59, 95% CI: 1.24-2.03) for proximal caries than those with high household income, there were no significant differences in household income in flossers. CONCLUSIONS The findings of the study suggest that flossing at home along with toothbrushing is one of the easiest ways to prevent proximal caries. Therefore, dental floss should not be excluded from oral healthcare products.
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Affiliation(s)
- Seon-Jip Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jae-Young Lee
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan, Republic of Korea
| | - Se-Hee Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hyun-Jae Cho
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Lee JH, Ha JH. Bioelectric Effect of a Microcurrent Toothbrush on Plaque Removal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168255. [PMID: 34444003 PMCID: PMC8394510 DOI: 10.3390/ijerph18168255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/23/2022]
Abstract
This study evaluated the effectiveness of a microcurrent toothbrush (approved by the US Food and Drug Administration [FDA]), which employs a superimposed alternating and direct electric current, named as a Proxywave® technology, similar to the intensity of the biocurrent, in plaque removal and reducing gingivitis by biofilm removal through the bioelectric effect. This study enrolled 40 volunteers with gingivitis. Dental observations were made every two weeks, before and after the use of each toothbrush. We randomly assigned participants into two groups: one group used the Proxywave® toothbrush (PB) for two weeks followed by the control toothbrush (CB) for two weeks, while the other group used the CB for two weeks followed by the PB. The participants had a two-week washout period. If the toothbrush used earlier has had an effect on the bacterial flora in the oral cavity, this is to remove this effect and return it to its previous state. During each dental visit, we recorded plaque index (PI) and gingival index (GI) scores. The PI and GI scores were significantly lower in both the PB and the CB (p < 0.05). Considering the PI, there was no significant difference between the toothbrushes on all the surfaces. Considering the GI, the PB showed a significant decrease in the interproximal surface, compared to the CB (p < 0.05). The PB showed a significant decrease in the interproximal GI and had a beneficial effect in the interproximal area where the bristles could not reach. No adverse events were observed in the participants during the clinical trial. The microcurrent toothbrush is a device that can be safely used for plaque removal.
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Affiliation(s)
- Ji-Hyun Lee
- Department of Periodontology, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 44033, Korea
- Correspondence: ; Tel.: +82-52-250-7230
| | - Jin-Hee Ha
- Department of Dentistry, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan 44033, Korea;
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Gare J, Kanoute A, Meda N, Viennot S, Bourgeois D, Carrouel F. Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137194. [PMID: 34281133 PMCID: PMC8297070 DOI: 10.3390/ijerph18137194] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/01/2021] [Accepted: 07/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. OBJECTIVES This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. METHODS The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. CONCLUSION A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.
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Affiliation(s)
- Jocelyne Gare
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
- Public Health Laboratory (LASAP), ED2S Doctoral School of Sciences and Health, University Joseph Ki Zerbo, Ouagadougou 7021, Burkina Faso;
| | - Aida Kanoute
- Public Health Service, Department of Dentistry, Faculty of Medicine, Pharmacy and Dentistry, University Cheikh Anta Diop, Dakar 10700, Senegal;
| | - Nicolas Meda
- Public Health Laboratory (LASAP), ED2S Doctoral School of Sciences and Health, University Joseph Ki Zerbo, Ouagadougou 7021, Burkina Faso;
| | - Stephane Viennot
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
| | - Denis Bourgeois
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
| | - Florence Carrouel
- Laboratory P2S (Health Systemic Process), UR4129, University Claude Bernard of Lyon 1, University of Lyon, Lyon, France; (J.G.); (S.V.); (D.B.)
- Correspondence: ; Tel.: +33-4-78-78-57-44
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Bertl K, Edlund Johansson P, Stavropoulos A. Patients' opinion on the use of 2 generations of power-driven water flossers and their impact on gingival inflammation. Clin Exp Dent Res 2021; 7:1089-1095. [PMID: 34060707 PMCID: PMC8638279 DOI: 10.1002/cre2.456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/17/2021] [Accepted: 04/28/2021] [Indexed: 01/03/2023] Open
Abstract
Objectives To assess patients' opinion on the use of 2 generations of power‐driven water flossers and their impact on gingival inflammation. Material & Methods In the present prospective cohort study 24 periodontitis patients under regular supportive periodontal therapy used daily 2 generations of a power‐driven water flosser (Sonicare AirFloss [SAF] and Sonicare AirFloss Ultra [SAFU]) for 12 weeks each. Patients were instructed to position the nozzle interproximally from the buccal aspect at each interproximal space. Patients' opinion was assessed by a questionnaire and interproximal bleeding on probing (BoP) was recorded. Results Overall satisfaction with SAF/SAFU was rated high, by about 80% of the patients. About 66% of the patients preferred SAF/SAFU compared to their previous interdental cleaning device and indicated that they would continue using SAF/SAFU after the study; none of the patients reported any discomfort or pain. Compared to only tooth brushing, daily use of SAF/SAFU caused a significant reduction of interproximal BoP values, which were well maintained over 6 months; that is, BoP at interproximal buccal and oral sites (pooled), as well as at interproximal buccal and oral sites separately, was proportionately reduced by 29.1%, 41.2%, and 24.8%, respectively (pooled: p = 0.027; buccal sites: p = 0.030; oral sites: p = 0.030). Conclusion Patients were very fond of the power‐driven water flossers tested herein, and daily use of the devices for 6 months (i.e., each device was used for 3 months) resulted in a significant reduction of gingival inflammation interproximally.
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Affiliation(s)
- Kristina Bertl
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Pia Edlund Johansson
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
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Bertl K, Edlund Johansson P, Bruckmann C, Leonhard M, Davies JR, Stavropoulos A. Bacterial colonization of a power-driven water flosser during regular use. A proof-of-principle study. Clin Exp Dent Res 2021; 7:656-663. [PMID: 34037327 PMCID: PMC8543452 DOI: 10.1002/cre2.393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives The present proof‐of‐principle study assessed whether daily use of a power‐driven water flosser (Sonicare AirFloss; SAF) leads to bacterial colonization in the nozzle and/or the device, resulting in contaminated water‐jet. Material and Methods In five participants, saliva samples at baseline and water‐jet samples of devices used daily with bottled water for 3 weeks (test) were collected. Additionally, water‐jet samples from devices used daily with bottled water extra‐orally for 3 weeks (positive control) and from brand new devices (negative control), as well as samples from newly opened and 1‐ and 3‐week opened water bottles were collected. Colony forming units (CFU) were recorded after 48 h culturing and 20 oral pathogens were assessed by polymerase chain reaction‐based analysis. Results Distinct inter‐individual differences regarding the number of detected bacteria were observed; water‐jet samples of test devices included both aerobic and anaerobic bacterial species, with some similarities to the saliva sample of the user. Water‐jet samples from positive control devices showed limited number of aerobic and anaerobic bacterial species, while the samples from negative control devices did not show any bacterial species. Very few aerobic bacteria were detected only in the 3‐week‐old bottled water samples, while samples of newly and 1‐week opened water bottles did not show any bacterial growth. Conclusions The present proof‐of‐principle study showed that daily use of a power‐driven water flosser for 3 weeks resulted in bacterial colonization in the nozzle and/or device with both aerobic and anaerobic, not only oral, species, that are transmitted via the water‐jet.
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Affiliation(s)
- Kristina Bertl
- Faculty of Odontology, Department of Periodontology, University of Malmö, Malmö, Sweden.,Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Pia Edlund Johansson
- Faculty of Odontology, Department of Periodontology, University of Malmö, Malmö, Sweden
| | - Corinna Bruckmann
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Matthias Leonhard
- Division of Phoniatrics-Logopedics, Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Julia R Davies
- Faculty of Odontology, Department of Oral Biology, University of Malmö, Malmö, Sweden
| | - Andreas Stavropoulos
- Faculty of Odontology, Department of Periodontology, University of Malmö, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.,Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland
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Pitchika V, Jordan R, Micheelis W, Welk A, Kocher T, Holtfreter B. Impact of Powered Toothbrush Use and Interdental Cleaning on Oral Health. J Dent Res 2021; 100:487-495. [PMID: 33213272 PMCID: PMC8058831 DOI: 10.1177/0022034520973952] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The long-term effectiveness of powered toothbrushes (PTBs) and interdental cleaning aids (IDAs) on a population level is unproven. We evaluated to what extent changes in PTB and IDA use may explain changes in periodontitis, caries, and tooth loss over the course of 17 y using data for adults (35 to 44 y) and seniors (65 to 74 y) from 3 independent cross-sectional surveys of the German Oral Health Studies (DMS). Oaxaca decomposition analyses assessed to what extent changes in mean probing depth (PD), number of caries-free surfaces, and number of teeth between 1) DMS III and DMS V and 2) DMS IV and DMS V could be explained by changes in PTB and IDA use. Between DMS III and V, PTB (adults: 33.5%; seniors: 28.5%) and IDA use (adults: 32.5%; seniors: 41.4%) increased along with an increase in mean PD, number of caries-free surfaces, and number of teeth. Among adults, IDA use contributed toward increased number of teeth between DMS III and V as well as DMS IV and V. In general, the estimates for adults were of lower magnitude. Among seniors between DMS III and V, PTB and IDA use explained a significant amount of explained change in the number of caries-free surfaces (1.72 and 5.80 out of 8.44, respectively) and the number of teeth (0.49 and 1.25 out of 2.19, respectively). Between DMS IV and V, PTB and IDA use contributed most of the explained change in caries-free surfaces (0.85 and 1.61 out of 2.72, respectively) and the number of teeth (0.25 and 0.46 out of 0.94, respectively) among seniors. In contrast to reported results from short-term clinical studies, in the long run, both PTB and IDA use contributed to increased number of caries-free healthy surfaces and teeth in both adults and seniors.
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Affiliation(s)
- V. Pitchika
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - R. Jordan
- Institute of German Dentists (IDZ), Cologne, Germany
| | - W. Micheelis
- Institute of German Dentists (IDZ), Cologne, Germany
| | - A. Welk
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - T. Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - B. Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Graetz C, Schoepke K, Rabe J, Schorr S, Geiken A, Christofzik D, Rinder T, Dörfer CE, Sälzer S. In vitro comparison of cleaning efficacy and force of cylindric interdental brush versus an interdental rubber pick. BMC Oral Health 2021; 21:194. [PMID: 33853594 PMCID: PMC8048228 DOI: 10.1186/s12903-021-01558-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Interdental brushes (IDB) are according to the actual evidence the first choice for cleaning interdental areas (IDR). Their size should be chosen individually according to the IDR morphology. However, interdental rubber picks (IRP) are appreciated better by the patients and are hence becoming more and more popular but the evidence regarding their efficacy is still limited. The aim of this in vitro study was to measure the experimental cleaning efficacy (ECE) and force (ECF) during the use of interdental brushes versus newer wireless types with rubber filaments (IRP), both fitted and non-fitted for different IDR. METHODS The medium size of a conical IRP (regular, ISO 2) with elastomeric fingers versus four sizes (ISO 1, 2, 3, 4) of cylindric IDB with nylon filaments (all Sunstar Suisse SA, Etoy, Switzerland) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to three different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at IDR (standardized, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. RESULTS Overall, a higher ECE was recorded for IDB compared to IRP (58.3 ± 14.9% versus 18.4 ± 10.1%; p < 0.001). ECE significantly depended on the fitting of the IDB. ECE was significant higher in isosceles triangle compared to concave and convex IDR for both IDB and IRP (p ≤ 0.001). ECF was lower for IDB (0.6 ± 0.4N) compared to IRP (0.8 ± 0.5N; p ≤ 0.001). ECE in relation to ECF increases with smaller IDB. For IRP highest values of ECF were found in the smallest IDR. CONCLUSIONS Within the limitations of an in vitro study, size fitted IDB cleaned more effectively at lower forces compared to conical IRP.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Kristina Schoepke
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Johanna Rabe
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Babayevska N, Woźniak-Budych M, Litowczenko J, Peplińska B, Jarek M, Florczak P, Bartkowiak G, Czarnecka B, Jurga S. Novel nanosystems to enhance biological activity of hydroxyapatite against dental caries. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 124:112062. [PMID: 33947556 DOI: 10.1016/j.msec.2021.112062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/24/2021] [Accepted: 03/16/2021] [Indexed: 01/17/2023]
Abstract
This work aimed to study for the first time to our knowledge the influence of the structure of the dental flosses (DF) coated by hydroxyapatite nanoparticles (HAP NPs) on the biological performance of saliva probiotic bacteria (S. salivarius), and human dermal and osteoblast-like cells. We used three types of HAP@DF composites (based on two unwaxed dental flosses - "fluffy" and "smooth", and one waxed "smooth") with different morphologies. Obtained composites were characterized from the point of view of their structure, morphological characteristics, elemental and chemical composition. We observed that HAP NPs coated "smooth" dental flosses led to an increase of viability and proliferation of oral cavity probiotic bacteria (Streptococcus salivarius) and human cells (dermal fibroblasts and osteoblast-like). In contrast, the highest viability loss of probiotic bacteria (S. salivarius), fibroblasts, and osteoblast-like cells were observed for "fluffy" unwaxed dental flosses due to high cytotoxicity. Our studies showed that HAP NPs significantly improved the biological properties of "fluffy" dental floss. Pristine "smooth" DFs (waxed and unwaxed), as well as all HAP-coated DFs, induced acceptable biocompatibility toward selected human cells.
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Affiliation(s)
- Nataliya Babayevska
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland.
| | - Marta Woźniak-Budych
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland.
| | - Jagoda Litowczenko
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland.
| | - Barbara Peplińska
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland
| | - Marcin Jarek
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland
| | - Patryk Florczak
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland
| | - Grażyna Bartkowiak
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland
| | - Beata Czarnecka
- Department of Biomaterials and Experimental Dentistry, University of Medical Sciences, ul. Bukowska 70, 60-812 Poznań, Poland
| | - Stefan Jurga
- NanoBioMedical Centre, Adam Mickiewicz University in Poznań, Wszechnicy Piastowskiej 3, 61-614 Poznań, Poland
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Langa GPJ, Muniz FWMG, Wagner TP, Silva CFE, Rösing CK. ANTI-PLAQUE AND ANTI-GINGIVITIS EFFICACY OF DIFFERENT BRISTLE STIFFNESS AND END-SHAPE TOOTHBRUSHES ON INTERPROXIMAL SURFACES: A SYSTEMATIC REVIEW WITH META-ANALYSIS. J Evid Based Dent Pract 2021; 21:101548. [PMID: 34391550 DOI: 10.1016/j.jebdp.2021.101548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/25/2021] [Accepted: 03/06/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This systematic review aimed to evaluate the efficacy of interproximal plaque scores and gingival inflammation reduction of different toothbrush bristle stiffness and end-shape. METHODS Randomized clinical trials evaluating the effect of different toothbrushes on interproximal plaque/gingivitis reduction, with a minimum follow-up of 1 week. MEDLINE-PubMed, Scopus and Embase were searched. Soft tapered-tip bristle toothbrushes were compared to soft end-rounded, medium (any end-shape), or hard (any end-shape) bristle toothbrushes. Two meta-analyses were performed for plaque and gingivitis reduction. For plaque index (PI) and gingival index (GI), a standard mean difference (SMD) and mean difference between baseline and 4 weeks were calculated, respectively. In all analyses, random effect models were used. RESULTS Nine studies were included. All included studies demonstrated statistically significant improvement, in at least one parameter, in favor of the tapered-tip bristle toothbrush compared to the end-rounded bristle toothbrush. When analyzing toothbrush stiffness, medium and hard toothbrushes presented significantly higher improvement when compared to soft toothbrushes in all parameters. In the meta-analyses, groups that used soft tapered-tip bristle toothbrushes demonstrated significant greater reductions in PI (SMD -2.64; 95% CI: -4.26 - -1.01) and in GI (MD -0.14; 95% CI: -0.18 - -0.10) when compared to soft end-rounded bristle toothbrushes. CONCLUSION It is concluded that, when considering interproximal surfaces, better results may be expected for tapered-tip bristle toothbrushes when compared to end-rounded bristles toothbrushes. Additionally, better results may be expected in medium or hard toothbrushes, regardless of the bristle end-shape, in non-interproximal cleaners.
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Affiliation(s)
- Gerson Pedro José Langa
- PhD student at Department of Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Tassiane Panta Wagner
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Caroline Fernandes E Silva
- PhD student at Department of Periodontology, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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46
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Slot DE, Valkenburg C, Van der Weijden GAF. Mechanical plaque removal of periodontal maintenance patients: A systematic review and network meta-analysis. J Clin Periodontol 2021; 47 Suppl 22:107-124. [PMID: 32716118 DOI: 10.1111/jcpe.13275] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 12/25/2022]
Abstract
AIM This systematic review synthesizes the available clinical evidence concerning efficacy of mechanical oral hygiene devices in periodontal maintenance patients. MATERIAL AND METHODS Three databases were searched up to October 2019 for clinical trials conducted in adult patients in periodontal maintenance which evaluated the effect of toothbrushes or an interdental device on plaque removal and parameters of periodontal diseases. Descriptive analysis and network meta-analysis (NMA) were performed. RESULTS Sixteen eligible publications, including 17 relevant comparisons, were retrieved. Four out of five comparisons found no clinical difference between a manual and power toothbrush. Of the interdental cleaning devices, the interdental brushes (IDBs) reduced plaque scores more effectively than a manual toothbrush alone. For the oral irrigator, two out of three comparisons indicated a positive effect on gingivitis scores, and probing pocket depth. The NMA demonstrated that for plaque removal the adjuvant use of IDBs was significantly more effective than the manual toothbrush alone. For the reduction of gingival inflammation, no product ranked higher than the manual toothbrush. CONCLUSION Due to the scarcity of studies that met the inclusion criteria for each of the oral hygiene devices and the low certainty of the resultant evidence, no strong "evidence-based" conclusion can be drawn concerning any specific oral hygiene device for patient self-care in periodontal maintenance.
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Affiliation(s)
- Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cees Valkenburg
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,General dentist and clinical epidemiologist, Hoevelaken, The Netherlands
| | - G A Fridus Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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47
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van der Weijden F, Slot DE, van der Sluijs E, Hennequin-Hoenderdos NL. The efficacy of a rubber bristles interdental cleaner on parameters of oral soft tissue health-a systematic review. Int J Dent Hyg 2021; 20:26-39. [PMID: 33630360 PMCID: PMC9292806 DOI: 10.1111/idh.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/03/2020] [Accepted: 02/10/2021] [Indexed: 11/28/2022]
Abstract
Aim This study aimed to establish the efficacy of a rubber bristles interdental cleaner (RBIC) as an adjunct to toothbrushing (TB) compared to that of the adjuvant use of other interdental cleaning devices and TB alone on plaque and gingivitis parameters. Additionally, the safety aspects and panellists’ appreciation were evaluated. Materials and Methods Databases were searched for randomized controlled clinical trials (RCTs) evaluating plaque (PI), bleeding (BS), and gingival index (GI) scores, safety assessments, and participants’ appreciation. Extracted data were summarized in a descriptive and, if possible, a meta‐analysis. Results The search retrieved 142 unique papers; six studies with 10 comparisons were included in a descriptive analysis. Five RCTs compared RBICs with interdental brushes (IDBs), four with dental floss (DF) and one with manual TB only. No comparisons to wood sticks were retrieved. Using an RBIC resulted in no difference in plaque scores compared to DF and IDBs. For overall bleeding scores, no difference was found. Two studies analysing the accessible sites separately found RBICs to be more favourable than DF and IDBs. Conversely, one study evaluating the efficacy of RBICs compared to IDBs, according to the GI scores, showed that IDBs achieved significantly greater reduction. Moreover, RBICs caused fewer gingival abrasions and were preferred by the study participants. Conclusion Based on a descriptive and a meta‐analysis of the available literature, it is synthesized that in gingivitis patients, a weak to very weak certainty exists that a RBIC is indicated for gingivitis and plaque reduction. The evidence supports user safety and participants’ preferences.
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Affiliation(s)
- Fridus van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Eveline van der Sluijs
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Nienke Lisette Hennequin-Hoenderdos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.,Scienfitic Office, Meander Medical Centre, Amersfoort, The Netherlands
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Kim EJ, Han SJ. The Effect of Proximal Cleaning Devices on Periodontal Status in Korean Adults between 2016 and 2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042116. [PMID: 33671564 PMCID: PMC7926615 DOI: 10.3390/ijerph18042116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 01/22/2023]
Abstract
Removal of the biofilm from the proximal space is essential for preventing periodontal disease. This study aimed to prove the association between the use of proximal cleaning devices, such as dental floss and interdental brushes, and periodontal health among nationally representative Korean adults. Data collected from the 7th National Health Nutrition Survey (KNHANES VII: 2016-2018) were used for this purpose. A total of 11,359 participants aged 19 years or older who participated in KNHANES were reviewed. The response variable was the prevalence of high CPI (CPI of 3-4), and the explanatory variables were dental floss and interdental brush. A multivariable logistic regression analysis was performed to adjust for potential confounding factors and to analyze the association between periodontal disease and proximal cleaning devices. It was found that 63.1% of the participants did not use proximal cleaning devices at all, 17.5% used dental floss alone, 11.9% used an interdental brush, and 7.5% used both. Subjects who used both dental floss and interdental brush had a high CPI rate nearly half that of all the models for those who did not. In particular, for those using dental floss, the aOR of high CPI was 0.681 in Model 1, 0.714 in Model 2, and 0.737 in Model 3. Dental hygiene products for cleaning the proximal space, such as dental floss, are essential for removing the dental biofilm as a basic tool along with toothbrushes. Teaching and explaining the need to use these devices well are important for oral health care and maintenance.
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Affiliation(s)
- Eun-Jeong Kim
- Department of Dental Hygiene, Gangdong University, Eumseong-gun 27600, Chungcheongbuk-do, Korea;
- Dental Research Institution, School of Dentistry, Seoul National University, Seoul 03080, Korea
| | - Su-Jin Han
- Department of Dental Hygiene, College of Health Science, Gachon University, Incheon 21936, Korea
- Correspondence: ; Tel.: +82-32-820-4373
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Chen TC, Cheng DH, Hsu ML, Lei YP. Application of masticatory control in dental treatment for elderly individuals. J Chin Med Assoc 2021; 84:125-128. [PMID: 33306597 DOI: 10.1097/jcma.0000000000000467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Taiwan transitioned to an aged society in 2018. Appropriate dental treatment is important for elderly individuals. Previously, reconstruction of the dentition was thought to help regain chewing function. However, concerns of the elderly population, such as decline in learning ability and saliva secretion, complicate dental reconstruction. Overlooking the special needs of elderly individuals may lead to impaired chewing function, resulting in nutritional imbalances and increased burden on the digestive tract, causing more health disorders. For the elderly population, treatment must be aimed at restoring as much chewing function as possible with minimal changes. Additionally, regular oral hygiene care, proper design of fixed partial dentures, and implant placement greatly reduce the difficulty in adapting to a new prosthesis. These measures allow us to provide better quality of life for elderly individuals.
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Affiliation(s)
- Ta-Chung Chen
- Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Dong-Hui Cheng
- Division of Prosthodontics, Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ming-Lun Hsu
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yen-Ping Lei
- Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan, ROC
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50
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van der Sluijs E, Slot DE, Hennequin‐Hoenderdos NL, Valkenburg C, van der Weijden F. Dental plaque score reduction with an oscillating-rotating power toothbrush and a high-frequency sonic power toothbrush: a systematic review and meta-analysis of single-brushing exercises. Int J Dent Hyg 2021; 19:78-92. [PMID: 32940391 PMCID: PMC7839525 DOI: 10.1111/idh.12463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 01/08/2023]
Abstract
AIM To establish the effect of a single-brushing exercise on dental plaque removal using an oscillating-rotating power toothbrush (OR-PTB) as compared to a high-frequency sonic power toothbrush (HFS-PTB). MATERIALS AND METHODS The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched up to September 2019. The inclusion criteria contained (randomized) controlled clinical trials involving healthy adult participants brushing with an OR-PTB as compared to an HFS-PTB. Plaque index (PI) scores were evaluated after a single-brushing exercise. RESULTS A total of 15 publications were included, representing 34 comparisons, of which 8 were professional brushing exercises and 26 participant brushing exercises. The potential risk of bias was estimated to be low. In the overall descriptive analysis of 34 comparisons, 19 comparisons showed a statistically significant difference in favour of the OR-PTB and 4 in favour of the HFS-PTB. The meta-analysis using the professional brushing study design showed a significant difference of means (DiffM) in favour of the OR-PTB (PI score) (DiffM 0.19; P < .0001) (95% CI [013; 0.25]). In those studies where the participants brushed themselves, the data were inconclusive. PI scores showed no difference between the two brushes (P = .15), while one plaque index (the Rustogi Modified Navy plaque index) indicated significant favour for the OR-PTB (DiffM 0.06; P = .002) (95% CI [0.02; 0.09]). CONCLUSION Based on the estimated evidence profile, there is moderate certainty of evidence of a very small but significant beneficial effect on plaque removal after a single-brushing exercise with the OR-PTB over the HFS-PTB.
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Affiliation(s)
- Eveline van der Sluijs
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Dagmar Else Slot
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Nienke L. Hennequin‐Hoenderdos
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Cees Valkenburg
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
- General Dentist and Clinical EpidemiologistHoevelakenThe Netherlands
| | - Fridus van der Weijden
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)The Faculty of Dentistry of the University of Amsterdam and The Faculty of Dentistry of the Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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