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Deeg I, Wicht MJ, Barbe AG, Derman SHM. Self-determined use of provided powered oral hygiene devices leads to improved gingival health after 1 year: a longitudinal clinical trial. BMC Oral Health 2024; 24:566. [PMID: 38745286 PMCID: PMC11094972 DOI: 10.1186/s12903-024-04313-7] [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: 06/03/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024] Open
Abstract
PURPOSE Our study aimed to evaluate the long-term concordance and acceptance when using powered devices for everyday oral hygiene routine and gingival health in patients showing papillary bleeding. PATIENTS AND METHODS Thirty-one participants were recruited at the dental clinic of the University Hospital of Cologne, Germany, over a 6-week duration. At baseline, a standard dental check-up was performed, including oral hygiene indices and documentation of oral hygiene devices used. The study consisted of two consecutive phases: the first (motivational trial) was designed to prove the effectiveness and safety of a microdroplet device and a powered toothbrush compared to dental floss and a manual toothbrush over a period of 4 weeks. The second (observational) phase began with all participants receiving the powered oral homecare devices. Participants were able to use their oral hygiene measures of choice over an unsupervised period of 1 year. All participants were then rescheduled for a routine dental check-up, where oral hygiene indices and oral hygiene devices used were reevaluated. RESULTS After 1 year, 93.3% of participants stated they performed interdental cleaning on a regular basis (baseline 60.0%). The percentage using a powered toothbrush increased from 41.9% (baseline) to 90.0% after 1 year. Oral hygiene parameters had improved after both the motivational trial and observational phases compared to baseline (papillary bleeding index p = .000; Rustogi Modified Navy Plaque Index p < .05; Quigley-Hein Index p = .000). CONCLUSION In the long term, participants preferred using powered oral hygiene devices over the gold standard dental floss and manual toothbrush. Improved oral hygiene parameters after 1 year may indicate implementation of newly acquired oral-hygiene skills during the 4-week instruction phase.
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Affiliation(s)
- I Deeg
- Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931, Cologne, Germany.
| | - M J Wicht
- Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931, Cologne, Germany
| | - A G Barbe
- Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931, Cologne, Germany
| | - S H M Derman
- Polyclinic for Operative Dentistry and Periodontology, University of Cologne, Faculty of Medicine and University Hospital Cologne, 50931, Cologne, Germany
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Altalhi AM, Alqahtani NS, Alareefi JA, Alamri SS, Almutairi KS, Bin Dous RA, Albaqami IA. A Comparative Review of Water Flossers in Periodontal Therapy. Cureus 2023; 15:e50162. [PMID: 38186424 PMCID: PMC10771714 DOI: 10.7759/cureus.50162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
This study investigated the efficacy of water flossers (WFs), devices used to irrigate the interdental and subgingival areas, compared to other interdental care methods, in the management of periodontal disease. A computerized PubMed search was conducted by the author, encompassing the years 1962 to 2023. The year 1962 was selected due to it being the introduction of the first WF. Keywords included "oral irrigator", "efficacy," and "water flossers." The review provided a broad comparative assessment of WFs, rather than an exhaustive detailed article review. We discussed the history and evolution of commercially available WFs and introduced a novel classification system. The research also evaluated the performance of WFs in comparison to traditional and novel interdental care methods, focusing on crucial clinical parameters such as plaque removal efficiency and reduction in gingival inflammation. The results of the study reveal that WFs appear to be superior in the management of periodontal disease and have demonstrated effectiveness in a variety of indices. However, it's worth noting that the author did not statistically analyze any of the data. We identified gaps in the literature and found opportunities for further clinical studies. These findings hold implications for optimal periodontal disease prevention and management, addressing the evolving landscape of oral care practices.
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Naito M, Shinada K, Seki N, Akiyama M, Yamamoto R, Onishi T, Taniyama K, Morio I. Effects of two-year oral health information provision on changes in gingival crevicular fluid in male day–night shift workers. J Dent Sci 2022; 17:1463-1470. [DOI: 10.1016/j.jds.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/10/2022] [Indexed: 10/18/2022] Open
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Dolińska E, Milewski R, Pietruska MJ, Gumińska K, Prysak N, Tarasewicz T, Janica M, Pietruska M. Periodontitis-Related Knowledge and Its Relationship with Oral Health Behavior among Adult Patients Seeking Professional Periodontal Care. J Clin Med 2022; 11:jcm11061517. [PMID: 35329843 PMCID: PMC8949077 DOI: 10.3390/jcm11061517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background: Periodontitis is a chronic inflammatory disease that not only damages the stomatognathic system, but may also adversely influence other systems and organs. Patients with low oral health literacy levels are more prone to gingivitis/periodontitis and have a more severe disease course. Methods: A written questionnaire was carried out to assess the knowledge of patients of the Outpatient Clinic of Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Poland. The questions concerned knowledge regarding the causes of periodontal disease, its risk factors, and the connection between periodontal disease and general health status. To analyze the population, patients were divided according to gender, age and if they were first-time or regular outpatients. Results: Written questionnaires were completed by a total of 302 patients. In the studied population, we noted knowledge deficits, particularly related to weaker periodontal disease risk factors (stress, diabetes, osteoporosis, obesity) and the genetic factor, which is the determinant of periodontitis. The patients’ awareness of the role of plaque bacteria and the effect of smoking on the periodontium was at a relatively high level. The respondents were also aware of the impact of periodontal disease on general health as well as the role of oral hygiene in preventing the disease. At the same time, few of them (26%) used interdental brushes or an irrigator (8%). Conclusions: We demonstrated that patients have an insufficient level of knowledge related to risk factors as well as the prevention of periodontal disease. Awareness of the extent of oral health literacy among patients will help to identify key issues connected with health education interventions
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Affiliation(s)
- Ewa Dolińska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland;
- Correspondence: ; Tel.: +48-85-748-59-05
| | - Robert Milewski
- Department of Statistics and Medical Informatics, Medical University of Bialystok, ul. Szpitalna 37, 15-295 Bialystok, Poland;
| | - Maria Julia Pietruska
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Katarzyna Gumińska
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Natalia Prysak
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Tomasz Tarasewicz
- Student’s Research Group, Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland; (M.J.P.); (K.G.); (N.P.); (T.T.)
| | - Maciej Janica
- Student’s Research Group, Department of Statistics and Medical Informatics, Medical University of Bialystok, ul. Szpitalna 37, 15-295 Bialystok, Poland;
| | - Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, ul. Waszyngtona 13, 15-269 Bialystok, Poland;
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Haraszthy VI, Raylae CC, Sreenivasan PK. Antimicrobial effects of a stannous fluoride toothpaste in distinct oral microenvironments. J Am Dent Assoc 2019; 150:S14-S24. [PMID: 30797255 DOI: 10.1016/j.adaj.2019.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/02/2019] [Accepted: 01/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Clinical research has shown a relationship between microbial accumulations and oral diseases such as gingivitis and caries. The mouth harbors large densities of bacteria in distinct oral microenvironments, that is, dental plaque on teeth, saliva, and soft tissues such as the tongue, cheek, and gingiva. In this home-use study, the authors compared the effects of brushing with a newly formulated stannous fluoride toothpaste and a sodium monofluorophosphate dentifrice on bacteria of distinct oral microenvironments. METHODS Adult participants completed a washout phase before baseline sampling of dental plaque, saliva, and scrapings from tongue, cheek, and gingiva, which were used for microbiological analysis. Treatments were randomly assigned: test (62 participants) and control (67 participants) for twice-daily toothbrushing over 8 weeks. After 4 weeks and 8 weeks, posttreatment samples 12 hours after brushing were collected for analysis. At these posttreatment visits, participants brushed in the dental clinic, and an additional sample was collected 4 hours later for microbiological analysis. RESULTS Relative to the control, 12 hours after brushing, the test toothpaste showed greater reductions of bacteria (ranging from 14% to 27%) at the 4-week evaluation, which increased to 27% to 41% after 8 weeks of brushing. Correspondingly, 4 hours after brushing with the test toothpaste at the 4-week evaluation, there were greater reductions of bacteria in the range of 22% to 59%, which increased to a range of 33% to 61% at the 8-week assessment for participants completing the study. CONCLUSIONS The stannous fluoride toothpaste provided bacterial reductions in all oral microenvironments 12 hours after brushing. In addition, the authors observed microbial reductions 4 hours after brushing, which increased after extended use. PRACTICAL IMPLICATIONS The results are appropriate for oral hygiene recommendations by dental professionals.
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Kalsi AS, Darbar U. Initial periodontal therapy before referring a patient: an audit. Br Dent J 2019; 227:977-983. [DOI: 10.1038/s41415-019-1048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Elkerbout TA, Slot DE, Rosema NAM, Van der Weijden GA. How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises. Int J Dent Hyg 2019; 18:17-26. [PMID: 31050195 PMCID: PMC7004084 DOI: 10.1111/idh.12401] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/11/2019] [Accepted: 04/26/2019] [Indexed: 12/16/2022]
Abstract
Objectives In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal? Methods MEDLINE‐PubMed and Cochrane‐CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley‐Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta‐analysis and subanalysis for brands and mode of action being oscillating‐rotating (OR) and side‐to‐side (SS) were performed when feasible. Results Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was −0.14 (P < 0.001; 95%CI [−0.19; −0.09]) for the Q&HPI and −0.10 (P < 0.001; 95%CI [−0.14; −0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM −0.16 (P < 0.001; 95%CI [−0.22, −0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed −0.10 (P < 0.001; 95%CI [−0.15; −0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of −0.15 (P < 0.001; 95%CI [−0.22; −0.08]) and the Colgate SS for RMNPI showed a DiffM of −0.15 (P < 0.001; 95%CI [−0.18; −0.12]). Conclusion There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.
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Affiliation(s)
- Therese A Elkerbout
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N A Martijn Rosema
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Akcalı A, Yıldız MS, Akcalı Z, Huck O, Friedmann A. Periodontal condition of patients with Thalassemia Major: A systematic review and meta-analysis. Arch Oral Biol 2019; 102:113-121. [PMID: 30999065 DOI: 10.1016/j.archoralbio.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition. MATERIALS & METHODS MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment. RESULTS The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p < 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p < 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality". CONCLUSION Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic.
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Affiliation(s)
- Aliye Akcalı
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany; Centre for Oral Clinical Research, Institute of Dentistry, Barts &The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, United Kingdom.
| | - Mehmet Selim Yıldız
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Zeynep Akcalı
- Department of Internal Medicine, Havran Government Hospital, Balıkesir, Turkey
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France; INSERM 1260 « Regenerative Nanomedicine », Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Anton Friedmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany
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Kumar S. Evidence-Based Update on Diagnosis and Management of Gingivitis and Periodontitis. Dent Clin North Am 2018; 63:69-81. [PMID: 30447793 DOI: 10.1016/j.cden.2018.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article is an overview to update the practicing general dental practitioner about clinically relevant evidence-based topics published in the recent past in the diagnosis, etiopathogenesis, and management of gingivitis and periodontitis.
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Affiliation(s)
- Satish Kumar
- A.T. Still University, Arizona School of Dentistry and Oral Health, 5855 E Still Circle, Mesa, AZ 85296, USA.
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11
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Jaedicke KM, Bissett SM, Finch T, Thornton J, Preshaw PM. Exploring changes in oral hygiene behaviour in patients with diabetes and periodontal disease: A feasibility study. Int J Dent Hyg 2018; 17:55-63. [PMID: 30184336 PMCID: PMC7379549 DOI: 10.1111/idh.12365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/06/2018] [Accepted: 09/01/2018] [Indexed: 11/30/2022]
Abstract
Objective Exploring the feasibility to understand changes in oral hygiene behaviour using the Health Action Process Approach (HAPA) model applied to qualitative research interviews in patients with diabetes and periodontitis undergoing standard periodontitis treatment. Methods Patients with type 1/2 diabetes and chronic periodontitis (n = 8) received standard non‐surgical periodontal treatment accompanied with personalized oral hygiene instructions by a dental hygienist. Clinical indices (% bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), % of sites with PD ≥ 5 mm, periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA) were recorded pre‐ and post‐treatment. At 3 months post‐treatment, patients were interviewed using a topic guide relating to oral health. A behaviour change framework was constructed from elements of the HAPA model and used directly to map interview data to evaluate oral hygiene behaviour in these patients. Results Data from this feasibility study suggest a clinical improvement in periodontal status, albeit only monitored for 3 months. Application of the HAPA model highlighted the behavioural change pathway that diabetes patients undertake before, during and after periodontal treatment. The data suggest that patients move through all elements of the motivation phase and all elements of the volition phase except for the recovery self‐efficacy element. Conclusion The novel approach of applying the HAPA model to qualitative research data allowed for the collection of richer data compared to quantitative analysis only. Findings suggest that, in general, patients with periodontitis and diabetes successfully manage to incorporate new oral hygiene behaviours into their daily routine.
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Affiliation(s)
- Katrin M Jaedicke
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Susan M Bissett
- Centre for Oral Health Research, School of Dental Sciences and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Coach Lane Campus West, Newcastle upon Tyne, UK
| | - Jared Thornton
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Philip M Preshaw
- Centre for Oral Health Research, School of Dental Sciences and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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Lin PJ, Chuang MC, Chang SC. Efficacy of using oxygen microbubble device for facultative anaerobe removal. IET Nanobiotechnol 2018; 12:973-980. [PMID: 30247140 PMCID: PMC8676216 DOI: 10.1049/iet-nbt.2017.0232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/17/2018] [Accepted: 05/04/2018] [Indexed: 11/20/2022] Open
Abstract
Patients with serious gingivitis or periodontal diseases suffer from receding gums. Brushing teeth with a toothbrush may result in bleeding gums and new wounds, which increases the difficulty of removing facultative anaerobes from gum pockets, to decrease the damage inflicted on gums, this study proposed a cleaning device that can generate and emit oxygen microbubbles for eliminating facultative anaerobes in the mouth cavity. In this study, the authors conducted simulations with a denture to investigate the efficacy of using this method to remove facultative anaerobes. In this research for the optimal device design, several variables were manipulated including rotation speeds of the bubble generator, different nozzle diameters, and different numbers of nozzle holes. The results revealed that the device is effective in removing facultative anaerobes; moreover, of all design variables, the number of nozzle holes was the factor having the largest effect on anaerobe removal, as it influenced the flow volume and oxygen content of the discharge: the greater the number of nozzles, the greater the flow volume, oxygen content, and efficacy of anaerobe removal.
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Affiliation(s)
- Pei-Ju Lin
- Department of Industrial Design, Institute of Applied Arts, National Chiao Tung University, Hsinchu, Taiwan.
| | - Ming-Chuen Chuang
- Department of Industrial Design, Institute of Applied Arts, National Chiao Tung University, Hsinchu, Taiwan
| | - Szu-Chung Chang
- Division of Periodontology of CM Dental Clinic, Taichung, Taiwan
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Abstract
This volume of Periodontology 2000 represents the 25th anniversary of the Journal, and uses the occasion to assess important advancements in periodontology over the past quarter-century as well as the hurdles that remain. Periodontitis is defined by pathologic loss of the periodontal ligament and alveolar bone. The disease involves complex dynamic interactions among active herpesviruses, specific bacterial pathogens and destructive immune responses. Periodontal diagnostics is currently based on clinical rather than etiologic criteria, and provides limited therapeutic guidance. Periodontal causative treatment consists of scaling, antiseptic rinses and occasionally systemic antibiotics, and surgical intervention has been de-emphasized, except perhaps for the most advanced types of periodontitis. Plastic surgical therapy includes soft-tissue grafting to cover exposed root surfaces and bone grafting to provide support for implants. Dental implants are used to replace severely diseased or missing teeth, but implant overuse is of concern. The utility of laser treatment for periodontitis remains unresolved. Host modulation and risk-factor modification therapies may benefit select patient groups. Patient self-care is a critical part of periodontal health care, and twice-weekly oral rinsing with 0.10-0.25% sodium hypochlorite constitutes a valuable adjunct to conventional anti-plaque and anti-gingivitis treatments. A link between periodontal herpesviruses and systemic diseases is a strong biological plausibility. In summary, research during the past 25 years has significantly changed our concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options.
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Abstract
Periodontal disease is synonymous with the presence of periodontal pockets, and very often the clinical success of periodontal therapy is based on periodontal pocket depth reduction. Therefore, in the fields of periodontology and implant dentistry, significant research effort has been placed on the etiopathogenesis, diagnosis and treatment of periodontal/peri-implant disease and as a consequence on pocket pathology. In this volume of Periodontology 2000, the in-depth reviews include topics ranging from preclinical models, anatomy and structure of tissues, and molecular and bacterial components, to treatments of pockets around teeth and implants. These reviews aim to provide the readers with current and future perspectives on the different areas of research into the periodontal pocket.
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Azcarate-Velázquez F, Garrido-Serrano R, Castillo-Dalí G, Serrera-Figallo MA, Gañán-Calvo A, Torres-Lagares D. Effectiveness of flossing loops in the control of the gingival health. J Clin Exp Dent 2017. [PMID: 28638551 PMCID: PMC5474330 DOI: 10.4317/jced.53858] [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] [Indexed: 11/20/2022] Open
Abstract
Background One of the key factor in the good condition of periodontal tissues is their daily hygiene. Oral hygiene techniques such brushing and a good interdental hygiene by correct flossing are very important. The aim of this study is to compare the use of dental floss in a loop vs traditional floss in the control of Loe-Silness Gingival Index (IG), Turesky´s Plaque Index (IPT), Gingival Bleeding Index (IS) and the values of interleukin 6 (IL-6) and interleukin 8 (IL-8). Material and Methods A comparative study of 40 patients in which each patient was his own control, using during 45 days each one of the devices (new loop floss and conventional floss) of interdental hygiene analysed. Data for Loe-Silness Gingival Index (IG), Turesky´s Plaque Index (IPT), Gingival Bleeding Index (IS) and the values of interleukin 6 (IL-6) and interleukin 8 (IL-8)were collected and measured in every visit for every type of interdental hygiene device. Results Our data indicates that the rate of Turesky´s Plaque Index presented statistically significant differences between groups (loop: 1.66 ± 0.8; traditional: 1.12 ± 0.8; p<0.0001). The rest of the indices studied showed no statistically significant differences. Conclusions The creation of new dental floss designs try to make their use easier and more sensitive, and plaque removal more effective. The loop design can facilitate interdental hygiene, reaching similar effectiveness than traditional floss, improving some indicators, such as Turesky´s Plaque Index. Key words:Dental floss, bacterial plaque, loop floss, plaque index, periodontal diseases.
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Affiliation(s)
| | - Roberto Garrido-Serrano
- Master in Oral Surgery. Department of Dentistry. Faculty of Dentistry. University of Seville, Spain
| | - Gabriel Castillo-Dalí
- Master in Oral Surgery. Department of Dentistry. Faculty of Dentistry. University of Seville, Spain
| | | | - Alfonso Gañán-Calvo
- Department of Aerospace Engineering and Fluid Mechanics. University of Seville, Spain
| | - Daniel Torres-Lagares
- Master in Oral Surgery. Department of Dentistry. Faculty of Dentistry. University of Seville, Spain
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Madhwani T, McBain AJ. The Application of Magnetic Bead Selection to Investigate Interactions between the Oral Microbiota and Salivary Immunoglobulins. PLoS One 2016; 11:e0158288. [PMID: 27483159 PMCID: PMC4970730 DOI: 10.1371/journal.pone.0158288] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/13/2016] [Indexed: 11/19/2022] Open
Abstract
The effect of humoral immunity on the composition of the oral microbiota is less intensively investigated than hygiene and diet, in part due to a lack of simple and robust systems for investigating interactions between salivary immunoglobulins and oral bacteria. Here we report the application of an ex situ method to investigate the specificity of salivary immunoglobulins for salivary bacteria. Saliva collected from six volunteers was separated into immunoglobulin and microbial fractions, and the microbial fractions were then directly exposed to salivary immunoglobulins of "self" and "non-self" origin. Antibody-selected bacteria were separated from their congeners using a magnetic bead system, selective for IgA or IgG isotypes. The positively selected fractions were then characterized using gel-based eubacterial-specific DNA profiling. The eubacterial profiles of positively selected fractions diverged significantly from profiles of whole salivary consortia based on volunteer (P≤ 0.001%) and immunoglobulin origin (P≤ 0.001%), but not immunoglobulin isotype (P = 0.2). DNA profiles of separated microbial fractions were significantly (p≤ 0.05) less diverse than whole salivary consortia and included oral and environmental bacteria. Consortia selected using self immunoglobulins were generally less diverse than those selected with immunoglobulins of non-self origin. Magnetic bead separation facilitated the testing of interactions between salivary antibodies and oral bacteria, showing that these interactions are specific and may reflect differences in recognition by self and non-self immunoglobulins. Further development of this system could improve understanding of the relationship between the oral microbiota and the host immune system and of mechanisms underlying the compositional stability of the oral microbiota.
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Affiliation(s)
- Tejal Madhwani
- Manchester Pharmacy School, The University of Manchester, Manchester, M13 9PT, United Kingdom
| | - Andrew J. McBain
- Manchester Pharmacy School, The University of Manchester, Manchester, M13 9PT, United Kingdom
- * E-mail:
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17
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Sälzer S, Slot DE, Van der Weijden FA, Dörfer CE. Efficacy of inter-dental mechanical plaque control in managing gingivitis--a meta-review. J Clin Periodontol 2016; 42 Suppl 16:S92-105. [PMID: 25581718 DOI: 10.1111/jcpe.12363] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 01/08/2023]
Abstract
FOCUSED QUESTION What is the effect of mechanical inter-dental plaque removal in addition to toothbrushing, on managing gingivitis using various formats of inter-dental self-care in adults based on evidence gathered from existing systematic reviews? MATERIAL & METHODS Three Internet sources were searched by a strategy designed to include systematic reviews on inter-dental cleaning devices. Plaque and gingivitis scores were the primary parameters of interest. Characteristics of selected papers were extracted. The potential risk of bias was estimated and the acquired evidence was graded. RESULTS Screening of 395 papers resulted in six systematic reviews. Two papers evaluated the efficacy of dental floss, two of inter-dental brushes (IDB), one of woodsticks and one of the oral irrigator. Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs in combination with toothbrushing reduce both plaque and gingivitis. CONCLUSION Evidence suggests that inter-dental cleaning with IDBs is the most effective method for inter-dental plaque removal. The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal. All investigated devices for inter-dental self-care seem to support the management of gingivitis, however, to a varying extend.
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Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
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Garcia RI, Compton R, Dietrich T. Risk assessment and periodontal prevention in primary care. Periodontol 2000 2016; 71:10-21. [DOI: 10.1111/prd.12124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 11/28/2022]
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Wilder RS, Bray KS. Improving periodontal outcomes: merging clinical and behavioral science. Periodontol 2000 2016; 71:65-81. [DOI: 10.1111/prd.12125] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 02/03/2023]
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Vernon LT, Howard AR. Advancing Health Promotion in Dentistry: Articulating an Integrative Approach to Coaching Oral Health Behavior Change in the Dental Setting. ACTA ACUST UNITED AC 2015; 2:111-122. [PMID: 26457237 DOI: 10.1007/s40496-015-0056-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Oral health is managed based on objective measures such as the presence and severity of dental caries and periodontal disease. In recent years, oral health researchers and practitioners have shown increasing interest in a widened array of physical, psychological, and social factors found to influence patients' oral health. In this article, we introduce a behavior change coaching approach that can be used to enhance psychosocial diagnosis and client-centered delivery of health-promoting interventions. Briefly, this health coaching approach is based on an interactive assessment (both physical and psychological), a non-judgmental exploration of patients' knowledge, attitudes, and beliefs, a mapping of patient behaviors that may contribute to disease progression, gauging patient motivation, and tailoring health communication to encourage health-promoting behavior change. Developed in a clinical setting, this coaching model is supported by interdisciplinary theory, research, and practice on health behavior change. We suggest that, with supervision, this coaching process may be learned.
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Affiliation(s)
- Lance T Vernon
- School of Dental Medicine, Department of Pediatric Dentistry and Community Dentistry, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4905, USA
| | - Anita R Howard
- Weatherhead School of Management, Department of Organizational Behavior, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4905, USA
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Langford G. Promoting patient empowerment and self-efficacy to achieve successful non-surgical periodontal outcomes. Prim Dent J 2014; 3:34-37. [PMID: 25198636 DOI: 10.1308/205016814812736691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abstract
Periodontitis is an infectious disease that affects the tooth-supporting tissues and exhibits a wide range of clinical, microbiological and immunological manifestations. The disease is associated with and is probably caused by a multifaceted dynamic interaction of specific infectious agents, host immune responses, harmful environmental exposure and genetic susceptibility factors. This volume of Periodontology 2000 covers key subdisciplines of periodontology, ranging from etiopathogeny to therapy, with emphasis on diagnosis, classification, epidemiology, risk factors, microbiology, immunology, systemic complications, anti-infective therapy, reparative treatment, self-care and affordability issues. Learned and unlearned concepts of periodontitis over the past 50 years have shaped our current understanding of the etiology of the disease and of clinical practice.
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