1
|
Sahoo S, Singh DK, Pattnaik N, Jalaluddin M, Mishra D, Mohapatra A, Pati J. Exploring Knowledge, Awareness, and Practices Regarding Periodontal Health Assessment and Mechanical Plaque Control Among the Shillong Population of Meghalaya, India: A Descriptive Cross-Sectional Investigation. Cureus 2024; 16:e57692. [PMID: 38711722 PMCID: PMC11070892 DOI: 10.7759/cureus.57692] [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: 03/03/2024] [Accepted: 03/28/2024] [Indexed: 05/08/2024] Open
Abstract
Background Periodontal diseases are widespread oral health conditions. However, there remains a lack of comprehensive understanding regarding the knowledge, awareness, and practices related to periodontal health assessment and mechanical plaque control among specific populations, such as those residing in Shillong, Meghalaya. Shillong, being the capital city of Meghalaya in northeastern India, represents a diverse demographic and cultural landscape. Aim This study aims to evaluate the knowledge, awareness, and practices related to mechanical plaque control among the population of Shillong City. Methodology A descriptive cross-sectional online survey was conducted among the residents of Shillong City, Meghalaya. Data collection involved the administration of an 18-item, closed-ended, self-structured questionnaire. Before the main data collection, a pilot study was conducted involving 63 individuals. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA), employing the chi-square test and ANOVA with a significance level of 0.05. Results Study participants were categorized into five age groups spanning from 21 to 64 years old, with the age group of 41 to 50 years demonstrating the highest mean knowledge score. Age exhibited a statistically significant influence on knowledge scores. Conclusion The study reveals a commendable level of knowledge, awareness, and adherence to practices regarding the primary tool for oral hygiene maintenance, the toothbrush, among the residents of Shillong City.
Collapse
Affiliation(s)
- Saismita Sahoo
- Department of Periodontology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| | - Dhirendra Kumar Singh
- Department of Periodontology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| | - Naina Pattnaik
- Department of Periodontology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| | - Mohammad Jalaluddin
- Department of Periodontology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| | - Debasish Mishra
- Department of Periodontology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| | - Arpita Mohapatra
- Department of Periodontology, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| | - Jugajyoti Pati
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology Deemed to be University, Bhubaneswar, IND
| |
Collapse
|
2
|
Oliveira LJCD, Cademartori MG, Sfreddo CS, Silveira MFD, Barros FC, Correa MB, Demarco FF. Factors associated with periodontal diseases in pregnancy: Findings of the 2015 Pelotas Birth Cohort Study. Braz Oral Res 2023; 37:e110. [PMID: 37970930 DOI: 10.1590/1807-3107bor-2023.vol37.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/20/2023] [Indexed: 11/19/2023] Open
Abstract
Although periodontal disease is common during pregnancy, little is known about socioeconomic, behavioral, or biological determinants related to clinically assessed periodontal condition during this period. We assessed the prevalence of periodontal disease and associated factors in pregnant women. This population-based survey used data used from the 2015 Pelotas Birth Cohort Study, Brazil. Pregnant women expected to give birth between December 2014 and May 2016 were interviewed and clinically examined by trained dentist, with periodontal measures collected in all teeth, six sites per tooth. Outcomes were periodontitis (using the 2012 Centers for Disease Control and Prevention and the American Academy of Periodontology criteria) and gingivitis (by the 2018 European Federation of Periodontology/ American Academy of Periodontology classification). Multivariate hierarchical Poisson regression was used to assess the associations between socioeconomic, systemic, and clinical oral factors and periodontal disease. A total of 2,474 pregnant women participated in the study. Prevalence of periodontitis and gingivitis was 14.63% and 21.67%, respectively. Lower educational level and calculus were associated with higher prevalence periodontitis and gingivitis (P<0.05). Smoking was also associated with periodontitis (P=0.05), and lower frequency of toothbrushing (P=0.005) with gingivitis. Periodontal disease, especially gingivitis, was prevalent in pregnant women and their determinants were socioeconomic, environmental, and clinical oral health factors.
Collapse
Affiliation(s)
| | | | - Camila Silveira Sfreddo
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Dentistry, Pelotas, RS, Brazil
| | | | - Fernando Celso Barros
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Epidemiology, Pelotas, RS, Brazil
| | - Marcos Britto Correa
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Dentistry, Pelotas, RS, Brazil
| | - Flávio Fernando Demarco
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Epidemiology, Pelotas, RS, Brazil
| |
Collapse
|
3
|
Park HM, Ryu S, Jo E, Yoo SK, Kim YW. A Study on the Biofilm Removal Efficacy of a Bioelectric Toothbrush. Bioengineering (Basel) 2023; 10:1184. [PMID: 37892914 PMCID: PMC10604395 DOI: 10.3390/bioengineering10101184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Effective oral care is a critical requirement to maintain a high quality of life. Most oral diseases are caused by plaque (oral biofilm), which is also correlated with systemic diseases. A common method to remove biofilm is brushing teeth with toothpaste. However, 3.5 billion people in the world have oral diseases, meaning that more efficient methods of removing biofilms are needed. We have developed a toothbrush that applies a bioelectric effect (BE) utilizing an electric force for biofilm removal. It demonstrated significantly higher biofilm removal efficiency than non-BE manual toothbrushes. Tests were performed in saline and toothpaste conditions using various pressures. Results showed that the BE toothbrush had a significantly higher biofilm removal efficiency in saline (0.5 N: 215.43 ± 89.92%, 2.5 N: 116.77 ± 47.02%) and in a toothpaste slurry (0.5 N: 104.96 ± 98.93%, 2.5 N: 96.23 ± 35.16%) than non-BE manual toothbrushes. Results also showed that BE toothbrushes were less dependent on toothpaste. This study suggests that the application of BE can be a new solution to plaque problems in oral care.
Collapse
Affiliation(s)
- Hyun Mok Park
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
- Graduate Program of Biomedical Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seungjae Ryu
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
| | - Eunah Jo
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
| | - Sun Kook Yoo
- Graduate Program of Biomedical Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Young Wook Kim
- PAIST (ProxiHealthcare Advanced Institute for Science and Technology), Seoul 04513, Republic of Korea; (H.M.P.); (S.R.); (E.J.)
| |
Collapse
|
4
|
Tsai KZ, Huang RY, Cheng WC, Han CL, Huang WC, Sui X, Lavie CJ, Lin GM. Association Between Dental Calculus and Hypertension Phenotypes in Highly Fit Adults: CHIEF Oral Health Study. Am J Hypertens 2023; 36:102-108. [PMID: 36270011 DOI: 10.1093/ajh/hpac119] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/31/2022] [Accepted: 10/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Poor oral health evaluated by presence of dental calculus has been associated with hypertension (HTN) among middle- and old-aged adults. However, it is unclear for the association of HTN phenotypes with dental calculus in young adults. METHODS This study examined the association between dental calculus and HTN in 5,345 military personnel, aged 19-45 years, without antihypertensive medications therapy in Taiwan from 2018 to 2021. Dental calculus was defined as presence of supragingival calculus in any teeth, except impacted teeth, and third molar. Combined HTN (CHTN) was diagnosed as systolic blood pressure (SBP) ≥130 mm Hg and diastolic blood pressure (DBP) ≥80 mm Hg. Isolated systolic and diastolic HTN were, respectively, defined as SBP ≥130 mm Hg only (ISHTN) and DBP ≥80 mm Hg only (IDHTN). Multiple logistic regression with adjustments for sex, age, toxic substance use, anthropometrics, lipid profiles, fasting glucose, and blood leukocyte counts were used to determine the association between dental calculus and HTN phenotypes in young adults. RESULTS The prevalence of those with dental calculus, CHTN, ISHTN, and IDHTN was 20.8%, 10.8%, 10.2%, and 7.0%, respectively. The dental calculus was associated a greater possibility with CHTN [odds ratio (OR) and 95% confidence interval: 1.60 (1.31-1.95)]. However, the associations of dental calculus with ISHTN and IDHTN were null [OR: 1.05 (0.81-1.27) and 1.12 (0.86-1.46), respectively]. CONCLUSIONS Our findings suggest that among young adults, poor oral health manifested by presence of dental calculus was associated with a greater possibility of CHTN, while not for ISHTN and IDHTN.
Collapse
Affiliation(s)
- Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan.,Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan.,Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan
| | - Ren-Yeong Huang
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan
| | - Wan-Chien Cheng
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Dental Science, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Lu Han
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Chun Huang
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana, USA
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan.,Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| |
Collapse
|
5
|
Kim YW, Lee J, Lee TH, Lim S. Bioelectric effect utilized a healthcare device for effective management of dental biofilms and gingivitis. Med Eng Phys 2022; 104:103804. [DOI: 10.1016/j.medengphy.2022.103804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/03/2022] [Accepted: 04/14/2022] [Indexed: 10/18/2022]
|
6
|
Hsiao TY, Ho YC, Lee SY, Sun CW. Degree of polarization uniformity for dental calculus visualization. JOURNAL OF BIOPHOTONICS 2022; 15:e202200011. [PMID: 35249264 DOI: 10.1002/jbio.202200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
During the treatment for periodontitis, the removal of dental calculus is essential. Previously, we have proposed the DAM algorithm for intuitive identification of the site of lesion, enabling the non-contact assessment during the operation. Nonetheless, the delineation of dental calculus was still imperfect. To this end, here we utilized the power of polarization-sensitive optical coherence tomography and evaluated the contrast called degree of polarization uniformity for dental calculus visualization. The result showed that the selected index demonstrated excellent contrast of dental calculus from other normal dental hard tissues. The proposed contrast is promising for accurate dental calculus delineation.
Collapse
Affiliation(s)
- Tien-Yu Hsiao
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| | - Yi-Ching Ho
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shyh-Yuan Lee
- School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dentistry, Yangming branch of Taipei City Hospital, Taipei, Taiwan
| | - Chia-Wei Sun
- Department of Photonics, College of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu City, Taiwan
| |
Collapse
|
7
|
Update on the Roles of Oral Hygiene and Plaque Control on Periodontal Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:329-339. [DOI: 10.1007/978-3-030-96881-6_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
8
|
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.
Collapse
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;
| |
Collapse
|
9
|
Harrel SK, Wilson TG, Tunnell JC, Stenberg WV. Laser identification of residual microislands of calculus and their removal with chelation. J Periodontol 2020; 91:1562-1568. [DOI: 10.1002/jper.19-0698] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/24/2020] [Accepted: 04/01/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Stephen K. Harrel
- Department of Periodontics Texas A&M University College of Dentistry Dallas TX
| | | | | | - William V. Stenberg
- Department of Biomedical Sciences Texas A&M University College of Dentistry Dallas TX
| |
Collapse
|
10
|
Akcalı A, Lang NP. Dental calculus: the calcified biofilm and its role in disease development. Periodontol 2000 2017; 76:109-115. [DOI: 10.1111/prd.12151] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
11
|
Larsen HC, Slot DE, Van Zoelen C, Barendregt DS, Van der Weijden GA. The effectiveness of conically shaped compared with cylindrically shaped interdental brushes - a randomized controlled clinical trial. Int J Dent Hyg 2016; 15:211-218. [PMID: 26751602 DOI: 10.1111/idh.12189] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this study was to compare the effectiveness of conically shaped versus cylindrically shaped interdental brushes (IDB) in patients receiving supportive periodontal therapy. MATERIALS AND METHODS Periodontal maintenance patients volunteered to be enrolled into this randomized controlled examiner-blind parallel study. At baseline and after 3 months, plaque scores, bleeding upon pocket probing scores and probing pocket depth (PPD) were assessed. The type of IDB (conical or cylindrical) was randomly assigned to each patient and individual instruction was provided regarding the method of use and the appropriate size. Only those approximal sites that had sufficient space for the IDB were eligible, and for those sites the data were analysed separately. Analyses were performed for all eligible approximal surfaces and a sub-analysis was performed for vestibular and lingual surfaces. RESULTS In total, 51 participants attended the baseline and the 3-month clinical appointments. Overall, there was no difference between conical and cylindrical IDBs. However, the conical IDB showed significantly higher plaque and bleeding scores at the lingual approximal sites. The cause of this difference was an increase in plaque and bleeding scores compared with baseline. With respect to the PPD, no difference between the IDBs was observed. CONCLUSION Within the limitations of this experiment, the conical IDBs are less effective than cylindrical IDBs with respect to lingual approximal plaque removal. Thus, in patients receiving supportive periodontal therapy, the cylindrical shape should be the first choice of IDB to obtain and maintain gingival health around natural teeth.
Collapse
Affiliation(s)
- H C Larsen
- Clinic for Periodontology Rotterdam, Rotterdam, The Netherlands.,Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - C Van Zoelen
- Clinic for Periodontology Rotterdam, Rotterdam, The Netherlands
| | - D S Barendregt
- Clinic for Periodontology Rotterdam, Rotterdam, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| |
Collapse
|
12
|
Abstract
Assessment of the periodontium has relied exclusively on a variety of physical measurements (e.g., attachment level, probing depth, bone loss, mobility, recession, degree of inflammation, etc.) in relation to various case definitions of periodontal disease. Periodontal health was often an afterthought and was simply defined as the absence of the signs and symptoms of a periodontal disease. Accordingly, these strict and sometimes disparate definitions of periodontal disease have resulted in an idealistic requirement of a pristine periodontium for periodontal health, which makes us all diseased in one way or another. Furthermore, the consequence of not having a realistic definition of health has resulted in potentially questionable recommendations. The aim of this manuscript was to assess the biological, environmental, sociological, economic, educational and psychological relationships that are germane to constructing a paradigm that defines periodontal health using a modified wellness model. The paradigm includes four cardinal characteristics, i.e., 1) a functional dentition, 2) the painless function of a dentition, 3) the stability of the periodontal attachment apparatus, and 4) the psychological and social well-being of the individual. Finally, strategies and policies that advocate periodontal health were appraised. I'm not sick but I'm not well, and it's a sin to live so well. Flagpole Sitta, Harvey Danger
Collapse
|
13
|
Teles R, Teles F, Frias-Lopez J, Paster B, Haffajee A. Lessons learned and unlearned in periodontal microbiology. Periodontol 2000 2014; 62:95-162. [PMID: 23574465 PMCID: PMC3912758 DOI: 10.1111/prd.12010] [Citation(s) in RCA: 227] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Periodontal diseases are initiated by bacterial species living in polymicrobial biofilms at or below the gingival margin and progress largely as a result of the inflammation elicited by specific subgingival species. In the past few decades, efforts to understand the periodontal microbiota have led to an exponential increase in information about biofilms associated with periodontal health and disease. In fact, the oral microbiota is one of the best-characterized microbiomes that colonize the human body. Despite this increased knowledge, one has to ask if our fundamental concepts of the etiology and pathogenesis of periodontal diseases have really changed. In this article we will review how our comprehension of the structure and function of the subgingival microbiota has evolved over the years in search of lessons learned and unlearned in periodontal microbiology. More specifically, this review focuses on: (i) how the data obtained through molecular techniques have impacted our knowledge of the etiology of periodontal infections; (ii) the potential role of viruses in the etiopathogenesis of periodontal diseases; (iii) how concepts of microbial ecology have expanded our understanding of host-microbe interactions that might lead to periodontal diseases; (iv) the role of inflammation in the pathogenesis of periodontal diseases; and (v) the impact of these evolving concepts on therapeutic and preventive strategies to periodontal infections. We will conclude by reviewing how novel systems-biology approaches promise to unravel new details of the pathogenesis of periodontal diseases and hopefully lead to a better understanding of their mechanisms.
Collapse
|
14
|
Armitage GC. Learned and unlearned concepts in periodontal diagnostics: a 50-year perspective. Periodontol 2000 2014; 62:20-36. [PMID: 23574462 DOI: 10.1111/prd.12006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the past 50 years, conceptual changes in the field of periodontal diagnostics have paralleled those associated with a better scientific understanding of the full spectrum of processes that affect periodontal health and disease. Fifty years ago, concepts regarding the diagnosis of periodontal diseases followed the classical pathology paradigm. It was believed that the two basic forms of destructive periodontal disease were chronic inflammatory periodontitis and 'periodontosis'- a degenerative condition. In the subsequent 25 years it was shown that periodontosis was an infection. By 1987, major new concepts regarding the diagnosis and pathogenesis of periodontitis included: (i) all cases of untreated gingivitis do not inevitably progress to periodontitis; (ii) progression of untreated periodontitis is often episodic; (iii) some sites with untreated periodontitis do not progress; (iv) a rather small population of specific bacteria ('periodontal pathogens') appear to be the main etiologic agents of chronic inflammatory periodontitis; and (v) tissue damage in periodontitis is primarily caused by inflammatory and immunologic host responses to infecting agents. The concepts that were in place by 1987 are still largely intact in 2012. However, in the decades to come, it is likely that new information on the human microbiome will change our current concepts concerning the prevention, diagnosis and treatment of periodontal diseases.
Collapse
|
15
|
Nagarajappa R, Sanadhya S, Sharda AJ, Asawa K, Tak M, Batra M, Daryani H, Ramesh G. Assessment of the Periodontal Status among Kota Stone Workers in Jhalawar, India. J Clin Diagn Res 2013; 7:1498-503. [PMID: 23998106 DOI: 10.7860/jcdr/2013/5420.3173] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 04/27/2013] [Indexed: 11/24/2022]
Abstract
CONTEXT Periodontal disease is one of the most prevalent dental diseases which affects the adult population of the world, varying only in degree from mild to severe. Its prevalence, which was reported in various studies which were conducted in different parts of the globe, signifies its need for a control. AIMS To assess the periodontal status among the Kota stone workers in Jhalawar and to provide a baseline data for the planning and evaluation of the oral health care promotion programmes. SETTINGS AND DESIGN A cross-sectional descriptive survey was conducted among the Kota stone workers who were working in the Kota stone factories which were located in the Ricco Industrial Area in Jhalawar. METHOD AND MATERIALS The study population comprised 420 subjects who were in the age group of 21 to 60 years. The data were collected by means of a close ended, self administered questionnaire and clinical examination with the use of the CPI index. Statistical analyses which were used: Chi-square, Student's t-test, One way Analysis of Variance (ANOVA), and Multiple Logistic Regression. RESULTS The socio-demographic characteristics, except the gender, were found to be significantly associated with the periodontal status in the study population (P≤0.05). Multivariate analysis showed high CPI scores which were associated with males (OR=1.313), the 21-40 year age group (OR=0.548), education upto 10th class (OR=4.776), oral hygiene practices other than toothbrush with toothpaste (OR=0.774) and smoking (OR=3.994). CONCLUSION The observations of this study indicate the need for a reorientation of the dental care services, with further emphasis on the preventive care in such a population.
Collapse
Affiliation(s)
- Ramesh Nagarajappa
- Professor and Head, Department of Public Health Dentistry, Pacific Dental College and Hospital , Udaipur, India
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Zanatta FB, Moreira CHC, Rösing CK. Association between dental floss use and gingival conditions in orthodontic patients. Am J Orthod Dentofacial Orthop 2012; 140:812-21. [PMID: 22133946 DOI: 10.1016/j.ajodo.2011.06.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 06/01/2011] [Accepted: 06/01/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Evidence comparing periodontal conditions in orthodontic patients who regularly use or do not use dental floss is scarce. METHODS The subjects were 330 patients who had been under fixed orthodontic treatment for at least 6 months. They were examined by 1 calibrated examiner for plaque and gingival indexes, probing pocket depths, clinical attachment losses, and excessive resin around brackets. Socioeconomic background, time with orthodontic appliances, and use of dental floss were assessed in interviews. Unadjusted and multiple logistic regression analyses were used to assess the associations. RESULTS The results demonstrated statistically significant higher means of plaque index, gingival index, pocket probing depth, and clinical attachment loss for nonusers of dental floss. Intragroup analyses showed higher means of these parameters in proximal sites and posterior teeth, compared with their counterparts' buccal and lingual sites and anterior teeth, respectively. After multivariate analysis, male subjects (P = 0.044) with a household income less than 5 national minimum wages (P = 0.044), and nonusers of dental floss (P = 0.000) showed higher probabilities of gingival bleeding (>30%) than did their counterparts. CONCLUSIONS Orthodontic patients who use dental floss regularly have somewhat better gingival conditions than those who do not use floss.
Collapse
|
17
|
Chongcharoen N, Lulic M, Lang NP. Effectiveness of different interdental brushes on cleaning the interproximal surfaces of teeth and implants: a randomized controlled, double-blind cross-over study. Clin Oral Implants Res 2011; 23:635-40. [PMID: 22146002 DOI: 10.1111/j.1600-0501.2011.02387.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare the interproximal cleansing efficacy of the novel, waist-shaped Circum brush (Topcaredent, Switzerland; CB) with that of a straight soft interdental brush (IB) (TePe, Sweden; SB) on posterior surfaces. MATERIAL & METHODS Eight patients after completion of initial periodontal therapy abolished oral hygiene for 3 days. Baseline plaque scores (PlI, Silness & Löe ) were assessed on eight surfaces of all premolars and molars. Subsequently, an instructed nurse applied at random one of the two IB, three times per interdental space . Following this, registration of the PlI was repeated by the same blinded examiner. After a 2-week recovery, patients abolished oral hygiene practices for another 3 days. Again, pre-and post-brushing PlI were recorded by the same examiner. The second IB was now applied. RESULTS Patient mean PlI and site PlI were evaluated before and after application of the SB or CB respectively. Paired t-tests were performed to yield statistically significant differences. The reduction of biofilm from before to after the use of the IB on a subject basis was highly significant (P < 0.0001). The mean PlI after the use of the CB was significantly lower than after the use of the SB (P < 0.0001). Comparing the PlI of the line angles (MB, ML, DB, DL), significantly more biofilm had been removed by applying CB compared with SB (P < 0.0001). Moreover, comparing the PlI of the buccal (MB, DB) or the lingual line angles (DL, ML) yielded a significantly higher reduction of biofilm in favour of the CB (P < 0.0001). The reduction of the PlI in the mid-interproximal portion, both mesially and distally did not differ significantly between CB and ST. No biofilm reduction was seen on the buccal sites with either IB. CONCLUSION The application of the waist-shaped Circum IB resulted in significantly lower PlI scores than the use of a straight IB. This was predominantly due to the higher cleansing effect of the waist-shaped CB on the buccal and lingual line angles.
Collapse
Affiliation(s)
- Nardnadda Chongcharoen
- Implant Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China
| | | | | |
Collapse
|
18
|
Ravald N, Johansson CS. Tooth loss in periodontally treated patients. A long-term study of periodontal disease and root caries. J Clin Periodontol 2011; 39:73-9. [DOI: 10.1111/j.1600-051x.2011.01811.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Nils Ravald
- Division of Cardiovascular Medicine; Department of Medical and Health Sciences; Linköping University; Center for Oral Rehabilitation; County Council of Östergötland; Linköping; Sweden
| | - Carin Starkhammar Johansson
- Division of Cardiovascular Medicine; Department of Medical and Health Sciences; Linköping University; Center for Oral Rehabilitation; County Council of Östergötland; Linköping; Sweden
| |
Collapse
|
19
|
Jepsen S, Deschner J, Braun A, Schwarz F, Eberhard J. Calculus removal and the prevention of its formation. Periodontol 2000 2010; 55:167-88. [DOI: 10.1111/j.1600-0757.2010.00382.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
20
|
Abstract
This review presents a selected overview of the literature concerning risk factors for periodontitis. That in some individuals gingivitis develops into periodontitis is still a matter of extensive research. Cross-sectional studies of clinical and microbiological factors can be meaningful. Longitudinal studies of the natural history allow analysis of potential factors and conditions that may have an impact on the disease process. At present, several possible risk factors for the initiation and progression of periodontitis have been identified: age, gender, plaque, calculus, existing attachment loss. A consistent finding appears to be genetic predisposition for the development of the disease. In terms of microbiology, several micro-organisms have been identified. The results of the Java Project on natural development of Periodontal Disease clearly pinpoint Actinobacillus actinimycetemcomitans as being associated with the onset of disease. The presence of subgingival calculus was found to be associated with onset and dental plaque with progression of disease. Consistent with literature males are more susceptible to disease. The presence of pockets > or = 5 mm appear to be a useful tool, since it was found to be a prognostic factor for disease progression.
Collapse
Affiliation(s)
- M F Timmerman
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.
| | | |
Collapse
|
21
|
Sakamoto T, Horiuchi M, Tomofuji T, Ekuni D, Yamamoto T, Watanabe T. Spatial extent of gingival cell activation due to mechanical stimulation by toothbrushing. J Periodontol 2003; 74:585-9. [PMID: 12816289 DOI: 10.1902/jop.2003.74.5.585] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mechanical stimulation by toothbrushing enhances gingival fibroblast proliferation and collagen synthesis, and reduces inflammatory cell infiltration. The aim of this study was to investigate the spatial extent of proliferation of fibroblasts and endothelial cells in dog gingiva in response to mechanical stimulation by toothbrushing. METHODS All maxillary fourth premolars and mandibular first molars of 6 mongrel dogs were used. Dental plaque was removed with a curet. One of each pair of bilateral teeth (in the same jaw) was assigned to the brushing group, and the corresponding tooth (opposite side) was assigned to the control group. The Bass method was used to brush the limited mesial half of the tooth at 1.96 N for 20 seconds with a fitted plastic stent. Immediately before fixation of tissue, the surface of brushed gingiva was notched to indicate the borderline between the brushed and non-brushed areas. Histometrical analyses of the sections were performed using assays for proliferating cell nuclear antigen (PCNA) and von Willebrand factor. RESULTS The numbers of fibroblasts and PCNA-positive fibroblasts in the subepithelial connective tissue adjacent to oral sulcular epithelium significantly increased in brushed gingiva, not only in the brushed area but also in the non-brushed area 0 to 0.5 mm from the notch. Increased numbers of vascular endothelial cells were observed only in the brushed area. CONCLUSION The effect of mechanical stimulation by toothbrushing on gingival cell proliferation was not observed more than 0.5 mm from the brushed area. These results indicate that effective activation of gingival cell proliferation requires mechanical stimulation of gingiva in all areas.
Collapse
Affiliation(s)
- Tomonori Sakamoto
- Department of Oral Health, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan
| | | | | | | | | | | |
Collapse
|
22
|
|
23
|
|
24
|
Nogueira-Filho GR, Stefani CM, Casati MZ, Nakai CM, Plaza CA, Nociti Júnior FH, Sallum EA, de Toledo S. [Need of periodontal treatment evaluated with CPITN and its relation to the quality of the cervical margin of restorations]. PESQUISA ODONTOLOGICA BRASILEIRA = BRAZILIAN ORAL RESEARCH 2001; 15:51-5. [PMID: 11708286 DOI: 10.1590/s1517-74912001000100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Irregularities of the cervical margin of restorations facilitate the retention of bacterial plaque, hindering plaque control through the habitual procedures of oral hygiene and favoring the development of periodontal disease. The aim of this study was to evaluate the periodontal condition and treatment needs (applying CPITN) in relation to the cervical margin of dental restorations. Three hundred and sixty-seven teeth with class II and V cavities restored with amalgam, class III cavities restored with composite resin, cast metal restorations and unitary prostheses were examined. With a WHO periodontal probe, the position of the cervical margins of restorations was verified (supragingival, subgingival or at the gingival margin level); the presence of defects (lack or excess of restoring material) and the presence of score 2 of CPITN were also assessed. After the analysis of the data, it was possible to conclude that: 1) supragingival margins offered the best marginal adaptation and the lowest frequency of score 2; 2) both the lack and the excess of restoring material favor the development of score 2, despite the utilized material and 3) in subgingival margins, incorrect marginal adaptation was the most frequent event, mainly due to excess of restoring material, and in these cases there was higher frequency of score 2 of CPITN.
Collapse
|
25
|
Abstract
While some periodontal disease may be as old as mankind itself, caries as a public health problem appeared with the development of flour and sugar mills, and the universal access to fermentable carbohydrates. As a consequence, during the last 500 years caries and periodontal disease have been the most common diseases afflicting the human mouth. Together, these two diseases have been responsible for untold pain and suffering, and for excessive destruction and loss of people's teeth. With improving social circumstances in most industrialised nations, increased availability and affordability of modern oral health care, and the promotion of conservative treatment concepts, the 20th century saw significant progress in eliminating pain and tooth loss. Moreover, during the last 50 years advances in the oral health sciences and in technology, have not only increased our understanding of the nature of these diseases and their causes, but also introduced and tested new approaches to their prevention.
Collapse
Affiliation(s)
- H Löe
- School of Dental Medicine, University of Bern, Switzerland
| |
Collapse
|
26
|
Abstract
OBJECTIVE To critically analyse the formation, composition, ethnic variations and pathogenic potential of subgingival calculus in comparison with supragingival calculus. DATA SOURCES Using CD-ROM and index medicus, scientific papers relating to subgingival calculus or subgingival and supragingival calculus written in the English language since 1960 were considered, with the emphasis on more recent articles. STUDY SELECTION Studies were selected for their relevance and contemporary nature re:composition and formation of dental calculus and comparisons of ethnic groups with regard to dental calculus, especially subgingival calculus. Some similar studies were not included. DATA EXTRACTION Abstracts of studies were kept brief unless particularly important to the review. Population, methodology, statistics and accurate conclusions were used as important guides to the quality and validity of studies. DATA SYNTHESIS Similarities and differences between supragingival and subgingival calculus in composition and formation were shown. Different morphological types of subgingival calculus were demonstrated. There was evidence for an association between calculus formation and ethnicity with regard to supragingival and subgingival calculus, and an association between subgingival calculus composition and ethnicity was indicated. CONCLUSIONS An association between ethnicity and subgingival calculus formation and composition was found. Further research into the reasons for these ethnic differences in dental calculus and the role of the mineral constituents especially of subgingival calculus would be valuable.
Collapse
|
27
|
Genco RJ, Ho AW, Grossi SG, Dunford RG, Tedesco LA. Relationship of stress, distress and inadequate coping behaviors to periodontal disease. J Periodontol 1999; 70:711-23. [PMID: 10440631 DOI: 10.1902/jop.1999.70.7.711] [Citation(s) in RCA: 281] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The association of stress, distress, and coping behaviors with periodontal disease was assessed. METHODS A cross-sectional study of 1,426 subjects between the ages of 25 and 74 years in Erie County, New York, was carried out to assess these relationships. Subjects were asked to complete a set of 5 psychosocial questionnaires which measure psychological traits and attitudes including discrete life events and their impact; chronic stress or daily strains; distress; coping styles and strategies; and hassles and uplifts. Clinical assessment of supragingival plaque, gingival bleeding, subgingival calculus, probing depth, clinical attachment level (CAL) and radiographic alveolar crestal height (ACH) was performed, and 8 putative bacterial pathogens from the subgingival flora measured. RESULTS Reliability of subjects' responses and internal consistencies of all the subscales on the instruments used were high, with Cronbach's alpha ranging from 0.88 for financial strain to 0.99 for job strain, uplifts, and hassles. Logistic regression analysis indicated that, of all the daily strains investigated, only financial strain was significantly associated with greater attachment and alveolar bone loss (odds ratio, OR = 1.70, 95% CI = 1.09 to 2.65 and OR = 1.68, 95% CI = 1.20 to 2.37, respectively) after adjusting for age, gender, and cigarette smoking. When coping behaviors were evaluated, it was found that those with more financial strain who were high emotion-focused copers (a form of inadequate coping) had a higher risk of having more severe attachment loss (OR = 2.24, 95% CI = 1.15 to 4.38) and alveolar bone loss (OR = 1.91, 95% CI = 1.15 to 3.17) than those with low levels of financial strain within the same coping group, after adjustment for age, gender, and cigarette smoking. Similar results were found among the low problem-focused copers for AL (OR = 2.21, 95% CI = 1.11 to 4.38) and ACH (OR = 2.12, 95% CI = 1.28 to 3.51). However, subjects with high levels of financial strain who reported high levels of problem-based coping (considered adequate or good coping) had no more periodontal disease than those with low levels of financial strain, suggesting that the effects of stress on periodontal disease can be moderated by adequate coping behaviors. CONCLUSIONS We find that psychosocial measures of stress associated with financial strain and distress manifest as depression, are significant risk indicators for more severe periodontal disease in adults in an age-adjusted model in which gender (male), smoking, diabetes mellitus, B. forsythus, and P. gingivalis are also significant risk indicators. Of considerable interest is the fact that adequate coping behaviors as evidenced by high levels of problem-based coping, may reduce the stress-associated risk. Further studies also are needed to help establish the time course of stress, distress, and inadequate coping with respect to the onset and progression of periodontal disease, and the mechanisms that explain this association.
Collapse
Affiliation(s)
- R J Genco
- State University of New York at Buffalo, School of Dental Medicine, Department of Oral Biology, Periodontal Disease Research Center, 14214-3092, USA.
| | | | | | | | | |
Collapse
|
28
|
|
29
|
Christou V, Timmerman MF, Van der Velden U, Van der Weijden FA. Comparison of different approaches of interdental oral hygiene: interdental brushes versus dental floss. J Periodontol 1998; 69:759-64. [PMID: 9706852 DOI: 10.1902/jop.1998.69.7.759] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of the present study was to compare in untreated patients suffering from moderate to severe periodontitis the efficacy of dental floss (DF) and interdental brushes (IDB) in the reduction of plaque, gingival inflammation, and probing depth in a 6-week period prior to subgingival debridement. Twenty-six patients (12 female, 14 male; mean age 37.4 years; range 27 to 72 years) were instructed to use DF for one side of the dentition and IDB for the other side as an adjunct to the daily toothbrushing for 6 weeks. Oral hygiene instructions for toothbrushing and the use of the two devices were given at baseline and at week 3. Measurements were carried out at baseline and at 6 weeks including plaque scores, probing depth, and 2 bleeding scores (periodontal pocket bleeding index and angulated bleeding index). With the IDB, the approximal plaque score at baseline of 3.09 reduced to 2.15 at 6 weeks and with DF from 3.10 to 2.47, respectively. IDB proved to remove significantly more plaque than DF. Baseline probing depth of 5.84 mm for IDB sites and 5.59 mm for DF sites was reduced to 5.01 mm at 6 weeks for both regimens. Analysis showed that the use of IDB resulted in a greater pocket reduction. Both bleeding indices were slightly reduced with IDB and DF, but no differences between devices were found. In relation to patient acceptance, more problems were observed with DF, and IDB were felt to be more efficacious. In conclusion, the results of the present study indicate that in combination with a manual toothbrush, the use of interdental brushes is more effective in removal of plaque and results in a larger reduction of probing depth than the use of dental floss. Although the differences were small, they indicate, in combination with patient preferences, that interdental brushes are to be considered preferable to floss for interdental plaque removal in patients suffering from moderate to severe periodontitis.
Collapse
Affiliation(s)
- V Christou
- Department of Periodontology, ACTA, Academic Centre for Dentistry, Amsterdam, The Netherlands
| | | | | | | |
Collapse
|
30
|
Timmerman MF, Van der Weijden GA, Armand S, Abbas F, Winkel EG, Van Winkelhoff AJ, Van der Velden U. Untreated periodontal disease in Indonesian adolescents. Clinical and microbiological baseline data. J Clin Periodontol 1998; 25:215-24. [PMID: 9543192 DOI: 10.1111/j.1600-051x.1998.tb02431.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
At present, several risk factors for the initiation and progression of periodontitis have been identified. In order to investigate the rôle of various potential clinical and microbiological risk factors and indicators, a longitudinal study was initiated in a young population deprived from regular dental care. The present communication describes the baseline cross-sectional data obtained in 1987 in terms of the clinical periodontal condition and prevalence of periodontal bacteria in the oral cavity. All inhabitants in the age range 15-25 years of a village with approximately 2000 inhabitants at a tea estate on Western Java, Indonesia, were examined clinically and microbiologically. In total, 255 adolescents, comprising 130 males and 125 females participated in the study. Samples for bacteriological examination were taken from the gingiva, the dorsum of the tongue, and the saliva. Plaque index, bleeding upon probing, pocket depth, and attachment loss (AL) were scored on the approximal surfaces from the vestibular aspect of all teeth as well as the mid-vestibular and mid-lingual aspects of the Ramfjord teeth. Calculus was scored only on the 4 surfaces of the Ramfjord teeth. Following the clinical measurements, the deepest bleeding pocket with no clinical loss of attachment was sampled for microbiological examination. In addition, in 37 subjects a deep bleeding (> or = 4 mm) with at least 4 mm of attachment loss was sampled. Moderate periodontitis (max. AL 3-4 mm) was found in 26% of the population, advanced periodontitis (max. AL > or = 5 mm) in 8%, whereas 66% of the population showed no or minor periodontitis (max. AL 0-2 mm). Actinobacillus actinomycetemcomitans was found in 57% of the population, Porphyromonas gingivalis in 87%, Prevotella intermedia and motile rods in all cases and spirochetes in 89%. P. gingivalis (66%), A. actinomycetemcomitans (37%) and spirochetes (63%) were, of all the sampled sites of the oral cavity, most frequently detected in pockets without attachment loss. Motile rods were most prevalent on the tongue and in the saliva (92% and 89%, respectively). A high prevalence of the investigated periodontal bacteria was detected both in the pockets without and with attachment loss. No significant association between the clinical periodontal parameters and the prevalence of the microorganisms was observed at a patient level. At a site level, both P. gingivalis and spirochetes were more prevalent in sites with attachment loss. The actual rôle of these putative periodontal pathogens may be elucidated more extensively, when longitudinal data on the present population become available.
Collapse
Affiliation(s)
- M F Timmerman
- Department of Periodontology, Academic Centre for Dentistry Amsterdam - ACTA, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
31
|
Tinoco EM, Sivakumar M, Preus HR. The distribution and transmission of Actinobacillus actinomycetemcomitans in families with localized juvenile periodontitis. J Clin Periodontol 1998; 25:99-105. [PMID: 9495608 DOI: 10.1111/j.1600-051x.1998.tb02415.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The prevalence and distribution of A. actinomycetemcomitans in families where at least one family member (proband) suffered from localized juvenile periodontitis was investigated. 25 probands with localized juvenile periodontitis (LJP) and their 78 close family members were screened for the presence of A. actinomycetemcomitans. Among these 25 families, 10 contained at least one additional family member colonized with oral A. actinomycetemcomitans. Genomic DNA from subgingival A. actinomycetemcomitans strains from each of the probands and their family members were amplified and characterized by the polymerase chain reaction (PCR) using a single primer known to distinguish A. actinomycetemcomitans strains. The PCR products from each strain were separated by electrophoresis on a 1% submarine agarose gel containing ethidium bromide and visualized by UV light transillumination. The studies showed that 41.2% of the parents and 58% of the siblings in this LJP-based population harbored the bacterium. Comparison of the PCR generated amplitypes showed that there was a wide distribution of amplitypes among the probands and immediate relatives. No clear transmission paths were observed in this specific population.
Collapse
Affiliation(s)
- E M Tinoco
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Norway.
| | | | | |
Collapse
|
32
|
Polson AM, Southard GL, Dunn RL, Yewey GL, Godowski KC, Polson AP, Fulfs JC, Laster L. Periodontal pocket treatment in beagle dogs using subgingival doxycycline from a biodegradable system. I. Initial clinical responses. J Periodontol 1996; 67:1176-84. [PMID: 8959567 DOI: 10.1902/jop.1996.67.11.1176] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The present study evaluated the clinical response of periodontal pockets in beagle dogs after treatment with a biodegradable delivery system containing 10% doxycycline hyclate (ABDS-D). Eight adult, female beagle dogs had generalized, severe periodontitis with plaque and calculus-laden pockets. In each animal, 3 teeth with multiple pocket sites > or = 4 mm (mean depth = 6.0 mm) associated with attachment loss (mean = 5.4 mm) and which bled on probing (mean score = 2.5) were treated with a single application of either ABDS-D (experimental group) or the delivery system alone without the doxycycline (control group). Residual polymer was removed at day 7. Bioassay of doxycycline in gingival crevicular fluid associated with presence of ABDS-D gave mean levels of bioactivity of approximately 250 micrograms/ml. Levels of bioactive doxycycline were detected for approximately 7 days after ABDS-D removal. Periodontal maintenance consisted of thrice-weekly toothbrushing the treated sites. Clinical responses were evaluated at 2 weeks, and at bi-weekly intervals thereafter for 4 months. Analyses of the data from the control group showed that there was only slight clinical improvement. In contrast, in the experimental group, bleeding on probing and probing depths were significantly reduced from baseline at all post-treatment time points. At 1 month, mean probing depth reduction was 2.4 mm and this was maintained at 4 months (mean reduction = 2.5 mm). These probing depth reductions occurred primarily through gain of clinical attachment which was 2.0 mm at 4 months. Bleeding had been virtually eliminated (mean = 0.2). It was concluded that, for the beagle dogs with severely infected periodontal pockets in this study, treatment with subgingival doxycycline using the delivery system resulted in substantial improvement in periodontal health.
Collapse
Affiliation(s)
- A M Polson
- Atrix Laboratories, Fort Collins, Co., USA
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Anderson GB, Palmer JA, Bye FL, Smith BA, Caffesse RG. Effectiveness of subgingival scaling and root planing: single versus multiple episodes of instrumentation. J Periodontol 1996; 67:367-73. [PMID: 8708961 DOI: 10.1902/jop.1996.67.4.367] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study evaluates the effectiveness of subgingival scaling and root planing comparing the effect of a single instrumentation to the effect of three instrumentations. A total of 35 teeth in 15 patients were selected; 15 were scaled once (Group A), 15 were scaled three times (Group B), and 5 were used as controls (Group C), representing teeth that were not instrumented. The Group A and B teeth were chosen in the same patient based on random selection. All the teeth were scored by the calculus index of the periodontal disease index. Six surface locations were probed to determine probing depth. The level of the gingival margin was marked on the teeth to locate supra- and subgingival calculus after extraction. The Group A and B teeth received the initial episode of scaling and root planing for not more than 10 minutes, then only the Group B teeth received two additional instrumentations of not more than 5 minutes each. The additional instrumentations were performed 24 hours after the initial scaling. The scaled and control teeth were extracted immediately after the third instrumentation period. The teeth were washed with water and stained with methylene blue. They were viewed under a stereomicroscope which had a tenth grid on its eyepiece. Assessments were made involving the total counts and percents of the surfaces covered with calculus on the scaled and unscaled teeth. The results demonstrated no significant difference in the effectiveness of calculus removal between single and multiple episodes of scaling and root planing. Similar results were found for the total amount of calculus removed, the calculus removed from individual surfaces, and the calculus removed from various probing depth levels.
Collapse
Affiliation(s)
- G B Anderson
- University of Texas, Department of Stomatology, Houston, USA
| | | | | | | | | |
Collapse
|
34
|
Ainamo J, Ainamo A. Risk assessment of recurrence of disease during supportive periodontal care. Epidemiological considerations. J Clin Periodontol 1996; 23:232-9. [PMID: 8707983 DOI: 10.1111/j.1600-051x.1996.tb02082.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although it is accepted that the primary cause of periodontitis is bacterial infection of long duration, there are a number of risk factors which may increase the probability of recurrence of periodontal disease during supportive periodontal care. The risk may in such cases be caused by other factors than poor oral hygiene measures per se. Cross-sectional and longitudinal studies show conflicting results concerning age as a risk factor for periodontal disease. The effect of smoking on the periodontal tissues has been discussed for decades and only lately has it been possible to demonstrate that smokers definitely have more periodontal problems than non-smokers. Another important risk factor for periodontitis relates to the insulin dependent and non-insulin dependent forms of diabetes mellitus. Poorly-controlled long-duration diabetics have more periodontitis and tooth loss than well-controlled or non-diabetics. Finally, the issue of compliance deserves attention. The medical literature has suggested that patients with chronic illnesses tend to comply poorly, especially if the disease is not perceived to be particularly threatening, if the therapy is time-consuming, or if the symptoms are non-disturbing. Suggestions for improved compliance are called for.
Collapse
Affiliation(s)
- J Ainamo
- Faculdade de Medicina Dentaria, Universidade de Lisboa, Portugal
| | | |
Collapse
|
35
|
Baelum V, Chen X, Manji F, Luan WM, Fejerskov O. Profiles of destructive periodontal disease in different populations. J Periodontal Res 1996; 31:17-26. [PMID: 8636871 DOI: 10.1111/j.1600-0765.1996.tb00459.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In this study we evaluated the traditional view that the severity of periodontal disease varies between populations in that African and Asian populations are more severely affected than other populations. Our data on periodontal destruction in two random samples of a Kenyan and a Chinese adult population were recalculated to conform with the methods of examination and data presentation utilized in each of 6 other studies of attachment loss levels in different populations. The adult Kenyan and the adult Chinese group, who had very poor oral hygiene conditions and massive gingival inflammation, had attachment loss levels which were quite similar to those in a Japanese population (31), in a Norwegian population (27) and in a New Mexico group of adults (30). Attachment losses were similar in a population of young US adults (26) aged between 35 and 60 years relative to the corresponding Kenyan and Chinese groups while young US citizens had higher and elderly US citizens had lower mean attachment levels than either Kenyans and Chinese. Higher attachment loss levels beyond the age of 27 years were reported for a population of Sri Lankan Tamil tea workers (27) and across all ages in two South Pacific island populations (29). Overall, the analysis indicates that the periodontal attachment loss profiles may differ between populations, but that these differences do not conform with the traditional generalization that African and Asian populations suffer more severe periodontal breakdown than other populations.
Collapse
Affiliation(s)
- V Baelum
- Department of Periodontology, Royal Dental College, Aarhus University, Denmark
| | | | | | | | | |
Collapse
|
36
|
Affiliation(s)
- R G Caffesse
- Division of Periodontics, University of Texas Health Science Center at Houston, Dental Branch, USA
| | | | | |
Collapse
|
37
|
Affiliation(s)
- D H Fine
- University of Medicine and Dentistry of New Jersey, New Jersey Dental School, Department of Oral Biology, Newark, USA
| |
Collapse
|
38
|
Affiliation(s)
- U Zappa
- Department of Crown and Bridge Prosthetics, Removable Prosthetics and Dental Materials, School of Dental Medicine University of Zürich, Switzerland
| |
Collapse
|
39
|
Aass AM, Rossow I, Preus HR, Gjermo P. Incidence of early periodontitis in a group of young individuals during 8 years: associations with selected potential predictors. J Periodontol 1994; 65:814-9. [PMID: 7990016 DOI: 10.1902/jop.1994.65.9.814] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aim of the present study was to assess the incidence of early radiographic bone loss in a birth cohort over 8 years and to assess possible associations between incidence of bone loss and reported dental behavior, ethnic background, and previous orthodontic treatment. In a case control study comprising a proportion of the study population, the detection of black pigmented Bacteroides and Actinobacillus actinomycetemcomitans and their association with early radiographic bone loss was assessed. At the beginning of the study in 1984, there were 2,767 subjects. In 1992 sets of bite-wing radiographs were obtained from 215 subjects, who also filled out a questionnaire concerning their present and past dental behavior, ethnic background, and orthodontic treatment. Radiographic alveolar bone loss was recorded if the distance from the cemento-enamel junction to the alveolar crest exceeded 2 mm. Thirteen subjects (6%) showed new sites with bone loss over the 8-year period. Subgingival plaque was sampled from these 13 subjects and from 13 control subjects. None of the independent variables could be associated with the observed incidence of radiographic bone loss in this cohort, with the possible exception of the presence of A. actinomycetemcomitans which was detected in about 50% of the new sites with bone loss.
Collapse
Affiliation(s)
- A M Aass
- Department of Periodontology, Dental Faculty, University of Oslo, Norway
| | | | | | | |
Collapse
|
40
|
White SN, Ingles S, Kipnis V. Influence of marginal opening on microleakage of cemented artificial crowns. J Prosthet Dent 1994; 71:257-64. [PMID: 8164167 DOI: 10.1016/0022-3913(94)90464-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study investigated the relationship between marginal opening and microleakage. Standardized preparations were made on intact human premolars, and copings were cast in a base metal alloy by use of conventional techniques. The castings were randomly assigned to the following luting agent groups: zinc phosphate cement, polycarboxylate cement, glass ionomer cement, phosphate ester composite resin, and a composite resin with a NPG-GMA dentinal bonding agent and were cemented in a standardized manner. The marginal openings between teeth and castings were measured, and microleakage was determined at the same points. Within the confines of the in vitro model used, no significant correlation between marginal opening and microleakage was established for either pooled data or individual luting agent groups.
Collapse
Affiliation(s)
- S N White
- Dept. of Restorative Dentistry/Biomaterials, University of Southern California, School of Dentistry, Los Angeles
| | | | | |
Collapse
|
41
|
Abstract
It has been assumed that poor oral hygiene predisposes to gingivitis with progression to periodontitis and tooth loss. However, a high prevalence of gingivitis occurs in some populations in which severe periodontitis is rare. To assess whether gingivitis is a reliable predictor of periodontitis, we compared the periodontal health of tea pickers and university students aged between 18 and 30 in Indonesia. Oral hygiene and gingival health was significantly better in students than in tea pickers. However, the prevalence and the severity of chronic periodontitis were similar in the two groups. Our findings suggest that gingivitis is a poor predictor of periodontitis in subjects younger than 30 years. Attempts to prevent periodontitis in young adults through antigingivitis measures such as plaque control may be unsuccessful.
Collapse
Affiliation(s)
- S W Prayitno
- Department of Periodontology, Dental School, Jakarta, Indonesia
| | | | | |
Collapse
|
42
|
Affiliation(s)
- N P Lang
- Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, University of Berne, Switzerland
| | | |
Collapse
|
43
|
Affiliation(s)
- B A Burt
- School of Public Health, University of Michigan, Ann Arbor, USA
| |
Collapse
|
44
|
Affiliation(s)
- K S Kornman
- Department of Periodontics, University of Texas Health Science Center, San Antonio, USA
| | | |
Collapse
|
45
|
Affiliation(s)
- H Löe
- National Institute of Dental Research, Bethesda, Maryland, USA
| |
Collapse
|
46
|
Affiliation(s)
- R J Genco
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, USA
| | | |
Collapse
|
47
|
Corbet EF, Davies WI. The role of supragingival plaque in the control of progressive periodontal disease. A review. J Clin Periodontol 1993; 20:307-13. [PMID: 8501269 DOI: 10.1111/j.1600-051x.1993.tb00365.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Levels of supragingival plaque and calculus have been related to progressive periodontal disease, and control of supragingival plaque in conjunction with professional tooth cleaning subgingivally forms the basis for the management of progressive periodontal disease. However, the contribution towards the management of progressive periodontal disease brought about by supragingival plaque control alone is not clear. There are studies which address, directly or indirectly, the contribution of supragingival plaque control alone towards the management of progressive periodontal disease. The effects of supragingival plaque control alone have been evaluated clinically, histologically and microbiologically, and taken together, the evaluations suggest that these effects may not be as marked as when professional subgingival tooth cleaning is also performed. These studies, however, given the patterns of periodontal disease found in adults in many communities, can form the basis for advocating high individual levels of supragingival plaque control as a community measure in the management of periodontal disease. Further long-term investigations into this approach may be warranted.
Collapse
Affiliation(s)
- E F Corbet
- Department of Periodontology and Public Health, Faculty of Dentistry, Prince Philip Dental Hospital, University of Hong Kong
| | | |
Collapse
|
48
|
Caton J. Biological and measurement issues critical to design of gingivitis trials. J Periodontal Res 1992; 27:364-8; discussion 373-4. [PMID: 1507025 DOI: 10.1111/j.1600-0765.1992.tb01697.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chronic plaque-induced gingivitis is usually of little consequence, thus the concern about prevention and treatment must stem from the belief that preexisting gingivitis is necessary for periodontitis to develop. When clinical signs of gingivitis are present, an inflammatory infiltrate can be found upon histological evaluation. When clinical signs are absent, however, significant inflammation may still be present within the gingival tissues. Therefore, multiple clinical evaluations should be made, with special attention given to the visually inaccessible midinterdental area. The "gold standard" for evaluation of gingivitis is histological evaluation and other measurements should be evaluated against this standard. The significance of clinical severity measurements of gingivitis is not well-understood relative to onset of periodontitis; therefore, it is suggested that consideration be given to gingival evaluations based on the presence or absence of clinical signs of inflammation. Furthermore, equivalency and superiority of antigingivitis agents or devices should be predicated, at least in part, on their ability to prevent the onset of periodontitis.
Collapse
Affiliation(s)
- J Caton
- Eastman Dental Center, Rochester, NY
| |
Collapse
|
49
|
White SN, Sorensen JA, Kang SK, Caputo AA. Microleakage of new crown and fixed partial denture luting agents. J Prosthet Dent 1992; 67:156-61. [PMID: 1538320 DOI: 10.1016/0022-3913(92)90447-i] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study measured the in vitro microleakage of conventional and new FPD luting agents. Standardized preparations were made on 42 freshly extracted premolars. Facial and lingual chamfer margins were placed in enamel, mesial and distal in dentin and cementum, and castings were made in Rexillium III alloy and were then cemented with a standardized technique. Six groups of seven samples were tested, (1) polycarboxylate, (2) zinc phosphate, (3) glass ionomer, (4) Den-Mat Thin Film cement, (5) Panavia Ex, and (6) Den-Mat Thin Film cement with Tenure. The ranking of groups for stain ingress was from the greatest (1) to the least (6). A one-way analysis of variance and Tukey-Student range analysis revealed significantly similar groups, p less than 0.05:(1,2,3,4) (5,6).
Collapse
Affiliation(s)
- S N White
- University of Southern California, School of Dentistry, Los Angeles
| | | | | | | |
Collapse
|
50
|
Persson GR. Effects of line-angle versus midproximal periodontal probing measurements on prevalence estimates of periodontal disease. J Periodontal Res 1991; 26:527-9. [PMID: 1837057 DOI: 10.1111/j.1600-0765.1991.tb01805.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- G R Persson
- Department of Periodontics, University of Washington, Seattle
| |
Collapse
|