Microbiological Effects of Sodium Hypochlorite/-Amino Acids and Cross-linked Hyaluronic Acid Adjunctive to Non-surgical Periodontal Treatment

PURPOSE

To investigate the microbiological outcomes obtained with either subgingival debridement (SD) in conjunction with a gel containing sodium hypochlorite and amino acids followed by subsequent application of a cross-linked hyaluronic acid gel (xHyA) gel, or with SD alone.

MATERIALS AND METHODS

Forty-eight patients diagnosed with stages II-III (grades A/B) generalised periodontitis were randomly treated with either SD (control) or SD plus adjunctive sodium hypochlorite/amino acids and xHyA gel (test). Subgingival plaque samples were collected from the deepest site per quadrant in each patient at baseline and after 3 and 6 months. Pooled sample analysis was performed using a multiplex polymerase chain reaction (PCR)-based method for the identification of detection frequencies and changes in numbers of the following bacteria: Aggregatibacter actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g), Tannerella forsythia (T.f), Treponema denticola (T.d), and Prevotella intermedia (P.i).

RESULTS

In terms of detection frequency, in the test group, statistically significant reductions were found for P.g, T.f, T.d and P.i (p < 0.05) after 6 months. In the control group, the detection frequencies of all investigated bacterial species at 6 months were comparable to the baseline values (p > 0.05). The comparison of the test and control groups revealed statistically significant differences in detection frequency for P.g (p = 0.034), T.d (p < 0.01) and P.i (p = 0.02) after 6 months, favouring the test group. Regarding reduction in detection frequency scores, at 6 months, statistically significant differences in favour of the test group were observed for all investigated bacterial species: A.a (p = 0.028), P.g (p = 0.028), T.f (p = 0.004), T.d (p <0.001), and P.i (p = 0.003).

CONCLUSIONS

The present microbiological results, which are related to short-term outcomes up to 6 months post-treatment, support the adjunctive subgingival application of sodium hypochlorite/amino acids and xHyA to subgingival debridement in the treatment of periodontitis.

The determination of pH of peri-implant crevicular fluid around one-piece and two-piece dental implants: A pilot study

There are two main groups of screw-type dental implant designs: one-piece and two-piece implants. Although success rates of both of these types of implants are high, none of them avoid complications, of which the most common are peri-implant mucositis and peri-implantitis. Current clinical diagnostic parameters are relatively noninvasive and cost-efficient; however, they are often not sensitive enough and fail to determine the activity of inflammation. The purpose of this study is to determine pH of peri-implant crevicular fluid (PICF) around one-piece and two-piece implants and pH of gingival crevicular fluid (GCF) around healthy teeth and to find out if our suggested method could function accurately for determination of pH of PICF and GCF. Thermo Fisher Scientific™ Orion™ 9863BN glass microelectrode was used to determine pH of PICF around 29 one-piece (ROOTT, TRATE AG) and 29 two-piece implants (multiple manufacturers) and pH of GCF around 29 healthy teeth. pH of PICF around two-piece implants was more acidic (P < 0.001). Average pH around one-piece implants was 6.46 and around two-piece implants was 6.15. Mean pH of GCF was 6.64. pH of PICF in women around two-piece implants was more alkaline (P < 0.05); no difference was found in control and one-piece implant groups. There was no statistically significant correlation found between age and pH of PICF and GFC. Design of dental implants has an impact on pH of PICF. Glass microelectrode is an appropriate tool for accurate determination of pH in PICF.

Change in dental pulp parameters in response to different modes of orthodontic force application

OBJECTIVES

(1) To evaluate dental pulp sensitivity by electrical pulp testing and measure aspartate aminotransferase activity in the pulp after 14 days of orthodontic intrusion, and (2) to compare those measurements with measurements obtained in teeth after 7 days of intrusion and 7 days of rest.

MATERIALS AND METHODS

The study sample included 13 subjects (mean age = 16.5 +/- 2.7 years). For every subject, before extraction, two contralateral premolars were included in a spring and loaded by a force. Two study groups were formed: Group A, teeth with 14 days of mechanical load, and Group B, teeth with 7 days of mechanical load plus 7 days of rest. Electrical pulp testing and aspartate aminotransferase activity measurements were performed after 14 days in all tested teeth. After extraction, aspartate aminotransferase activity in the pulp was determined spectrophotometrically at 20 degrees C.

RESULTS

Mean aspartate aminotransferase activity values were 0.21 U/mg (SD = 0.15) in Group A and 0.27 U/mg (SD = 0.17) in Group B. Mean electrical pulp testing readings were 38.92 microA (SD = 24.61) in Group A and 36.77 microA (SD = 26.84) in Group B. Mean values of the intrusive force magnitude did not differ in both groups.

CONCLUSIONS

Different durations of orthodontic intrusion, defined as 14 days of load and 7 days of load followed by 7 resting days, were not reflected by electrical pulp testing or by aspartate aminotransferase activity levels in the pulp of the affected teeth. However, the response threshold to electrical pulp stimulation was elevated in all tested teeth.

Aspects of xerostomia prevalence and treatment among rheumatic inpatients

OBJECTIVES

The aim of the study was to evaluate the prevalence of xerostomia among inpatients with rheumatic disorders at the Hospital of Kaunas University of Medicine (HKUM) and its association with age, sex, and xerophthalmia. Determining adequate treatment for xerostomia was also important, because untreated xerostomia may become aggravated and thus significantly impair patient's quality of life.

MATERIAL AND METHODS

The authors designed a special questionnaire for conducting all study-related enquiries. Patients for this study were selected according to their case records ranging from 1998 to 2004. In total, there were 483 cases chosen based on prevalent rheumatic diseases, which were most conducive to xerostomia.

RESULTS

The results showed no significant evidence that the prevalence of xerostomia increased with age. Also, women were more susceptible to rheumatic diseases than men (W:M = 10:1) and are more likely to be affected by xerostomia and xerophthalmia (W:M = 2.5:1). A significant correlation was found between xerostomia and xerophthalmia. Only 17.7% of xerostomia-positive patients were treated for xerostomia, in comparison with xerophthalmia-positive patients who were treated for xerophthalmia in 84.8% of cases. It was shown that the modalities of treatment administered for xerostomia were neither sufficient nor up-to-date according to current recommendations found in medical literature.

CONCLUSIONS

Xerostomia is closely correlated with xerophthalmia in rheumatic diseases. Xerostomia is more prevalent in older segments of population, especially in women, but we failed to prove statistical significance of older age in prevalence of sicca symptoms. Treatment administered to rheumatic patients for xerostomia in the HKUM is neither sufficient nor adequate.

[Xerostomia: clinic, etiology, diagnosis and treatment]

The aim of this article is to review the problem of xerostomia considering its clinical, etiological, diagnostic and treatment features, basing on the today's tutorials and scientific articles found in databases on the Internet. Recent epidemiologic data on the prevalence of xerostomia in different countries are introduced. There are analyzed the main aspects of clinical manifestations of xerostomia, according to the different etiology analyzed. The most common etiological factors causing xerostomia, especially the main three of them: radiation therapy, Sjögren's syndrome, and drugs, are pointed out. The most popular and accepted clinical and laboratory assays for measuring and evaluating the function of salivary glands are represented. Attention is paid to xerostomia as substantiation of the separate diagnosis and its role in diagnosing other diseases. The concept of possible treatment modalities and prognosis are discussed. The main and most common problems concerning xerostomia are revealed.