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Aim The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials ( RCTs). Material and Methods A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences ( WMD) and 95% confidence intervals. Results After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD −0.217), modified gingival index ( n = 23, −0.415), gingivitis severity index ( n = 26, −14.939%) or bleeding index ( n = 23, −7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD −0.475), Silness & Löe ( n = 26, −0.109), and plaque severity ( n = 12, −23.4%) indices, with significant heterogeneity. Conclusion Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

Aim To report the evidence on the effect of mechanical and/or chemical plaque control in the simultaneous management of gingivitis and caries. Material and Methods A protocol was designed to identify randomized ( RCTs) and controlled ( CCTs) clinical trials, cohort studies and prospective case series ( PCS), with at least 6 months of follow-up, reporting on plaque, gingivitis and caries. Relevant information was extracted from full papers, including quality and risk of bias. Meta-analyses were performed whenever possible. Results After the screening of 1,373 titles, 15 RCTs, 10 CCTs and 2 PCS were included. Low to moderate evidence support that combined professional and self-performed mechanical plaque control significantly reduces standardized plaque index [ n = 4; weighted mean difference ( WMD) = 1.294; 95% CI (0.445; 2.144); p = 0.003] and gingivitis scores [ n = 4; WMD = 1.728; 95% CI (0.631; 2.825); p = 0.002]. The addition of fluoride to mechanical plaque control is relevant for caries management [ n = 5; WMD = 1.159; 95% CI (0.145; 2.172); p = 0.025] while chlorhexidine rinses are relevant for gingivitis. Conclusion Mechanical plaque control procedures are effective in reducing plaque and gingivitis. The addition of fluoride to mechanical plaque control is significant for caries management. Chlorhexidine rinse has a positive effect on gingivitis and inconclusive role in caries. [ABSTRACT FROM AUTHOR]

Objectives To compare the use of sonic powered or manual toothbrush in patients with intellectual disability ( ID) in terms of plaque (PlI) and gingival ( GI) indices and adverse effects. Material and Methods Subjects with ID were recruited for this cluster-randomized, single blinded (examiner), 6-month clinical trial, comparing powered versus manual toothbrushing. Outcome variables included PlI and GI, evaluated at baseline and 3 months after supervised toothbrushing and after 3 additional months of unsupervised used. Clinical outcome variables were analysed by repeated measures ANCOVA considering time and group as factors and respective baseline values as covariates (generalized linear model). Results Sixty-four patients (34 male, mean age 34.5) in six clusters were included in the study. No statistically significant effect of toothbrushing group was observed for PlI or GI. A significant effect of time was identified ( p < 0.001) with mean reductions ranging 0.44-0.45 for PlI and 0.30-0.36 for GI from baseline to 3-6 months. No relevant adverse effect or technical problems were observed. Conclusion The tested sonic powered toothbrush was as effective and safe as the manual toothbrush. The use of powered or manual toothbrushes, together with fluoride toothpaste, may improve plaque and gingivitis levels, in patients with mild to limit ID. [ABSTRACT FROM AUTHOR]

Aim To systematically assess the efficacy of patient-administered mechanical and/or chemical plaque control protocols in the management of peri-implant mucositis (PM). Material and Methods Randomized (RCTs) and Controlled Clinical Trials (CCTs) were identified through an electronic search of three databases complemented by manual search. Identification, screening, eligibility and inclusion of studies was performed independently by two reviewers. Studies without professional intervention or with only mechanical debridement professionally administered were included. Quality assessment was performed by means of the Cochrane Collaboration's tool for assessing risk of bias. Results Eleven RCTs with a follow-up from 3 to 24 months were included. Definition of PM was lacking or heterogeneously reported. Complete resolution of PM was not achieved in any study. One study reported 38% of patients with complete resolution of PM. Surrogate end-point outcomes of PM therapy were often reported. The choice of control interventions showed great variability. The efficacy of powered toothbrushes, a triclosan-containing toothpaste and adjunctive antiseptics remains to be established. High quality of methods and reporting was found in four studies. Conclusions Professionally- and patient-administered mechanical plaque control alone should be considered the standard of care in the management of PM. Therapy of PM is a prerequisite for the prevention of peri-implantitis. [ABSTRACT FROM AUTHOR]

Aim The objective of this study was to evaluate the effects of lozenges containing L. reuteri as an adjuvant treatment to initial periodontal therapy for chronic periodontitis patients and to detect the level of L. reuteri colonization in the periodontal pockets of treated patients. Material and Methods A total of 40 patients were selected and randomly divided into two groups. Each patient had at least two teeth with one approximal site each with a probing depth ( PD) of 5-7 mm and gingival index ( GI) of ≥2 in each quadrant. Group I received scaling and root planing ( SRP) plus L. reuteri-containing lozenges, and Group II received SRP plus placebo. The plaque index ( PI), GI, bleeding on probing (BoP), PD and relative attachment level were measured. Microbiological sampling was performed at baseline and on days 21, 90, 180 and 360 and were analysed by culturing. The Bonferroni-corrected paired sample t-test, Bonferroni-corrected Wilcoxon signed rank test and paired sample t-test were used to evaluate intra-group differences. The Bonferroni-corrected Student's t-test and the Mann-Whitney U-tests were used to evaluate inter-group differences. Results After treatment, the measured PI, GI, BoP and PD were significantly ( p < 0.05) lower in Group I compared with Group II at all time points. Similar observations were made for the total viable cell counts and the proportions of obligate anaerobes with the exception of day 360. In Group I, significantly fewer patients required surgery on ≥3 sites. Conclusion L. reuteri-containing lozenges may be a useful adjuvant agent to slow re-colonization and improve clinical outcomes of chronic periodontitis. Further studies are required to clarify the optimal dose of the lozenges. [ABSTRACT FROM AUTHOR]

Aim Investigate short-term effects of power brushing following experimental induction of biofilm overgrowth in periodontal disease states. Materials and Methods Overall, 175 subjects representing each of five biofilm-gingival interface ( BGI) periodontal groups were enrolled in a single-blind, randomized study. After stent-induced biofilm overgrowth for 21 days subjects received either a manual or a power toothbrush to use during a 4 weeks resolution phase. At baseline and during induction and resolution, standard clinical parameters were measured. Subclinical parameters included multikine analysis of 13 salivary biomarkers and 16s Human Oral Microbe Identification Microarray ( HOMIM) probe analysis of subgingival plaque samples. Results All groups exhibited significantly greater reductions in bleeding on probing ( BOP) ( p = 0.002), gingival index ( GI) ( p = 0.0007), pocket depth ( PD) ( p = 0.04) and plaque index ( p = 0.001) with power brushing compared to manual. When BGI groups were combined to form a shallow PD ( PD ≤ 3 mm) and a deep PD group ( PD > 4 mm) power brushing reduced BOP and GI in subjects with both pocket depths. Power brushing significantly reduced IL-1β levels at resolution while changes in bacterial levels showed non-significant trends between both brushing modalities. Conclusions Short-term changes in select clinical parameters and subclinical salivary biomarkers may be useful in assessing efficacy of power brushing interventions in a spectrum of periodontal disease states. [ABSTRACT FROM AUTHOR]

Aim The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing ( SRP). Material and Methods Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test ( SRP + probiotic, n = 15) or control ( SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks. Results At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction ( p < 0.05) and attachment gain ( p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group. Conclusions The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis. [ABSTRACT FROM AUTHOR]

Aim To assess the efficacy of a 0.07% cetylpyridinium chloride ( CPC) mouth rinse in the control of plaque and gingival inflammation during a 6-month period. Material and Methods Adult subjects with moderate gingivitis were selected [≥40% bleeding on marginal probing ( BOMP)]. After retrieving microbiological samples and evaluating the clinical parameters (plaque, BOMP and stain indexes), a professional prophylaxis was performed and subjects were randomly assigned to the test ( CPC mouth rinse) or to the placebo group. Subjects were re-assessed after 3 and 6 months. Results A total of 67 patients (35 test, 32 placebo) were included in the analysis. At 6 months, intra-group significant plaque reductions were observed in the test group (0.691, p < 0.001), but not in the placebo (0.181, p = 0.653). At 6 months, the mean BOMP values were lower in the test group ( p = 0.052). Changes between baseline and 6 months were significantly higher in the test group both for plaque ( p = 0.002) and BOMP ( p = 0.037) when compared with the placebo. A microbiological impact was observed in the test group, especially for Prevotella intermedia. Conclusion The evaluated 0.07% CPC-based mouth rinse, used three times per day adjunctively to mechanical tooth cleaning, prevents plaque accumulation and gingival inflammation, as compared to the placebo, for at least 6 months. [ABSTRACT FROM AUTHOR]