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The surface of dental materials is exposed to various prophylaxis protocols during routine dental care. However, the impact of these protocols on the functional properties of the material's surface remains unclear. This study investigates the influence of different dental prophylaxis protocols on the surface properties and their effect on the mechanical performance of CAD-CAM restorative materials. Discs (Ø = 15 mm, thickness = 1.2 mm) were fabricated from resin composite (RC, Tetric CAD), leucite-reinforced (LEU, IPS Empress CAD), lithium disilicate (LD, IPS e.max CAD), and zirconia ceramics (ZIR, IPS e.max ZirCAD MT). The materials were subjected to six prophylactic treatments: untreated (CTRL), prophylactic paste fine (PPF), prophylactic paste coarse (PPC), pumice stone (PS), air abrasion with sodium bicarbonate jet (BJ), and ultrasonic scaling (US). Biaxial flexural fatigue tests, along with fractographic, roughness, and topographic analyses, were conducted. No significant changes in fatigue strength were observed for RC, LD, and ZIR under any prophylaxis protocols. However, LEU subjected to BJ treatment exhibited significantly reduced fatigue strength (p = 0.004), with a 22% strength reduction compared to the monotonic test and substantial surface alterations. Surface roughness analyses revealed increased roughness for RC treated with PPF, PPC, and PS compared to CTRL (p < 0.05), while LD exhibited decreased roughness following PPF, PS, and US treatments (p < 0.05). In ZIR, only the BJ protocol increased roughness (p = 0.001). In conclusion, dental prophylaxis protocols do not significantly affect the mechanical strength of RC, LD, and ZIR materials, thus allowing any protocol to be used for these materials. However, for LEU ceramics, the BJ protocol should be avoided due to its effect of reducing fatigue strength and damaging the surface. [ABSTRACT FROM AUTHOR]

Background: The effect of an immune-boosting beverage (SAM) containing Sambucus Nigra, an energy beverage (ENE), an in-office bleaching (BLE) agent with 25% hydrogen peroxide superior, glazing (GLA) or polishing (POL) methods, and professional dental prophylaxis (PDP) on the color of CAD-CAM restorative materials is unknown. Methods: In total 210 specimens were prepared, consisting of CAD-CAM feldspathic (FC), zirconia-reinforced lithium disilicate ceramic (ZLS) and hybrid ceramic (HC). The ceramic specimens were divided according to the polishing methods of glazing (GLA) and mechanical polishing (POL). All materials were divided into two groups: with and without BLE. A 25% hydrogen peroxide superior (HPS) gel was used for BLE. After the baseline (BAS) measurement, the specimens were immersed in 3 different beverages (distilled water (DIS), SAM, ENE). After 28 days, a fine-grained (RDA 7) prophylaxis paste was applied. Statistical analysis of ∆E00 color difference values was performed by 3-way ANOVA and Bonferroni test (α = 0.05). Results: The effect of all other actions except material-BLE-beverage on color for BAS-Day 28 was statistically different (p < 0.05). The effect of material, material-BLE, beverage on color for Day 28-PDP was statistically different (p < 0.05). After 28 days, the lowest color change was found in FC-GLA and HC immersed in DIS (p = 0.0001) and the highest in FC-POL immersed in ENE (p = 0.0002). PDP was efficient in color recovery in HC immersed to DIS, ENE and SAM (p = 0.0010). For FC, HC and ZLS, BLE caused a higher color change (p < 0.0001). Regardless of the material, the highest color change for BLE-beverage was found in BLE-treated specimens immersed in ENE (p = 0.0496) and the lowest color change was found in non-BLE-treated specimens immersed in SAM (p = 0.0074). Conclusions: In materials pre-exposed to 25% HPS, the effect of PDP on color recovery was lower than in unexposed materials. After 28 days, mechanical polishing produced higher color change in FC than glazing, however, in ZLS effects of glazing and mechanical polishing on color were similar. For material/polishing method, HC was the most effective. ENE caused higher color change than DIS and SAM. PDP was more effective than ENE in restoring color to DIS- and SAM-immersed specimens. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the effects of diabetes care on periodontal inflammation. Materials and Methods: This prospective cohort study included 51 Japanese patients with type 2 diabetes who underwent intensive diabetes care including educational hospitalization and regular outpatient treatment for 6 months. Dental prophylaxis without subgingival scaling was provided three times during the observational period. Associations between changes in periodontal parameters and glycaemic control levels were evaluated using multiple regression analysis. Results: Overall, 33 participants (mean age: 58.7 ± 12.9) were followed up for 6 months. At baseline examination, 82% were diagnosed with Stage III or IV periodontitis. Haemoglobin A1c (HbA1c) level changed from 9.6 ± 1.8% at baseline to 7.4 ± 1.3% at 6 months. The ratio of probing pocket depth (PPD) ≥4 mm, bleeding on probing (BOP), full‐mouth plaque control record (PCR), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) also significantly improved. The reduction in PPD and PESA was significantly associated with changes in both HbA1c and fasting plasma glucose (FPG) levels, and the reduction in PISA was significantly associated with an improvement in FPG after adjusting for smoking, change in body mass index and full‐mouth PCR. Conclusions: This is the first study to report a significant improvement in PPD and BOP after intensive diabetes care and dental prophylaxis without subgingival scaling. Clinical trial registration number: UMIN000040218. [ABSTRACT FROM AUTHOR]

In the context of optimizing dental care for patients who are elderly, the purpose of this in vitro study was to evaluate the surface gloss (with a micro-area gloss meter) of, surface roughness (with a compact surface roughness measuring instrument) of, and color change (with a dental colorimeter) in two commercially available injectable resin-based composites (Estelite Universal Flow (EUF) and Beautifil Flow Plus F00 (BFP)) as well as two glass–ionomer cements (GC Fuji II LC CAPSULE (FLC) and GC Fuji IX GP EXTRA CAPSULE (FGP)), before and after dental prophylaxis. After 24 h, the surfaces of each specimen were polished at 2500 rpm with a prophy brush (Mersage Brush, Shofu) and one-step prophylaxis paste (Prophy Paste Pro, Directa): under 100 or 300 gf load, and for 10 or 30 s, 4× cycles of cleaning. After mechanical cleaning, conditions were found for a significant reduction in the gloss level (EUF, BFP, or FLC; p < 0.05) and a significant increase in surface roughness (BFP; 300 gf load, 10 s × four cycles of cleaning). Overall, the longer time or higher prophylaxis load tended to decrease the surface gloss. However, the observed change in surface roughness varied between the restorative materials. There was no color change post-prophylaxis. [ABSTRACT FROM AUTHOR]

A 31-year-old man presented with gingival mass-like lesions. The patient reported occasional bleeding from lesions; otherwise, the lesions were asymptomatic. Intraoral examination revealed multiple interdental red/purple soft, sessile, nodular lesions involving both the maxillary and mandibular buccal and lingual gingivae, with poor oral hygiene. After performing incisional biopsy, the patient was diagnosed with pyogenic granuloma. Subsequently, the patient underwent cleaning of his teeth and within only 3 days of dental cleaning, the patient reported rapid regression of all his lesions. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the effectiveness of a patient-centered standardized prophylaxis process in improving patient satisfaction and intentions to return to dental clinics. Conducted in a first-tier city in China from 9 June to 26 July 2023, the cross-sectional survey included 826 patients from 38 dental clinics. Among the respondents, 438 received standardized prophylaxis services, while 388 were in the non-standardized group, with a mean age of 38.2 ± 12.1 years and 50.24% male participation. The results revealed that patients in the standardized prophylaxis group reported significantly higher satisfaction scores (average 4.74 vs. 3.34, p < 0.0001) and greater intentions to return (average 4.77 vs. 4.10, p < 0.0001) compared to those receiving non-standardized care. The ordinal logistic regression analysis identified patient satisfaction as a strong predictor of return intention, with an odds ratio of 24.487, while the standardized service group had an odds ratio of 16.063, indicating a substantial positive effect on satisfaction. Age was also found to significantly affect return intention, reflected in an odds ratio of 0.969. Furthermore, the model showed strong predictive accuracy, which was supported by a Somers' D value of 0.806. Additionally, an impressive 89.9% of the observations were correctly ordered, which strengthens the reliability of the findings. These outcomes highlight the significant contribution of patient-centered, standardized practices to the satisfaction of the patients as well as the development of their desire to return for follow-up care. However, the findings should be interpreted with caution due to the study's cross-sectional nature, which limits causal inferences, and the specific demographic characteristics that may affect the general applicability of the results. Further research is needed to explore these dynamics across diverse populations and settings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the clinical outcomes in dental prophylaxis between rubber cup polishing and an air polishing system using erythritol powder, with or without prior dental plaque disclosure. Method and materials: In this single-blind, randomized, controlled, split-mouth clinical trial, healthy participants with full-mouth plaque score ≥ 60% were recruited. Quadrants in each participant were randomly assigned to four treatment groups: air polishing with prior plaque disclosure; air polishing without plaque disclosure; rubber cup polishing with prior plaque disclosure; or rubber cup polishing without plaque disclosure. Plaque scores and treatment time for each quadrant were recorded. Posttreatment satisfaction questionnaires for both the participants and operators were also completed. Results: In total, 88 participants consisting of 42 men and 46 women (mean age 23.1 ± 2.0 years) were recruited. Air polishing with prior plaque disclosure had significantly lower posttreatment marginal mean plaque score (21.7 ± 17.5%) compared to air polishing (33.5 ± 23.4%) or rubber cup polishing (34.5 ± 19.7%) without prior plaque disclosure (P < .001). Marginal mean treatment time for air polishing (325 seconds; SE = 10 seconds) was significantly shorter compared to rubber cup polishing (407 seconds; SE = 15 seconds) (P < .001). Both the participants and operators preferred air polishing over rubber cup polishing (P < .001). Conclusion: Prior plaque disclosure enhanced the effectiveness of plaque removal. Air polishing exhibited better treatment efficiency than rubber cup polishing and was the patients' and clinicians' preferred treatment modality. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the influence of dental prophylaxis cleaning procedures and artificial aging on veneers in human teeth. The external marginal and internal tooth veneer as well as the restoration surfaces were examined. Material and methods: Thirty-two extracted premolars were restored with resin-based composite (RBC) and polymer-infiltrated ceramic network (PICN) veneers. Artificial aging by alternating thermocycling and subsequent prophylaxis procedure (glycine-based powder air polishing or ultrasonic scaling) was conducted for five consecutive cycles. The external marginal interface was examined by height profile measurements and the internal interface was investigated using micro X-ray computed tomography. In addition, the surface texture of the veneer surface was analyzed using confocal laser scanning microscopy. Results: The application of both prophylaxis procedures resulted in a deepening of the marginal interface (10 µm ± 8 µm) for materials. Furthermore, the internal interface of PICN restorations showed marginal gaps after both treatments and artificial aging (16 µm ± 3 µm). In contrast to the RBC specimens, a significant increase in surface roughness was identified for PICN veneers after ultrasonic scaling. Conclusions: The marginal and internal interface regions in veneers fabricated from PICN and RBC were affected by prophylaxis procedures. Furthermore, it may result in increased veneer surface roughness, especially in PICN and after ultrasonic scaling, which might affect bioadhesion and longevity. Clinical relevance: After dental prophylaxis procedures, examination of the marginal and the internal interface as well as the veneer surface provides a precise insight into damage mechanisms and offers an assessment of longevity. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the effect of an immune-boosting beverage with Sambucus nigra (SAM), an energy beverage (ENE), an in-office bleaching agent with a novel composition, and a fine-grain professional dental prophylaxis (PDP) paste on the surface roughness (Ra) and microhardness (MH) of CAD/CAM restorative materials over time. Methods: Feldspathic ceramic (FC) and polymer infiltrated ceramic network (PICN) specimens were prepared (N = 126). Glazing, polishing, bleaching and immersion in beverages groups were formed. Bleaching gel containing 25% Hydrogen Peroxide Superior was applied to the specimens with a bleaching pen. Ra and MH were measured at five time points of baseline, days 1, 14, 28 and after PDP. Scanning electron microscopy (SEM) images were taken after PDP. Statistics were performed by ANOVA and Bonferroni tests (α = 0.05). Results: Ra increased over time regardless of material type, polishing method, beverage type and bleaching (p < 0.0001). Glazed and polished FCs caused higher roughness than PICN, SAM and ENE than distilled water, and bleaching than no bleaching (p < 0.0001). For glazed or polished FCs, MH decreased slightly lower at all time points, but for PICN, MH increased until day 28, not changing after PDP. Beverages decreased the MH of ceramics at all time points, but PDP did not lead to a change for PICN (p < 0.0001). The MH decreased more in bleached specimens than in non-bleached specimens up to day 28 (p < 0.0001). According to the SEM images after PDP, the glazed FC had numerous crack marks, pores and detached particles. The polished FC had traces of mechanical polishing. The polymer part of the PICN had voids, but the ceramic part was better preserved. Conclusions: Both energy beverages and immune-boosting beverages can increase roughness on FCs compared to PICNs. There was no significant difference between glazing and polishing in terms of lower roughness in FCs. PDP tended to slightly increase the roughness for ceramics, while it tended not to change it for PICN. Beverages decreased the microhardness of ceramics. PDP further decreased the microhardness in glazed ceramics, but increased it in polished ones. In PICN the microhardness increased over time, but decreased slightly after PDP. [ABSTRACT FROM AUTHOR]

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Introduction: Gingivitis is a common intraoral disease in patients with chronic kidney disease (CKD), which poses a particular interdisciplinary challenge. We aimed to determine the influence of an intensive oral prophylaxis program (OPP) compared to standard prevention measures on the tongue microbiome of young patients with CKD. Methods: Thirty patients with CKD (mean age 14.2 ± 5.2 years) and generalized gingivitis were included. The effects of the intensive OPP were compared with standard prophylaxis according to statutory health insurance (treatment as usual, TAU) as a control. Tongue swabs were taken from the patients at baseline (t1) and after 3 (t2) and 6 (t3) months. Next-generation sequencing of 16S rDNA genes was used to quantitatively characterize microbial communities. Results: There were no differences in the abundance, richness, or diversity of the observed genera and species between the two study groups at baseline or after 3 or 6 months. Furthermore, no change in predefined gingivitis and oral health bacterial clusters were found. At the phylum level, Firmicutes were decreased after intervention in the TAU group (t2TAU 42.9 ± 7.1 to t3TAU 34.8 ± 4.7 (npairs=14), p=0.003; false discovery rate 0.02). The decrease of Firmicutes was not significant in the OPP group. Conclusions: Despite the intensity of dental prophylaxis and decreasing clinical signs of inflammation and decreasing plaque amount, no clinically relevant changes in the tongue microbiome were observed. Our results confirm the conserved and stable nature of the tongue microbiome, even in children with CKD. [ABSTRACT FROM AUTHOR]

This case report describes the presentation and management of a 12-year-old female patient with a tissue mass and spacing between her upper front teeth. Clinical examination revealed a reddish pink, lobulated tissue mass measuring approximately 1.5 cm × 2 cm, extending from the upper labial frenum to the incisive papilla and involving the interdental gingiva of the two central incisors. The mass was moderately firm, pedunculated, and prone to bleeding. The patient had poor oral hygiene, exacerbating the condition. Radiographic evaluation ruled out underlying bony lesions, leading to a provisional diagnosis of pyogenic granuloma with differential diagnoses of gingival fibroma or traumatic fibroma. The treatment plan involved excision of the gingival overgrowth and frenectomy. Following routine oral prophylaxis, the surgical procedure was performed, with the excised tissue sent for histopathological evaluation, confirming the diagnosis as pyogenic granuloma. Postoperative care was provided, and the patient was advised against active orthodontic treatment. Regular follow-up appointments were scheduled to monitor healing and spontaneous space closure. This case report underscores the significance of considering both the aberrant labial frenum and the gingival overgrowth in treatment planning and highlights the need for meticulous follow-up care. [ABSTRACT FROM AUTHOR]

In a group of palliative patients, venous thromboembolism (VTE) is a significant cause of death and reduction in quality of life. Current guidelines and scientific research on thromboprophylaxis most often refer to the population of oncology patients, who differ in many aspects from patients receiving palliative care. Thus, doctors working with patients undergoing palliative treatment have to face many problems related to safety and effectiveness of antithrombotic therapy in this type of care. In the case of chronically ill patients, diagnostic process may be somewhat difficult because the symptoms resulting from the underlying diseases can mask VTE symptoms. The aim of this article is to review the literature on symptoms and thromboprophylaxis in this group of patients. According to the latest guidelines of the American Society of Clinical Oncology (ASCO), it is not recommended to use VTE prophylaxis in outpatient oncology patients routinely, but it should be considered in high-risk patients who received a Khorana score of at least 2 before starting a new chemotherapy cycle. In patients diagnosed with VTE, in long-term prophylaxis lasting at least 6 months, due to greater effectiveness, it is recommended to use low-molecular-weight heparins, edoxaban, rivaroxaban or apixaban instead of vitamin K antagonists, which can be used if the previously mentioned drugs are unavailable. There are some studies which show that thromboprophylaxis may be beneficial for patients in palliative care. On the other hand, another studies’ results suggest that patients won’t gain any benefit from prevention. As our article shows it is very crucial to conduct scientific research on palliative patients and create clear guidelines for prophylaxis for this group of people. [ABSTRACT FROM AUTHOR]

Objective: To evaluate dental prophylaxis influence in tooth color assessment with the use of different methods. Materials and methods: Volunteers were consecutively recruited and screened according to appropriate inclusion/exclusion criteria. Each participant's upper right central incisive and canine color was measured before and after dental prophylaxis with a one‐week interval. Tooth color assessment was performed by calibrated operators and the patient using a VITA Classical shade guide and by spectrophotometric methods with a proper device (SpectroShade). Color was reported as mean with SD of Commission Internationale De l'Eclairage (CIE) L*a*b* values, ΔEab and ΔE00. One‐way analysis of variance and Tukey post hoc were performed to assess differences between methods and paired t test for assessing differences in tooth color coordinates after dental prophylaxis. Values of P <.05 were taken as significant. Results: Fifty patients were included. Self‐assessed dental prophylaxis effects equated to a significantly different mean ΔE00 value of 2.3 ± 1.7 (P <.01), when compared to the calibrated operator reported 0.8 ± 1.1 and the spectrophotometer 1.0 ± 0.5. Half of volunteer's ΔE00 values surpassed the acceptability threshold, when compared to 28% from investigator and 10% from spectrophotometer. Conclusion: Performing a dental prophylaxis did have an influence in tooth color perception with a higher self‐perceived effect in the patient assessment. Clinical significance: The results of this study suggest that performing professional dental prophylaxis presented a perceived effect in tooth color regardless of the method used being that patients precepted whiter and less yellowish teeth. Since extrinsic stain is considered as one of the factors that could influence tooth color assessment, performing professional dental prophylaxis prior to composite or ceramic color selection in anterior teeth restorations could consequently increase treatment predictability. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the impact of dental prophylaxis on 5-fluorouracil (5-FU)–related oral mucositis (OM) according to the head and neck cancer (HNC) locations and treatment times. Methods: A total of 13,969 HNC participants, including 482 5-FU–related OM subjects and 13,487 comparisons were enrolled from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2008. All subjects were stratified into subgroups based on the times to perform chlorhexidine use, scaling, and fluoride application before 5-FU administration. The dental prophylaxis related to 5-FU–related OM was estimated by multiple logistic regression and represented with odds ratio (OR) and 95% confidence interval (CI). Results: Fluoride gel application and scaling significantly impacted on OM development (p < 0.001), and the joint effect of fluoride gel and scaling induced 5-FU–related OM (OR = 3.46, 95% CI = 2.39–5.01). The risk of OM was raised 2.25-fold as scaling within 3 weeks before 5-FU–related chemotherapy (95% CI = 1.81–2.81), and a 3.22-fold increased risk of OM while fluoride gel was applied during 5-FU–related treatment (95% CI = 1.46–7.13). Conclusion: Dental prophylaxis significantly affected 5-FU–related OM in the HNC population. A short interval between dental scaling or fluoride application and 5-FU administration may be associated with higher prevalence of OM. Scaling simultaneously combined with chlorohexidine promoted 5-FU–related OM in specific HNC patients excluding the oral cancer and nasopharyngeal cancer population. Proper timing of the prophylactic dental treatments prior to 5-FU therapy could reduce the risk to develop 5-FU–related OM. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) still leads to high mortality rates, mainly due to cardiovascular disease. One important influencing factor is persisting low-grade chronic inflammation partly maintained by gingivitis that favors transient bacteremia during daily activities such as toothbrushing. Methods: To examine whether intensive dental prophylaxis can restore oral health, reduce the prevalence of bacteremia and degree of systemic inflammation indicated by CRP levels, we conducted this pilot study examining 30 CKD patients aged 6–26 years, 15 receiving intensive prophylaxis (IP), 15 receiving treatment as usual (TAU) serving as control group. There were three appointments for examination, each 10 ± 1 weeks apart (at baseline, after intervention periods one and two, when TAU also received IP, and the IP group stopped prophylaxis). Results: The gingival index (GI) in the IP group decreased by 90% (GI 0.09; p=0.001), resulting in almost healthy gingiva. There was no significant change in CRP or prevalence of bacteremia. General prevalence of bacteremia after toothbrushing was 9.5% affecting 7 (26%) of the participants. In three participants, bacteremia dissolved after IP, in one after TAU. Two patients developed bacteremia ≥ 10 weeks after ending IP. We identified eight different bacterial species. Conclusions: We were able to show that IP can effectively treat gingivitis. It might be a promising approach to reduce systemic inflammation and subsequently lower premature cardiovascular disease, despite the lack of statistical significance. Future research requires a larger patient cohort to enable matched treatment groups with long-term follow-up and molecular detection methods for bacteremia. [ABSTRACT FROM AUTHOR]

The loss of teeth causes inevitable resorption of the alveolar bone. In the anterior arches, the curved anatomy further adds to the challenge of rehabilitation. These areas often require the shaping of membranes and multiple bone blocks through complex surgery to compensate for the curvature. The split bone block technique (SBBT) has been successfully used in complicated cases. However, the inability to create curves from the blocks means that larger quantities of bone or membranes are needed to compensate for this. Bone bending based on an ancient woodbending technique known as kerfing is proposed to shape rigid SBB plates to recreate the natural anatomy of anterior arches. Three patients presenting with bone destruction of the anterior maxilla underwent bone augmentation before implant placement using the SBBT combined with kerfing. The plates were successfully bent to the shape of each maxilla without any deleterious effects. All bone grafts healed uneventfully, and the bone curvature was successfully reconstructed. No complications were reported. Implant placement took place after 4 months and definitive restorations after 7 to 9 months. Clinical and radiographic assessments were performed at 1 year. Full customization of autogenous bone plates was possible through kerfing. This approach resulted in an ideal bone curve and shape in the facial and palatal aspects of the anterior maxilla. In addition, it enabled ideal implant placement with reduced bone harvesting volumes and decreased the need for soft tissue augmentation to recreate the curved shape. This technique promoted close-fitting autologous osseous plates that followed the anatomical curvature of the anterior maxilla, leading to optimal healing and excellent regeneration of the ridge width. This principle can be valuable when dealing with complex anatomical defects. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored. Methods: Three volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU). Results: While there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients' mothers and nurses. Conclusions: Young CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating. Trial registration: The German Clinical Trial Register (# DRKS00010580). [ABSTRACT FROM AUTHOR]

Background: Periodontitis represents the foremost oral condition in young men, strongly correlated with socioeconomic elements and oral health behaviors. This research aimed to assess the prevalence of periodontitis and associated associations with socio-demographics and oral health practices for subsequent Hazard Ratio (HR) estimation. Methods: A total of 46,476 young men were recruited to the study between August 2022 and October 2023. A questionnaire on socio-demographic factors and oral health-related behaviors related to periodontitis was completed. The standard procedure was used for oral examination. Logistic regression and hazard ratios were used to estimate the influencing factors, whereas the nomogram was used to predict the risk of periodontitis in young men. Results: A total of 46,476 young men were surveyed and completed the questionnaire. The overall prevalence of periodontitis among young men was 1.74%. Out of these, 1.7% had mild periodontitis and 0.6% had moderate periodontitis. Age and dental calculus were important factors in the periodontal health of young men. This nomogram, which includes 7 easily obtainable clinical characteristics routinely collected during periodontitis risk assessment, provides clinicians with a user-friendly tool to assess the risk of periodontal disease in young men. Conclusions: Regular dental prophylaxis is crucial for young men to maintain their gingival health and prevent the onset of periodontitis. Dental calculus plays a prominent role in this matter, as it serves as a significant contributing factor. [ABSTRACT FROM AUTHOR]

Dental caries remains a prevalent concern among children globally and is associated with Candida sp. Some researchers have suggested probiotic supplements as a possible solution for reducing dental caries. A study conducted in Tamil Nadu focused on collecting 80 dental caries samples from both males and females, obtained from two different locations. The samples underwent processing using the spread plate technique, followed by anticandidal activity assessments. Through ITS sequence analysis, candida strains were identified, including C. albicans (DDGRPO1, DDGRPO2). The study specifically investigated the ability of the probiotic bacterial strain Lb. fermentum cell-free filtrate to inhibit C. albicans. The research revealed that Lb. fermentum probiotics effectively inhibited the growth of C. albicans DDGRP01, displaying strong antifungal activity against Candida sp. (98%). While these results are promising, it is worth mentioning the increasing interest in exploring innovative alternatives to probiotic-based treatments. This avenue of research offers potential for a more comprehensive approach to addressing this issue. Notably, Lb. fermentum, derived from the human oral cavity, emerges as a significant postbiotic candidate for dental prophylaxis, indicating a hopeful direction for future studies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the advantages of a novel protocol involving full‐mouth erythritol‐powder air‐polishing followed by ultrasonic calculus removal in the maintenance of patients treated for gingivitis, with a focus on time and comfort. Methods: Systemically healthy patients with gingivitis were selected. Following a split‐mouth design, quadrants 1–4 and 2–3 were randomly allocated to receive air‐polishing followed by ultrasonic calculus removal following a protocol known as Guided Biofilm Therapy (GBT) or traditional full‐mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US + P). Bleeding on probing (BoP) and the plaque index (PI) were collected at baseline (T0), 2 weeks (T1), 4 weeks (T2), 3 months (T3), and 6 months (T4) and 12 months (T5). Following the same randomization, prophylactic therapy was provided at 3 months (T3) and 6 months (T4). Clinical parameters, treatment time and patient comfort and satisfaction were evaluated. Results: A total of 41 patients were selected, 39 completed the study. The clinical parameters were clinically satisfactory for both treatments at every time. At 4 months after treatment, GBT maintained significantly lower BoP and PI. GBT protocol required a significantly lower treatment time, especially at T3 and T4, when it saved 24.5% and 25.1% of the time, respectively. Both treatments were rated positively by most patients. However, GBT was perceived as more comfortable, and a higher number of patients preferred it. Conclusion: No significant difference was observed between GBT and conventional ultrasonic debridement and rubber cup polishing in terms of BoP and PI levels. The GBT protocol allowed less time expenditure and higher patients' perceived comfort. [ABSTRACT FROM AUTHOR]

Background: Restoring first permanent molars affected with molar incisor hypomineralization (MIH) is challenging. Focusing on improving the quality of life for children affected by MIH, at least until the complete eruption of first permanent molars to receive full coverage, to decrease the hypersensitivity and to be able to perform proper oral hygiene measures, the purpose of this study was to compare silver modified atraumatic restorative technique (SMART) versus the conventional restoration and fluoride varnish application on moderate to severe hypomineralized molars. The comparison considered the restoration survival, hypersensitivity, and digital surface area changes after one year follow up. Methods: Twenty-eight children were selected (20 girls and 8 boys) with at least 2 MIH molars with the same defect severity. The study comprised 2 groups; MOD group (moderate hypomineralized molar severity) and SEV group (Severe hypomineralized molar severity) (n = 28 tooth). Each group was further subdivided into 2 subgroups according to the technique of restoration: SMART subgroup and CONV subgroup (high viscosity glass ionomer restoration and fluoride varnish application) (each = 14 tooth). Evaluation was done in terms of the restoration survival (6 months and 12 months), hypersensitivity at 1 weak, 6 months and 12 months and occlusal surface area changes at 12 months). Professional Fluoride varnish application and home prophylaxis using MI paste were the protocol for each child patient. Results: There was no significant difference between the 4 subgroups, regarding tooth restoration integrity at 6-months vs. 12-months. However, a statistically significant difference in tooth restoration integrity between the 4 subgroups at 12-months (P =.049). Also, the hypersensitivity score, there was a statistically significant difference between the 4-time intervals (P <.001) and a statistically significant difference in surface area changes between the 4 subgroups. Conclusions: Selective removal of carious tissue and SMART restoration, combined with dental home and professional preventive measures every 3 months maintained the integrity of restorations in severely and moderately affected permanent molars up to 1 year. Trial registration: The study protocol was retrospectively registered on Clinical Trials (NCT05931822–05/ 07/2023). [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests the type of periodontal treatment could differentially influence the reduction of key cardiovascular risk mediators in periodontitis patients. This randomized, controlled clinical trial compared the impact of minimally invasive non‐surgical therapy (MINST) with quadrant‐wise subgingival instrumentation (Q‐SI) on C‐reactive protein (CRP) together with lipoprotein‐associated phospholipase A2 (Lp‐PLA2) levels, and clinical periodontal outcomes in patients with periodontitis. Moreover, it was evaluated if baseline CRP levels impacted the efficacy of non‐surgical periodontal therapy protocols. Methods: Forty‐two periodontitis patients were enrolled and randomly treated by means of MINST (n = 21) or Q‐SI (n = 21). The outcomes assessed were serum CRP and Lp‐PLA2, and periodontal parameters (probing depth [PD], clinical attachment level [CAL], full‐mouth bleeding score [FMBS]), at baseline and at follow‐ups at 1, 3, and 6 months and at 1 year after treatment. Results: At 1 year, MINST significantly reduced, among others, mean PD (p = 0.007), mean CAL (p = 0.007), the number of pockets >4 mm (p = 0.011) and ≥6 mm (p = 0.005), and FMBS (p = 0.048) compared to Q‐SI. Generalized multivariate analysis evidenced that high baseline CRP (p = 0.039) and FMBS (p = 0.046) levels, together with MINST treatment (p = 0.007) were significant predictors of PD reduction at 1‐year follow‐up. Moreover, the Jonckheere–Terpstra test showed that patients with high baseline CRP levels gained more benefits from MINST treatment at 1‐year follow‐up than they did from Q‐SI. Conclusion: Patients receiving MINST showed a greater reduction in CRP levels than patients with Q‐SI after 1 year of follow‐up. Moreover, patients with high baseline levels of CRP and Lp‐PLA2 gained more benefits from the MINST approach at 1‐year follow‐up. [ABSTRACT FROM AUTHOR]

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Periodontal disease is one of the most commonly diagnosed oral diseases in dogs and can result from undisturbed dental plaque. Dental prophylaxis is a routinely practiced veterinary procedure, but its effects on both the plaque and oral microbiota is not fully understood. The objectives of this study were to evaluate the impact of dental prophylaxis on the composition of the supragingival plaque and composite oral microbiota in clinically healthy dogs and to determine if composite sampling could be used in lieu of sampling the plaque microbiota directly. Thirty dogs received a dental prophylaxis. Supragingival plaque and composite oral samples were collected just prior to, and one week after dental prophylaxis. A subsample of 10 dogs was followed, and additional samples were collected two and five weeks post-prophylaxis. The V4 region of the 16S rRNA gene was used for Illumina MiSeq next-generation sequencing. Results demonstrate that decreases in Treponema as well as increases in Moraxella and Neisseria distinguished the plaque pre- and one week post-prophylaxis timepoints (all P<0.05). Within the oral microbiota, the initially dominant Psychrobacter (20% relative abundance) disappeared one week later (P<0.0001), and Pseudomonas became the dominant taxon one week after treatment (80% relative abundance, P<0.0001). A rapid transition back towards the pre-dental prophylaxis microbiota by five weeks post-treatment was seen for both niches, suggesting the canine oral microbiota is resilient. Direct comparison of the two environments yielded striking differences, with complete separation of groups. Firmicutes (40%) and Spirochaetes (22%) predominated in the plaque while Proteobacteria (58%) was predominant in the oral microbiota. Greater richness was also seen in the plaque microbiota. This study reveals that prophylaxis had a profound impact on both the plaque and oral microbiota, and the longitudinal results help elucidate the pathophysiology of periodontal disease. The results suggest that oral swabs are a poor proxy for plaque samples and highlight the need to study specific oral niches. [ABSTRACT FROM AUTHOR]

Infection management in solid organ transplantation poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic "myths" may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss 6 therapeutic myths with particular relevance to solid organ transplantation and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population. [ABSTRACT FROM AUTHOR]

(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three different curettes. Curette A was a prototype with a novel adaptive design, Curette B had a conventional stainless-steel design, and Curette C featured a conventional silicon-covered handle. Time-based work in four muscles, comfort, fatigue, tactile feedback, grip and blade position, and pinch and grasp strength were recorded. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey's post hoc test. The level of significance was set at p < 0.05. (3) Results: Comfort, correct grasp, fingertip placement, and blade-to-tooth adaptation were significantly better with Curette A (p < 0.05). While pinch and grasp strength were significantly reduced post-instrumentation for Curettes B and C (p < 0.05), they remained unchanged for Curette A. Curette A required significantly less total muscle work and work in individual muscles, resulting in significantly less post-instrumentation fatigue than for Curettes B and C, but similar levels of tactile feedback (p < 0.05). (4) Conclusions: The ergonomic performance of a prototype adaptive periodontal curette was significantly better than that of two conventional instruments with rigid handle designs. [ABSTRACT FROM AUTHOR]

ABSTRACT: Aim: The current study's objective was to assess and contrast the benefits of herbal and chemical mouthwash in patients with persistent, widespread gingivitis. Material and Method: Forty-five patients between the ages of 30 and 50 having persistent generalized gingivitis were enrolled in the study and randomly assigned to three groups: Group A received oral prophylaxis, group B received oral prophylaxis and prescribed chemical mouthwash, group C received oral prophylaxis and prescribed herbal mouthwash. The patients were under observation for forty-five days. At the baseline, 7th, 30th, and 45th day gingival index was measured, and the data were statistically analyzed. The one-way ANOVA and Tukey's post-hoc test were performed. Result: The gingival index showed a significant difference. Over time, the gingival index tends to decrease with the use of herbal mouthwash. Conclusion: In summary, our initial investigation demonstrates that herbal mouthwashes are just as successful in reducing gingival inflammation as chlorhexidine further significant difference observed in 30th and 45th day with chlorhexidine. Therefore, in addition to routine dental care, these ayurvedic medications can be taken to reduce gingivitis. [ABSTRACT FROM AUTHOR]

Objective: Chlorhexidine is the gold standard for chemical biofilm control in dentistry. As with all therapeutic agents, side effects should be considered, which may include allergic reactions. The present review focused on the allergy-causing potential of dental CHX mouthrinses. Method and materials: Four databases were searched for systematic reviews related to chlorhexidine and dentistry (MEDLINE, Embase, Web of Science, and Scopus). Original papers available in the identified studies and meta-analyses were individually screened for allergy by both authors. Results: An initial 804 studies were identified, of which 46 systematic reviews and the original papers described therein were ultimately analyzed. Only two reviews explicitly addressed the topic of allergy. In a total of 194 original studies and a total of 9,698 patients, no allergies were reported. In 44 control studies, the topic was touched upon, but only in connection with the inclusion and exclusion criteria and possible contraindications. Conclusions: The topic of "allergy" regarding chlorhexidine application as a mouth rinse in dentistry seems to be omnipresent. Nevertheless, true allergies to chlorhexidine in dentistry appear to be low to nonexistent. Precautions, however, should still be taken in practice and further studies should be envisaged, especially in patients with an alleged history of chlorhexidine contact allergy. [ABSTRACT FROM AUTHOR]

Introduction: Dental examination and stabilization are performed prior to allogeneic hematopoietic cell transplantation to decrease infection risk during neutropenia. Burden of dental disease and treatment need is not well characterized in this population. Objectives: This report describes the dental status of a cohort of patients within the Chronic Graft‐versus‐Host Disease Consortium and treatment rendered prior to transplant. Methods: The cohort included 486 subjects (Fred Hutchinson: n = 245; Dana‐Farber: n = 241). Both centers have institutional‐based dental clearance programs. Data were retrospectively abstracted from medical records by calibrated oral health specialists. Results: The median age at transplant was 55.9 years, 62.1% were male, and 88% were white. Thirteen patients were edentulous (2.7%). The mean teeth among dentate patients before clearance was 26.0 (SD, 4.6). Dental findings included untreated caries (31.2%), restorations (91.6%), endodontically treated teeth (48.1%), and dental implants (5.7%). Pretransplant procedures during clearance included endodontic therapy (3.6%; mean = 0.1 teeth), restorations (25.1%; mean = 0.7), dental prophylaxis (59.2%), scaling/root planing (5.1%), and extraction (13.2%; mean = 0.3). The mean teeth after clearance was 25.6 (SD, 5.0). Conclusions: Retrospective analysis of pre‐AlloHCT dental data in subjects at two large transplant centers identified low levels of dental need. Findings suggest high access to care. [ABSTRACT FROM AUTHOR]

To evaluate the timing, duration and incidence of bacteremia following invasive dental procedures (IDPs) or activities of daily living (ADL). Eight databases were searched for randomized (RCTs) and nonrandomized controlled trials (nRCTs) evaluating bacteremia before and after IDPs or ADL in healthy individuals. The risk of bias was assessed by RoB 2.0 and ROBINS‐I. For the meta‐analysis, the primary outcomes were the timing and duration of bacteremia. The secondary outcome was the incidence of bacteremia, measuring the proportion of patients with bacteremia within 5 min after the end of the procedure compared with baseline. We included 64 nRCTs and 25 RCTs. Peak bacteremia occurred within 5 min after the procedure and then decreased over time. Dental extractions showed the highest incidence of bacteremia (62%–66%), followed by scaling and root planing (SRP) (44%–36%) and oral health procedures (OHP) (e.g., dental prophylaxis and dental probing without SRP) (27%–28%). Other ADL (flossing and chewing) (16%) and toothbrushing (8%–26%) resulted in bacteremia as well. The majority of studies had some concerns RCTs or moderate risk of bias nRCTs. Dental extractions, SRP and OHP, are associated with the highest frequency of bacteremia. Toothbrushing, flossing, and chewing also caused bacteremia in lower frequency. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Odontopediatría Latinoamericana is the property of Asociacion Latinoamericana de Odontopediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Odontología Pediátrica is the property of Asociacion Sociedad Peruana de Odontopediatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study examined the utilization of antimicrobials in canines and felines receiving dental treatments in veterinary clinics in the United States, retrospectively. A total of 818,150 animals (713,901 procedures in dogs and 104,249 procedures in cats) underwent dental procedures under general anesthesia in 2020. These included dental prophylaxis and extractions. Patient demographic data, antimicrobial treatment, treatment duration, dose, periodontal disease score, whether tooth extractions were performed and how many extractions were performed was recorded. Our results showed that local or systemic antimicrobials were used in 116,723/713,901 (16.4%) procedures in dogs and 14,264/104,249 (14%) procedures in cats. Age, weight, extraction of one or more teeth and diagnosis of periodontal disease (any stage) were associated with increased likelihood of antimicrobial administration using univariable analysis (all P<0.001) and in the multivariable model. Clindamycin, amoxicillin-clavulanate and amoxicillin were the most common oral antimicrobials used in dogs and cats. Drugs classified as highest priority clinically important antibiotics (HPCIA) were administered to 30,960/116,723 (26.5%) of dogs and 7,469/14,264 (52%) of treated cats. The results obtained can inform interventions to optimize patient care and promote prudent use of antimicrobials during dental procedures in canine and feline patients. [ABSTRACT FROM AUTHOR]

Background: This study focuses on the determination and classification of patients as rapid or slowcalculusformersbasedontherateofcalculusformationafteroralprophylaxis. It also aims to determine the factors that positively impact the formation and deposition of calculus in patients and identify the factors that accelerate or decelerate the deposition of calculus. Methods: The study was conducted in the Department of Periodontology, Dr Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University Chandigarh, India. We examined 51 patients after a month of the oral prophylaxis, recorded the amount of calculus present in the oral cavity, and then recorded a detailed history which was briefly divided into Age, Sex, Residence, Oral habits, and maintenance of oral hygiene. Results: An evident and meaningful link was found between age and the rate at which dental calculus forms. The average age of individuals differed significantly between the rapid and slow calculus formers, which could be ascribed to the decline in manual dexterity as age increases, resulting in less effective oral hygiene habits, including toothbrushing. None of the other factors dietary and oral hygiene related could be identified distinctly, probably owing to the small sample of the study. The oral health status exhibited a significant difference between slow and rapid calculus formers. Conclusions: Within the limitations of the study, the data analyzed, identified age as a significant determinant that impact the rate of formation of calculus in patients and reported a significant difference in the oral health status of rapid and slow calculus formers. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between adherence to professional oral maintenance visits and tooth loss is generally accepted in periodontal treatment; however, this relationship has not been clarified in general dental practices. We evaluated the effectiveness of adherence to professional maintenance by a retrospective survey in a private practice. Methods: We retrospectively extracted data of 395 patients in a general dental practice who had been followed for more than 20 years. For comparisons, two patient groups were created based on oral maintenance rates: a high‐ (≥75%) and a low‐ (<75%) adherence groups. Additionally, multiple logistic regression analysis for tooth loss was conducted with the same two adherence groups and three adherence groups (<50%, ≥50% and <75% and ≥75%), adjusting with risk factors including sex, age, decayed, missing, and filled teeth (DMFT), periodontal status, smoking status, and diabetes at the beginning of maintenance. Results: The number of teeth lost and increased DMFT over time were significantly lower in the high‐adherence group than in the low‐adherence group. Multiple logistic regression analysis for tooth loss in the two adherence groups yielded an odds ratio (95% confidence interval) of 6.50 (3.73–11.32) in the low‐adherence group relative to the high‐adherence group. Further analysis with the three adherence groups showed highest risk in the low‐adherence group and a higher risk in the moderate‐adherence group than the high‐adherence group. Conclusions: Patients with high adherence to maintenance schedules for more than 20 years demonstrated significantly less tooth loss. Dental practitioners should promote high adherence to professional maintenance in general dental practices. [ABSTRACT FROM AUTHOR]

Aim: This study evaluated the efficacy of quadrantwise subgingival instrumentation (Q‐SI) versus one‐stage full‐mouth subgingival instrumentation (FM‐SI) on probing depth and periodontal pathogen reduction over a 6‐month follow‐up period, as well as whether baseline periodontal pathogens influenced the impact of periodontal treatment protocols on outcomes. Methods: Patients with periodontitis were randomized to receive Q‐SI (n = 43) or FM‐SI (n = 45). Patients were instructed and motivated to maintain optimal oral hygiene during the treatment sessions. Clinical (probing pocket depth [PPD], clinical attachment loss [CAL], and bleeding on probing [BOP]) and periodontal pathogens were assessed at baseline and after 30, 90, and 180 days. Total bacterial load and periodontal pathogens were analysed via real‐time PCR. Results: At the 6‐month follow‐up, the median PPD decreased from 4.8 mm (interquartile range [IQR]: 4.3–5.2) to 2.6 mm (IQR: 2.3–2.9) in FM‐SI patients and from 4.7 mm (IQR: 4.1–5.2) to 3.2 mm (IQR: 2.4–3.5) in Q‐SI patients (p <.001). At 6 months, FM‐SI was more effective at reducing the median proportions of Porphyromonas gingivalis (Pg), Aggregatibacter actinocomyctemcomitans, and Tannerella forsythia (Tf) (p <.001 for each value). Multilevel linear regression analysis demonstrated that high baseline PPD (p =.029), Pg (p =.014), and Tf (p <.001) levels and the FM‐SI protocol (p <.001) were statistically significant predictors of PPD reduction at 6 months. Furthermore, PPD reduction was significantly greater in the FM‐SI group when lower baseline Pg levels were detected. Conclusion: The FM‐SI was more effective than the Q‐SI in reducing the mean PPD and number of periodontal pathogens in periodontitis patients over a 6‐month follow‐up period. Higher baseline PPD and Pg levels had a negative impact on PPD reduction at 6 months after FM‐SI. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the effect of in-vivo produced Nisin which is an antimicrobial peptide (AMP) added to adhesive resin on shear bond strength (SBS) and the adhesive remnant index (ARI) of orthodontic brackets. Methods: Bacterial AMP was produced by fermentation and the ideal AMP/Bond concentration and antimicrobial efficacy of the mixture were tested. To evaluate the SBS and ARI scores of AMP-added adhesive resins, 80 maxillary premolar teeth extracted for orthodontic purposes were used and randomly assigned into 2 groups (n = 40). Group 1: Control Group (teeth bonded with standard adhesive resin); Group 2: Experimental Group (teeth bonded with AMP-added adhesive resin). Statistical analysis was performed using the SPSS package program and applying the Mann-Whitney U and Fisher's exact tests. P < 0.05 was considered as statistically significant. Results: Nisin synthesized in-vivo from Lactococcus lactis (L. lactis) (ATCC 7962) bacteria was provided to form a homogenous solution at an ideal concentration To find the minimum AMP/Bond mixture ratio that showed maximum antimicrobial activity, AMP and Bond mixtures were tested at various concentration levels between 1/160 and 1/2 (AMP/Bond). As a result, the optimum ratio was determined as 1/40. The antimicrobial efficacy of Nisin-added adhesive resin was tested against Streptococcus mutans (S. mutans) (ATCC 35,688) and Lactobacillus strains (cariogenic microorganisms). AMP formed a 2.7 cm diameter zone alone, while 1/40 AMP-bond mixture formed a 1.2 cm diameter zone. SBS values of the teeth bonded with Nisin added adhesive (17.49 ± 5.31) were significantly higher than the control group (14.54 ± 4.96) (P = 0.004). According to the four point scale, Nisin added adhesive provided a higher ARI score in favour of the adhesive and tooth compared to the control group (ARI = 3, n = 20). Conclusions: Nisin produced from L. lactis (ATCC 7962) had greater antimicrobial effects after mixing with adhesive bond against cariogenic microorganisms S. mutans (ATCC 35,688) and Lactobacillus strains. Nisin added adhesive increased shear bond strength (SBS) of orthodontic brackets and ARI scores in favor of adhesive & teeth. Clinical relevance: Clinicians should take into account that using Nisin-added adhesive resin in orthodontic treatments can provide prophylaxis against tooth decay, especially in patients with poor oral hygiene. [ABSTRACT FROM AUTHOR]

Introduction: Proper tooth brushing is a complicated process for children. Therefore, the aim of this study was to investigate the effect of differential learning to improve tooth brushing in children. Methods: In this prospective, controlled, single-blinded, randomized clinical trial, 58 children between 3 and 8 years of age (mean: 5.7 ± 1.5 years; 29 female) were randomly assigned to test or control group through the child's self-drawing of an unlabeled envelope from a box. All children received oral hygiene instructions and information in these sealed envelopes and were asked to follow the corresponding instructions at home for 28 days. Children in the test group received instructions with exercises using the differential learning method, whereas the children in the control group received the usual tooth brushing instructions. Results: At baseline and planned follow-ups after 4 and 12 weeks, plaque and gingival indices (QHI, PBI) were recorded in both groups by 2 calibrated and blinded investigators. At baseline, there were no significant differences between the test and control groups regarding plaque and gingival indices (QHI: 4.1 ± 0.5 vs. 4.1 ± 0.4; p = 0.7; PBI: 0.6 ± 0.3 vs. 0.6 ± 0.3; p = 0.7). At the 1st and 2nd follow-up, both groups showed improved oral health indices, but there was an overall better improvement in the test group. While the difference in gingival indices was statistically significant in the 1st recall (PBI/test: 0.1 ± 0.2 vs. control: 0.3 ± 0.2; p < 0.001), the difference in plaque indices was not (QHI/test: 2.1 ± 0.9; control: 2.6 ± 0.9; p = 0.07). At the 2nd recall (mean week = 19.5 weeks), the test group showed statistically significant and clinically relevant better oral health indices than the control group (2nd recall, QHI/test: 2.1 ± 0.9 vs. control: 3.2 ± 1; p < 0.001; PBI/test: 0.1 ± 0.2 vs. control: 0.5 ± 0.2; p < 0.001). Conclusion: In conclusion, differential learning leads to oral hygiene improvement in children with high caries risk and initially poor oral hygiene, which was superior to the conventional learning method through repetition in the medium term. [ABSTRACT FROM AUTHOR]

Focal osteoporotic bone marrow defects (FOBMDs) of jaws are rare and usually discovered as an incidental radiographic finding. They present as a poorly demarcated radiolucency affecting the posterior mandible of middle-aged women with pathogenesis remaining unknown. A 60-year-old female patient had visited our dental college for routine dental checkup and oral prophylaxis. Her radiograph revealed a well-defined radiolucency in the left mandibular posterior region as an incidental finding. Clinical examination revealed a diffuse swelling in the above-mentioned region which the patient had not noticed. The patient gave a history of trauma in the same region almost 20 years back. Incisional biopsy was performed. Microscopic examination revealed multiple bits of fatty fibro cellular tissue resembling the bone marrow with aggregates of blood cells. A diagnosis of FOBMD was given. FOBMD, although rare, should be included in differential diagnosis of the radiolucent lesions of the jaws. [ABSTRACT FROM AUTHOR]

Aim: To evaluate site‐related changes in periodontal pocket depth (PPD) after non‐surgical periodontal therapy and to identify predictors for PPD changes in a retrospective patient data analysis. Materials and Methods: PPD, clinical attachment level, bleeding on probing, tooth mobility (TM), furcation involvement (FI), abutment status, adherence to supportive periodontal care (SPC) and SPC follow‐ups were obtained from fully documented patient data before periodontal therapy (baseline, T0), after active periodontal therapy (APT, T1) and during SPC (T2). PPD changes were classified into deteriorated or unchanged/improved at the site level. Multi‐level logistic regression analysis was performed to identify factors influencing PPD changes during SPC. Results: This retrospective study included 51 females and 65 males (mean T0 age: 54.8 ± 10.1 years, 25 smokers, 12 diabetics) suffering from Stage III/IV periodontitis. Evaluation outcome: T0/16,044 sampling sites/2674 teeth; T1/15,636/2606; T2/14,754/2459. During 9.0 ± 2.3 years SPC, PPD decreased (−1.33 ± 0.70 mm) by 21.8% of the sites, remained unchanged by 41.4% and increased (1.40 ± 0.78 mm) by 36.8%. Distopalatal FI (p <.001, odds ratio [OR]: 0.252, 95% confidence interval [CI] for OR: 0.118–0.540), residual pockets (p <.001, OR: 0.503, 95% CI: 0.429–0.590) and TM Degrees I–III (Degree I: p =.002, OR: 0.765, 95% CI: 0.646–0.905; Degree II: p =.006, OR: 0.658, 95% CI: 0.489–0.886; Degree III: p =.023, OR: 0.398, 95% CI: 0.180–0.879) correlated significantly with increasing PPD. Conclusions: Over 75% of PPD remained unchanged or increased during SPC. Distopalatal FI, TM Degrees I–III and residual pockets after APT lead to worsening of periodontal pockets. [ABSTRACT FROM AUTHOR]

Background: Pneumonia shows higher rates of morbidity and mortality in elderly and compromised individuals. Poor oral health has been suggested to be a significant risk factor for the disease, though little is known about acquisition of pathogens that could cause bacterial pneumonia. We investigated the prevalence of respiratory pathogens harbored in the oral cavity of independent elderly. Materials and Methods: The study cohort consisted of 110 community-dwelling, independent elderly. Dental examinations were conducted by 5 dentists, and information regarding oral health was collected by questionnaire. 12 species of opportunistic pathogens were detected in saliva and identified. Results: Polymerase chain reaction results revealed opportunistic pathogens in 67.3% of the participants, with Klebsiella pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Serratia marcescens, and Candida spp. isolated from 4, 38, 17, 3, and 38 participants, respectively. Age was significantly lower in participants harboring H. influenzae and higher in participants with Candida albicans. 82 of the participants received routine dental prophylaxis and showed a significantly lower rate of S. aureus colonization while the frequency of dental prophylaxis had no relationship with the colonization of S. aureus. Conclusion: Our findings suggested that elderly individuals who receive routine dental prophylaxis prevent oral colonization by S. aureus. [ABSTRACT FROM AUTHOR]

The rehabilitation of severely worn teeth is a complex challenge for dental practitioners. There are many different types of dental materials and restorative techniques, and there is not a single way to achieve the desired result. This clinical report demonstrates a complete oral rehabilitation with composite resins when using an indirect application and direct techniques, with the support of the Lucia Jig technique, the Willis technique, and diagnostic waxing for the vertical dimension correction. The wide clinical improvement was achieved with the recovery of the function, the esthetics, and the increase of vertical dimension of occlusion through the planned treatment. The proposed treatment maintained the natural teeth, without the intense wear by the application of the composite resins instead of ceramics, together with excellent conditions for the patient to control the posttreatment and extend the durability, with the correct follow-up of appointments. Young patients with extensive dental wear and the loss of vertical dimension should not be directly submitted to ceramic treatments, with preparations for full crowns. Oral rehabilitation using composite resins, either directly or indirectly, allows for the recovery of the function and esthetics, without the intense predictable dental wear, and reduced financial investment. [ABSTRACT FROM AUTHOR]

Objectives: People with severe intellectual or multiple disabilities (PIMD) have been receiving dental care in a specialized unit offering special care dentistry. For most of these adult patients, the initial consultation is complaint driven. In addition, the limited ability to cooperate due to their disabilities often means that dental treatment for these patients is usually carried out under general anesthesia (GA). Chairside treatment attempts are the exception rather than the rule. This retrospective study evaluated whether consistent practice of behavioral management principles and techniques embedded in a specific dental environment enables successful dental treatment of PIMD. Materials and methods: The feasibility of chairside dental prophylaxis in PIMD (n=36) was analyzed: specific behavioral management techniques were applied, and professional tooth cleaning (PTC) was performed in the dental chair. Clinical data obtained from medical records and a questionnaire were analyzed. Results: All patients had severe intellectual or multiple disabilities and had previously undergone at least one dental treatment under GA. Of these patients, 55.6% never had their teeth professionally cleaned before. Applying different behavioral techniques, all patients were compliant with receiving PTC in the dental chair. Conclusions: An individualized and disability-specific treatment strategy using various noninvasive and nonpharmacological behavioral guidance techniques resulted in a higher compliance rate in PIMD, which allowed chairside PTC and reduced the need for treatment under GA. Clinical relevance: Consistent implementation of various behavioral guidance techniques and communication strategies in a supportive environment enabled all patients to receive chairside PTC and be involved in a lifelong recall program. [ABSTRACT FROM AUTHOR]

Aim: To compare caregivers' acceptance, consent, and concern toward utilization of a combination of basic behavior guidance technique (CBBGT) and Papoose Board (PB) for their special needs children and to evaluate the impact of PB usage on the caregiver's attitude and the association between their education level, monthly household income, and previous dental experience. Materials and Methods: This cross-over study incorporated 90 special needs children who were recruited to receive dental treatment with two ways of behavior guidance exposures consecutively in the order of A-B/B-A design. Exposure A is CBBGT (distraction, tell-show-do, and positive reinforcement), while Exposure B is PB. The dental procedures were either dental prophylaxis or restoration with a handpiece. Caregivers need to answer a paper-based questionnaire before and after exposure. The Wilcoxon sign rank test and logistic regression were utilized in order to establish the comparability, impacts, and association. Result: About 88 caregivers of special needs children aged between 2 and 15 years completed the sequence. Overall, 98.9% of the children presented with neurodevelopmental disorders. Twenty-seven caregivers were significantly concerned when the combination of basic BGT was applied to their children, and 14 caregivers felt the same for PB. However, the Wilcoxon sign rank test revealed insignificant caregiver scores on acceptance and consent for both methods but significantly improved attitudes towards the use of PB after observing the placement of their children. Conclusion: The studied caregiver demonstrated equivalent acceptance, consent, and concern toward the use of PB and a combination of basic BGT with improved attitudes after comprehensive explanation and real-time observation of PB usage during their children's dental treatment. [ABSTRACT FROM AUTHOR]

Background: Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention. Method: An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed. Results: 204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention – depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01–0.32)] to 0.28 [95%CI: (0.20–0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants. Conclusion: Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries. [ABSTRACT FROM AUTHOR]

The objective of the study was to investigate various aspects of evidence-based dental prophylaxis education in postdoctoral pediatric dentistry training programs in the United States. An anonymous nationwide postal survey of fifty-two postdoctoral pediatric dentistry program directors was conducted in September 2001. The survey had a response rate of 75 percent with all geographic regions of the nation represented and with a preponderance of university-based programs (62 percent). Most of the training programs (74 percent) routinely recommended dental prophylaxis for all recall patients. The proportion of programs that recommended dental prophylaxis for the following indications were: plaque, stain and/or calculus removal--97 percent; caries prevention--59 percent; prior to topical fluoride application--67 percent; prior to sealant application--62 percent; and for behavioral modification--77 percent. Most training programs (77 percent) defined dental prophylaxis as both rubber cup pumice prophylaxis and toothbrush prophylaxis. However, only one-half of the training programs (51 percent) had modified their teaching to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. In conclusion, only one half of postdoctoral pediatric dentistry training programs in the United States teach evidence-based practice of dental prophylaxis for recall patients. [ABSTRACT FROM AUTHOR]