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Objectives: To assess the efficacy of a new toothbrush (Balene) for the mechanical removal of dental plaque in patients with acquired brain injury. Material and methods: The study group consisted of 25 adults with acquired brain injury. The participants underwent 2 sessions of toothbrushing lasting 1 min, one with a conventional toothbrush and the other with the Balene toothbrush. This new double-headed toothbrush has 6 active sides, which allows for the simultaneous toothbrushing of both alveolar arches, with elastomer bristles angled at 45°, as well a handle that rotates up to 180°. Therefore, the user does not need to remove the toothbrush from the oral cavity during the toothbrushing process. Dental plaque accumulation was assessed using the simplified oral hygiene index of Greene and Vermillion. Results: The plaque index was significantly reduced both with the Balene toothbrush (p < 0.001) and with the conventional toothbrush (p < 0.001). The dental plaque removal efficacy was similar with the two toothbrushes. There were also no statistically significant differences in the removal of plaque with the Balene toothbrush between the autonomous and assisted toothbrushing modalities (p = 0.345). Conclusions: For patients with acquired brain injury, the Balene toothbrush was as effective as a conventional toothbrush, regardless of whether the toothbrushing modality was autonomous or assisted. Clinical relevance: The Balene® toothbrush's efficacy in removing dental plaque is similar to that of conventional toothbrushes, both with the autonomous and assisted toothbrushing modality. Given its particular ergonomics, this toothbrush could be indicated for certain select patients with acquired brain injury (i.e., those whose degree of cooperation allows for toothbrushing, with a sufficient mouth opening, with no substantial abnormalities in the intermaxillary relationship, and with no significant edentulous sections)

OBJECTIVE: To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes. MATERIAL AND METHODS: In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual. RESULTS: > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups. CONCLUSIONS: Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.

OBJECTIVE: To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes. MATERIAL AND METHODS: In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10-16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual. RESULTS: > 0 (OR = 2.33, 95% CI: 1.47 - 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 - 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups. CONCLUSIONS: Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding.

Aim: The aim of this review was to systematically assess and report the effectiveness of chlorhexidine (CHX) mouthwash in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment.Material and Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and registered under PROSPERO database (CRD42020170776). Four electronic databases were systematically searched along with a complimentary manual search of orthodontic journals until June 2022. Only Randomized Control Trials (RCTs) reporting on antiplaque and antigingivitis efficacy of Chlorhexidine mouthwash compared with placebo or control in orthodontic patients were included. Risk of bias assessment was done using Cochrane ROB-2. Quantitative analysis (Random-Effects Model and Standard Mean Difference (SMD)) with 95 % confidence interval was used. Results: Six RCTs were included for qualitative analysis and four were included for quantitative analysis with a total of 211 participants. Out of six studies, 3 were judged to have a low risk of bias, two had some concerns and one of them had high risk of bias. Random effects meta-analysis performed for anti-plaque effect reported a significant reduction of -1.2 SMD for CHX at 4 to 6 weeks with low heterogeneity (I2-35%). The anti-gingivitis effect at 4 to 6 weeks was significant for CHX with a SMD of -1.03 and a moderate heterogeneity (I2-65%).Conclusion: On analyzing the available evidence a moderate level of certainty supports a short-term reduction in plaque accumulation and gingivitis in orthodontic patients subjected to rinsing with chlorhexidine oral rinse., Objetivo: El objetivo de esta revisión fue evaluar e informar sistemáticamente la efectividad del enjuague bucal con clorhexidina (CHX) para prevenir la acumulación de placa y la gingivitis en pacientes que reciben tratamiento de ortodoncia.Material y Métodos: La revisión se preparó de acuerdo con las pautas de Preferred Reporting Items for Systematic Reviews (PRISMA) y se registró en la base de datos PROSPERO (CRD42020170776). Se realizaron búsquedas sistemáticas en cuatro bases de datos electrónicas junto con una búsqueda manual gratuita de revistas de ortodoncia hasta junio de 2022. Solo se incluyeron ensayos controlados aleatorios (ECA) que informaron sobre la eficacia antiplaca y antigingivitis del enjuague bucal con clorhexidina en comparación con placebo o control en pacientes de ortodoncia. La evaluación del riesgo de sesgo se realizó mediante Cochrane ROB-2. Se utilizó un análisis cuantitativo (modelo de efectos aleatorios y diferencia de medias estándar (SMD)) con un intervalo de confianza del 95 % Resultados: Se incluyeron seis ECA para el análisis cua-litativo y cuatro para el análisis cuantitativo con un total de 211 participantes. De los seis estudios, se consideró que tres tenían un bajo riesgo de sesgo, dos tenían algunas preocupaciones y uno de ellos tenía un alto riesgo de ses-go. El metanálisis de efectos aleatorios realizado para el efecto antiplaca informó una reducción significativa de -1,2 SMD para CHX a las 4 a 6 semanas con baja heterogeneidad (I2-35%). El efecto antigingivitis a las 4 a 6 semanas fue significativo para CHX con una SMD de -1,03 y una heterogeneidad moderada (I2-65%).Conclusión: Al analizar la evidencia disponible, un nivel de certeza moderado apoya una reducción a corto plazo en la acumulación de placa y gingivitis en pacientes ortodóncicos sometidos a enjuague con enjuague bucal con clorhexidina.

In the literature, 16S rRNA gene sequencing is the most widely used technology for studying the periodontal microbiota. However, there is no evidence on how methodological aspects such as primer coverage, detection of matching amplicons (MAs), and clustering into operational taxonomic units (OTUs) could influence the results obtained for the oral niche. Furthermore, the comparison of 16S sequencing-based studies on periodontal microbiota is controversial due to significant methodological differences. Therefore, meta-omics analyses would favour the accuracy of phylogenetic data associated with different periodontal conditions. In the present Thesis, we analysed in silico 1) the coverage of primers employed in sequencing-based studies of the mouth microbiota using oral-specific databases containing bacterial and archaeal 16S rRNA gene sequences; 2) the number of 16S rRNA genes in the complete genomes of bacterial and archaeal species inhabiting the human mouth, and how the use of different primers would affect the detection of MAs from different taxa; and 3) the performance of different primers to detect distinct oral species with 16S rRNA gene amplicon similarity ≥97%, identifying the taxa that may be erroneously grouped into the same OTU.

Background The mouth can be colonized by many bacterial species that are associated with both health and disease. Bacteria analyses are an important part of diagnosing and treating dental diseases, but there is no consensus regarding which sampling method to use for these analyses. Aim The aim of this study was to find out whether there are differences in bacterial composition in one, two and three days old dental plaque and if there are regional differences between anterior, posterior, right and left surfaces in the mouth over time. Method Plaque sample collection was performed at specific tooth sites on six healthy young adults. Sampling was made three times after dental plaque had been accumulated for one, two and three days respectively. During the accumulation periods the participants had to abstain from all forms of oral hygiene. Bacteria DNA extraction was performed followed by 16S sequencing. All gene sequences were matched against the Human Oral microbiome database. The results were analyzed in SPSS and SIMCA. Result When comparing the bacteria composition between day one, two and three a statistically significant difference was found. The analyzes also showed a difference in composition between the posterior and anterior regions of the mouth over time, but no significant difference between the right and the left side of the mouth over time. Conclusion The result suggests that the sampling method should be chosen carefully and determined by the specific aim of the dental plaque analysis.

Background The mouth can be colonized by many bacterial species that are associated with both health and disease. Bacteria analyses are an important part of diagnosing and treating dental diseases, but there is no consensus regarding which sampling method to use for these analyses. Aim The aim of this study was to find out whether there are differences in bacterial composition in one, two and three days old dental plaque and if there are regional differences between anterior, posterior, right and left surfaces in the mouth over time. Method Plaque sample collection was performed at specific tooth sites on six healthy young adults. Sampling was made three times after dental plaque had been accumulated for one, two and three days respectively. During the accumulation periods the participants had to abstain from all forms of oral hygiene. Bacteria DNA extraction was performed followed by 16S sequencing. All gene sequences were matched against the Human Oral microbiome database. The results were analyzed in SPSS and SIMCA. Result When comparing the bacteria composition between day one, two and three a statistically significant difference was found. The analyzes also showed a difference in composition between the posterior and anterior regions of the mouth over time, but no significant difference between the right and the left side of the mouth over time. Conclusion The result suggests that the sampling method should be chosen carefully and determined by the specific aim of the dental plaque analysis.

V teoretické části se práce zabývá anatomickým popisem a fyziologickým osídlením dutiny ústní mikroorganismy. Zohledněna je zde i patologická oblast, věnující se vybraným onemocněním, která dané mikroorganismy mohou vyvolat, jejich etiologii, průběhu a následkům. Praktická část se zaměřuje na povědomí veřejnosti o hygieně dutiny ústní a onemocněních parodontu., The theoretical of the thesis deals with anatomical description and physilogical colonization of the oral cavity by microorganisms. The pathological area is also considered, dealing with selected diseases that can be caused by these organisms, their etiology, course and consequences. The practical part focuses on public awareness of oral hygiene and periodontal disease., Fakulta chemicko-technologická, Prezentace výsledků bakalářské práce. Diskuze k posudku vedoucího bakalářské práce. Studentka zodpověděla všechny dotazy a připomínky k BP., Dokončená práce s úspěšnou obhajobou

Introduction: Helicobacter Pylori bacteria (Gram negative) is associated with the etiology of acute and chronic gastritis, peptic ulcer, adenocarcinoma, and gastric cancer; The detection methods that have been used are invasive, therefore, it is important to evaluate different non-invasive techniques for their detection in accessible substrates such as serum and saliva. In addition, relate the detection of Helicobacter Pylori to dental plaque. Objective: Determine the modification of the test in saliva and dental plaque for the detection of Helicobacter Pylori, by reviewing different scientific articles. Materials and methods: Descriptive, cross-sectional, and retrospective study. The search consisted of 70 articles in different databases such as: PubMed, Scopus, Scielo, Medigraphic, Web of Science, Dialnet and Springer Link. Results: 33 scientific articles were used, from which the use of saliva was obtained for the rapid diagnosis of this bacterium. It was recommended, but not as a sole diagnostic method. In relation to dental plaque, it is related to the presence of periodontal disease, therefore, in individuals with a healthy oral health, it is not possible to detect the presence of Helicobacter Pylori through dental plaque tests. Conclusion: Saliva is a rapid method of diagnosis and dental plaque is related to periodontal disease; therefore, it is not an indicative method of Helicobacter Pylori infection., Introducción: La bacteria Helicobacter Pylori (Gram- negativo) está asociada a la etiología de gastritis aguda y crónica, úlcera péptica, adenocarcinoma y cáncer gástricos; los métodos de detección que se han utilizado son invasivos, por lo tanto, es importante valorar distintas técnicas no invasivas para su detección en sustratos accesibles como es el suero y la saliva. Además, relacionar la detección de Helicobacter Pylori con la placa dental. Objetivo: Determinar la efectividad de la prueba en saliva y placa bacteriana para la detección de Helicobacter Pylori, mediante la revisión de diferentes artículos científicos. Materiales y métodos: Estudio de tipo descriptivo, transversal y retrospectivo. Constó de la búsqueda 70 artículos científicos en diferentes bases de datos como: PubMed, Scopus, Scielo, Medigraphic, Web of Science, Dialnet y Springer Link. Resultados: Se utilizaron 33 artículos científicos de donde se obtuvo que el uso de la saliva para el diagnóstico rápido de esta bacteria fue recomendado, pero no como un método único de diagnóstico. Con relación a la placa dental está relacionada con la presencia de enfermedad periodontal, por lo tanto, en individuos con un estado de salud bucal sano no es posible detectar la presencia de Helicobacter Pylori mediante pruebas en placa dental. Conclusión: La saliva es considerada un método rápido de diagnóstico y la placa dental está relacionada con la enfermedad periodontal por lo tanto no es un método indicativo de infección de Helicobacter Pylori.

Purpose: Space maintainers are important for the health and placement of children’s primary and permanent teeth. However, plaque and caries levels can be negatively affected when a dental appliance is in the mouth. This study aims to evaluate the oral health of pediatric patients that have space maintainers applied as a result of early tooth loss. Methods: This study included 100 systemically healthy patients between the ages of 4-15 years that were treated with space maintainers due to early loss of teeth. Decayed, missing, filled tooth index values and dental plaque status of the participants were recorded. Controls were performed in the 6th and 12th month. The index results were compared and evaluated statistically using ANOVA and paired-t-tests. Results: A total of 116 space maintainers, including 36 band and loops, 16 lingual arches, 21 palatal arches, 43 removable appliances, were evaluated in the study. Statistically significant differences were found between the pre-treatment and post-treatment index values (p<0.001). In the group of band and loops and removable space maintainers; the increases in DMFT/dft values of 6th month and 12th month according to initial DMFT/dft values were statistically significant (p<0.05). For plaque index, the increase in 12th month of all types of appliances were found statistically significant (p<0.001). The greatest increase in plaque index level was seen in the teeth of patients that had been treated with a lingual arch. Conclusions: Incompatible space maintainers can lead to caries, increased plaque accumulation, demineralized areas, and periodontal problems. The accumulation of plaque and difficulty of cleaning the teeth, especially in the fixed space maintainers, negatively affects the health of teeth. For this reason, good oral hygiene should be provided to patients and controls should be regularly performed., Los mantenedores de espacio son importantes para la salud y la colocación de la dentición primaria y permanente de los niños. Sin embargo, los niveles de placa y caries pueden verse afectados negativamente cuando se coloca un aparato dental en la boca. Este estudio tiene como objetivo evaluar la salud bucal de pacientes pediátricos a los que se les aplicó mantenedores de espacio como resultado de la pérdida temprana de los dientes. Métodos: Este estudio incluyó a 100 pacientes sistémicamente sanos entre las edades de 4 a 15 años que fueron tratados con mantenedores de espacio debido a la pérdida temprana de dientes. Se anotaron los valores del índice de dientes cariados, faltantes y el estado de la placa dental. Los controles se realizaron en el 6 ° y 12 ° mes. Los resultados del índice se compararon y evaluaron estadísticamente mediante ANOVA y pruebas t pareadas. Resultados: Un total de 116 mantenedores de espacio, incluyendo 36 bandas y bucles, 16 arcos linguales, 21 arcos palatinos, 43 dispositivos removibles, fueron evaluados en el estudio. Se encontraron diferencias estadísticamente significativas entre los valores de los índices en el pretratamiento y postratamiento (p <0.001). En el grupo de bandas, bucles y mantenedores de espacio removibles los aumentos en los valores de DMFT/dft en el sexto mes y el 12º mes fueron estadísticamente significativos (p <0.05). Para el índice de placa, el aumento en el 12º mes de todos los tipos de aparatos se encontró estadísticamente significativo (p <0,001). El mayor aumento en el nivel del índice de placa se observó en los pacientes que habían sido tratados con un arco lingual. Conclusiones: los mantenedores de espacio pueden provocar caries, aumento de la acumulación de placa, áreas desmineralizadas y problemas periodontales. La acumulación de placa y la dificultad de limpiar los dientes, especialmente en los mantenedores de espacio fijos, afecta negativamente la salud dental. Por esta razón, se debe proporcionar una bue

Orthodontic appliances in the oral cavity may cause problems such as white spot lesions, dental plaque, periodontal disease and root resorption. The aim of this study was to investigate the association between orthodontic treatment and oral health parameters including visible dental plaque, gingival recession and white spot lesions (WSLs). A total of 170 patients (86 females, 84 males) were randomly selected to determine visible dental plaque, gingival recession and white spot lesions by using pre-treatment and post-treatment oral photographs. Except of previously extracted teeth, maxillary and mandibular incisors, canine, 1st and 2nd premolars and 1st molar were evaluated. There was a significant difference between the T0 (before treatment) and T1 (after treatment) groups in visible plaque (P< 0.001). The distribution of gingival recession frequencies according to Miller classification before treatment did not differ from the after treatment (P=.082). A statistically significant increase in the severity of WSL was detected between the two time points (P< 0.001). Males have been shown to have higher WSL incidence after treatment. In conclusion, the present study showed that visible dental plaque and white spot lesions significant increase after orthodontic treatment. Considering the relationship between oral health and orthodontic treatment, clinicians and patients should know the risks and take precautions., Los aparatos de ortodoncia en la cavidad oral puede causar problemas como lesiones de mancha blanca, placa dental, enfermedad periodontal y reabsorción radicular. El objetivo de este estudio fue investigar la asociación entre el tratamiento de ortodoncia y los parámetros de salud bucal, incluida la placa dental visible, la recesión gingival y las lesiones de mancha blanca (LMB). Un total de 170 pacientes (86 mujeres, 84 hombres) fueron seleccionados al azar para determinar la placa dental visible, la recesión gingival y las lesiones de manchas blancas mediante el uso de fotografías orales antes y después del tratamiento. Excepto los dientes extraídos previamente, se evaluaron incisivos maxilares y mandibulares, caninos, premolares y primeros molares. Hubo una diferencia significativa entre los grupos T0 (antes del tratamiento) y T1 (después del tratamiento) en la placa visible (P<0.001). La distribución de las frecuencias de recesión gingival según la clasificación de Miller antes del tratamiento no mostraron diferencias significativas con respecto al postratamiento (P=0.082). Se detectó un aumento estadísticamente significativo en la gravedad de LMB entre los dos puntos de tiempo (P<0.001). Se ha demostrado que los hombres tienen una mayor incidencia de LMB después del tratamiento. En conclusión, el presente estudio mostró que la placa dental visible y las lesiones de manchas blancas aumentaron significativamente durante el tratamiento de ortodoncia. Teniendo en cuenta la relación entre la salud bucal y el tratamiento de ortodoncia, los médicos y los pacientes deben conocer los riesgos y tomar precauciones.

The oral microbiome plays key roles in human biology, health, and disease, but little is known about the global diversity, variation, or evolution of this microbial community. To better understand the evolution and changing ecology of the human oral microbiome, we analyzed 124 dental biofilm metagenomes from humans, including Neanderthals and Late Pleistocene to present-day modern humans, chimpanzees, and gorillas, as well as New World howler monkeys for comparison. We find that a core microbiome of primarily biofilm structural taxa has been maintained throughout African hominid evolution, and these microbial groups are also shared with howler monkeys, suggesting that they have been important oral members since before the catarrhine-platyrrhine split ca. 40 Mya. However, community structure and individual microbial phylogenies do not closely reflect host relationships, and the dental biofilms of Homo and chimpanzees are distinguished by major taxonomic and functional differences. Reconstructing oral metagenomes from up to 100 thousand years ago, we show that the microbial profiles of both Neanderthals and modern humans are highly similar, sharing functional adaptations in nutrient metabolism. These include an apparent Homo-specific acquisition of salivary amylase-binding capability by oral streptococci, suggesting microbial coadaptation with host diet. We additionally find evidence of shared genetic diversity in the oral bacteria of Neanderthal and Upper Paleolithic modern humans that is not observed in later modern human populations. Differences in the oral microbiomes of African hominids provide insights into human evolution, the ancestral state of the human microbiome, and a temporal framework for understanding microbial health and disease.

The oral microbiome plays key roles in human biology, health, and disease, but little is known about the global diversity, variation, or evolution of this microbial community. To better understand the evolution and changing ecology of the human oral microbiome, we analyzed 124 dental biofilm metagenomes from humans, including Neanderthals and Late Pleistocene to present-day modern humans, chimpanzees, and gorillas, as well as New World howler monkeys for comparison. We find that a core microbiome of primarily biofilm structural taxa has been maintained throughout African hominid evolution, and these microbial groups are also shared with howler monkeys, suggesting that they have been important oral members since before the catarrhine-platyrrhine split ca. 40 Mya. However, community structure and individual microbial phylogenies do not closely reflect host relationships, and the dental biofilms of Homo and chimpanzees are distinguished by major taxonomic and functional differences. Reconstructing oral metagenomes from up to 100 thousand years ago, we show that the microbial profiles of both Neanderthals and modern humans are highly similar, sharing functional adaptations in nutrient metabolism. These include an apparent Homo-specific acquisition of salivary amylase-binding capability by oral streptococci, suggesting microbial coadaptation with host diet. We additionally find evidence of shared genetic diversity in the oral bacteria of Neanderthal and Upper Paleolithic modern humans that is not observed in later modern human populations. Differences in the oral microbiomes of African hominids provide insights into human evolution, the ancestral state of the human microbiome, and a temporal framework for understanding microbial health and disease.

In people with disabilities, the state of oral health could be related to poor oral hygiene, causing highly prevalent diseases such as gingivitis, periodontal disease, or tooth decay because of insufficient dental care for these patients. Objective: To evaluate the state of oral health in people with disabilities belonging to the Proyecto Municipal “Misión Social Rumiñahui” in 2020. Method: Observational study that was approved by SEISH UCE 446 FO G 2019, the state of oral health was evaluated of 176 people (91 men and 85 women) with different types of disabilities, whose ages ranged from 3 to 96 years. A clinical examination was performed to determine their oral health using the simplified oral hygiene index (IHOS) and the DMFT / ceod indices. To find out if there was a relationship between the degree and type of disability and the state of oral health, a Spearman Correlation was performed. Results: A correlation was determined between the degree of disability and the IHOS (p = 0.03). Conclusions: The state of health decreases as the degree of disability increases., En personas con discapacidad, una pobre higiene bucal, ocasiona enfermedades de alta prevalencia como la gingivitis, enfermedad periodontal o caries y como resultado de una atención odontológica insuficiente para estos pacientes. Objetivo: Evaluar el estado de salud bucal en personas con discapacidad pertenecientes al Proyecto Municipal “Misión Social Rumiñahui” en el año 2020. Método: Estudio observacional que contó con la aprobación del SEISH UCE 446 FO G 2019, se evaluó el estado de salud bucal de 176 personas (91 hombres y 85 mujeres) con diferentes tipos de discapacidades, cuyas edades fluctuaban entre 3 y 96 años. Se realizó un examen clínico para determinar su salud oral mediante el índice de higiene oral simplificado (IHOS) y los índices CPOD/ ceod. Para conocer si existió relación entre el grado y tipo de discapacidad con el estado de salud bucal se realizó una Correlación de Spearman. Resultados: Se determinó una correlación entre el grado de discapacidad y el IHOS (p=0,03). Conclusiones: El estado de salud disminuye a medida que aumenta el grado de discapacidad.

To study the presence of bacterial plaque and dental caries in adults in the city of Milagro, Ecuador. From a population of 288 patients attended within the specific period of 2016-2017, patients were selected who were between the ages of 16 and 70, consisting of 187 patients, 131 female and 55 male, in turn they were subdivided into 2 groups under 35 years old and another group over 35 years of age. Of the CPO results found, the highest frequency of caries prevails in patients older than 35 years, the presence of bacterial plaque is higher in young men, although the percentages of bacterial plaque are greater in patients older than 35 years. We can observe the relationship that exists between the presence of dental plaque and the appearance of dental caries, although it is true that young patients have a greater accumulation of plaque., La presencia de placa bacteriana puede desencadenar otras enfermedades bucales mas agresivas. Objetivo. Estudiar la presencia de placa bacteriana y caries dental en los adultos de la ciudad de Milagro, Ecuador. Materiales y métodos. De una población de 288 pacientes atendidos dentro del periodo específico de 2016-2017, se selecciono los pacientes que encontraban dentro del rango de edades entre 16 y 70 años, conformada por 187 pacientes, 131 femeninos y 55 masculinos, a su vez se los subdividió en 2 grupos menores de 35 años y otro con mayores de 35 años de edad. Resultados. De los resultados de CPO encontrados, prevalece la mayor frecuencia de caries en pacientes mayores de 35 años, la presencia de placa bacteriana es mayor en hombres jóvenes, a pesar que los porcentajes de placa bacteriana se evidencian mayores en los pacientes mayores de 35 años. Conclusiones. Podemos observar la relación que existe entre la presencia de placa dental con la aparición de caries dental, si bien es cierto los pacientes jóvenes presentan mayor acumulación de placa.

Nowadays, there is a considerable interest to study the biological and microbiological changes that accompany orthodontic treatment. Growing knowledge on oral microbiota allows, day after day, to identify and characterize the microbial arrangements specifically associated with oral and extra-oral conditions. The aim of the present work is to highlight any further correlations between orthodontic appliances and the qualitative and quantitative modifications of the oral microbiota, such as predisposing factors for the onset of caries, periodontal diseases, and other infections, which can impact the oral and systemic health of the orthodontic patients. When compared with subjects without orthodontic appliances, orthodontic patients reported significant qualitative and quantitative differences in supra-and subgingival plaque during the entire treatment period. Certain components of fixed appliances (mainly bonded molar brackets, ceramic brackets, and elastomeric ligatures) showed high risks of periodontal disease and tooth decay for patients. An unclear prevalence of Candida spp. and the paucity of studies on viruses and protozoas in the oral microbiota of orthodontic patients need to be further investigated. The evidence emerging from this study could guide clinicians in modulating the timing of controls and enhance patient motivation to prevent the formation of mature plaque, thus reducing the risks of oral-plaque-related diseases.

Objectives: To study the association between anticholinergic burden and oral hygiene practices and oral hygiene status among 46-year-old people. Materials and methods: The study included 1945 participants from the Northern Finland Birth Cohort 1966 (NFBC1966), who had a complete dental status. The participants underwent clinical medical and dental examinations, and their medication data were gathered by combining self-reported drug use with information from the National Prescription Register. Anticholinergic burden was measured using nine previously published anticholinergic scales. Oral hygiene practices were assessed with toothbrushing frequency and oral hygiene status with the presence of visible dental plaque. Poisson regression with robust variance estimation and negative binomial regression models were used to estimate relative risks (RR). Results: Thirty percent of the participants reported brushing their teeth twice a day and about 25% of their teeth had dental plaque on them. Fifteen percent of the participants used at least one anticholinergic drug or had an anticholinergic burden according to the nine anticholinergic scales. After adjustments for confounding factors, the RRs of anticholinergic burden varied between 0.95 and 1.11 for toothbrushing frequency. Anticholinergic burden (according to Anticholinergic Activity Scale, Anticholinergic Cognitive Burden, Chew’s scale) was associated statistically significantly with the number of teeth with dental plaque. For the three scales, RRs varied from 1.24 to 1.50. Conclusions: Anticholinergic burden associated with poor oral hygiene. Clinical relevance: The findings stress the importance of providing oral hygiene instructions and prophylactic measures to patients taking anticholinergic drugs.

The oral microbiome plays key roles in human biology, health, and disease, but little is known about the global diversity, variation, or evolution of this microbial community. To better understand the evolution and changing ecology of the human oral microbiome, we analyzed 124 dental biofilm metagenomes from humans, including Neanderthals and Late Pleistocene to present-day modern humans, chimpanzees, and gorillas, as well as New World howler monkeys for comparison. We find that a core microbiome of primarily biofilm structural taxa has been maintained throughout African hominid evolution, and these microbial groups are also shared with howler monkeys, suggesting that they have been important oral members since before the catarrhine-platyrrhine split ca. 40 Mya. However, community structure and individual microbial phylogenies do not closely reflect host relationships, and the dental biofilms of Homo and chimpanzees are distinguished by major taxonomic and functional differences. Reconstructing oral metagenomes from up to 100 thousand years ago, we show that the microbial profiles of both Neanderthals and modern humans are highly similar, sharing functional adaptations in nutrient metabolism. These include an apparent Homo-specific acquisition of salivary amylase-binding capability by oral streptococci, suggesting microbial coadaptation with host diet. We additionally find evidence of shared genetic diversity in the oral bacteria of Neanderthal and Upper Paleolithic modern humans that is not observed in later modern human populations. Differences in the oral microbiomes of African hominids provide insights into human evolution, the ancestral state of the human microbiome, and a temporal framework for understanding microbial health and disease.

AimsTo assess feasibility, acceptability, and early efficacy of monetary incentive-based interventions on fostering oral hygiene in young children measured with a Bluetooth-enabled toothbrush and smartphone application.DesignA stratified, parallel-group, three-arm individually randomized controlled pilot trial.SettingTwo Los Angeles area Early Head Start (EHS) sites.Participants36 parent-child dyads enrolled in an EHS home visit program for 0-3 year olds.InterventionsEligible dyads, within strata and permuted blocks, were randomized in equal allocation to one of three groups: waitlist (delayed monetary incentive) control group, fixed monetary incentive package, or lottery monetary incentive package. The intervention lasted 8 weeks.OutcomesPrimary outcomes were a) toothbrushing performance: mean number of Bluetooth-recorded half-day episodes per week when the child's teeth were brushed, and b) dental visit by the 2-month follow-up among children with no prior dental visit. The a priori milestone of 20% more frequent toothbrushing identified the intervention for a subsequent trial. Feasibility and acceptability measures were also assessed, including frequency of parents syncing the Bluetooth-enabled toothbrush to the smartphone application and plaque measurement from digital photographs.FindingsDigital monitoring of toothbrushing was feasible. Mean number of weekly toothbrushing episodes over 8 weeks was 3.9 in the control group, 4.1 in the fixed incentive group, and 6.0 in the lottery incentive group. The lottery group had 53% more frequent toothbrushing than the control group and 47% more frequent toothbrushing than the fixed group. Exploratory analyses showed effects concentrated among children ≤24 months. Follow-up dental visit attendance was similar across groups. iPhone 7 more reliably captured evaluable images than Photomed Cannon G16.ConclusionsTrial protocol and outcome measures were deemed feasible and acceptable. Results informed the study protocol for a fu

Extremity reconstruction surgery is increasingly performed rather than amputation for patients with large-segment pathologic bone loss. Debate persists as to the optimal void filler for this "limb salvage" surgery, whether metal or allograft bone. Clinicians focus on optimizing important functional gains for patients, and the risk of devastating implant infection has been thought to be similar regardless of implant material. Recent insights into infection pathophysiology are challenging this equipoise, however, with both basic science data suggesting a novel mechanism of infection of Staphylococcus aureus (the most common infecting agent) into the host lacunar-canaliculi network, and also clinical data revealing a higher rate of infection of allograft over metal. The current translational study was therefore developed to bridge the gap between these insights in a longitudinal murine model of infection of allograft bone and metal. Real-time Staphylococci infection characteristics were quantified in cortical bone vs metal, and both microarchitecture of host implant and presence of host immune response were assessed. An orders-of-magnitude higher bacterial burden was established in cortical allograft bone over both metal and cancellous bone. The establishment of immune-evading microabscesses was confirmed in both cortical allograft haversian canal and the submicron canaliculi network in an additional model of mouse femur bone infection. These study results reveal a mechanism by which Staphylococci evasion of host immunity is possible, contributing to elevated risks of infection in cortical bone. The presence of this local infection reservoir imparts massive clinical implications that may alter the current paradigm of osteomyelitis and bulk allograft infection treatment.

Flossing, an important oral hygiene skill, is technique-sensitive and challenging for children with developing manual dexterity. GumChucks is a novel flossing device designed to assist children with proper flossing technique. The aim of this study was to assess the efficacy of the GumChucks flossing device compared to string floss (SF). We conducted a randomized trial with 40 children aged 4-15 years at the UCLA Children's Dental Center from January- April 2017. Participants were randomly assigned to either GumChucks or SF. Interdental plaque score (IPS) and gingival index (GI) were recorded at baseline and 4-week post-usage. Flossing speed and interdental plaque reduction were also determined immediately after first use. In addition, questionnaires were completed by children, parents and dentists. Overall, children flossed significantly faster (p < 0.001) and achieved greater IPS reduction after first use (47.0% vs. 26.8%) with GumChucks compared to SF. After 4-week post-usage, children ages 10-15 in the GumChucks group demonstrated significantly greater improvement in GI and IPS from baseline (p < 0.01) and greater efficacy in interdental plaque removal compared to the SF group (p < 0.01). Children ages 4-9 flossed more effectively (p < 0.01) with GumChucks after first use, but no significant IPS and GI improvement after 4-week post-usage. Children preferred GumChucks (92.5%) over SF, with a similar positive attitude reported by parents and dentists. GumChucks is an effective alternative interdental plaque removal aid that allows children to floss with greater speed and efficacy, with recommended parental supervision for children under age 10.

In recent decades, a body of literature examining the relationships between oral health and general health has rapidly developed. However, the biological mechanisms involved in explaining such relationships have not been fully described. Recent evidence has suggested that these relationships could be partially explained by the composition and interaction of the microbiome/microbiota between local and systemic body sites. For instance, it has been suggested that intestinal microbiota could have effects on non-communicable diseases, such as diabetes or cardiovascular diseases. The objective of this study is to explore current evidence of the link between oral and systemic diseases, to discuss whether oral microbiome/microbiota could represent an unexplored biological pathway partially explaining those relationships. A non-systematic review of the literature was carried out using keyword searches in Pubmed from February to May 2019. The ultimate goal was to present recent scientific evidence to update the general knowledge on this topic to professionals in dentistry. This review is divided in two parts for journal publication; however, it is intended to be used as one piece. In this first part, we will summarize the conceptual background of oral microbiome/microbiota, we will describe the main methods used in microbiology to characterize oral organisms, and will present the main composition of bacteria in oral microbiome/microbiota. The second part highlights the main evidence regarding the biological plausibility that links oral microbiome and systemic diseases and we will conclude with some future research recommendations. Taking into account the role of oral microbiota in the development of systemic diseases could change the main paradigm of how oral health is currently conceptualized by dental professionals., En las últimas décadas, se ha acumulado evidencia sobre las relaciones existentes entre la salud oral y la salud general. Sin embargo, los mecanismos biológicos implicados en la explicación de tales relaciones no se han logrado describir completamente. Investigaciones recientes han sugerido que parte de esta relación se podría explicar por la composición e interacción del microbioma o la microbiota a nivel local y sistémico. Por ejemplo, la evidencia ha mostrado que la microbiota intestinal parece tener efectos sobre enfermedades crónicas no transmisibles, como la diabetes o las enfermedades cardiovaculares. En esta revisión bibliográfica, se han seleccionado algunos estudios que han tratado de hipotetizar que el microbioma y la microbiota oral podrían representar un mecanismo biológico poco explorado que podría explicar parcialmente las relaciones que se han observado entre condiciones orales y enfermedades sistémicas. El objetivo de esta revisión es analizar la evidencia actual que explica los posibles mecanismos que desempeñan un papel en las asociaciones entre la salud oral y la salud sistémica. La hipótesis discutida es que el microbioma y microbiota oral podría ser un mecanismo biológico que podría explicar parcialmente las influencias de las enfermedades orales sobre la salud general. Se realizó una revisión no sistemática de la literatura entre febrero y mayo del 2019 en la plataforma PubMed. El objetivo final es presentar evidencia científica reciente para actualizar el conocimiento general sobre este tema para los profesionales en odontología. Esta revisión se presenta en dos partes por consideraciones editoriales, sin embargo, la intención es que ambas sean leídas como una sola pieza. En esta primera parte, se presentarán las bases conceptuales, se describirán los principales métodos utilizados en microbiología para caracterizar los organismos orales y se mencionará la composición descrita en la literatura de los principales microorganismos presentes en l

Introduction: Dental caries and periodontal diseases are bacterial plaque-mediated oral health problems so disclosing agents have been recommended as auxiliaries in oral hygiene. Objective: The purpose of the present study was to assess the effect of disclosing agents in oral hygiene. Methods: A randomized double-blind crossover study was carried out using a 2% malachite green solution and criteria from Quigley & Hein (1962) index for effective comparison among 82 school children aged 11-13 years. First of all, adolescents were separated into thirteen groups. Seven groups were exposed to technique A (regular toothbrushing with disclosing agent and without dentifrice) and six groups to technique B (regular toothbrushing without disclosing agent or dentifrice). After three weeks, the subjects of technique A were exposed to technique B and vice-versa. Average plaque values were compared using Student’s t test. Results: The groups showed no difference between techniques, but significant differences were shown in both groups between the first and second steps. Conclusion: The results of this study show that disclosing agents play no crucial role in oral hygiene improvement. Explanatory hypothesis related to motivational effects engendered by the participation of the subject in the study are discussed.

The anatomical complexity of tooth roots provides place for bacterial deposits, making eradication of periodonto pathogens difficult. The conventional methods for the removal of dental plaque like mechanical treatment and antimicrobial therapy have their own limitations. To overcome the limitations, a novel non-invasive photochemical approach called Photodynamic Therapy (PDT) was applied which is based on the principle that a visible range of light activates a photosensitizer (PS), leading to the formation of reactive oxygen species which induce phototoxicity to the bacterial cell. In this project, a light source was designed using red Light Emitting Diode (LED) to illuminate the biofilm formed by Streptococcus viridians group. The biofilm was formed in 96 well microtiter plates and was sensitized with Toluidine Blue O (TBO) of two concentrations (500mg/l, 100mg/l). The viability of cells when evaluated using MTT ((3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay was found to be decreased significantly. It was also found that high concentration of TBO (HTBO-500mg/l) was more effective assuming that the biofilms were exposed with equal intensity of light.

The anatomical complexity of tooth roots provides place for bacterial deposits, making eradication of periodonto pathogens difficult. The conventional methods for the removal of dental plaque like mechanical treatment and antimicrobial therapy have their own limitations. To overcome the limitations, a novel non-invasive photochemical approach called Photodynamic Therapy (PDT) was applied which is based on the principle that a visible range of light activates a photosensitizer (PS), leading to the formation of reactive oxygen species which induce phototoxicity to the bacterial cell. In this project, a light source was designed using red Light Emitting Diode (LED) to illuminate the biofilm formed by Streptococcus viridians group. The biofilm was formed in 96 well microtiter plates and was sensitized with Toluidine Blue O (TBO) of two concentrations (500mg/l, 100mg/l). The viability of cells when evaluated using MTT ((3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide) assay was found to be decreased significantly. It was also found that high concentration of TBO (HTBO-500mg/l) was more effective assuming that the biofilms were exposed with equal intensity of light.

Objectives: The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Data and sources: Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Study selection: Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. Conclusions: The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Clinical relevance: Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

Aim:The aim of the thesis was to study the effect of a self-care education in oral health for a group of dental nurse students in Danang, Vietnam. Methods: A quantitative intervention study was performed consisting of 53 selected participants, who were clinically examined to measure the dental biofilm and gingival inflammation. The intervention was a self-care education session where both information and instruction about the materials and methods of self-care in toothbrush technique and interdental cleaning were included. Results: The self-care education in oral health proved to have an effect on the students' oral hygiene. There was a statistically significant difference between the first and the second examination of the gingival inflammation. No statistically significant difference was found between the first and second examination of dental plaque but plaque score of buccal, lingual and distal surfaces significantly decreased before the second examination.The results did not show any significant difference between the group from the rural area and the group from the urban area. Conclusion:The result of the study shows that the self-care education in oral health had a positive impact on the participant´s oral hygiene. It would be beneficial to develop a self-care educational program for the population in Vietnam to improve the oral hygiene.Through knowledge and information about good self-care habits and its positive effects, more people can achieve a better and healthier oral health as a result., Syfte:Syftet med studien var att studera effekten av en given egenvårdsutbildning i oral hälsa för en grupp dental nurse studenter i Danang, Vietnam. Metod:En kvantitativ interventionsstudie utfördes, bestående av 53 utvalda deltagare som undersöktes kliniskt för att mäta dental biofilm och gingival inflammation. Interventionen var en egenvårdsutbildning där information och instruktion i material och metoder för egenvård i tandborstteknik och approximal rengöring inkluderades. Resultat:Egenvårdsutbildningen i oral hälsa visade sig ha effekt på studenternas munhygien. Det var en statistiskt signifikant skillnad mellan den första och den andra undersökningen av gingival inflammation. Ingen statistiskt signifikant skillnad uppnåddes mellan den första och andra undersökningen av dentalt plack. Dock sjönk plackförekomsten på de buccala, linguala och distala ytorna avsevärt innan den andra undersökningen. Resultaten visade inte någon signifikant skillnad mellan gruppen från landsbygd eller gruppen från tätort. Slutsats:Resultatet av studien visar att egenvårdsutbildningen haft en positiv inverkan på deltagarens munhygien. Det skulle vara fördelaktigt att utveckla ett egenvårdsprogram för befolkningen i Vietnam för att allmänt förbättra den orala hygienen. Genom kunskap och information om goda egenvårdsvanor och dess positiva effekter kan fler människor uppnå en bättre och hälsosammare oral hälsa.

Aim:The aim of the thesis was to study the effect of a self-care education in oral health for a group of dental nurse students in Danang, Vietnam. Methods: A quantitative intervention study was performed consisting of 53 selected participants, who were clinically examined to measure the dental biofilm and gingival inflammation. The intervention was a self-care education session where both information and instruction about the materials and methods of self-care in toothbrush technique and interdental cleaning were included. Results: The self-care education in oral health proved to have an effect on the students' oral hygiene. There was a statistically significant difference between the first and the second examination of the gingival inflammation. No statistically significant difference was found between the first and second examination of dental plaque but plaque score of buccal, lingual and distal surfaces significantly decreased before the second examination.The results did not show any significant difference between the group from the rural area and the group from the urban area. Conclusion:The result of the study shows that the self-care education in oral health had a positive impact on the participant´s oral hygiene. It would be beneficial to develop a self-care educational program for the population in Vietnam to improve the oral hygiene.Through knowledge and information about good self-care habits and its positive effects, more people can achieve a better and healthier oral health as a result., Syfte:Syftet med studien var att studera effekten av en given egenvårdsutbildning i oral hälsa för en grupp dental nurse studenter i Danang, Vietnam. Metod:En kvantitativ interventionsstudie utfördes, bestående av 53 utvalda deltagare som undersöktes kliniskt för att mäta dental biofilm och gingival inflammation. Interventionen var en egenvårdsutbildning där information och instruktion i material och metoder för egenvård i tandborstteknik och approximal rengöring inkluderades. Resultat:Egenvårdsutbildningen i oral hälsa visade sig ha effekt på studenternas munhygien. Det var en statistiskt signifikant skillnad mellan den första och den andra undersökningen av gingival inflammation. Ingen statistiskt signifikant skillnad uppnåddes mellan den första och andra undersökningen av dentalt plack. Dock sjönk plackförekomsten på de buccala, linguala och distala ytorna avsevärt innan den andra undersökningen. Resultaten visade inte någon signifikant skillnad mellan gruppen från landsbygd eller gruppen från tätort. Slutsats:Resultatet av studien visar att egenvårdsutbildningen haft en positiv inverkan på deltagarens munhygien. Det skulle vara fördelaktigt att utveckla ett egenvårdsprogram för befolkningen i Vietnam för att allmänt förbättra den orala hygienen. Genom kunskap och information om goda egenvårdsvanor och dess positiva effekter kan fler människor uppnå en bättre och hälsosammare oral hälsa.

Objectives: The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Data and sources: Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Study selection: Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. Conclusions: The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Clinical relevance: Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

Objectives: The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Data and sources: Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Study selection: Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. Conclusions: The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Clinical relevance: Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

Objectives: The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Data and sources: Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Study selection: Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. Conclusions: The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Clinical relevance: Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

Objectives: The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Data and sources: Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Study selection: Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. Conclusions: The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Clinical relevance: Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

Objectives: The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF2) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining. Data and sources: Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018). Study selection: Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF2 dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF2 dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity. Conclusions: The present review found that stabilized SnF2 toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings. Clinical relevance: Adding a SnF2 toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

A system for Caries Management by Risk Assessment (CAMBRA®) has been developed in California. The purpose of this article is to summarize the science behind the methodology, the history of the development of CAMBRA, and the outcomes of clinical application. The CAMBRA caries risk assessment (CRA) tool for ages 6 y through adult has been used at the University of California, San Francisco (UCSF), for 14 y, and outcome studies involving thousands of patients have been conducted. Three outcomes assessments, each on different patient cohorts, demonstrated a clear relationship between CAMBRA-CRA risk levels of low, moderate, high, and extreme with cavitation or lesions into dentin (by radiograph) at follow-up. This validated risk prediction tool has been updated with time and is now routinely used at UCSF and in other settings worldwide as part of normal clinical practice. The CAMBRA-CRA tool for 0- to 5-y-olds has demonstrated similar predictive validity and is in routine use. The addition of chemical therapy (antibacterial plus fluoride) to the traditional restorative treatment plan, based on caries risk status, has been shown to reduce the caries increment by about 20% to 38% in high-caries-risk adult patients. The chemical therapy used for high-risk patients is a combination of daily antibacterial therapy (0.12% w/v chlorhexidine gluconate mouth rinse) and twice-daily high-concentration fluoride toothpaste (5,000 ppm F), both for home use. These outcomes assessments provide the evidence to use these CRA tools with confidence. Caries can be managed by adding chemical therapy, based on the assessed caries risk level, coupled with necessary restorative procedures. For high- and extreme-risk patients, a combination of antibacterial and fluoride therapy is necessary. The fluoride therapy must be supplemented by antibacterial therapy to reduce the bacterial challenge, modify the biofilm, and provide prevention rather than continued caries progression.

ObjectivesThe Stopping Cavities Trial investigated effectiveness and safety of 38% silver diamine fluoride in arresting caries lesions.Materials and methodsThe study was a double-blind randomized placebo-controlled superiority trial with 2 parallel groups. The sites were Oregon preschools. Sixty-six preschool children with ≥1 lesion were enrolled. Silver diamine fluoride (38%) or placebo (blue-tinted water), applied topically to the lesion. The primary endpoint was caries arrest (lesion inactivity, Nyvad criteria) 14-21days post intervention. Dental plaque was collected from all children, and microbial composition was assessed by RNA sequencing from 2 lesions and 1 unaffected surface before treatment and at follow-up for 3 children from each group.Results and conclusionAverage proportion of arrested caries lesions in the silver diamine fluoride group was higher (0.72; 95% CI; 0.55, 0.84) than in the placebo group (0.05; 95% CI; 0.00, 0.16). Confirmatory analysis using generalized estimating equation log-linear regression, based on the number of arrested lesions and accounting for the number of treated surfaces and length of follow-up, indicates the risk of arrested caries was significantly higher in the treatment group (relative risk, 17.3; 95% CI: 4.3 to 69.4). No harms were observed. RNA sequencing analysis identified no consistent changes in relative abundance of caries-associated microbes, nor emergence of antibiotic or metal resistance gene expression. Topical 38% silver diamine fluoride is effective and safe in arresting cavities in preschool children.Clinical significanceThe treatment is applicable to primary care practice and may reduce the burden of untreated tooth decay in the population.

Patient with fixed appliances (braces) must have good oral hygiene to prevent dental caries, decalcification, periodontal problems and oral health diseases. Many orthodontic patients’ complaint of not able to clean between their fixed appliances (braces) due to the arch wires prevented the insertion of the toothbrush. Food can also get stuck between the fixed appliances and their teeth. This could result in dental cavity and gum disease for this patient if left untreated. In this study, a new device of tooth cleaning was tested against normal tooth brushing. A new cleaning device which uses water irrigation to remove dental plaque on tooth enamel surfaces were develop for this study. Both method of tooth cleanings was compared between each other on the effectiveness to remove dental plaque on tooth enamel surfaces. In the end, water irrigator was found to be slightly more effective to clean dental plaque.   &nbsp

Patient with fixed appliances (braces) must have good oral hygiene to prevent dental caries, decalcification, periodontal problems and oral health diseases. Many orthodontic patients’ complaint of not able to clean between their fixed appliances (braces) due to the arch wires prevented the insertion of the toothbrush. Food can also get stuck between the fixed appliances and their teeth. This could result in dental cavity and gum disease for this patient if left untreated. In this study, a new device of tooth cleaning was tested against normal tooth brushing. A new cleaning device which uses water irrigation to remove dental plaque on tooth enamel surfaces were develop for this study. Both method of tooth cleanings was compared between each other on the effectiveness to remove dental plaque on tooth enamel surfaces. In the end, water irrigator was found to be slightly more effective to clean dental plaque.   &nbsp

This study aimed to compare the bacterial viability and diversity of a substrate-formed biofilm (SF-biofilm) in situ to a supragingival tooth-formed biofilm (TF-biofilm) in the same group of individuals. The impact of the device/disc position and toothbrushing during the formation of SF-biofilm was also assessed. Two tests were run. In test 1, 15 volunteers wore two hemi-splints carrying six discs of human enamel, glass, and hydroxyapatite for 2 days, and were instructed to not perform any oral hygiene measure. Biofilm samples were collected from the substrates and the contralateral tooth and were analysed using CLSM. In five volunteers, half of the biofilm present on the discs and their contralateral teeth were scraped and analysed using 16S pyrosequencing. In test 2, the microscopic analysis was repeated only on the SF-biofilm samples, and the volunteers were allowed to brush their teeth. Multivariate analyses revealed that the donors had a significant effect on the composition of the biofilm, confirming its subject-dependent character. The bacterial composition of the SF-biofilm was similar to the TF-biofilm, with significant differential abundance detected in very few taxa of low abundance. The toothbrushing during the formation of SF-biofilm was the only factor that conditioned the thickness or bacterial viability

Background: Previous studies have suggested the quorum sensing signal AI-2 as a potential target to prevent the biofilm formation by Streptococcus mutans, a pathogen involved in tooth decay. Objective: To obtain inhibition of biofilm formation by S. mutans by extracts obtained from the marine bacterium Tenacibaculum sp. 20J interfering with the AI-2 quorum sensing system. Design: The AI-2 inhibitory activity was tested with the biosensors Vibrio harveyi BB170 and JMH597. S. mutans ATCC25175 biofilm formation was monitored using impedance real-time measurements with the xCELLigence system®, confocal laser microscopy, and the crystal violet quantification method. Results: The addition of the cell extract from Tenacibaculum sp. 20J reduced biofilm formation in S. mutans ATCC25175 by 40–50% compared to the control without significantly affecting growth. A decrease of almost 40% was also observed in S. oralis DSM20627 and S. dentisani 7747 biofilms. Conclusions: The ability of Tenacibaculum sp. 20J to interfere with AI-2 and inhibit biofilm formation in S. mutans was demonstrated. The results indicate that the inhibition of quorum sensing processes may constitute a suitable strategy for inhibiting dental plaque formation, although additional experiments using mixed biofilm models would be required

Objectives Studies on dental plaque removal by chewing an apple are scarce and dated, with conflicting findings. This study aimed to determine whether chewing an apple produced mechanical removal of dental plaque or had any effect on salivary bacterial viability. Methods The study group consisted of 20 healthy adults with good oral health status who were randomly assigned to brush their teeth or eat an apple. After 2 weeks, the experiment was repeated with the order reversed. Plaque index (PI) and the bacterial viability (BV) in a sample of whole saliva (spit) were determined before brushing or apple eating (baseline, B), immediately afterward (A) and 24 hours afterward (24). Results After chewing an apple, PI-A was significantly higher than both PI-B (P < .001) and PI-24 (P < .001). BV-A was significantly lower than BV-B (P < .001), with a return to baseline values at the BV-24 measurement. Conclusions Chewing an apple does not remove dental plaque, and may favor plaque regrowth during the first 24 hours, but it does produce an immediate reduction in salivary bacterial viability similar to that after tooth brushing

Orthodontic treatment with fixed orthodontic appliances modifies the oral environment, changing the supra gingival and sub gingival microbiota. The fixed orthodontic appliances could increase the number of retention areas, resulting in increased possibilities for accumulation of dental plaque. The study was undertaken to evaluate and compare the efficiency of oral hygiene measures like orthodontic toothbrush, mouthwash and water jet in maintenance of oral hygiene in fixed orthodontic patients. Special hygiene care should be given to orthodontic patients to help control bleeding and plaque accumulation during active treatment. The 90-days randomised single blind study demonstrated that orthodontic tooth brush and water jet devices are effective oral hygiene regimens for orthodontic patients with fixed appliances.

Orthodontic treatment with fixed orthodontic appliances modifies the oral environment, changing the supra gingival and sub gingival microbiota. The fixed orthodontic appliances could increase the number of retention areas, resulting in increased possibilities for accumulation of dental plaque. The study was undertaken to evaluate and compare the efficiency of oral hygiene measures like orthodontic toothbrush, mouthwash and water jet in maintenance of oral hygiene in fixed orthodontic patients. Special hygiene care should be given to orthodontic patients to help control bleeding and plaque accumulation during active treatment. The 90-days randomised single blind study demonstrated that orthodontic tooth brush and water jet devices are effective oral hygiene regimens for orthodontic patients with fixed appliances.

Dipeptidyl peptidase (DPP) 4, DPP5, DPP7, and DPP11, expressed in the periplasmic space, are crucial for energy production for Porphyromonas gingivalis, an asaccharolytic bacterium that causes periodontal disease. Bacterial DPP4 seems to be involved in regulation of blood glucose level via degradation of incretins. The present study aimed to identify four dpp orthologs in oral microbiota by database searches, and their enzymatic activities in periodontopathic and cariogenic bacteria, as well as oral specimens were determined. Search in the databases suggested that 43 species of 772 taxa possess dpp4 and other dpp genes. Most species are in the genera Bacteroides, Capnocytophaga, Porphyromonas, Prevotella, and Tannerella, indicating a limited distribution of dpp orthologs in anaerobic periodontopathic rods. In accordance with those results, activities of all four DPPs were demonstrated in P. gingivalis, Porphyromonas endodontalis, and Tannerella forsythia, while they were negligible in Treponema denticola, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans. Furthermore, DPP activities were also detected in subgingival dental plaque at different intensities among individual specimens, while DPP4 activity presumably derived from human entity was solely predominant in saliva samples. These findings demonstrated that DPP activities in dental plaque serve as potent biomarkers to indicate the presence of periodontopathic bacteria, FEMS Microbiology Letters, 365(22), fny221; 2018

Caries is one of the most prevalent and costly infectious diseases affecting humans of all ages. It is initiated by cariogenic supragingival dental plaques forming on saliva-coated tooth surfaces, yet the etiology remains elusive. To determine which microbial populations may predispose a patient to caries, we report here an in-depth and comprehensive view of the microbial community associated with supragingival dental plaque collected from the healthy teeth of caries patients and healthy adults. We found that microbial communities from caries patients had a higher evenness and inter-individual variations but simpler ecological networks compared to healthy controls despite the overall taxonomic structure being similar. Genera including Selenomonas, Treponema, Atopobium, and Bergeriella were distributed differently between the caries and healthy groups with disturbed co-occurrence patterns. In addition, caries and healthy subjects carried different Treponema, Atopobium, and Prevotella species. Moreover, distinct populations of 13 function genes involved in organic acid synthesis, glycan biosynthesis, complex carbohydrate degradation, amino acid synthesis and metabolism, purine and pyrimidine metabolism, isoprenoid biosynthesis, lipid metabolism, and co-factor biosynthesis were present in each of the healthy and caries groups. Our results suggested that the fundamental differences in dental plaque ecology partially explained the patients' susceptibility to caries, and could be used for caries risk prediction in the future.

This study examined the microbial diversity and community assembly of oral microbiota in periodontal health and disease and after nonsurgical periodontal treatment. The V4 region of 16S rRNA gene from DNA of 238 saliva and subgingival samples of 21 healthy and 48 diseased subjects was amplified and sequenced. Among 1979 OTUs identified, 28 were overabundant in diseased plaque. Six of these taxa were also overabundant in diseased saliva. Twelve OTUs were overabundant in healthy plaque. There was a trend for disease-associated taxa to decrease and health-associated taxa to increase after treatment with notable variations among individual sites. Network analysis revealed modularity of the microbial communities and identified several health- and disease-specific modules. Ecological drift was a major factor that governed community turnovers in both plaque and saliva. Dispersal limitation and homogeneous selection affected the community assembly in plaque, with the additional contribution of homogenizing dispersal for plaque within individuals. Homogeneous selection and dispersal limitation played important roles, respectively, in healthy saliva and diseased pre-treatment saliva between individuals. Our results revealed distinctions in both taxa and assembly processes of oral microbiota between periodontal health and disease. Furthermore, the community assembly analysis has identified potentially effective approaches for managing periodontitis.

ObjectivesThe goal of this clinical study was to determine the effects of a dental gel containing 2.6% edathamil on overnight plaque re-accumulation and plaque removal.MethodsIn this double-blind, randomized crossover study, 10 subjects first brushed for one week with a washout toothpaste. On the evening of Day 7, prior to tooth brushing, Plaque Index (PI) was recorded, then plaque stained and photographed. Subsequently subjects were randomized to either brush with the test dental gel or the control. After overnight plaque accumulation, PI was recorded. Plaque was stained and photographed before and after subjects brushed with the same toothpaste as the previous night. Subsequently, the process was repeated with the second toothpaste. Image J software was used to quantify plaque presence.ResultsMean increase in PI overnight after brushing (1.78 versus 0.94) and final PI after tooth brushing the next morning (2.20 versus 1.31) were significantly (p < 0.05) better after use of the test gel. Tooth surface covered by plaque overnight was significantly higher after using the control gel (22.3%) than the test gel (11.8%; p < 0.05). After morning brushing, the residual area of plaque on the teeth was significantly higher for the control gel (9.2%) than for the test gel (3.6%; (p < 0.05).ConclusionsA test dental gel more effectively reduced overnight plaque re-accumulation and achieved better plaque removal than a control dentifrice.

Plaque-induced gingivitis is the most common form of periodontal disease and can affect 100% of the population. Gingivitis prevalence in Latin American population is not well documented, therefore the aim of this study was to determine the prevalence and severity of plaque-induced gingivitis in adult populations of three Latin American cities. Methods: This cross sectional multicenter study included 1650 participants, 550 from the Great Metropolitan Area of Costa Rica (GAM), 550 from Mexico City, Mexico (CDMX) and 550 from Bogota City, Colombia (BC). Subjects completed a questionnaire about their medical history and oral hygiene. Clinical assessment included recording of missing teeth, visible plaque index, calculus recording and gingival index (GI, Loe-Silness index). Results: Average GI was 1.36. No statistical difference was found between GAM (1.45) and BC (1.48); however, GI in CDMX was significantly lower (1.16). Average gingival bleeding on probing was 43%. Total plaque index was 0.76 showing the highest accumulation at interproximal sites (p=0.0001). A positive correlation was found between plaque and gingivitis (r=0.59). Dental calculus was present in at least one of the 18 evaluated sites per subject with no statistical difference between cities. There was no statistical difference in GI between smokers, former smokers and non- smokers. Conclusion: Gingivitis prevalence was 99.6%. Moderate Gingivitis was the predominant form, with no statistically significant difference between cities or gender. Dental plaque accumulation was the most important risk factor associated with the establishment of the disease., La gingivitis inducida por placa es la forma más común de enfermedad periodontal y puede afectar al 100% de la población. La prevalencia de gingivitis en Latinoamerica no está bien documentada, por lo tanto, el objetivo de este estudio fue determinar la prevalencia y severidad de la gingivitis inducida por placa en poblaciones adultas de tres ciudades latinamericanas. Metodología: Este estudio transversal multicéntrico incluyó 1650 sujetos, 550 del Gran Área Metropolitana de Costa Rica (GAM), 550 de la Ciudad de México, México (CDMX) y 550 de la Ciudad de Bogotá, Colombia (BC). Los sujetos completaron un cuestionario sobre su historia médica y hábitos de higiene oral. El examen clínico incluyó el registro de piezas dentales ausentes, el índice de placa visible, el registro de cálculo y el índice gingival (GI, Índice de Silness y Loe). Resultados: El GI promedio fue de 1.36. No se encontró diferencia estadísticamente significativa entre GAM (1.45) y BC (1.48); sin embargo, el índice gingival en CDMX fue menor (1.16). El promedio de sangrado al sondaje fue de 43%. El índice de placa total fue 0.76, mostrando la mayor acumulación en sitios interproximales (p=0.0001). Se encontró una correlación positiva entre placa y gingivitis (r=0.59). Hubo presencia de cálculo dental en al menos uno de los 18 sitios evaluados por cada sujeto sin diferencia estadística entre ciudades. No se encontró diferencia estadísticamente significativa en cuanto al índice gingival entre fumadores, ex fumadores y no fumadores. Conclusión: La prevalencia de Gingivitis fue del 99.6%. La Gingivitis Moderada fue la forma predominante, sin diferencia estadísticamente significativa por ciudad o sexo. La acumulación de placa fue el principal factor de riesgo asociado con el establecimiento de la enfermedad.

Patient with fixed appliances (braces) must have good oral hygiene to prevent dental caries, decalcification, periodontal problems and oral health diseases. Many orthodontic patients’ complaint of not able to clean between their fixed appliances (braces) due to the arch wires prevented the insertion of the toothbrush. Food can also get stuck between the fixed appliances and their teeth. This could result in dental cavity and gum disease for this patient if left untreated. In this study, a new device of tooth cleaning was tested against normal tooth brushing. A new cleaning device which uses water irrigation to remove dental plaque on tooth enamel surfaces were develop for this study. Both method of tooth cleanings was compared between each other on the effectiveness to remove dental plaque on tooth enamel surfaces. In the end, water irrigator was found to be slightly more effective to clean dental plaque.   &nbsp