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Background The present study is aimed to compare the osteoblastic activity in periodontally accelerated osteogenic orthodontics (PAOO) with and without the platelet-rich fibrin (PRF) membrane by evaluating the gingival crevicular fluid (GCF), alkaline phosphate (ALP) levels and also to explore the efficiency of PRF membrane in terms of healing. Methods A split-mouth randomized controlled trial, which comprised 16 sites, was randomly treated with PAOO + PRF membrane and PAOO alone. The primary outcome was to analyze the GCF ALP levels at baseline, 3rd, week, 5th week (2 weeks after surgery, 1 h before and after activation), 7th week (4 weeks after surgery), and 9th week (6 weeks after surgery). The clinical parameters (plaque index [PI], gingival index [GI], bleeding index [BI]) were assessed at baseline, 3rd week, 15th week, and 27th week. Healing index was recorded at 4th week (1 week after surgery), 5th week (2 weeks after surgery), and 7th week (4 weeks after surgery). Results There was a statistically significant increase in GCF ALP levels (p Conclusions Within the limitations of this split-mouth study, PRF membrane showed significant osteoblastic activity in the 5th week (2 weeks after PAOO) with the increased GCF ALP levels and accelerated healing in the 1st week after PAOO. They also maintained post-orthodontic stability until 18 months.

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS: Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. RESULTS: At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION: PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

Purpose To conduct a systematic review to evaluate the clinical parameters for periodontal diseases in individuals with cleft lip and/or palate (CL/P). Methods The authors searched six indexed databases without language restriction through July 2021. The eligibility criteria were observational studies that compared the periodontal clinical measures of individuals with CL/P to those without CL/P. Meta-analysis was conducted using random-effects models with inverse variance weighting. Results The literature search generated 1277 records, and 40 full-text articles were reviewed. Twenty-three studies comprising 3,235 individuals from 4 continents fulfilled our selection criteria. The meta-analysis revealed significant difference in mean plaque index scores (MD = 0.31, 95%CI = 0.22, 0.41), gingival index scores (MD = 0.50, 95%CI = 0.24, 0.77) and periodontal pocket depth (MD = 0.64, 95%CI = 0.12, 1.16) between individuals with and without CL/P. A slight increase in clinical attachment loss was detected among individuals with CL/P; however, such an increase may have little clinical significance. Conclusions As age is positively related to periodontal disease progression, and individuals with CL/P are more likely to present with more plaque accumulation and gingival inflammation, clinicians should reinforce preventive dental care from an early age.

The problems of anterior teeth include dental plaque, dental caries, and fracture, which are usually treated with common composite resin clinically. Although good repair effect can be achieved, patients are prone to anterior tooth sensitivity after surgery. Therefore, the purpose of this study is to analyze the cosmetic effect of nanocomposite resin on anterior teeth. Up to 176 patients (176 teeth) undergoing anterior dental cosmetic restoration in our hospital were selected and assigned to the LR group ( n = 88 ) and the NR group ( n = 88 ) according to patients’ voluntary choice of prosthetic materials. The LR group was cured with light-cured composite resin, while the NR group was cured with nanocomposite resin. By comparing the related indexes of patients in the two groups, it was discovered that in the NR group, the excellent and good rate and patients’ evaluation of the repair effect were higher, while the periodontal attachment, gingival index, dental plaque index, VAS score, and the incidence of tooth sensitivity were lower, all P < 0.05 . The results indicated that the nanocomposite resin had significant cosmetic effect on anterior teeth and had application value.

Objectives Mouth breathing is a key feature of obstructive sleep apnea (OSA). The current study evaluated dental, salivary and orthodontic characteristics of children with OSA, and compared them to those of children without OSA. Materials and methods Twenty-two children (mean age 5.3 years, 13 males) with OSA and 21 children without OSA who served as a control group (mean age 6.8 years, 11 males) underwent dental examinations. The OSA group was classified according to the apnea-hypopnea Index. Clinical examination included plaque index, gingival index, caries status, pH at 7 oral sites, salivary carries bacterial counts and inflammatory cytokine levels. Orthodontics measurements were calculated as the percentage of children with values in the normal range, in each group. Results The mean values of the decayed, missing and filled teeth (DMFT)/dmft index, the gingival index and the plaque index were higher in the OSA than the control group. Salivary Mutans streptococci and lactobacilli counts were significantly higher in the OSA than the control group; as were pH values in the hard and soft palate, and in the posterior and middle tongue. Significantly lower values were observed in the OSA than the control group for most of the orthodontic variables examined. Similarly, stratification of AHI according to severity shows the lowest values among those with mild OSA, and the highest among those with severe AHI. Conclusions Compared to a control group, mouth breathing children with obstructive sleep apnea had differences in oral microbiota, greater acidity and poorer dental status. Clinical relevance Clinicians should be aware of the various oral disturbances that may accompany OSA, and implement preventive measures.

Purpose: This study aimed to compare two treatment modalities; All on four fixed prostheses and locator retained overdentures; to rehabilitate patients having problems associated with edentulous maxilla opposing mandibular implant assisted overdentures. Materials and methods: Ten patients complaining from looseness and instability of their maxillary dentures that oppose mandibular 2-implant-retained overdentures were randomly divided into 2 groups: Group I included 5 patients who received four implants according to the All-on- four Concept (2 parallel middle implants and 2 posterior implants with distal inclination). Implants were immediately loaded with fixed acrylic prosthesis, then after 6 months the prosthesis was replaced with fixed ceramometal restoration, Group II, included 5 patients who received four implants that were immediately loaded with Locator retained maxillary overdentures using new maxillary dentures. Clinical (plaque index (PI), gingival index (GI), probing depth (PD) and implant stability (IS)) and radiographic (marginal bone loss (MBL) outcomes were recorded at baseline (T0), 6 (T6) and 12 (T12) month after prosthesis insertion.

Objective: The present study evaluated marginal bone level around immediate loaded implants using one piece and two piece implants. Subjects and methods: A group of 22 patients were divided into two groups; Group 1: 11 Patients received immediate loaded implant placement using one piece implants. Group 2: 11 Patients received immediate loaded implant placement using two piece implants. According to clinical evaluation; plaque Index, gingival Index and peri-implant probing depth were recorded and measured at three and six months and nine months, also implant quality score was measured. Radiographically, marginal bone level was measured and bone density and compared in three months, six months, nine months. Results: Group 1 showed a significant decrease in the peri-implant probing depth compared to Group 2. Group 1 showed significant buccal marginal bone loss than Group 2 allover the time intervals. There is no significant difference in the palatal or mesial or distal surface between the two groups. Also no significant difference between the two groups including plaque index or gingival index or bone density. Concerning the implant quality scale; 100% of group 2 were scale 1 , while 50% of group 1 were considered scale 1. Conclusion: immediate loading of two piece dental implants appeared significantly superior than one piece type.

Objectives To investigate the prevalence of true periodontal chief complaints (CC) and the factors affecting their reporting by patients with periodontal diseases (PD). Materials and Methods This cross‐sectional study was based on retrospective analysis of available periodontal records. Different personal and demographic variables were obtained from these records including CC, age, gender, working status, past medical/dental history, smoking status and diagnosis. In addition, clinical parameters of plaque index, gingival index, probing pocket depth (PPD), and number of missing teeth. Periodontal CC were retrieved and divided either into true periodontal (bleeding, tooth mobility, and alteration in gingival color/shape) or others (emergency and esthetic‐related) CC. Results A total of 1161 records were included in the final analysis. Results showed that only 287 (24.7%) of patients reported true periodontal CC whereas the remaining 874 (75.3%) patients were not aware about symptoms of PD. Regression modeling indicated that reporting of true CC was positively associated with smoking and PPD but negatively associated with number of missing teeth and gender (male). Conclusions Results suggested that recognition of true periodontal CC by the patients was low. Reporting of true periodontal CC was significantly associated with smoking, PPD, female and lower number of missing teeth. These results shed light on the importance of increasing public knowledge about PD which is essential to aid people in recognizing these diseases at early stages.

AIM AND OBJECTIVE The aim of the study is to assess "Myths in dentistry related to Oral Hygiene and its association with Gingival Health Status among patients visiting Institutional diagnostic clinic in Aseer region of Saudi Arabia." MATERIALS AND METHODS The present study was a cross-sectional study done on 152 subjects attending Institutional diagnostic clinic in Aseer region Saudi Arabia. Myths in dentistry related to oral hygiene were assessed by using a ten-item, multiple-choice, close-ended structured questionnaire and Gingival Health Status was assessed using gingival index described by Loe and Silness on the Ramfjord teeth. For the comparison of proportions, a Chi-Square test was used with continuity correction whenever appropriate. "p" value of

Objective: To evaluate the effect of chewable probiotic tablets on plaque accumulation and gingival inflammation, salivary pH and remineralization of white spot lesions in pre-school children with high caries risk. Materials and Methods: A randomized clinical trial with two parallel arms was used with a sample of 40 high caries risk children 3-5 years old. Children were divided randomly into two equal groups. Group I: children received probiotic tablets and were instructed to chew it once daily after routine tooth brushing for two weeks. Group II: children performed only routine tooth brushing. A plaque and gingival indices were scored, salivary pH was assessed, and DIAGNOdentTM readings were recorded from all participants at baseline and after two weeks of intervention. Results: Data showed that after two weeks of intervention, the mean plaque index after using the probiotic chewable tablets was lower than the control group with statistically significant difference. The mean gingival index was lower in the test group than the control group with statistically significant difference. Probiotic showed a percent increase in the mean pH values, while the control group showed a percent decrease at the end of the study with statistically significant difference between the two groups. Both groups showed a decrease in the mean DIAGNOdentTM scores with no statistically significant difference between them. Conclusion: Probiotics play an important role in the improvement of oral health. Additionally, they can be used as an adjunct to fluoride in dental caries prevention or control in high caries risk children.

Introduction: Ginger and honey have shown to be effective against pathogens routinely encountered in periodontal infection. However, none of literature has shown antibacterial effect of ginger and honey on the levels of dental plaque when used as a gel. Aim: To compare the effect of honey with ginger extract on the dental plaque levels and gingival health. Methodology: Fifteen systemically healthy patients were randomly allocated to either the test group [G1(ginger and honey gel = 15 sites)] or the control group [G2 (Chlorhexidine gel = 15 sites]. Full mouth Gingival Index (GI) Full mouth Plaque Index (PI) were evaluated at baseline and on 7th day. Results: The mean PI at baseline was 0.23 ± 0.02 (G1) and 0.29 ± 0.01 (G2) which was increased to 0.36 ± 0.01 (G1) and 0.37 ± 0.01 (G2) on 7th day. However, mean GI at baseline was 0.30 ± 0.04 (G1) and 0.34 ± 0.02 (G2) which was increased to 0.38 ± 0.03 (G1) and 0.43 ± 0.03 (G2) on 7th day. Conclusion: The results of this study suggest that the chlorhexidine gel and Natural gel containing Honey and Zingibar officinale both are effective in controlling plaque during the periodontal maintenance period.

Introduction This research aimed to investigate the effect of Nano-Bio Fusion Gingival Gel ([NBFG] NanoCureTech, Gangdong-gu, Seoul, Korea) as an aid along with oral hygiene advice and routine scaling in patients with malocclusion to control treatment-induced gingivitis and periodontitis in patients undergoing fixed orthodontic treatment. Methods A split-mouth design, prospective analysis after application of NBFG in 32 subjects with fixed orthodontic treatment-induced gingivitis was conducted. Patients applied NBFG to their gingiva twice daily, after brushing, for 90 consecutive days. Outcomes measured included: the plaque index (PI), papillary bleeding gingival index (PBI), probing depth (PD), and clinical attachment loss using standard assessment. PI, PBI, PD, and clinical attachment loss were measured at baseline, on the seventh day of gel application, at the next visit at the orthodontic clinic (28th day), and after 90 days. Results From baseline to the seventh day to the 90th day, the treatment group showed significant improvement in PI, PBI, and PD over time compared with the placebo group. Conclusions NBFG showed positive clinical effects in patients undergoing fixed orthodontic treatment. Clinical outcomes were measured in a comparatively short period.

Most orthodontic patients struggle to maintain good oral hygiene during treatment. To determine oral hygiene habits and status of patients undergoing fixed orthodontic treatment at University of Pretoria, Oral and Dental Hospital. A cross-sectional descriptive study. A modified, validated, self-administered questionnaire was used, and clinical examinations were conducted using Orthodontic Plaque Index, Gingival index, and Bleeding index. The questionnaire sought to determine knowledge and practice patterns. Data analysis included frequencies and correlations using chi-square test, with a significance of p

Background. Periodontal disease is one of the major causes of alveolar bone loss. There are various ways of regenerating the lost bone, i.e. guided tissue regeneration, bone grafts, and growth factors. In this purview, it becomes immensely important for a clinician to decide the best modality of treatment. In this study, we compared the effect of demineralized freeze-dried bone allograft (DFDBA) in combination with concentrated growth factors (CGF) verses CGF alone. Methods. This double-blind, split-mouth study was conducted on ten patients with two comparable bilateral intrabony defects. Each pair of defects was randomly treated by DFDBA + CGF or CGF alone. Clinical parameters such as plaque index (PI), modified gingival index (MGI), pocket probing depth (PPD), and relative attachment level (RAL) were recorded at baseline, three months, and six months. In addition, radiograph with grids was also taken at baseline and six months. The paired t-test was used to compare the pre- and post-treatment values and the unpaired t-test was used to compare the test and control group. Results. The PI score decreased significantly from baseline to six months. Similarly, the mean MGI score decreased significantly from baseline to six months. The intragroup comparison showed that there was a significant reduction in PPD in both the test and control group. However, the intergroup comparison showed that the reduced pocket depth was not significant. The intragroup radiographic comparison showed that there was the significant formation of bone in both the test and control group but inter-group showed that the formation of bone among both the group were non-significant. Conclusion. Radiographic and clinical outcomes of this study concluded that post six months, both groups demonstrated significant improvement in clinical and radiographic parameters. However, the addition of DFDBA to CGFs did not give any additional benefits.

The present study aimed at evaluating clinical utility of periosteal pedicle graft with coronally advanced flap (PPG ​+ ​CAF) vs modified coronally advanced flap (M-CAF) in cases of multiple adjacent gingival recessions involving maxillary and mandibular anteriors labially. Random allocation of 40 patients with 269 gingival recessions was done into two groups. In Test group (20 patients) periosteal pedicle graft followed by coronally advanced flap (PPG ​+ ​CAF) technique was performed and in control group (20 patients) modified coronally advanced flap (M-CAF) was attempted. Primary outcome measures included percentage root coverage (PRC), gingival thickness (GT), probing depth (PD), clinical attachment level (CAL), recession depth (RD) and width of keratinized gingiva (WKG). Secondary outcomes measures were patient centred outcomes, plaque index (PI) and gingival index (GI). Patients were recalled at baseline, 3,6 and 18 months postoperatively. Results There was a significant decrease in the mean recession depth from 3.58 ​± ​0.53 ​mm (baseline) to 0.22 ​± ​0.01 ​mm (18 months) in PPG ​+ ​CAF test group and 3.7 ​± ​0.56 ​mm (baseline) to 0.21 ​± ​0.01 mm (18 months) in M-CAF control group. With 85% root coverage in test group and 78% root coverage in control group, the difference was statistically significant at 18 months. The test group showed significant higher clinical attachment level gain and increase in width of keratinized gingiva as compared to control group. Conclusion In both the study groups PPG ​+ ​CAF and M-CAF, significant root coverage was achieved. However, in terms of increase in width of keratinized gingiva, gingival thickness and percentage root coverage, PPG ​+ ​CAF group presented significantly better results than M-CAF group at 18 months follow up. Thus, periosteum can be used as a pedicle graft along with coronally advanced flap as an alternative method in achieving better results with minimal cost.

Amaç: Bu çalışmanın amacı, oral antikoagülan (OAK) kullanan atriyal fibrilasyon (AF) hastalarında spontan dişeti kanaması (SDK) ve buna bağlı ilaç bırakma sıklığının değerlendirilmesidir.Gereç ve Yöntem: OAK ilaç kullanan 457 AF hastası taranarak spontan dişeti kanaması olan 32 hasta tespit edildi. Bu hastalar, spontan dişeti kanaması olmayan 32 AF hastası ile yaş, cinsiyet ve OAK tedavi protokolü açısından eşleştirilerek periodontal parametreleri karşılaştırıldı.Bulgular: Çalışmaya dahil edilen total popülasyonda, 32 hastada (32/457; % 7.0) SDK saptandı ve bu hastaların 13'ünde (% 40.6) kanamaya bağlı OAK ilaç kullanımını bıraktığı tespit edildi. Plak indeksi (PI), gingival indeks (GI) ve cep derinlikleri (CD) SDK olan hastalarda anlamlı olarak daha yüksek bulundu. Gingival indeksin, hastaların OAK ilacı bırakma riskini bağımsız olarak etkilediği tespit edildi.Sonuç: OAK tedavisi altındaki AF hastalarında, önceden var olan periodontal hastalık nedeniyle önemli oranda SDK ve buna bağlı hastanın OAK ilaç kullanımını bıraktığı gözlendi. Ayrıca gingival indeks skorları, SDK ve OAK ilacın bırakılmasında risk indikatörüdür. OAK tedavisinden önce hastaların periodontal muayenesi ve / veya tedavisi yapılması önerilir., Purpose: The aim of this study was to investigate the frequency of gingival bleeding (GB) and associated drug-withdrawal in atrial fibrillation (AF) patients using oral anti-coagulants (OAC).Materials and Methods: 457 patients with AF receiving OAC were screened. The periodontal parameters and OAC drug-withdrawal of 32 patients with spontaneous GB were compared with 32 patients without bleeding who were matched for age, sex and OAC treatment protocol.Results: GB was detected in 32 patients (7.0%) and 13 of these patients (40.6%) had OAC drug-withdrawal due to bleeding. The plaque index (PI), gingival index (GI) and probing pocket depths (PPD) were significantly higher in patients with GB. The GI scores independently determined the risk of OAC drug-withdrawal. Conclusion: AF patients under OAC treatment may have significant rates of GB and subsequent OAC withdrawal due to pre-existing periodontal disease. The GI scores and GB can predict the risk of OAC drug-withdrawal. The periodontal examination and/or treatment of these patients should be performed before OAC treatment.

The removal of third molars (M3) is one of the most common oral-maxillofacial surgical procedures affecting periodontal tissues of neighboring second molars (M2). The aim of this study was to evaluate the periodontal status of lower M2 following the removal of unerupted lower M3 up to 5 years after removal.Primary predictor variable in this prospective cohort-study was time [baseline (BL; preoperatively), 6 and 60 months postoperatively]. The primary outcome variable was probing pocket depth (PPD). Clinical attachment level (CAL) was defined as a secondary outcome variable. Plaque index (PlI) and gingival index (GI) were assessed descriptively. All variables were compared using nonparametric tests. M3 were classified as either completely bony or partially bony unerupted. Risk factors (removed M3, type of impaction, mean BL PPD≥4 mm, gender, age) were analyzed (repeated measures ANCOVA). The significance level was set at 0.05.From originally 91 subjects enrolled in this study, 39 subjects (22 females; mean age: 21.6 ± 2.5 years) contributing 39 M3 completed the study after 5 years. Average BL PPD significantly decreased at 6 (-0.50 ± 0.61 mm, P = .001), 60 months (-0.81 ± 0.56, P .0001), as well as between 6 and 60 months (-0.31 ± 0.51 mm, P = .030). Corresponding CAL values decreased accordingly (BL-6 months: -0.37 ± 0.59 mm, P = .004; BL-60 months: -0.67 ± 0.55 mm, P .0001; 6 to 60 months: -0.34 ± 0.48 mm, P = .004). The was confirmed as risk factor for PPD (P = .026) and CAL (P = .042) changes.Average PPD and CAL of mandibular M2 in young subjects improved 5 years after early removal of unerupted M3 in favor of an initial partially bony unerupted type of impaction.

Objectives We describe the prevalence, and individual and familial risk indicators for dental caries and gingivitis among 10–19-year-old adolescents in Ile-Ife, South-West Nigeria. Methods This cross-sectional study collected data through household surveys conducted between December 2018 and January 2019. Adolescents were recruited through multistage sampling. Oral health outcomes were caries, measured by the ‘Decayed, Missing due to caries, and Filled Teeth’ (DMFT) index, and gingivitis, measured by the Loe and Silness gingival index. Explanatory variables were individual (sex, age, oral health perception) and familial (socioeconomic status, birth rank, family size and parental living status) factors. Oral health behaviors (daily tooth-brushing, use of fluoridated toothpaste, consuming refined carbohydrates in-between meals, use of dental floss, dental service utilization in past 12 months, and smoking habits) were treated as confounders. Poisson regression models with robust estimation were constructed to determine associations between explanatory factors and oral health outcomes. Results A total of 1472 adolescents were surveyed. Caries prevalence was 3.4%, with mean (standard deviation) DMFT of 0.06 (0.36) and plaque index of 0.84 (0.56). Only 128 (8.7%) adolescents brushed their teeth twice daily, 192 (16.1%) used dental floss daily, 14 (1.1%) utilized dental services in the last 12 months, and 508 (36.1%) consumed refined carbohydrates in-between meals less than once daily. The proportion of respondents who currently smoked cigarettes was 1.6%, and 91.7% of respondents used fluoridated toothpaste daily. The adjusted prevalence ratio of having caries increased by 18% for every additional age-year (APR: 1.18; 95% CI 1.004, 1.34). Additionally, participants with high socioeconomic status had significantly lower prevalence of caries compared to those with lower status (APR: 0.40; 95% CI 0.17, 0.91). Moderate/severe gingivitis was significantly associated with higher frequency of consuming refined carbohydrates in-between meals (APR: 2.33; 95% CI 1.36, 3.99) and higher plaque index scores (APR: 16.24; 95% CI 9.83, 26.82). Conclusion Caries prevalence increased with increasing age and was higher among Nigerian adolescents with low socioeconomic status, while moderate/severe gingivitis was associated with frequent consumption of refined carbohydrates and higher plaque index score. While behavioral interventions may reduce the risk of gingivitis, structural interventions may be needed to reduce the risk for caries in this population.

Objectives To evaluate the effects of different lingual retainers on periodontal health and stability of mandibular anterior teeth at the 1-year follow-up. Materials and Methods One hundred thirty-two patients were randomly allocated to four groups using different lingual retainers: group 1, 0.016 × 0.022-in dead-soft wire; group 2, 0.0215-in 5-strand stainless steel wire; group 3, 0.014 × 0.014-in computer-aided design/computer-aided manufacturing nitinol retainer (Memotain); group 4, connected bonding pads. Plaque, gingival, and calculus indexes were used to evaluate periodontal health, and Little's irregularity index, intercanine width, and arch length measurements were performed to evaluate stability. All measurements were performed at each time point (debonding and 3, 6, 9, and 12 months). Results The mean value of the gingival index obtained in group 3 was lower than the mean value for all other groups. The mean value of the calculus index was the lowest in group 3, and there was a significant difference between group 3 and groups 1 and 2. No differences were found among the groups in terms of plaque index, intercanine width, and arch length. The least irregularity was obtained in groups 2 and 3. There were no significant differences between these groups and groups 1 and 4. Conclusions Gingival inflammation and calculus accumulation were the lowest in group 3 (Memotain). The irregularity for Memotain and stainless steel retainers was less than or the other groups. However, no clinically significant worsening of periodontal health or relapse were seen in any groups after 1 year.

People of all ages are suffering from periodontal disease. It causes indirect damage in the oral cavity. It is of interest to evaluate the efficacy of xanthan-based chlorhexidine gel (Xan-CHX) in patients with mild-severe chronic periodontitis. Five patients with 60 sites were divided in two groups. Group A (treated with SRP) and group B (treated with Chlosite i.e., SRP + CHL). The recorded clinical parameters were Plaque index (PI), Gingival index (GI), Bleeding index (BI), and Clinical attachment Level (CAL) with sub gingival plaque subjected to microbial analysis. Significant reduction was observed in both groups. However, group B (treated with Chlosite i.e., SRP + CHL) showed statistically significant improvement on above mentioned parameters as compared to group A. Data suggest that in the treatment of periodontal disease (viz. PI, GI, BI and CAL) combination of SRP and Chlosite showed added benefits over only SRP.

Objectives To assess oral hygiene indices, dental status, and oral health practices among head and neck cancer patients at King Faisal Specialist Hospital and Research Center (KFSHRC)-Jeddah. Materials and Methods The charts of 117 patients with head and neck cancer were reviewed to identify the decayed/missing/filled teeth (DMFT) index, calculus index (CI), gingival index (MGI), and oral hygiene index. The type of cancer, other systemic diseases, and sex data were extracted from the records and analyzed using SPSS statistical software for descriptive statistics, Student’s t-test, analysis of variance (ANOVA), and Spearman correlation statistical analyses. Results The total mean DMFT index was 14.33. The significant caries index (SiC) for the studied sample was 25.87. Men had a mean DMFT of 14.11 (SD 9.8). The mean DMFT index for women was 14.63 (SD 9.7). The DMFT score for patients with systemic disease was 17.47 (SD 9.9). Patients with no other diseases had a mean DMFT score of 12.82 (SD 9.3). The DMFT index was not significantly different between men and women (p = 0.925). One-way ANOVA (F = 1.729) revealed no significant difference (p = 0.110) between DMFT scores according to the location of the cancer. DMFT with systemic disease showed no significant difference (p = 0.6) in comparison to patients without systemic disease. The Spearman rho statistic revealed no correlation between the DMFT score and CI (p = 0.383). Conclusions The total DMFT score was 14.33. The total SiC was 25.87. The DMFT scores of men and women were not significantly different. Cancer location and presence or absence of systemic diseases did not affect the DMFT score. The DMFT score and CI were not correlated, but a correlation was found between the DMFT score and MGI and the oral hygiene index.

Background: Gingival recession (GR) can result in hypersensitivity, esthetic concern to the patient, and chances for root caries. The purpose of this randomized clinical study was to evaluate the effect of guided tissue regeneration (GTR) procedure using a bioabsorbable collagen membrane in comparison to autogenous Subepithelial connective tissue graft (SCTG) for root coverage in Miller’s class I and II gingival recession defects. Materials and methods: In this split mouth study, 10 patients with 20 contralateral Miller’s class I or II recession defects were randomly treated with coronally advanced flap using either Subepithelial connective tissue graft (control group) or resorbable collagen membrane (experimental group). The clinical evaluations were done using plaque index, gingival index, height of gingival recession, probing sulcus depth and clinical attachment level at baseline, 3 and 6 months post- operatively. Results: Data analysis was done using descriptive statistics and student’s t test was used for comparisons. P value

The purpose of this study was to compare the anti-inflammatory efficacy of sodium chloride- and a 0.12% chlorhexidine mouth rinses in patients undergoing minimal invasive periodontal surgery. Forty-seven patients with a diagnosis of periodontitis and indication for access flap procedure were randomly selected. Group A: a sodium chloride (salt)water-based mouth rinse (test group) or group B: a 0.12% chlorhexidine mouth rinse (control group) administered after surgery. Gingival Index (GI) were evaluated in the whole mouth and in the surgical site at baseline (T1), a week later (T2), and 12 weeks (T3) after the treatment. Total MMP activity was measured in GCF using a commercial kit and plate reader. Medians of total MMP activity and GI were compared for time intervals T1 vs. T2, T1 vs. T3, and T2 vs T3 using Friedman tests and Wilcoxon signed rank tests, and were also compared between test and control using Mann-WhitneyU tests at each timepoint. The average GI values showed significant differences between baseline and T2 (p = 0.0005) and baseline and T3 (p = 0.003) in the test group. The sodium chloride-mouth rinse use after periodontal surgery seems to have similar anti-inflammatory properties as CHX mouth rinse and can be used regularly postoperatively after periodontal surgical procedures. The use of salt water mouthwash showed an anti-inflammatory effect similar to CHX 0.12% after minimal invasive periodontal surgery. Salt water mouthwash is accessible to the world population and can contribute on the healing process after periodontal surgery.

Background: Aim of the present meta-analysis was to evaluate the effect of Aloe vera in various forms such as gel, mouthwash, and dentifrice on gingival and plaque index (PI) in comparison to various allopathic products such as chlorhexidine, metformin, chlorine dioxide, fluoridated toothpaste, and alendronate. Materials and Methods: A comprehensive electronic search was conducted on PubMed/MEDLINE, GOOGLE SCHOLAR, and HAND SEARCH of reference list of archived articles published till January 2020. Randomized controlled trials were searched comparing the Aloe vera product with other products which used PI and gingival index (GI) to evaluate the outcomes. Finally, nine studies assessing PI and four studies evaluating GI were considered for the meta-analysis. After extracting the information, a risk of bias was estimated. The standardized mean differences (SMDs) and fixed and random effect models were obtained from the mean treatment differences. Results: The estimates of SMD of PI from fixed effects (SMD = 0.271, 95% confidence interval [CI] = 0.00134–0.407, P < 0.001) and random effects (SMD = 0.288, 95% CI = 0.048–0.529, P = 0.019) were found slightly different, the models showed consistent results yielding positive and significant treatment effects. For GI fixed effects (SMD = 0.27, 95% CI = −0.035–0.575, P = 0.0803, not significant) and random effects (SMD = 0.259, 95% CI = 0.049–0.469, P = 0.016, significant) were found slightly different and positive. However, one model showed significant and another model showed nonsignificant treatment effects. Conclusion: Results from our meta-analyses confirmed the beneficial effects of A. vera in improving the periodontal parameters and hence may be considered as a safe alternative drug delivery agent for the management of periodontal diseases in future.

© 2021 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.Aim: This study aimed to establish the efficacy of a rubber bristles interdental cleaner (RBIC) as an adjunct to toothbrushing (TB) compared to that of the adjuvant use of other interdental cleaning devices and TB alone on plaque and gingivitis parameters. Additionally, the safety aspects and panellists’ appreciation were evaluated. Materials and Methods: Databases were searched for randomized controlled clinical trials (RCTs) evaluating plaque (PI), bleeding (BS), and gingival index (GI) scores, safety assessments, and participants’ appreciation. Extracted data were summarized in a descriptive and, if possible, a meta-analysis. Results: The search retrieved 142 unique papers; six studies with 10 comparisons were included in a descriptive analysis. Five RCTs compared RBICs with interdental brushes (IDBs), four with dental floss (DF) and one with manual TB only. No comparisons to wood sticks were retrieved. Using an RBIC resulted in no difference in plaque scores compared to DF and IDBs. For overall bleeding scores, no difference was found. Two studies analysing the accessible sites separately found RBICs to be more favourable than DF and IDBs. Conversely, one study evaluating the efficacy of RBICs compared to IDBs, according to the GI scores, showed that IDBs achieved significantly greater reduction. Moreover, RBICs caused fewer gingival abrasions and were preferred by the study participants. Conclusion: Based on a descriptive and a meta-analysis of the available literature, it is synthesized that in gingivitis patients, a weak to very weak certainty exists that a RBIC is indicated for gingivitis and plaque reduction. The evidence supports user safety and participants’ preferences.

Background: The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. Methodology: Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. Results: The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 μg and in Group II was 0.91 ± 0.04 μg. A highly significant difference between both groups was found (P < 0.05). Conclusion: There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.

Background: Increased C-reactive protein (CRP) levels are associated with various diseases such as cardiovascular diseases (CVDs), periodontal diseases, and other inflammatory diseases and can be an effective biomarker for predicting future risks of periodontal diseases. Aims: The present trial was carried out to evaluate if CRP levels are lower in healthy and young individuals as compared to individuals with high body mass index (BMI), gingival index, and CVDs by assessing CRP levels in young and old individuals (more than 45 years). Materials and Methods: A total of 174 participants were recruited for the study and were divided into three following groups: Less than 45 years healthy participants (n = 124), more than 45 years healthy participants, and more 45-year-old participants with CVDs (n = 25). The collected data were subjected to the statistical analysis. Results: In Group I, females had a CRP level of 8476 ± 6.86 pg, females of Group II had a CRP value of 13,262 ± 3.76, and in females of Group III CRP value was 22,761 ± 6.24 pg. These values, respectively, for males were 8494 ± 7.68, 13,840 ± 4.82, and 13,839 ± 3.8. In smokers, the CRP values for Group I, II, and III were 29,012 ± 14.66, 12,568 ± 4.16, and 16,826 ± 3.42, respectively. Conclusion: CRP levels were higher in males as compared to females. Higher BMI was associated with higher values of CRP. The participants with higher BMI presented higher CRP values irrespective of age.

Introduction: Diet of an individual plays a remarkable role in maintaining health. Urbanization has had a great impact on the food habits of the society with the balance shifting to sweetened and refined food consumption. Dietary habits also has remarkable contribution to dental and overall health status. Aim: This study was designed to evaluate oral health awareness, practices, status, and the use of sugary products among urban and rural high school adolescents of Al-Ahsa, Saudi Arabia. Materials and methods: A cross-sectional mixed study was conducted using questionnaire and clinical examination among two female and two male urban and rural schools. Information on oral health awareness, practices, and use of sugar products were obtained using a self-reported structured questionnaire. Oral health status was assessed using decayed, missing, and filled teeth (DMFT) index, gingival index, Angle's classification at University dental clinics. The Chi-square test and t-test were performed using SPSS. Results and Discussion: Ninety-seven urban and one hundred and twenty-eight rural students with a median age of 17 years for males and 16 years for females completed the study. Eighty-five percent urban and 86% rural students demonstrated oral health awareness and practices, showing significant level for rural females (54%, P = 0.002) and urban females (72%, P = 0.006). Ninety-four percent urban and 89% of rural students used sugary products with a significant level for rural females (P = 0.001) for carbonated drinks only. Eighty-six percent of students had decayed, 22% missing and 38% filled teeth. Mean DMFT was 7.0 ± 4.7. Ninety-five (95%) participants showed mild-to-moderate gingivitis, 35% malocclusion, 11% other oral pathologies. Rural and urban difference for oral health parameters was significant only for filled teeth (P = 0.001) for urban and missing teeth (P = 0.019) among 15 years old for rural adolescents. Conclusion: This study demonstrates a good level of oral health awareness, but poor oral health status among both urban and rural students with an insignificant difference for most of the parameters studied.

Introduction: The dental health of people with disabilities has been reported to be worse than that of normal people. Maintenance of oral hygiene by tooth brushing is the most important and effective way of reducing levels of plaque and gingivitis.Aim: To evaluate the effectiveness of supervised tooth brushing in various special schools of Mathura district.Materials and Methodology: 160 subjects (6-14years) were selected for the study and the participants were divided into four groups depending upon their disability as: Down’s syndrome, Cerebral palsy, Autism spectrum disorder & Hearing impaired. Baseline of half of the subjects were maintained; Gingival & plaque index were recorded followed by oral hygiene instructions to all the children, supervising staff and caregivers. Plaque and gingival index were recorded again in 3 months and again reminded the taught technique & subsequently a 6 months follow-up.Result: Gingival health status was improved in all the groups. Statistical significant result was found in Plaque index of hearing impaired whose baseline were maintained and statistical analysis was done using paired t-test.Conclusion: School based dental programs for oral health education should be done regularly and frequently as it will help in avoiding the expensive and lengthy dental procedures.

Objective The aim: To study the clinical efficciency of the proposed scheme of gingivitis treatment in women with physiological course of pregnancy. Patients and methods Materials and methods: Clinical approbation of the proposed complex of therapeutic and prophylactic measures was carried out in 32 pregnant women with gingivitis, aged 18 to 35 years. The efficiency of the treatment was assessed by the dynamics of the clinical picture, the index assessment of an oral hygiene and the periodontium condition in each trimester of pregnancy. Results Results: According to the data of performed observations, the high efficiency of the proposed treatment scheme is shown: 84.4% in the main group versus 46.9% in the control group. It has been clinically proven that the proposed scheme of inflammatory periodontal diseases treatment in terms of therapeutic efficiency exceeds the generally accepted basic treatment. Conclusion Conclusions:The use of the proposed complex of therapeutic and prophylactic measures in the main group of patients contributed to the elimination of the inflammatory process in the periodontal tissues, suspended the progression of existing diseases, made it possible to prevent the emergence of new nosological forms, improved the condition of the oral hygiene, which makes it possible to recommend it for treatment of periodontal diseases in pregnant women.

Objectives To investigate plaque inhibition of 0.1% octenidine mouthwash (OCT) vs. placebo over 5 days in the absence of mechanical plaque control. Materials and methods For this randomized, placebo-controlled, double-blind, parallel group, multi-center phase 3 study, 201 healthy adults were recruited. After baseline recording of plaque index (PI) and gingival index (GI), collection of salivary samples, and dental prophylaxis, subjects were randomly assigned to OCT or placebo mouthwash in a 3:1 ratio. Rinsing was performed twice daily for 30 s. Colony forming units in saliva were determined before and after the first rinse. At day 5, PI, GI, and tooth discoloration index (DI) were assessed. Non-parametric van Elteren tests were applied with a significance level of p Results Treatment with OCT inhibited plaque formation more than treatment with placebo (PI: 0.36 vs. 1.29; p p = 0.003) and salivary bacterial counts (2.73 vs. placebo 0.24 lgCFU/ml; p p = 0.0011). Mild tongue staining and dysgeusia occurred. Conclusions OCT 0.1% mouthwash inhibits plaque formation over 5 days. It therefore can be recommended when regular oral hygiene is temporarily compromised. Clinical relevance When individual plaque control is compromised, rinsing with octenidine mouthwash is recommended to maintain healthy oral conditions while side effects are limited.

Background and Objectives: Miswak is the public name of Salvadora persica, which is beneficial for dental treatments and can thus be used to treat gingivitis. This study compares the therapeutic effects of miswak (S. persica), toothbrush, S. persica mouthwash, and chlorhexidine mouthwash on patients with mild to moderate gingivitis by estimating gingival index and (debris) plaque index. Patients and Methods: The study is a selective sampling, cross-sectional, clinical comparative study of 50 systemically healthy patients in Erbil city. The patients were divided randomly into five groups, with each group having 10 patients. Group 1 used S. persica chewing stick only; group 2 used toothbrush only; group 3 used both S. persica and toothbrush, group 4 used S. persica mouthwash and toothbrush; while group 5 used chlorhexidine mouthwash and tooth-brush. The patients’ mouths were examined, recording clinical indices before and after four weeks from the administration of treatments. Results: There is significant improvement observed between groups 3 and 1 and groups 3 and 2 regarding gingival index. Moreover, there is significant improvement in debris (plaque) index between groups 2 and 3 and groups 2 and 1. Conclusion: The gingival index indicates that using S. persica and toothbrush together is better than using S. persica or toothbrush alone. Meanwhile, the debris index shows that using S. persica alone or using it with toothbrush is more effective than using toothbrush alone. Keywords: Salvadora persica, gingivitis, gingival index, debris index.

Aim The aim of this study was to systematically review and analyse the difference in efficacy of stannous fluoride toothpaste formulations in comparison to other fluoridated toothpastes without stannous fluoride. Materials and methods A systematic search of the literature was performed according to PRISMA guidelines. A search strategy was developed to answer the study question and was performed in PubMed-Medline databases. Inclusion criteria were randomised controlled clinical trials comparing stannous fluoride toothpaste formulations with other fluoridated toothpastes not containing stannous fluoride. Results The search in PubMed-Medline databases resulted in 384 articles; 23 articles were downloaded for review, 16 articles were included in the report and six could be used for meta-analysis. All studies were randomised controlled clinical trials that compared clinical outcomes between toothpastes with stannous fluoride combinations and toothpastes with only fluoride. The overall results of the 16 studies favoured the stannous fluoride formulations. However, in a meta-analysis of the randomised controlled clinical trials, it was demonstrated that stannous fluoride toothpaste formulations provided significantly better outcomes based on the Gingival Index (SMD -0.14, 95% CI -0.20, -0.07, P = 0.0001), but not the Modified Gingival Index (SMD -0.30, 95% CI -0.7, 0.09, P = 0.13). Practical implications The antibacterial properties of stannous seem to provide favourable results when formulated with a fluoridated toothpaste. This systematic review highlights the lack of homogenous research available to rigorously compare stannous fluoride toothpaste formulations with other fluoridated toothpastes without stannous fluoride.

Background:Because smoking is harmful to free gingival graft procedures,donor site healing, graft shrinkage and success of root coverage,so The present study was designed to evaluate effect of light smoking(≤10 cigarettes per day)and number of years of cigarettes smoking on free gingival graft procedures (donor site healing and graft shrinkage, success). Methods: A total of 22 patients with miller classI,II gingival recession consist of two group,groupI was 12 non-smokers and groupII 10 smokers(≤10 cigarettes per day,less than five years on smoking habits) . All patients treated with free gingival graft. Phase I therapy was performed for all patients to provide an oral environmental more favorable to wound healing.. The following clinical indices measurements of plaque index, gingival index, probing depth clinical attachment level, recession height ,recession width, width of keratinized gingiva, gingival thickness, graft shrinkage (length, width),immediate and delayed bleeding, complete epithelization and discomfort, sensibilty disorder all were recorded at 1 month,3month and 6month. Results: the non smokers group showed significant decrease of recession width and graft shrinkage area compared to smokers group, The clinical parameters showed improvement in non-smoker group more than smokers group but the difference was not statistically significant.probing depth,clinical attachment level, Recession height, keratinzation tissue width , gingival thickness, the improvement occurs at all follow up periods was more in non smokers than smokers Conclusion: following free gingival graft procedures,free gingival graft undergoes graft shrinkage which decrease amount root coverage ,light and young smokers showed increased in recession width and graft shrinkage area .

To prospectively compare the short-term periodontal effects and survival rates of mandibular lingual canine-to-canine Memotain (CA-Digital, Mettmann, Germany) and five-stranded bonded retainers.In all, 52 patients requiring retention after orthodontic treatment were assigned to 2 study groups (n = 26 in each group). Retention was provided by Memotain retainers which were fabricated digitally using CAD-CAM (computer-aided design and computer-aided manufacturing) technology in the first group and by five-stranded retainers which were fabricated manually using a conventional bending method in the second group. The patients were examined at the following time points: 1 week, 1 month, 3 months and 6 months. Plaque index, gingival index, probing depth, marginal recession, bleeding on probing, failure rate per tooth, and survival rate of retainer wires were analyzed by Mann-Whitney U, Friedman, Wilcoxon signed-rank, and χThe differences between the groups were nonsignificant for plaque index, gingival index, probing depth, marginal recession, bleeding on probing, failure rate per tooth and survival rate of retainer wires. Significant differences were observed within the groups throughout the follow-up period for plaque index and probing depth. The survival rates of retainer wires were 77% for the Memotain retainers and 73% for the five-stranded retainers for the 6‑month follow-up period.Periodontal outcomes and survival rates of Memotain and five-stranded mandibular lingual bonded retainers were similar. Furthermore, periodontal health was maintained and considerably high survival rates were achieved with both retainer types.ZIELSETZUNG: Prospektiver Vergleich der kurzfristigen parodontalen Effekte und Überlebensraten von Memotain (CA-Digital, Mettmann, Deutschland) und fünfsträngigen geklebten Eckzahn-zu-Eckzahn-Retainern im Unterkiefer.Insgesamt wurden 52 Patienten, die nach kieferorthopädischer Behandlung eine Retention brauchten, in 2 Studiengruppen eingeteilt (n = 26). Die Retention erfolgte in der ersten Gruppe durch Memotain-Retainer, die digital mit CAD-CAM(„computer-aided design and computer-aided manufacturing“)-Technologie hergestellt wurden, in der zweiten Gruppe durch fünfsträngige Retainer, die manuell mit einer konventionellen Biegemethode hergestellt wurden. Die Patienten wurden zu den folgenden Zeitpunkten untersucht: 1 Woche, 1 Monat sowie 3 und 6 Monate. Plaqueindex, Gingivaindex, Sondierungstiefe, marginale Rezession, Blutung bei Sondierung, Ausfallrate pro Zahn und Überlebensrate der Retainerdrähte wurden analysiert (Mann-Whitney-U-, Friedman‑, Wilcoxon-Signed-Rank- und χDie Intergruppen-Unterschiede waren für den Plaqueindex, den Gingivaindex, die Sondierungstiefe, die marginale Rezession, die Blutung bei Sondierung, die Ausfallrate pro Zahn und die Überlebensrate der Retainerdrähte nicht signifikant. Während der gesamten Nachbeobachtungszeit wurden innerhalb der Gruppen signifikante Unterschiede beim Plaqueindex und bei der Sondierungstiefe beobachtet. Während der 6‑monatigen Nachbeobachtungszeit betrugen die Überlebensraten 77% für die Memotain- und 73% für die fünfsträngigen Retainer.Die parodontalen Ergebnisse und die Überlebensraten für Memotain- und fünfsträngige lingual geklebte Retainer im Unterkiefer waren ähnlich. Darüber hinaus blieb die parodontale Gesundheit erhalten und es wurden mit beiden Retainer-Typen erheblich hohe Überlebensraten erzielt.

Introduction: Periodontal dressings, also known as periodontal packs, have been employed over centuries for the purpose of protection of surgical sites. Many modifications have been made to improve their physical and therapeutic properties. Hence this study was designed to compare and evaluate the clinical efficacy of light cured periodontal dressing to most widely used non-eugenol pack. Materials and method: Ten patients suffering from generalized chronic periodontitis, requiring periodontal flap surgeries on contralateral sides of the arch were selected and randomly divided into two groups: Group I (Control group) and Group II (Test group). In Group I, non-eugenol periodontal dressing and in Group II light cured periodontal dressing was applied at the surgical sites. Clinical parameters that were assessed on day 7 after the removal of the pack are debris index, plaque scores and gingival index. Patients were also be assessed for acceptance and compliance of the material. All the data recorded was then statistically analysed. Result: Group II showed better results when compared with the control group on debris index, plaque scores and gingival index, though the differences were found to be statistically insignificant. Group II also showed better results in terms of esthetics, associated mucosal problems, retention of the dressing and over all patient satisfaction.Conclusion: Light cured periodontal dressing showed better patient acceptability and compliance and could be considered to be a clinically efficient and alternative to the non-eugenol pack as the periodontal dressing.

Background: Effective and selective oral rinses are required in the daily medical and dental practice. Currently mouthwashes used have substantial side effects. Objectives: Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods: This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The search terms used were “chlorine dioxide” AND “oral”, and only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2-tests. Results: 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487-0.952 vs 0.489-1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457–0.967 vs 0.489– 1.001, respectively) and also in bacterial counts. Conclusion: Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this outcome is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.

People with a diagnosis of serious mental illness (SMI) have a greater incidence of poorer oral health as compared to the general population. The aim of this quasi-experimental study was to determine the effect that a combination of the use of a battery-operated toothbrush and a related educational intervention may have on the oral health of individuals with serious mental illness. Key findings include that the battery-operated toothbrush resulted in a significant improvement in the mean change in gingival index, a common indicator of oral health. The study also found that oral home care instructions, smoking and level of negative symptoms did not have an effect on the mean change in plaque or gingival indices. This project suggests that the implementation of a relatively simple, cost effective measures such as a battery-operated toothbrush may have a positive impact on the oral health in this population.

Aim The aim of this study was to assess self-reported oral health attitudes and behaviors of the Iraqi dental students and compare the variations in these attitudes and behaviors that linked to dental education level and gender. Materials and methods A self-administered questionnaire depended on the English version of the Hiroshima University Dental Behavioral Inventory (HU-DBI) was prepared, the questionnaire given to 198 dental students. Results About 91.4% of the dental students were worried about the teeth colour, and merely minor percentage of them (18.8%) thought it is not crucial to seek dental advice until they acquire a tooth pain; however, 26.3% of the students were disturbed because of their gum colour, and 75.3% of them examined their teeth after brushing. Besides, 72.2% of the students replied that gum disease could not be prevented by tooth brushing only, 60.1% of the students do not give visiting the dentist such concern, and 14.1% of dental students were smokers. The plaque and gingival indices were significantly higher in preclinical students than clinical students. Conclusion Iraqi dental students had somewhat good oral health behavior and attitudes; however, extra concentrating is required on the anticipatory and behavioral aspects of oral self-care practices. Female dental students displayed better oral health behavior and attitudes than male colleagues on some issues.

Objectives This clinical study measured the change in opening and height of the displaced gingiva using paste and cord retraction materials for definitive impression making of natural teeth and assessed if they were comparable and clinically acceptable. Methods Impressions of 4 maxilla premolars from 10 participants were taken using a split-mouth protocol. All participants were free of periodontal disease, had a thick biotype, a minimal of 3 mm height of keratinized gingival tissue and gingival sulci depths of 2 mm. The bleeding index (BI), gingival index (GI) plaque index (PI), sulcular depth, level of attachment and tooth sensitivity were recorded at baseline, just after retraction, at 24 hours and at 2 weeks. Impressions were poured in stone and then after initial analysis were cross-sectioned to allow measurements of the gingival height change and gap size to be recorded. Results The paste produced a slightly smaller gap compared to the cord (0.041 mm less, P = .014) whilst the mean displacement for the cord was 0.282 mm and paste was 0.241 mm respectively. Gingival height with the paste was 0.047 mm lower than that achieved by the cord (P = .208). Conclusions Cord and paste retraction produced comparable clinically acceptable gingival gaps, with the cord producing statistically larger gap size. Clinical significance The cord and paste retraction materials produced comparable clinically acceptable gingival retraction.

Purpose: The current clinical study was done to examine clinical and biochemical changes of Vascular Endothelial Growth factor (VEGF) biomarker present in (GCF) in response to LLLT combined with Platelet Rich Fibrin (PRF) & bovine xenograft to treat infra-bony defects. Material and methods: The current study was conducted on twenty (20) sites from ten (10) patients. A spilt-mouth design used, sites were randomly selected from each patient, into two groups: laser group; ten (10) sites received PRF system without irradiation, and control group; ten (10) sites received PRF system and it will be irradiated with low level laser. Clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), Plaque index (PI), and gingival index (GI). ELISA quantification analysis of VEGF was done. Results: comparison between the groups at 6 months showed significant difference between both Probing depth and clinical attachment level, while Plaque index and Gingival index showed a significance difference starting from 2 weeks postoperatively. VEGF revealed no significant difference among groups. Conclusion: The using of low intensity laser with PRF system showed an improvement in the outcome of infra bony defects treatment.

Objectives: The purpose of this study is to compare the clinical, antibacterial and microbiological effects of the non-fluoride and fluoride toothpastes. Materials and Methods: In this study eighty children (3 to 12 years old) were divided into four groups and followed for four weeks. First and second groups (40 children, 6-12 years) used different fluoride toothpastes; third and fourth groups (40 children, 3-5 years) used nonfluoride toothpastes. The halitosis score, plaque index, gingival index, bleeding index, buffering capacities, Mutans Streptococci, Lactobacilli and yeast counts were recorded on 1st day, 7th day, 15th day and 30th day. First and second group; third and fourth group were compared with each other. Data were analyzed statistically by using Mann Whitney U tests, Wilcoxon Sign Test, Fisher Freeman Halton Exact Test and Mc Nemar Test with a significance level of p0.05), between groups on first day. All four toothpastes produced statistically significant reductions from 1st day to 30th days in scores of halitosis, plaque index, gingival index, bleeding index and buffering capacity (p0.05). Conclusion: All tested toothpastes proved to be safe and significantly effective clinical and microbiological features.

Background: There are several potential advantages in optimizing the initial events of osseointegration in the benefit of clinical outcome. Objective: The objective of the present study was to evaluate the behavior of osteoblastic cells on surfaces treated by double acid etching using HNO3 and H2SO4. Methods: Commercially pure titanium (grade 4) discs measuring 6 mm in diameter and 2 mm in thickness were used. The discs were divided into two groups: machined group and double acid-etched discs (HNO3 and H2SO4). Surface characteristics were assessed using Scanning Electron Microscopy. Pre-osteoblastic MC3T3-E1 cells were used for cell culture on the tested surfaces to assess proliferation, viability (MTT), as well as secretion (ELISA) and cytoplasmic expression (Western blot) of type I collagen. Results: The data obtained were analyzed using t-test or two-way ANOVA followed by Bonferroni’s test at 95% significance. The titanium surfaces showed average roughness values for the machined and treated surfaces of 0.29 and 1.16, respectively (pp Conclusion: Implant surfaces treated by double acid etching positively affected the early events of the interaction between titanium and osteoblastic cells, suggesting optimization of osseintegration.

Objectives To evaluate the effects of adhesive precoated (APC) flash-free brackets on enamel demineralization and periodontal status in patients during fixed orthodontic treatment. Materials and Methods Thirty patients, age 12 to 18 years, who had Angle Class I or Class II malocclusion with mild to moderate crowding in the permanent dentition were selected for this study. APC flash-free and conventional ceramic brackets were bonded for a split-mouth study design. The quadrant allocation was randomized. Demineralization records were obtained immediately after bonding (T0), 1 month after bonding (T1), and 6 months after bonding (T2). Clinical periodontal measurements, including gingival index, plaque index, and bleeding upon probing, were obtained before bonding (T0) and at the same time points (T1 and T2). Data were analyzed using Mann-Whitney U and Friedman tests to compare parameters between groups and times. Results Demineralization values decreased on most sides of the brackets for both groups between T0 and T1. In the conventional group, there was significantly higher demineralization on more sides compared with flash-free brackets between T1 and T2. With one exception, the decreased values were found in the incisal/occlusal sides of all brackets at T2. All periodontal parameters showed significant increases after 6 months of treatment in both groups. Intergroup comparison showed no significant differences in demineralization or periodontal measurements at any of the time points. Conclusions The effects of APC flash-free and conventional brackets on enamel demineralization and periodontal health did not differ from each other.

Introduction: The study was conducted to assess the impact of oral health status on the oral health-related quality of life (OHRQOL) of children between 12 and 15 years with type-1 diabetes mellitus (IDDM) in Saudi Arabia and compare these findings to age and gender matched medically fit children. Materials and Method: A total of 40 children aged between 12 and 15 years with (IDDM) group presenting to the pediatric endocrinology clinic of the KSMC, Riyadh were age and gender matched to a control group of children reporting for a routine dental checkup at the dental clinics of the REU. The oral health of all children was recorded using WHO examination criteria. Parental perception of the OHRQoL was recorded using the validated Arabic version of the short-form child oral health impact profile—short-form COHIP-19. The independent samples t-test was used to compare the DMFT, Gingival index, and COHIP19 domains of the two groups. Results: Individuals with IDDM had higher Gingival Index and DMFT scores; however, the differences were not statistically significant. The IDDM group showed higher COHIP scores across all domains. However, the differences were only statistically significant for the oral health domain (P = 0.003). Conclusion: Children with IDDM had better oral health both in terms of dental caries and gingival status when compared to their age-matched controls. However, they had significantly higher oral health domains that suggest a poorer overall OHRQoL in children with IDDM.

INTRODUCTION: Gingival and periodontal diseases are still the most common prevalent oral diseases affecting a community/individual people and can lead to irreversible consequences, both local (bone loss, tooth mobility etc. ) and systemic (Cardiac Disease etc.) AIM: To compare the efficacy of NBF gingival gel alone and as an adjunct to conventional therapy in patients with gingivitis MATERIALS AND METHOD: This randomized study design (parallel arm study design) consisted of 7 patients with 21 quadrants and having a score 2 (moderate gingivitis) & 3 (severe gingivitis) based upon the gingival score given by Loe & Silness (1964). All the subjects were evaluated by two parameters i.e. gingival index [Loe & Silness (1964)] and Papillary Bleeding Index [Muhleman (1977)] at baseline and after one month of rendering treatment. Following random allocation (flip of coin), the first Group was given conventional therapy [Scaling and Root Planing(SRP)] followed by NBF gingival gel application, while the 2nd Group was given NBF gel application alone and the 3rd Group was given conventional therapy (SRP) alone. Statistical analysis was done using SPSS version 19.0 using paired t‑test as well as the Wilcoxon Signed Rank test. RESULTS: After follow up, the highest percentage of mean scores of gingival index decreased among all the groups was seen in group 1 (38.15±5.46), followed by group 3(32.54±7.58) and group 2(18.91±7.62). Similarly, in the Papillary Bleeding Index, the highest percentage reduction was seen in group 1 (82.30±2.39), followed by group 3(53.54±6.02) and group 2(31.71±4.34). All observed values were significant with p≤05. CONCLUSION: NBF gel seems to provide to boost the immunity of the gingiva and periodontium, and when used as an adjunct to conventional therapy (SRP) can benefit the patient immensely.

AIM The study aimed to assess the efficacy of using WhatsApp instant messages in enhancing the oral hygiene in patients with gingivitis. MATERIALS AND METHODS Forty-three systemically healthy male dental patients with gingivitis were recruited consecutively and randomly divided into two groups: WhatsApp group (n = 24) and a control group (n = 19). At baseline visit, the participants were educated and motivated about oral health and given a folio on instructions about the oral hygiene preventive measures. The participants in the study group further received WhatsApp messages about the dental care at weekly intervals throughout the study (3 months). Plaque index (PI) and gingival index (GI) were measured at baseline and after 1 and 3 months. RESULTS The averages of PI and GI were not significantly different between both groups at any time point of measurement (baseline, after one, and three months; p value >0.05). Intragroup comparisons revealed that the reductions in PI were highly significant after 1 and 3 months (-0.26 ± 0.26 and -0.57 ± 0.35, respectively, for WhatsApp group, and -0.24 ± 0.27 and -0.64 ± 0.4. respectively, for the control group; p value range: 0.001 to

Aim: The aim of the study was to compare light-cured dressing with most widely used noneugenol pack in the perspective of esthetics, acceptance, and healing following periodontal flap surgery. Materials and Methods: Fifty-eight patients suffering from generalized chronic periodontitis, requiring periodontal flap surgery on contralateral sides of the arch, were selected and divided randomly into Group I (control) and Group II (test). In Group I, a noneugenol dressing and in Group II light-cured dressing were applied after flap surgery. Clinical parameters such as debris index, plaque index, and modified gingival index were recorded at baseline (day 0) and 10 days postoperatively (after removal of the dressing). The data were collected and statistically analyzed. Results: Group II showed better results than Group I when debris index, plaque index, and modified gingival index scores were compared though the differences were not statistically significant. Patients found no unpleasant taste/smell and perceived the light-cured dressing to be better. Conclusion: The noneugenol dressing retained more plaque on its undersurface than light-cure dressing. However, this did not have much influence on the healing outcome and clinical gingival parameters, which were optimal and comparable in both groups. The greater number of patients showed a preference for light-cure dressing, based on its superior esthetics and taste.

Background: This study aimed to identify the prevalence and potential factors associated with Entamoeba gingivalis in adolescents in the city of Kerman, southeastern Iran, 2017. Methods: In this descriptive cross-sectional study, 315 adolescents (mean age; 15 yr) consisting of 189 males and 126 females were randomly selected. For each adolescent, two specimens were collected for culturing and examination by polymerase chain reaction (PCR). Univariate and multivariate logistic regression models were performed to explore any association with demographic and clinical variables. Results: The prevalence of E. gingivalis was 11.7%. Totally, 30 (15.9%) males and 7 (5.6%) females were infected with E. gingivalis. The rate of infection in males was 2.8 times higher than that in females (P

Aim: To evaluate the efficacy of Clorni* gel as an adjunct to phase 1 therapy, in the treatment of gingivitis. Methodology: The study was carried out on 30 patients. Group 1(control group): scaling and root planing, oral hygiene instruction and Hexi* gel application. Group 2(test group): scaling and root planing, oral hygiene instruction and Clorni* gel application. Clinical parameters like Gingival Index, Plaque Index and Papillary Bleeding Index were recorded at baseline, one week and after one month for each patient. Results: There were reduction in the PI, GI and Papillary bleeding index scores in both the groups. Within the groups (group1 and group 2) clinical parameters showed overall reduction from baseline to 1 month and on multiple analysis the results were statistically significant from baseline to one month, but no statistical significance was seen from one week to one month. On comparison between the groups there was no statistical significance in the clinical parameters. Conclusion: Clorni gel can be used as an adjunct to SRP in the treatment of gingivitis.