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Objective: To evaluate the advantages of a novel protocol involving full-mouth erythritol-powder air-polishing followed by ultrasonic calculus removal in the maintenance of patients treated for gingivitis, with a focus on time and comfort., Methods: Systemically healthy patients with gingivitis were selected. Following a split-mouth design, quadrants 1-4 and 2-3 were randomly allocated to receive air-polishing followed by ultrasonic calculus removal following a protocol known as Guided Biofilm Therapy (GBT) or traditional full-mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US + P). Bleeding on probing (BoP) and the plaque index (PI) were collected at baseline (T0), 2 weeks (T1), 4 weeks (T2), 3 months (T3), and 6 months (T4) and 12 months (T5). Following the same randomization, prophylactic therapy was provided at 3 months (T3) and 6 months (T4). Clinical parameters, treatment time and patient comfort and satisfaction were evaluated., Results: A total of 41 patients were selected, 39 completed the study. The clinical parameters were clinically satisfactory for both treatments at every time. At 4 months after treatment, GBT maintained significantly lower BoP and PI. GBT protocol required a significantly lower treatment time, especially at T3 and T4, when it saved 24.5% and 25.1% of the time, respectively. Both treatments were rated positively by most patients. However, GBT was perceived as more comfortable, and a higher number of patients preferred it., Conclusion: No significant difference was observed between GBT and conventional ultrasonic debridement and rubber cup polishing in terms of BoP and PI levels. The GBT protocol allowed less time expenditure and higher patients' perceived comfort., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The aim of the study is to evaluate the effectiveness of different toothbrushes in reducing gingival inflammation and dental biofilm removal in gingivitis patients with fixed orthodontic appliances., Methods: Following baseline clinical assessments, including the Turesky modification of the Quigley-Hein plaque index (TQHI), gingival index (GI), bleeding on probing (BOP), and probing pocket depth (PPD), all patients received nonsurgical periodontal therapy. Patients were then randomly assigned to one of three groups: conventional toothbrush (C-TB), orthodontic toothbrush (O-TB), or single-tufted toothbrush (ST-TB). Each group received tailored oral hygiene instructions based on their assigned toothbrush type. Clinical assessments were repeated and recorded in the first week, sixth week, and third month., Results: Thirty-six patients with a mean age of 23.14 ± 3.86 (18-32 years) participated in the study. All groups with twelve patients each demonstrated significant improvements in clinical parameters compared to baseline. In the sixth week, the O-TB and ST-TB groups showed significantly greater improvements in TQHI and BOP scores compared to the C-TB group (p < 0.05). By the third month, the ST-TB group maintained significantly lower TQHI and BOP scores, while the O-TB group's scores became similar to those of the C-TB group. ST-TB and C-TB groups had significantly lower GI scores than the O-TB group in all time points. Although the effectiveness of ST-TB was significantly higher than that of other toothbrushes, all toothbrushes demonstrated lower efficacy in the posterior region., Conclusions: The ST-TB was shown to be more effective in reducing gingival inflammation over three months, while it demonstrated similar efficacy to the O-TB in dental biofilm removal. Further research is necessary to substantiate these findings and to demonstrate the efficacy of this approach in promoting periodontal tissue health in patients with fixed orthodontic appliances., Trial Registration: This study was registered with the National Library of Medicine Clinical Trials Registry Platform on 19/07/2024 as NCT06510179., (© 2024. The Author(s).)

Background: This single-blind randomized controlled trial was aimed to evaluate the microbiological and clinical effects of Zeger therapy on gingival health., Methods: Twenty-four adults with gingivitis were recruited and monitored micro-biologically and clinically at baseline (Day 0), 4 weeks (Day 29) after therapy. All volunteers received one-stage full-mouth supragingival scaling as basic oral health care for baseline, and then randomly divided into experimental (koumiss, n = 12) or control (none, n = 12) group. The koumiss was used once a day for 4 weeks., Results: The microbial diversity of the experimental group increased significantly after drinking koumiss (p < 0.05), mainly owing to increasing of Gram-positive bacteria (p = 0.038) and oral health-related microbes (Rothia, Corynebacterium, Actinomyces, Saccharibacteria&#95;TM7, etc.), decreasing of Gram-negative bacteria (p = 0.009) and periodontal disease-related microbes (Porphyromonas, Fusobacterium, Veillonella, etc.), while the microbial diversity of the control group had no significant change (p > 0.05). However, there was no significant difference between the two groups in the clinical parameters (p > 0.05)., Conclusions: Zeger therapy promotes the diversity of supragingival microbiome in adults with gingivitis and increases the abundance of some beneficial flora while decreasing some harmful without clinical parameters marked changing, which holds promise for improving of gingivitis and may be a valuable oral health care approach in the future., Trial Registration: The clinical trial was approved by the Medical Ethics Committee of West China Hospital of Stomatology, Sichuan University, batch No. WCHSIRB-D-2021-428. Before patient registration began, the prospective clinical trial was registered in www., Clinicaltrials: gov public repository in China under the registration number ChiCTR2200060555 on 04/06/2022., (© 2024. The Author(s).)

The occurrence of desquamation, shedding and erythema on marginal and attached gingiva is described as desquamative gingivitis (DG). Various autoimmune/dermatological disorders cause DG.The aim of the present systematic review was to gather information on all possible kinds of treatment for DG, based on specific DG diagnoses.The review was organized following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol. An electronic search was conducted in the PubMed, Scopus and Google Scholar databases, up to April 2022. Reviews, letters and studies with less than 2 participants were excluded.Fifteen publications matched the eligibility criteria: 6 case series; 5 clinical trials; 3 randomized clinical trials (RCTs), and 1 cohort study. A total of 330 patients were enrolled, mostly women (81.52%), with an average age of 57.6 years. Diagnostic characteristics corresponded to oral lichen planus (OLP) (n = 249), mucous membrane pemphigoid (MMP) (n = 30), pemphigus vulgaris (PV) (n = 19), plasma cell gingivitis (PCG) (n = 4), erythema multiforme (EM) (n = 1), and non-specified diseases (NSD) (n = 27). Oral lichen planus and MMP were eliminated using oral hygiene instructions with topical clobetasol and/or doxycycline monohydrate. Pemphigus vulgaris, PCG and EM were treated with topical clobetasol.To conclude, each DG case requires personalized treatment, depending on the diagnosis.

A common condition found in many patients, gingival inflammation results from irritation from dental plaque and the bacteria contained in plaque. Although effective management of dental plaque and the resulting gingivitis through daily homecare continues to be heavily emphasized, the high prevalence of oral diseases globally suggests that most individuals do not achieve sufficient plaque removal with their manual toothbrushing routine. To help enhance a patient's homecare regimen, daily oral rinsing has been shown to improve oral hygiene. The simple use of mouthwash after toothbrushing optimizes plaque removal while leading to an improvement in gingival health. This article reviews a single-center, randomized, controlled, single-blind, 6-week study designed to evaluate the safety and efficacy of a professional chlorhexidine alternative oral care mouthrinse as an adjunct to toothbrushing with sodium fluoride toothpaste with regard to plaque removal and gingivitis reduction.

Chronic inflammatory processes in the oral mucosa and periodontitis are common disorders caused by microflora and microbial biofilms. These factors activate both the innate and adaptive immune systems, leading to the production of pro-inflammatory cytokines. Cytokines are known to play a crucial role in the pathogenesis of gingivitis and periodontitis and have been proposed as biomarkers for diagnosis and follow-up of these diseases. They can activate immune and stromal cells, leading to local inflammation and tissue damage. This damage can include destruction of the periodontal ligaments, gingiva, and alveolar bone. Studies have reported increased local levels of pro-inflammatory cytokines, such as interleukin-1beta (IL-1beta), tumor necrosis factor (TNF), IL-6, IL-17, and IL-23, in patients with periodontitis. In experimental models of periodontitis, TNF and the IL-23/IL-17 axis play a pivotal role in disease pathogenesis. Inactivation of these pro-inflammatory pathways through neutralizing antibodies, genetic engineering or IL-10 function has been demonstrated to reduce disease activity. This review discusses the role of cytokines in gingivitis and periodontitis, with particular emphasis on their role in mediating inflammation and tissue destruction. It also explores new therapeutic interventions that offer potential for research and clinical therapy in these chronic inflammatory diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Neurath and Kesting.)

Objective: The purpose of this study was to investigate interleukin (IL)-1β, IL-18, nod-like receptor pyrin domain-containing protein 3 (NLRP3), apoptosis-related speck-like protein containing a caspase activation and recruitment domain (ASC), and caspase-1 levels in saliva and serum in different periodontal diseases and to evaluate the changes after non-surgical periodontal treatment (NSPT)., Design: A total of 45 participants, 15 healthy, 15 gingivitis, and 15 stage III grade C (SIIIGC) periodontitis patients, were included in the study. Periodontal parameters were assessed, and salivary and serum samples were collected at baseline in all groups and one and three months after NSPT in gingivitis and periodontitis groups. An enzyme-linked immunosorbent assay was used to analyse IL-1β, IL-18, NLRP3, ASC, and caspase-1 levels., Results: After NSPT, improvement was observed in all clinical parameters, along with periodontal inflamed surface area (PISA) in gingivitis and periodontitis groups. PISA scores were positively correlated with IL-1β, NLRP3, and caspase-1 at baseline (p < 0.05). Salivary and serum IL-1β, NLRP3 levels were higher in periodontitis compared to healthy controls at baseline and reduced after treatment (p < 0.05). Receiver operating characteristic analysis revealed that salivary IL-1β, NLRP3, and caspase-1 had the ability to discriminate SIIIGC periodontitis patients from healthy subjects (p < 0.05)., Conclusion: In conclusion, salivary IL-1β, NLRP3, and caspase-1 are at aberrantly high levels in SIIIGC periodontitis and are remarkably decreased following NSPT; these inflammasome biomarkers may show potential utility in diagnosing and monitoring periodontitis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Periodontal disease during pregnancy can produce adverse events; in the current study stress was investigated as an exacerbating factors of periodontal disease. The aims of this study were to evaluate the possible associations between stress and pregnancy through scanning for gingivitis and to explore the effect of non-surgical periodontal therapy (NPT) on stress-related markers (CgA, AA, β-endorphin, DHEA, sIgA and NPY) and sex steroid levels (estrogen and progesterone) in pregnant and non-pregnant women., Material and Methods: A total of 87 subjects; 22 pregnant women with gingivitis, 25 periodontally healthy pregnant women; 22 non-pregnant women with gingivitis and 15 periodontally healthy non-pregnant women, participated in this study. Periodontal clinical measures, stress hormones and sex steroid levels were measured at baseline and following the periodontal therapy., Results: While periodontal therapy showed an improvement in salivary CgA, AA, β-endorphin, DHEA, and sIgA levels (p<0.05) in non-pregnant women with gingivitis; neuropeptide Y levels were found to be unaffected (p>0.05). There were no significant changes in salivary CgA, AA, DHEA, sIgA, and neuropeptide Y levels in pregnant women with gingivitis (p>0.05); however, a decrease in β-endorphin levels was observed after therapy (p<0.05). Pregnant women with gingivitis had higher gingival crevicular fluid (GCF) β-endorphin levels in comparison to non-pregnant women with gingivitis., Conclusions: Gingival inflammation can be a psychosocial stress inducing factor during pregnancy. Furthermore, periodontal therapy may assist in reducing stress-related hormone levels in GCF during pregnancy.

Objectives: To evaluate, (i) if subjects submitted to a structured oral hygiene training program (OHt) maintain adopted habits over 180 days without professional guidance; and (ii) in perspective whether flossing provides additional benefits to toothbrushing on gingival health., Materials and Methods: Seventy-five adult subjects showing approximately 40% proximal gingival bleeding were randomized to receive OHt (1 session weekly over 8 weeks) using toothbrush and dental floss or toothbrush alone. The subjects were then followed over 180 days without professional guidance. Primary outcomes were mean interproximal Gingival Index (GI) and GI = 2 (gingival bleeding). Mixed linear models were used for the comparison between groups (p < 0.05)., Results: 68 subjects received OHt, 48 subjects completed the 180-day follow-up. Subjects maintained adequate oral hygiene routines. Besides a reduction in gingival inflammation, no alterations in gingival status were observed among groups, subjects additionally instructed to use dental floss showing a mean interproximal GI = 2 of 12.8 ± 2.5 compared with 19.8 ± 2.2 for subjects limited to tooth brushing alone., Conclusions: OHt intensive training promotes gingival health and maintenance lasting at least 6 months without professional supervision reinforcing important principles: (i) dental health professionals should dedicate time training and motivating their patients to reach adequate self-performed plaque control; and (ii) the adjunctive use of dental floss appears essential to reduce interproximal gingival inflammation in subjects with intact interdental papillae., Clinical Relevance: Dentists need to invest time in training/motivating/engage their patients to achieve adequate OH; adjunct flossing in subjects with papilla filling the interdental space appears essential to reach and maintain gingival health., Clinicaltrials: GOV : (53831716.5.0000.5346)., Trial Registration: The protocol registration was filed May 9, 2018 (# 538,311,716.5.0000.5346) on ClinicalTrials.gov. An NCT number (NCT04909840) was generated upon completed registration., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: This study aimed to explore the effect of nonsurgical periodontal treatment on Galectin-1 and -3 GCF levels in gingivitis and periodontitis stage III compared to periodontally healthy individuals, to determine whether they could serve as diagnostic markers / therapeutic targets for periodontitis and revealing their possible role in periodontal disease., Materials and Methods: Forty-five systemically healthy participants were included and equally subdivided into three groups: gingivitis, periodontitis (stage III), and a periodontally healthy control group. The clinical parameters were recorded. Galectin-1 and -3 GCF levels were evaluated (before and after non-surgical treatment for periodontitis) using an enzyme linked immune-sorbent assay (ELISA) kit. Receiver operating characteristic (ROC) curve was performed to reveal sensitivity, specificity, predictive value, and diagnostic accuracy of both markers., Results: The study showed statistical significance between different groups regarding Galectin-3 with higher values in periodontitis and the lowest values in healthy control. Also, Galectin-1 was significantly higher in the periodontitis/gingivitis groups than in the control group. Moreover, non-surgical periodontal treatment in periodontitis patients caused a statistical reduction in clinical parameters and biomarkers. ROC analysis revealed excellent diagnostic ability of both biomarkers in discriminating periodontitis/gingivitis against healthy individuals (100% diagnostic accuracy for Galectin-1 and 93% for Galectin-3, AUC > 0.9) and acceptable diagnostic ability between periodontitis participants against gingivitis (73% diagnostic accuracy for Gal-1 and 80% for Gal-3, AUC > 0.7)., Conclusions: Both Galectin-1 and Galectin-3 seem to have outstanding diagnostic accuracy for the identification of periodontal disease, an acceptable ability to measure periodontal disease activity and the severity of inflammatory status. Additionally, they could serve as therapeutic targets to monitor treatment efficiency., Clinicaltrial: GOV REGISTRATION NUMBER: (NCT06038812)., (© 2024. The Author(s).)

Background and Objectives: The literature about oral manifestations and dental management in maple syrup urine disease (MSUD) is sparse. The aim of this report is to present a new case of MSUD with special emphasis on oral findings and to review the relevant literature., Method: A case report of a 4-year-old boy with MSUD was described according to the CARE guidelines for describing case reports. Scoping review of relevant literature was performed, according to the PRISMA-ScR guidelines, by searching PubMed, Medline, Embase, and the grey literature for articles describing dental management and/or oral manifestations in MSUD., Results: The initial search identified 219 articles, but only 4 met the inclusion criteria. Rampant caries and plaque induced gingivitis were the main oro-dental findings in MSUD. Other oral findings included enamel hypoplasia, skeletal abnormalities, and abnormal oral behaviors. Disease-related factors appeared to play a major role in the development of the observed oral phenotype., Conclusion: Oral health in MSUD seems to be influenced by the reliance on semi-synthetic diet and associated neurocognitive complications. Tailored oral health promotional interventions should be included in the multidisciplinary management of patients with MSUD., (© 2024. The Author(s).)

Background: Chemical plaque control with mouthwashes as an adjunct to mechanical plaque control with a toothbrush and dental floss has been considered an effective method for controlling gingivitis. The anti-inflammatory effects of chemical plaque control benefit the oral tissues by reducing inflammation and bleeding., Objectives: The aim of the present study was to evaluate and compare the clinical efficacy of probiotic, Aloe vera, povidine-iodine, and chlorhexidine (CHX) mouthwashes in treating gingivitis patients by assessing changes in their clinical parameters., Material and Methods: This prospective study was conducted on 40 patients from our outpatient department, divided into 4 groups of 10 patients each: probiotic mouthwash group (group 1); herbal (Aloe vera) mouthwash group (group 2); povidone-iodine mouthwash group (group 3); and CHX mouthwash group (group 4). All participants were provided with the same type of manual toothbrush, the Pepsodent® toothpaste and a respective mouthwash for twice-daily use until the end of a 28-day observation period. Clinical parameters, such as the marginal plaque index (MPI) and bleeding on interdental brushing (BOIB), were recorded at baseline, and on the 14th and 28th day of the study period., Results: All groups showed a significant decrease in the MPI and BOIB scores. The results were similar in patients who used a probiotic mouthwash and those who used a CHX mouthwash. A comparable change in the mean scores was observed among the herbal and povidone-iodine groups from baseline to day 28., Conclusions: In the treatment of chronic gingivitis patients,a probiotic mouthwash was nearly as effective as CHX in reducing the plaque and bleeding scores. It showed better results in all clinical parameters than herbal and povidone-iodine mouthwashes. Using a mouthwash along with routine tooth brushing can help in treating gingivitis and slow the progression of the periodontal disease.

Purpose: The aim of the present study was to compare the effect of systemically administered lycopene (LycoRed) as a monotherapy and as an adjunct to scaling and root planing in gingivitis patients.Materials and Methods: Twenty systemically healthy patients showing clinical signs of gingivitis were involved in a randomised, double-blind, parallel, split-mouth study. The subjects were randomly distributed between the two treatment groups: experimental group (n = 10), 8 mg lycopene/day for 2 weeks; and controls (n = 10), placebo for 2 weeks. Quadrant allocation within each group was randomised with two quadrants treated with oral prophylaxis (OP) and two quadrants not receiving any form of treatment (non-OP). Bleeding index (SBI) and non-invasive measures of plaque (PI) and gingivitis (GI) were assessed at baseline, 1 and 2 weeks. Salivary uric acid levels were also measured.Results: All the treatment groups demonstrated statistically significant reductions in the GI, SBI and PI. Treatment with OP-lycopene resulted in a statistically significant decrease in GI when compared with OP-placebo (p < 0.05) and non-OP-placebo (p < 0.01). Treatment with non-OP-lycopene resulted in a statistically significant decrease in GI when compared with non-OP-placebo (p < 0.01). The OP-lycopene group showed a statistically significant reduction in SBI values when compared with the non-OP-lycopene group (p < 0.05) and the non-OP-placebo group (p < 0.001). There was a strong negative correlation between the salivary uric acid levels and the percentage reduction in GI at 1 and 2 weeks in the OP-lycopene group (r = -0.852 and -0.802 respectively) and in the non-OP-lycopene group (r = -0.640 and -0.580 respectively).Conclusions: The results presented in this study suggest that lycopene shows great promise as a treatment modality in gingivitis. The possibility of obtaining an additive effect by combining routine oral prophylaxis with lycopene is also an exciting possibility, which deserves further study. [ABSTRACT FROM AUTHOR]

Objective: The efficacy of a topical application of hyaluronic acid (HA) was tested for treating gingivitis. Method and materials: Sixty nonsmoking outpatients in good general condition, with clinical signs of gingivitis, were included in the study. Forty patients (HA group, 20 men, 20 women; age: 32.8 ± 11.3 years) used a spray containing HA 5 times daily over a period of 1 week. The control group consisted of 20 patients (10 men, 10 women; age: 31.3 ± 9.3 years). The clinical parameters DMF-T (decayed, missed, filled teeth) index, approximal plaque index, sulcus bleeding index, papilla bleeding index, and gingival crevicular fluid were measured at baseline (T1), after 3 days (T2), and after 7 days (T3). Results: A reduction in the sulcus bleeding index of the HA group (T1: 72.9 ± 19.5%) to 50.3 ± 2i .1% was noted at T2, and at T3 the sulcus bleeding index was 40.7 ± 23.0%. The papilla bleeding index values of the HA group were 1.6 at T1, 1.0 at T2, and 0.7 at T3. The gingival crevicular fluid showed significant reductions in the HA group. At T1 the recorded mean value was 16.3, at T2 it was 11.8, and at T3 it was 7.9. Only insignificant changes were observed in the respective indices of the control group. There were no significant alterations in the plaque values of either group throughout the study period. Conclusion: The results obtained by this study demonstrate that the topical application of an HA-containing preparation represents a potentially useful adjunct in the therapy of gingivitis, although its use does not diminish the need for plaque reduction as a primary therapeutic measure. [ABSTRACT FROM AUTHOR]

Background: Recalcitrant gingival erosions, blisters and desquamative gingivitis are common features in oral autoimmune blistering diseases (AIBD). First line treatments include high-dosage corticosteroids and other immunosuppressive drugs, with several side effects and elevated number of recurrences. Autologous platelet-rich plasma (PRP) has been recently introduced as an alternative treatment and its use seems to be promising and safe., Methods: In this study we describe the use of topical application of heterologous PRP in nine patients affected by mucous membrane pemphigoid, with gingival lesions refractory to previous treatments. Topical applications of PRP were performed once a week for 2 months and the endpoint for clinical evaluation was set 3 months after the last session. Oral disease severity score (ODSS) and VAS scores for pain measurement were recorded before and after treatment., Results: The procedure was painless, well accepted, and free from adverse reactions. All patients (100%) reported a reduction in VAS whereas reduction in ODSS was observed in 89% of patients., Conclusions: Within the limits of the study, topical heterologous PRP is a safe and promising procedure to be studied in future controlled randomized trials as adjuvant treatment for refractory gingival lesions in patients with AIBDs.

Dental implant inflammation is primarily caused by oral biofilms, which form within 8 h, particularly at 37 °C, thereby requiring diligent cleaning. Considering the complex management of dental implants, a novel technology based on the bioelectric effect (BE) to combat inflammation has emerged. A BE-integrated toothbrush was developed and clinically tested on patients with dental implants (N = 36). Our findings revealed a significant average plaque index reduction of 67% with BE technology compared with that at baseline (P < 0.05), whereas non-BE did not yield statistical significance even after 4 weeks of use (P > 0.05). The bleeding index demonstrated a 59% average reduction in all surfaces with BE technology (P < 0.05), whereas the non-BE group exhibited no significant change. Substantial reductions in total plaque and bleeding indices suggest that using BE toothbrushes can help effectively remove oral biofilms and treat bleeding symptoms., (© 2023. The Author(s).)

The present study aims to test whether probiotics protect against experimental gingivitis incited by 14 days of oral hygiene neglect and/or subsequently support the restoration of oral homeostasis. Eighty systemically and orally healthy participants refrained from oral hygiene procedures for 14 days, followed by 14 days with regular oral hygiene procedures. Additionally, participants consumed either probiotics ( n = 40) or placebo ( n = 40) throughout the trial. At baseline, day 14, and day 28, supragingival plaque score and bleeding-on-probing percentage (BOP %) were registered, and supragingival plaque and saliva samples were collected. The supragingival microbiota was characterized using 16S sequencing, and saliva samples were analyzed for levels of pro-inflammatory cytokines and proteases. At day 28, the relative abundance of Lautropia ( p = 0.014), Prevotella ( p = 0.046), Fusobacterium ( p = 0.033), and Selenomonas ( p = 0.0078) genera were significantly higher in the placebo group compared to the probiotics group, while the relative abundance of Rothia ( p = 0.047) species was associated with the probiotics group. Streptococcus sanguinis was associated with the probiotics group, while Campylobacter gracilis was associated with the placebo group. No difference was observed in salivary cytokines, albumin, or any enzyme activity. The present study suggests that probiotics support the resilience of the oral microbiota in the resolution period after gingivitis.

We aimed to assess the effect of oral probiotic containing the Streptococcus salivarius M18 strain on gingival inflammation, bleeding on probing, and oral biofilm. Sixty-one consenting participants aged between 18 and 25 with gingivitis were recruited in this double-blind, parallel-group study and randomly divided into the probiotic group ( n = 31) and the placebo group ( n = 30). Fifty-seven participants completed the entire study protocol, 27 in the probiotic group and 30 in the placebo group. The outcomes were assessed after 4 weeks of intervention and 4 weeks of follow-up. There was a significant decrease in the Gingival Index, with the effect size of 0.58 [95%CI 0.05-1.10], and Turesky modification of the Quigley and Hein Plaque Index, with the effect size of 0.55 [95%CI: 0.02-1.07], in the probiotic group after the intervention. However, after a 4-week follow-up, the only significant treatment outcome was improved gingival condition according to the Gingival Index. The Gingival Bleeding Index also decreased significantly in the probiotic group after the intervention period; after the follow-up, this parameter did not differ significantly in both groups from the baseline values. In the placebo group, there were no significant improvements in the assessed parameters throughout this study. No serious side effects were registered. Within the limitations of this study, we conclude that the use of oral probiotic containing the Streptococcus salivarius M18 strain resulted in a significant improvement in gingival condition and oral hygiene level in young adults with gingivitis. Trial registration NCT05727436. Funding: none.

Background: Neutrophils continuously migrate into the oral cavity from various sources like gingival crevicular fluid and saliva both in health and in inflammation. The migration of the neutrophils into the various tissues and into the oral cavity occurs when the host microbial interplay tips the balance favoring the initiation of the inflammatory and immune reactions which depending on the amount of the microbial load results in the development of acute and chronic infections in the susceptible host., Aim: The present study was designed to quantify and compare the oral salivary neutrophil levels in patients with gingivitis and chronic and aggressive periodontitis as well as in healthy controls, before and after scaling and root planing (SRP) and to compare the difference within the selected study groups., Materials and Methods: Forty subjects were classified into four groups, that is, healthy controls, gingivitis, and chronic and aggressive periodontitis. Oral rinse samples were collected using Hank's balanced salt solution from each patient before and after phase I periodontal therapy. Cells in the rinse samples were stained with Acridine orange, and neutrophil counts were carried out using a fluorescence microscope and a hemocytometer., Results: Baseline oral salivary neutrophil levels were maximum in the chronic periodontitis group followed by the aggressive group and then the gingivitis group. Oral salivary neutrophil levels also positively correlated to probing pocket depth, plaque index, calculus index, and gingival index in all four study groups. Maximum reduction in the oral salivary neutrophil levels after phase I periodontal therapy was seen in the gingivitis group., Conclusion: From our study, we conclude that the oral salivary neutrophil levels decreased significantly after SRP. Estimation of changes in the oral salivary neutrophil levels has the potential to aid in monitoring treatment outcomes. Thus, it suggests that it could be used as a simple, noninvasive laboratory technique to monitor the periodontal status and disease progression., Competing Interests: None

Introduction Mild-to-moderate gingivitis is treatable by effective toothbrushing with appropriate over-the-counter oral health care products; however, rates remain high.Aim To determine patient knowledge of gingivitis and dentists' views on management.Methods Surveys were completed by dentists and dental hospital patients.Results In total, 224 patients and 50 dentists participated. Clinical health, gingivitis, or periodontitis was detected in 2%, 33% and 56% of patients, respectively; 32% reported never suffering gingival bleeding. Moreover, 74% of patients reported gingival health as very important but only 53.7% with gingivitis occasionally/often were moderately-extremely worried about their symptoms. More than 50% of patients knew gingivitis causes poor oral health but <20% knew it elevated risks of other systemic conditions. Patients thought education on risks associated with poor oral health and product recommendations were most likely, and daily reminders least likely, to improve compliance with oral health advice (OHA). Also, 40% of dentists thought their patients were relatively unaware of the importance of gingival health, 76.9% of their patient-base had gingivitis, and 96% give OHA to these patients but only 30% thought this effected improvement. The most useful tools for improving oral health were better patient knowledge of the consequences and one-to-one instruction.Conclusion Patients struggle to attain oral health following OHA. Education about gingivitis-associated risks might improve OHA compliance., (© 2023. The Author(s).)

Introduction: Plasma cell gingivitis (PCG) is a rare benign condition usually found on marginal and attached gingiva. This case details a generalized PCG, to include the management of the patient and clinicopathologic characteristics of the disorder., Case Presentation: The patient, a 24-year-old African American female, was referred to the periodontics clinic for severe generalized gingival erythema and edema. Past medical history review was remarkable for sickle cell anemia and systemic lupus erythematosus. The patient was initially prescribed dexamethasone oral rinse (0.5 mg/5 ml) pending biopsy and medical consult for potential causes of any hypersensitivity reaction. The patient also was instructed to discontinue her current type of oral mouthrinse and dentifrice. Biopsy results confirmed a diagnosis of PCG. Resolution of signs and symptoms started 1 month later, and approximately 2 years after initial diagnosis the patient was clinically stable., Conclusion: This report describes the management of a diffuse plasma cell gingivitis and reviews pertinent literature on the lesion. The etiology of PCG, although unclear, may be attributable to a hypersensitivity reaction. PCG may mimic other pathological entities, which underscores the importance of microscopic examination in establishing a definitive diagnosis before treatment initiation.

In recent years, as the number of adults seeking orthodontic treatment has increased, so too has the number of periodontal tissue problems, particularly regarding the impact on periodontal tissue of receiving orthodontic treatment. Orthodontic treatment improves the occlusion and appearance of teeth by moving the teeth appropriately. These movements have a significant impact on the interactions between the teeth and periodontal tissues. Orthodontic treatment can also recover tooth alignment for patients with tooth displacement caused by periodontitis; however, orthodontic treatment also often has adverse effects on periodontal soft tissue, such as gingivitis, gingival enlargement and gingival recession. The purpose of this review is to summarise the current evidence and solid knowledge of periodontal soft tissue problems in orthodontic treatment and outline some prevention strategies.

Objectives: This double-blind, randomized, placebo-controlled clinical trial evaluated the adjuvant effects of Bifidobacterium lactis HN019 on the treatment of plaque-induced generalized gingivitis., Materials and Methods: Sixty patients were submitted to professional supragingival scaling and prophylaxis. They were randomly assigned to test (probiotic lozenges containing B. lactis HN019, n = 30) or control (placebo lozenges, n = 30) groups. Lozenges were consumed twice a day for 8 weeks. Bleeding on probing (BoP), Gingival Index (GI), Plaque Index (PI), probing depth (PD), and clinical attachment level (CAL) were evaluated at baseline and after 2 and 8 weeks. Gingival crevicular fluid (GCF) was collected at baseline and at 8 weeks for analysis of the inflammatory mediators IL-1β, IL-1α, IL-8, MCP-1, and MIP-1β. Data were statistically analyzed (p < 0.05)., Results: After 8 weeks, both groups showed reduction in the percentage of PI, with no significant difference between groups (p = 0.7423). The test group presented a lower percentage of BoP and a higher percentage of sites with GI ≤ 1 when compared with the control group at the end of the study (p < 0.0001). At 8 weeks, the test group had a greater number of patients without generalized gingivitis than the control group (20 and 11 patients, respectively; p < 0.05). The test group presented significantly lower levels of IL-1α, IL-1β, and MCP-1 in GCF than the control group at the end of the study (p < 0.05)., Conclusion: The adjunct use of B. lactis HN019 promotes additional clinical and immunological benefits in the treatment of generalized gingivitis., Clinical Relevance: B. lactis HN019 can be an efficient and side-effect-free adjunct strategy in the treatment of generalized gingivitis., (© 2022. The Author(s).)

Objectives: In our research, we evaluated the effect of coconut and sesame oils using the microneedling technique on gingival inflammation and plaque accumulation among patients with gingivitis by creating microholes in the gingiva to facilitate the concentration and entrance of the oils through gingival tissues., Materials and Methods: Twenty-four patients with clinically diagnosed plaque-induced gingivitis were selected from Vision dental hospital, Riyadh, KSA, and assigned to one of three groups randomly; group A consisted of eight participants who were treated with dermapen and topical coconut oil, group B had eight participants who were treated with dermapen and topical sesame oil, and group C involved eight patients who received periodontal mechanical treatment only. Postintervention gingival status and plaque status for all participants were assessed using a modified average gingival index and a plaque index at Weeks 1, 2, and 4., Results: Groups A and B experienced highly significant reductions in gingival indices, while group C showed reduced scores but was not significantly notable. On the contrary, the three studied groups exhibited no significant difference in the reduction of plaque indices when compared altogether., Conclusion: Our study demonstrated an effective novel technique that revealed a noticeable improvement in gingival status and a reduction in the average gingival index and plaque index., (© 2022 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Oral healthcare is a critical condition for high quality of life. According to statistics, gingivitis is one of major diseases in the world (The Global Burden of Disease Study 2019, 3.5 billion population worldwide). Oral diseases, that initiated by a group of multispecies bacteria with diverse extracellular slime that called biofilms, are modifiable risk factors with the cancer, cardiovascular disease, chronic respiratory disease. Hence, effective management of biofilms is important. Since biofilms are comprised of extracellular matrix that inhibit drug diffusion, the traditional antibiotic treatment requires 500 -5000 times more concentration than planktonic bacterial infection. The biofilm cleaning in dentistry includes time-consuming and painful physical brushing. In this work, we have developed a new electric toothbrush in emphasis on demonstration of convenient and painless gingivitis improvement device. For the first time, the toothbrush has been integrated with an electromagnetic technology for effective biofilm removal, known for bioelectric effect (BE). Biofilms consists of electrically charged molecules that are affected by external electric fields. Thus, when an electric field is applied, it creates interruption of metabolism, reduction of enzyme activity, weakening surface attachment, and nonuniform electrolyte distribution, resulting in separation from the surface. Thus, integration of the BE on a toothbrush enables enhanced biofilm reduction. The toothbrush tested with mild gingival patient (N=40) at the department of dentistry, Ulsan University Hospital, South Korea. The patient used the BE toothbrush and non-BE toothbrush consecutively for 2 weeks in each, following their gingival index (GI) and plaque index (PI) measurement for the quantitative analysis. The results demonstrate 1.75 times more decrease of GI in BE toothbrush than the data of the non-BE device (p < 0.05). In conclusion, a new electromagnetic wave toothbrush has been successfully demonstrated especially in reduction of inflammation. Based on this work, we are going to further develop a medical device that dedicated on the treatment of inflammation., (Copyright © 2022. Published by Elsevier Ltd.)

Objectives: To evaluate the clinical efficacy in the short-term resolution of gingivitis of a novel protocol involving full-mouth erythritol powder air polishing followed by ultrasonic calculus removal., Methods: Forty-one healthy patients completed the study. Following a split-mouth design, quadrants 1-4 and 2-3 were randomly allocated to receive air polishing followed by ultrasonic calculus removal (A+US) or traditional full-mouth ultrasonic debridement followed by polishing with a rubber cup and prophylactic paste (US+P). Bleeding on probing (BoP) and plaque index (PI) were collected at baseline and 2 and 4 weeks. Moreover, the residual plaque area (RPA), treatment time and patient comfort/satisfaction were evaluated at the end of the treatment., Results: Both treatments showed a significant reduction in BoP and PI. At 4 weeks, A+US seems to reach a statistically significant lower BoP (8.7% [6.9; 10.9] vs. 11.6%[9.3; 14.4], p < 0.0001) and PI (10.7% [8.9; 13.0] vs. 12.3% [10.2; 14.9], p = 0.033). Moreover, A+US treatment time lasted on average 9.2% less than US+P (p < 0.0001) and was the preferred treatment for a significantly higher number of patients (73.2% vs. 17.1%, p = 0.0001)., Conclusion: The A+US protocol is suitable for the short-term resolution of plaque-induced gingivitis., (© 2021 The Authors. International Journal of Dental Hygiene published by John Wiley & Sons Ltd.)

To evaluate the effect of probiotics on gingival inflammation and oral microbiota in patients suffering from plaque-induced gingivitis. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE were electronically searched until December 2020. The quality of included studies was assessed with the Cochrane Collaboration's Risk of Bias tool. The differences were expressed as weighted mean differences (WMD) and 95% of confidence interval (95% CI). I 2 test was performed to evaluate the heterogeneity of the studies. All analyses were performed using Review Manager (version 5.3). Eleven randomized and controlled trials were included, enrolling 554 patients. All comparisons displayed that oral probiotics had no significant improvement in the Gingival Index (GI), Plaque Index (PI), and bleeding on probing (BOP) of patients with plaque-induced gingivitis. In terms of microecology, no significant difference in the volumes of gingival crevicular fluid (GCF), the concentration of IL-1β, and the counts of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), and Fusobacterium nucleatum (Fn) were found between the probiotic group and the placebo group. There exists no clear evidence that oral probiotics have positive effect on gingival inflammation and oral microecological environment of patients with plaque-induced gingivitis., (© 2021 Wiley Periodicals LLC.)

Background: The aim of this clinical trial was to evaluate the effect of a periodontal health education session (PHES), which included education on the pathogenesis and consequences of periodontal diseases on oral hygiene motivation in patients with gingivitis., Methods: A randomized controlled clinical trial was conducted on 50 (26 females and 24 males) patients with gingivitis who underwent periodontal treatment. Subjects were randomly allocated into the PHES group (experimental group) and standard oral hygiene education group (control group). The Rustogi Modified Navy Plaque Index (RMNPI) and Papillary Bleeding Index (PBI) were used to evaluate oral hygiene at baseline and were repeated after 1, 3, and 6 months. Knowledge about periodontal disease was measured and the participants' motivation was determined using the Oral Hygiene Motivation Scale., Results: Although baseline knowledge levels and motivation scores were not different between the groups, following the educational motivational interviewing (MI) session, levels were higher in the experimental compared with the control group. The subjects' RMNPI and PBI scores at the 1-, 3-, and 6- month re-examinations were statistically higher in the control group than the experimental group. Furthermore, the level of knowledge and intrinsic and total motivation scores were moderately positively correlated with a reduction in clinical indices at 6 months compared with baseline., Conclusions: The results of this study indicated that increased knowledge and awareness about periodontal diseases and its consequences, including systemic effects, via educational MI session increased intrinsic motivation and improved oral hygiene of patients with gingivitis, especially regarding interproximal surfaces., (© 2021 American Academy of Periodontology.)

Objective: To evaluate how chronic gingivitis treatment impacts the oral and circulating cytokine expressions after six-month follow-up in patients with juvenile systemic lupus erythematosus (jSLE) and also to evaluate the circulating expression of anti-Porphyromonas gingivalis peptidylarginine deiminase antibodies (anti-PPAD) before and after treatment., Background: Juvenile systemic lupus erythematosus patients present a worse periodontal condition associated with higher gingival crevicular fluid (GCF) levels of interleukin (IL)-1β, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein (MCP)-1., Materials and Methods: Twenty-one adolescents with jSLE (mean age: 16.2 ± 1.5 years) were recruited. Participants were rheumatologically and periodontally examined. All individuals were clinically diagnosed with gingival inflammation. Chronic gingivitis treatment consisted of supragingival scaling, prophylaxis and oral hygiene instructions. The cytokine levels were determined by bead-based multiplex assays and the anti-PPAD levels by ELISA. Gingival crevicular fluid (GCF) and serum samples were collected at baseline and 6 months after treatment., Results: We observed a reduction in attachment loss, SLE Disease Activity Index (SLEDAI), IL-1β, IL-10 and MCP-1 GCF levels, and the IL-4 and IL-5 serum levels 6 months after periodontal treatment. On the contrary, a significant increase in GCF expression of IL-4, IL-12, IL-17, IFN-γ and serum levels of anti-PPAD antibody was observed., Conclusion: Juvenile systemic lupus erythematosus patients seem to positively benefit from periodontal treatment by a significantly reduced CAL, a GCF reduction of pro-inflammatory cytokines and an increasing of anti-inflammatory ones. However, an increase in the GCF expression of IL-17 and the serum expression of anti-PPAD antibody 6 months after periodontal treatment might negatively affect the treatment outcome of such patients in the long term., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: This study aimed to investigate whether treatment of gingivitis in pregnant women affects pregnancy outcomes., Materials and Methods: This was a systematic review and meta-analysis of clinical trials using PRISMA guidelines to appraise the treatment of gingivitis on pregnancy outcomes, including preterm birth (less than 37 weeks), low birth weight (less than 2,500 g), gestational age and birth weight. Pooled odds ratios (OR), mean difference, and 95% confidence intervals (CI) were calculated using the random effect model. A search was conducted in databases including Medline, Pubmed, Web of Science, Google Scholar and Embase without restrictions regarding language or date of publication., Results: Three clinical trials comprising 1,031 participants were included in this review. Treatment of gingivitis during pregnancy was associated with a decreased risk of preterm birth (OR = 0.44, 95% CI [0.20-0.98], P = 0.045) and higher birth weight (weighted mean difference (WMD) =105.36 g, 95% CI [36.72-174.01], P = 0.003). Gestational age at birth in the treatment group (WMD = 0.31 weeks, 95% CI [-0.02-0.64], P = 0.64) as well as likelihood of low birth weight (OR = 0.92, 95% CI [0.38-2.21], P = 0.851) did not reach statistical significance., Conclusion: The results of this meta-analysis indicate that treatment of gingivitis in pregnancy may improve pregnancy outcomes including increased infants birth weight and reduced preterm births. Future trials are warranted to validate the true effect size of gingivitis treatment on pregnancy outcomes.

Objective: The objective of the study was to evaluate the effect of non-surgical periodontal treatment on gingival crevicular fluid (GCF) periostin levels in patients with gingivitis (G) and periodontitis (P)., Subjects and Methods: A total of 90 subjects, 30 patients with P, 30 with G, and 30 periodontally healthy (H) subjects were included. Patients with periodontal disease received non-surgical periodontal treatment. GCF periostin levels were assessed at baseline, at the 6th week, and the 3rd month after treatment., Results: It was found that GCF periostin level was the lowest in the H group (89.31[47.12] pg/30 sec), followed by the G group (132.82[145.14] pg/30 sec), and the highest in the P group (207.75[189.45] pg/30 sec). These differences were statistically significant between H and the other groups (p < .001). After treatment, GCF periostin levels significantly decreased at the 6th week and the 3rd month in the G group, at the 3rd month in the P group compared to baseline values (p < .05)., Conclusion: The results of this study suggest that GCF periostin plays a role as a reliable biological marker in the pathogenesis of periodontal disease and non-surgical periodontal treatment is effective in decreasing GCF periostin levels., (© 2020 Wiley Periodicals LLC.)

Background: Dental implant surgery despite its growing popularity poses several challenges like include tissue inflammation, pain discomfort and tissue injury., Objective: To evaluate the effect of ozone therapy on inflammation, pain and wound healing after implant surgery., Methods: A clinical study was conducted on 60 systematically healthy patients- 30 patients treated with ozone (Experimental group) and 30 patients without ozone treatment (control group). In the control group osteotomy procedure was performed with saline irrigation and in the experimental group irrigation was done with ozonated water at 25 µg/mL concentration, along with ozone gas. Clinical assessment was done by evaluating C-reactive Protein (CRP) for inflammation, pain using Visual Analogue Scale (VAS) score and tissue wound healing using wound healing index. Side effects, if any, were noted., Results: Postoperative increment in CRP levels was 0.10 and 0.63 mg/dl in Experimental and control groups respectively (p < 0.001). At 24-hr, 48-hr and 7 day post-operative intervals mean VAS scores for pain were significantly higher in Control group as compared to that in Experimental Group (p < 0.001). At day 7, mean VAS scores for pain were 3.50 ± 0.63 and 37.70 ± 4.17 in Experimental and Control groups respectively (p < 0.001). Mean tissue healing indices were significantly higher on Day 7 and Day 14 in Experimental Group (4.23 ± 0.43 and 4.97 ± 0.18) as compared to that in control group (3.07 ± 0.45 and 4.03 ± 0.18) (p < 0.001). No potential side effects were noted in either of two groups., Conclusion: Ozone therapy accelerated the tissue wound healing, minimized tissue inflammation and decreased pain., (Copyright © 2021. Published by Elsevier B.V.)

Probiotics are thought to be beneficial microbes that influence health-related outcomes through host immunomodulation and modulation of the bacteriome. Its reported success in the treatment of gastrointestinal disorders has led to further research on its potential applicability within the dental field due to similarities such as a polymicrobial aetiology and disease associated microbial-shifts. Although the literature is replete with studies demonstrating its efficacy, the use of probiotics in dentistry continues to polarise opinion. Here, we explore the evidence for probiotics and its effect on periodontal and peri-implant health. MEDLINE, EMBASE, and CENTRAL were systemically searched from June 2010 to June 2020 based on a formulated search strategy. Of 1,956 potentially relevant articles, we selected 27 double-blinded randomised clinical trials in the areas of gingivitis, periodontitis, residual pockets during supportive periodontal therapy, and peri-implant diseases, and reviewed their efficacy in these clinical situations. We observed substantial variation in treatment results and protocols between studies. Overall, the evidence for probiotic therapy for periodontal and peri-implant health appears unconvincing. The scarcity of trials with adequate power and follow-up precludes any meaningful clinical recommendations. Thus, the routine use of probiotics for these purposes are currently unsubstantiated. Further multi-centre trials encompassing a standardised investigation on the most promising strains and administration methods, with longer observation times are required to confirm the benefits of probiotic therapy for these applications.

Background: The aim of study was to evaluate galectin-3 levels in gingival crevicular fluid (GCF) from periodontally healthy (H) patients and those with periodontitis (P), gingivitis (G) and the effect of initial periodontal treatment on GCF galectin-3 level., Methods: A total of 75 participants, 25 patients with periodontitis, 25 with gingivitis and 25 periodontally healthy subjects were included into the study. Patients with periodontal disease received initial periodontal treatment. GCF galectin-3 level was assessed at baseline and at the 6th-8th weeks after completion of periodontal treatment. GCF galectin-3 level was evaluated by enzyme-linked immunosorbent assay., Results: GCF galectin-3 level was the lowest in the H group (102.31[63.07] μg/30 s), followed by the G group (241.45[145.89] μg/30 s) and the highest in the P group (338.27[219.37] μg/30 s). These differences were statistically significant between H and the other groups (P < 0.001). After initial periodontal treatment, GCF galectin-3 level significantly decreased in the G and P groups compared to baseline values (P < 0.01)., Conclusion: The results of this study suggest that GCF galectin-3 level is a potential biomarker for the evaluation of gingival inflammation and initial periodontal treatment is effective in decreasing GCF galectin-3 level., (© 2020 Australian Dental Association.)

The objective of the present study was to investigate the effects of various types of fixed prostheses on periodontal tissues and explore the association of gingival biotype and gum recession in relation to prosthesis types. The study participants (N = 95) were divided into three groups based on the type of dental prosthesis: Group-I: cobalt-chrome (Co-Cr) ceramic prosthesis fabricated by the conventional method (n = 35); Group-II: consisted of patients with Co-Cr ceramic prostheses fabricated by a computer-aided design and computer aided manufacturing (CAD/CAM) technique (n = 30); and Group-III: zirconia-based prostheses fabricated by the CAD/CAM technique (n = 30). Following the use of prostheses, periodontal examinations were performed using the Community Periodontal Index (CPI) and Modified Approximal Plaque Index (MAPI). In addition, the gingival biotype was examined using a probe transparency method. The Statistical Package for the Social Sciences (SPSS), Version 20 (IBM Company, Chicago, IL, USA), was used to analyze the results, and the significance level was set at p = 0.05. It showed the MAPI results after the use of prosthetic rehabilitation for 12 months of periodontitis in 87.9% ± 15.4 of patients in Group-I, in 80.6% ± 17.97 in those in Group-II, and in 62.5% ± 21.4 in those in Group-III ( p < 0.01). The CPI index results indicated a high prevalence of periodontal disease in all groups. The number of people with healthy periodontium constituted 17.1% of patients in Group-I, 24.2% in Group-II, and 37.1% in Group-III. Our study concluded that prosthetic treatment with periodontal diseases showed better outcomes while using dental prostheses fabricated by the CAD/CAM technique compared to the conventionally fabricated dental prostheses. The thin gingival biotype is more often associated with gingival recession than the thick biotype.

Purpose: To compare clinical outcomes and oral fluid biomarkers in gingivitis subjects using an electric toothbrush/irrigator combination (test) or a manual toothbrush alone (control) over 8 weeks., Materials and Methods: Subjects were randomly assigned to two groups of n = 30. In both groups, toothbrushing was performed twice daily at home and no additional interdental cleaning aids were allowed. Plaque Index (PLI), Gingival Index (GI), whole saliva (WS), and gingival crevicular fluid (GCF) samples were collected at weeks 2, 4, and 8., Results: Subjects' mean age was 23 years and 52% were female. Overall baseline means were 1.31 for PLI, 1.07 for GI, and 34.9 for number of bleeding sites. At every follow-up visit, both groups differed statistically significantly (p < 0.001) from baseline for all clinical parameters. The test group demonstrated statistically significantly (p < 0.001) greater reductions in GI vs the control group by 18% at week 2, 17% at week 4 and 24% at week 8. The test group also demonstrated statistically significantly (p < 0.002) greater reductions in the number of bleeding sites vs the control group by 33% at week 2, 34% at week 4 and 43% at week 8. Between-group comparisons for both WS and GCF revealed numerical trends for decreased levels of interleukin (IL)-1β in GCF after 4 and 8 weeks, but these were not statistically significant., Conclusion: In subjects using the electric toothbrush/irrigator combination, increased clinical improvements may be found accompanied by similarly improved trends for oral fluid biomarkers such as IL-1β.

Background: The gingivitis treatment protocols aim to stop the progression of inflammation and prevent the affliction of deeper periodontal tissues. Current research focuses on novel methods that can be applied with handheld and ultrasonic devices to increase the effectiveness of non-surgical periodontal treatment. Ozone has been shown to have a strong antimicrobial effect against bacteria that play a role in the etiology of gingival/periodontal diseases. Research evaluating the effects of ozone gas on the treatment of gingival tissues is limited., Aim: We investigated the effects of ozone application during the scaling procedure on clinical parameters of gingivitis in smokers and non-smokers and to investigate the efficacy of ozone gas in periodontal treatment., Methods: A total of 40 subjects, 27 males/13 females-20 smokers/20 non-smokers-with plaque-induced gingivitis, were selected. The patients underwent a single session of full-mouth supragingival and subgingival scaling. Gaseous ozone application was performed on a randomly selected maxillary quadrant. The other maxillary quadrant was designated as the control group receiving only initial periodontal treatment. Clinical parameters, such as PI, GI, GBTI, and PPD, were measured before and 1 week after treatment., Results: Our study shows that ozone therapy significantly improves clinical parameters in smokers and non-smokers when applied in addition to periodontal therapy., Conclusions: Additional studies comparing the effect of ozone therapy on smokers and non-smokers to the effects of oral mouthwashes may provide valuable contributions to the field.

The aim of the present examiner-blind randomized controlled clinical study was to compare the efficacy two soft-bristle toothbrushes in terms of plaque removal. Seventy volunteers were randomly allocated to Group A (tapered-tip toothbrush) or Group B (end-rounded toothbrush). At baseline appointment (Day 0), volunteers underwent plaque examination using the Improved Plaque Identification Index. Under supervision, they brushed their teeth for 1 minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers continued the oral hygiene regimen (assigned toothbrush and a regular dentifrice provided by the researchers) for 7 days. The experimental procedures of Day 0 were then repeated. Separate statistical analyses were performed for mean percent reduction of plaque in the whole-mouth, interproximal and gumline scores at both times, using Mann-Whitney test, p<0.05. After a single toothbrushing, on Day 0, mean percent plaque was significantly reduced in both groups (p<0.05), with statistically greater reductions of whole-mouth (21.39±12.44 vs. 11.40±11.17), gumline (6.32±7.37 vs. 2.89±4.57) and interproximal (10.82±10.49 vs. 5.21±7.68) for Group A as compared to Group B. However, on day 7, no significant difference was observed between groups for whole-mouth (29.94±20.91 vs. 26.58±18.64), gumline (14.04±18.82 vs. 13.78±17.63) and interproximal surfaces (26.41±22.77 vs. 23.12±20.98) (p>0.05). In conclusion, on Day 0, Group A presented higher efficacy in supragingival plaque removal than Group B, as reflected by whole-mouth, gumline and interproximal plaque scores., Competing Interests: none, (Sociedad Argentina de Investigación Odontológica.)

Background: Dental biofilm accumulation and poor personal oral hygiene are known major risk factors for gingivitis and halitosis. However, it is not clear how studies compare the effectiveness of hygiene regimens, associated with outcomes centered on patients., Methods: A randomized, blind, controlled clinical trial involving 58 participants aged from 12 to 17 years, who search the Department of Pediatric Dentistry of Universidade Metropolitana de Santos, will be conducted. Immediately, the volunteers will be inserted into Group 1 (commercially available hygiene regimen) or Group 2 (tooth brushing alone). In Group 1, participants will receive Colgate Total 12 toothpastes, Plax mouthwashes and Colgate Ultrasoft toothbrushes, while Group 2 will use Colgate Cavity Protection toothpastes and Colgate Ultrasoft toothbrushes. The interventions will be conducted in the periods of 1, 3, and 6 months after the baseline, when the evaluations will also be performed. Biofilm and halitosis indexes will be evaluated. Data regarding discomfort, satisfaction and the socioeconomic/individual characteristics will also be computed., Discussion: Although toothbrushing has shown positive effects in decreasing biofilm and in gingival health, there is no comparison in the literature of different brushing regimens with halitosis measurement in adolescents. In addition, the effectiveness of these protocols would be confirmed from the acceptability of the volunteers.

Feline chronic gingivostomatitis is a frustrating disease to manage owing to its elusive etiopathogenesis and its subsequently suboptimal treatment options. Nevertheless, efforts to shed light on the disease over the past few decades have advanced the knowledge on its potential etiopathogenesis and the success rates of available treatment options. Further research is ongoing, with promising attempts to better understand and treat this, likely, multifactorial disease., Competing Interests: Disclosure The authors have no financial disclosures to acknowledge., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: To evaluate the efficacy of synbiotic tablets on the clinical and biochemical parameters of smokers and non-smokers with gingivitis., Methods: Eighty patients with gingivitis [40 smokers (+), 40 non-smokers (-)] were randomly assigned to test (T) or control (C) groups. Four groups were defined: T(+), T(-), C(+) and C(-). The subjects daily chewed a synbiotic or placebo tablet for 30 days. The gingival crevicular fluid levels of interleukin (IL)-6, IL-8 and IL-10 were determined as the primary outcome variables., Results: The clinical and biochemical parameters for all groups significantly reduced compared with the baseline (P < 0.05). While there were no significant differences between the groups for gingival index, the plaque index was significantly higher in both smoker groups than that in the T(-) group during the second month (P < 0.05). IL-8 levels in C(-) and IL-6 levels in both control groups were significantly higher than those in the T(+) group. The IL-10 levels in both control groups were significantly higher than those in the T(-) group during the second month (P < 0.05)., Conclusions: Adjunctive synbiotic tablets significantly reduce subclinical therapeutic outcomes for both smokers and non-smokers compared with placebo according to the biochemical parameters., (© 2020 Australian Dental Association.)

Introduction This case series highlights the condition juvenile spongiotic gingivitis; how to recognise it, where it lies in a list of differential diagnoses and why conservative management is the authors' recommended treatment.Case series The authors present ten cases that were successfully managed conservatively on the Joint Oral Medicine Paediatric Dentistry Clinic at Guy's and St Thomas' NHS Foundation Trust over a six-year period. Follow-ups reached up to 5 years and 11 months to date, with no adverse outcomes observed in any of the cases.Conclusion The pathogenesis of this benign condition and its ideal management is not well understood. Recurrence can occur after surgical treatment and the condition is likely to spontaneously resolve or regress with age. Therefore, particularly in asymptomatic cases, conservative management is recommended.

Aim: The aim of this study was to evaluate and compare two different techniques for the treatment of plaque-induced gingivitis, demonstrating whether the causal therapy supported by diode laser can allow a resolution of the edema caused by gingivitis in less time compared to the single traditional causal therapy., Materials and Methods: Twenty-five patients between 20 and 60 years of age with a specific diagnosis of gingivitis were evaluated at the CLID-HSR oral hygiene department. Once the clinical parameters (bleeding index, plaque index, recession, and clinical attack level) were recorded, each of them was subjected to a professional oral hygiene session and instructed in correct home hygiene procedures. Through a split-mouth protocol for each individual patient, hemi-arches were treated by simple randomization to be treated with causal therapy supported by the action of the diode laser (experimental therapy) and which with traditional causal therapy (control therapy). A first intraoral scan was performed before therapy (T0), which was repeated 20 min after rinsing with CHX. The intraoral scans were repeated at a control 7 (T1) and 14 days (T2) after the session. For each intraoral scan, a volumetric value was calculated, proportional to the edema of the gingival tissues, using special digital software. The operator who carried out the volumetric measurements on the software was not aware of the therapy implemented on each half-arch. The operator who carried out the statistical analysis was not aware of the therapy applied to each group. The collected data were statistically compared in order to detect any differences between the volumetric variations between the two therapy groups and within the therapy groups over time. After evaluating the distribution of data by means of the Kolmogorov-Smirnov statistical test, the appropriate nonparametric tests were chosen to carry out the statistical comparisons., Results: Based on the analysis of the gingival-periodontal health parameters and the volumetric value of the treated areas, no statistically significant differences were detected between the areas treated with the adjuvant action of the diode laser compared to those treated with causal therapy alone., Conclusions: With the limitations of this study, in accordance with the statistical results obtained, diode laser therapy does not allow a faster resolution of gingival edema compared to traditional therapy; the two treatment techniques for plaque-induced gingivitis, therefore, have the same efficacy.

Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.

It is known that the presence of orthodontic brackets predisposes for a change in the biofilm, facilitating the development of gingivits. The sites are difficult to access with a toothbrush and periodontal curette, worsening inflammation, in addition, a gingival hyperplasia is associated with poor hygiene. The objective of this study is to evaluate the impact of photodinamyc therapy (PDT) as an adjuvant treatment, considering clinical immunoregulatory and microbiological parameters. This randomized, controlled, double-blind clinical study will include 34 patients, both genders, having used fixed appliance for more than 12 months, with gingivitis. Participants will be divided into two groups: G1 (n = 17)- Scaling and Root Planing + PDT placebo and G2 (n = 17)- Scaling and Root Planing + PDT. In G2 the following dosimetric parameters will be used: methylene blue 0.005%, λ= 660 nanometers (nm), 9 Joules (J) per site, irradiance= 3.5Watts (W)/ centimeters (cm), radiant exposure= 318J/cm. All participants will receive oral hygiene guidance prior the curetes scaling. The clinical periodontal data to be analyzed are plaque index, gingival index and probing depth. Crevicular fluid, from 4 pre-determined sites and saliva, will be collected and analysed for IL-6, IL-1β, IL-8, TNF-α and IL-10 cytokines using ELISA (Enzyme immunoabsorption assay) method. Total Bacteria count will also be performed, by qPCR and Universal16SrRNA gene. All analysis will be realized using in the baseline (T0), 7 (T1) and 21 (T2) days after treatment. Oral health-related quality of life will be assessed using the OHIP-14 questionnaire at times T0 and T2. If sample distribution is normal, the Student T-test will be applied if it is not normal, the Mann-Whitney test will be used. The data will be presented in terms of ± PD and The significance level will be set at p < 0.05. Our results may improve quality of life and add data to establish a therapeutic alternative for gingivitis during the orthodontic treatment. Registration: clinicaltrials.gov NCT04037709. https://clinicaltrials.gov/ct2/show/NCT04037709 - Registered in July 2019.

The present study was intended to prepare and optimize the mucoadhesive buccal patch of gambier leaf extract using chitosan (CH) and tapioca starch (TS) composite as the polymer complexes. The patch formulation was designed based on 2 2 factorial design in order to optimize the composition of CH and TS. The physical and chemical characteristics of the prepared patches, including mass and thickness uniformity, folding endurance, surface pH, swelling index, percent of elongation, and mucoadhesive time were successfully evaluated. Based on statistical analysis, the optimum concentration of CH and TS was 900 mg and 300 mg, respectively, with desirability percent of 0.968. The characterization of the optimum patch showed that the variability coefficient of the mass and thickness uniformity was 0.4805 ± 0.1887% and 0.9716 ± 1.2026%, surface pH of the patch was 6, folding endurance >300 times, elongation percent was 53.333 ± 0.1082%, and mucoadhesive time was 320 ± 1.1547 min. The catechin content, as the active agent of the gambier leaf extract, was 92.1667 ± 0.3626%, and the FT-IR characterization indicated that there are no chemical interactions between each patch component., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: To explore peptidomic changes of peptides in saliva and gingival crevicular fluid (GCF) before and after treatment of gingivitis. Methods: From January 2017 to September 2017, seventeen participants at the age of 24-62 (6 males and 11 females) at Department of Preventive Dentistry, Peking University School and Hospital of Stomatology with gingivitis were recruited in the present study. Their clinical parameters were measured and recorded. Saliva and GCF samples were collected from each of the participants at the baseline and 7 days after ultrasonic supragingival scaling, respectively. Matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) was employed to detect the changes of peptidomic profiles, while ano-liquid chromatography-electrospray ionization-tandem mass spectrometry (nano-LC/ESI-MS/MS) was performed to identify the possible proteins from which the peptides might derive. Results: Initially, four peptide peaks [mass-to-charge ratio (m/z) values: 1 030.6, 1 043.4, 1 053.4 and 1 064.6] were screened out exhibiting a decreasing trend after treatment ( P< 0.05). Besides, five peptide peaks from gingival crevicular fluid ( P< 0.05) exhibited differential expression, among which 1 055.5 and 1 168.3 demonstrating a decrease after treatment, while 3 363.7, 3 480.9 and 3 489.5 increased overtime. Certain positive correlations were detected between some peptides and clinical parameters. Principle component analysis using the above mentioned peptide peaks showed a distinct distribution before and after treatment and peptides from GCF showed a slightly better capacity to discriminate patients before and after treatment. The peptides with m/z values of 1 055.5 in GCF and 1 064.6 in saliva were identified to be segments of serum albumin and complement C3, respectively. Conclusions: Several differentially expressed peptides were detected in saliva and GCF by MALDI-TOF MS, exhibiting the potentiality to act as biomarkers in gingivitis patients.

The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.