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The aim of the present study was to evaluate the efficacy of manual and electric toothbrushes in plaque control in periodontal patients after proper instructions. Thirty six periodontal patients (mean age of 49 years, 21 females and 15 males) were included and completed the study (100% compliance). A single-blinded, randomized, controlled, cross-over clinical design was adopted, with the patients using during 2 periods of 14 days each the manual and/or electric toothbrush. Four subgroups of 9 individuals were studied: A1 - used manual toothbrush in both experimental periods; A2 - used the manual toothbrush during the first period and the electrical toothbrush during the second period; B1 - used electrical toothbrush during both periods; B2 - used the electrical toothbrush in the first period and the manual one in the second period. Brushing was performed during 14 days and at day 14 and 28 it was performed in the clinic, and timing of brushing was recorded without patients being aware. The Plaque Index (Silness, Löe, 1964) was used. Intra-group comparisons were performed by paired t-test and inter-group comparisons by independent sample t-test, with an alpha level of 0.05. The results showed no difference between the tested brushes neither for plaque nor for timing. However, re-instruction was detected as an important factor, since for all groups the second period, after reinstruction, showed lower plaque scores. It is concluded that professional advice and instruction and re-instruction seem more important in order to obtain good plaque control than the choice of toothbrush in subjects with periodontal disease.O objetivo do presente estudo foi avaliar a eficácia de escovas dentais manual e elétrica no controle de placa em pacientes periodontais após instruções apropriadas. Trinta e seis pacientes periodontais (média de idade de 49 anos, 21 mulheres e 15 homens) foram incluídos e completaram o estudo (100% de adesão). Um delineamento de ensaio clínico randomizado controlado cego e cruzado foi adotado, com pacientes usando durante 2 períodos de 14 dias cada escovas manuais e/ou elétricas. Quatro subgrupos de 9 indivíduos foram estudados: A1 - utilizou escova manual em ambos os períodos experimentais; A2 - utilizou a escova manual durante o primeiro, e a escova elétrica, no segundo período; B1 - usou escova elétrica em ambos os períodos; B2 - iniciou com escova elétrica e utilizou escova manual no segundo período. A escovação foi realizada durante 14 dias e, nos dias 14 e 28, essa foi realizada na clínica, e o tempo de escovação foi cronometrado sem que os pacientes soubessem. O Índice de Placa (Silness, Löe, 1964) foi utilizado. Comparações intragrupo foram realizadas por teste t pareado e intergrupo por teste t para amostras independentes, com um nível alfa de 0,05. Os resultados não identificaram diferenças entre as escovas testadas em relação à placa ou ao tempo utilizado. Entretanto, reinstrução foi detectada como um fator importante, uma vez que, para todos os grupos, o segundo período, após reinstrução, demonstrou menores escores de placa. Conclui-se que aconselhamento profissional e instrução e reinstrução parecem mais importantes para se obter um bom controle de placa do que a escolha da escova em pacientes com doença periodontal.

Local antibiotics have been reported successful in the treatment of destructive periodontitis. However, design, stringency and outcome of such studies seem variable. Thus our focused question was: are scaling and root planing (SRP) with adjunctive topical antibiotics superior to SRP alone in treating chronic periodontitis? Reports from 1990 and 15 years on were electronically searched in central databases using the terms 'periodontitis'/'periodontology' combined with 'local antibiotics'/'topical antibiotics'. Only randomised, blinded, controlled clinical trials (RCTs), comprising more than 20 patients diagnosed with chronic periodontitis, adjunctively treated with a single, topical antibiotic, and with a follow-up of more than 3 months were accepted. Treatment outcome was assessed by changes in clinical attachment level from baseline to end of study. The initial searches produced 198 articles, which eventually were reduced to 11 according to the inclusion criteria. The analyses of this group of articles gave no clear-cut answer to the focused question, but displayed a possible benefit of applying topical antibiotics in conjunction with SRP. However, the benefit was small and of doubtful clinical significance. [ABSTRACT FROM AUTHOR]

In animal models it has been shown experimentally that psychological stress may negatively affect the outcome of periodontitis. Several studies in various populations have confirmed an association between negative life events, the level of depression and anxiety, as well as personality traits and periodontitis. The aim of the present study was to explore these relationships in a Norwegian adult population. Patients aged 40+ yr were selected on the basis of their periodontitis experience as assessed radiographically, and the participants were grouped in 2 groups: group 1 consisted of periodontally healthy subjects (no detectable bone loss); and group 2 consisted of subjects with >3mm radiographic bone loss in >3 sites. Four different questionnaires were employed to assess the participants level of anxiety, depression and neuroticism, as well as their Health Locus of Control. Negative life events and smoking habits were also recorded. The results revealed a statistically significant bivariate relationship between periodontitis and negative life events or the degree of anxiety among the selected psychosocial variables. However, these associations did not appear to be significant when smoking was introduced in a linear multiple regression model. One explanation offered is that good access to dental care and a high utilization of oral health services in Norway may have compensated for the possible underlying causal effects of psychosocial stressors on periodontal health. Thus, comparisons of such studies between different populations may not always be feasible. [ABSTRACT FROM AUTHOR]

Background: Tooth loss is the ultimate negative consequence of periodontitis, and reports of the extent to which different treatment strategies may influence long-term tooth loss are hard to find. This study aims to test the hypothesis that there is no difference in 5-year clinical outcome of therapy in terms of tooth mortality between groups of patients treated with conventional scaling and root planing (SRP) over weeks or same-day full-mouth disinfection (FDIS), with or without adjunctive metronidazole (MET).Methods: One hundred eighty-four patients with moderate-to-severe periodontitis were randomly allocated to one of four treatment groups: 1) FDIS+MET; 2) FDIS+placebo; 3) SRP+MET; and 4) SRP+placebo. Total 161 patients (88%) completed the 5-year follow-up examination, and data on number and timing of tooth extractions as well as pre-extraction diagnoses and reasons for extractions were analyzed.Results: No differences were observed between groups with regard to number of, reasons for, or time of extractions in the four groups at baseline and 1, 3, and 5 years after treatment.Conclusion: If extraction or retention of teeth is regarded as a measure of failure or success 5 years after completion of periodontal therapy, none of the four strategies produced an end result better than the other. [ABSTRACT FROM AUTHOR]

Background: The benefit of full-mouth disinfection (FDIS) over traditional scaling and root planing (SRP), with or without adjunctive metronidazole, when treating chronic destructive periodontitis remains equivocal, as does the long-term association between clinical and microbiologic outcomes after such strategies. The aim of this study is to examine the relationship between clinical and microbiologic outcomes of four different treatment strategies for chronic destructive periodontitis among patients who maintain excellent oral hygiene and low gingival bleeding scores. Methods: One hundred eighty-four patients with periodontitis and capable of maintaining a high standard of oral hygiene were randomly allocated to one of four treatment groups: 1) FDIS + metronidazole; 2) FDIS + placebo; 3) SRP + metronidazole; and 4) SRP + placebo. Recordings of plaque, bleeding on probing, probing depth (PD), and clinical attachment level were carried out in four sites per tooth at baseline, 3 and 12 months after treatment. Before treatment, pooled subgingival samples were obtained from the five deepest pockets, which were sampled again 3 and 12 months after treatment. Microbiologic assessments of eight putative periodontal pathogens were performed using the checkerboard DNA-DNA hybridization method. Results: Levels of bacterial species were already relatively low at baseline. The only microbial factor statistically significantly associated with the clinical outcomes of treatment after 12 months was the association between reductions of Tannerella forsythia and being free from PD ≥5 mm. Conclusion: In this clinical trial, the only microbial factor associated with the clinical outcomes after 12 months was a statistically significant association between the reductions of T. forsythia and being free from PD ≥5 mm. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the clinical and microbiologic effects of the combination of amoxicillin and metronidazole therapy as an adjunct to mechanical treatment in the management of localized juvenile periodontitis. Twenty-five localized juvenile periodontitis (LJP) patients from a Brazilian population were randomly allocated into an experimental group receiving mechanical treatment and antibiotics, and a control group receiving mechanical treatment and placebo. Clinical and radiographic assessments, as well as microbiologic sampling for Actinobacillus actinomycetemcomitans, were performed at baseline and one year after the end of the treatment. At the termination of the study A. actinomycetemcomitans could be isolated from the oral cavity of all patients in the control group who harbored the bacterium at baseline and in 4 out of 8 patients in the experimental group. Both treatment modalities resulted in significant benefit on an individual basis. The experimental group, however, displayed better results than did the control group regarding gingival index (GI), probing depth (PD), clinical attachment level (CAL), and radiographic analysis of crestal alveolar bone mass, but not with respect to plaque index (PI). No serious adverse effects of the antibiotic treatment were observed in the present study. [ABSTRACT FROM AUTHOR]

Background: The benefit of full-mouth disinfection (FDIS) over traditional scaling and root planing (SRP) remains equivocal, and it is not known whether the use of adjunctive antibiotics may enhance the effect of FDIS. The aim of the present study is to test the hypothesis that there is no difference in the 1-year clinical outcome of therapy among groups of patients treated with conventional SRP performed over 2 to 3 weeks, or same-day FDIS, with or without adjunctive metronidazole. Methods: A total of 184 patients with moderate-to-severe periodontitis were randomly allocated to one of four treatment groups: 1) FDIS+metronidazole; 2) FDIS+placebo; 3) SRP+metronidazole; or 4) SRP+placebo. Recordings of plaque, bleeding on probing, probing depth (PD), and clinical attachment level (CAL) were carried out in four sites per tooth at baseline and at 3 and 12 months after treatment. Results: No differences were observed in the mean CAL or PD values between the four experimental groups at baseline and 3 or 12 months post-treatment. All four groups displayed significant improvements in all parameters. However, using absence of pockets ≥5 mm as the criterion for treatment success, the two groups receiving adjunctive metronidazole performed significantly better than the two placebo groups. Conclusion: Metronidazole had a significant, adjunctive effect in patients with a metronidazole-sensitive subgingival microbiota on the clinical parameters of CAL, PD, and absence of pockets ≥5 mm. [ABSTRACT FROM AUTHOR]

Background: Successful periodontal treatment requires a commitment to regular lifelong maintenance and may be perceived by patients to be costly. This study calculates the total lifetime cost of periodontal treatment in the setting of a specialist periodontal practice and investigates the cost implications of choosing not to proceed with such treatment. Methods: Data from patients treated in a specialist practice in Norway were used to calculate the total lifetime cost of periodontal treatment that included baseline periodontal treatment, regular maintenance, retreatment, and replacing teeth lost during maintenance. Incremental costs for alternative strategies based on opting to forego periodontal treatment or maintenance and to replace any teeth lost with either bridgework or implants were calculated. Results: Patients who completed baseline periodontal treatment but did not have any additional maintenance or retreatment could replace only three teeth with bridgework or two teeth with implants before the cost of replacing additional teeth would exceed the cost of lifetime periodontal treatment. Patients who did not have any periodontal treatment could replace ≤ 4 teeth with bridgework or implants before a replacement strategy became more expensive. Conclusions: Within the limits of the assumptions made, periodontal treatment in a Norwegian specialist periodontal practice is cost-effective when compared to an approach that relies on opting to replace teeth lost as a result of progressive periodontitis with fixed restorations. In particular, patients who have initial comprehensive periodontal treatment but do not subsequently comply with maintenance could, on average, replace ≤3 teeth with bridgework or two teeth with implants before this approach would exceed the direct cost of lifetime periodontal treatment in the setting of the specialist practice studied. J Periodontol 2012;83:1455-1462. [ABSTRACT FROM AUTHOR]

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

BACKGROUND: Gingivitis is an inflammatory disorder of the periodontium induced by dental plaque bacteria. Soluble beta-1,3/1,6-glucan (SBG) is known to enhance infection defense by preventing excessive inflammatory responses caused by bacterial endotoxins. AIM: The aim of the present study was to investigate the effect of SBG on experimental gingivitis in man. MATERIAL AND METHODS: Experimental gingivitis was induced over a period of 24 days in 30 healthy volunteers who were simultaneously treated with SBG. Two groups (n=10/group) rinsed twice daily with an SBG mouthwash that was either swallowed or expectorated. A third group (n=10) received a water rinse as a control. Plaque index (Pl.I), gingival index (GI), and amount of gingival crevicular fluid (GCF) were assessed at baseline and at six times during the study. RESULTS: The results showed that in the SBG groups, GCF decreased significantly during the study. The swallow group experienced a significant increase in GCF during the first week. The control group followed the expected pattern of experimental gingivitis, with a significant increase in the gingival fluid secretion during the test period. There was a significant increase in GI and Pl.I during the study for all groups, with no significant differences between them. No adverse effects of SBG were recorded. CONCLUSIONS: In this 24-day experimental gingivitis study of subjects who used either a SBG or a control mouthrinse: (1) all subjects had increased plaque and gingivitis, (2) GCF increased in control-rinse subjects and GCF decreased in SBG-rinse subjects. The only statistically significant difference between the SBG-rinse and control-rinse subjects was an increase in GCF at day 7 for subjects who rinsed and swallowed SBG. [ABSTRACT FROM AUTHOR]

Background: This randomized, double-masked, placebo-controlled clinical trial evaluated the effect of enamel matrix derivative (EMD) on clinical and radiographic parameters of periodontal intrabony defects. Methods: A split-mouth design was used in 16 chronic periodontitis patients who had similar defects (> or =6 mm of probing depth). Both groups underwent scaling and root planing and were acid-etched with EDTA. The test sites received the EMD solution and the controls a placebo. Clinical examinations of all 16 patients and radiographs of 14 patients were available at baseline and 6 and 12 months after surgery. Clinical outcomes included probing depth (PD) and clinical attachment level (CAL); radiographic analysis was performed using computerized linear measurements. Intergroup comparisons were performed by paired samples t test, and over time comparisons were made by general linear model (alpha = 0.05). Results: A statistically significant improvement over time for PD and CAL and a decrease of the vertical component of the defect was detected in both groups. Comparisons between groups revealed at baseline a mean+/-SD value of CAL of 12.93+/-2.00 and 13.47+/-2.93 for test and control groups, respectively. These values decreased to 10.92+/-1.92 and 11.31+/-1.86 after 12 months for test and control. No statistically significant differences could be observed between groups. PD displayed similar results from 7.57+/-1.02 and 7.38+/-1.16 for test and control groups at baseline to 3.40+/-1.82 and 2.99+/-1.07 after 12 months. If the data are divided into smokers and non-smokers, no differences are observed. Conclusion: Use of EMD did not result in more improvement in clinical and radiographic parameters compared to the placebo. [ABSTRACT FROM AUTHOR]

The purpose of the study was to compare the efficacy of two electric toothbrushes (Philips HP555 and the Philips Jordan 2-action Plaque Remover HP510). A manual toothbrush Jordan V-shaped, medium) served as control. Fifty subjects, aged 18-60 years, participated in a randomized, single-blind, 3 x 3 weeks crossover study. Plaque was assessed according to the Turesky modification of the Quigley-Hein index (P.I.), while the Løe-Silness index was used for assessing gingivitis. Adverse effects were assessed according to the ADA specifications. Compliance and preference were assessed through questionnaires and interviews, respectively. All periods mean P.I. (all surfaces) were 2.79, 3.01, and 2.86 for the manual, the HP555, and the HP510 electric brushes and the corresponding gingivitis values were 1.19, 1.22, and 1.21. For both indices, only the difference between the manual and the HP555 yielded significance (P = 0.04 and P = 0.02). Most subjects (28/50) preferred the HP5 10 brush, as it felt more practical to use and was perceived to have better cleaning ability. In conclusion. no clinically relevant differences in plaque reducing and gingivitis controlling ability were observed. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to investigate the effect of polyvalent cations on plaque formation in a test panel of students Heavy plaque formers were selected and plaque formation was enhanced by frequent sucrose rinses. Mouthrinses were performed twice daily with 20 mmol/l SnF2, SnCI2, AlCl3, ZnCl2 and MgCI2, and 40 mmol/l NaF and NaCI, It was found that SnF2 and SnCI2 exhibited a marked plaque-inhibiting capacity compared with NaF or NaCl. The aluminum, zinc and magnesium salts also reduced plaque formation, although not to the same degree Polyvalent cations may prevent plaque formation by interaction with negatively charged plaque components essential in the adsorption mechanism, or by inhibiting some enzyme activity essential in plaque formation [ABSTRACT FROM AUTHOR]

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

The Periodontal Treatment Need System (PTNS) was applied to a population group to test the system in the field. Three hundred and seventeen employees in a factory in Oslo, Norway, were examined. Their need for periodontal treatment was estimated Examples of manpower and cost calculations were formulated. The needs were also studied according to age, sex and income distribution. Age was found to be the important variable. Six stratified subsamples, based on age and sex distribution, were drawn. Ten, 20 and 30 % subsamples resulted in fairly accurate calculations when compared with the actual PTNS values. The application of the PTNS in the field indicated that the need for both preventive and interceptive periodontal therapy can be evaluated. From the PTNS scores, planning of manpower and thereby estimations of the costs to provide treatment were obtained. The system seemed to be simple and quick to apply. [ABSTRACT FROM AUTHOR]

Six alkyl-, 4 alicyclic- and 2 aryl-bis-biguanide formulations have been tested for plaque inhibition in vivo. The participants refrained from mechanical oral hygiene for 3 days while they employed aqueous test solutions as mouthrinses twice daily. During the experimental period the plaque formation was enhanced with frequent sucrose rinses. The antibacterial activity, the toxicity in cell agents showed plaque inhibitory capacity, most of them on a level comparable to that of chlorhexidine. There was a trend towards correlation between antibacterial activity, toxicity in cell culture, and plaque inhibition. The affinity of the compounds for bovine albumin seemed to be pH-dependent, thus indicating an electrostatic affinity between the bis-biguanides and protein. It has been suggested previously that protein-drug interaction might be an important aspect of the mechanism of chlorhexidine retention in the mouth. Discoloration of teeth and silicate fillings were frequently observed. [ABSTRACT FROM AUTHOR]