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Purpose: To evaluate the efficacy of SmartMouth Clinical DDS compared with 0.12% chlorhexidine and placebo mouthrinses.Materials and Methods: Seventy-six subjects with gingivitis or chronic periodontitis were enrolled in a double-blind, placebo-controlled, clinical study. Examinations included Gingival Index (GI), Bleeding Score (BS), Plaque Index (PI), Tooth Stain Index (TSI), and Calculus Index (CI). Subjects were given a prophylaxis and oral hygiene instructions at the time of enrolment. Subjects were assigned to one of three groups: SmartMouth Clinical DDS (SM), 0.12% chlorhexidine (CHX), or placebo (PL). Subjects were examined at 3 and 6 weeks. Data were evaluated as differences from baseline for each group. Analysis of variance (ANOVA), t tests or non-parametric alternatives were used to analyse data.Results: The GI, BS and PI decreases from baseline were statistically significant at both 3 and 6 weeks for all three groups (p ≤ 0.025). Differences between groups were not statistically significant, except that the PI decrease for CHX was significantly greater than PL at 6 weeks (p = 0.048). At 6 weeks there was a statistically significant increase in TSI for CHX (p ≤ 0.001). CI decreased significantly for all groups at 3 weeks (p ≤ 0.004) and for PL at 6 weeks (p ˂ 0.001). At 3 weeks and 6 weeks, the percentages for compliance were significantly higher for SM and PL than for CHX (p ˂ 0.001). SM had less taste alteration reported than CHX (p = 0.003).Conclusion: While all three groups were shown to improve GI, BS and PI scores; non-prescription SM resulted in less taste alteration, less tooth stain and better compliance than CHX. [ABSTRACT FROM AUTHOR]

Three case reports are presented that demonstrate the use of full-thickness flap/subepithelial connective tissue grafting for root coverage on the lingual surfaces of the mandibular anterior teeth. This is accomplished using an envelope full-thickness flap technique with intramarrow penetrations at the recipient site. Miller Class I, II, and III gingival recession defects and gingival perforation defects were treated. Complete root coverage was achieved in two Miller Class I gingival recession defects, in one Miller Class II gingival recession defect, and in two gingival perforation defects in areas that exhibited no radiographic evidence of bone loss. Partial root coverage was achieved in two Miller Class III gingival recession defects in an area that exhibited radiographic evidence of bone loss. Although the majority of the exposed root surface was covered in these two Miller Class III defects, about 1 mm of root surface remained exposed, which seemed to closely correspond to the amount of bone loss that was noted radiographically. A grafting technique has been presented that can be used to restore the functional properties of the lingual gingiva of the mandibular anterior teeth by repairing gingival defects and re-establishing the continuity and integrity of the zone of keratinized gingiva. Our clinical impression is that this has made it easier for the three patients presented in this report to maintain the lingual surfaces of the mandibular anterior teeth with routine oral hygiene measures. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is an etiologically and clinically heterogeneous group of metabolic disorders that share the commonality of hyperglycemia. Long-term hyperglycemia produces tissue damage, which ultimately manifests as microvascular and macrovascular disease, and neuropathy. The presence of macrovascular disease should alert clinicians to the possibility that the patient may have coronary artery disease, particularly because coronary artery disease and myocardial ischemia are likely to be silent. Elderly patients with diabetes mellitus are also more likely to develop congestive heart failure. Patients with unstable coronary syndromes, decompensated heart failure, and symptomatic cardiac arrhythmias are at increased risk of perioperative cardiovascular complications (myocardial infarction, heart failure, and sudden death) while undergoing noncardiac procedures. In addition, clinicians must avoid the risk of hypoglycemic episodes. Oral health care providers can expect to be called upon to care for patients with this progressively debilitating disease. To provide competent care to patients with diabetes mellitus, dental clinicians must understand the disease, its treatment, and the impact the disease and its treatment may have on the patient's ability to undergo and respond to dental care. [ABSTRACT FROM AUTHOR]