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Objective To investigate the efficacy of antibacterial photodynamic therapy (aPDT) as an adjunct to subgingival scaling and root planning in the treatment of chronic periodontitis. Methods This study followed medical ethics guidelines, and informed consent was obtained from all patients. Sixteen patients were recruited for this randomized split-mouth controlled trial. The control group underwent subgingival scaling and root planning (SRP), while the experimental group received subgingival scaling and root planing plus aPDT treatment using Perowave® with a toluidine blue O solution photosensitizer. The probing pocket depth (PD), recession, plaque index (PLI), bleeding index (BI) and proportion of positive sites of bleeding on probing (BOP) (BOP%) at all sites were examined at baseline (before treatment) and at 1, 3 and 6 months after treatment. Results Follow-up was completed for 13 patients. On the control side, 356 teeth were tested at 2 136 sites. A total of 360 teeth on the test side and 2 160 sites were included in the study. Before treatment, there was no significant difference in the baseline indicators between the two groups. After treatment, both groups showed significant improvement in clinical parameters, including PD, PLI, BI, and BOP%,compared with baseline. At 3 months, the BOP% and PLI in the experimental group were significantly lower than those in the control group (PP

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office 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: Studies suggest that chronic psychological stress can lead to oral health deterioration, alter the immune response, and possibly contribute to increased inflammation, which can impact the physiological healing of periodontal tissues. This cross-sectional study seeks to assess and improve clinical understanding regarding the relationship between perceived stress, mindfulness, and periodontal health. Methods: A total of 203 people were analyzed from December 2022 to June 2023. The Periodontal Screening and Recording (PSR) score and Gingival Bleeding Index (GBI), and Plaque Control Record (PCR) of every patient were registered. Subsequently, participants completed the Sheldon Cohen Perceived Stress Scale (PSS) and the Mindfulness Awareness Attention Scale (MAAS) questionnaires. The collected data underwent statistical analysis, encompassing the evaluation of correlations and dependencies. Applying Welch's t-test to assess the relationship between MAAS and the variable indicating the presence or absence of periodontitis, a noteworthy p-value of 0.004265 was obtained. Results: This underscores a significant distinction in MAAS scores between patients affected by periodontitis and those unaffected by the condition. Additionally, Pearson correlations were computed for GBI and perceived stress, PCR and perceived stress, PCR and MAAS. The resulting p-values of 2.2–16, 3.925–8, and 2.468–8, respectively, indicate a statistically significant correlation in each instance. Conclusions: These findings contribute valuable insights into the interconnectedness of these variables, emphasizing the significance of their associations in the study context. Despite the limitations, the findings of this study suggest a significant relationship between psychological stress, mindfulness, and periodontal tissue health. Clinical trials are necessary to incorporate the assessment of a patient's psychological status as a new valuable tool in the management of periodontal health. [ABSTRACT FROM AUTHOR]

Objectives: Recent data show that teeth prepared with horizontal finishing lines supporting crowns and fixed partial dentures present more periodontal disorders than untreated control teeth. Several studies have shown that NitrAdine (bonyf ) induces a significant reduction of dental biofilm. The aim of this study was to demonstrate that 10-day use of PerioTabs (bonyf ), a NitrAdine-based gingiva brushing solution, is effective in treating gingival inflammation of prosthodontic patients. Method and materials: Forty-nine subjects were instructed to brush their teeth, gingivae, and prostheses with the PerioTabs solution for 10 days (treatment group) and 49 with any toothpaste (control group). The initial and 11-day Plaque Index and Bleeding Index were recorded. A five-point Likert scale was used to evaluate the level of patient satisfaction. The Shapiro-Wilk statistical test was used to compare the results for the two groups. Results: Highly significant differences between the treatment and control group (P < .001) for the Plaque Index and Bleeding Index resulted. The treatment group patients' satisfaction was high: 31 (63.3%) reported the highest level, 5, on the Likert scale, and 18 (36.7%) declared they were satisfied (level 4). Conclusions: The use of a NitrAdine-based gingiva brushing solution (PerioTabs) was effective in reducing the gingival inflammation in periodontally affected patients treated with fixed partial dentures. Clinical relevance: The NitrAdine-based gingiva brushing solution (PerioTabs) was highly accepted by the patients and seems to be a promising alternative to the solutions widely used. [ABSTRACT FROM AUTHOR]

Restorative dentistry, in particular whole crown preparation is known to cause gingival recession. Inadequate partial dentures and soft tissue support can cause severe gum recession. Incorrect use of elevators in oral surgery procedures can destroy the alveolar bone of adjacent teeth causing recession. The aim of this study is to evaluate the cumulative factors influencing the final therapeutic success following the lowering of periodontal status with the type of prosthetic restoration performed.We evaluated a total of 80 prosthetic restorations, 20 veneers and 25 zirconia-supported ceramic crowns and 35 metal-ceramic crowns(CCM). The percentage of sites showing a periodontal space depth greater than 3 mm was lower in the porcelain veneer group. The frequency of periodontal pockets of 4 mm was 1% in the buccal surfaces of the veneers, 4% in the CCM buccal surfaces and 2% in the CCM palatal surfaces. There were no statistically significant differences between the determinations made at the sites assessed at the CCM level and those assessed at the veneers level. 1. Subgingival placement of prosthetic restorations has a negative impact on periodontal health and consequently on their aesthetic outcome. Ceramic veneers, due to their preparation requirements and the advantage they offer due to their all-ceramic structure, have the least impact on periodontal health status.

Objective To investigate the influence of smoking on subgingival flora after periodontitis treatment through microbiological experiments. Methods Fifty-nine patients with periodontitis who completed periodontal treatment in the Department of Stomatology of Nanjing Jiangbei Hospital from 2019 to 2021 were selected and divided into smoking group(30 patients) and non-smoking group(29 patients). The clinical samples of patients's periodontal pockets before and after treatment were collected for detection of Actinobacillus (Aa), Porphyromonas gingivalis (Pg), Plasmobacterium intermedius (PI), Bacteroides forsythiae (Bf), Fusobacterium nucleatum (Fn) and Streptococcus minimus (Pm). Results After treatment, the bleeding index and periodontal attachment of the smoking group were better than those before treatment, while the plaque area index, bleeding index, periodontal pocket depth and periodontal attachment of the non-smoking group were better than those before treatment, and the plaque area index, periodontal pocket depth and periodontal attachment of the non-smoking group were better than those of the smoking group, with statistically significant differences(P＜0.05). After treatment, the positive rate of Pg and Pi in the smoking group was lower than that before treatment, the positive rate of Aa, Pg, Pi, Bf, Fn and Pm in the non-smoking group was lower than that before treatment, and the positive rate of Pg, Bf, Fn and Pm in the non-smoking group was lower than that in the smoking group, with statistically significant differences(P＜0.05). Conclusion Compared with smokers, non-smokers have better periodontal attachment recovery and lower detection rate of periodontal bacteria after periodontal treatment.

Aim: To analyze and compare the effectiveness of two antibacterial gels in the treatment of mucositis. Methods: After signing the informed consent, in accordance with the Helsinki Declaration of 1975, revised in 2000, 21 patients were included in the study and divided by randomization into two groups. At the baseline, the modified bleeding index (mBI) and plaque index (PI) values were measured, and an oral hygiene and implant disinfection session was carried out. The session was repeated at 7, 15, and 30 days and after 2 and 3 months from the baseline. Two products were used—a bioadhesive gel in the test group and a 1% chlorhexidine gel in the control group. Results: Due to three dropouts, the final sample was composed of 18 patients. An improvement in periodontal indices was observed, similar to mBI and PI values, in both groups. There were no complications except for the appearance of pigmentations in the control group. Conclusions: The antibacterial power and effectiveness of the two gels are comparable. Considering the small sample size of the study cohort, further studies are needed to validate the results obtained from this pilot study. [ABSTRACT FROM AUTHOR]

Introduction: While Chlorhexidine mouthwash is widely studied for the treatment of periodontal disease, research on chlorhexidine in the form of dental floss is limited. This study aims to evaluate the effect of chlorhexidine wax-coated dental floss on dental plaque accumulation and gingival bleeding. Additionally, antibacterial activity and cellular toxicity were also investigated in vitro., Methods: Various concentrations of chlorhexidine wax-coated floss (0%, 0.12%, 1%, and 2%) were prepared. The antibacterial activity against Streptococcus mutans was studied using a disc diffusion assay. Cellular toxicity was assessed in L929 cells and human gingival fibroblasts using an MTT assay. To evaluate the effects on plaque accumulation and gingival bleeding, 27 participants were randomly divided into 3 groups: 1) 0% chlorhexidine wax-coated dental floss (control), 2) 0.12% chlorhexidine wax-coated dental floss, and 3) 1% chlorhexidine wax-coated dental floss. All participants were instructed to use the provided dental floss once daily at bedtime for 14 days. Six sites per tooth were evaluated for the Quigley-Hein plaque index and bleeding index (BI) at day 0 (baseline) and day 15. All fully erupted teeth, except the third molars, were examined., Results: Chlorhexidine-coated floss exhibited antibacterial activity against S. mutans in a dose-dependent manner. In an in-vitro study, a 2% concentration of chlorhexidine in the floss was found to be highly toxic, leading to its exclusion from clinical trials. After 14 days of use, significantly lower levels of BI were observed in the groups using chlorhexidine wax-coated dental floss, compared to the control. Additionally, there was no significant difference in BI between the 0.12% and 1% chlorhexidine wax-coated dental floss groups. However, no significant difference in plaque index was found between the groups using chlorhexidine wax-coated dental floss and the control group., Conclusions: This study demonstrated the antibacterial and anti-gingivitis properties of chlorhexidine wax-coated dental floss. Our results showed that using chlorhexidine wax-coated dental floss at a concentration as low as 0.12% could significantly reduce gingival bleeding. However, no additional benefit of chlorhexidine wax-coated dental floss on dental plaque accumulation was found., Competing Interests: Conflict of interest The author declares that there are no conflicts of interest to report., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose: This study aimed to compare the efficacy of single implants in the symphyseal and parasymphyseal regions with that of two implants in complete mandibular overdentures., Patients and Methods: Fifteen completely edentulous male patients (50-65 years) were chosen and randomly grouped into three equal groups (five patients in each) according to the position and number of the received implants to assist mandibular complete overdentures: group I: single median implant; group II: single parasymphyseal implant; and group III: two implants were inserted in the canine area bilaterally. After three months of osseointegration, the lower denture was transformed into an implant-assisted complete mandibular overdenture. Clinical observations were documented on the day of loading, and three, six, and nine months later for each implant. Follow-up cone beam computed tomography scans were performed to assess marginal bone loss on the day of loading, and six and twelve months later. The masticatory efficiency evaluation was conducted one and three months after loading., Results: The obtained results demonstrated insignificant differences between the three groups concerning marginal bone loss, plaque index, pocket depth, and bleeding index. Regarding the masticatory efficiency, the results revealed a significantly higher masticatory efficiency in group III than in groups I and II., Conclusion: Using two implants to retain mandibular overdentures is the first choice due to their higher masticatory efficiency than a single implant. However, a single implant may be a viable treatment alternative, especially in cases where there are any limitations that restrict the use of additional implants., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Research Ethics Committee, Faculty of Dental Medicine, Al-Azhar University, Asyut issued approval AUAREC20210006-5. The Research Ethics Committee, Faculty of Dental Medicine, Al-Azhar University, Asyut, met on June 8, 2021, and reviewed the presented documents for the research and approved the research. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Al-Gazzar et al.)

Statement of the Problem: Ultra-soft bristles are recommended for individuals with gingival recession, dentinal hypersensitivity, and patients who have undergone periodontal surgeries. However, comparative effectiveness of ultra-soft toothbrushes on dental plaque and bleeding indices has not extensively been studied, and a consensus has yet to be reached on their efficacy. Purpose: The aim of this study was to investigate the effect of ultra-soft toothbrushes with different commercial brands on plaque and bleeding indices. Materials and Method: In this crossover randomized clinical trial, 30 participants were selected using convenience sampling method. The subjects were randomly divided into three groups (n=10). In the first session, the bleeding index was recorded. Then each subject was given a toothbrush (Oral B, GUM, or Fuchs), asked to brush at least twice a day using the Bass technique, then avoid brushing for 24 hours after a week and refer for recording the indices. During the second session, bleeding on probing was recorded before brushing, and plaque indices were recorded before and after brushing. Plaque indices before brushing were considered the baseline plaque indices. After one week of washout, each subject used the next toothbrush in terms of the group involved. Turesky plaque index, O’Leary plaque index, and bleeding index were evaluated. The distribution of data was normal. Therefore, ANOVA, t-test, and post hoc tests were used for the analysis of data. Results: The bleeding and plaque indices decreased significantly compared to the baseline with the use of all the three ultra-soft toothbrushes evaluated (p< 0.05), with no significant differences between the three brands (p> 0.05) except for the superiority of Fuchs toothbrush in decreasing the Turesky plaque index. Conclusion: Ultra-soft toothbrushes can reduce plaque index compared to the baseline, but they do not decrease the plaque index up to the optimal level, which might affect their prescription.

Background and objectives: The primary etiology for gingivitis is dental plaque resulting in gum inflammation. Beside mechanical procedures, chemical agents in mouthwash can help in removal of plaques. Oil of Trachyspermum ammi rich in thymol may provide beneficial effect in control of gingivitis; therefore, the present study aimed to compare the effect of mouthwash containing the oil with chlorhexidine to control dental plaque and inflammation of gingivae. Methods: Essential oil of the plant was analyzed using GC-MS and amount of thymol was assayed by GC method. Herbal mouthwash was prepared and applied in an open-label non-randomized study, adult female and male suffering of gingivitis (N=30) entered in two groups after oral prophylaxis. Examining for plaque index (PI), bleeding index (BI), and modified gingival index (MGI) were conducted after two weeks administration of the herbal mouthwash. Results: The herbal mouthwash was stable for two months with no physical change and microbial contamination (0.05). Conclusion: The effect of T. ammi oil in control of inflammation was comparable with chlorhexidine, while chlorhexidine reduced risks of PI, BI, and MGI higher than those receiving the herbal mouthwash.

Aim: To analyze and compare the effectiveness of two antibacterial gels in the treatment of mucositis. Methods: After signing the informed consent, in accordance with the Helsinki Declaration of 1975, revised in 2000, 21 patients were included in the study and divided by randomization into two groups. At the baseline, the modified bleeding index (mBI) and plaque index (PI) values were measured, and an oral hygiene and implant disinfection session was carried out. The session was repeated at 7, 15, and 30 days and after 2 and 3 months from the baseline. Two products were used—a bioadhesive gel in the test group and a 1% chlorhexidine gel in the control group. Results: Due to three dropouts, the final sample was composed of 18 patients. An improvement in periodontal indices was observed, similar to mBI and PI values, in both groups. There were no complications except for the appearance of pigmentations in the control group. Conclusions: The antibacterial power and effectiveness of the two gels are comparable. Considering the small sample size of the study cohort, further studies are needed to validate the results obtained from this pilot study.

Objective: To investigate the value of elastase in gingival crevicular fluid before and after orthodontic treatment in patients with periodontitis, it hope to provide reference for early prediction of patient prognosis. Methods: From December 2016 to October 2019, 68 cases of patients with periodontitis in our hospital were selected as the research target. All patients were given orthodontic treatment, and the changes of elastase, Probing depth (PD), bleeding on probing (BOP), attachment loss (AL) at before and after orthodontic treatment were detected, and were to determine the patient's condition and prognosis, and they given correlation analysis and influencing factor analysis. Results: All patients were completed the treatment and were satisfied with the aesthetics, retention and stability of orthodontic treatment. The PD, BOP, AL gingival crevicular elastase values at 1 month after treatment and 3 months after treatment were lower than before treatment (P<0.05), and the 3 months after treatment were also lower than 1 month after treatment (P<0.05). The gingival crevicular elastase values at 1 month after treatment and 3 months after treatment were lower than before treatment(P<0.05), and the 3 months after treatment were also lower than 1 month after treatment(P<0.05). Spearman analysis showed that there were significant positive correlation between the difference in the change of sputum fluid elastase and the difference of PD, BOP and AL before treatment and 3 months after treatment(P<0.05). Multivariate logistic regression showed that the difference of PD, BOP and AL were the main factor affected the difference of eosinase change in gingival crevicular fluid (P<0.05). Conclusion: The level of elastase in gingival crevicular fluid of patients with periodontitis are significantly decreased before and after orthodontic treatment, which are significantly correlated with the patient's condition and are important indicators to reflect and predict the prognosis of patients. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Ultra-soft bristles are recommended for individuals with gingival recession, dentinal hypersensitivity, and patients who have undergone periodontal surgeries. However, comparative effectiveness of ultra-soft toothbrushes on dental plaque and bleeding indices has not extensively been studied, and a consensus has yet to be reached on their efficacy. Purpose: The aim of this study was to investigate the effect of ultra-soft toothbrushes with different commercial brands on plaque and bleeding indices. Materials and Method: In this crossover randomized clinical trial, 30 participants were selected using convenience sampling method. The subjects were randomly divided into three groups (n=10). In the first session, the bleeding index was recorded. Then each subject was given a toothbrush (Oral B, GUM, or Fuchs), asked to brush at least twice a day using the Bass technique, then avoid brushing for 24 hours after a week and refer for recording the indices. During the second session, bleeding on probing was recorded before brushing, and plaque indices were recorded before and after brushing. Plaque indices before brushing were considered the baseline plaque indices. After one week of washout, each subject used the next toothbrush in terms of the group involved. Turesky plaque index, O’Leary plaque index, and bleeding index were evaluated. The distribution of data was normal. Therefore, ANOVA, t-test, and post hoc tests were used for the analysis of data. Results: The bleeding and plaque indices decreased significantly compared to the baseline with the use of all the three ultra-soft toothbrushes evaluated (p< 0.05), with no significant differences between the three brands (p> 0.05) except for the superiority of Fuchs toothbrush in decreasing the Turesky plaque index. Conclusion: Ultra-soft toothbrushes can reduce plaque index compared to the baseline, but they do not decrease the plaque index up to the optimal level, which might affect their prescription. [ABSTRACT FROM AUTHOR]

Background: Orthodontic patients are at greater risk due to the inability to clean around the components directly bonded to teeth. Hence, the aim of the present network meta‐analysis is to compare the utility of powered toothbrushes in plaque control in patients with orthodontic brackets compared with manual tooth brushing. Methodology: Necessary data were extracted and analysed for Risk of Bias. Heterogeneity was assessed using Chi‐square and I2 tests. Random effects model was used for both direct and mixed treatment comparisons. Standardized mean difference with 95% confidence interval was the effect estimate for plaque and bleeding scores and mean difference for pocket depth. Inconsistencies between the direct and indirect estimates were evaluated by H‐statistics. GRADE approach was used to assess the quality of evidence. Results: Pooled results from 14 studies showed significantly higher plaque scores in patients using manual toothbrushes. Pooled results from 13 studies showed significant higher bleeding scores as well with manual brushes. There was a significant reduction in pocket depth with electric toothbrushes. Conclusion: Powered toothbrushes are a promising alternative for plaque control in patients with fixed orthodontic brackets. Stronger evidence can be established with addition of long‐term clinical trials based on the recommendations. [ABSTRACT FROM AUTHOR]

Purpose: Pre-operative anaemia treatment has been associated with reduced morbidity in joint arthroplasty. This study examined the impact of a surgical prescription of epoetin (EPO) in contemporary total hip arthroplasty (THA).Methods: We conducted a comparative study in a series of 1402 primary THAs performed in patients all having a pre-operative haemoglobin (Hb) level documented four to eight  weeks before THA surgery. In group A (647 hips), one subcutaneous injection of 40,000 IU EPO once a week for four weeks was prescribed at the discretion of anaesthetist during the pre-operative visit in patients with pre-operative Hb between 10 and 13 g/dl. In group S comprising the remaining 755 hips, an amended EPO therapy including two  injections of 20,000 to 40,000 IU was prescribed by the surgeon in patients with Hb less than 12 g/dl deemed at high risks to be transfused following THA. Primary study endpoint was the bleeding index (BI).Results: EPO therapy was delivered in 43 patients (6.7%) in group A and in 26 patients (3.4%) in group S (p = 0.006). The mean total dose of EPO administrated was 115,349 IU in group A versus 75,200 IU in group S (p < 0.001). The mean BI were 2.7 ± 1.0 in group A and 2.8 ± 1.0 g/dl in group S (p = 0.375). No patient was blood-transfused up to post-operative day seven in group S versus five patients in group A (p = 0.021).Conclusions: The amended protocol does not lead to increased peri-operative bleeding. Advances in intra-operative methods to reduce the bleeding allow changing indications of EPO in patients undergoing THA with a low level of Hb. [ABSTRACT FROM AUTHOR]

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH 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.)

To explore the clinical efficacy of photodynamic therapy (PDT) in the treatment of patients with mild and moderate periodontitis. Methods: 46 patients with mild and moderate periodontitis who were treated in our hospital from January 2016 to August 2017 were selected as the research subjects, a total of 276 teeth were selected, which were randomly divided into the observation group and the control group, with 138 teeth in each group. The control group was treated with scaling and root planing (SRP), and the observation group was treated with PDT on the basis of the control group. The probing depth (PD), the positive rate of bleeding on probing (BOP) and bleeding index (BI) in two groups before treatment, 1 months, 2 months and 3 months after treatment were compared. Results: After 1 month, 2 months and 3 months of treatment, PD in the two groups gradually became shallower with time (P<0.05), and the PD in the observation group at each time point after treatment were shallower than that in the control group (P<0.05); The positive rate of BOP in two groups was lower than before treatment, and the positive rate of BOP in the observation groupat each time point after treatment were lower than that in the control group (P<0.05); The BI in the two groups became lower with time，and the BI in observation group at each time point after treatment were lower than that in the control group (P<0.05). Conclusion: PDT assisted treatment of mild and moderate periodontitis has a good clinical effect, which can reduce PD, and Bl, improve the positive rate of BOP. [ABSTRACT FROM AUTHOR]

Background and Aim: Substantial evidence supports an association between chronic infections/inflammation, and cancer. The aim of this study was to assess the effect of chronic periodontitis on head and neck squamous-cell carcinoma (HNSCC).

BACKGROUND AND AIM: Due to the inadequate of a toothbrush in cleaning of interdental areas and further advanced developing of the disease in this area, dental flossing seems essential. However, the developing of people’s using dental floss as a habit is difficult. The purpose of this paper is to determine the use of dental floss frequency in reducing plaque and the optimal dental floss daily use frequency in people with a healthy periodontium. METHODS: In this study, 44 dental students of School of Dentistry, Kerman, Iran, with healthy periodontal or at most a few bleeding on probing (BOP) areas were investigated. Scaling and root planning was performed for all subjects at baseline as well as necessary trainings about how to use the toothbrush and dental floss were instructed. In terms of using dental floss frequency, participants were divided into four groups of 22 each G1, G2, G3, and G4 which were meant to be used dental floss in every second day, a day, 2 or 3 times a day, respectively. At baseline, total plaque index (TPI), internal plaque index, and internal bleeding index were evaluated after 3 and 6 weeks. The collected data were analyzed by SPSS, statistical tests ANOVA, and paired t-test. RESULTS: In this study, there was a significant reduction in plaque index after 6 weeks (P < 0.050) however there was no significant difference between groups in terms of the interdental bleeding index (IBI). CONCLUSION: According to the results of this study, if a person with normal periodontal tissues uses the toothbrush and dental floss properly, using dental floss in every other day is sufficient to maintain the gingival healthy.

Background and aim Substantial evidence supports an association between chronic infections/inflammation, and cancer. The aim of this study was to assess the effect of chronic periodontitis on head and neck squamouscell carcinoma (HNSCC). Material and methods The study population consisted of 46 patients, divided into two groups. Cases were patients diagnosed with primary HNSCC (n=26). Controls were all patients seen during the same period of time but negative for malignancy (n=20). The severity of periodontitis was assessed through clinical determination of the bleeding index, periodontal index, tooth mobility degree and alveolar bone loss (ABL) on standardized panoramic radiographs. Results and discussions: Each millimeter of ABL was associated with >4-fold increased risk of HNSCC. The strength of the association was greatest in the oral cavity, followed by the oropharynx and larynx. The association persisted in subjects who never used tobacco and alcohol. Patients with periodontitis, whose bleeding and periodontal indices and tooth mobility values were higher, were more likely to have poorly differentiated oral cavity SCC than those without periodontitis (32.8% versus 11.5%; P = 0.038). Conclusions This study suggests that chronic periodontitis is a risk factor for HNSCC. These results have implications for practical and improved strategies for prevention, diagnosis, and treatment of HNSCC.

Background: Several studies have recently demonstrated that active communication to explain the importance of oral hygiene can improve the oral health of orthodontic patients. The main objective of this study was to evaluate the effects of a structured text message communication on orthodontic patient's oral hygiene compliance for tooth brushing, plaque control and gingival health. This Randomized clinical trial was conducted on 100 patients of both sex with age range between 15-25 years recruited from orthodontics department de, Montmorency College of Dentistry, Lahore. All participants were undergoing fixed orthodontic appliance therapy. Participants were randomized in to text message and control group. Pre, during and post-trial examinations were carried out by author her-self using blind and calibrated methodology using plaque, bleeding and modified gingival indices. Results showed that text message group expressed a statistically significant (P<0.001) decrease in Bleeding Index score, Plaque Index score and Modified Gingival Index score from 0-60 days as compared to control group. This was concluded that text message reminder system is effective for improving oral hygiene compliance in orthodontic patients. Bleeding Index, Plaque Index and Modified Gingival Index scores were significantly lower in the text message group than control group. There is a need of clinical trial with longer duration on large number of subjects in the age range of 15-40. [ABSTRACT FROM AUTHOR]

Neonatal thrombocytopenia is widespread in preterm and term neonates admitted to neonatal intensive care units, with up to one-third of infants demonstrating platelet counts <150 × 10(9)/L. Thrombocytopenia may arise from maternal, placental or fetal/neonatal origins featuring decreased platelet production, increased consumption, or both mechanisms. Over the past years, innovations in managing neonatal thrombocytopenia were achieved from prospectively obtained clinical data on thrombocytopenia and bleeding events, animal studies on platelet life span and production rate and clinical use of fully automated measurement of reticulated platelets (immature platelet fraction). This review summarizes the pathophysiology of neonatal thrombocytopenia, current management including platelet transfusion thresholds and recent developments in megakaryopoietic agents. Furthermore, we propose a novel index score for bleeding risk in thrombocytopenic neonates to facilitate clinician's decision-making when to transfuse platelets. [ABSTRACT FROM AUTHOR]

•Introduction: Systemic disease is often closely linked to the state of the oral cavity. One of thesesystemic diseases is diabetes mellitus. The purpose of this study is to determine the effect of scaling androot planning and mouth rinse on blood sugar level in type 2 diabetic patients.•Methods and Materials: 30 uncontrolled type 2 diabetic patients suffering from sever chronicperiodontitis were selected and divided into two groups; each group consisted of 15 patients: Firstgroup (control): received oral hygiene instruction. Second group (case): received scaling and rootplanning plus oral hygiene instruction and chlorhexidine degluconate mouthrinse. In all groups,probing depth (in 6 sites of each tooth), bleeding index (in 4 sites of each tooth), fasting blood sugarand glycated hemoglobin were measured at first and three months after treatment. Then the before andafter treatment results were compared.•Results: Mean fasting blood sugar in second group, reduced from 184.2 to 163.87 mg/dl. Glycatedhemoglobin in this group reduced from 8.78% to 7.29% (p

This study was conducted to evaluate the use of plasma rich in growth factors (PRGFs) with immediate implant placement in periodontally compromised extraction sites. Fifteen patients with chronic periodontitis were included. Each received two implants placed immediately after extraction in the anterior region of the mandible. One of the two implants was treated with PRGFs (group I), while the other was not and served as a control (group II). Implant survival, plaque index (PI), bleeding index (BI), probing pocket depth (PPD), and marginal bone loss (MBL) were evaluated for both groups. Complete soft tissue healing occurred in all patients and all implants were successfully osseointegrated over 12 months. At 12 months, results showed mean PPD values of 3.8 ± 0.3 mm at the control site (group II) and 3.4 ± 0.4 mm at the test site (group I); the mean MBL values were 1.1 ± 0.1 mm at the control site and 0.6 ± 0.1 mm at the test site. There were no statistically significant differences between the test and control groups regarding PI or BI, while there were statistical differences between the test and control groups regarding PPD and MBL throughout the follow-up period. [ABSTRACT FROM AUTHOR]

The growing awareness about dental aesthetics and functionality in the general population has led to more and more people seeking orthodontic treatment. The patient's ability to achieve and maintain good overall oral hygiene and prevent periodontal disease is fundamental while undergoing orthodontic treatment. This study was done to evaluate the periodontal health status of Saudi patients scheduled for fixed orthodontic treatment. Fifty patients (12-26 years old) were selected from orthodontic clinics of King Abdul-Aziz Medical City of National Guard, Riyadh, Saudi Arabia. The periodontal health status of the patients was evaluated using the plaque index (PI), the orthodontic plaque index (OPI) and the gingival bleeding index (GBI). These indices were determined prior to the placement of fixed appliances, after 6 months and after 12 months of the beginning of the orthodontic treatment. Results showed that PI and OPI were high with mean scores of 65.24 ± 16.43 for PI and 53.56 ± 8.74 for OPI, while the average GBI scored a much lower value of 19.14 ± 7.95. After 6 months of treatment, the probing pocket depth at the first molars was 1.5-2.0 mm. In some severe cases it exceeded 3mm. After 12 months of treatment, the probing pocket depth was greater than that observed at 6 months and it mostly fell in the range of 2.0-2.5mm. No significant differences were observed between male and female patients for the PI (p=0.925) and for OPI (p=0.072); However, a significant difference was observed for the GBI (p=0.033). Thus it was concluded that plaque deposition during orthodontic treatment can promote periodontal inflammation and destruction. Oral hygiene measures, patient education and motivation can help maintain oral hygiene and minimize the hazardous effects of orthodontic treatment on periodontal tissues. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effectiveness of two varieties of special needs toothbrushes in terms of dental plaque removal and bacterial contamination vs a conventional toothbrush in patients with Down syndrome., Materials and Methods: This single-blinded, two-group, randomised clinical trial included 16 patients diagnosed with Down syndrome (age 6-15 years) from various special needs centers located in the Jazan Province of Saudi Arabia. The patients were randomly allocated to two groups based on the type of special needs toothbrush provided (Collis Curve or superfine nano). The plaque and bleeding indices of the patients in both groups were measured at baseline (T0) and both groups were initially given a conventional toothbrush to use for four weeks. After this period, the plaque and bleeding indices were re-evaluated (T1). The patients were instructed to use the special needs toothbrush for 4 weeks, after which the periodontal indices were re-evaluated (T2). Microbial contamination on the bristles of the special needs brushes was evaluated at T2., Results: No notable changes in the mean plaque and bleeding indices were observed between the two groups at each visit; however, statistically significant reductions were noted between visits in both groups (p < 0.05). The CFU scores in cultures from the Collis Curve toothbrush bristles (1411.5 ± 541.1) were higher than those obtained from the superfine nano-toothbrush bristles (1118.3 ± 423.9), but without statistically significant differences., Conclusion: The findings indicate that the use of special needs toothbrushes can statistically significantly improve the gingival health status in individuals with Down syndrome in terms of both resolution of periodontal inflammation and reduction of plaque accumulation.

Objective The aim of this study was to compare the use of two chlorhexidine-based antimicrobial agents as an adjunct to mechanical therapy for the treatment of peri-implant mucositis. Materials and methods Thirty patients with peri-implant mucositis were included in the study and randomized in two groups. In addition to mechanical therapy, group A was treated with chlorhexidine 0.2% mouthwash, while group B was treated with chlorhexidine 1% gel. Probing depth, plaque index and bleeding index were recorded at each scheduled follow-up visit: ten days, 1 month and 3 months after giving the patients the assigned formulation. Patients had to fill in a questionnaire investigating their satisfaction and ease of use of the product. Results A total of 23 patients (13 in group A and 10 in group B) attended all the follow-up visits. Chlorhexidine 0.2% mouthwash and chlorhexidine 1% gel were equally useful in the treatment of peri-implant mucositis leading to the reduction in inflammatory parameters. Probing depth decreased over time in both groups. Patients showed preference for gel formulation even if they found it more difficult to use. Conclusions Adjunctive treatment with different chlorhexidine formulations was beneficial to the treatment of peri-implant mucositis. Besides, no differences could be found between 0.2% mouthwash and 1% gel. [ABSTRACT FROM AUTHOR]

Abstract: We aimed to assess bleeding complications after increasing the thromboprophylactic dose of dalteparin from 2500 to 5000 units 12h preoperatively in line with guidance on risk stratification and appropriate pharmacological thromboprophylaxis. We evaluated two groups of patients for confounding factors and bleeding, a prospective consecutive high dose group (n =29), and a retrospective low dose group (n =30) who had had ablative and microvascular reconstructive surgery for oral or oropharyngeal cancer. The bleeding index over 5 days (range 40–60) was used as an objective measure of perioperative bleeding. The null hypothesis was that there was no difference in the bleeding index between the two groups. We found no significant difference in the mean bleeding index between the two groups (p =0.56) (mean (SD) bleeding index in the high dose group 45.3 (26.1), and 48.7 (18.1) in the low dose group). The 95% confidence interval (CI) was −1.51 lower to 0.83 higher in the high dose group. Five patients (2 (7%) in the high dose, and 3 (10%) in the low dose group) were returned to theatre with bleeding complications. There was a trend to a higher failure rate of free flaps in the high dose group (4 (13%) complete, and 1 partial failure compared with 1 (3%) complete and 1 partial failure in the low dose group). There were no symptomatic thromboembolic events in either group. An increased dose of dalteparin did not seem to increase conventional surgical bleeding complications, which was consistent with the null hypothesis at evidence level 2b, but a larger sample is needed to explore its impact on venous thromboembolic events and on the failure of microvascular free flaps. [Copyright &y& Elsevier]

Aim: To compare the use of interdental brushes to a periodontal probe in assessing marginal bleeding, in natural gingivitis. Materials and methods: Sixty-four consecutive volunteers presenting with gingival inflammation were recruited at their semiannual recall appointments for this study. All had ≥50% papillary height and no pocketing that exceeded 4 mm. Contra-lateral quadrants (1 & 3 or 2 & 4) were randomly tested for bleeding with one pass-through with an interdental brush or with a periodontal probe inserted 2 mm into the gingival sulcus. The presence or absence of both bleeding and plaque were then recorded. Correlation coefficients were calculated for the interdental brushes and the periodontal probe, and the plaque and bleeding scores. Results: The periodontal probe and the interdental brushes showed mean average bleeding scores of 47.39% and 45.74% respectively. The correlation coefficient for the two methods was 0.73 (P < 0.0001). No correlation between plaque and bleeding was found. Conclusions: Interdental brushes can be considered a valid alternative to a periodontal probe in assessing marginal bleeding in gingivitis patients. An interdental brush, sized correctly for each interdental space, is easy to handle, atraumatic to the papillae and will allow gingivitis patients to monitor their own progress, while at the same time performing a beneficial oral hygiene procedure and removing any interdental plaque present. [ABSTRACT FROM AUTHOR]

Aim: Examination of parodontal status in patients with partial removable dental prostheses in comparison with the patients with fixed prostheses or without. Material and method: 60 patients were clinically examined, divided in 3 groups: patients with partial removable dental prostheses, patients with fixed dental prostheses and patients without prostheses. Parodontal exam was made, the bleeding, plaque and gingival indices were determined and the insertion loss and dental mobility were measured. Results and discussions: A more important parodontal affection was observed in patients with partial removable dental prostheses in respect to the other groups. Maximum values of parodontal indexes appear at the abutmant teeth of partial removable dental prostheses, no metter if they are covered by fixed restaurations or not. Abutmant teeth present greater values of the parodontical indexes than the remaining teeth. Conclusions: Abutmant teeth of partial removable prostheses present more often parodontal affection than the rest of the teeth. Through a careful supervision and proper hygiene, the degradation of the prosthetic field can be prevented. [ABSTRACT FROM AUTHOR]

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Abstract Aim: The purpose of the present study was to compare 2 indices, i.e., the Eastman interdental bleeding (EIB) index and the bleeding on marginal probing (BOMP) index. The comparison was made (a) in terms of the degree of bleeding provoked and the relationship with plaque in natural gingivitis and (b) for the ability of these 2 methods to detect differences between the development of experimental gingivitis in a control group and a group in which the development of gingival inflammation was suppressed by treatment. For the present studies, subjects were selected without interdental recession of the gingival tissues. Methods experiment 1: In this experiment, 43 subjects having established moderate gingivitis were assessed using a random splitmouth design (1st and 3rd/2nd and 4th quadrant). Plaque was scored on all approximal sites after which the BOMP index was assessed in one half of the mouth and the EIB index in the other. Results experiment 1: The BOMP index showed a bleeding score of 84% and the EIB index of 87%. The significant correlation between plaque and gingival bleeding for the BOMP index (0.55) was higher than for the EIB index (0.44). Methods experiment 2: For this experiment, 25 subjects participated in an experimental gingivitis trial of the lower jaw. At baseline, first the BOMP index and immediately thereafter the EIB index were assessed at all approximal sites. Experimental gingivitis (EG) was carried out in one randomly assigned quadrant and as a treatment modality only floss was used in the other (FL). Results experiment 2: In the EG quadrant, the BOMP index increased to 69% and the EIB index to 73%. Both indices showed a significant correlation with plaque; 0.60 and 0.64 respectively. In the FL quadrant, the BOMP index increased to 38% and the EIB index to 30%. No significant correlation between both gingivitis indices and the amount of plaque was present in the FL quadrant. Conclusion: The ability of the BOMP index and the EIB index... [ABSTRACT FROM AUTHOR]

A number of gingival indices have been described which include visual and invasive components, either separately or in combination. In selecting indices for use in gingivitis therapeutic trials, some investigators maintain that only invasive indices should be used, since indices that include a bleeding-on-provocation component are deemed to be the most objective. Other investigators, however, maintain that non-invasive indices are the more appropriate insofar as invasive procedures will not only disrupt the plaque at the gingival margin, but could also mildly traumatize the tissue and present an impediment to assessing examiner standardization and reproducibility. This paper discusses these aspects of gingivitis evaluation. The data indicate that all validated indices, whether invasive or non-invasive, have some degree of both objectivity and subjectivity. Therefore, the selection of an appropriate index will depend upon the ability of a given index to achieve the objectives of the clinical trial in which it is to be utilized. [ABSTRACT FROM AUTHOR]

This investigation was undertaken to determine the intra- and inter- examiner reliability of the method of stimulation for bleeding used in the Eastman interdental bleeding index. 26 subjects were examined twice, 1 h apart. by either a single examiner or 2 examiners in each half of their mouths, for the presence of bleeding after stimulation with a wooden interdental cleaner. Scores were tabulated and intra- and inter-examiner % agreements and χ-coefficients calculated. Z-tests were performed on the pairs of agreement statistics to check for significant differences. Overall. intra-examiner agreement statistics were high (91.3% to 93.1% agreement; 0.79 to 0.86 χ-coefficient). Further breakdowns of the data into facial and lingual sites by arch and location (anterior or posterior) resulted in similar levels of reliability, with no significant differences within examiners. The overall inter-examiner agreement statistics were good (82.8% to 87.6% agreement; 0.62 0.75 kappa coefficient). When inter-examiner data were analyzed at facial or lingual sites by arch and location, a significant difference existed in reliability for mandibular posterior lingual sites, but reliability was high in all other areas. These data demonstrate a high level of reproducibility for this method, which suggests that the Eastman interdental bleeding index is suitable for clinical trials and epidemiologic studies of interdental gingivitis. [ABSTRACT FROM AUTHOR]

• NUG is an acute periodontal infection generally treated by robust periodontal therapy. • Bleeding scores were significantly improved with PCT. • PCT has a large impact in reducing pathogenic bacteria over the period of 6 weeks. This study was designed to investigate the clinical and microbiological parameters with photochemotherapy (PCT) against conventional debridement (CD) among patients with necrotizing ulcerative gingivitis (NUG). Patients with a diagnosis of NUG were divided into two groups: 'Group-PCT' that underwent indocyanine green-mediated PCT with adjunctive mechanical debridement, and Group-CD that underwent mechanical debridement with adjunctive 3 % hydrogen peroxide/chlorhexidine rinse. Clinical inflammatory gingival parameters including full-mouth plaque scores (FMPS), bleeding scores (FMBS), and probing depth (PD) were measured. Counts of Treponema microdentium , Fusobacterium nucleatum and Prevotella intermedia were assessed using polymerase chain reaction technique. All assessments were done at baseline, 3 weeks and 6 weeks. Twenty-six participants were contacted and agreed to participate in the trial. The mean age of participants in group-PCT was 24.5 years while the mean age of patients in group-CD was 26.7 years. FMPS showed significant but equal reduction in both the groups at 3 weeks and 6 weeks (p < 0.01). The reduction in mean FMBS was higher in the group-PCT at 6 weeks follow-up (p < 0.05). All bacterial levels reduced from baseline to follow-up with both PCT and CD groups (p < 0.05). Group-PCT showed significantly reduced counts of T. microdentium and F. nucleatum at 3 weeks and 6 weeks compared with group-CD (p = 0.024). Equal reduction was shown for P. intermedia between both the groups at 3 and 6 weeks, respectively. Application of adjunctive photochemotherapy was both clinically and microbiologically effective in the treatment of NUG. [ABSTRACT FROM AUTHOR]

Background: Recent researches have known long term infections such as periodontal disease to be related with the process of atherosclerosis. Periodontitis causes peripheral inflammation and immune cell stimulation which leads to an increase in C - reactive protein (CRP) and IgA Ab and there is a definite relation between cardiovascular disease, CRP increase and Periodontitis. The aim of this study was to evaluate the periodontal health status of patients with myocardial infarction who were hospitalized in Babol and Sari Hospitals., Methods: This descriptive study was done on 95 men and women age ranging from 40 to 70 years old hospitalized due to myocardial infarction diagnosis in Babol and Sari Hospitals. Periodontal health, of patients evaluated via Cowell Bleeding Index, Green and vermillion Debri Index, Tooth Mobility, Clinical attachment Level on Ramfjord teeth. Data were analyzed with SPSS and Kruskal-Wallis test and Mann-whitney test., Results: Considered indexes were evaluated in 81men and 14 women studied which showed no significant difference among them in the average BI (p=0.52), average tooth mobility (p=0.117) and average CAL index (p=0.745). The only significant difference between men and women was found in average DI index (p=0.08). There was a significant difference between average CAL in Ramfjord teeth of upper and lower jaw (p=0.002)., Conclusion: According to high prevalence of periodontitis in our study, periodontitis may be a risk factor of cardiovascular disease, it should be pointed out that here is the cardiologists' emphasis on their patients referring to the dentists.