Tian, Lingyang; Sato, Takuichi; Niwa, Kousuke; Kawase, Mitsuo; Mayanagi, Gen; Washio, Jumpei; Takahashi, Nobuhiro
The onset of plaque-mediated disease, including dental caries and periodontal diseases, is highly associated with compositional change of the resident microflora from the ecological perspective. As specific bacterial profiles have been linked to different disease stages, microbial compositional measurements might therefore have great value for clinical diagnosis. Previously we have reported a dry-reagent strip biosensor-PCR-dipstick DNA chromatography, which utilized molecular recognition of oligonucleotides and biotin-streptavidin, and the optical property of colored microspheres, for semiquantifying a five-membered subgroup of caries-associated bacterial species in supragingival plaque from healthy coronal surfaces of teeth. The present study aimed to evaluate this technique's ability to differentiate microflora by comparing the subset profiles. Sixteen subgingival plaque specimens were pooled from periodontal pockets and analyzed for the composition of Streptococcus mutans, Streptococcus sobrinus, Scardovia wiggsiae, Actinomyces sp. and Veillonella parvula. Detection frequencies, relative abundance of each bacterial species, and the five-membered bacterial profiles were compared between supra- and subgingival groups. The supragingival plaque harbored significantly more of the tested species and higher amount of Actinomyces sp. and V. parvula. In subgingival plaque, the predominance was obscured, since several highly overlapped profiles were found at comparable frequencies. Thus, PCR-dipstick DNA chromatography using the same plaque sample enabled simultaneous profiling of multiple species at species level and facilitated discrimination between anticipated different microflora, making this technique a promising chair-side microbiota profiling method.
Hassell, T M; Harris, E L
Deciphering the relative roles of heredity and environmental factors ("nature vs. nurture") in the pathogenesis of dental caries and diseases of the periodontium has occupied clinical and basic researchers for decades. Success in the endeavor has come more easily in the case of caries; the complex interactions that occur between host-response mechanisms and putative microbiologic pathogens in periodontal disease have made elucidation of genetic factors in disease susceptibility more difficult. In addition, during the 30-year period between 1958 and 1987, only meager resources were targeted toward the "nature" side of the nature/nurture dipole in periodontology. In this article, we present a brief history of the development of genetic epistemology, then describe the three main research mechanisms by which questions about the hereditary component of diseases in humans can be addressed. A critical discussion of the evidence for a hereditary component in caries susceptibility is next presented, also from a historical perspective. The evolution of knowledge concerning possible genetic ("endogenous", "idiotypic") factors in the pathogenesis of inflammatory periodontal disease is initiated with an analysis of some foreign-language (primarily German) literature that is likely to be unfamiliar to the reader. We identify a turning point at about 1960, when the periodontal research community turned away from genetics in favor of microbiology research. During the past five years, investigators have re-initiated the search for the hereditary component in susceptibility to common adult periodontal disease; this small but growing body of literature is reviewed. Recent applications of in vitro methods for genetic analyses in periodontal research are presented, with an eye toward a future in which persons who are at risk--genetically predisposed--to periodontal disease may be identified and targeted for interventive strategies. Critical is the realization that genes and environment
Gupta, Sarika; Arya, Astha
Background: Dental caries and periodontal disease are the most prevalent dental disease among mentally retarded children worldwide. Aims and Objectives: A study was carried out in Jodhpur city of Rajasthan state of India to assess the Dental caries and periodontal Status of Mentally handicapped attending special schools children in Jodhpur city. Materials and Methods: A cross-sectional descriptive survey was conducted in 80 mentally handicapped subjects, attending a Special Needs school in Jodhpur City. Dental caries and Periodontal Status were recorded following the WHO basic oral health survey. Results: None of the subject had healthy periodontal status, dental caries was found in 79.2% of the subjects, Lymphadenopathy was observed in highest number of subjects 55 (76.3%). Conclusion: Health professionals should therefore be aware of the impact of mental illness and its treatment on oral health, Health personnel should receive training to support and provide all possible services to this population. PMID:25177632
Kodama, Yasushi; Matsuura, Masahiro; Sano, Tomoya; Nakahara, Yutaka; Ozaki, Kiyokazu; Narama, Isao; Matsuura, Tetsuro
Many epidemiologic studies have suggested that diabetes may be an important risk factor for periodontal disease. To determine whether diabetes induces or enhances periodontal disease or dental caries, dental tissue from diabetic male and nondiabetic female WBN/KobSlc rats and male and female age-matched nondiabetic F344 rats was analyzed morphologically and morphometrically for these 2 types of lesions. Soft X-ray examination revealed that the incidence and severity of both molar caries and alveolar bone resorption were much higher in male WBN/KobSlc rats with chronic diabetes than in nondiabetic female rats of the same strain. Histopathologic examination showed that dental caries progressed from acute to subacute inflammation due to bacterial infections and necrosis in the pulp when the caries penetrated the dentin. In the most advanced stage of dental caries, inflammatory changes caused root abscess and subsequent apical periodontitis, with the formation of granulation tissue around the dental root. Inflammatory changes resulted in resorption of alveolar bone and correlated well with the severity of molar caries. Our results suggest that diabetic conditions enhance dental caries in WBN/KobSlc rats and that periodontal lesions may result from the apical periodontitis that is secondary to dental caries. PMID:21819682
Tanner, Anne C. R.
Background Anaerobic culture has been critical in our understanding of the oral microbiotas. Highlight Studies in advanced periodontitis in the 1970’s revealed microbial complexes that associated with different clinical presentations. Taxonomy studies identified species newly-observed in periodontitis as Aggregatibacter (Actinobacillus) actinomycetemcomitans, Campylobacter (Wolinella) rectus and other Campylobacter species, and Tannerella (Bacteroides) forsythia. Anaerobic culture of initial periodontitis showed overlap in the microbiota with gingivitis, and added Selenomonas noxia and Filifactor alocis as putative periodontal pathogens. Porphyromonas gingivalis and T. forsythia were found to be associated with initial periodontitis in adults. The dominant microbiota of dental caries differs from that of periodontitis. The major cariogenic species are acidogenic and acid tolerant species particularly Streptococcus mutans, and Lactobacillus and Bifidobacterium species. Anaerobic culture of severe early childhood caries revealed a widely diverse microbiota, comparable to that observed using cloning and sequencing. The PCR-based cloning approach, however, underestimated Actinobacteria compared with culture. Only a subset of the caries-associated microbiota was acid tolerant, with different segments of the microbiota cultured on blood agar compared to a low pH acid agar. While the major caries-associated species was S. mutans, a new species, Scardovia wiggsiae, was significantly associated with early childhood caries. Higher counts of S. wiggsiae were also observed in initial white spot carious lesions in adolescents. Conclusion In periodontitis and dental caries, anaerobic culture studies of advanced disease provided a comprehensive analysis of the microbiota of these infections. Anaerobic culture highlighted the limitation of PCR with standard primers that underestimate detection of Actinobacteria. PMID:25678835
Ghasempour, Maryam; Sefidgar, Seyed Ali Asghar; Eyzadian, Haniyeh; Gharakhani, Samaneh
Background: Candida albicans may have cariogenic potential but its role in caries etiology has not been established. The aim of this study was to determine candida albicans in supragingival dental plaque and infected dentine of cervical and proximal in early childhood caries (ECC). Methods: This cross-sectional study was carried out on 6o children aged 2-5 years, which were divided into 3 groups: children with at least one cervical caries; children with at least one proximal caries and caries-free. The infected dentine was collected from cervical and proximal caries lesions and plaque samples were collected from the three groups in order to compare the frequency of candida albicans in the collected sites. All samples were cultured in Sabouraud and CHROMagar medium and the cases that were positive for candida albicans were cultured in germ tube. Data were collected and analyzed. Results: The mean age of the children was 3.9 years. From 100 samples, candida albicans samples were isolated in 55%, mold fungi were found in 29% cases and there was no fungal growth in 16% of the samples. In plaque samples, candida albicans were found in 15% of caries-free samples, 20% of the proximal and 80% of the cervical caries. In samples extracted from the caries, candida albicans were found in 60% of the proximal and 100% of the cervical caries. Mothers with university educational level had children with more cervical decays, caries free and proximal caries, respectively. Conclusion: The results showed that prevalence of Candida albicans in dental plaque and caries lesions of children with early childhood caries were relatively high and the prevalence was higher in cervical caries group. PMID:24551436
Novotna, Marta; Podzimek, Stepan; Broukal, Zdenek; Lencova, Erika; Duskova, Jana
Type 1 diabetes mellitus is a chronic metabolic disease of an autoimmune origin with early manifestation predominantly in the childhood. Its incidence has been rising in most European countries. Diabetes has been intensively studied by all branches of medicine. There were a number of studies investigating oral consequences of diabetes; however, unambiguous conclusions were drawn only for the relationship between diabetes and periodontal impairment. Many studies confirmed higher plaque levels and higher incidence of chronic gingivitis both in adults and in children with diabetes. Juvenile periodontitis is rare both in healthy subjects and in those with type 1 diabetes. Yet certain findings from well-conducted studies, for example, differences in oral microflora or the impact of metabolic control of diabetes on periodontal health, indicate a higher risk of periodontitis in children with type 1 diabetes. As for the association of diabetes and dental caries, the results of the studies are inconsistent. However, it was found that some risk factors for dental caries are either more or less prevalent in the diabetic population. Despite an extensive research in this area we have to acknowledge that many questions have remained unanswered. There is a need for continued, thorough research in this area. PMID:26347009
Lăcătuşu, St; Ghiorghe, Angela
Patients treated with adrenal glucocorticoids may run a higher risk of dental caries, both as a result of their medical condition and of the physical and physiological effects of their pharmacotherapy. Our clinical study reports about patients treated with glucocorticoids who were also having an odonto-periodontal condition. They were examined and we found rampant caries and periodontal diseases. The slow evolution of asymptomatic periodontal disease encouraged destruction of teeth in root caries. The rampant caries were correlated with immunodeficiency and treatment of these caries must take into account the general treatment.
Carneiro, L. C.; Kabulwa, M. N.
The prevalence of dental caries and supragingival plaque and calculus in 785 secondary schools students was assessed. More than half (53.6%) of the students were caries-free, and the majority of those with dental caries experience were aged 14–17 (68.1%) and females (53%). Mean DMFT was 1.26, with mean D-component of 1.05, and molars were most affected. Most students had supragingival plaque (74%) and calculus (56.9%) and more so in males than females (P > 0.05). Less than half of the students had experience of dental caries and those with caries were mostly females and of the younger age group. The low DMFT was contributed to the D-component, and molars were the tooth type most affected.The majority of students had supra-gingival plaque and calculus and more so in males than females. PMID:22461985
Belstrøm, Daniel; Fiehn, Nils-Erik; Nielsen, Claus H.; Klepac-Ceraj, Vanja; Paster, Bruce J.; Twetman, Svante; Holmstrup, Palle
Bacterial profiles of saliva in subjects with periodontitis and dental caries have been demonstrated to differ from that of oral health. The aim of this comparative analysis of existing data generated by the Human Oral Microbe Identification Microarray (HOMIM) from 293 stimulated saliva samples was to compare bacterial profiles of saliva in subjects with periodontitis and dental caries. PMID:25854857
Patiño Marín, Nuria; Loyola Rodríguez, Juan P; Medina Solis, Carlo E; Pontigo Loyola, América P; Reyes Macías, Juan F; Ortega Rosado, Jenny C; Aradillas García, Celia
The aim of this work was to determine the frequency of caries, periodontal disease and tooth loss in patients affected by diabetes mellitus types 1 and 2. It was a cross-sectional study involving 175 subjects distributed in the following groups: (1) 35 patients with diabetes type 1 (glycosylated hemoglobin values from 6.5%-7%), (2) 35 patients with diabetes type 1 (values of glycosylated hemoglobin higher than 7%), (3) 35 subjects without diabetes mellitus type 1, (4) 35 patients with diabetes type 2 and (5) 35 subjects without diabetes mellitus type 2. The following clinical parameters were evaluated for all the subjects who participated in the study: frequency of caries, filled teeth, missing teeth, prosthetic restoration, bacterial dental plaque, calculus index, probing depth and attachment level. On comparing the groups of patients with diabetes type 1 to the control group, there were no statistically significant differences among any of the study variables. On comparing the group of patients with diabetes type 2 to the control group, there were statistically significant differences in the variables missing teeth (p=0.0134), calculus (p=0.0001), probing depth (p=0.0009) and attachment level (p=0.0093). The variable periodontal disease showed statistically significant dIfferences in the group of patients with diabetes type 2. Prevention, supervision and review of the oral health of patients with diabetes (types 1 and 2) are needed in order to prevent oral alterations.
Radnai, Márta; Gorzó, István; Nagy, Erzsébet; Urbán, Edit; Eller, József; Novák, Tibor; Pál, Attila
A great number of clinical studies focused on the periodontal health of the pregnant women in the last decades, since an association has been presumed between the pregnant women's periodontal disease and the adverse pregnancy outcome. Altogether 161 healthy women were examined soon after delivery in Szeged/Hungary. The periodontal status of the patients was recorded by the Silness-Löe Plaque index (0.67), frequency of calculus (21.07%), mean probing pocket depth (1.67 mm) and the frequency of bleeding on probing (37.8%). A significant correlation was found between the state of the periodontium and the educational level and the pregnant women's profession. The periodontal state of women with higher education and the intellectuals was much better, than of the less educated patients and the manual workers.
Simultaneous measurement of the viability, aggregation, and live and dead adherence of Streptococcus crista, Streptococcus mutans and Actinobacillus actinomycetemcomitans in human saliva in relation to indices of caries, dental plaque and periodontal disease.
Rudney, J D; Staikov, R K
Salivary proteins have multiple functions and many share similar functions, which may be why it has been difficult to relate variations in their concentrations to oral health and ecology. An alternative is to focus on variations in the major functions of saliva. An hydroxyapatite-coated microplate model has been developed that simultaneously measures saliva-promoted bacterial viability, bacterial aggregation, and live and dead bacterial adherence, while simulating oral temperature and shearing forces from swallowing. That model was applied to resting whole and stimulated parotid saliva from 149 individuals, using representative strains of Streptococcus crista, S. mutans, and Actinobacillus actinomycetemcomitans. Two major factors were defined by multivariate analysis (this was successful only for whole-saliva). One factor was correlated with aggregation, live adherence and dead adherence for all three strains; the other was correlated with total viability of all three strains. Participants were grouped <25th percentile and >75th percentile for each factor. Those groups were compared for clinical indices of oral health. Caries scores were significantly lower in those with high scores for aggregation-adherence, regardless of whether total viability scores were low or high. Live bacteria always predominated on surfaces when live and dead adherence scores were expressed as ratios. However, participants with high scores for aggregation-adherence showed significantly more dead adherent bacteria than those with low scores (these ratios were uncorrelated with total viability). This finding may indicate that extreme differences in the ability to kill bacteria on surfaces can influence caries risk.
Radnai, Márta; Gorzó, István; Nagy, Erzsébet; Urbán, Edit; Eller, József; Novák, Tibor; Pál, Attila
A misconception exists in the society regarding the caries frequency during pregnancy. The condition of the teeth of the child can be influenced by the state of the teeth and the oral hygiene habits of the mother. An examination was conducted among young women soon after delivery in Szeged/Hungary. The number of the examined patients was 161, with the average age of 27.6 years. The DMFT (Decayed, Missing, Filled Teeth) index was 12.45, while the DMFS (Decayed, Missing, Filled Surfaces) index was 26.07 in the examined population. The DMFT index significantly correlated with age, number of pregnancies, plaque index, probing pocket depth and bleeding on probing, while the DMFT index was not dependent on education level, profession and place of residency. There was no significant correlation between the number of previous pregnancy and the incidence of caries.
Williams, K A; Schemehorn, B R; McDonald, J L; Stookey, G K; Katz, S
Weanling rats were given high-sucrose cariogenic diets containing 2 per cent lauric acid, linoleic acid, nonanoic acid or monolaurin. Plaque accumulation was determined on the incisors of half the animals during only the last 3 days of the study and on the remaining animals at the conclusion of a 21-day test period when both sulcal and smooth-surface caries were assessed. No significant differences between the test groups in food consumption were observed nor were there any differences in body weight gain. The least amount of plaque was observed in the animals given monolaurin; the other fatty acids exerted no significant effect upon plaque accumulation. The smooth-surface caries data indicated that the least number of lesions occurred in the animals on the diet containing monolaurin. Nonanoic acid was significantly more effective in limiting sulcal caries than any of the other fatty acids studied. Thus both monolaurin and nonanoic acid have significant cariostatic activity in the rat.
Zhang, Meng; Chen, Yongxing; Xie, Lingzhi; Li, Yuhong; Jiang, Han; Du, Minquan
Despite recent successes in the control of dental caries, the mechanism of caries development remains unclear. To investigate the causes of dental decay, especially in early childhood caries, the supragingival microflora composition of 20 twins with discordant caries phenotypes were analyzed using high-throughput pyrosequencing. In addition, the parents completed a lifestyle questionnaire. A total of 228,789 sequencing reads revealed 10 phyla, 84 genera, and 155 species of microflora, the relative abundances of these strains varied dramatically among the children, Comparative analysis between groups revealed that Veillonella, Corynebacterium and Actinomyces were presumed to be caries-related genera, Fusobacterium, Kingella and Leptotrichia were presumed to be healthy-related genus, yet this six genera were not statistically significant (P>0.05). Moreover, a cluster analysis revealed that the microbial composition of samples in the same group was often dissimilar but that the microbial composition observed in twins was usually similar. Although the genetic and environmental factors that strongly influence the microbial composition of dental caries remains unknown, we speculate that genetic factors primarily influence the individual's susceptibility to dental caries and that environmental factors primarily regulate the microbial composition of the dental plaque and the progression to caries. By using improved twins models and increased sample sizes, our study can be extended to analyze the specific genetic and environmental factors that affect the development of caries. PMID:26524687
Costalonga, Massimo; Herzberg, Mark C
The composition of the oral microbiome differs from one intraoral site to another, reflecting in part the host response and immune capacity at each site. By focusing on two major oral infections, periodontal disease and caries, new principles of disease emerge. Periodontal disease affects the soft tissues and bone that support the teeth. Caries is a unique infection of the dental hard tissues. The initiation of both diseases is marked by an increase in the complexity of the microbiome. In periodontitis, pathobionts and keystone pathogens such as Porphyromonas gingivalis appear in greater proportion than in health. As a keystone pathogen, P. gingivalis impairs host immune responses and appears necessary but not sufficient to cause periodontitis. Historically, dental caries had been causally linked to Streptococcus mutans. Contemporary microbiome studies now indicate that singular pathogens are not obvious in either caries or periodontitis. Both diseases appear to result from a perturbation among relatively minor constituents in local microbial communities resulting in dysbiosis. Emergent consortia of the minor members of the respective microbiomes act synergistically to stress the ability of the host to respond and protect. In periodontal disease, host protection first occurs at the level of innate gingival epithelial immunity. Secretory IgA antibody and other salivary antimicrobial systems also act against periodontopathic and cariogenic consortia. When the gingival immune response is impaired, periodontal tissue pathology results when matrix metalloproteinases are released from neutrophils and T cells mediate alveolar bone loss. In caries, several species are acidogenic and aciduric and appear to work synergistically to promote demineralization of the enamel and dentin. Whereas technically possible, particularly for caries, vaccines are unlikely to be commercialized in the near future because of the low morbidity of caries and periodontitis.
Costalonga, Massimo; Herzberg, Mark C.
The composition of the oral microbiome differs from one intraoral site to another, reflecting in part the host response and immune capacity at each site. By focusing on two major oral infections, periodontal disease and caries, new principles of disease emerge. Periodontal disease affects the soft tissues and bone that support the teeth. Caries is a unique infection of the dental hard tissues. The initiation of both diseases is marked by an increase in the complexity of the microbiome. In periodontitis, pathobionts and keystone pathogens such as Porphyromonas gingivalis appear in greater proportion than in health. As a keystone pathogen, P. gingivalis impairs host immune responses and appears necessary but not sufficient to cause periodontitis. Historically, dental caries had been causally linked to Streptococcus mutans. Contemporary microbiome studies now indicate that singular pathogens are not obvious in either caries or periodontitis. Both diseases appear to result from a perturbation among relatively minor constituents in local microbial communities resulting in dysbiosis. Emergent consortia of the minor members of the respective microbiomes act synergistically to stress the ability of the host to respond and protect. In periodontal disease, host protection first occurs at the level of innate gingival epithelial immunity. Secretory IgA antibody and other salivary antimicrobial systems also act against periodontopathic and cariogenic consortia. When the gingival immune response is impaired, periodontal tissue pathology results when matrix metalloproteinases are released from neutrophils and T cells mediate alveolar bone loss. In caries, several species are acidogenic and aciduric and appear to work synergistically to promote demineralization of the enamel and dentin. Whereas technically possible, particularly for caries, vaccines are unlikely to be commercialized in the near future because of the low morbidity of caries and periodontitis. PMID:25447398
Kerebel, B; Clergeau-Guerithault, S; Forlot, P
Bacterial plaques from the teeth of individuals without caries were prepared for examination under the electron microscope (Ryter and Kellenberger's fixation). Microbial polymorphism within bacterial plaques has previously been usually studied in relation to the age of the plaque. Actually, the presence of polymorphous micro-organisms and variations in microbial density observed in 48 hours old plaques, must be related to other factors. Micro-organisms of the same type, as well as bacteria of different types which adhere together, reveal symbiosis and a competition process within the bacterial plaque, thus leading to changes in metabolism and lysis of many of the bacteria. Disturbances in bacterial cell walls; septal vesicular formation and intracellular structures are observed. Bacteriophages found in the plaques may be the cause of lysis of bacteria. Disturbances in bacterial metabolism could explain the lack of carcinogenicity of micro-organisms, and bacterial antigenic complexes which induce probably useful immunological reactions in the host are revealed by the lack of dental caries.
Timoshchuk, Mari-Alina I.; Ridge, Jeremy S.; Rugg, Amanda L.; Nelson, Leonard Y.; Kim, Amy S.; Seibel, Eric J.
An ultrathin scanning fiber endoscope, originally developed for cancer diagnosis, was used in a case study to locate plaque and caries. The imaging system incorporated software mitigation of background auto-fluorescence (AF). In conventional fluorescence imaging, varying AF across a tooth surface can mask low-level porphyrin signals. Laser-induced auto-fluorescence signals of dental tissue excited using a 405-nm laser typically produce fluorescence over a wavelength range extending from 440-nm to 750-nm. Anaerobic bacterial metabolism produces various porphyrin species (eg. protoporphyrin IX) that are located in carious enamel, dentin, gingivitis sites, and plaque. In our case study, these porphyrin deposits remained as long as one day after prophylaxis. Imaging the tooth surface using 405-nm excitation and subtracting the natural AF enhances the image contrast of low-level porphyrin deposits, which would otherwise be masked by the high background AF. In a case study, healthy tissues as well as sites of early and advanced caries formations were scanned for visual and quantitative signs of red fluorescence associated with porphyrin species using a background mitigation algorithm. Initial findings show increasing amplitudes of red fluorescence as caries severity increases from early to late stages. Sites of plaque accumulation also displayed red fluorescence similar to that found in carious dental tissue. The use of real-time background mitigation of natural dental AF can enhance the detection of low porphyrin concentrations that are indicators of early stage caries formation.
Shimotoyodome, A; Kobayashi, H; Tokimitsu, I; Hase, T; Inoue, T; Matsukubo, T; Takaesu, Y
Colonization of enamel surfaces by Streptococcus mutans is thought to be initiated by the attachment of bacteria to a saliva-derived conditioning film (acquired pellicle). However, the clinical relevance of the contribution of saliva-promoted S. mutans adhesion in biofilm formation has not yet been fully elucidated. The aim of this study was to correlate saliva-promoted S. mutans adhesion with biofilm formation in humans. We correlated all measurements of salivary factors and dental plaque formation in 70 healthy subjects. Dental plaque development after thorough professional teeth cleaning correlated positively with S. mutans adhesion onto saliva-coated hydroxyapatite pellets and the glycoprotein content of either parotid or whole saliva. Saliva-promoted S. mutans adhesion and glycoprotein content were also positively correlated with each other in parotid and whole saliva. By contrast, neither salivary mutans streptococci, Lactobacillus nor Candida correlated with biofilm formation. Parotid saliva-mediated S. mutans adhesion was significantly higher in 12 caries-experienced (CE) subjects than in 9 caries-inexperienced (CI) subjects. Salivary S. mutans adhesion was significantly less (p < 0.01) in the CI group than in the CE group. In conclusion, the present findings suggest the initial S. mutans adhesion, modulated by salivary protein adsorption onto the enamel surface, as a possible correlate of susceptibility to dental plaque and caries.
Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases.
Chapple, Iain L C; Bouchard, Philippe; Cagetti, Maria Grazia; Campus, Guglielmo; Carra, Maria-Clotilde; Cocco, Fabio; Nibali, Luigi; Hujoel, Philippe; Laine, Marja L; Lingstrom, Peter; Manton, David J; Montero, Eduardo; Pitts, Nigel; Rangé, Hélène; Schlueter, Nadine; Teughels, Wim; Twetman, Svante; Van Loveren, Cor; Van der Weijden, Fridus; Vieira, Alexandre R; Schulte, Andreas G
Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management.
policy to control the availability of highly cariogenic foods should be considered. Fissure sealants, when applied properly, are highly effective in preventing caries in occlusal surfaces. Their use is recommended on newly erupted teeth in susceptible persons, and they may be specially useful in the handicapped. Trained operators are required and the procedure is reasonably expensive; these factors may restrict the use of sealants where resources are limited. The ability of the individual patient to control plaque by toothbrushing, flossing or chewsticks should be developed to the utmost as the first step in controlling periodontal disease. 2+.
Shashikiran, N D; Reddy, V V S; Raju, P Krishnam
The prevalence of asthma has been increasing since the 1980s. Asthma and tooth decay are the two major causes of school absenteeism. There are few studies present in the literature. The objectives of the present study were to know the severity of dental caries and periodontal problems in children before and after taking antiasthmatic medication. The present study was conducted on 105, six- to fourteen-year-old asthmatic children to determine the condition of their dental caries and their periodontal status before and after taking antiasthmatic medication, for a period of 1 year and these were matched with their controls. The results showed that salbutamol inhaler shows increased caries rate with high significance over other groups, which was followed by salbutamol tablets and beclamethasone inhaler respectively. It has been concluded that antiasthmatic medication has its effects on dental caries and periodontal disease and asthmatic patients are recommended to adopt more precautionary oral hygiene practices and keep their caries activity and periodontal health under constant check.
Polson, A M
A series of studies has investigated interactions between periodontal trauma and marginal periodontitis in relation to the initiation, progression and treatment of periodontal disease. Lesions of trauma in the periodontal ligament do not initiate the loss of connective tissue attachment characteristic of marginal periodontitis. Studies conducted in squirrel monkeys and beagle dogs in which jiggling forces were superimposed upon an established marginal periodontitis reported increased loss of alveolar bone, but the accelerated loss of attachment which occurred in the dog model did not occur in the monkey model. In order to clarify the relative importance of inflammation and tooth mobility in the treatment of advanced periodontal disease, periodontal responses were evaluated after removing combinations of traumatic and inflammatory components. Elimination of trauma in the presence of existing marginal inflammation did not reduce tooth mobility or increase bone volume. Osseous regeneration and decreased tooth mobility occurred after resolving both components; however, similar findings occurred after resolving inflammation in the presence of continued tooth mobility. After resolution of inflammation, remaining tooth mobility does not result in increased loss of connective tissue attachment. On a clinical level for periodontal disease treatment, the findings place decreased emphasis upon management of tooth mobility and increased emphasis upon resolution of marginal inflammation.
Serra e Silva Filho, Wagner; Casarin, Renato C. V.; Nicolela Junior, Eduardo L.; Passos, Humberto M.; Sallum, Antônio W.; Gonçalves, Reginaldo B.
Background and Objective The immune and infectious alterations occurring in periodontitis have been shown to alter the development and severity of cardiovascular disease. One of these relationships is the translocation of oral bacteria to atheroma plaques, thereby promoting plaque development. Thus, the aim of this study was to assess, by 16s cloning and sequencing, the microbial diversity of the subgingival environment and atheroma plaques of patients concomitantly suffering from periodontitis and obstructive coronary artery atherosclerosis (OCAA). Methods Subgingival biofilm and coronary balloons used in percutaneous transluminal coronary angioplasty were collected from 18 subjects presenting with generalized moderate to severe periodontitis and OCAA. DNA was extracted and the gene 16S was amplified, cloned and sequenced. Results Significant differences in microbial diversity were observed between both environments. While subgingival samples mostly contained the phylum Firmicutes, in coronary balloons, Proteobacteria (p<0.05) was predominant. In addition, the most commonly detected genera in coronary balloons were Acinetobacter, Alloprevotella, Pseudomonas, Enterobacter, Sphingomonas and Moraxella, while in subgingival samples Porphyromonas, Filifactor, Veillonella, Aggregatibacter and Treponema (p<0.05) were found. Interestingly, 17 identical phylotypes were found in atheroma and subgingival samples, indicating possible bacterial translocation between periodontal pockets and coronary arteries. Conclusion Periodontal pockets and atheromatous plaques of cardiovascular disease patients can present similarities in the microbial diversity. PMID:25329160
Sakanaka, Akito; Kuboniwa, Masae; Hashino, Ei; Bamba, Takeshi; Fukusaki, Eiichiro; Amano, Atsuo
Onset of chronic periodontitis is associated with an aberrant polymicrobial community, termed dysbiosis. Findings regarding its etiology obtained using high-throughput sequencing technique suggested that dysbiosis holds a conserved metabolic signature as an emergent property. The purpose of this study was to identify robust biomarkers for periodontal inflammation severity. Furthermore, we investigated disease-associated metabolic signatures of periodontal microbiota using a salivary metabolomics approach. Whole saliva samples were obtained from adult subjects before and after removal of supragingival plaque (debridement). Periodontal inflamed surface area (PISA) was employed as an indicator of periodontal inflammatory status. Based on multivariate analyses using pre-debridement salivary metabolomics data, we found that metabolites associated with higher PISA included cadaverine and hydrocinnamate, while uric acid and ethanolamine were associated with lower PISA. Next, we focused on dental plaque metabolic byproducts by selecting salivary metabolites significantly decreased following debridement. Metabolite set enrichment analysis revealed that polyamine metabolism, arginine and proline metabolism, butyric acid metabolism, and lysine degradation were distinctive metabolic signatures of dental plaque in the high PISA group, which may be related to the metabolic signatures of disease-associated communities. Collectively, our findings identified potential biomarkers of periodontal inflammatory status and also provide insight into metabolic signatures of dysbiotic communities. PMID:28220901
Harjunmaa, Ulla; Doyle, Ronan; Mulewa, Simeon; Charlie, Davie; Maleta, Ken; Callard, Robin; Walker, A. Sarah; Balloux, Francois; Ashorn, Per; Klein, Nigel
ABSTRACT Periodontal disease ranges from gingival inflammation (gingivitis) to the inflammation and loss of tooth-supporting tissues (periodontitis). Previous research has focused mainly on subgingival plaque, but supragingival plaque composition is also known to be associated with disease. Quantitative modeling of bacterial abundances across the natural range of periodontal severities can distinguish which features of disease are associated with particular changes in composition. We assessed a cross-sectional cohort of 962 Malawian women for periodontal disease and used 16S rRNA gene amplicon sequencing (V5 to V7 region) to characterize the bacterial compositions of supragingival plaque samples. Associations between bacterial relative abundances and gingivitis/periodontitis were investigated by using negative binomial models, adjusting for epidemiological factors. We also examined bacterial cooccurrence networks to assess community structure. The main differences in supragingival plaque compositions were associated more with gingivitis than periodontitis, including higher bacterial diversity and a greater abundance of particular species. However, even after controlling for gingivitis, the presence of subgingival periodontitis was associated with an altered supragingival plaque. A small number of species were associated with periodontitis but not gingivitis, including members of Prevotella, Treponema, and Selenomonas, supporting a more complex disease model than a linear progression following gingivitis. Cooccurrence networks of periodontitis-associated taxa clustered according to periodontitis across all gingivitis severities. Species including Filifactor alocis and Fusobacterium nucleatum were central to this network, which supports their role in the coaggregation of periodontal biofilms during disease progression. Our findings confirm that periodontitis cannot be considered simply an advanced stage of gingivitis even when only considering supragingival plaque
Nathel, H.; Kinney, J.H.; Otis, L.L.
A method is disclosed for detecting the presence of active and inactive caries in teeth and diagnosing periodontal disease uses non-ionizing radiation with techniques for reducing interference from scattered light. A beam of non-ionizing radiation is divided into sample and reference beams. The region to be examined is illuminated by the sample beam, and reflected or transmitted radiation from the sample is recombined with the reference beam to form an interference pattern on a detector. The length of the reference beam path is adjustable, allowing the operator to select the reflected or transmitted sample photons that recombine with the reference photons. Thus radiation scattered by the dental or periodontal tissue can be prevented from obscuring the interference pattern. A series of interference patterns may be generated and interpreted to locate dental caries and periodontal tissue interfaces. 7 figs.
Nathel, Howard; Kinney, John H.; Otis, Linda L.
A method for detecting the presence of active and inactive caries in teeth and diagnosing periodontal disease uses non-ionizing radiation with techniques for reducing interference from scattered light. A beam of non-ionizing radiation is divided into sample and reference beams. The region to be examined is illuminated by the sample beam, and reflected or transmitted radiation from the sample is recombined with the reference beam to form an interference pattern on a detector. The length of the reference beam path is adjustable, allowing the operator to select the reflected or transmitted sample photons that recombine with the reference photons. Thus radiation scattered by the dental or periodontal tissue can be prevented from obscuring the interference pattern. A series of interference patterns may be generated and interpreted to locate dental caries and periodontal tissue interfaces.
Scannapieco, F A; Torres, G; Levine, M J
Salivary alpha-amylase, one of the most plentiful components in human saliva, has at least three distinct biological functions. The enzymatic activity of alpha-amylase undoubtedly plays a role in carbohydrate digestion. Amylase in solution binds with high affinity to a selected group of oral streptococci, a function that may contribute to bacterial clearance and nutrition. The fact that alpha-amylase is also found in acquired enamel pellicle suggests a role in the adhesion of alpha-amylase-binding bacteria. All of these biological activities seem to depend on an intact enzyme conformation. Binding of alpha-amylase to bacteria and teeth may have important implications for dental plaque and caries formation. alpha-Amylase bound to bacteria in plaque may facilitate dietary starch hydrolysis to provide additional glucose for metabolism by plaque microorganisms in close proximity to the tooth surface. The resulting lactic acid produced may be added to the pool of acid in plaque to contribute to tooth demineralization.
Kageyama, Shinya; Takeshita, Toru; Asakawa, Mikari; Shibata, Yukie; Takeuchi, Kenji; Yamanaka, Wataru; Yamashita, Yoshihisa
Increasing attention is being focused on evaluating the salivary microbiota as a promising method for monitoring oral health; however, its bacterial composition greatly differs from that of dental plaque microbiota, which is a dominant etiologic factor of oral diseases. This study evaluated the relative abundance of subgingival plaque-specific bacteria in the salivary microbiota and examined a relationship between the abundance and severity of periodontal condition in patients with periodontitis. Four samples (subgingival and supragingival plaques, saliva, and tongue coating) per each subject were collected from 14 patients with a broad range of severity of periodontitis before periodontal therapy. The bacterial composition was analyzed by 16S rRNA gene amplicon sequencing using Ion PGM. Of the 66 species-level operational taxonomic units (OTUs) representing the mean relative abundance of ≥ 1% in any of the four niches, 12 OTUs corresponding to known periodontal pathogens, including Porphyromonas gingivalis, were characteristically predominant in the subgingival plaque and constituted 37.3 ± 22.9% of the microbiota. The total relative abundance of these OTUs occupied only 1.6 ± 1.2% of the salivary microbiota, but significantly correlated with the percentage of diseased sites (periodontal pocket depth ≥ 4 mm; r = 0.78, P < 0.001), in addition to the abundance of subgingival plaque microbiota (r = 0.61, P = 0.02). After periodontal therapy, the total relative abundance of these 12 OTUs was evaluated as well as before periodontal therapy and reductions of the abundance through periodontal therapy were strongly correlated in saliva and subgingival plaque (r = 0.81, P < 0.001). Based on these results, salivary microbiota might be a promising target for the evaluation of subgingival plaque-derived bacteria representing the present condition of periodontal health.
Kageyama, Shinya; Takeshita, Toru; Asakawa, Mikari; Shibata, Yukie; Takeuchi, Kenji; Yamanaka, Wataru
Increasing attention is being focused on evaluating the salivary microbiota as a promising method for monitoring oral health; however, its bacterial composition greatly differs from that of dental plaque microbiota, which is a dominant etiologic factor of oral diseases. This study evaluated the relative abundance of subgingival plaque-specific bacteria in the salivary microbiota and examined a relationship between the abundance and severity of periodontal condition in patients with periodontitis. Four samples (subgingival and supragingival plaques, saliva, and tongue coating) per each subject were collected from 14 patients with a broad range of severity of periodontitis before periodontal therapy. The bacterial composition was analyzed by 16S rRNA gene amplicon sequencing using Ion PGM. Of the 66 species-level operational taxonomic units (OTUs) representing the mean relative abundance of ≥ 1% in any of the four niches, 12 OTUs corresponding to known periodontal pathogens, including Porphyromonas gingivalis, were characteristically predominant in the subgingival plaque and constituted 37.3 ± 22.9% of the microbiota. The total relative abundance of these OTUs occupied only 1.6 ± 1.2% of the salivary microbiota, but significantly correlated with the percentage of diseased sites (periodontal pocket depth ≥ 4 mm; r = 0.78, P < 0.001), in addition to the abundance of subgingival plaque microbiota (r = 0.61, P = 0.02). After periodontal therapy, the total relative abundance of these 12 OTUs was evaluated as well as before periodontal therapy and reductions of the abundance through periodontal therapy were strongly correlated in saliva and subgingival plaque (r = 0.81, P < 0.001). Based on these results, salivary microbiota might be a promising target for the evaluation of subgingival plaque-derived bacteria representing the present condition of periodontal health. PMID:28369125
Xiao, Cuicui; Ran, Shujun; Huang, Zhengwei; Liang, Jingping
Dental caries has a polymicrobial etiology within the complex oral microbial ecosystem. However, the overall diversity and structure of supragingival plaque microbiota in adult dental health and caries are not well understood. Here, 160 supragingival plaque samples from patients with dental health and different severities of dental caries were collected for bacterial genomic DNA extraction, pyrosequencing by amplification of the 16S rDNA V1–V3 hypervariable regions, and bioinformatic analysis. High-quality sequences (2,261,700) clustered into 10,365 operational taxonomic units (OTUs; 97% identity), representing 453 independent species belonging to 122 genera, 66 families, 34 orders, 21 classes, and 12 phyla. All groups shared 7522 OTUs, indicating the presence of a core plaque microbiome. α diversity analysis showed that the microbial diversity in healthy plaques exceeded that of dental caries, with the diversity decreasing gradually with the severity of caries. The dominant phyla of plaque microbiota included Bacteroidetes, Actinobacteria, Proteobacteria, Firmicutes, Fusobacteria, and TM7. The dominant genera included Capnocytophaga, Prevotella, Actinomyces, Corynebacterium, Neisseria, Streptococcus, Rothia, and Leptotrichia. β diversity analysis showed that the plaque microbial community structure was similar in all groups. Using LEfSe analysis, 25 differentially abundant taxa were identified as potential biomarkers. Key genera (27) that potentially contributed to the differential distributions of plaque microbiota between groups were identified by PLS-DA analysis. Finally, co-occurrence network analysis and function predictions were performed. Treatment strategies directed toward modulating microbial interactions and their functional output should be further developed. PMID:27499752
Chalmers, Natalia I.; Oh, Kevin; Hughes, Christopher V.; Pradhan, Nooruddin; Kanasi, Eleni; Ehrlich, Ygal; Dewhirst, Floyd E.; Tanner, Anne C. R.
Background and objective Bacterial invasion into pulps of primary teeth can lead to infection and premature tooth loss in children. This pilot study aimed to explore whether the microbiota of carious exposures of dental pulps resembles that of carious dentin or that of infected root canals. Design Children with severe early childhood caries were studied. Children were consented and extent of caries, plaque, and gingivitis measured. Bacteria were sampled from carious lesion biofilms and vital carious exposures of pulps, and processed by anaerobic culture. Isolates were characterized from partial sequences of the 16S rRNA gene and identified by comparison with taxa in the Human Oral Microbiome Database (http://www.HOMD.org). The microbiotas of carious lesions and dental pulps were compared using univariate and multivariate approaches. Results The microbiota of cariously exposed pulps was similar in composition to that of carious lesion biofilms except that fewer species/taxa were identified from pulps. The major taxa identified belonged to the phyla Firmicutes (mainly streptococci) and Actinobacteria (mainly Actinomyces species). Actinomyces and Selenomonas species were associated with carious lesions whereas Veillonella species, particularly Veillonella dispar was associated with pulps. Other bacteria detected in pulps included Streptococcus mutans, Parascardovia denticolens, Bifidobacterium longum, and several Lactobacillus and Actinomyces species. By principal, component analysis pulp microbiotas grouped together, whereas those in caries biofilms were widely dispersed. Conclusions We conclude that the microbiota of cariously exposed vital primary pulps is composed of a subset of species associated with carious lesions. Vital primary pulps had a dominant Firmicutes and Actinobacteria microbiota which contrasts with reports of endodontic infections which can harbor a gram-negative microbiota. The microbiota of exposed primary pulps may provide insight into bacterial
Cardoso, Andreia M R; Gomes, Lays N; Silva, Clara Regina D; Soares, Renata de S C; Abreu, Mauro Henrique N G de; Padilha, Wilton W N; Cavalcanti, Alessandro L
The aim of the present study was determine the prevalence and factors associated with dental caries and periodontal disease in Brazilian children and adolescents with cerebral palsy (CP). This is a cross-sectional study conducted with 80 patients ranging in age from 2 to 18 years old. Oral exams were conducted by an examiner with records of DMFT, dmft, Gingival Bleeding Index (GBI) and Community Periodontal Index (CPI). The statistical analysis used Poisson Regression with robust variance estimation (α = 0.05). The prevalence of dental caries was 59.3%, with DMFT and mean dmft of 1.71 ± 2.42 and 2.22 ± 3.23, respectively. The mean GBI was 22.44%, and in the CPI, the prevalence of gingival bleeding, calculus, shallow and deep pockets were 94.73%, 79.62%, 12.90% and 3.22%, respectively. The caregiver's educational level of less than eight years were associated with the dental caries experience (PR = 1.439; 95%CI = 1.09-1.89). The periodontal alterations were associated with female sex (PR = 0.82; 95%CI = 0.69-0.97), caregiver's educational level of less than eight years (PR = 1.15; 95%CI = 1.03-1.29), poor oral perception (PR = 0.89; 95%CI = 0.80-0.98), serious communication problem (PR = 0.87; 95%CI = 0.76-0.99) and athetoid type of CP (PR = 0.85; 95%CI = 0.75-0.97). The patients with CP presented high dental caries experience and periodontal alterations, which were associated with their demographic, socioeconomic, oral health perception and systemic information.
De-la-Torre, Janire; Ortiz-Samperio, María Esther; Marcos-Arias, Cristina; Marichalar-Mendia, Xabier; Eraso, Elena; Echebarria-Goicouria, María Ángeles; Aguirre-Urizar, José Manuel; Quindós, Guillermo
Caries and chronic periodontitis are common oral diseases where a higher Candida colonization is reported. Antifungal agents could be adjuvant drugs for the therapy of both clinical conditions. The aim of the current study has been to evaluate the in vitro activities of conventional and new antifungal drugs against oral Candida isolates from patients suffering from caries and/or chronic periodontitis. In vitro activities of amphotericin B, fluconazole, itraconazole, miconazole, nystatin, posaconazole and voriconazole against 126 oral Candida isolates (75 Candida albicans, 18 Candida parapsilosis, 11 Candida dubliniensis, six Candida guilliermondii, five Candida lipolytica, five Candida glabrata, four Candida tropicalis and two Candida krusei) from 61 patients were tested by the CLSI M27-A3 method. Most antifungal drugs were highly active, and resistance was observed in less than 5% of tested isolates. Miconazole was the most active antifungal drug, being more than 98% of isolates susceptible. Fluconazole, itraconazole, and the new triazoles, posaconazole and voriconazole, were also very active. Miconazole, fluconazole and voriconazole have excellent in vitro activities against all Candida isolates and could represent suitable treatment for a hypothetically adjunctive therapy of caries and chronic periodontitis.
Cicciù, Marco; Risitano, Giacomo; Lo Giudice, Giuseppe; Bramanti, Ennio
Parkinson's disease (PD) is a progressive neurodegenerative disorder related to the loss or absence of dopaminergic neurons in the brain. These deficits result in slowness of movement, tremor, rigidity, and dysfunction of behaviour. These symptoms negatively influence the patient's capability to carry out the daily oral hygiene manoeuvres. The aim of this work is to record the oral health condition of PD patients evaluated at the IRCSS Bonino-Puleio in Messina. The oral health of 45 consecutive PD patients (study group) with neurologic diagnosis based on United Kingdom Brain Bank Criteria has been compared with that of another 45 no PD patients of the same age (control group). The evaluation of the general oral condition was recorded underlining tooth loss, active periodontal disease, and presence of untreated caries. The frequency of untreated caries, periodontal diseases, and missing teeth of the study group was significantly higher than in control group. Based on the data results, clinicians should direct high attention to the oral hygiene of patients with PD, above all at the early stages of the caries or periodontal disease, in order to prevent serious evolution of those pathologic dental conditions that may finally result in the tooth extraction event.
Cicciù, Marco; Risitano, Giacomo; Lo Giudice, Giuseppe; Bramanti, Ennio
Parkinson's disease (PD) is a progressive neurodegenerative disorder related to the loss or absence of dopaminergic neurons in the brain. These deficits result in slowness of movement, tremor, rigidity, and dysfunction of behaviour. These symptoms negatively influence the patient's capability to carry out the daily oral hygiene manoeuvres. The aim of this work is to record the oral health condition of PD patients evaluated at the IRCSS Bonino-Puleio in Messina. The oral health of 45 consecutive PD patients (study group) with neurologic diagnosis based on United Kingdom Brain Bank Criteria has been compared with that of another 45 no PD patients of the same age (control group). The evaluation of the general oral condition was recorded underlining tooth loss, active periodontal disease, and presence of untreated caries. The frequency of untreated caries, periodontal diseases, and missing teeth of the study group was significantly higher than in control group. Based on the data results, clinicians should direct high attention to the oral hygiene of patients with PD, above all at the early stages of the caries or periodontal disease, in order to prevent serious evolution of those pathologic dental conditions that may finally result in the tooth extraction event. PMID:23320249
Nakahara, Yutaka; Sano, Tomoya; Kodama, Yasushi; Ozaki, Kiyokazu; Matsuura, Tetsuro
We have previously reported that dental caries progress in spontaneously and chemically induced diabetic rodent models. The aim of this study was to clarify the relationship between hyperglycemia and dental caries by evaluating the preventive effect of glycemic control with insulin on the progression of the lesions in diabetic rats. Male WBN/KobSlc rats aged 15 weeks were divided into groups of spontaneously diabetic rats (intact group), spontaneously diabetic rats with insulin treatment (INS group), alloxan-induced prolonged diabetic rats (AL group), and alloxan-induced prolonged diabetic rats with insulin treatment (AL + INS group). The animals were killed at 90 weeks of age, and their oral tissue was examined. Dental caries and periodontitis were frequently detected in the intact group, and the lesions were enhanced in the AL group (in which there was an increased duration of diabetes). Meanwhile, glycemic control with insulin reduced the incidence and severity of dental caries and periodontitis in the INS group, and the effects became more pronounced in the AL + INS group. In conclusion, glycemic control by insulin prevented the progression of dental caries and caries-related periodontitis in the diabetic rats.
Passos, Cristina Pinho; Santos, Poliana Ramos Braga; Aguiar, Márcio Cajazeira; Cangussu, Maria Cristina Teixeira; Toralles, Maria Betánia Pereira; da Silva, Maria Christina Bahiana Olympio; Nascimento, Roberto José Meyer; Campos, Maria Isabela Guimarães
This study investigated the prevalence of dental caries and periodontal condition in a population with sickle cell disease (SCD), analyzing some associations with disease severity. The Decayed, Missing and Filled Teeth index (DMFT) and Community Periodontal Index (CPI) were recorded for 99 individuals with SCD and 91 matched controls. Socio-demographic status, oral health behaviors, and history of clinical severity of SCD were assessed. Statistical comparisons were performed between the group with SCD and the control group, as well as multivariate logistic regression analyses with DMFT index and CPI as the dependent variables. The mean number of decayed teeth was significantly higher in individuals with HbSS. Older age, female gender, and daily smoking were identified as risk factors for higher DMFT, while older age and absence of daily use of dental floss were risk factors for the development of periodontal disease. In conclusion, risk factors known to cause caries and periodontal disease had more influence on oral health than the direct impact of SCD.
Malmsten, A; Dalin, A-M; Pettersson, A
Between January and December 2013, the dental and periodontal health of 99 Swedish wild boars (Sus scrofa) was investigated. Sampling occurred in conjunction with routine hunting at six large estates in the southern and middle parts of Sweden. All six of the estates use supplemental feeding. The weight of the animals, their sex and their dates of death were noted. Age was estimated using tooth eruption and tooth replacement patterns. The oral cavity was inspected and abnormalities were recorded on a dental chart modified for wild boars. The findings included supernumerary teeth, absence of teeth, mild class II malocclusion, severe tooth wear, periodontitis, calculus, caries, tooth fractures and the presence of enamel defects. Swedish wild boars suffer from different dental lesions and the impact of supplemental feeding on dental and periodontal health is still to be investigated.
Dwiyanti, Stephani; Soeroso, Yuniarti; Sunarto, Hari; Radi, Basuni
Coronary heart disease is a narrowing of coronary artery due to plaque build-up.  Chronic periodontitis increases risk of cardiovascular disease. P.gingivalis is linked to both diseases. Objective: to analyse quantitative difference of P.gingivalis on dental plaque and its relationship with periodontal status of CHD patient and control. Methods: Periodontal status of 66 CHD patient and 40 control was checked. Subgingival plaque was isolated and P.gingivalis was measured using real-time PCR. Result: P.gingivalis of CHD patient differs from control. P.gingivalis is linked to pocket depth of CHD patient. Conclusion: P.gingivalis count of CHD patient is higher than control. P.gingivalis count is not linked to any periodontal status, except for pocket depth of CHD patient.
Anand, Pradeep S; Kamath, Kavitha P; Anil, Sukumaran
Helicobacter pylori (H. pylori) infection is one of the most common bacterial infections in humans. Although H. pylori may be detected in the stomach of approximately half of the world’s population, the mechanisms of transmission of the microorganism from individual to individual are not yet clear. Transmission of H. pylori could occur through iatrogenic, fecal-oral, and oral-oral routes, and through food and water. The microorganism may be transmitted orally and has been detected in dental plaque and saliva. However, the role of the oral cavity in the transmission and recurrence of H. pylori infection has been the subject of debate. A large number of studies investigating the role of oral hygiene and periodontal disease in H. pylori infection have varied significantly in terms of their methodology and sample population, resulting in a wide variation in the reported results. Nevertheless, recent studies have not only shown that the microorganism can be detected fairly consistently from the oral cavity but also demonstrated that the chances of recurrence of H. pylori infection is more likely among patients who harbor the organism in the oral cavity. Furthermore, initial results from clinical trials have shown that H. pylori-positive dyspeptic patients may benefit from periodontal therapy. This paper attempts to review the current body of evidence regarding the role of dental plaque, saliva, and periodontal disease in H. pylori infection. PMID:24914323
Hamp, S E; Lindhe, J; Fornell, J; Johansson, L A; Karlsson, R
The effect of a field program, based on systematic plaque control, on caries and gingivitis was tested during a 3-year period on 1,100 schoolchildren. Once every 3rd week the children were given oral hygiene instructions, professional toothcleaning and fluorides topically delivered by specially trained dental nurses. The children of a control group of approximately the same number of pupils, participated in a preventive program consisting of mouthrinsings once every 2nd week with a 0.2% sodium fluoride solution. The children of the third and fourth grades were, at the start of the experiment, selected as reference groups and then continuously examined once every year. At the end of the trial the mean reduction of surfaces haboring plaque and units with gingival inflammation was 59% and 73%, respectively. The reduction in caries increment was 51%.
Rao, S P; Bharambe, M S
The oral health status in school children of Wardha was studied to find out the geographical differences in oral health status and to relate it with the teeth cleaning habit and nutritional status. A cluster sample of 778 children studying in 2 urban, 4 rural and 2 tribal primary schools was selected. Majority (60.8%) of children were habituated to clean their teeth with Manjan. The prevalence of periodontal diseases was significantly high in children habituated to ash, Manjan and coal. The tribal children showed a better oral health status than urban counterparts. Nutritional status has played no role in dental decay. The school oral health education campaigns should be addressed to dental caries, periodontal diseases and the harmful teeth cleaning materials.
Banas, Jeffrey A.; Zhu, Min; Dawson, Deborah V.; Blanchette, Derek R.; Drake, David R.; Gu, Hongjie; Frost, Ryan; McCaulley, Grant; Levy, Steven M.
Background Non-mutans low pH oral streptococci are postulated to contribute to caries etiology. Objective This study was undertaken to investigate whether the acidogenicity and acid tolerance of clinical strains of Streptococcus oralis and Streptococcus mitis correlate with health or early-stage enamel caries. Design S. oralis and S. mitis were isolated from plaque samples taken from the occlusal surfaces of second molars sampled at two different visits 4 years apart. All sites were sound at Visit 1; subjects were segregated into one of three groups based on the status of the site at Visit 2 and caries elsewhere in the dentition. Strains of S. oralis and S. mitis were evaluated for acidogenicity and acid tolerance, and the results correlated with the clinical status of the sites from which they were isolated. Mutans streptococci (MS) isolated from the plaque samples were also quantified, and the presence or absence of growth on pH 5.5 media or on media selective for bifidobacteria was recorded. Results No significant positive correlations were found between the acidogenicity properties of the S. oralis and S. mitis clones and caries at either visit. Similar results were obtained for acid tolerance of S. oralis clones but were inconclusive for S. mitis clones. A statistically significant positive correlation between MS levels and caries (or future caries) was evident at both visits, but there were no statistical correlations with the growth on pH 5.5 media or media selective for bifidobacteria. Conclusions The low pH potential likely varies considerably among oral streptococcal species and is least likely to be found among strains of S. mitis. Accordingly, the concept and constitution of ‘low pH streptococci’ may need to be re-evaluated. PMID:27790973
Stîngu, Cătălina Suzana; Turcu, Tatiana; Dimitriu, St; Alexa, Florentina; Archip, Daniela
The authors' goal has been to establish the distribution of anaerobic morpho-types in sub gingival plaque collected from patients with periodontal disease. The study included 26 patients. Samples of sub gingival plaque were transported in thioglycolate broth. The authors did Gram stains and culture on three types of media. The plates were incubated at 37 degrees C in anaerobic atmosphere for 5-7 days. From colonies with growth of at least +2 Gram stains and tolerance to oxygen were studied. The authors isolated 156 strains (an average of 6 strains per patient). 134 strains were anaerobic bacteria. Anaerobic morpho-types were distributed as follows: 70.01%--gram negative bacilli, 11.19%--gram positive cocci, 10.44%--gram negative cocci, 8.20% gram positive bacilli. Gram negative anaerobic bacilli were present in all samples and in 80% cases they were associated with other bacteria.
Rajesh, K. S.; Zareena; Hegde, Shashikanth; Arun Kumar, M. S.
Aim: This study was conducted to estimate and compare inorganic salivary calcium, phosphate, magnesium, salivary flow rate, and pH of unstimulated saliva and oral hygiene status of healthy subjects, subjects with periodontitis and dental caries, and to correlate salivary calcium level with number of intact teeth. Materials and Methods: The study population consisted of 48 systemically healthy subjects in the age group of 18-55 years, which was further divided into three groups: healthy, periodontitis, and dental caries. Oral hygiene index-simplified, probing pocket depth, clinical attachment level, the number of intact teeth, and active carious lesions were recorded. Estimation of inorganic salivary calcium, phosphate, and magnesium was performed spectrophotometrically using Vitros 5.1 FS. Statistical analysis was performed using the one-way analysis of variance test at 5% significance level. Results: There was a statistically significant increase in inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene status in periodontitis group compared to dental caries and healthy group. Conclusion: Subjects with increased inorganic salivary calcium, phosphate, pH, flow rate, and poor oral hygiene are at a higher risk of developing periodontitis. Since there is increased remineralization potential, these subjects have more number of intact teeth compared to the dental caries group. PMID:26681848
Nalcaci, Ruhi; Demirer, Serhat; Ozturk, Firat; Altan, Burcu A; Sokucu, Oral; Bostanci, Vildan
The aim of this study was to determine the relationship of orthodontic malocclusion with periodontal status, dental caries, and sociodemographic status. Our study population consisted of a sample of 836 school children (384 male and 452 female, aged 11-14 years). Four experienced orthodontists and two experienced periodontists performed the clinical examinations. The Treatment Priority Index (TPI), Community Periodontal Index of Treatment Needs (CPITN), decayed, missing, filled teeth (DMFT) scores, and a questionnaire that surveyed socio-demographic status of students were used. Spearman's rank correlation coefficients were used to measure the association between variables. TPI scores showed that 36.4% of the students had normal occlusion, while 41.2% had slight, 15.7% had definite, 4% had severe, and 2.7% had very severe malocclusion. TPI values did not show any significant differences between pupils in different age, gender, socioeconomic status groups, and CPITN scores, whereas there was a significant relationship between TPI and DMFT scores. The orthodontic treatment need was not significantly correlated with CPITN or socio-demographic status; however, the correlation coefficient showed a significant relationship between TPI and DMFT scores.
Liébana, José; Castillo, Ana María; Alvarez, Marta
The location of plaque-associated gingivitis at the gingival portion of the tooth plays an essential role in its genesis. However, at times local and other host response modifying factors also have an influence. The pathogeny of periodontitis is more complex. The microorganisms that comprise subgingival plaque are capable of acting directly on periodontal tissues or of modifying the host response, whereas the participation of the plaque per se (normal, decreased, or increased) is as decisive as the action of the bacteria themselves in the emergence of the disease. Different types of periodontitis are associated with specific microorganisms. The most periodontopathogenic are A. actinomycetemcomitans, P. gingivalis, and T. forsythensis. Periodontitis as a whole, represent the source of complications such as root caries, endoperiodontal processes and periodontal abscesses. They are associated with various illnesses such as atherosclerosis, diabetes, and respiratory infections, amongst others, as well as pathological oral halitosis. The different modalities of PCR are particularly important in the microbiological diagnosis of periodontitis, although on the negative side of things, it must be pointed out that in vitro sensitivity studies cannot be performed using this technique. First line antibiotic treatment of periodontitis includes amoxicillin/ clavulanic acid, metronidazole (associated or not with amoxicillin) and clindamycin.
Damgaard, Christian; Jensen, Lars J.; Holmstrup, Palle
Background The composition of the salivary microbiota has been reported to differentiate between patients with periodontitis, dental caries and orally healthy individuals. To identify characteristics of diseased and healthy saliva we thus wanted to compare saliva metaproteomes from patients with periodontitis and dental caries to healthy individuals. Methods Stimulated saliva samples were collected from 10 patients with periodontitis, 10 patients with dental caries and 10 orally healthy individuals. The proteins in the saliva samples were subjected to denaturing buffer and digested enzymatically with LysC and trypsin. The resulting peptide mixtures were cleaned up by solid-phase extraction and separated online with 2 h gradients by nano-scale C18 reversed-phase chromatography connected to a mass spectrometer through an electrospray source. The eluting peptides were analyzed on a tandem mass spectrometer operated in data-dependent acquisition mode. Results We identified a total of 35,664 unique peptides from 4,161 different proteins, of which 1,946 and 2,090 were of bacterial and human origin, respectively. The human protein profiles displayed significant overexpression of the complement system and inflammatory markers in periodontitis and dental caries compared to healthy controls. Bacterial proteome profiles and functional annotation were very similar in health and disease. Conclusions Overexpression of proteins related to the complement system and inflammation seems to correlate with oral disease status. Similar bacterial proteomes in healthy and diseased individuals suggests that the salivary microbiota predominantly thrives in a planktonic state expressing no disease-associated characteristics of metabolic activity. PMID:27672500
In 1974, 401 dental students of the Humboldt University in Berlin were examined for caries incidence, periodontal condition, oral hygiene and temporamandibular joint pain. The findings were brought in relation to the extent of extant tooth malalignment and malocclusion (model analysis according to Eismann). Statistical methods were employed to test existing relationship for significance, allowing for age, sex and former orthodontic treatment. The results were evaluated in view of the need for orthodontic treatment.
Davis, Ian J; Wallis, Corrin; Deusch, Oliver; Colyer, Alison; Milella, Lisa; Loman, Nick; Harris, Stephen
Periodontal disease is the most widespread oral disease in dogs which if left untreated results in significant pain to the pet and loss of dentition. The objective of this study was to identify bacterial species in canine plaque that are significantly associated with health, gingivitis and mild periodontitis (<25% attachment loss). In this survey subgingival plaque samples were collected from 223 dogs with healthy gingiva, gingivitis and mild periodontitis with 72 to 77 samples per health status. DNA was extracted from the plaque samples and subjected to PCR amplification of the V1-V3 region of the 16S rDNA. Pyrosequencing of the PCR amplicons identified a total of 274 operational taxonomic units after bioinformatic and statistical analysis. Porphyromonas was the most abundant genus in all disease stages, particularly in health along with Moraxella and Bergeyella. Peptostreptococcus, Actinomyces, and Peptostreptococcaceae were the most abundant genera in mild periodontitis. Logistic regression analysis identified species from each of these genera that were significantly associated with health, gingivitis or mild periodontitis. Principal component analysis showed distinct community profiles in health and disease. The species identified show some similarities with health and periodontal disease in humans but also major differences. In contrast to human, healthy canine plaque was found to be dominated by Gram negative bacterial species whereas Gram positive anaerobic species predominate in disease. The scale of this study surpasses previously published research and enhances our understanding of the bacterial species present in canine subgingival plaque and their associations with health and early periodontal disease.
Eid, M A; al-Shammery, A R; Selim, H A
For centuries, chewing sticks have been used as a tooth-cleaning device. One of the most commonly used types is known as the Miswak. Despite its common use, few studies have examined possible effects on the gingiva and the surrounding structures. The purpose of this study was to examine the relationship between Miswak and periodontal health. The incisors, canines, and premolars were examined in 236 patients. All patients were interviewed regarding their demographic data, oral hygiene habits, and use of Miswak. Clinical examination included scoring of plaque, gingival inflammation, pocket depths, attachment loss, and gingival recession. Patients were divided into three groups: a Miswak group, a toothbrush group, and a Miswak/toothbrush group. The results of this study indicated that use of the Miswak may influence plaque accumulation and periodontal health.
Stafford, Graham P; Chaudhuri, Roy R; Haraszthy, Violet; Friedrich, Valentin; Schäffer, Christina; Ruscitto, Angela; Honma, Kiyonobu; Sharma, Ashu
We report the genome sequences of three clinical isolates of Tannerella forsythia from the subgingival plaque of periodontitis patients attending clinics at the School of Dental Medicine, University at Buffalo. The availability of these genome sequences will aid the understanding of the pathogenesis of periodontitis.
Stafford, Graham P.; Chaudhuri, Roy R.; Haraszthy, Violet; Friedrich, Valentin; Schäffer, Christina; Ruscitto, Angela; Honma, Kiyonobu
We report the genome sequences of three clinical isolates of Tannerella forsythia from the subgingival plaque of periodontitis patients attending clinics at the School of Dental Medicine, University at Buffalo. The availability of these genome sequences will aid the understanding of the pathogenesis of periodontitis. PMID:27908987
Quantitative Analysis of Three Hydrogenotrophic Microbial Groups, Methanogenic Archaea, Sulfate-Reducing Bacteria, and Acetogenic Bacteria, within Plaque Biofilms Associated with Human Periodontal Disease▿
Vianna, M. E.; Holtgraewe, S.; Seyfarth, I.; Conrads, G.; Horz, H. P.
Human subgingival plaque biofilms are highly complex microbial ecosystems that may depend on H2-metabolizing processes. Here we investigated the ubiquity and proportions of methanogenic archaea, sulfate reducers, and acetogens in plaque samples from 102 periodontitis patients. In contrast to the case for 65 healthy control subjects, hydrogenotrophic groups were almost consistently detected in periodontal pockets, with the proportions of methanogens and sulfate reducers being significantly elevated in severe cases. In addition, antagonistic interactions among the three microbial groups indicated that they may function as alternative syntrophic partners of secondary fermenting periodontal pathogens. PMID:18326571
de Silva, Andrea M; Martin-Kerry, Jacqueline M; McKee, Katherine; Cole, Deborah
Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease.Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population.Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult.Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia.What is known about the topic? Many studies
Han, Jing; Wang, Peng; Ge, Shaohua
The object of this study is to characterize the bacterial community of subgingival plaque of two subjects with generalized aggressive periodontitis (GAgP) pre- and post-treatment. We picked two patients with GAgP and used high-throughput 16S rDNA sequencing. V4 hypervariable region was picked for PCR amplification of subgingival samples. Then, the PCR products were sequenced through Illumina MiSeq platform. One month after therapy, both the clinical features and periodontal parameters improved obviously. Moreover, the composition and structure of subgingival bacterial community changed after initial periodontal therapy. Also, the composition of the subgingival microbiota was highly individualized among different patients. Bacteroidetes, Spirochaetes and Fusobacteria were related to pathogenicity of GAgP while Actinobacteria and Proteobacteria seemed associated with clinical symptoms resolution. In this study, we found the subgingival bacterial community was high in species richness but dominated by a few species or phylotypes, with significant shifts of microbiota that occurred after treatment. This study demonstrated the shift of the subgingival bacterial community before and after treatment by high-throughput 16S rDNA sequencing, and provided a concise method for analysis of microbial community for periodontal diseases.
Solomon, Deborah; Katz, Ralph V; Bush, Anneke C; Farley, Victoria K; McGerr, Trevor J; Min, Hoon; Carbonella, Anthony M; Kayne, Joseph D
This study sought to determine whether the self-perceived image of a young adult's anterior dental esthetics is linked with periodontal health, dental caries, and oral hygiene practices. Two hundred subjects were assessed via a clinical examination, including intraoral photographs. The subjects were questioned about their demographics and oral hygiene practices and given the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) to measure their self-perceived variables related to dental esthetics. A high PIDAQ score indicates a negative image of one's own dental esthetics, while a low PIDAQ score indicates a positive outlook. A self-perceived negative psychosocial impact of anterior dental esthetics was detected in subjects with higher levels of dental caries and visible gingival inflammation in the anterior region of the mouth.
del Socorro Herrera, Miriam; Medina-Solis, Carlo Eduardo; Minaya-Sánchez, Mirna; Pontigo-Loyola, América Patricia; Villalobos-Rodelo, Juan José; Islas-Granillo, Horacio; de la Rosa-Santillana, Rubén; Maupomé, Gerardo
Background Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. Material/Methods A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Results Mean age was 7.49±1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54±3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. Conclusions The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators. PMID:24247119
Emmanuel, R; Palanisamy, Selvakumar; Chen, Shen-Ming; Chelladurai, K; Padmavathy, S; Saravanan, M; Prakash, P; Ajmal Ali, M; Al-Hemaid, Fahad M A
Development of biologically inspired green synthesis of silver nanoparticles is evolving into an important branch of nano-biotechnology. In the present investigation, we report the green synthesis of silver nanoparticles (AgNPs) employing the leaf extract of Justicia glauca. Water-soluble organics present in the leaf extract are mainly responsible for the reduction of silver nitrate (AgNO3) solution to AgNPs. The AgNPs are 10-20nm in dimensions as determined by TEM images. The antimicrobial activities of green synthesized AgNPs and drug blended AgNPs have been evaluated against the dental caries and periodontal disease causing microorganisms such as Streptococcus mutans, Staphylococcus aureus, Lactobacillus acidophilus, Micrococcus luteus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. The AgNPs and drug blended AgNPs show a significant antibacterial and antifungal activity. Minimum inhibitory concentration (MIC) value of AgNPs determined against the selected dental caries and periodontal disease causing microorganisms are noticeable between the range of 25-75μg/mL.
Davis, Ian J.; Wallis, Corrin; Deusch, Oliver; Colyer, Alison; Milella, Lisa; Loman, Nick; Harris, Stephen
Periodontal disease is the most widespread oral disease in dogs which if left untreated results in significant pain to the pet and loss of dentition. The objective of this study was to identify bacterial species in canine plaque that are significantly associated with health, gingivitis and mild periodontitis (<25% attachment loss). In this survey subgingival plaque samples were collected from 223 dogs with healthy gingiva, gingivitis and mild periodontitis with 72 to 77 samples per health status. DNA was extracted from the plaque samples and subjected to PCR amplification of the V1-V3 region of the 16S rDNA. Pyrosequencing of the PCR amplicons identified a total of 274 operational taxonomic units after bioinformatic and statistical analysis. Porphyromonas was the most abundant genus in all disease stages, particularly in health along with Moraxella and Bergeyella. Peptostreptococcus, Actinomyces, and Peptostreptococcaceae were the most abundant genera in mild periodontitis. Logistic regression analysis identified species from each of these genera that were significantly associated with health, gingivitis or mild periodontitis. Principal component analysis showed distinct community profiles in health and disease. The species identified show some similarities with health and periodontal disease in humans but also major differences. In contrast to human, healthy canine plaque was found to be dominated by Gram negative bacterial species whereas Gram positive anaerobic species predominate in disease. The scale of this study surpasses previously published research and enhances our understanding of the bacterial species present in canine subgingival plaque and their associations with health and early periodontal disease. PMID:24349448
Ismail, Amid L.; And Others
Dental caries and periodontal disease in Mexican American children of the southwestern United States occur mainly in molars, lending strong support for the use of fissure sealants as a preventive procedure. This study also reports on the prevalence of fillings decay and gingivitis in this population. (VM)
Kush, Anil; Thakur, Rachna; Patil, Sandya Devi S.; Paul, Santhosh T.; Kakanur, Madhu
Background: In the present scenario, we are made available with chemomechanical caries removal system containing a natural proteolytic enzyme for the ease in the excavation of infected dentine. The additive action for these agents is providing antimicrobial and anti-inflammatory properties. Aim: This study was undertaken for assessing the action of Carie Care™ and Papacarie Duo™ on Aggregatibacter actinomycetemcomitans. Materials and Methods: The samples were collected for cultivation of the periodontal pathogen from the clinical periodontal pockets using sterile paper points. The samples cultured under suitable conditions were analyzed with quantitative polymerase chain reaction targeting 16s r-DNA. The samples were divided into three groups namely, Group A: Control, Group B: With Papacarie Duo, Group C: With Carie Care. The pathogen inoculums plugs were inserted in the petri dishes containing chemically defined medium and the experimental gels at different concentrations and were incubated under optimal conditions. The inhibition of growth of the pathogen was studied visually. Results: There was visual inhibition of growth for Group B and C and also exhibited a dose-dependent effect also. Conclusion: Based on the results of the present study, Carie Care™ gel demonstrated better antimicrobial action against A. actinomycetemcomitans which is a major periodontal disease causing pathogen. PMID:26681861
... This is called gingivitis, the mildest form of periodontal disease. Ongoing inflammation eventually causes pockets to develop between ... you to a specialist in the treatment of periodontal disease (periodontist). Diagnosis of periodontitis is generally simple. Diagnosis ...
Kirakodu, S.S.; Govindaswami, M.; Novak, M.J.; Ebersole, J.L.; Novak, K.F.
Quantitative PCR (qPCR) has recently been used to quantify microorganisms in complex communities, including dental plaque biofilms. However, there is variability in the qPCR protocols being used. This study was designed to evaluate the validity of two of these variables with the intent of developing a more standardized qPCR protocol. The two variables evaluated were (1) the use of DNA content versus actual cell counts to estimate bacterial numbers in mixed plaque samples and (2) the effectiveness of three different universal primers versus species specific primers in amplifying specific target pathogens in these samples. Results lead to the development of a standardized protocol that was shown to be highly reproducible as demonstrated by low coefficients of variation. The results also confirmed that this standardized qPCR protocol can be used as a sensitive method for quantifying specific bacterial species in human plaque samples. PMID:19088882
Kirakodu, S S; Govindaswami, M; Novak, M J; Ebersole, J L; Novak, K F
Quantitative PCR (qPCR) has recently been used to quantify microorganisms in complex communities, including dental plaque biofilms. However, there is variability in the qPCR protocols being used. This study was designed to evaluate the validity of two of these variables with the intent of developing a more standardized qPCR protocol. The two variables evaluated were (1) the use of DNA content versus actual cell counts to estimate bacterial numbers in mixed plaque samples and (2) the effectiveness of three different universal primers versus species specific primers in amplifying specific target pathogens in these samples. Results lead to the development of a standardized protocol that was shown to be highly reproducible as demonstrated by low coefficients of variation. The results also confirmed that this standardized qPCR protocol can be used as a sensitive method for quantifying specific bacterial species in human plaque samples.
Schlagenhauf, Ulrich; May, Theodor W.; Gravemeier, Martina; Prior, Karola; Petersilka, Gregor; Ehmke, Benjamin
Aim This 12-week prospective, randomized, double-blind, two-center trial evaluated the impact of a microcrystalline zinc hydroxyapatite (mHA) dentifrice on plaque formation rate (PFR) in chronic periodontitis patients. We hypothesized that mHA precipitates cause delayed plaque development when compared to a fluoridated control (AmF/SnF2), and therefore would improve periodontal health. Material & Methods At baseline and after 4 and 12 weeks, PFR and other clinical and microbiological parameters were recorded. Seventy periodontitis patients received a mHA or AmF/SnF2 dentifrice as daily oral care without hygiene instructions. Four weeks after baseline, participants received full mouth debridement and continued using the dentifrices for another 8 weeks. Results Primary outcome PFR did not change statistically significantly from baseline to weeks 4 and 12, neither in mHA (n = 33; 51.7±17.2% vs. 48.5±16.65% vs. 48.4±19.9%) nor in AmF/SnF2-group (n = 34; 52.3±17.5% vs. 52.5±21.3% vs. 46.1±21.8%). Secondary clinical parameters such as plaque control record, gingival index, bleeding on probing, and pocket probing depth improved, but between-group differences were not statistically significant. Microbiological analyses showed similar slight decreases in colony-forming units in both groups. Conclusion In patients with mild-to-moderate periodontitis, periodontal therapy and use of a mHA-or AmF/SnF2 dentifrice without instructions induced comparable improvements in periodontal health but did not significantly reduce the PFR. Trial Registration ClincalTrials.gov NCT02697539 PMID:27467683
Srivastava, Rahul; Gupta, Sanjeev Kumar; Mathur, Vijay Prakash; Goswami, Anil; Nongkynrih, Baridalyne
Dental health is often neglected in the older persons, and dental conditions associated with aging are complex, adversely affecting the quality of life. The present study was undertaken to estimate the prevalence of dental caries and periodontal diseases among older persons from Delhi, India, and to study their association with selected socio-behavioral risk factors. We conducted a community-based cross sectional study among persons aged > or = 60 years from Delhi during 2009-2010. A questionnaire was used to interview elderly regarding dental health. The World Health Organization (WHO) oral health assessment form was used for examining the study participants. A total of 448 participants were examined and included in the study. Of the dentate, 47.1% had active dental caries. The mean decayed, missing and filled teeth (DMFT) score for the study population was 14.4. The prevalence of gingival bleeding, periodontal pockets and loss of attachment was 96.6, 89.1, and 80.3%, respectively. The prevalence of tobacco use was 47.9%. Age, frequency of teeth cleaning, and method used for teeth cleaning were statistically associated with the DMFT score. The prevalence of dental caries and periodontal disease was high in the study population, and warrants intervention.
Harvey, John D
This article provides a review of current information about periodontal bacteria, their activities within dental plaque biofilm, their interactions with the host immune system, and the infections with which they are associated. Periodontal disease, plaque formation, and the host immune response are also discussed, as are antimicrobial measures used to control the bacteria and the disease.
Carrillo Martínez, J J; Zermeño Ibarra, J A; Mercado Martínez, E G; Villanueva Neuman, Y; Castellanos Olmedo, R
Since a great number of teeth could be rehabilitated and not extracted, in this paper we analyze the relation Perio-protesis by the point of the biology of marginal periodontal ligament, and the different options to establish this relations when are lost by decay or traumatism. We discuss the contraindications to avoid greater problems than benefits when intend to rehabilitate lost teeth.
Burgess, Ralph C.
Dental caries is one of the most prevalent diseases afflicting mankind. It reached a peak in the 1950s but has been declining drastically in recent years in children and young adults. This article describes the three contributing factors in dental caries: microbial plaque, tooth susceptibility, and diet, and discusses practical preventive measures which help to reduce caries incidence. Some of these, such as vaccines and antimicrobial varnishes, are still in the research stages, while others, such as sucrose substitutes, low-calorie sweeteners, and limitation of frequency of sugar snacks are well established and can be promoted by family physicians. PMID:21253193
Almas, Khalid; Al-Sanawi, Essam; Al-Shahrani, Bander
Tongue cleaning is an ancient habit. Recent literature has shown that tongue cleaning leads to healthy oral environment. The aims of this study were to assess the effect of tongue scraper among male adult patients with caries and periodontal disease, on Mutans streptococci (MS) and Lactobacilli (Lb) bacteria and secondly to assess the effect on self perceived oral malodour. Sixty male patients completed the study. The age ranged from 20-55 years (32 +/- 9.53). Fifty percent of the subjects were with university education level. Mean DMFT score was 9.17 (+/-5.46), while 88% of the subjects were with early to moderate periodontitis assessed by CPITN. Thirty one percent of the subjects were smoker, while 86.7% had tea/coffee drinking habit and tooth brushing. Only 28% claimed of using miswak (chewing stick). All patients were advised to use a tongue scraper twice daily for at least 2 minutes per day for 7 days. No effort was made to change tooth brushing or dietary habits of patients. Self perceived oral malodour was reported by 41.7% at baseline and 30% after use of tongue scraper. Salivary count of Mutans Streptococci and Lactobacilli had significant decrease 3.37 (+/- 0.71) to 2.27 (+/- 0.80) and 3.22 (+/- 0.85) to 2.32 (+/- 0.87) respectively (P = 0.000). It was concluded that tongue scraping twice daily for 7 days had significant effect on MS and Lb bacteria and also decreased oral malodour
Sharda, Archana J; Shetty, Srinath
Aim To find the relationship of periodontal status and dental caries status with oral health knowledge, attitude, behavior, among professional students in India. Methodology In a cross sectional study, a total of 825 students (males: 577, females: 248) from six professions were surveyed using a self administered structured questionnaire including 41 multiple choice questions and the WHO Oral Health Assessment Form (1997). The data was analyzed using the SPSS version 13.0 to perform the Student's t-test, ANOVA test, Scheffe's test and Chi-square test, linear regression analysis. Results The mean percentage scores of the students for knowledge were 53.25 ± 15.05; for attitude 74.97 ±20.48; and for behavior 59.09 ± 18.77. The percentage of students with calculus score was found to be significantly high (43.8%). The percentage of professional students with DMFT>4 was 14.1% and the percentage of students with decayed teeth was 46.2%. The regression analysis showed that the oral health behavior of the students was dependent on the attitude (P <0.001), but showed no significant linear relation with the knowledge. Also, that the mean DMFT score was dependent on the oral health behavior (P <0.05), but showed no significant relationship with the knowledge and attitude of the students. The periodontal status was independent on the knowledge, but showed a significant relationship with attitude and behavior of the students. Conclusion A positive attitude and adherence to good oral hygiene behaviors is associated with better oral health. PMID:20690423
Armingohar, Zahra; Jørgensen, Jørgen J.; Kristoffersen, Anne Karin; Abesha-Belay, Emnet; Olsen, Ingar
Background Several studies have reported an association between chronic periodontitis (CP) and cardiovascular diseases. Detection of periodontopathogens, including red complex bacteria (RCB), in vascular lesions has suggested these bacteria to be involved in the pathogenesis of atherosclerosis and abdominal aortic aneurysms. Objective In this study, we investigate bacteria and their DNA in vascular biopsies from patients with vascular diseases (VD; i.e. abdominal aortic aneurysms, atherosclerotic carotid, and common femoral arteries), with and without CP. Methods DNA was extracted from vascular biopsies selected from 40 VD patients: 30 with CP and 10 without CP. The V3-V5 region of the 16S rDNA (V3-V5) was polymerase chain reaction (PCR)-amplified, and the amplicons were cloned into Escherichia coli, sequenced, and classified (GenBank and the Human Oral Microbiome database). Species-specific primers were used for the detection of Porphyromonas gingivalis. In addition, 10 randomly selected vascular biopsies from the CP group were subjected to scanning electron microscopy (SEM) for visualization of bacteria. Checkerboard DNA–DNA hybridization was performed to assess the presence of RCB in 10 randomly selected subgingival plaque samples from CP patients. Results A higher load and mean diversity of bacteria were detected in vascular biopsies from VD patients with CP compared to those without CP. Enterobacteriaceae were frequently detected in vascular biopsies together with cultivable, commensal oral, and not-yet-cultured bacterial species. While 70% of the subgingival plaque samples from CP patients showed presence of RCB, only P. gingivalis was detected in one vascular biopsy. Bacterial cells were seen in all 10 vascular biopsies examined by SEM. Conclusions A higher bacterial load and more diverse colonization were detected in VD lesions of CP patients as compared to patients without CP. This indicated that a multitude of bacterial species both from the gut and the
Dani, Sneha; Prabhu, Ashwin; Chaitra, K. R.; Desai, N. C.; Patil, Sudhir R.; Rajeev, Ranjan
Background: Dental caries and periodontal disease are most common oral diseases. Streptococcus mutans are considered to be the major pathogens in initiation of dental caries. Evidence shows that periodontal disease and caries share a number of contributory factors. Thus in view of these findings it would be worthwhile to examine whether Streptococcus mutans persist within the saliva and subgingival environment of the periodontitis patients and to determine whether there is any association between Streptococcus mutans colonization, pH of saliva and sub-gingival plaque pH in periodontal diseases before therapy. Methods: The study comprises of 75 subjects aged between 20-70 years, reporting to department of Periodontology, KLEs Institute of Dental Sciences, Bangalore. Subjects were divided into 3 groups of 25 each. Group 1 – Healthy controls, Group 2 – Gingivitis Group, 3 – Chronic periodontitis. Unstimulated saliva was collected in sterile container and immediately pH was evaluated. Subgingival plaque samples were collected from four deepest periodontal pockets in chronic periodontitis and from first molars in healthy subjects using 4 sterile paper points. In gingivitis subjects samples were collected from areas showing maximum signs of inflammation. All paper points and saliva samples were cultured on mitis salivarius agar culture media with bacitracin for quantification of the Streptococcus mutans colonies. Results: Increased colonization of Streptococcus mutans was seen in chronic periodontitis subjects both in saliva and sub-gingival plaque samples. There was also a positive correlation seen with the periodontal parameters. Conclusion: More severe forms of periodontal disease may create different ecological niches for the proliferation of Streptococcus mutans. PMID:27994423
Sagel, P A; Lapujade, P G; Miller, J M; Sunberg, R J
Dental plaque is the precursor to many oral diseases (e.g. gingivitis, periodontitis, caries) and thus its removal and control are an important aspect of oral hygiene. Many of the oral care products available today remove or inhibit the growth of dental plaque. Historically, the antiplaque efficacy of products was measured in blinded clinical trials where the amount of plaque on teeth is assessed via subjective visual grading with predefined scales such as the Turesky index. The ability of the examiner to consistently apply the index over time and the sensitivity of the scales often leads to large, expensive clinical trials. The present invention is an automatic measurement of plaque coverage on the facial surfaces of teeth using a digital image analysis technique. Dental plaque disclosed with fluorescein is digitally imaged under long-wave ultraviolet light. Ultraviolet illumination of fluorescein-disclosed plaque produces an image where the pixels of the image can be categorically classified based on color into one of five classes: teeth; plaque; gingiva; plaque on gingiva, or lip retractors. The amount of plaque on teeth can be determined by summation of the number of plaque pixels. The percent coverage is calculated from the number of plaque pixels and teeth pixels in the image. The digital image analysis of plaque allows facial plaque levels to be precisely measured (RSD = 3.77%). In application, the digital image analysis of plaque is capable of measuring highly significant plaque growth inhibition of a stannous fluoride dentifrice with as few as 10 subjects in a cross-over design.
Szyszka-Sommerfeld, Liliana; Buczkowska-Radlińska, Jadwiga
Dental caries is a disease of the mineralized tissues of teeth. It usually has a chronic course and is caused by external factors which can be modified. Current opinions about the contribution of malocclusions to the etiology of dental caries are conflicting. Some researchers believe that malocclusions like crowded teeth cause improper contacts between neighboring teeth and make effective oral hygiene more difficult. The difficulty in cleaning crowded teeth is believed to increase plaque accumulation and consequently predisposes the tooth to the development of dental caries and periodontal disease. Others claim that malocclusion has a minimal influence on the development of dental caries and periodontal disease. Ideal oral hygiene is of basic importance for plaque elimination which is the harmful factor in caries and in this way is decisive for the health of mineral and soft tissues to a much greater extent than lack of malocclusion. However, if a person with malocclusion is more susceptible to dental caries, oral hygiene cannot be the decisive factor.
Rosén, Birgitta; Olavi, Göran; Birkhed, Dowen; Edvardsson, Stig; Egelberg, Jan
A long-term study in adults at a public dental clinic in Sweden was initiated to evaluate the relative effectiveness of prophylactic treatments on the progression of dental caries and periodontal discase. With treatments scheduled every 3rd, 6th, 12th or 18th month, this report presents results on caries for the 3-month, 6-month and 18-month groups, and evaluates the impact of various caries-related risk factors. Caries increment over approximately 5 years was determined by adding clinical and radiographic findings of manifest primary and secondary caries during the study. Overall caries activity among all 105 participating individuals was low to moderate. No significant differences for caries on any of the various tooth surfaces or for total caries were observed among the three groups. Multiple regression analysis with 5-year caries increment as dependent variable showed that the following factors had a statistically significant association with caries increment: percentage filled surfaces at baseline examination, dietary score, plaque score, and number of mutans streptococci and lactobacilli in saliva. Non-significant factors included number of preventive treatments provided during the 5-year interval. The results of this long-term trial suggest that preventive treatments as often as every 3 6 months may not be justified in the case of patients with low to moderate caries activity.
... your dentist if you have signs of gum disease. Prevention Good oral hygiene is the best way to prevent periodontitis. This includes thorough tooth brushing and flossing, and regular professional dental cleaning. Preventing and treating ... References Amsterdam JT. ...
Anyanechi, CE; Chukwuneke, FN; Ngim, N
Background: Arthocare forte medication is made up of different constituents and the advantages offered by this disposition have not been explored in the management of chronic periodontitis. Aim: The aim was to assess the clinical response of bacterial plaque-induced generalized chronic periodontitis to arthocare medication, and the relationship of age and gender to the prevalence of chronic periodontal disease. Subjects and Methods: This study was done at the Dental Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria. It was a Prospective randomized controlled trial evaluating the effect of arthocare treatment on 81/162 patients with teeth mobility over a period of 5 years. All the patients (162) underwent root planing, and 81/162 (50%) were treated with arthocare for comparative analysis. The variables recorded were patient's age, gender, and degree of tooth mobility, periodontal pocket, and bleeding from the pocket after treatment. Statistical analysis was done using EPI INFO 7. Results: Majority of the patients were between 46 and 75 years in both control (n = 59/81, 72.8%) and experimental groups (n = 52/81, 64.2%). There were 86/162 (53.1%) males and 76/162 (46.9%) females, giving a male-to-female ratio of 1.1:1. Seventy-seven patients (95.1%) in the experimental group had total remission in comparison to 32/81 (39.5%) in control group which was statistically significant (P < 0.001). Conclusion: The arthocare administered to patients in the experimental group speeds up the regenerative capacity and stability of the periodontium when compared with the control. Multicentre clinical trials are recommended to validate the use of arthocare forte in the treatment of generalized chronic periodontitis. PMID:26097755
Shellis, R P
Lesion formation on root surfaces of human posterior teeth was studied in acetate/lactate buffers with a background electrolyte composition based on plaque fluid analyses. Lesion depth after 28 days at 37 degrees C was measured in relation to: the presence or absence of cementum; the concentration of undissociated buffer; the presence or absence of magnesium ions at plaque fluid concentration. Each factor was evaluated at several values of -log(ion activity product for hydroxyapatite): pI(HA). Solutions were formulated to minimize variation in pH, which varied by < or =0.03 for a given comparison (individual pI(HA)) and by 0.42-0.82 over the range of pI(HA) within experiments. Lesions on surfaces from which cementum had been ground were significantly deeper than on intact surfaces, but this is considered to be due to subsurface mechanical damage and not to a solubility difference. Neither the concentration of undissociated buffer nor the presence of magnesium ions significantly affected lesion depth. Lesion depth was strongly influenced by the correlated variations in pI(HA) and pH. At pI(HA) 54 and 55, only extremely shallow lesions formed. From pI(HA) 56, lesion depth increased with increasing pI(HA). The results confirm that the solubility of the mineral of root tissues is higher than that of hydroxyapatite, but indicate that it is probably lower than suggested by Hoppenbrouwers et al. [Arch Oral Biol 1987;32:319-322]. For calcium concentrations of 3-12 mM, the critical pH for root tissue mineral was calculated as 5.22-5.66 assuming solubility equivalent to pI(HA) 54 and 5.08-5.51 assuming pI(HA) 55.
Tomita, Sachiyo; Kasai, Shunsuke; Imamura, Kentaro; Ihara, Yuichiro; Kita, Daichi; Ota, Koki; Sekino, Jin; Nakagawa, Taneaki; Saito, Atsushi
This study aimed to assess changes in antimicrobial susceptibilities of subgingival bacteria in acute periodontal lesions following systemic administration of a new-generation fluoroquinolone, sitafloxacin and to monitor the occurrence and fate of quinolone low-sensitive strains. Patients with acute phase of chronic periodontitis were subjected to microbiological assessment of their subgingival plaque samples at baseline (A1). Sitafloxacin was then administered systemically (100 mg/day for 5 days). The microbiological examinations were repeated one week after administration (A2). Susceptibilities of clinical isolates from acute sites to various antimicrobials were determined using broth and agar dilution methods. At A2, subgingival bacteria with low sensitivity to levofloxacin were identified in four patients, and they were subjected to a follow-up microbiological examination at on the average 12 months after sitafloxacin administration (A3). The patients received initial and supportive periodontal therapy during the period A2 to A3. From the examined subgingival sites, 8 and 19 clinical isolates were obtained at A2 and A3, respectively. Some Streptococcus strains isolated at A2 were found to be resistant to levofloxacin (MIC 16-64 μg/ml), azithromycin (MIC 2->128 μg/ml) or clarithromycin (MIC 1->32 μg/ml). At A3, isolated streptococci were highly susceptible to levofloxacin (MIC 0.5-2 μg/ml), while those resistant to azithromycin or clarithromycin were still isolated. It is suggested that the presence of the quinolone low-sensitive strains in initially acute lesions after sitafloxacin administration was transient, and they do not persist in the subgingival milieu during the periodontal therapy.
Devaraj, C.G.; Agarwal, Payal
Introduction Tulsi is a popular healing herb in Ayurvedic medicine. It is widely used in the treatment of several systemic diseases because of its anti-microbial property. However, studies documenting the effect of Tulsi on oral disease causing organisms are rare. Hence, an attempt was made to determine the effect of Tulsi on a periodontal microorganism in human dental plaque. Aim To determine if Ocimum sanctum (Linn.) has an anti-microbial activity (Minimum Inhibitory Concentration and zone of inhibition) against Actinobacillus actinomycetemcomitans in human dental plaque and to compare the antimicrobial activity of Ocimum sanctum(Linn.) extract with 0.2% chlorhexidine as the positive control and dimethyl sulfoxide as the negative control. Materials and Methods A lab based invitro experimental study design was adopted. Ethanolic extract of Ocimum sanctum (Linn.) was prepared by the cold extraction method. The extract was diluted with an inert solvent, dimethyl sulfoxide, to obtain ten different concentrations (1%, 2%, 3%, 4%, 5%, 6%, 7%, 8%, 9%, 10%) of extract. Plaque sample was collected from 05 subjects diagnosed with periodontal disease. Isolation of Actinobacillus actinomycetemcomitans from plaque samples was done using Tryptic Soy Serum Bacitracin Vancomycin agar (TSBV) medium. Identification of Actinobacillus actinomycetemcomitans was done based on cultural, microscopic, biochemical characterization and multiple drug resistance patterns. Anti-microbial activity of Ocimum sanctum (Linn.) extract was tested by agar well-diffusion method against 0.2% chlorhexidine as a positive control and dimethyl sulfoxide as a negative control. The zone of inhibition was measured in millimeters using Vernier callipers. Results At the 6% w/v concentration of Ocimum sanctum (Linn.) extract, a zone of inhibition of 22 mm was obtained. This was the widest zone of inhibition observed among all the 10 different concentrations tested. The zone of inhibition for positive control
Hallmon, W W
While there is evidence that suggests that occlusal trauma is a risk factor for periodontal destruction, there is no evidence that indicates that occlusal trauma will initiate periodontal destruction. Effective plaque control and compliance with periodontal maintenance recommendations are key and essential factors necessary to assure successful treatment and control of periodontal disease.
There are four main factors involved in the carious process: at-risk tooth structure, plaque flora, fermentable carbohydrates, and time. Based on our knowledge of the carious process, four main preventive strategies have been developed over the years, namely, fluorides, fissure sealing, dietary choice, and plaque control. Fluorides are having a major impact on smooth-surface caries; hence, strategies combining fluorides and fissure sealing are very effective. However, use of fissure sealing is still problematic. Changing dietary practices with a view to reducing dental caries seems to be having little impact on a global scale. Plaque control, as practiced routinely by the majority of people, is not sufficient to result in caries reductions. Deprivation and poverty are strongly associated with high caries levels. Although the preventive strategies currently available are likely to result in lower caries levels for many, for logistical reasons and because of factors associated with deprivation and poverty, caries is likely to remain a major public health problem in most communities for the foreseeable future.
Tatikonda, Aravind; Debnath, Surangama; Chauhan, Vivek Singh; Chaurasia, Vishwajit Rampratap; Taranath, M; Sharma, Akanksha Manmohan
Background: Presence of plaque may be the culprit for dental caries, gingivitis, periodontal problems, and halitosis. Many mechanical aids are practiced worldwide to remove or control plaque, including tooth brushes, dental floss, mouth rinses, and dentifrices. The objective of this clinical study was to investigate the effectiveness of herbal toothpaste (Dabur Red) in controlling plaque and gingivitis, as compared to conventional (non-herbal) dentifrice (Pepsodent). Materials and Methods: In this study, 30 subjects aged 35–43 years with established gingivitis and at least 20 natural teeth, and having a probing depth <3 mm were investigated. After the washout period, plaque and gingival index (PI and GI, respectively) scores were assessed at days 0 and 30. Differences between groups were compared with Mann–Whitney U test and the mean scores of PI and GI by Wilcoxon test. Statistical difference between the weights of dentifrices tubes on days 0 and 30 was evaluated by Student's t-test. Results: At the end of 30 days of the study, there was statistically significant difference between both the groups for plaque and gingival scores. Conclusion: After 30 days of trial, both test and control groups showed effective reduction of plaque and gingivitis, which was statistically significant. No adverse reactions to dentifrices products were observed during the trial. It was concluded that herbal dentifrice was as effective as non-herbal dentifrices in the control of plaque and gingivitis. PMID:25558453
Erridge, Mey E; Cox, Alistair L; Dixon, Padraic M
Peripheral caries of equine cheek teeth is a poorly described disorder and, in particular little is known of its histopathology. Histological examinations of decalcified sections of 21 equine peripheral caries-affected cheek teeth showed two different patterns of cemental lesions; including progressive enlargement of focal, flask-like lesions leading to breakdown of the adjacent cementum, and secondly; a more generalized flaking-off of thin layers of under-run, surface cementum. A thick layer of plaque and food material usually lay on the surface of affected cementum and also within cemental defects. Gram-stained sections showed large numbers of bacteria within the lacunae and canaliculi of affected peripheral cementum and within associated plaque. Pioneer bacteria were also seen within dentinal tubules of adjacent, normal-appearing dentin. Subgingival extension of peripheral caries lesions with localized periodontal destruction was rare. Grading of peripheral caries lesions by gross examination was found to underestimate the severity of the disorder as compared to histological grading.
Jayanthi, Mungara; Shilpapriya, Mangalampally; Reddy, Venumbaka Nilaya; Elangovan, Arun; Sakthivel, Rajendran; Vijayakumar, Poornima
Background: Today, most approaches to caries viewed that catastrophic change in normal plaque biofilm is responsible for the disease. The behavior and composition of the biofilm are a reflection of the oral environment; the caries is a reflection of adverse changes occurring in that environment. Thus, it is important to identify the pathogenicity of the plaque biofilm so as to predict the caries risk. The recently developed three-tone plaque disclosing agent was used to test its ability in identifying the pathogenicity of plaque. Aim: To assess the efficacy of three-tone plaque disclosing agent in identifying the plaque pathogenicity and correlate with the clinical caries status and microbiological findings. Materials and Methods: Sixty children of 6–13 years age group of both sexes were clinically examined for caries and plaque scores, and then disclosing agent was applied; the color stained plaque samples were collected and cultured for microbiological assessment, and the data were analyzed based on the caries status of the children. Results: There was a significant difference between the pathological plaque of caries active and caries free group (P < 0.05). The pathological plaque scores and the total colony counts, Streptococcus counts and mutans streptococci counts increased with the increase in caries. Conclusion: Three-tone plaque disclosing agent was effective in identifying pathological plaque and can be used as one of the chairside adjuvants in caries risk assessment. PMID:26321835
Tan, A E S
The main goal of periodontal therapy is to establish an oral environment compatible with periodontal health by the physical disruption of the plaque biofilm and adjunctive chemical means if required. Implicit in this objective is the ongoing requirement of detection and interception of new and recurrent disease, which continues at selected intervals for the life of the dentition after the initial ("active") phase of periodontal treatment. This concept of ongoing periodontal maintenance therapy has been embraced as the mandatory requirement for favourable periodontal outcomes based on institutional clinical trials and in practice-based studies in various parts of the world. This review examines the ramifications of periodontal maintenance therapy based upon a multi-level assessment of logistic issues and risk factors at three levels: (1) The patient level - treatment time; patient attendance compliance; and homecare measures, antiseptics/antibiotics and smoking. (2) The level of the individual tooth - tooth loss; and evaluation of success versus survival. (3) The level of each tooth surface ("site") - probing depth, loss of attachment and bleeding on probing; and changes in clinical attachment levels. In spite of the diversity of studies conducted, there is agreement on the efficacy of periodontal maintenance therapy when compared with studies on untreated populations and in treated cases that were not maintained.
Jacob Raja, S. A.; Raja, J. Johnson; Vijayashree, R.; Priya, B. Meena; Anusuya, G. Sai; Ravishankar, P.
Aim: After the introduction of the multidrug therapy, the incidence of leprosy is decreasing every year. However, periodontal complaints are commonly seen in these patients due to compromised immunity and impaired oral hygiene. The aim of the present study is to assess the oral and periodontal status of the leprosy patients in Dindigul district. Materials and Methods: The study was conducted on 62 patients treated in a leprosy center at Dindigul district. Among these, 22 (35.5%) were female patients and 40 were male patients (64.5%). Age ranges between 40 and 70 with the mean age being 52. Facial changes, periodontal status, dental caries, attrition, tooth loss, plaque index (Silness and Loe), and calculus component of oral hygiene index-simplified were assessed. Results: Majority of the patients presented with loss of eyebrows and eyelashes, saddle nose, ocular involvement, and leonine facies. Gingival recession (54.8%) was a predominant finding followed by tooth loss (69.5%), mobility (60.86%), attrition (56%), chronic pulpitis (34.7%), and dental caries (26%). Most of the patients had severe periodontitis. Conclusions: Compromised immunity and altered autonomy pave way for many dental complaints such as periodontitis and deposits in tooth with poor oral hygiene. Awareness about the oral health problems and reinforcement of oral hygiene should be insisted to the leprosy patients to prevent further morbidity. PMID:27829761
Dental caries result from erosion of tooth enamel or cementum by acidic substances produced by bacteria found in dental plaque. Caries can lead to pulp necrosis and tooth loss. Risk factors include certain dietary habits, poor oral hygiene, and dry mouth. Diabetes and Sjogren's syndrome can also promote dental caries. Psychotropic substances such as cocaine, methamphetamine, heroin and cannabis can promote dental caries. Many medicinal drugs facilitate the formation of dental caries, through various mechanisms; they include formulations with a high sugar content; drugs that cause dry mouth (especially antimuscarinics); drugs that lower the buccal pH (inhaled powders, etc.); and drugs that cause demineralisation (tetracyclines, etc.). In practice, patients (and parents) should be informed that some drugs can increase the risk of dental caries. They should be encouraged to adapt and reinforce dental hygiene, and advised to visit a dentist regularly.
Indrei, L L
It is difficult ro assess the role of nutrition in the etiology and progression of periodontal disease because many other factors besides the local effect of plaque affect periodontal tissue metabolism. It is clear that nutrition can affect host response to bacterial plaque and it is also apparent that there may be a need for the intake of greater amounts of certain nutrients (such as ascorbic acid, iron etc.). Inadequate nutrient intake or deficiency is significant because of the number of interactions that occur during the assimilation of foods and the effects of stress and medication. Periodontal health cannot be achieved unless nutrient deficiency is corrected along with the other phases of treatment.
Peterson, Scott N.; Meissner, Tobias; Su, Andrew I.; Snesrud, Erik; Ong, Ana C.; Schork, Nicholas J.; Bretz, Walter A.
Dental caries remains a significant public health problem and is considered pandemic worldwide. The prediction of dental caries based on profiling of microbial species involved in disease and equally important, the identification of species conferring dental health has proven more difficult than anticipated due to high interpersonal and geographical variability of dental plaque microbiota. We have used RNA-Seq to perform global gene expression analysis of dental plaque microbiota derived from 19 twin pairs that were either concordant (caries-active or caries-free) or discordant for dental caries. The transcription profiling allowed us to define a functional core microbiota consisting of nearly 60 species. Similarities in gene expression patterns allowed a preliminary assessment of the relative contribution of human genetics, environmental factors and caries phenotype on the microbiota's transcriptome. Correlation analysis of transcription allowed the identification of numerous functional networks, suggesting that inter-personal environmental variables may co-select for groups of genera and species. Analysis of functional role categories allowed the identification of dominant functions expressed by dental plaque biofilm communities, that highlight the biochemical priorities of dental plaque microbes to metabolize diverse sugars and cope with the acid and oxidative stress resulting from sugar fermentation. The wealth of data generated by deep sequencing of expressed transcripts enables a greatly expanded perspective concerning the functional expression of dental plaque microbiota. PMID:25177549
Zaura, Egija; Buijs, Mark J.; Hoogenkamp, Michel A.; Ciric, Lena; Papetti, Adele; Signoretto, Caterina; Stauder, Monica; Lingström, Peter; Pratten, Jonathan; Spratt, David A.; Wilson, Michael
The aim of the current study was to investigate the anticariogenic potential of the (sub)fractions obtained from the edible mushroom shiitake (Lentinula edodes) in in vitro caries model. We used a modified constant depth film fermentor (CDFF) with pooled saliva as the inoculum and bovine dentin as a substratum. The test compounds were low molecular weight fraction (MLMW) of the shiitake extract and subfractions 4 and 5 (SF4 and SF5) of this fraction. Chlorhexidine (CHX) and water served as a positive and a negative control, respectively. Dentin mineral loss was quantified (TMR), microbial shifts within the microcosms were determined (qPCR), and the acidogenicity of the microcosms was assessed (CIA). From the compounds tested, the SF4 of shiitake showed strong inhibiting effect on dentin demineralization and induced microbial shifts that could be associated with oral health. The acid producing potential was increased, suggesting uncoupling of the glycolysis of the microbiota by the exposure to SF4. In conclusion, the results suggest that SF4 of shiitake has an anticariogenic potential. PMID:21941428
Cook, R A; Stoller, N H
Periodontal examinations were performed on ten 1- to 22-year-old snow leopards (6 males and 4 females), using dentistry methods for determining the plaque and gingival indices. All tooth surfaces were probed, and alveolar bone attachment loss was determined. After subgingival plaque removal, plaque specimens were examined for differential bacterial morphotypes. The small number of leopards evaluated precluded definitive statistical analysis. However, the progression from gingival health to gingivitis to periodontitis was similar to that seen in man. Therefore, the use of plaque index, gingival index, alveolar bone attachment loss, and differential bacterial morphotypes can be used to determine the dental health of snow leopards.
Analytical, oral epidemiological studies in adult 'toothbrushing' populations show that the highest prevalence of missing teeth is for molars and maxillary premolars ('key-risk' teeth). The highest prevalence of subgingival microflora, gingivitis (CPITN-1), plaque retentive factors, such as subgingival calculus and restoration overhangs (CPITN-2), and diseased pockets > 3 mm (CPITN-3-4) is found on the approximal surfaces of the same teeth ('key-risk' surfaces). Primary and secondary prevention, as well as treatment of periodontal disease should be focused on these 'key-risk' surfaces. One single, well-executed subgingival scaling and root-planning procedure in deep, diseased periodontal pockets, followed by oral hygiene training and professional mechanical tooth-cleaning (PMTC) at need-related intervals, will prevent further loss of periodontal attachment. However, if the root cementum is removed during instrumentation, and the post-treatment plaque control programme fails, microorganisms will recolonize and invade the rough exposed root dentine, resulting in recurrence of periodontitis and possibly, root caries and pulpitis. Some of these problems may be overcome by the application of new instruments and methods for self-care, PMTC, removal of overhangs, scaling and root-planing without removing 'non-diseased' cementum.
Winter, G B
The most recent epidemiological data on the prevalence of dental caries in children indicate a halting of the increasing levels in many developing countries and a continuing decrease in many highly industrialized countries of the world. However, a further fall in caries levels predicted for 5-yr-old children in the U.K. has not occurred and the decline in caries may have begun to level out. 'Polarization' of caries to a minority of high-risk individuals is occurring in the developed world, with 20-25% of children accounting for more than 50% of the disease. Socio-economic factors are important in determining the proportion of high-risk children in these countries. The multifactorial aetiology of caries allows a number of different interpretations to account for changes in the prevalence of the disease with time, in both the developing and developed countries. These changes are variously ascribed to alterations in dietary habits, especially the consumption of sugar; variations in the patterns of oral hygiene; increased contact with trace elements, especially fluoride, in the environment; changes in the ecology and/or virulence of oral and dental plaque microflora and alterations in the oral protective mechanisms including the immune status. The epidemiological evidence available on the relationship of all these social, environmental and other factors to changes in the prevalence levels of caries does not, however, fully explain all the changes that have been observed. The claim that caries is no longer a public health problem is premature, as it ignores the still high proportion of individuals with tooth decay throughout the world.
IQuaD dental trial; improving the quality of dentistry: a multicentre randomised controlled trial comparing oral hygiene advice and periodontal instrumentation for the prevention and management of periodontal disease in dentate adults attending dental primary care
Background Periodontal disease is the most common oral disease affecting adults, and although it is largely preventable it remains the major cause of poor oral health worldwide. Accumulation of microbial dental plaque is the primary aetiological factor for both periodontal disease and caries. Effective self-care (tooth brushing and interdental aids) for plaque control and removal of risk factors such as calculus, which can only be removed by periodontal instrumentation (PI), are considered necessary to prevent and treat periodontal disease thereby maintaining periodontal health. Despite evidence of an association between sustained, good oral hygiene and a low incidence of periodontal disease and caries in adults there is a lack of strong and reliable evidence to inform clinicians of the relative effectiveness (if any) of different types of Oral Hygiene Advice (OHA). The evidence to inform clinicians of the effectiveness and optimal frequency of PI is also mixed. There is therefore an urgent need to assess the relative effectiveness of OHA and PI in a robust, sufficiently powered randomised controlled trial (RCT) in primary dental care. Methods/Design This is a 5 year multi-centre, randomised, open trial with blinded outcome evaluation based in dental primary care in Scotland and the North East of England. Practitioners will recruit 1860 adult patients, with periodontal health, gingivitis or moderate periodontitis (Basic Periodontal Examination Score 0–3). Dental practices will be cluster randomised to provide routine OHA or Personalised OHA. To test the effects of PI each individual patient participant will be randomised to one of three groups: no PI, 6 monthly PI (current practice), or 12 monthly PI. Baseline measures and outcome data (during a three year follow-up) will be assessed through clinical examination, patient questionnaires and NHS databases. The primary outcome measures at 3 year follow up are gingival inflammation/bleeding on probing at the
Khocht, Ahmed; Janal, Malvin; Turner, Bobby
Fifty-five dentate patients with Down syndrome (DS) and 74 with mental disability non-Down (MR) were compared to 88 control subjects. Subjects in the MR and Control groups were matched by gender and ethnicity to subjects with DS. All subjects were nonsmokers. Periodontal evaluation included plaque index (PI), gingival index (GI), bleeding on probing (BOP), and clinical periodontal attachment levels. Caries and missing teeth were recorded. Measures of personal dental hygiene and the frequency of professional dental care were also recorded. Most subjects brushed their teeth at least once per day, but did not floss. Both groups with DS and MR had significantly more missing teeth, more BOP, and higher GI and PI levels than the control group. Patients with DS had more attachment loss (AL) than the other two groups (p < .001). Increased AL in patients with DS was not associated with differences in socioeconomic status, personal/professional dental care, or mental disability.
Khazandi, Manouchehr; Bird, Philip S; Owens, Jane; Wilson, Gary; Meyer, James N; Trott, Darren J
Periodontal disease is a common disease of dogs and cats often requiring antimicrobial treatment as an adjunct to mechanical debridement. However, correct compliance with oral antimicrobial therapy in companion animals is often difficult. Cefovecin is a recently introduced veterinary cephalosporin that has demonstrated prolonged concentrations in extracellular fluid, allowing for dosing intervals of up to 14 days. Subgingival samples were collected from the oral cavity of 29 dogs and eight cats exhibiting grade 2 or grade 3 periodontal disease. Samples were cultivated on Wilkin Chalgrens agar and incubated in an anaerobic chamber for seven days. Selected anaerobic bacteria were isolated and identified to species level using 16S rRNA gene sequence analysis. Minimum inhibitory concentrations were determined for cefovecin and six additional antimicrobials using the agar dilution methodology recommended by the Clinical and Laboratory Standards Institute. The 65 clinical isolates were identified as Porphyromonas gulae (n = 45), Porphyromonas crevioricanis (n = 12), Porphyromonas macacae (n = 1), Porphyromonas cangingivalis (n = 1) Fusobacterium nucleatum (n = 2), Fusobacterium russii (n = 1) and Solobacterium moorei (n = 3). This is the first report of S. moorei being isolated from companion animals with periodontal disease. All isolates were highly susceptible to cefovecin, with a MIC90 of ≤0.125 μg/ml. Conversely, different resistance rates to ampicillin, amoxicillin and erythromycin between isolates were detected. Cefovecin is thus shown to be effective in vitro against anaerobic bacteria isolated from dogs and cats with periodontal disease.
Lin, Guo-Hao; Boynton, James R
The primary etiology of periodontal disease is bacterial plaque and its byproducts in a susceptible host. Although the prevalence of plaque-induced periodontal disease is relatively low for the child and adolescent, destructive periodontal disease may be a manifestation of an underlying systemic disease. In some cases, childhood periodontal destruction may be the first sign of systemic disease, making appropriate recognition and determination of etiology critical in this population. Therefore, this literature review discusses the periodontal considerations for the child and adolescent patient, aiming to offer a guide for differential diagnosis and oral management of periodontal disease in the young population.
Gaffar, A; Afflitto, J; Nabi, N
This presentation provides an overview of the technologies available for the chemical control of plaque. It is generally accepted that the formation of dental plaque at the interfaces of tooth/gingiva is one of the major causes of gingival inflammation and dental caries. Several therapeutic approaches have been used to control dental plaque and supragingival infections. These include fluoride preparations such as stannous fluoride, oxygenating agents, anti-attachment agents, and cationic and non-cationic antibacterial agents. Among the fluoride preparations, stable stannous fluoride pastes and gels have been shown to reduce supragingival plaque, gingivitis, hypersensitivity and caries. The effect of the oxygenating agents on the supragingival plaque has been equivocal, but recent data indicate that a stable agent which provides sustained active oxygen release is effective in controlling plaque. A polymer, PVPA, which reduced attachment of bacteria to teeth was shown to significantly reduce plaque formation in humans. A new generation of antibacterials includes non-ionics such as triclosan, which in combination with a special polymer delivery system, has been shown to reduce plaque, gingivitis, supragingival calculus and dental caries in long-term studies conducted around the world. Unlike the first generation of agents, the triclosan/copolymer/sodium fluoride system is effective in long-term clinicals and does not cause staining of teeth, increase in calculus, or disturbance in the oral microbial ecology.
Although dental caries in the pediatric and adolescent population has consistently declined in the United States, it is still the most common childhood disease. Dental problems are the number one reason for missing school next to the common cold. Dental caries are an infectious, communicable disease resulting in destruction of tooth structure by…
Al-Alawi, Haidar; Al-Jawad, Abdulfatah; Al-Shayeb, Mahdi; Al-Ali, Ali; Al-Khalifa, Khalifa
Objective This is a pilot case-control study conducted to investigate the prevalence of dental caries and periodontal disease and examine the possible association between oral health deterioration and SCD severity in a sample of Saudi SCD patients residing in the city of Al-Qatif, Eastern Province, Saudi Arabia. Materials and methods Dental examination to determine the Decayed, Missing and Filled Teeth index (DMFT), Community Periodontal Index (CPI), and plaque index system were recorded for 33 SCD patients and 33 age and sex-matched controls in the Al-Qatif Central Hospital, Qatif, Saudi Arabia. Self-administered surveys used to assess socio-economic status; oral health behaviors for both SCD patients and controls were recorded. In addition, the disease severity index was established for all patients with SCD. SPSS data analysis software package version 18.0 was used for statistical analysis. Numerical variables were described as mean with a standard deviation. Results Decayed teeth were significantly more in individuals with ages ranging from 18 to 38 years with SCD compared to the control group (p = 0.036) due to oral hygiene negligence. The mean number of filled teeth was significantly lower in individuals with SCD when compared to the control group (p = 0.015) due to the lack of appropriate and timely treatment reflected in the survey responses of SCD patients as 15.2% only taking oral care during hospitalization. There were differences between the cases and controls in the known caries risk factors such as income level, flossing, and brushing habit. The DMFT, CPI, and plaque index systems did not differ significantly between the SCD patients and the control group. Conclusion Data suggest that patients with SCD have increased susceptibility to dental caries, with a higher prevalence of tooth decay and lower prevalence of filled teeth. Known caries risk factors influenced oral health more markedly than did factors related to SCD. PMID:25544813
Nichols, C; Laster, L L; Bodak-Gyovai, L Z
A sample of 54 patients with diabetes mellitus were subjects to detailed assessment of periodontal disease levels using standard indices. In order to determine whether the severity of periodontal disease was related to the severity of diabets mellitus, a series of parameters of the diabetes mellitus population was simultaneously studied. There were no significant relationships between the levels of periodontal disease and the duration of diabetes, the type of treatment and the frequency of systemic complications. Periodontal disease in the diabetic appeared to the affected by the same etiologic factors [plaque, calculus, neglect] as would be expected in nondiabetic patients. Further studies with larger population samples would be appropriate.
Johansson, I; Holgerson, P Lif; Kressin, N R; Nunn, M E; Tanner, A C
Dental caries is caused by a combination of infection and diet. This disease, if left untreated, may lead to pain, and impair the quality of life, nutritional status and development of young children. The objective was to investigate the association between snacking and caries in a population at high risk of dental caries. American preschool children (n = 1,206) were recruited in the offices of paediatricians. Data on sociodemographic characteristics, oral hygiene, breast-feeding, use of bottle and snacking were collected by questionnaire. Plaque presence, the number of teeth and their caries status (deft) were scored. The children sampled were 61% Black, 27% White and 10% Asian. Of the 1- to 2-, 2- to 3- and 3- to 4-year-old children, 93.8, 82.4 and 77.3% were caries free, and their mean caries scores were 0.16, 0.58 and 0.93, respectively. Multivariate partial least squares (PLS) modelling revealed plaque presence, lowest income, descriptors for tooth exposure time (number of teeth and age) and cariogenic challenge (total intake of sugar-containing snacks and chips/crisps, and chips intake with a sugar-containing drink) to be associated with more caries. These differences were also found in univariate analyses; in addition, children who continued breast-feeding after falling asleep had significantly higher deft values than those who did not. PLS modelling revealed that eating chips clustered with eating many sweet snacks, candies, popcorn and ice cream. We conclude that, in addition to the traditional risk indicators for caries - presence of plaque, sugar intake and socioeconomic status -, consumption of chips was associated with caries in young children.
Johansson, I.; Lif Holgerson, P.; Kressin, N.R.; Nunn, M.E.; Tanner, A.C.
Dental caries is caused by a combination of infection and diet. This disease, if left untreated, may lead to pain, and impair the quality of life, nutritional status and development of young children. The objective was to investigate the association between snacking and caries in a population at high risk of dental caries. American preschool children (n = 1,206) were recruited in the offices of paediatricians. Data on sociodemographic characteristics, oral hygiene, breast-feeding, use of bottle and snacking were collected by questionnaire. Plaque presence, the number of teeth and their caries status (deft) were scored. The children sampled were 61% Black, 27% White and 10% Asian. Of the 1- to 2-, 2- to 3- and 3- to 4-year-old children, 93.8, 82.4 and 77.3% were caries free, and their mean caries scores were 0.16, 0.58 and 0.93, respectively. Multivariate partial least squares (PLS) modelling revealed plaque presence, lowest income, descriptors for tooth exposure time (number of teeth and age) and cariogenic challenge (total intake of sugar-containing snacks and chips/crisps, and chips intake with a sugar-containing drink) to be associated with more caries. These differences were also found in univariate analyses; in addition, children who continued breast-feeding after falling asleep had significantly higher deft values than those who did not. PLS modelling revealed that eating chips clustered with eating many sweet snacks, candies, popcorn and ice cream. We conclude that, in addition to the traditional risk indicators for caries – presence of plaque, sugar intake and socioeconomic status –, consumption of chips was associated with caries in young children. PMID:20720422
Forssten, Sofia D.; Björklund, Marika; Ouwehand, Arthur C.
Dental caries and dental plaque are among the most common diseases worldwide, and are caused by a mixture of microorganisms and food debris. Specific types of acid-producing bacteria, especially Streptococcus mutans, colonize the dental surface and cause damage to the hard tooth structure in the presence of fermentable carbohydrates e.g., sucrose and fructose. This paper reviews the link between S. mutans and caries, as well as different simulation models that are available for studying caries. These models offer a valuable approach to study cariogenicity of different substrates as well as colonization of S. mutans. PMID:22254021
Saito, Atsushi; Kikuchi, Momomi; Ueshima, Fumie; Matsumoto, Shinya; Hayakawa, Hiroki; Masuda, Hitomi; Makiishi, Takemi
Background Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models. Methods A cross-sectional study design was used. The study population consisted of sixty-five patients (age range 23-77) with chronic periodontitis. The pre-tested 19-item questionnaire comprised 3 domains; 1) oral hygiene, 2) dietary habits and 3) perception of oral condition. The questionnaire was used as a part of the comprehensive assessment. Results Analyses of the assessment data revealed no major problems with the respondents' perceived oral hygiene habits, although their actual plaque control levels were not entirely adequate. Most of the respondents acknowledged the importance of prevention of dental caries and periodontal diseases, but less than one third of them were regular users of the dental care system. Twenty-five percent of the respondents were considered to be reluctant to change their daily routines, and 29% had doubts about the impact of their own actions on oral health. Analyzing the relationships between patient responses and oral hygiene status, factors like 'frequency of tooth brushing', 'approximal cleaning', 'dental check-up' and 'compliance with self-care advice' showed statistically significant associations (P < 0.05) with the plaque scores. Conclusion The clinical utilization of the present questionnaire facilitates the inclusion of multiple aspects of patient information, before initiation of periodontal treatment. The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care. PMID:19874626
Peterson, Scott N.; Snesrud, Erik; Liu, Jia; Ong, Ana C.; Kilian, Mogens; Schork, Nicholas J.; Bretz, Walter
Dental decay is one of the most prevalent chronic diseases worldwide. A variety of factors, including microbial, genetic, immunological, behavioral and environmental, interact to contribute to dental caries onset and development. Previous studies focused on the microbial basis for dental caries have identified species associated with both dental health and disease. The purpose of the current study was to improve our knowledge of the microbial species involved in dental caries and health by performing a comprehensive 16S rDNA profiling of the dental plaque microbiome of both caries-free and caries-active subjects. Analysis of over 50,000 nearly full-length 16S rDNA clones allowed the identification of 1,372 operational taxonomic units (OTUs) in the dental plaque microbiome. Approximately half of the OTUs were common to both caries-free and caries-active microbiomes and present at similar abundance. The majority of differences in OTU’s reflected very low abundance phylotypes. This survey allowed us to define the population structure of the dental plaque microbiome and to identify the microbial signatures associated with dental health and disease. The deep profiling of dental plaque allowed the identification of 87 phylotypes that are over-represented in either caries-free or caries-active subjects. Among these signatures, those associated with dental health outnumbered those associated with dental caries by nearly two-fold. A comparison of this data to other published studies indicate significant heterogeneity in study outcomes and suggest that novel approaches may be required to further define the signatures of dental caries onset and progression. PMID:23520516
Straka, Michal; Straka-Trapezanlidis, Michaela; Deglovic, Juraj; Varga, Ivan
Today's knowledge and studies show a firm correlation between osteoporosis and periodontitis, particularly in postmenopausal women. This review study deals with epidemiological and etiopathogenetic association between chronic periodontitis and an osteoporosis. A special emphasis is put on explanation of possible relations between a premature tooth loss and decrease of length and density of jaw bones, particularly their alveolar prolongations. The second part of the paper deals with principles of treatment in patients suffering of osteoporosis. Osteoporosis reduces density of jaw bones and decreases a number of teeth in jaws, but it does not affect other clinical signs and markers of periodontitis such as inflammation, bleeding and the depth of periodontal pockets and microbial plaque.
Novak, M John; Donley, Timothy G
Periodontal disease is the result of a complex interaction between microbial plaque, the host's inflammatory response to the plaque, and host modifying factors (e.g., smoking, diabetes, genetics) that may have an impact on the disease process. It is known that plaque initiates periodontal disease but that the host response is responsible for the destruction of periodontal tissues. This article describes why host response modifiers may be used to help control inflammation and tissue destruction as part of the initial phase of periodontal therapy in selected patient groups.
Drisko, C H
Regular home care by the patient in addition to professional removal of subgingival plaque is generally very effective in controlling most inflammatory periodontal diseases. When disease does recur, despite frequent recall, it can usually be attributed to lack of sufficient supragingival and subgingival plaque control or to other risk factors that influence host response, such as diabetes or smoking. Causative factors contributing to recurrent disease include deep inaccessible pockets, overhangs, poor crown margins and plaque-retentive calculus. In most cases, simply performing a thorough periodontal debridement under local anesthesia will stop disease progression and result in improvement in the clinical signs and symptoms of active disease. If however, clinical signs of disease activity persist following thorough mechanical therapy, such as increased pocket depths, loss of attachment and bleeding on probing, other pharmacotherapeutic therapies should be considered. Augmenting scaling and root planing or maintenance visits with adjunctive chemotherapeutic agents for controlling plaque and gingivitis could be as simple as placing the patient on an antimicrobial mouthrinse and/or toothpaste with agents such as fluorides, chlorhexidine or triclosan, to name a few. Since supragingival plaque reappears within hours or days after its removal, it is important that patients have access to effective alternative chemotherapeutic products that could help them achieve adequate supragingival plaque control. Recent studies, for example, have documented the positive effect of triclosan toothpaste on the long-term maintenance of both gingivitis and periodontitis patients. Daily irrigation with a powered irrigation device, with or without an antimicrobial agent, is also useful for decreasing the inflammation associated with gingivitis and periodontitis. Clinically significant changes in probing depths and attachment levels are not usually expected with irrigation alone. Recent
Dental caries: Dental caries and periodontitis were for many decades considered the most important global oral health burden. During the last 40 years when more focus was put on the prevention of dental caries by using products with fluoride, the problem decreased. However, our new lifestyle with more sugar has given rise to concern, and in US the amount of children being diagnosed with dental caries has increased . In addition the increasing amount of elderly in the population using many different types of medicines giving dry mouth has a negative impact of the status of their teeth .
Liang, Rongguang; Wong, Victor; Marcus, Michael; Burns, Peter; McLaughlin, Paul
Dental caries is a disease in which minerals of the tooth are dissolved by surrounding bacterial plaques. A caries process present for some time may result in a caries lesion. However, if it is detected early enough, the dentist and dental professionals can implement measures to reverse and control caries. Several optical, nonionized methods have been investigated and used to detect dental caries in early stages. However, there is not a method that can singly detect the caries process with both high sensitivity and high specificity. In this paper, we present a multimodal imaging system that combines visible reflectance, fluorescence, and Optical Coherence Tomography (OCT) imaging. This imaging system is designed to obtain one or more two-dimensional images of the tooth (reflectance and fluorescence images) and a three-dimensional OCT image providing depth and size information of the caries. The combination of two- and three-dimensional images of the tooth has the potential for highly sensitive and specific detection of dental caries.
Keyes, Paul H.; Rams, Thomas E.
Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993
The American Academy of Periodontology has developed the following parameter on plaque-induced gingivitis in the absence of clinical attachment loss. Plaque-induced gingivitis is the most common form of the periodontal diseases, affecting a significant portion of the population in susceptible individuals. Patients should be informed of the disease process, therapeutic alternatives, potential complications, expected results, and their responsibility in treatment. Consequences of no treatment should be explained. No treatment may result in continuation of clinical signs of disease, with possible development of gingival defects and progression to periodontitis. Given this information, patients should then be able to make informed decisions regarding their periodontal therapy.
Vinod, K; Reddy, Y Giridhar; Reddy, Vinay P; Nandan, Hemant; Sharma, Meenakshi
In this present era, when a significant number of patients seeking orthodontic treatment are adults, importance of multidisciplinary treatment approach cannot be overemphasized. Higher susceptibility of plaque accumulation in patients undergoing orthodontic treatment makes involvement of periodontist almost unavoidable. Also, orthodontic treatment frequently results in undesirable periodontal changes which require immediate attention. More recently, orthodontics has been used as an adjunct to periodontics to increase connective tissue support and alveolar bone height. The purpose of this article is to review the adverse effects of orthodontic treatment on the periodontal tissues and to discuss the mutually beneficial relationship shared between the two specialties.
Vinod, K.; Reddy, Y. Giridhar; Reddy, Vinay P.; Nandan, Hemant; Sharma, Meenakshi
In this present era, when a significant number of patients seeking orthodontic treatment are adults, importance of multidisciplinary treatment approach cannot be overemphasized. Higher susceptibility of plaque accumulation in patients undergoing orthodontic treatment makes involvement of periodontist almost unavoidable. Also, orthodontic treatment frequently results in undesirable periodontal changes which require immediate attention. More recently, orthodontics has been used as an adjunct to periodontics to increase connective tissue support and alveolar bone height. The purpose of this article is to review the adverse effects of orthodontic treatment on the periodontal tissues and to discuss the mutually beneficial relationship shared between the two specialties. PMID:22628956
Nassar, Carlos A; Nassar, Patrícia O; Secundes, Mayron B; Busato, Priscilla do Monte Ribeiro; Camilotti, Veridiana
Diabetes mellitus is a set of metabolic diseases characterized by hyperglycemia resulting from absolute or relative deficiency in insulin secretion by the pancreas and/or impaired insulin action in target tissues. Oral health maintenance through health care, as well as metabolic control are important measures for the overall health of diabetic patients. The objective of this study was to determine the relationship between biocompatibility of composite resin restorations with different nanoparticles, polishing in abfraction lesions in anterior and posterior teeth with periodontal tissues in patients with diabetes mellitus. We selected 20 patients--10 patients with diabetes mellitus and 10 patients without diabetes mellitus-, but with a total of 30 restorations in each group receiving composite resin restorations, who were evaluated for periodontal purposes: Plaque Index, Gingival Index; Probing Depth, Clinical Attachment Level and Bleeding on Probing. In addition, the restorations will receive assessments according to criteria for Marginal Adaptation, Anatomical Shape, Marginal Discoloration, ormation of caries, Post-operative Sensitivity and Retention. The total period was 90 days. The results showed a significant improvement in periodontal parameters assessed (p < 0.05) in both groups. With regard to assessments of the restorations, it was observed that there was no statistically significant difference (p > 0.05) among all criteria evaluated within the 90-day period. Thus, we conclude that in a short period (90 days) there is clinical biocompatibility of composite resin with nanoparticles restorations in abfraction lesions and periodontal tissues of patients with diabetes mellitus, regardless the type of polish these restorations receive.
... Diseases Small Text Medium Text Large Text Periodontal Diseases Periodontal diseases are disorders of the gums, or gingiva, and other tissues around the teeth. Periodontal diseases vary in severity, from the reversible, recurring mild ...
Govil, Somya; Gupta, Vishesh; Misra, Neeta; Misra, Pradyumna
The bilateral lateral periodontal cyst is a rare nasological entity, which despite clinical and radiological presentation is being diagnosed by histological characteristics. It is asymptomatic in nature and is observed in routine radiography. The aim and objective of this article is to present a rare case of bilateral lateral periodontal cyst in a 14-year-old child. The clinical and radiographical findings, along with its management have been discussed. Enucleation of bilateral cyst without extraction of the adjacent tooth was performed. Lesion samples were sent for histopathological analysis. The histopathological analysis revealed a thin, non keratinised stratified squamous epithelium resembling reduced enamel epithelium. Epithelial plaques were also seen. A clinicopathological correlation incorporating the surgical, radiographical and gold standard histopathological findings was obtained to suggest the final diagnosis of the bilateral lateral periodontal cyst.
Morou-Bermudez, Evangelia; Rodriguez, Selena; Bello, Angel S.; Dominguez-Bello, Maria G.
Objective Urease enzymes produced by oral bacteria generate ammonia, which can have a significant impact on the oral ecology and, consequently, on oral health. To evaluate the relationship of urease with dental plaque microbial profiles in children as it relates to dental caries, and to identify the main contributors to this activity. Methods 82 supragingival plaque samples were collected from 44 children at baseline and one year later, as part of a longitudinal study on urease and caries in children. DNA was extracted; the V3–V5 region of the 16S rRNA gene was amplified and sequenced using 454 pyrosequencing. Urease activity was measured using a spectrophotometric assay. Data were analyzed with Qiime. Results Plaque urease activity was significantly associated with the composition of the microbial communities of the dental plaque (Baseline P = 0.027, One Year P = 0.012). The bacterial taxa whose proportion in dental plaque exhibited significant variation by plaque urease levels in both visits were the family Pasteurellaceae (Baseline P<0.001; One Year P = 0.0148), especially Haemophilus parainfluenzae. No association was observed between these bacteria and dental caries. Bacteria in the genus Leptotrichia were negatively associated with urease and positively associated with dental caries (Bonferroni P<0.001). Conclusions Alkali production by urease enzymes primarily from species in the family Pasteurellaceae can be an important ecological determinant in children’s dental plaque. Further studies are needed to establish the role of urease-associated bacteria in the acid/base homeostasis of the dental plaque, and in the development and prediction of dental caries in children. PMID:26418220
Rashidi Maybodi, Fahimeh; Haerian Ardakani, Ahmad; Fattahi Bafghi, Ali; Haerian Ardakani, Alireza; Zafarbakhsh, Akram
Statement of the Problem Trichomonas tenax and Entamoeba gingivalis are commensal protozoa which inhabit the human oral cavity. These parasites are found in patients with poor oral hygiene and might be a reason for progressive periodontal diseases. Purpose The aim of this study was to evaluate the effect of nonsurgical periodontal treatment on the frequency of these protozoa in saliva and plaque samples. Materials and Method In this clinical trial, samples of saliva and dental plaque were collected from 46 patients with moderate to severe chronic periodontitis before and after periodontal therapy. The samples were assessed for the frequency of parasites. Results The frequency of Entamoeba gingivalis was reduced in saliva (p= 0.007) and plaque (p= 0.027) three weeks after the treatment. Likewise, the frequency of Trichomonas tenax reduced in saliva (p= 0.030); however, the decrease was not significant in plaque (p= 0.913). Trichomonas tenax frequency in dental plaque directly related to the severity of periodontitis (r= 0.565, p≤ 0.000). In contrast, the number of Entamoeba gingivalis in both saliva (r= -0.405, p≤ 0.005) and plaque (r= -0.304, p= 0.040) was inversely related with the severity of the periodontal disease. Conclusion Nonsurgical periodontal treatment could reduce the number of Trichomonas Tenax and Entamoeba gingivalis in the oral environment of patients with chronic periodontitis. PMID:27602391
Kanasi, E.; Dewhirst, F.E.; Chalmers, N.I.; Kent, R.; Moore, A.; Hughes, C.V.; Pradhan, N.; Loo, C.Y.; Tanner, A.C.R.
Background/Aims Severe early childhood caries is a microbial infection that severely compromises the dentition of young children. The aim of this study was to characterize the microbiota of severe early childhood caries. Methods Dental plaque samples from 2- to 6-year-old children were analyzed using 16S rRNA gene cloning and sequencing, and by specific PCR amplification for Streptococcus mutans and Bifidobacteriaceae species. Results Children with severe caries (n = 39) had more dental plaque and gingival inflammation than caries-free children (n = 41). Analysis of phylotypes from operational taxonomic unit analysis of 16S rRNA clonal metalibraries from severe caries and caries-free children indicated that while libraries differed significantly (p < 0.0001), there was increased diversity than detected in this clonal analysis. Using the Human Oral Microbiome Database, 139 different taxa were identified. Within the limits of this study, caries-associated taxa included Granulicatella elegans (p < 0.01) and Veillonella sp. HOT-780 (p < 0.01). The species associated with caries-free children included Capnocytophaga gingivalis (p < 0.01), Abiotrophia defectiva (p < 0.01), Lachnospiraceae sp. HOT-100 (p < 0.05), Streptococcus sanguinis (p < 0.05) and Streptococcus cristatus (p < 0.05). By specific PCR, S. mutans (p < 0.005) and Bifidobacteriaceae spp. (p < 0.0001) were significantly associated with severe caries. Conclusion Clonal analysis of 80 children identified a diverse microbiota that differed between severe caries and caries-free children, but the association of S. mutans with caries was from specific PCR analysis, not from clonal analysis, of samples. PMID:20861633
Zheng, Pei; Zhou, Weiying
Objective: The correlation between periodontitis and Helicobacter pylori (H. pylori) infection in the mouth was analyzed. Method: 70 elderly patients with periodontitis treated at our hospital from January 2013 to December 2014 were recruited. Dental plaques and gargle were collected for H. pylori detection using PCR technique. Periodontal health status of the patients was recorded. 70 control cases with healthy periodontium were also included. The symptoms of H. pylori infection in the mouth were compared between the two groups, and the results were analyzed statistically. Results: The positive rate of urease C gene of H. pylori in the periodontitis group was 71.4%; the positive rate of cagA gene was 35.7%. The positive rate of urease C gene of H. pylori in the control group was 34.3% and that of cagA gene was 12.9%. The two groups did not show significant differences in these two indicators (P<0.05). The positive detection rate of urease C gene of H. pylori in subgingival plaques was higher than that in supragingival plaques, and the difference was of statistical significance (P<0.05). The positive detection rate of H. pylori in patients with moderate and severe periodontitis was obviously higher than that of patients with mild periodontitis (P<0.05). Conclusion: Periodontal health status of elderly people with periodontitis correlated with H. pylori infection in the stomach. PMID:26629215
Dental caries is still a common disease among children and adolescents. The aims of the present thesis were therefore: 1) to investigate the approximal caries prevalence in posterior teeth in 15-year-olds, 2) to study past caries experience in the primary dentition in relation to future caries development and need for treatment, 3) to investigate factors during early childhood which are associated with caries development later in life, and 4) to study the association between age-specific body mass index (isoBMI) and approximal caries status in 15-year-olds. Paper I has a retrospective design and the analyses were based on record data from a randomly selected sample. Papers II, III and IV are based on radiographic analyses of posterior teeth in 15-year-olds followed longitudinally from 1 to 15 years of age. The data for these studies were selected from examinations, interviews and questionnaires from early childhood and school health care records at 15 years (isoBMI values). The result showed that the approximal caries prevalence in 15-year-olds is underestimated in official caries data, since initial caries lesions are not included in these statistics. Two thirds of all 15-year-olds had approximal caries and initial caries constituted 86% of the total number of caries lesions. There was a strong relationship between caries in early childhood and approximal caries prevalence in the posterior teeth at 15 years of age. Children with caries experience at 6 years received significantly more treatment in the primary dentition during the period from 7 to 12 years compared with children who were caries free at the same age. Further, it was pointed out that parents' attitudes to dental health and psychosocial factors during early childhood have an effect on approximal caries in 15-year-olds. Additionally, plaque on primary incisors at 1 year of age and infrequent toothbrushing at 3 years of age were associated with a high caries experience at 15 years. It was also
Moskovskiĭ, A V; Shumskiĭ, A V
Results of complex clinical and immunological study of patients with caries and pulpitis in combination with periodontitis were presented. It was revealed that high intensity of caries and parodontitis combines with significant disturbances in cellular and humoral parts of immune system.
Hossam, A. Eid; Rafi, A. Togoo; Ahmed, A Saleh; Sumanth, Phani CR
Background: This is an in vitro study to investigate the effects of ultrasonic scaling on the surface roughness and quantitative bacterial count on four different types of commonly used composite restorative materials for class V cavities. Materials & Methods: Nanofilled, hybrid, silorane and flowable composites were tested. Forty extracted teeth served as specimen and were divided into 4 groups of 10 specimens, with each group receiving a different treatment and were examined by a Field emission scanning electron microscope. Bacterial suspension was then added to the pellicle-coated specimens, and then bacterial adhesion was analyzed by using image analyzing program. Results: Flowable and silorane-based composites showed considerably smoother surfaces and lesser bacterial count in comparison to other types, proving that bacterial adhesion is directly proportional to surface roughness. Conclusion: The use of ultrasonic scalers affects the surfaces of composite restorative materials. Routine periodontal scaling should be carried out very carefully, and polishing of the scaled surfaces may overcome the alterations in roughness, thus preventing secondary caries, surface staining, plaque accumulation and subsequent periodontal inflammation. How to cite this article: Eid H A, Togoo R A, Saleh A A, Sumanth C R. Surface Topography of Composite Restorative Materials following Ultrasonic Scaling and its Impact on Bacterial Plaque Accumulation. An In-Vitro SEM Study. J Int Oral Health 2013; 5(3):13-19. PMID:24155597
The caries process is the ubiquitous, natural metabolism in the biofilm that causes numerous fluctuations in pH. The interaction of this biofilm with the dental tissues may result in a caries lesion. However, lesion formation and progression can be controlled, particularly by disturbing plaque regularly with a fluoride containing toothpaste. This paradigm implies that everyone with teeth is at risk to lesion development. Treatment of caries is principally non-operative, involving plaque control, fluoride and a sensible diet. Operative dentistry repairs un-cleansable cavities and is part of plaque control. A diagnosis is a mental resting place on the way to a treatment decision. The relevant diagnostic features with respect to caries are lesion activity (active lesions require active management) and un-cleansable cavities. When teaching undergraduates, it is important that they are credited for the non-operative treatment of caries as well as for operative dentistry. This is equally important in dental practice where an appropriate skills mix of the dental team is required to deliver dental health cost-effectively. Training more dentists may be an expensive mistake as far as disease control is concerned. It is ironic that dentists make most money from operative care and specialist treatment when disease control could be delivered relatively cheaply. The key to dental health is regular and effective plaque control with a fluoride containing toothpaste, from cradle to grave.
Gupta, Prahlad; Gupta, Nidhi; Pawar, Atish Prakash; Birajdar, Smita Shrishail; Natt, Amanpreet Singh; Singh, Harkanwal Preet
Dental caries is a chronic disease which can affect us at any age. The term "caries" denotes both the disease process and its consequences, that is, the damage caused by the disease process. Dental caries has a multifactorial aetiology in which there is interplay of three principal factors: the host (saliva and teeth), the microflora (plaque), and the substrate (diet), and a fourth factor: time. The role of sugar (and other fermentable carbohydrates such as highly refined flour) as a risk factor in the initiation and progression of dental caries is overwhelming. Whether this initial demineralization proceeds to clinically detectable caries or whether the lesion is remineralized by plaque minerals depends on a number of factors, of which the amount and frequency of further sugars consumption are of utmost importance. This paper reviews the role of sugar and sugar substitutes in dental caries.
Bradshaw, David J; Lynch, Richard J M
The microbial and dietary factors that drive caries have been studied scientifically for 120 years. Frequent and/or excessive sugar (especially sucrose) consumption has been ascribed a central role in caries causation, while Streptococcus mutans appeared to play the key role in metabolising sucrose to produce lactic acid, which can demineralise enamel. Many authors described caries as a transmissible infectious disease. However, more recent data have shifted these paradigms. Streptococcus mutans does not fulfil Koch's postulates - presence of the organism leading to disease, and absence of the organism precluding disease. Furthermore, molecular microbiological methods have shown that, even with a sugar-rich diet, a much broader spectrum of acidogenic microbes is found in dental plaque. While simple sugars can be cariogenic, cooked starches are also now recognised to be a caries threat, especially because such starches, while not 'sticky in the hand', can be highly retentive in the mouth. Metabolism of starch particles can yield a prolonged acidic challenge, especially at retentive, caries-prone sites. These changes in the paradigms of caries aetiology have important implications for caries control strategies. Preventing the transmission of S. mutans will likely be inadequate to prevent caries if a sufficiently carbohydrate-rich diet continues. Similarly, restriction of sucrose intake, although welcome, would be unlikely to be a panacea for caries, especially if frequent starch intake persisted. Instead, approaches to optimise fluoride delivery, to target plaque acidogenicity or acidogenic microbes, to promote plaque alkali generation, to increase salivary flow or replace fermentable carbohydrates with non-fermentable alternatives may be more promising.
Huynh, Hong T. T.; Pignoly, Marion; Nkamga, Vanessa D.; Drancourt, Michel; Aboudharam, Gérard
In previous studies, the abundance and diversity of methanogenic archaea in the dental microbiota have been analysed by the detection of specific DNA sequences by PCR-based investigations and metagenomic studies. Few data issued regarding methanogens actually living in dental plaque. We collected dental plaque specimens in 15 control individuals and 65 periodontitis patients. Dental plaque specimens were cultured in an anoxic liquid medium for methanogens in the presence of negative control tubes. Dental plaque methanogens were cultured from 1/15 (6.67%) control and 36/65 (55.38%) periodontitis patient samples (p<0.001). The cultures yielded Methanobrevibacter oralis in one control and thirty-one patients, Methanobrevibacter smithii in two patients and a potential new species named Methanobrevibacter sp. strain N13 in three patients with severe periodontitis. Our observations of living methanogens, strengthen previous observations made on DNA-based studies regarding the role of methanogens, in periodontitis. PMID:25830311
Zhang, Yifei; Sun, Xiangyu; Tong, Peiyuan; Si, Yan; Zheng, Shuguo
Objective Early childhood caries (ECC) has become a prevalent public health problem among Chinese preschool children. The bacterial microflora is considered to be an important factor in the formation and progress of dental caries. However, high-throughput and large-scale studies of the primary dentition are lacking. The present study aimed to compare oral microbial profiles between children with severe ECC (SECC) and caries-free children. Methods Both saliva and supragingival plaque samples were obtained from children with SECC (n = 20) and caries-free children (n = 20) aged 3 to 4 years. The samples were assayed using the Human Oral Microbe Identification Microarray (HOMIM). Results A total of 379 bacterial species were detected in both the saliva and supragingival plaque samples from all children. Thirteen (including Streptococcus) and two (Streptococcus and Actinomyces) bacterial species in supragingival plaque and saliva, respectively, showed significant differences in prevalence between the two groups. Of these, the frequency of Streptococcus mutans detection was significantly higher in both saliva (p = 0.026) and plaque (p = 0.006) samples from the SECC group than in those from the caries-free group. Conclusions The findings of our study revealed differences in the oral microbiota between the SECC and caries-free groups Several genera, including Streptococcus, Porphyromonas, and Actinomyces, are strongly associated with SECC and can be potential biomarkers of dental caries in the primary dentition. PMID:25821962
Menghini, Giorgio; Steiner, Marcel; Imfeld, Thomas
In 2003, 771 randomly selected two-year-old children from the town of Zurich were examined. Teeth with carious cavities were observed in 12.6% of the children. Caries including initial (not yet cavitated) lesions was seen in 25.3% of children. Caries prevalence was strongly associated with immigrant background. Caries was found in 7.5% of Swiss children and in 38.5% of children from ex-Jugoslavia. 5% of children of mothers born in Switzerland, and 17.4% of children of mothers not born in Switzerland showed caries. The average number of teeth with carious lesions in children with caries was 4.3 irrespective of immigrant or Swiss background. This finding suggests that all kids with caries had similar risk behaviours. Multivariate logistic regressions elucidated the behavioural components associated with caries. The presence of plaque and the use of a night-time bottle proved to be the strongest predictor variables for caries. Frequent drinking of sugared non-milk drinks, age and no pacifier use were further risk indicators in children of foreign-born mothers. A significant improvement of oral health of small children can be achieved by a concerted action of child welfare consultants, paediatricians and carers of day-nurseries. The primary goal is to convince parents to actively participate in preserving dental health of their offsprings. The following recommendations should be adhered to: 1. Parents should brush the teeth of the children daily, using a fluoridated children-toothpaste starting the very day of the appearance of the first milk tooth. 2. At the age of 12 months, the bottle should be replaced by a cup and the continuous use of a nursing bottle while falling asleep and during the night should absolutely be avoided. 3. Children should primarily be offered water and milk as a beverage. A first dental inspection is due at the age of two years.
Tellapragada, Chaitanya; Eshwara, Vandana Kalwaje; Acharya, Shashidhar; Bhat, Parvati; Kamath, Asha; Vishwanath, Shashidhar; Mukhopadhyay, Chiranjay
In view of recent understanding of the association of periodontal infections and adverse pregnancy outcomes, the present investigation was undertaken to study the periodontal infections among 390 asymptomatic pregnant women and to find an association of bacterial etiologies with the disease. Prevalence of gingivitis was 38% and clinical periodontitis was 10% among the study population. Subgingival plaque specimens were subjected to multiplex PCR targeting ten putative periodontopathogenic bacteria. Among the periodontitis group, high detection rates of Porphyromonas gingivalis (56%), Prevotella nigrescens (44%), Treponema denticola (32%), and Prevotella intermedius (24%) were noted along with significant association with the disease (P < 0.05). PMID:24899898
Hasan, A; Palmer, R M
An appreciation of dental plaque and the host response provides an essential basis from which to understand the disease process and treatment rationale. This information will help the reader to understand not only the way that plaque may have an impact on oral tissues but also why regular effective cleaning may improve periodontal health and why some individuals appear to have a greater susceptibility to periodontitis than others, either intrinsically or in relation to various systemic factors.
Cabanilla, Leyvee; Molinari, Gail
Periodontal diseases and conditions, as defined by The 1999 International Workshop for Classification of Periodontal Diseases and Conditions presented some significant paradigm shifts based on evidence that the transition from plaque-associated reversible gingival diseases to periodontitis can occur in children and adolescents with characteristics which were previously thought to be typical of adult periodontitis. The purposes of this paper are to present the periodontal diseases and conditions described in the 1999 workshop sponsored by the American Academy of Periodontology, review the risk factors for the development of periodontal diseases in the pediatric and adolescent populations, and present appropriate clinical periodontal assessment and management for these age groups.
Ishi, Eduardo de Paula; Bertolo, Manoel Barros; Rossa, Carlos; Kirkwood, Keith Lough; Onofre, Mirian Aparecida
The purpose of this clinical study was to investigate if periodontal disease and rheumatoid arthritis (RA) are associated. The study included 39 RA patients (test group) and 22 age- and gender-matched healthy individuals (control group). Questionnaires on general and oral health were applied and a complete periodontal exam, including visible plaque, marginal bleeding, attachment loss (AL) and number of teeth present, was also performed by a single calibrated examiner. Diabetes mellitus patients and smokers were excluded. RA patients had fewer teeth, higher prevalence of sites presenting dental plaque and a higher frequency of sites with advanced attachment loss. Although the prevalence of dental plaque was higher in the test group (Chi-square test, p = 0.0006), the percentage of sites showing gingival bleeding was not different (Fishers exact test, p > 0.05). Based on our results, we suggest that there is an association between periodontal disease and RA.
Livingstone, David; Murthy, Varsha; Reddy, Vineela Katam; Pillai, Ajay
Aggressive periodontitis previously termed as juvenile periodontitis is characterised by rapid destruction of the periodontium at a relatively young age. Rehabilitation of these patients is often challenging and difficult. Controlling the disease and restoring periodontal health is essential for successful prosthodontic rehabilitation. This clinical report describes an interdisciplinary approach in the rehabilitation of a young adult patient with generalised aggressive periodontitis. Treatment objectives included plaque control, prevention of further attachment loss, reduction/elimination of pockets, and prosthetic rehabilitation to enhance aesthetics and restore masticatory function. One year recall evaluation revealed stable periodontal support with no further loss of attachment and no other complications. PMID:25743856
Celik, Esra Uzer; Gokay, Necmi; Ates, Mustafa
Objective The aims of this study were to: (1) evaluate the caries risk in young adults using Cariogram and (2) compare the efficiency of Cariogram with the regression risk models created using the same variables in Cariogram by examining the actual caries progression over a 2-year period. Methods: This study included 100 subjects that were either twenty or twenty-one years-old. Data on general health, diet, oral hygiene and use of fluoride were obtained. Saliva analyses were performed, including mutans streptococci and lactobacilli counts, secretion rate and buffer capacity. DMFT and DMFS values were calculated by clinical examinations and radiographs. The participants were divided into 5 groups according to their Cariogram caries risk scores at baseline. Re-examination for caries was done after 2-years. The data were analyzed using Kruskall Wallis, Mann Whitney-U, and logistic regression analyses. Results: Diet frequency, plaque amount and secretion rate were significantly associated with caries increment (P<.05). Cariogram and the regression risk models explained the caries formation at a higher rate than single-variables. However, the regression risk model developed by diet frequency, plaque amount and secretion rate explained the caries formation similar to Cariogram, while the other regression model developed by all variables used in Cariogram explained the caries formation at a higher rate than this computer program. Conclusions: Cariogram is effective and can be used for caries risk assessment instead of single variables; however, it is possible to develop simplier models with regression analyses to determine caries risk. PMID:22904655
Austin, G B; Quart, A M; Novak, B
The periodontal conditions of two patients with hereditary hemorrhagic telangiectasia were successfully treated by a two-phase plan. The first phase of treatment eliminated inflammation from local etiologic factors by removing plaque and plaque-retaining factors. The second phase eliminated the residual anatomic defects of periodontal disease. Gingival bleeding has been indicated as a symptomatic factor of hereditary hemorrhagic telangiectasia, but such bleeding is more likely the result of periodontal inflammation.
Vogel, G.L.; Carey, C.M.; Chow, L.C.; Tatevossian, A. )
Despite the site-specific nature of caries, nearly all data on the concentration of ions relevant to the level of saturation of plaque fluid with respect to calcium phosphate minerals or enamel are from studies that used pooled samples. A procedure is described for the collection and analysis of inorganic ions relevant to these saturation levels in plaque fluid samples collected from a single surface on a single tooth. Various methods for examining data obtained by this procedure are described, and a mathematical procedure employing potential plots is recommended.
Arabaci, T; Ciçek, Y; Canakçi, C F
Periodontal therapy aims at arresting periodontal infection and maintaining a healthy periodontium. The periodic mechanical removal of subgingival microbial biofilms is essential for controlling inflammatory periodontal disease. Mechanical periodontal therapy consists of scaling, root planing and gingival curettage. The sonic and ultrasonic scalers are valuable tools in the prevention of periodontal disease. The vibration of scaler tips is the main effect to remove the deposits from the dental surface, such as bacterial plaque, calculus and endotoxin. However, constant flushing activity of the lavage used to cool the tips and cavitational activity result in disruption of the weak and unattached subgingival plaque. The aim of the study was to review the safety, efficacy, role and deleterious side-effects of sonic and ultrasonic scalers in mechanical periodontal therapy.
Miyajima, Shin-ichi; Naruse, Keiko; Kobayashi, Yasuko; Nakamura, Nobuhisa; Nishikawa, Toru; Adachi, Kei; Suzuki, Yuki; Kikuchi, Takeshi; Mitani, Akio; Mizutani, Makoto; Ohno, Norikazu; Noguchi, Toshihide; Matsubara, Tatsuaki
A relationship between periodontal disease and atherosclerosis has been suggested by epidemiological studies. Ligature-induced experimental periodontitis is an adequate model for clinical periodontitis, which starts from plaque accumulation, followed by inflammation in the periodontal tissue. Here we have demonstrated using a ligature-induced periodontitis model that periodontitis activates monocytes/macrophages, which subsequently circulate in the blood and adhere to vascular endothelial cells without altering the serum TNF-α concentration. Adherent monocytes/macrophages induced NF-κB activation and VCAM-1 expression in the endothelium and increased the expression of the TNF-α signaling cascade in the aorta. Peripheral blood-derived mononuclear cells from rats with experimental periodontitis showed enhanced adhesion and increased NF-κB/VCAM-1 in cultured vascular endothelial cells. Our results suggest that periodontitis triggers the initial pathogenesis of atherosclerosis, inflammation of the vasculature, through activating monocytes/macrophages.
Tinanoff, Norman; Reisine, Susan
The 2000 Surgeon General's Report on Oral Health included a limited discussion of the condition known as early childhood caries. Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, early childhood caries is arguably one of the most serious and costly health conditions among young children. A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci, also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk. On the basis of this knowledge of specific risk factors for an individual, different preventive strategies and different intensities of preventive therapies can be implemented. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with a fluoridated dentifrice, systemic fluoride supplement to children who live in a nonfluoridated area and who are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent.
Vallejo-Aisa, Francisco J.; Estefanía-Fresco, Ruth
Objectives: To evaluate bone loss around implants placed in patients with a history of treated chronic periodontitis and who did or did not attend supportive periodontal therapy, after one year in function. Furthermore, the influence of periodontal biotype and level of plaque was also evaluated. Material and Methods: Forty-nine patients participated voluntarily in the study. All subjects had a history of chronic periodontitis, which had been previously treated. After the active treatment, 27 patients attended supportive periodontal therapy (SPT) and the rest did not (No SPT). The O’Leary plaque index and periodontal biotype were recorded for each subject and 246 Astra Tech® OsseospeedTM implants were radiographically analysed (123 placed in SPT patients and 123 in No SPT patients) at the time of loading and one year later, measuring marginal bone loss with the program Dental Studio NX 6.0®. The statistical analysis was performed with Windows SPSS, applying Pearson’s correlation index and the Kruskal-Wallis and U-Mann Whitney non-parametric tests. Results: Six patients were found to have periimplantitis and sixteen mucositis. The survival rate was 99.59% (100% SPT and 99.18% No SPT). Mean bone loss was 0.39 mm (range [-0.71 - 8.05]). Among SPT patients, 95% of the implants had losses less than or equal to the mean (mean bone loss of 0.16 mm) compared to 53.7% for the No SPT group (mean bone loss of 0.62 mm). A statistically significant relationship was demonstrated between bone loss around the implant and the patient’s periodontal biotype and plaque index. Conclusions: The marginal bone loss around implants in patients with treated chronic periodontitis is minimal if they are in a controlled SPT programme and there is individual control of plaque index. Moreover, the presence of a thin periodontal biotype represents a risk factor for additional bone loss. Key words:Peri-implantitis, chronic periodontitis, bacterial plaque, periodontal biotype. PMID:23722147
techniques to obtain adequate plaque removal. Failure to manage plaque removal during orthodontic treatment may lead to early loss of tooth support2 and an...demonstrating a technique of plaque removal that is effective before orthodontic treatment begins. This is fol- lowed by positive reinforcement...Zachrisson, B.U. and Zachrisson, S. Carie Incidence and Oral Hygiene During Orthodontic Treatment . Scand. J. Dent. Res. 79:394-401, 1971. 4. Alexander, C.M
Splieth, C; Bernhardt, O
Risk-specific caries prevention requires validated and simple parameters for a caries risk assessment. The aim of the study was to evaluate the validity of a site-specific chair-side mutans streptococci (MS) test for the prediction of caries incidence in fissures. In 230 6- to 7-yr-old children, occlusal plaque samples of teeth 16 and 36 were cultured with Dentocult SM tests at 37 degrees C for 24 hr. Caries (DMFS), initial caries, sealants, and a plaque index (QHI) were recorded and oral hygiene habits were assessed. Not erupted, carious, filled and sealed teeth were excluded from the analysis (n = 154). After 2 yr, the status of the fissures was re-examined, and a fluoride history was recorded with a questionnaire filled out by the children's parents. Sealed teeth were excluded again (n = 54). With a classification of MS score 0 or 1 as low and MS score 2 or 3 as high caries risk, 92% agreement was reached by two independently working examiners. The MS scores and caries incidence correlated significantly. Seventy-eight % of the caries progression in fissures was prognosed correctly. Sensitivity was 50%, specificity 82%, positive predictive value 29%, and negative predictive value 92%. Children with caries progression tended to have lower fluoride scores. Low MS scores were most likely to be associated with low caries incidence, while high mutans streptococci scores seem to be partially compensated by other parameters.
Teng, Fei; Yang, Fang; Huang, Shi; Bo, Cunpei; Xu, Zhenjiang Zech; Amir, Amnon; Knight, Rob; Ling, Junqi; Xu, Jian
Microbiota-based prediction of chronic infections is promising yet not well established. Early childhood caries (ECC) is the most common infection in children. Here we simultaneously tracked microbiota development at plaque and saliva in 50 4-year-old preschoolers for 2 years; children either stayed healthy, transitioned into cariogenesis, or experienced caries exacerbation. Caries onset delayed microbiota development, which is otherwise correlated with aging in healthy children. Both plaque and saliva microbiota are more correlated with changes in ECC severity (dmfs) during onset than progression. By distinguishing between aging- and disease-associated taxa and exploiting the distinct microbiota dynamics between onset and progression, we developed a model, Microbial Indicators of Caries, to diagnose ECC from healthy samples with 70% accuracy and predict, with 81% accuracy, future ECC onsets for samples clinically perceived as healthy. Thus, caries onset in apparently healthy teeth can be predicted using microbiota, when appropriately de-trended for age.
Gupta, Nidhi; Pawar, Atish Prakash; Birajdar, Smita Shrishail; Natt, Amanpreet Singh; Singh, Harkanwal Preet
Dental caries is a chronic disease which can affect us at any age. The term “caries” denotes both the disease process and its consequences, that is, the damage caused by the disease process. Dental caries has a multifactorial aetiology in which there is interplay of three principal factors: the host (saliva and teeth), the microflora (plaque), and the substrate (diet), and a fourth factor: time. The role of sugar (and other fermentable carbohydrates such as highly refined flour) as a risk factor in the initiation and progression of dental caries is overwhelming. Whether this initial demineralization proceeds to clinically detectable caries or whether the lesion is remineralized by plaque minerals depends on a number of factors, of which the amount and frequency of further sugars consumption are of utmost importance. This paper reviews the role of sugar and sugar substitutes in dental caries. PMID:24490079
Tinanoff, Norman; Reisine, Susan
The 2000 Surgeon General's Report on Oral Health (SGROH) included a limited discussion of the condition known as Early Childhood Caries (ECC). Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, ECC is arguably one of the most serious and costly health conditions among young children. A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk. Based on this knowledge of specific risk factors for an individual, different preventive strategies as well as different intensities of preventive therapies can be employed. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with fluoridated dentifrice, systemic fluoride supplement to children living in a non-fluoridated area that are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent. PMID:19945074
Doméjean, Sophie; Léger, Stéphanie; Rechmann, Peter; White, Joel M; Featherstone, John D B
Research has demonstrated the validation of specific caries risk assessment (CRA) systems, but little is known about how dental practitioners assign a caries risk level to their patients. The aim of this study was to explore dental students' decision making in caries risk assignment when using the Caries Management By Risk Assessment (CAMBRA) system. Multiple correspondence analysis and chi-squared automated interaction detector analysis were performed on data collected retrospectively for a period of six years (2003-09) at the University of California, San Francisco predoctoral dental clinic. The study population consisted of 12,952 patients from six years of age through adult who received a baseline CRA during the period, were new to CAMBRA, and had not received any prior CAMBRA recommendations. The results showed variation in decision making and risk level assignment, illustrated by the range of percentages for the three scores (low, moderate, and high/extreme caries risk) when CRA was assigned for the first time. For those first-time CRAs, decision making was mainly based on four factors: cavities or caries lesions into dentin on radiograph, restorations during the last three years due to caries, visible heavy plaque, and interproximal lesions into enamel (by radiographs). This study's findings provide important data regarding one group of CAMBRA users and thus contribute to the development of knowledge about the implementation of caries risk assessment in contemporary dental practice.
Albalat, Salvador E.; Alcaniz-Raya, Mariano L.; Juan, M. Carmen; Grau Colomer, Vincente; Monserrat, Carlos
Evolution of periodontal disease is one of the most important data for the clinicians in order to achieve correct planning and treatment. Clinical measure of the periodontal sulcus depth is the most important datum to know the exact state of periodontal disease. These measures must be done periodically study bone resorption evolution around teeth. Time factor of resorption indicates aggressiveness of periodontitis. Manual probes are commonly used with direct reading. Mechanical probes give automatic signal but this method uses complicated and heavy probes that are only limited for University researchers. Probe position must be the same to have right diagnosis. Digital image analysis of periodontal probing provides practical, accurate and easy tool. Gum and plaque index could also be digitally measured with this method.
Barnes, V M; Teles, R; Trivedi, H M; Devizio, W; Xu, T; Mitchell, M W; Milburn, M V; Guo, L
Periodontal diseases, such as gingivitis and periodontitis, are characterized by bacterial plaque accumulation around the gingival crevice and the subsequent inflammation and destruction of host tissues. To test the hypothesis that cellular metabolism is altered as a result of host-bacteria interaction, we performed an unbiased metabolomic profiling of gingival crevicular fluid (GCF) collected from healthy, gingivitis, and periodontitis sites in humans, by liquid and gas chromatography mass spectrometry. The purine degradation pathway, a major biochemical source for reactive oxygen species (ROS) production, was significantly accelerated at the disease sites. This suggests that periodontal-disease-induced oxidative stress and inflammation are mediated through this pathway. The complex host-bacterial interaction was further highlighted by depletion of anti-oxidants, degradation of host cellular components, and accumulation of bacterial products in GCF. These findings provide new mechanistic insights and a panel of comprehensive biomarkers for periodontal disease progression.
Kumar, Vivek; Sinha, Jolly; Verma, Neelu; Nayan, Kamal; Saimbi, C S; Tripathi, Amitandra K
Periodontal disease results from inflammation of the supporting structure of the teeth and in response to chronic infection caused by various periodontopathic bacteria. The mechanical removal of this biofilm and adjunctive use of antibacterial disinfectants and antibiotics have been the conventional methods of periodontal therapy. However, the removal of plaque and the reduction in the number of infectious organisms can be impaired in sites with difficult access. Photodynamic therapy (PDT) is a powerful laser-initiated photochemical reaction, involving the use of a photoactive dye (photosensitizer) activated by light of a specific wavelength in the presence of oxygen. Application of PDT in periodontics such as pocket debridement, gingivitis, and aggressive periodontitis continue to evolve into a mature clinical treatment modality and is considered as a promising novel approach for eradicating pathogenic bacteria in periodontitis.
Buckley, L A
Certain features of malocclusion considered important in relation to periodontal health were analyzed in a study of 300 subjects. It was found that plaque and gingival inflammation were not related to vertical incisor overbite, horizontal incisor overjet or posterior cuspal interdigitation. Individual tooth irregularity measured as tilting, rotation, displacement and crowding had a low but statistically significant correlation with plaque, calculus and gingival inflammation. However, the study showed that these features of malocclusion are far less important than the extent of plaque and calculus deposits in the development of gingival inflammation.
Featherstone, John D B
Dental caries progression or reversal depends upon the balance between demineralization and remineralization. The 'Caries Balance' is determined by the relative weight of the sums of pathological factors and protective factors. Minimally invasive dentistry aims at the least possible removal of enamel or dentin, including reducing pathological factors and enhancing remineralization to avoid any removal of hard tissues. A structured caries risk assessment should be carried out based upon the concept of the caries balance. Following the risk assessment a treatment plan is devised which leads to the control of dental caries for the patient. The balance between pathological and preventive factors can be swung in the direction of caries intervention and prevention by the active role of the dentist and his/her auxiliary staff. Much is now understood about the mechanism of dental caries. We have known for a long time that demineralization of enamel, dentin or cementum is caused by organic acids that are generated by so-called acidogenic bacteria in the plaque when these bacteria feed upon fermentable carbohydrates (Silverstone, 1973; Featherstone, 2000; Loesche, 1986). The natural repair process is remineralization, which occurs when the pH rises again and calcium and phosphate from saliva together with fluoride enter the subsurface region of the lesion and form a new veneer on the existing crystal remnants in the lesion (Ten Cate and Featherstone, 1991). This veneer is less soluble than the original mineral and resists further acid attacks. The key to improved dental health for all is now for the dental profession to embrace this knowledge and put it into practice in the real world, to inhibit caries formation and progression, and to enhance the natural repair process.
Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory diseases. Gingivitis affects the majority of people, and advanced periodontitis is estimated to affect 5-15% of adults. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. All patients should undergo periodontal assessment as part of routine oral examination. Periodontal screening using methods such as the Basic Periodontal Examination/Community Periodontal Index or Periodontal Screening Record should be performed for all new patients, and also on a regular basis as part of ongoing oral health care. If periodontitis is identified, full periodontal assessment is required, involving recording of full mouth probing and bleeding data, together with assessment of other relevant parameters such as plaque levels, furcation involvement, recession and tooth mobility. Radiographic assessment of alveolar bone levels is driven by the clinical situation, and is required to assess bone destruction in patients with periodontitis. Risk assessment (such as assessing diabetes status and smoking) and risk management (such as promoting smoking cessation) should form a central component of periodontal therapy. This article provides guidance to the oral health care team regarding methods and frequencies of appropriate clinical and radiographic examinations to assess periodontal status, to enable appropriate detection and diagnosis of periodontal conditions. PMID:26390822
Nualart Grollmus, Zacy Carola; Morales Chávez, Mariana Carolina; Silvestre Donat, Francisco Javier
A number of systemic disorders increase patient susceptibility to periodontal disease, which moreover evolves more rapidly and more aggressively. The underlying factors are mainly related to alterations in immune, endocrine and connective tissue status. These alterations are associated with different pathologies and syndromes that generate periodontal disease either as a primary manifestation or by aggravating a pre-existing condition attributable to local factors. This is where the role of bacterial plaque is subject to debate. In the presence of qualitative or quantitative cellular immune alterations, periodontal disease may manifest early on a severe localized or generalized basis--in some cases related to the presence of plaque and/or specific bacteria (severe congenital neutropenia or infantile genetic agranulocytosis, Chediak-Higiashi syndrome, Down syndrome and Papillon-Lefévre syndrome). In the presence of humoral immune alterations, periodontal damage may result indirectly as a consequence of alterations in other systems. In connective tissue disorders, bacterial plaque and alterations of the periodontal tissues increase patient susceptibility to gingival inflammation and alveolar resorption (Marfan syndrome and Ehler-Danlos syndrome). The management of periodontal disease focuses on the control of infection and bacterial plaque by means of mechanical and chemical methods. Periodontal surgery and even extraction of the most seriously affected teeth have also been suggested. There are variable degrees of consensus regarding the background systemic disorder, as in the case of Chediak-Higiashi syndrome, where antibiotic treatment proves ineffective; in severe congenital neutropenia or infantile genetic agranulocytosis, where antibiotic prophylaxis is suggested; and in Papillon-Lefévre syndrome, where an established treatment protocol is available.
Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn
Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P < 0.01, periodontal disease index; r = 0.56, P < 0.01). After completion of periodontal therapy, clinical periodontal indexes were significantly lower and high sensitivity C-reactive protein significantly decreased from 2.93 to 2.21 mg/L. Moreover, blood urea nitrogen increased from 47.33 to 51.8 mg/dL, reflecting nutritional status improvement. Erythropoietin dosage requirement decreased from 8000 to 6000 units/week while hemoglobin level was stable. Periodontitis is an important source of chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients.
Skaleric, U; Kovac-Kavcic, M
Inflammatory periodontal disease is one of the most common diseases of mankind. Gingival inflammation is widespread, but advanced periodontitis is limited to relatively small subgroups of the population. Gingivitis is initiated by microbial plaque deposits on the dento-gingival interface but progression to periodontitis is modified by several environmental, behavioural, biological and health care variables. This paper reviews the reports dealing with some risk factors for periodontal disease published in recent years and compares the data with findings in a Ljubljana population. It is concluded that male smokers with lower education and low frequency of tooth brushing represent a risk population for progression of periodontal disease. Marital status and body mass need further study to be proved as risk factors for periodontitis. A socioecological model proposed by Hansen et al. (1993) should be used for understanding the interplay of different risk factors for progression of periodontal disease.
Chałas, Renata; Wójcik-Chęcińska, Ilona; Woźniak, Michał J; Grzonka, Justyna; Święszkowski, Wojciech; Kurzydłowski, Krzysztof J
Bacteria living constantly in the oral cavity are in the form of a biofilm. The biofilm formed on a solid base such as the enamel of the teeth, fillings, restorations, orthodontic appliances or obturators is dental plaque. Disturbance of homeostasis of biofilm, excessive growth or increase in the number of acid-forming bacteria leads to the development of the most common diseases of the oral cavity, i.e. dental caries and periodontal disease. The presence of bacterial biofilm on the walls of the root canal or at the top of the root on an outer wall leads to complications and failure in endodontic treatment. The aim of the study was to present the latest information on the occurrence, development and the role of biofilm in the etiopathogenesis of oral diseases and its control. Based on the literature analyzed, it can be concluded that the biofilm, due to its complex structure and numerous mechanisms of bacteria adaptation, is an effective barrier against the traditional agents with antibacterial properties. There are now great hopes for nanotechnology as an innovative method for obtaining new structures of nanometric size and different properties than source materials. The use of antibacterial properties of nano-silver used in dentistry significantly reduces the metabolic activity and the number of colony forming bacteria and lactic acid production in the biofilm.
Novak, M J; Polson, A M; Freeman, E
Systemic administration of gold salts for treatment of arthritis is thought to limit tissue destruction through alteration of inflammatory cell function. The present study ascertained if gold salts could modify the tissue destruction associated with an experimental marginal periodontitis. Therapeutic levels of serum gold salts were established in four squirrel monkeys (experimental) by intramuscular injection of Myochrisine (gold sodium thiomalate 25 mg/ml) at 5 mg/kg/body weight at 4-day intervals for 12 days. Marginal periodontitis was then induced around mandibular bicuspids by tying plaque retentive ligatures at the gingival margins. Periodontitis was induced around corresponding teeth in four control animals which had not received gold salts. Serum levels of gold salts were maintained in experimental animals, and all animals were killed 2 weeks after induction of periodontitis. Progression of periodontitis was evaluated histometrically on step-serial sections, and the results analyzed statistically. Specimens from gold-receiving animals had significantly smaller areas of infiltrated supracrestal connective tissue, and less loss of connective tissue attachment and coronal alveolar bone. Quantitation of total plaque around the ligatures showed no differences; however, there was less plaque located apical to the ligatures in gold-receiving specimens. Although the study design did not permit identification of the relative importance of cellular or microbial factors, it was concluded that administration of systemic gold salts was associated with significantly less periodontal destruction.
Non-surgical removal of plaque and calculus has been part of the initial phase of the management of patients with gingivitis and periodontitis for decades. It consists of patient motivation and oral hygiene instruction as well as mechanical removal of supra and subgingival plaque deposits. The purpose of this review was to assess recent changes. The article reports on changes in our understanding of plaque as a biofilm, developments in patient plaque control, chemical plaque control and scaling instruments. It also comments on full-mouth disinfection, the use of lasers and host modulation. Modern technology has made removal of microbial deposits by the patient and dental professionals more efficient. However, other advancements need to be used in conjunction with mechanical debridement at this time.
Matarasso, S; Cafiero, C; Bizzarri, L; Nicolò, M
Having described the morphological and functional characteristics of phagocytic cells, the paper underlines that, in addition to the etiological responsibility of bacterial plaque, the main role in the onset and evolution of periodontitis is played by the host's response. Phagocytic response plays a fundamental role in the host's defence reaction and represents the first barrier to the penetration of bacteria into periodontal tissue. In addition to their defensive role, phagocytic cells may also be responsible for damage to periodontal tissue as a collateral effect of their phagocytic function, thus worsening the periodontal lesion.
Yildiz, G; Ermis, R B; Calapoglu, N S; Celik, E U; Türel, G Y
Dental caries is a multifactorial disease that can be conceptualized as an interaction between genetic and environmental risk factors. The aim of this study is to examine the effects of AMELX, CA6, DEFB1, and TAS2R38 gene polymorphism and gene-environment interactions on caries etiology and susceptibility in adults. Genomic DNA was extracted from the buccal mucosa, and adults aged 20 to 60 y were placed into 1 of 2 groups: low caries risk (DMFT ≤ 5; n = 77) and high caries risk (DMFT ≥ 14; n = 77). The frequency of AMELX (+522), CA6 (T55M), DEFB1 (G-20A), and TAS2R38 (A49P) single-nucleotide polymorphisms was genotyped with the polymerase chain reaction-restriction fragment length polymorphism method. Environmental risk factors examined in the study included plaque amount, toothbrushing frequency, dietary intake between meals, saliva secretion rate, saliva buffer capacity, mutans streptococci counts, and lactobacilli counts. There was no difference between the caries risk groups in relation to AMELX (+522) polymorphism (χ(2) test, P > 0.05). The distribution of CA6 genotype and allele frequencies in the low caries risk group did not differ from the high caries risk group (χ(2) test, P > 0.05). Polymorphism of DEFB1 (G-20A) was positively associated, and TAS2R38 (A49P) negatively associated, with caries risk (χ(2) test, P = 0.000). There were significant differences between caries susceptibility and each environmental risk factor, except for the saliva secretion rate (Mann-Whitney U test, P = 0.000). Based on stepwise multiple linear regression analyses, dental plaque amount, lactobacilli count, age, and saliva buffer capacity, as well as DEFB1 (G-20A), TAS2R38 (A49P), and CA6 (T55M) gene polymorphism, explained a total of 87.8% of the variations in DMFT scores. It can be concluded that variation in CA6 (T55M), DEFB1 (G-20A), and TAS2R38 (A49P) may be associated with caries experience in Turkish adults with a high level of dental plaque, lactobacilli count
Puig-Silla, Miriam; Montiel-Company, José María; Dasí-Fernández, Francisco; Almerich-Silla, José Manuel
The aim of this study was to determine the relationship between the prevalence of Porphyromonas gingivalis, its fimA genotypes, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Treponema denticola and the evolution of periodontal health. In a longitudinal prospective study, samples of subgingival plaque were taken from 114 patients (37 with chronic periodontitis, 17 with gingivitis, and 60 periodontally healthy) in the course of a full periodontal examination. PCR was employed to determine the presence of the periodontopathogenic bacteria. Four years later, a second examination and sample collection were performed in 90 of these patients (20 with chronic periodontitis, 12 with gingivitis, and 58 periodontally healthy). T. forsythia, P. gingivalis, and T. denticola are the most prevalent bacteria in patients with chronic periodontitis (78.4%, 62.2 y 56.8%, respectively). The P. gingivalis bacterium and its fimA genotypes I, II, and IV showed the highest correlation between the baseline and follow-up assessments. P. gingivalis fimA genotype II and T. forsythia were associated to a significant degree with unfavourable periodontal evolution. Of the variables studied, P. gingivalis fimA genotype II and T. forsythia increase the risk of an unfavourable evolution of periodontal status.
Machida, Tatsuya; Tomofuji, Takaaki; Ekuni, Daisuke; Azuma, Tetsuji; Takeuchi, Noriko; Maruyama, Takayuki; Mizutani, Shinsuke; Kataoka, Kota; Kawabata, Yuya; Morita, Manabu
This cross-sectional study addressed the relationship between coffee consumption and periodontitis in patients during the maintenance phase of periodontal treatment. A total of 414 periodontitis patients in the maintenance phase of periodontal treatment completed a questionnaire including items related to coffee intake and underwent periodontal examination. Logistic regression analysis showed that presence of moderate/severe periodontitis was correlated with presence of hypertension (Odds Ratio (OR) = 1.99, p < 0.05), smoking (former, OR = 5.63, p < 0.01; current, OR = 6.81, p = 0.076), number of teeth present (OR = 0.89, p < 0.001), plaque control record ≥20% (OR = 1.88, p < 0.05), and duration of maintenance phase (OR = 1.07, p < 0.01). On the other hand, presence of severe periodontitis was correlated with smoking (former, OR = 1.35, p = 0.501; current, OR = 3.98, p < 0.05), coffee consumption (≥1 cup/day, OR = 0.55, p < 0.05), number of teeth present (OR = 0.95, p < 0.05), and bleeding on probing ≥ 20% (OR = 3.67, p < 0.001). There appears to be an inverse association between coffee consumption (≥1 cup/day) and prevalence of severe periodontitis in the maintenance phase of periodontal treatment.
Describes the school reading program at Cary Woods Elementary School (in Auburn, Alabama), one of several school reading programs designated by the International Reading Association as exemplary. (SR)
Wang, Hom-Lay; Greenwell, Henry; Fiorellini, Joseph; Giannobile, William; Offenbacher, Steven; Salkin, Leslie; Townsend, Cheryl; Sheridan, Phillip; Genco, Robert J
Untreated periodontal disease leads to tooth loss through destruction of the attachment apparatus and tooth-supporting structures. The goals of periodontal therapy include not only the arrest of periodontal disease progression,but also the regeneration of structures lost to disease where appropriate. Conventional surgical approaches (e.g., flap debridement) continue to offer time-tested and reliable methods to access root surfaces,reduce periodontal pockets, and attain improved periodontal form/architecture. However, these techniques offer only limited potential towards recovering tissues destroyed during earlier disease phases. Recently, surgical procedures aimed at greater and more predictable regeneration of periodontal tissues and functional attachment close to their original level have been developed, analyzed, and employed in clinical practice. This paper provides a review of the current understanding of the mechanisms, cells, and factors required for regeneration of the periodontium and of procedures used to restore periodontal tissues around natural teeth. Targeted audiences for this paper are periodontists and/or researchers with an interest in improving the predictability of regenerative procedures. This paper replaces the version published in 1993.
Ritter, André V.; Shugars, Daniel A.; Bader, James D.
Objective To identify risk indicators that are associated with root caries incidence in published predictive risk models. Methods Abstracts (n=472) identified from a MEDLINE, EMBASE, and Cochrane registry search were screened independently by two investigators to exclude articles not in English (n=39), published prior to 1970 (none), or containing no information on either root caries incidence, risk indicators, or risk models (n=209). A full-article duplicate review of the remaining articles (n=224) selected those reporting predictive risk models based on original/primary longitudinal root caries incidence studies. The quality of the included articles was assessed based both on selected criteria of methodological standards for observational studies and on the statistical quality of the modeling strategy. Data from these included studies were extracted and compiled into evidence tables, which included information about the cohort location, incidence period, sample size, age of the study participants, risk indicators included in the model, root caries incidence, modeling strategy, significant risk indicators/predictors, and parameter estimates and statistical findings. Results Thirteen articles were selected for data extraction. The overall quality of the included articles was poor to moderate. Root caries incidence ranged fro m 12%–77% (mean±SD=45%±17%); follow-up time of the published studies was ≤10 years (range=9; median=3); sample size ranged from 23–723 (mean±SD=264±203; median=261); person-years ranged from 23–1540 (mean±SD=760±556; median=746). Variables most frequently tested and significantly associated with root caries incidence were (times tested; % significant; directionality): baseline root caries (12; 58%; positive); number of teeth (7; 71%; 3 times positive, twice negative), and plaque index (4; 100%; positive). Ninety-two other clinical and non-clinical variables were tested: 27 were tested 3 times or more and were significant between 9
Zupancic, Spela; Kocbek, Petra; Baumgartner, Sasa; Kristl, Julijana
Periodontal disease is chronic inflammation of periodontal tissues resulting in formation of periodontal pockets, periodontal attachment loss and progressive destruction of the ligament and alveolar bone. This review gives an update on periodontal disease pathogenesis, which is important for the development of novel methods and delivery systems for its treatment. The available treatment approaches, including removal of dental plaque, modulation of the host inflammatory response, and regeneration of periodontal tissue, are reviewed and their drawbacks discussed. Furthermore the latest achievements involving development of nanomedicines, which represent a new approach to better treatment of periodontal disease, are highlighted. They enable local drug delivery to particular tissues, cells, or subcellular compartments in periodontal pockets, either to biofilm pathogens or host cells, as well as control the release of incorporated drugs, usually antibiotic or anti-inflammatory. Specific examples of the nanocarriers or nanomaterials such as liposomes, lipid and polymeric nanoparticles, nanocrystals, dendrimers, and nanofibers under development for the treatment of periodontal disease are also clearly reviewed. Nanofibers are of special interest as nanodelivery systems and scaffolds for the regeneration of periodontal tissue. Finally, the future outlook of novel therapeutic approaches involving nanodelivery systems in the treatment of periodontal disease is provided.
Shirmohamadi, Adileh; Chitsazi, Mohamad Taghi; Faramarzi, Masoumeh; Salari, Ashkan; Naser Alavi, Fereshteh; Pashazadeh, Nazila
Background. Transferrin is a negative acute phase protein, which decreases during inflammation and infection. The aim of the present investigation was to evaluate changes in the transferrin serum levels subsequent to non-surgical treatment of chronic periodontal disease. Methods. Twenty patients with chronic periodontitis and 20 systemically healthy subjects without periodontal disease, who had referred to Tabriz Faculty of Dentistry, were selected. Transferrin serum levels and clinical periodontal parameters (pocket depth, clinical attachment level, gingival index, bleeding index and plaque index) were measured at baseline and 3 months after non-surgical periodontal treatment. Data were analyzed with descriptive statistical methods (means ± standard deviations). Independent samples t-test was used to compare transferrin serum levels and clinical variables between the test and control groups. Paired samples t-test was used in the test group for comparisons before and after treatment. Statistical significance was set at P < 0.05. Results. The mean transferrin serum level in patients with chronic periodontitis (213.1 ± 9.2 mg/dL) was significantly less than that in periodontally healthy subjects (307.8 ± 11.7 mg/dL). Three months after periodontal treatment, the transferrin serum level increased significantly (298.3 ± 7.6 mg/dL) and approached the levels in periodontally healthy subjects (P < 0.05). Conclusion. The decrease and increase in transferrin serum levels with periodontal disease and periodontal treatment, respectively, indicated an inverse relationship between transferrin serum levels and chronic periodontitis. PMID:27651883
Kanaparthy, Rosaiah; Kanaparthy, Aruna; Mahendra, Muktishree
Periodontal subgingival pathogens affect local and systemic immune and inflammatory response and cause the release of cytokines; this results in periodontal destruction and initiation of an acute phase systemic inflammatory response characterized by the release of C-reactive proteins (CRP). This study set out to evaluate the serum concentration of CRP that can be used as a marker of periodontal disease as well as a risk indicator for cardiovascular disease. Based on their periodontal status, 45 patients were divided into three groups. The following clinical parameters were recorded: plaque index, gingival index, bleeding index, probing pocket depth, and clinical attachment levels. Scoring was done on six tooth surfaces for all teeth. For the CRP assessment, blood samples were collected from subjects at the time of clinical examination. The results indicated an increase in serum CRP levels in patients with generalized aggressive periodontitis and chronic periodontitis as compared to controls.
Periodontics is more associated with debridement of periodontal pockets and not generally thought of as using dental materials in the treatment of patients. However, the last 30 years have seen the development of materials used in regeneration of the periodontal tissues following periodontal disease, guided tissue regeneration, and the use of these materials in bone regeneration more recently, guided bone regeneration. The materials used include bone grafts and membranes, but also growth factors and cells-based therapies. This review provides an overview of the materials currently used and looks at contemporary research with a view to what may be used in the future. It also looks at the clinical effectiveness of these regenerative therapies with an emphasis on what is available in Australia.
Litonjua, Luis A; Cabanilla, Leyvee L; Abbott, Lawrence J
The presence of restorative materials on tooth surfaces is perceived to be a contributing factor to periodontal disease. This observation is a result of the increased accumulation of plaque on restorations adjacent to the gingiva, which may lead to gingivitis. Plaque is believed to adhere better to restorations than to enamel. This may be due to the surface characteristics of restorative materials such as surface roughness and surface-free energy inherent in the materials. This article reviews the experimental studies of plaque formation on different restorative materials. In addition, clinical studies analyzing and comparing restorative materials and the consequent formation of gingivitis are reviewed. While in vitro and in vivo studies show variations in plaque formation among restorative materials and enamel, clinical studies demonstrate that the progression of gingivitis can be prevented if patients maintain adequate oral hygiene and home care. Therefore, instructing the patient to maintain proper oral hygiene and home care is more important than the choice of restorative material.
Litonjua, Luis A; Cabanilla, Leyvee L; Abbott, Lawrence J
The presence of restorative materials on tooth surfaces is perceived to be a contributing factor to periodontal disease. This observation is a result of the increased accumulation of plaque on restorations adjacent to the gingiva, which may lead to gingivitis. Plaque is believed to adhere better to restorations than to enamel. This may be due to the surface characteristics of restorative materials such as surface roughness and surface-free energy inherent in the materials. This article reviews the experimental studies of plaque formation on different restorative materials. In addition, clinical studies analyzing and comparing restorative materials and the consequent formation of gingivitis are reviewed. While in vitro and in vivo studies show variations in plaque formation among restorative materials and enamel, clinical studies demonstrate that the progression of gingivitis can be prevented if patients maintain adequate oral hygiene and home care. Therefore, instructing the patient to maintain proper oral hygiene and home care is more important than the choice of restorative material.
Barbato, Luigi; Francioni, Edoardo; Bianchi, Massimiliano; Mascitelli, Eleonora; Marco, Leila Brancato; Tonelli, Duvina Paolo
Summary Periodontitis is a plaque induced disease characterized by tissue destruction. The extent of the alveolar bone loss depends on the host response stimulated by bacterial infection. Recently researchers have focused on the role of the immune system, of RANK/RANKL/OPG pathway and of cytokines network. Another recent field of interest is osteoimmunology that try to explain the relationship between immune and bone cells in activating bone resorption. Advances in the understanding of the pathogenic mechanisms allowed a better understanding of the relationship with other diseases like osteoporosis and also to hypothesize new therapies based on modulation of host response (host modulatory therapy - HMT). The purpose of this mini-review is to briefly discuss these topics. PMID:26604945
Bermejo-Fenoll, Ambrosio; Sánchez-Pérez, Arturo
Necrotizing gingivitis (NG) or necrotising ulcerative gingivitis (NUG) is considered to be an acute opportunistic gingival infection caused by bacterial plaque. It appears more frequently in undernurished children and young adults as well as patients with immunodeficiency. In its pathogenesis, there are factors related to the oral microbiota with invasion processes on the one hand, and on the other hand, factors associated with the host, such as signs of capillary and immunological disorders as well as undernurishment. The disease is characterized by pain, bleeding and papillary necrosis with tendency to relapse. Diagnosis is made by a simple clinical examination. However, complementary tests ought to be performed in order to eliminate the possibility of illnesses systemic or immunodeficiency. Early and sustained treatment is strongly recommended. Lesions of the gums (craters in the interdental papillae) as an aftermath of the disease is a possibility, or if there is necrotizing periodontitis there will be loss of attachment tissue.
von Troil-Lindén, B; Alaluusua, S; Wolf, J; Jousimies-Somer, H; Torppa, J; Asikainen, S
Suspected periodontal pathogens can be transmitted between spouses. The treatment response may be unsuccessful in periodontitis patients, if the spouse harbors these bacteria. The aim of the present 6-month follow-up study was to clarify whether the microbiological treatment outcome of periodontitis patients is related to the detection of suspected periodontal pathogens in the saliva of the spouse. 10 patients with advanced periodontitis and their spouses were included in the study. The patients received mechanical periodontal treatment and 500 mg metronidazole systemically 2x a day for 7 days. The presence of visible plaque, gingival bleeding after probing, suppuration, supragingival and subgingival calculus and pocket depths were assessed at baseline and 1 and 6 months after treatment. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia/Prevotella nigrescens, Campylobacter rectus and Peptostreptococcus micros were cultured from pooled subgingival samples from the patients and from salivary samples from the spouses at corresponding occasions. Periodontal conditions in the patients improved after treatment as determined by the significantly lower values of clinical variables 1 and 6 months after treatment compared to those at baseline. However, the re-emergence of periodontal bacteria after treatment of the patients was not related to the concurrent detection of the respective bacteria in the saliva of the spouses. In this study design, it seemed that the salivary bacterial load in the spouse was of minor importance for the microbiological treatment outcome of the patient.
Sofrata, A; Lingström, P; Baljoon, M; Gustafsson, A
The aim of this study was to document changes in plaque pH when an acidic challenge was followed by rinsing with miswak extract (Salvadora persica), and to evaluate the effect of miswak rinse on parotid gland secretion rate. Plaque pH was measured in 3-day-old plaque using the microtouch electrode. Rinsing with miswak extract, compared with water rinsing, resulted in protracted elevation of plaque pH (>6.0). The difference in plaque pH between miswak extract and water rinse was statistically significant at 30 min (p < 0.001). Rinsing with miswak extract stimulated parotid gland secretion (p < 0.01). In conclusion, miswak extract raised the plaque pH, suggesting a potential role in caries prevention.
Palmer, Elizabeth A.; Nielsen, Truman; Peirano, Patricia; Nguyen, Anna T.; Vo, Alex; Nguyen, Aivan; Jackson, Stephen; Finlayson, Tyler; Sauerwein, Rebecca; Marsh, Katie; Edwards, Issac; Wilmot, Beth; Engle, John; Peterson, John; Maier, Tom; Machida, Curtis A.
Purpose Genotypic strains of mutans streptococci (MS) may vary in important virulence properties, and may be differentially affected by specific components of full-mouth caries restorative therapy. The purpose of this pilot study was to identify MS strains that predominate following caries restorative therapy. Methods Plaque from seven children with severe early childhood caries was collected before and following therapy. MS isolates (N=828) were subjected to polymerase chain reaction (PCR), and arbitrarily primed-PCR (AP-PCR) for assignment within MS strains. Determining the longitudinal changes in MS strain distribution over time within each patient required the isolation of larger numbers of isolates per patient, but from fewer patients. Results Up to 39 genotypic strains of S. mutans and S. sobrinus, and seven genotypic strains of non-MS streptococci were identified by AP-PCR and 16S ribosomal rRNA gene sequencing. The number of MS strains isolated from each patient were 3–7 prior to treatment, diminishing to 1–2 dominant MS strains in most patients 6 months post-therapy. Conclusions Caries restorative therapy resulted in shifts of specific MS and non-MS streptococci strains. The implications are that caries restorative therapy affects the distribution of MS strains, and that well-accepted practices for caries prevention should be more closely examined for efficacy. PMID:22583870
Marulanda, Ana María; Coral, Diana; Sabogal, Diego; Serrano, Carlos
Epidemiological data on the periodontal health and oral hygiene practices of young individuals in Latin America are limited. This study was conducted in a sample of 355 first-year students randomly selected from 3,251 new students entering the largest university in Colombia. Participants received a periodontal examination and were interviewed about oral hygiene practices. Specifically, this study assessed the relationship between oral hygiene practices (including smoking tobacco) and plaque accumulation and/or periodontal bleeding on probing (BOP). Participants had extensive plaque accumulation and BOP, with a mean O´Leary plaque index of 56% and mean BOP of 37%. Both measures were higher for proximal surfaces. Plaque indices of at least 50% were not associated with any oral hygiene factors; however, plaque index and use of dental floss were associated with a BOP of at least 50%. Frequency of tooth brushing was higher in female than in male participants. Only 5% of participants reported smoking tobacco. On average, participants had 2.7±4.6 pockets of at least 4 mm (18% of participants had ≥5 and 9% of participants had ≥10 pockets of this depth, respectively). On average, participants had 2.1±4.4 sites with clinical attachment loss of at least 2 mm (15% and 6% of participants had ≥5 and ≥10 sites with this level of loss). Only 8% of participants were diagnosed with moderate periodontitis, and no participants were diagnosed with severe periodontitis. In conclusion, although participants had high levels of plaque and BOP, signs of advanced destructive periodontal disease were minimal.
Clark, Danielle; Febbraio, Maria; Levin, Liran
Aggressive periodontal disease is an oral health mystery. Our current understanding of this disease is that specific bacteria invade the oral cavity and the host reacts with an inflammatory response leading to mass destruction of the alveolar bone. Aggressive periodontal disease is typically observed in a population under the age of 30 and occurs so rapidly that it is difficult to treat. Unfortunately, the consequence of this disease frequently involves tooth extractions. As a result, the aftermath is chewing disability and damage to self-esteem due to an altered self-image. Furthermore, patients are encumbered by frequent dental appointments which have an economic impact in regards to both personal financial strain and absent days in the workplace. Aggressive periodontal disease has a tremendous effect on patients' overall quality of life and needs to be investigated more extensively in order to develop methods for earlier definitive diagnosis and effective treatments. One of the mysteries of aggressive periodontal disease is the relatively nominal amount of plaque present on the tooth surface in relation to the large amount of bone loss. There seems to be a hidden factor that lies between the response by the patient's immune system and the bacterial threat that is present. A better mechanistic understanding of this disease is essential to provide meaningful care and better outcomes for patients.
The purpose of this paper is to focus on functional characteristics of leukocyte adhesion molecules, on their localization and specific ligands. In fact, leukocyte chemotaxis and adhesion to endothelium is an essential step in promoting adequate immune response to bacterial infections. Since periodontal health is highly dependent on neutrophil function against the microbial dental plaque, defects in chemotaxis and adhesion of leukocytes to endothelium often result in severe, early onset periodontitis. Furthermore, oral lesions may be the only clinical manifestation of neutrophil impairment.
Jain, Poonam; Gary, Julie J
Dental caries is a multifactorial disease with various risk factors. Oral hygiene and dietary factors--specifically, the consumption of snacks and beverages with added sugars--have been shown to be risk indicators for this disease. It is critical for dental professionals to understand the relative roles of each of these food categories in the dental caries process. This article presents a cross-sectional study of 76 people living in a Southern Illinois fluoridated community. The amount of sugar-sweetened beverages, snack food consumption, plaque index, and age showed statistically significant relationships with the outcome variable--dental caries (P < 0.05). The results indicated that dietary factors and oral hygiene both contribute equally to dental caries in young adults living in a fluoridated community. Sugar-sweetened beverage consumption was a much stronger indicator of dental caries than snack food consumption in our study population.
Liu, Peng; Yue, Ji; Han, Shufang; Deng, Tianzheng; Fu, Chongjian; Zhu, Guoxiong; Chen, Dong
We explored the epidemiological risk factors for dental caries to help explain differences in the prevalence of adult dental caries. We examined 841 people for the presence of Helicobacter pylori in their dental plaque and for dental caries. Of the 841 subjects, 574 (68.25%) were infected with H pylori, and 516 (61.36%) were diagnosed with dental caries. Among the 574 subjects with H pylori, the prevalence of dental caries was 73.52% (422/574), while the prevalence among the 267 cases without H pylori was 35.21% (94/267). A correlation existed between the presence of H pylori and the occurrence of dental caries (χ(2) = 112.8, P < .01, odds ratio = 5.110, 95% confidence interval = 3.740-6.982). The 574 persons with H pylori had a higher mean dental plaque index than those without. In conclusion, H pylori infection in the oral cavity is associated with dental caries and poor dental hygiene.
Dursun, Erhan; Akalin, Ferda Alev; Genc, Tolga; Cinar, Nese; Erel, Ozcan; Yildiz, Bulent Okan
Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women.Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated.Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P < 0.05 for all). GCF TOS was higher in the obese women (P < 0.05), whereas there was a nonsignificant trend for higher serum TOS in obese women (P = 0.074). GCF TAOC values showed a negative correlation with body mass index, whereas GCF OSI was positively correlated with fasting insulin and low-density lipoprotein-cholesterol levels (P < 0.05 for all). Clinical periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status markers
Dursun, Erhan; Akalın, Ferda Alev; Genc, Tolga; Cinar, Nese; Erel, Ozcan; Yildiz, Bulent Okan
Abstract Periodontal disease is a chronic inflammatory disease of the jaws and is more prevalent in obesity. Local and systemic oxidative stress may be an early link between periodontal disease and obesity. The primary aim of this study was to detect whether increased periodontal disease susceptibility in obese individuals is associated with local and systemic oxidative stress. Accordingly; we analyzed periodontal status and systemic (serum) and local (gingival crevicular fluid [GCF]) oxidative status markers in young obese women in comparison with age-matched lean women. Twenty obese and 20 lean women participated. Periodontal condition was determined by clinical periodontal indices including probing depth, clinical attachment level, gingival index, gingival bleeding index, and plaque index. Anthropometric, hormonal, and metabolic measurements were also performed. Blood and GCF sampling was performed at the same time after an overnight fasting. Serum and GCF total antioxidant capacity (TAOC), and total oxidant status (TOS) levels were determined, and oxidative stress index (OSI) was calculated. Clinical periodontal analyses showed higher gingival index and gingival bleeding index in the obese group (P = 0.001 for both) with no significant difference in probing depth, clinical attachment level, and plaque index between the obese and the lean women. Oxidant status analyses revealed lower GCF and serum TAOC, and higher GCF and serum OSI values in the obese women (P < 0.05 for all). GCF TOS was higher in the obese women (P < 0.05), whereas there was a nonsignificant trend for higher serum TOS in obese women (P = 0.074). GCF TAOC values showed a negative correlation with body mass index, whereas GCF OSI was positively correlated with fasting insulin and low-density lipoprotein-cholesterol levels (P < 0.05 for all). Clinical periodontal indices showed significant correlations with body mass index, insulin, and lipid levels, and also oxidant status
Puig-Silla, Miriam; Dasí-Fernánde, Francisco; Montiel-Company, José-María
Objectives: The aim of this study was to determine the prevalence of the different fimA genotypes of Porphyromonas gingivalis in adult Spanish patients with chronic periodontitis, patients with gingivitis and periodontally healthy subjects, and the relationship between these genotypes and other periodontopathogenic bacteria. Study design: Samples of subgingival plaque were taken from 86 patients (33 with chronic periodontitis, 16 with gingivitis, and 37 periodontally healthy) in the course of a full periodontal examination. PCR was employed to determine the presence of the 6 fimA genotypes of Porphyromonas gingivalis (I-V and Ib) and of Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola. Results: Porphyromonas gingivalis fimA genotypes II and Ib were present in significantly higher percentages in periodontal patients (39.4% and 12.1% respectively) than in healthy or gingivitis subjects. The prevalence of Tannerella forsythia, Treponema denticola, and Porphyromonas gingivalis fimA genotype IV was significantly higher in the group that presented bleeding greater than 30%. A positive correlation was found between Porphyromonas gingivalis fimA genotype IV and Treponema denticola. Conclusions: A strong association between Porphyromonas gingivalis fimA genotypes II and Ib and chronic periodontitis exists in the Spanish population. The most prevalent genotype in periodontal patients is II. Key words:Periodontitis, Porphyromonas gingivalis, fimA genotype, periodontal bacteria, polymerase chain reaction. PMID:22549664
TORO, E; NASCIMENTO, MM; SUAREZ-PEREZ, E; BURNE, RA; ELIAS-BONETA, A; MOROU-BERMUDEZ, E
Objective Dietary sugar exposures induce an immediate drop of the plaque pH. Based on in vitro observations, it was hypothesized that oral bacteria may rapidly respond to this environmental change by increasing the activity or expression of alkali-generating pathways, such as the urease pathway. The objective of this exploratory in vivo study was to determine the short-term effect of a brief sucrose exposure on plaque and saliva urease activity and expression, and to relate this effect to caries experience. Methods Urease activity levels were measured in plaque and saliva samples collected from 20 children during fasting conditions and 30 minutes after rinsing with a sucrose solution. Streptococcus salivarius ureC-specific mRNA in saliva was quantified using Real-Time RT-PCR. The impact of host-related factors, such as age, gender, sugar consumption, salivary mutans streptococci levels and caries status on urease activity was evaluated. Results Plaque urease activity under fasting conditions was higher in subjects with low caries and mutans streptococci levels. This difference was not observed after the sucrose exposure. The response of urease to sucrose in vivo did not depend on caries experience or salivary mutans levels. Significant increase in urease activity of plaque and saliva after exposure to sucrose was observed only in the subjects who had low urease levels at baseline. Conclusions The findings of this exploratory study suggest that plaque urease activity may have an important long-term influence in caries development but not during a cariogenic challenge. PMID:20096398
Apostolska, S; Rendzova, V; Ivanovski, K; Peeva, M; Elencevski, S
The objective of this abstract is to examine the presence of caries in the adult population with different levels of oral hygiene; to examine the concentration of Streptococcus Mutans in saliva of patients with different levels of oral hygiene; to examine the correlation among Streptococcus Mutans, caries and level of oral hygiene. This examination was made on 50 (fifty) patients, both male and female, at the age of 20 to 65. The examinees were split into 5 groups. The examinations and sampling were done randomly at the Department of Cariology and Endodontics at the Faculty of Dental Medicine in Skopje. The microbiological researches were made at the Institute of Microbiology and parasitology at the Faculty of Medicine in Skopje. The examination of all patients was made according to a unique methodology. The results obtained indicate that the Plaque index level and the number of Streptococcus Mutans in saliva (CFU) are correlated to the number of carious teeth in all age groups except for Group V (61-65) where the Plaque index level and the level of Streptococcus Mutans in saliva were much higher compared to the number of carious teeth (51-99 and >100 CFU), particularly for examinees with prosthesis. Initial enamel caries was dominant in patients up to the age of 50, and for those older than 50 surface root caries was dominant. Initial caries was present in 28.62% of Group I and was 5.66% in Group V, unlike the root surface caries in Group 1, with 1.14%, and Group 5 with 28.30%.
Meller, C; Santamaria, R M; Connert, T; Splieth, C
The aim of this study was to analyse the predictive power of several clinical baseline parameters and the de-/remineralisation properties of in vivo etched sites measured with quantitative light-induced fluorescence (QLF) for subsequent 2-year caries increment. At baseline, in 44 children (8.23 ± 1.5 years) two areas (diameter 2 mm) of the buccal surface of a primary posterior tooth were etched with 36% phosphoric acid gel for 1 and 4 min, respectively. The etched sites were analysed immediately after etching (ΔQ1) and 24 h (ΔQ2) later by QLF. Additionally, caries status (deft/DMFT and initial caries), approximal plaque, bleeding on probing, and the patient's current use of fluorides were recorded. In the 2-year follow-up, 29 children were re-assessed. After clinical examination, the caries increment was calculated (ΔDMFT) and correlated with the baseline clinical variables and the QLF readings. Results showed a significant positive correlation between ΔQ(1 min) and the ΔDMFT (r = 0.44, p = 0.02). The ΔDMFT was significantly correlated with the baseline deft (r = 0.56, p = 0.002), cavitated active caries lesions (r = 0.52, p = 0.003), and filled teeth (r = 0.53, p = 0.003). In a regression analysis the use of fluoridated salt (SC = -0.10) and fluoride gel (SC = -0.14) were negatively associated with ΔDMFT. In conclusion, these findings suggest that the demineralisation properties of the etched sites and the outcome of the 24-hour measurements with QLF are significantly associated with caries increment. Previous caries experience strongly correlated with caries increment in this group of children.
Ieong, Cheng Cheng; Zhou, Xue Dong; Li, Ji Yao; Li, Wei; Zhang, Ling Lin
Dental caries is the most common oral diseases, and it gives a serious threat to oral and general health. Fluoride, a classic anti-caries agent, has a profound effect on caries prevention and treatment. However, fluorosis and fluoride-resistant strains limit the further application of fluoride treatment. Therefore, it is still of significant benefit to seek alternatives, bringing more effective anti-caries agents. The potential role of enamel matrix proteins(EMPs) in promoting the regeneration of periodontal tissue and inducing bone have been proved. EMPs have been successfully applied in the field of periodontal disease and dental implants in recent years. Previous researches revealed that enamel matrix proteins had an important role in the synthesis of hydroxyapatite in vitro. Some experiments about the degeneration or removal of EMP suggest that enamel matrix proteins are related to the occurrence and development of caries. Based on evidences illustrated by these experiments, this paper hypothesizes that functional peptides based on the function and structure of EMPs could promote remineralization of enamel caries, which could perform as a suitable treatment to enamel caries. The hypothesis may lead a new direction in the study on the prevention and treatment of enamel caries, and further study of the anti-caries mechanisms of EMP will enable researchers to find out the most effective anti-caries peptides, which could be developed into a bionics anti-cariogenic agent.
Basic, A; Dahlén, G
Periodontitis is a polymicrobial anaerobe infection. Little is known about the dysbiotic microbiota and the role of bacterial metabolites in the disease process. It is suggested that the production of certain waste products in the proteolytic metabolism may work as markers for disease severity. Hydrogen sulfide (H2S) is a gas produced by degradation of proteins in the subgingival pocket. It is highly toxic and believed to have pro-inflammatory properties. We aimed to study H2S production from subgingival plaque samples in relation to disease severity in subjects with natural development of the disease, using a colorimetric method based on bismuth precipitation. In remote areas of northern Thailand, adults with poor oral hygiene habits and a natural development of periodontal disease were examined for their oral health status. H2S production was measured with the bismuth method and subgingival plaque samples were analyzed for the presence of 20 bacterial species with the checkerboard DNA-DNA hybridization technique. In total, 43 subjects were examined (age 40-60 years, mean PI 95 ± 6.6%). Fifty-six percent had moderate periodontal breakdown (CAL > 3 < 7 mm) and 35% had severe periodontal breakdown (CAL > 7 mm) on at least one site. Parvimonas micra, Filifactor alocis, Porphyromonas endodontalis and Fusobacterium nucleatum were frequently detected. H2S production could not be correlated to periodontal disease severity (PPD or CAL at sampled sites) or to a specific bacterial composition. Site 21 had statistically lower production of H2S (p = 0.02) compared to 16 and 46. Betel nut chewers had statistically significant lower H2S production (p = 0.01) than non-chewers. Rapid detection and estimation of subgingival H2S production capacity was easily and reliably tested by the colorimetric bismuth sulfide precipitation method. H2S may be a valuable clinical marker for degradation of proteins in the subgingival pocket.
Pugach, M.K.; Strother, J.; Darling, C.L.; Fried, D.; Gansky, S.A.; Marshall, S.J.; Marshall, G.W.
Caries Detector staining reveals 4 zones in dentin containing caries lesions, but characteristics of each zone are not well-defined. We therefore investigated the physical and microstructural properties of carious dentin in the 4 different zones to determine important differences revealed by Caries Detector staining. Six arrested dentin caries lesions and 2 normal controls were Caries-Detector-stained, each zone (pink, light pink, transparent, apparently normal) being analyzed by atomic force microscopy (AFM) imaging for microstructure, by AFM nano-indentation for mechanical properties, and by transverse digital microradiography (TMR) for mineral content. Microstructure changes, and nanomechanical properties and mineral content significantly decreased across zones. Hydrated elastic modulus and mineral content from normal dentin to pink Caries-Detector-stained dentin ranged from 19.5 [10.6-25.3] GPa to 1.6 [0.0-5.0] GPa and from 42.9 [39.8-44.6] vol% to 12.4 [9.1-14.2] vol%, respectively. Even the most demineralized pink zone contained considerable residual mineral. PMID:19131321
Sabatoski, Claudio Vinicius; Bueno, Regis Claret; Reyes Pacheco, Ariel Adriano; Pithon, Matheus Melo; Tanaka, Orlando Motohiro
A 41-year-old man had a significant loss of bone and supporting tissues with pathologic migration of several teeth and several missing teeth. He was treated with an interdisciplinary therapeutic protocol that included nonsurgical periodontal therapy based on strict control of supragingival plaque, subgingival periodontal therapy, orthodontic and endodontic treatment, and replacement of restorations. The orthodontic therapy was performed in a severely reduced bone support and the presence of pathological tooth migration after periodontal disease control. The interdisciplinary treatment protocol was the key to achieve a significant improvement in his facial and dental esthetics, masticatory function, and quality of life. PMID:26587295
Pinto, Graça; Silva, Maria Daniela; Peddey, Mark; Sillankorva, Sanna; Azeredo, Joana
The human periodontium health is commonly compromised by chronic inflammatory conditions and has become a major public health concern. Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria - bacteriophages - are most common in the oral cavity. Despite this, their role in the progression of periodontal disease remains poorly explored. This review aims to summarize how bacteriophages interact with the oral microbiota, their ability to increase bacterial virulence and mediate the transfer of resistance genes and suggests how bacteriophages can be used as an alternative to the current periodontal disease therapies.
Zhang, Ning; Melo, Mary A. S.; Chen, Chen; Liu, Jason; Weir, Michael D.; Bai, Yuxing; Xu, Hockin H. K.
Objectives The objectives of this study were to: (1) develop a novel adhesive for prevention of tooth root caries and secondary caries by possessing a combination of protein-repellent, antibacterial, and remineralization capabilities for the first time; and (2) investigate the effects of 2-methacryloyloxyethyl phosphorylcholine (MPC), dimethylaminohexadecyl methacrylate (DMAHDM), and nanoparticles of amorphous calcium phosphate (NACP) on dentine bond strength, protein-repellent properties, and dental plaque microcosm biofilm response. Methods MPC, DMAHDM and NACP were added into Scotchbond Multi-Purpose primer and adhesive. Dentine shear bond strengths were measured. Adhesive coating thickness, surface texture and dentine-adhesive interfacial structure were examined. Protein adsorption onto adhesive resin surface was determined by the micro bicinchoninic acid method. A human saliva microcosm biofilm model was used to investigate biofilm metabolic activity, colony-forming unit (CFU) counts, and lactic acid production. Results The resin with 7.5% MPC + 5% DMAHDM + 30% NACP did not adversely affect dentine shear bond strength (p > 0.1). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP produced a coating on root dentine with a thickness of approximately 70 μm and completely sealed all the dentinal tubules. The resin with 7.5% MPC + 5% DMAHDM + 30% NACP had 95% reduction in protein adsorption, compared to SBMP control (p < 0.05). The resin with 7.5% MPC + 5% DMAHDM + 30% NACP was strongly antibacterial, with biofilm CFU being four orders of magnitude lower than that of SBMP control. Significance The novel multifunctional adhesive with strong protein-repellent, antibacterial and remineralization properties is promising to coat tooth roots to prevent root caries and secondary caries. The combined use of MPC, DMAHDM and NACP may have wide applicability to bonding agents, cements, sealants and composites to inhibit caries. PMID:26187532
Jorgensen, M G; Slots, J
New products and treatment modalities for the management of periodontal disease continue to offer the clinician a large number of choices, many of which involve antimicrobials. Specific pathogenic bacteria play a central role in the etiology and pathogenesis of destructive periodontal disease. Under suitable conditions, periodontal pathogens colonize the subgingival environment and are incorporated into a tenacious biofilm. Successful prevention and treatment of periodontitis is contingent upon effective control of the periodontopathic bacteria. This is accomplished by professional treatment of diseased periodontal sites and patient-performed plaque control. Attention to community factors, such as water contamination and bacterial transmission among family members, facilitates preventive measures and early treatment for the entire family. Subgingival mechanical debridement, with or without surgery, constitutes the basic means of disrupting the subgingival biofilm and controlling pathogens. Appropriate antimicrobial agents that can be administered systemically (antibiotics) or via local delivery (povidone-iodine) may enhance eradication or marked suppression of subgingival pathogens. Microbiological testing may aid the clinician in the selection of the most effective antimicrobial agent or combination of agents. Understanding the benefits and limitations of antibiotics and antiseptics will optimize their usefulness in combating periodontal infections.
Anwar, N; Zaman, N; Nimmi, N; Chowdhury, T A; Khan, M H
There have been an association between systemic diseases and hormonal changes particularly diabetes which has been cited as a risk factor in the progression of periodontitis in pregnant women. The incidence and severity of periodontal diseases are increasing at a higher rate and a common condition in pregnant diabetic women among Bangladeshi population. This cross sectional study included 200 pregnant women who were selected from gynecological department and examined at the dental unit. The clinical parameters used were the Silness and Loe plaque index (PI), gingival scores and periodontal status and any relationship to socio demographic variables (age, occupation, level of education and urban or rural residence) and clinical variables (gestation period, previous pregnancy, type of diabetes and periodontal maintenance) were evaluated. The results showed that these clinical parameters increased concomitantly with an increase in the stage of pregnancy and in women with multiple pregnancies. Increased age, lower level of education, unemployment and patients residing in rural areas were associated with significantly higher gingival scores and periodontal measures. Women with increased age and multiple pregnancies usually have less interest to frequent periodontal maintenance showing a significant statistical relation between an increased age and changes in gingival and periodontal status; however no significant association was found between increased age and plaque index. It is concluded that gingival inflammatory symptoms are aggravated during pregnancy in diabetic women and are related to different clinical and demographic variables.
Kaur, Gagandeep; Mohindra, Kanika; Singla, Shifali
Autoimmune reactions reflect an imbalance between effector and regulatory immune responses, typically develop through stages of initiation and propagation, and often show phases of resolution (indicated by clinical remissions) and exacerbations (indicated by symptomatic flares). The fundamental underlying mechanism of autoimmunity is defective elimination and/or control of self-reactive lymphocytes. Periodontal diseases are characterized by inflammatory conditions that directly affect teeth-supporting structures, which are the major cause of tooth loss. Several studies have demonstrated the involvement of autoimmune responses in periodontal disease. Evidence of involvement of immunopathology has been reported in periodontal disease. Bacteria in the dental plaque induce antibody formation. Autoreactive T-cells, natural killer cells, ANCA, heat shock proteins, autoantibodies, and genetic factors are reported to have an important role in the autoimmune component of periodontal disease. The present review describes the involvement of autoimmune responses in periodontal diseases and also the mechanisms underlying these responses.
Almaz, Merve Erkmen; Sönmez, Işıl Şaroğlu
The purpose of this article was to assess the effectiveness of ozone therapy in the management and prevention of caries, reviewing clinical and in vitro studies. Ozone has proven to be effective against gram-negative and gram-positive bacteria, viruses, and fungi. In dentistry, most of the published articles are based on ozone's antimicrobial effects and the treatment of caries. Most of the clinical studies reported ozone to be a promising alternative to conventional methods for caries management. However, a few studies have shown ozone to be insufficient for preventing caries and reducing microorganisms in open occlusal carious lesions. Ozone might be a useful tool to reduce and control oral infectious microorganisms in dental plaque and dental cavity. However, the results of in vitro studies are controversial; while some researchers reported that ozone therapy had a minimal or no effect on the viability of microorganisms, others suggested ozone to be highly effective in killing both gram-positive and gram-negative oral microorganisms. Therefore, more evidence is required before ozone can be accepted as an alternative to present methods for the management and prevention of caries.
Vanderas, A P; Manetas, C; Papagiannoulis, L
Urinary catecholamines have been used to measure emotionally stressful states which may affect the development of dental caries. This study investigates the hypothesis that children with and without dental caries do not differ significantly in the mean values of urinary catecholamines such as epinephrine, norepinephrine, and dopamine. As a test of this hypothesis, 314 children, males and females, aged from 6 to 8 years, were included in the study. Dental caries were recorded clinically and radiographically, and oral hygiene was evaluated by the recording of dental plaque. A 24-hour urine sample was collected for each subject, and a representative sample (25 mL) was analyzed by the HPLC technique to assay the catecholamine content. Socioeconomic factors such as parental age, education, and profession were recorded by a questionnaire distributed to the parents. Of the examined children, 38 (14 males and 24 females) were free of dental caries and constituted the case group. Two control groups, A and B, of 38 children each (14 males and 24 females) with dental caries were matched by age and gender. Differences in the quantitative and qualitative data were tested by the paired t test and the X2-test, respectively, while a regression analysis was applied to measure the effects of norepinephrine and dopamine on epinephrine. The logistic multiple-regression analysis was used to test, in the entire population, the impact of catecholamines and other related factors on the probability of subjects' developing dental caries. The 95% probability was used. The results showed statistically significant differences in epinephrine values between the case group and control groups A and B. The data suggest, therefore, that children with emotionally stressful states have higher probability of developing dental caries.
Chen, Fu; Wang, Dong
Importance of the field: Dental caries is one of the most common preventable childhood diseases; people are susceptible to this ailment throughout their lifetime. In the United States, 90% of late adolescents and young adults have dental caries, while 94% of all dentate adults had evidence of treated or untreated coronal caries. Dental caries is often not self-limiting and without proper care, caries can progress until the tooth is destroyed. Areas covered in this review: In this paper, the etiology of dental caries was briefly introduced. It was followed by a thorough review of patents and literatures on the recent development of various novel technologies for the prevention and treatment of dental caries. What the reader will gain: Recent advances in anti-plaque agents, including chemoprophylactic agents, antimicrobial peptides, vaccines, probiotics/replacement therapy and sugar substitutes, and remineralization agents including fluorides and casein phosphopeptides are analyzed. Take home massage: Both the discovery of new anti-caries agents and the development of dentotropic delivery systems will be the future focus of this research field. PMID:20230309
Pérez-Chaparro, P.J.; Gonçalves, C.; Figueiredo, L.C.; Faveri, M.; Lobão, E.; Tamashiro, N.; Duarte, P.; Feres, M.
There is substantial evidence supporting the role of certain oral bacteria species in the onset and progression of periodontitis. Nevertheless, results of independent-culture diagnostic methods introduced about a decade ago have pointed to the existence of new periodontal pathogens. However, the data of these studies have not been evaluated together, which may generate some misunderstanding on the actual role of these microorganisms in the etiology of periodontitis. The aim of this systematic review was to determine the current weight of evidence for newly identified periodontal pathogens based on the results of “association” studies. This review was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE, and Cochrane databases were searched up to September 2013 for studies (1) comparing microbial data of subgingival plaque samples collected from subjects with periodontitis and periodontal health and (2) evaluating at least 1 microorganism other than the already-known periodontal pathogens. From 1,450 papers identified, 41 studies were eligible. The data were extracted and registered in predefined piloted forms. The results suggested that there is moderate evidence in the literature to support the association of 17 species or phylotypes from the phyla Bacteroidetes, Candidatus Saccharibacteria, Firmicutes, Proteobacteria, Spirochaetes, and Synergistetes. The phylum Candidatus Saccharibacteria and the Archaea domain also seem to have an association with disease. These data point out the importance of previously unidentified species in the etiology of periodontitis and might guide future investigations on the actual role of these suspected new pathogens in the onset and progression of this infection. PMID:25074492
Vanderas, A P; Manetas, K; Papagiannoulis, L
This one-year follow-up study investigates the relationship between urinary catecholamine levels and dental caries increment in 314 children, boys and girls, ages six to eight years. Dental caries was recorded clinically and radiographically and oral hygiene was evaluated by recording the dental plaque. A 24-hour urine sample was collected for each subject, in a year interval, and a representative sample was analyzed by the HPLC technique to assay the catecholamine content. Socioeconomic factors such as parental age, education, and profession were recorded by a questionnaire distributed to the parents. Of the examined children, forty-four (16 boys and 28 girls) did not develop new dental caries and constituted the Caries-Free group. Two New Caries groups, A and B, of forty-four children each (16 boys and 28 girls) were matched by age and sex. Differences were tested in the quantitative and qualitative data by the paired t-test and the chi 2 test, respectively, while a regression analysis was applied to measure the effects of norepinephrine and dopamine on epinephrine. The logistic multiple-regression analysis was used to test, in the entire population, the impact of catecholamines and other related factors on the probability of a subject's developing new dental caries. The 95 percent probability was used. The results showed statistically significant differences in epinephrine and norepinephrine values between Caries-Free and New Caries group A in both examinations. Also, significant differences were found between Caries-Free and New Caries group B in epinephrine and norepinephrine at the first examination, while at the second examination the difference was significant only in epinephrine. The data provide evidence, therefore, that an emotionally stressful state can be an etiologic factor of dental caries.
Corbet, E; Smales, R
A high level of sustained personal plaque control is fundamental for successful treatment outcomes in patients with active periodontal disease and, hence, oral hygiene instructions are the cornerstone of periodontal treatment planning. Other risk factors for periodontal disease also should be identified and modified where possible. Many restorative dental treatments in particular require the establishment of healthy periodontal tissues for their clinical success. Failure by patients to control dental plaque because of inappropriate designs and materials for restorations and prostheses will result in the long-term failure of the restorations and the loss of supporting tissues. Periodontal treatment planning considerations are also very relevant to endodontic, orthodontic and osseointegrated dental implant conditions and proposed therapies.
Dave, Tarun; Ezhilan, J.; Vasnawala, Hardik; Somani, Vinod
Atherosclerosis is characterized by formation of plaques on the inner walls of arteries that threatens to become the leading cause of death worldwide via its sequelae of myocardial infarction and stroke. Endothelial dysfunction leads to cholesterol uptake and accumulation of inflammatory markers within the plaque. The stability of a plaque eventually depends on the balance between vascular smooth muscle cells that stabilize it and the inflammatory cells like macrophages and T lymphocytes that make it prone to rupture. The current approach to manage atherosclerosis focuses on the treatment of a ruptured plaque and efforts have been made to reduce the risk of plaque rupture by identifying vulnerable plaques and treating them before they precipitate into clinical events. New diagnostic approaches such as IVUS and CIMT ultrasound are now being preferred over traditional coronary angiography because of their better accuracy in measuring plaque volume rather than the level of stenosis caused. The present review highlights the literature available on two prevalent approaches to manage a vulnerable plaque, namely, plaque stabilization and plaque regression, and their validation through various treatment modalities in recent plaque management studies. Plaque stabilization focuses on stabilizing the content of plaque and strengthening the overlying endothelium, while plaque regression focuses on the overall reduction in plaque volume and to reverse the arterial endothelium to its normal functional state. Although earlier studies contemplated the practicality of plaque regression and focused greatly on stabilization of a vulnerable plaque, our review indicated that, aided by the use of superior diagnostics tools, more intensive lipid modifying therapies have resulted in actual plaque regression. PMID:24381872
Albino, J.; Tiwari, T.
The etiology of dental caries reflects a complex interplay of biochemical, microbial, genetic, social and physical environmental, and health-influencing behavioral factors. This review updates the literature on the efficacy of behavioral approaches to caries prevention for children up to 18 y of age. Included were studies of behavioral interventions implemented at individual, family, and community levels that assessed results in terms of reductions in caries increments. Only those reports published since 2011 were considered. Outcomes were variable, although motivational interviewing, which involves individuals in decisions about oral health within the context of their respective life circumstances, proved effective in 3 of 4 reported studies, and more definitive trials are underway. Recommendations for future research include examinations of the cost-effectiveness of interventions, as well as work focused on understanding the mechanisms underlying oral health behavior change and variables that may mediate or moderate responses to interventions. PMID:26438210
The ultimate goal of periodontal therapy is the regeneration of the tissues destroyed as a result of periodontal disease. Currently, two clinical techniques, based on the principles of "guided tissue regeneration" (GTR) or utilization of the biologically active agent "enamel matrix derivative" (EMD), can be used for the regeneration of intrabony and Class II mandibular furcation periodontal defects. In cases where additional support and space-making requirements are necessary, both of these procedures can be combined with a bone replacement graft. There is no evidence that the combined use of GTR and EMD results in superior clinical results compared to the use of each material in isolation. Great variability in clinical outcomes has been reported in relation to the use of both EMD and GTR, and these procedures can be generally considered to be unpredictable. Careful case selection and treatment planning, including consideration of patient, tooth, site and surgical factors, is required in order to optimize the outcomes of treatment. There are limited data available for the clinical effectiveness of other biologically active molecules, such as growth factors and platelet concentrates, and although promising results have been reported, further clinical trials are required in order to confirm their effectiveness. Current active areas of research are centred on tissue engineering and gene therapy strategies which may result in more predictable regenerative outcomes in the future.
CONDÒ, R.; CASAGLIA, A.; CONDÒ, S.G.; CERRONI, L.
SUMMARY Fixed orthodontic appliances make it difficult to maintain the oral hygiene, resulting in plaque accumulation. Retention of bacterial plaque, represents a risk for white spot lesions and development of periodontal disease. Aim Purpose of this study was to determine in vivo the retention of plaque on three different elastic ligatures, in comparison with stainless steel ligature, to determine a possible association between type of ligatures and accumulation of microorganisms. Material and Methods three elastic ligation systems were analyzed for plaque retention: ring-shape, clear, latex ligatures (Leone® Spa), ring-shape, grey, polyurethane ligatures (Micerium® Spa) and grey, polyurethane, Slide low-friction ligatures (Leone® Spa), compared with stainless steel ligatures (Leone® Spa) used as control. Forthy orthodontic patients undergoing fixed orthodontic therapy were selected. A sample for each type of ligature were applied inside the oral cavity of each subject. Samples were kept in the oral cavity for 28 days, ligating 0.16 X 0.22 stainless steel archwire to stainless steel orthodontic premolars brackets. The presence of bacterical slime was quantified by spectrophotometric method (crystal violet-Bouin’s fixative) and morphological observations was evaluated by Scanning Electron Microscopy (SEM). Results From analysis of bacterical slime emerges that all the elastics showed a low plaque retention, especially if compared to the group of steinless steel ligatures, that presented a greater plaque adhesion, statistically significant compared to the Slide group (r<0.0002) and the two elastic groups (r<0.0001). This study reported no significant difference between the Slide ligatures and the traditional elastic ligatures as regards the retention of plaque. SEM images showed presence of cocci, rods and few filamentous organisms and an interbacterial matrix in all observed samples. Conclusion Elastomeric ligatures showed a significant lower susceptibility
Latha, S; Thirugnanamsambandan, S; Arun, R T; Masthan, K M K; Malathi, L; Rajesh, E
Periodontitis, which is a chronic inflammatory disease causes reduction in the number of erythrocytes and hemoglobin. It is found to be caused by specific pathogenic subgingival plaque bacteria. Periodontitis is host mediated through release of pro inflammatory cytokines by local tissues and immune cells in response to bacterial flora and its products, especially lipopolysacharides. Periodontitis is found to have systemic effect and the cytokines produced inhibit proliferation and differentiation of erythrocytes leading to anaemia. This study evaluate level of hemoglobin erythrocytes, hematocrit and serum ferritin levels in healthy subjects and periodontitis patient.
Almerich-Silla, Jose Manuel; Montiel-Company, Jose María; Pastor, Sara; Serrano, Felipe; Puig-Silla, Miriam; Dasí, Francisco
Objective. To determine the association between oxidative stress parameters with periodontal disease, bleeding, and the presence of different periodontal bacteria. Methods. A cross-sectional study in a sample of eighty-six patients, divided into three groups depending on their periodontal status. Thirty-three with chronic periodontitis, sixteen with gingivitis, and thirty-seven with periodontal healthy as control. Oxidative stress biomarkers (8-OHdG and MDA), total antioxidant capacity (TAOC), and the activity of two antioxidant enzymes (GPx and SOD) were determined in saliva. Subgingival plaque samples were obtained from the deepest periodontal pocket and PCR was used to determine the presence of the 6 fimA genotypes of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Treponema denticola. Results. Periodontal disease was found to be associated with increased oxidative stress parameter levels. These levels rose according to the number and type of different periodontal bacteria found in the periodontal pockets. The presence of different types of periodontal bacteria is predictive independent variables in linear regresion models of oxidative stress parameters as dependent variable, above all 8-OHdG. Conclusions. Oxidative stress parameter levels are correlated with the presence of different types of bacteria. Determination of these levels and periodontal bacteria could be a potent tool for controlling periodontal disease development. PMID:26494938
Fukushima, Henrique; Alves, Vanessa Tubero Euzebio; Carvalho, Verônica Franco de; Ambrósio, Lucas Macedo Batitucci; Eichler, Rosangela Aparecida Dos Santos; Carvalho, Maria Helena Catelli de; Saraiva, Luciana; Holzhausen, Marinella
Recent studies investigating protease-activated receptor type 2 (PAR-2) suggest an association between the receptor and periodontal inflammation. It is known that gingipain, a bacterial protease secreted by the important periodontopathogen Porphyromonas gingivalis can activate PAR-2. Previous studies by our group found that PAR-2 is overexpressed in the gingival crevicular fluid (GCF) of patients with moderate chronic periodontitis (MP). The present study aimed at evaluating whether PAR-2 expression is associated with chronic periodontitis severity. GCF samples and clinical parameters, including plaque and bleeding on probing indices, probing pocket depth and clinical attachment level, were collected from the control group (n = 19) at baseline, and from MP patients (n = 19) and severe chronic periodontitis (SP) (n = 19) patients before and 6 weeks after periodontal non-surgical treatment. PAR-2 and gingipain messenger RNA (mRNA) in the GCF of 4 periodontal sites per patient were evaluated by Reverse Transcription Polymerase Chain Reaction (RT-qPCR). PAR-2 and gingipain expressions were greater in periodontitis patients than in control group patients. In addition, the SP group presented increased PAR-2 and gingipain mRNA levels, compared with the MP group. Furthermore, periodontal treatment significantly reduced (p <0.05) PAR-2 expression in patients with periodontitis. In conclusion, PAR-2 is associated with chronic periodontitis severity and with gingipain levels in the periodontal pocket, thus suggesting that PAR-2 expression in the GCF reflects the severity of destruction during periodontal infection.
Kwan, John Y
Current literature supports the use of powered instrumentation over traditional hand instrumentation. The objective of scaling and root planing is the complete removal of plaque and calculus from root surfaces. While this is unrealistic, the accepted end-point is a smooth, glassy root surface during periodontal instrumentation. This often has resulted in overinstrumentation and excessive removal of cementum. Cementum removal has been deemed generally unnecessary. What is essential is the removal of plaque, calculus, and the endotoxin adherent to the root surface. This cleaning of root surfaces is best done with judicious use of powered instrumentation. The excessive removal of cementum during hand instrumentation is due to the lack of visualization. Using endoscopic technology, the ability to visually debride roots can improve chances of success in a more conservative and minimally invasive way. This article provides a brief review of micro ultrasonic technologies and periodontal endoscopy, its implementation in our practice, and a limited case series.
Meenawat, Ajita; Govila, Vivek; Goel, Sudhir; Verma, Sunil; Punn, Karan; Srivastava, Vivek; Dolas, Rameshwar Shantaram
Background and Objective: Smoking is an important environmental risk factor involved in the causation and progression of periodontal disease. Smoking can impair various components of the host immune response and immune system. The virulence factors of periodontal pathogens stimulate inflammatory cytokine expression by mononuclear cells. IL-1β is the key mediator involved in the pathogenesis and disease progression. Therefore, whole gingival biopsy samples are assessed for this increased expression of IL-1. Materials and Methods: 29 male subjects’ age and gender matched were divided into three groups based on the periodontal and smoking status (Group A:healthy, Group B: non-smokers suffering from chronic periodontitis, Group C: smokers suffering from chronic periodontitis). Periodontal parameters like plaque index, gingival index, probing pocket depth and clinical attachment level were recorded at baseline and post scaling. The mRNA expression of IL-1β was determined by real time polymerase chain reaction and correlated with the periodontal and smoking status. Results: The improvement in the periodontal parameters was statistically significant in the non- smokers (Group B) and there was a 2 fold increase in the mRNA expression in this group. The smokers (Group C) showed lesser improvement in the periodontal parameters and there was an 8 fold increase in the mRNA expression of IL-1β. Conclusion: Association of smoking status with periodontal destruction can thus be correlated with the increased mRNA expression of IL-1β in chronic periodontitis patients. PMID:26392684
Levin, Liran; Margvelashvili, Vladimer; Bilder, Leon; Kalandadze, Manana; Tsintsadze, Nino; Machtei, Eli E
Objectives. The aim of the present pathfinder study was to screen and map the periodontal status of Georgian population in accordance with the guidelines of the World Health Organization for population based surveys. Methods. During 2012, a pathfinder study was conducted to collect this data. For the periodontal portion of the study, 15-year-old school children were examined in the capital city of Tbilisi as well as in two other large cities and 4 smaller villages. All participants were examined by a trained dental team in a classroom using a dental mirror and a periodontal probe. Periodontal examination included plaque scores, calculus scores, probing depth measurements and bleeding on probing. These measurements were recorded for the Ramfjord index teeth. Results. A total of 397 15-year-old participants were examined in this pathfinder study. There were 240 females (60.45%) and 157 males (39.55%). Of the total participants 196 (49.37%) were urban adolescents while 201 (50.63%) were from rural communities. Mean probing depth was 3.34 ± 0.57 mm with a range of 1 to 10 mm; a relatively high proportion (34.26%) of these subjects presented with at least one site with pockets of 5 mm or deeper. Males presented with greater plaque, calculus and probing depths than females. When urban and rural populations were compared, urban participants presented with more plaque, probing depths and bleeding on probing. Greater pocket depths were found to be related to the presence of plaque calculus and bleeding on probing. Conclusions. Overall, rather high incidences of periodontal pockets ≥ 5 mm were detected in this population. This data should serve to prepare further more detailed epidemiological studies that will serve to plan and implement prevent and treat strategies for periodontal diseases in Georgia and also help make manpower decisions.
Trombelli, L; Farina, R
An individual variation in the gingival inflammatory response to the dental biofilm has been demonstrated. This variability can be observed between individuals with neither quantitative nor qualitative differences in plaque accumulation. The reported significant differences in gingival inflammatory response under quantitatively and/or qualitatively almost identical bacterial challenge suggest that the gingival response to plaque accumulation may be an individual trait, possibly genetic in origin. The most recent classification of periodontal diseases acknowledges that the clinical expression of plaque-induced gingival inflammation can be substantially modified by systemic factors, either inherent to the host or related to environmental influences. The aim of the present literature review is to describe (i) the factors influencing the development of plaque-induced gingivitis as well as (ii) those metabolic, environmental and systemic factors which have a direct impact on the etiopathogenetic pathway of plaque-induced gingivitis, thus altering the nature or course of the gingival inflammatory response to dental biofilm.
de Vasconcellos Piscoya, Maria Dilma Bezerra; de Alencar Ximenes, Ricardo Arraes; da Silva, Genivaldo Moura; Jamelli, Sílvia Regina; Coutinho, Sônia Bechara
OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth ≥4 mm and an attachment loss ≥3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene. PMID:22249477
López Silva, M C; Diz-Iglesias, P; Seoane-Romero, J M; Quintas, V; Méndez-Brea, F; Varela-Centelles, P
About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis.
Cox, Alistair; Dixon, Padraic; Smith, Sionagh
Equine periodontal disease (EPD) is a common and painful condition, the aetiology and pathology of which are poorly understood. To characterise the histopathological lesions associated with EPD, the skulls of 22 horses were assessed grossly for the presence of periodontal disease, and a standard set of interdental tissues taken from each for histopathological examination. Histological features of EPD included ulceration and neutrophilic inflammation of the gingival epithelium. Mononuclear and eosinophilic inflammation of the gingival lamina propria and submucosa was commonly present irrespective of the presence or degree of periodontal disease. Gingival hyperplasia was present to some degree in all horses, and was only weakly associated with the degree of periodontal disease. In all horses dental plaque was present at the majority of sites examined and was often associated with histological evidence of peripheral cemental erosion. Bacteria (including spirochaetes in four horses) were identified in gingival samples by Gram and silver impregnation techniques and were significantly associated with the presence of periodontal disease. This is the first study to describe histological features of EPD, and the first to identify associated spirochaetes in some cases. Histological features were variable, and there was considerable overlap of some features between the normal and diseased gingiva. Further investigation into the potential role of bacteria in the pathogenesis and progression of EPD is warranted.
Purpose With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients’ periodontal health irrespective of orthodontic techniques. PMID:26734489
As the population ages and life expectancy increases, clinicians today find themselves in the wake of an ever-growing demand for high-quality aesthetic dental treatment, by increasingly informed patients. The long-term success of both cosmetic and restorative dentistry is dependent on well designed restorations and the health of the periodontal tissues. Overhanging restorations, full crown restorations with poor marginal fit, and implant-supported prosthetics with inadequate hygiene access all increase the risk for periodontal sequelae and interproximal caries. When planning restorative treatment, consideration should be given to the restorative design, the need for hygiene access and the location of intended implants. In addition, the patient's manual dexterity and ability to manipulate oral hygiene aids is a crucial consideration, as is adequate access for the hygienist to manually debride and maintain the restorations.
Manrikian, M E; Markarian, M M; Vardanian, I F
The stomatological survey of Tavoush region schoolchildren showed, that the caries intensity formed on average 90.8-96.8%. The dental caries intensity of schoolchildren corresponded to the average and high levels of caries intensity according to WHO gradation and didn't differ depending on the habitation environment. The state value of periodontal tissues showed a tendency increase of periodontal tissue lesions' indices: there has been diagnosed a periodontal pocket with the depth of 4-5mm among the juveniles in 2.04% cases. The introduction of preventive measures in RA had the aim to reduce the indices of dental caries prevalence and intensity among 6- and 12-year-old children in the Republic, but the analysis of obtained data showed that the prophylaxis program turned out to be inefficient, as worsening of indices of stomatological status has taken place.
Crispino, Antonio; Figliuzzi, Michele Mario; Iovane, Claudio; Del Giudice, Teresa; Lomanno, Simona; Pacifico, Delfina; Fortunato, Leonzio; Del Giudice, Roberto
Summary Background Chronic periodontitis affects 47% of adult population over the age of 30. The first phase of periodontal treatment is always represented by scaling and root planning (SRP), that is a causal, non-surgical therapy that recognizes as primary aims the control of bacterial infection and the reduction of periodontal plaque-associated inflammation. Yet, another innovative causal therapy is represented by the irradiation of periodontal pockets with laser. Aim To evaluate the effect of a 940-nm diode laser as an adjunct to SRP in patients affected by periodontitis. Materials and methods Sixty-eight adult patients with moderate-to-severe periodontitis were sequentially enrolled and undergone to periodontal examination (V1) in order to detect gingival index (GI), plaque index (PI) and probing depth (PD). The patients were randomly divided into two groups: the first (n=34) received SRP treatment alone, the control group (n=34) received SRP and 940-nm diode laser therapy. Results Data were analyzed by Student’s t-test, with two tails; for all clinical parameters, both groups reported statistically significant differences compared to basal values (p<0.0001). Both procedures were effective in improving GI, PI and PD, but the use of diode laser was associated with more evident results. Conclusions Considered the better clinical outcomes, diode laser can be routinely associated with SRP in the treatment of periodontal pockets of patients with moderate-to-severe periodontitis. PMID:26161248
Pejcic, A; Kesic, L J; Milasin, J
Periodontitis has been identified as a potential risk factor for systemic pathologies such as cardiovascular disease (CVD). The aims of this investigation were to assess the relationship between periodontitis and systemic inflammatory factor, as well as to discover whether there is a relation to the severity of periodontitis and to the periodontopathogens. Periodontal examinations and serum C-reactive protein (CRP) level measurements were performed in 50 patients with periodontitis. Periodontal health indicators included the gingival bleeding on probing index and periodontal disease status. The patients with moderate periodontitis had low attachment loss and pocket depth <4 mm. The patients with severe periodontitis had high attachment loss and pocket depth >5 mm. The control group comprised 25 volunteers with healthy gingiva, gingival sulcus <2 mm and no attachment loss. The presence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in subgingival plaque samples was analysed by the polymerase chain reaction (PCR) method. The periodontal parameters and CRP levels were significantly higher in the patients with periodontitis. Patients who had severe periodontitis, with high levels of mean clinical attachment loss, and subjects with moderate periodontitis had higher mean CRP levels. The percentage of subjects with elevated levels of CRP >5 mg/l was greater in the higher clinical attachment loss group compared to the group with lower attachment loss. The presence of P. gingivalis and A. actinomycetemcomitans were also associated with elevated CRP levels and poor periodontal status. Periodontitis and the presence of P. gingivalis are associated with an enhanced inflammatory response expressed by higher CRP levels. The association of periodontitis with CRP levels appears to be a contributing factor for CVD and might be a possible intermediate pathway in this association.
Rous, V.; Studeny, J.
Pleural plaques were found in 644 (6·6%) of 9,760 photofluorograms taken in 1965 in a region of Pelhřimov district; the incidence was highest in the age group 66-70 years. The advanced age of those affected may be explained by the greater frequency of the causative agent in the past. The disorder was known in Pelhřimov district as early as 1930; it was then thought to be posttuberculous. The past history of the cases was uninformative; as a rule, the only common previous disease was pleurisy with effusion, occurring in 9·7%. The general condition of those affected was excellent; only 8% were aware of the fact that pleural lesions were present. The disorder was found mainly in farmers, familial incidence was common, and if two generations of one family suffered from the condition, the older generation was affected in 100%. Pleural plaques consist morphologically of limited areas of hyalinized collagenous connective tissue with calcium salt deposits. Tubercle bacilli could not be cultivated from the lesions. Mineralological analysis showed no evidence of silicates in the pleural plaques and a normal content in the lungs. The aetiological factor responsible for the development of pleural plaques in Pelhřimov district is not known, but asbestos cannot be implicated. The unknown noxious agent is carried to the pleura by the lymph and blood stream. Pleural plaques are an endemic disorder. The traditional view that lesions are post-tuberculous appears, in the region submitted to this study, to be a possible explanation. Images PMID:5465601
Cagetti, Maria Grazia; Mastroberardino, Stefano; Milia, Egle; Cocco, Fabio; Lingström, Peter; Campus, Guglielmo
This paper aims to provide a systematic review of the caries-prevention effect of probiotics in human. The hypothesis was that the administration of probiotic strains might play a role in caries lesion prevention and in the control of caries-related risk factors. The main relevant databases (Medline, Embase) were searched. Quality of the Randomized Clinical Trials (RCTs) was classified using the “Consolidated Standards of Reporting Trials” (CONSORT) checklist and the Impact Factor (IF) value of each journal was recorded. Sixty-six papers were identified, and 23 fulfilled the inclusion criteria. Only three studies had caries lesion development as outcome, all the others reported caries risk factors as interim evaluation. Using the CONSORT Score, the papers were coded as 4 excellent, 9 good and 10 poor. The mean IF value recorded was 1.438. Probiotics may play a role as antagonistic agent on mutans streptococci (MS), acidogenic/aciduric bacteria that contributes to the caries process. In two-thirds of the selected papers, probiotics have demonstrated the capacity to reduce MS counts in saliva and/or plaque in short-term. The effect of probiotics on the development of caries lesion seems encouraging, but to date, RCTs on this topic are insufficient to provide scientific clinical evidence. PMID:23857225
Chandra Shekar, B. R.; Nagarajappa, Ramesh; Singh, Rupal; Thaku, Roopesh
Background: There is an urgent need for innovative strategies to combat the two most common dental diseases of mankind namely dental caries and periodontitis. Objective: The aim was to assess the antimicrobial efficacy of the double combinations of Acacia nilotica (AN), Murraya koenigii L. Sprengel (MKL), Eucalyptus hybrid and Psidium guajava on primary plaque colonizers. Materials and Methods: The plant extracts of AN, MKL. Sprengel, Eucalyptus hybrid and P. guajava were prepared using Soxhlet apparatus. The stock solutions of individual plant extracts (100 mg/ml) were prepared. Equal quantities of stock solutions were mixed to obtain six double combinations of herbal extracts. The antimicrobial efficacy testing was done against three primary plaque colonizers using agar well-diffusion method. 0.2% chlorhexidine and dimethyl sulfoxide were used as positive and as negative controls. The mean inhibition zone between the categories was compared using one-way Analysis of Variance and Tukey's post hoc test. Results: The combination of AN and P. guajava produced the highest mean diameter of inhibition zone (21.08 mm ± 2.11) against Streptococcus mutans. The chlorhexidine produced the least inhibition zone against S. mutans (14.50 ± 2.07). The combination of AN and P. guajava produced the maximum antimicrobial efficacy against Streptococcus sanguis (19.67 ± 1.03) and Streptococcus salivarius (20.33 ± 1.86). Conclusion: All the combinations of plant extracts have the potential to be used as antiplaque and anticaries agents. The combinations of herbal extracts offer enhanced antimicrobial efficacy due to the synergistic effects besides slowing the development of resistance. PMID:25316992
Seringec, Nurten; Guncu, Guliz; Arihan, Okan; Avcu, Nihal; Dikmenoglu, Neslihan
Periodontal diseases are frequently associated with cardiovascular diseases (CVD). On the other hand, occurrence of CVD has also been related with increased blood viscosity. This study was planned to investigate four main hemorheological parameters contributing to blood viscosity - hematocrit, erythrocyte deformability, erythrocyte aggregation and plasma viscosity - and also some biochemical parameters (hs-CRP, fibrinogen, globulin etc.) in patients with periodontal disease. We hypothesized that poor periodontal health would be associated with deterioration of hemorheological properties. According to periodontal health status, subjects were divided into three groups as control (healthy), with plaque induced gingivitis and with chronic periodontitis. All groups included 15 males who had not received periodontal therapy in the last six months before the study, were non-smokers, had no systemic diseases and were not on any medication. Erythrocyte deformability and erythrocyte aggregation were measured with laser-assisted optical rotational cell analyzer (LORCA). Plasma viscosity was measured by a cone-plate viscometer. Data were analyzed with Kruskal-Wallis, Mann-Whitney U Test and Spearman Correlation Coefficient. Plasma viscosity (1.36 ± 0.01 mPa.s in the control group and 1.43 ± 0.02 mPa.s in the chronic periodontitis group, P < 0.01), erythrocyte aggregation tendency (aggregation index, amplitude and t½ were 58.82 ± 1.78% , 20.22 ± 0.40 au, 2.80 ± 0.25 s respectively in the control group, and 67.05 ± 1.47% , 22.19 ± 0.50 au, 1.84 ± 0.15 s in the chronic periodontitis group, P < 0.01), hs-CRP, fibrinogen and globulin levels were significantly higher, whereas HDL level was significantly lower in the chronic periodontitis group (P < 0.05) compared to the control group. All of these conditions may contribute to cardiovascular morbidity and mortality observed in people with periodontal disease, via increasing blood viscosity.
Schachtele, C F; Jensen, M E
Changes in human dental plaque pH can be used to obtain estimates of the acidogenic potential of ingested foods. The presence of acid in plaque is influenced by a large number of host, microbial, and substrate factors. Several useful methods have been developed for monitoring changes in plaque pH. Plaque sampling involves repeated removal of small samples of plaque from a number of teeth at intervals after food ingestion, dispersion of the sample, and in vitro measurement of pH. Touch electrode methods utilize glass or antimony microelectrodes, which are placed onto plaque in situ where direct readings can be obtained. Telemetry methods involve placement of glass microelectrodes or ion-sensitive field effect transistors within the dentition. Plaque is allowed to accumulate, and pH changes can subsequently be transmitted with radio or wire. Each of the methods has clear advantages and limitations. The methods have been simultaneously compared in human volunteers using solutions of fermentable carbohydrate. Inter-method differences in response were observed depending upon the site of measurement. Data obtained from caries-prone surfaces via telemetry showed lower pH minima and retarded returns to resting pH levels. The technology is available for controlled comparative plaque pH studies, with the method of choice depending upon the goals of the investigation. It is essential that the results be compared to data obtained with other models designed to evaluate the cariogenic potential of foods.
Lam, Anty; Chu, C H
Dental caries is the single most common, chronic oral disease of childhood. It is progressive and cumulative, and becomes more complex over time. The Surgeon General's Report on Oral Health revealed that more than 51 million school hours are lost each year as a result of dental problems. Contemporary caries management philosophy has changed from the traditional surgical approach to a medical model that emphasizes prevention. Among various strategies for caries prevention or reduction, fluoride therapy has been highly promoted. Various in-office and over-the-counter fluoride products are available for caries prevention. Dental professionals should identify and assess the caries risk level of patients and optimize the use of fluorides in caries management. Since multiple sources of fluoride exposure exist, a coordinated approach to fluoride delivery is essential.
Mandel, I D
Why are some people more resistant to dental caries than others? Certainly diet plays a part, but are there hereditary factors that affect caries development? This report explores genetic components that appear related to caries resistance and susceptibility.
All visible plaque was professionally removed from teeth of 40 children who were highly infected with S. mutans and lactobacilli. Shortly before and after the removal of plaque the concentrations of those bacteria were assessed in saliva stimulated by chewing. S. mutans and lactobacilli correlated well at baseline but not after plaque elimination, e.g. more than 80% of children who were heavily infected with S. mutans could be identified by a lactobacillus test at baseline. After the elimination of plaque, the mean concentration of S. mutans dropped by 64% but lactobacilli remained unchanged. The results indicate that oral hygiene measures taken by the patient prior to sampling of saliva may mask the true concentration of salivary S. mutans and complicate the identification of high caries risk patients.
Horowitz, A M; Suomi, J D; Peterson, J K; Voglesong, R H; Mathews, B L
In September 1973, a three-year school-based study was initiated in East Hampton, Connecticut, a rural nonfluoridated community. The purpose of the study is to determine the effect on dental decay, gingival inflammation and oral hygiene of removing dental plaque through supervised daily toothbrushing and flossing in school during a three-year period. To establish baseline data, three indexes were used: the DHC Index to evaluate gingivitis; the DMF Surface Index to quantify dental caries and the PHP Index to measure dental plaque. The examinations for dental caries, including radiographs, are scheduled annually in September, whereas the plaque and gingival examinations are done biannually, in September and June. After the baseline examinations the 481 children were blocked according to grade and sex and then were randomly assigned to either a treatment group or to a control group. In November, the treatment group was provided 10 sessions of instruction in plaque removal. For the remainder of the year (six months) they practiced daily plaque removal, supervised by a dental hygienist and a nurse. The control group was not instructed in oral hygiene procedures. In the treatment group, mean plaque and gingival scores at the June (first follow-up) examination were 14 percent and 29 percent lower, respectively, than at baseline. No change was seen in the control group. At the second follow-up examination in September (after summer vacation), the same indexes were nearly at baseline levels in the treatment group. There was no treatment effect on dental caries increments after one year of study. Considering the nature of the treatment regimen and the few treatments during the first year of the study, it is not surprising that there were no caries-preventive benefits demonstrated among children in the treatment group after one year. The total number of the plaque removal sessions will be greater during the second year of the study. Therefore, the possibility of detecting a
Hicks, John; Garcia-Godoy, Franklin; Flaitz, Catherine
Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The physicochemical properties of the mineral comprising the tooth surface and subsurface modulate the development, arrestment and remineralization of dental caries. Post-eruption maturation of enamel surfaces and exposed root surfaces is important in order for more susceptible mineral phases to be modified by incorporation of soluble fluoride from the plaque into dental hydroxyapatite. The chemical reactions that occur during acidic conditions when tooth mineral dissolves (critical pH) are determined by the supersaturation of calcium and phosphate within plaque and saliva, as well as if fluoride is present.
Zanin, Fatima A. A.; Pinheiro, Antonio L. B.; Souza-Campos, Dilma H.; Brugnera, Aldo, Jr.; Pecora, Jesus D.
Caries prevention is a goal to be achieved by dentist in order to promote health. There are several methods used to detect dental caries each one presenting advantages and disadvantages, especially regarding hidden occlusal caries. The improvement of laser technology has permitted the use of laser fluorescence for early diagnosis of hidden occlusal caries. The aim of this study was to assess the efficacy of the use of 655 nm laser light on the detection of hidden occlusal caries. Forty molar teeth from patients of both sexes which ages ranging from 10 - 18 years old were used on this study. Following manufacture's instructions regarding the use of the equipment, the teeth had their occlusal surface examined with the DIAGNOdent. Twenty six of 40 teeth had hidden occlusal caries detected by the DIAGNOdent. However only 17 of these 26 teeth showed radiographic signs of caries the other 9 teeth showed no radiological signs of the lesion. Radiographic examination was able to identify 34,61% of false negative cases. This means that many caries would be left untreated due to the lack of diagnosis using both visual and radiographic examination. The use of the DIAGNOdent was effective in successfully detecting hidden occlusal caries.
Dental plaque is a necessary but not sufficient etiologic factor of the destructive periodontal disease. The manifestation of periodontal destruction is influenced by a wide variety of risk factors and determinants. In the introduction the terminology of different etiologic and risk factors are discussed in general. Than the risk factors and determinants of destructive periodontitis are overviewed. In the first part the acquired and behavioral factors and determinates are discussed. Among the local factors the role of the individual oral hygiene, the specificity of subgingival dental plaque the plaque retentive factors and occlusal traumatism are discussed. The hormonal, the acquired immunological factors, osteoporosis and the age are discussed as systemic risk factors and determinants. Among the behavioral factors smoking, psychological stress and socio-economic factors are covered. The second part is going to cover the genetic predisposing factors.
Ledić, Karla; Marinković, Sonja; Puhar, Ivan; Spalj, Stjepan; Popović-Grle, Sanja; Ivić-Kardum, Marija; Samarzija, Miroslav; Plancak, Darije
The aim of this study was to explore whether a periodontal disease could be a risk indicator for a chronic obstructive pulmonary disease (COPD). The examined group comprised 93 patients with COPD (mean age 65.8 years). The control group comprised 43 systemically healthy individuals (mean age 62.1 years). Respiratory and periodontal conditions were examined in both groups. COPB subjects had significantly worse periodontal conditions than controls (p < 0.05) with regard to each parameter of periodontal condition, except for gingival inflammation. COPD patients had higher Plaque Index than control patients (82.84 +/- 22.81 vs. 57.15 +/- 26.96; p < 0.001), higher periodontal depth (3.02 +/- 0.92 vs. 2.57 +/- 0.79 mm; p = 0.007), higher gingival recession (1.97 +/- 1.09 vs. 0.91 +/- 0.79 mm; p < 0.001), and higher mean clinical attachment loss (CAL) (4.12 +/- 1.74 vs. 2.91 +/- 1.27 mm; p < 0.001). Multiple logistic regression model, after controlling for other risk indicators, showed that periodontal disease, presented as CAL > or = 4 mm at > or = 60% sites, was associated with odds ratio of 3.2 (95% CI 1.0-9.8) for the COPB group. Data suggest that periodontal disease could be a risk indicator for COPD.
Zermeño-Ibarra, Jorge A; Delgado-Pastrana, Soledad; Patiño-Marín, Nuria; Loyola-Rodríguez, Juan P
The aim of this study was to examine the association between overweight-obesity and periodontal disease in subjects who attended the clinic of Periodontics, Faculty of Dentistry, San Luis de Potosi, México. This was cross-sectional study involving 88 subjects--60 without overweight-obesity and 28 with overweight-obesity. The following clinical parameters were evaluated: dental bacterial plaque, index of calculus, gingivitis, probing depth and periodontal disease index (PDI). When comparing the group of subjects with overweight-obesity to the control, there were statistically significant differences in the variables calculus (p = 0.0015), gingivitis (p = 0.0050) and periodontal disease (p = 0.0154). Regarding the logistic regression analysis, the dependent variable was subjects with and without overweight-obesity and the independent variables were sex, age and periodontal disease. We found statistically significant differences (p = 0.0162) with OR = 3.16 in periodontal disease. Periodontal disease showed statistically significant differences in the group of subjects with overweight-obesity. The oral health of subjects with overweight-obesity should be supervised and checked in order to prevent oral alterations.
Spano, Frank; Donovan, Jeff C.
Résumé Objectif Présenter aux médecins de famille des renseignements de base pour faire comprendre l’épidémiologie, la pathogenèse, l’histologie et l’approche clinique au diagnostic de la pelade par plaques. Sources des données Une recension a été effectuée dans PubMed pour trouver des articles pertinents concernant la pathogenèse, le diagnostic et le pronostic de la pelade par plaques. Message principal La pelade par plaques est une forme de perte pileuse auto-immune dont la prévalence durant une vie est d’environ 2 %. Des antécédents personnels ou familiaux de troubles auto-immuns concomitants, comme le vitiligo ou une maladie de la thyroïde, peuvent être observés dans un petit sous-groupe de patients. Le diagnostic peut souvent être posé de manière clinique en se fondant sur la perte de cheveux non cicatricielle et circulaire caractéristique, accompagnée de cheveux en « point d’exclamation » en périphérie chez ceux dont le problème en est aux premiers stades. Le diagnostic des cas plus complexes ou des présentations inhabituelles peut être facilité par une biopsie et un examen histologique. Le pronostic varie largement et de mauvais résultats sont associés à une apparition à un âge précoce, une perte importante, la variante ophiasis, des changements aux ongles, des antécédents familiaux ou des troubles auto-immuns concomitants. Conclusion La pelade par plaques est une forme auto-immune de perte de cheveux périodiquement observée en soins primaires. Les médecins de famille sont bien placés pour identifier la pelade par plaques, déterminer la gravité de la maladie et poser le diagnostic différentiel approprié. De plus, ils sont en mesure de renseigner leurs patients à propos de l’évolution clinique de la maladie ainsi que du pronostic général selon le sous-type de patients.
Spano, Frank; Donovan, Jeff C.
Résumé Objectif Présenter aux médecins de famille des renseignements de base pour faire comprendre les schémas thérapeutiques et les résultats des traitements pour la pelade par plaques, de même que les aider à identifier les patients pour qui une demande de consultation en dermatologie pourrait s’imposer. Sources des données Une recension a été effectuée dans PubMed pour trouver des articles pertinents concernant le traitement de la pelade par plaques. Message principal La pelade par plaques est une forme auto-immune de perte pileuse qui touche à la fois les enfants et les adultes. Même s’il n’y a pas de mortalité associée à la maladie, la morbidité découlant des effets psychologiques de la perte des cheveux peut être dévastatrice. Lorsque la pelade par plaques et le sous-type de la maladie sont identifiés, un schéma thérapeutique approprié peut être amorcé pour aider à arrêter la chute des cheveux et possiblement faire commencer la repousse. Les traitements de première intention sont la triamcinolone intralésionnelle avec des corticostéroïdes topiques ou du minoxidil ou les 2. Les médecins de famille peuvent prescrire ces traitements en toute sécurité et amorcer ces thérapies. Les cas plus avancés ou réfractaires pourraient avoir besoin de diphénylcyclopropénone topique ou d’anthraline topique. On peut traiter la perte de cils avec des analogues de la prostaglandine. Les personnes ayant subi une perte de cheveux abondante peuvent recourir à des options de camouflage ou à des prothèses capillaires. Il est important de surveiller les troubles psychiatriques en raison des effets psychologiques profonds de la perte de cheveux. Conclusion Les médecins de famille verront de nombreux patients qui perdent leurs cheveux. La reconnaissance de la pelade par plaques et la compréhension du processus pathologique sous-jacent permettent d’amorcer un schéma thérapeutique approprié. Les cas plus graves ou r
Lynch, Richard J M
Zinc is an essential trace element. In the mouth, it is present naturally in plaque, saliva and enamel. Zinc is formulated into oral health products to control plaque, reduce malodour and inhibit calculus formation. It has good oral substantivity, and elevated concentrations can persist for many hours in plaque and saliva following delivery from mouthrinses and toothpastes. Although low concentrations of zinc can both reduce enamel demineralisation and modify remineralisation, during caries clinical trials, the addition of zinc to fluoride toothpastes has not affected their ability to reduce caries. Mechanistic studies may help explain this apparent contradiction. Zinc is readily desorbed from hydroxyapatite by calcium, which is plentiful in plaque and saliva. Where crystal-growth sites remain occupied by zinc despite this, they may simply be 'over-grown' by remineralisation initiated at unoccupied sites. Further, under certain conditions, low concentrations of zinc can enhance remineralisation of enamel lesions, by retarding lesion arrestment. Although this may help to explain the apparent lack of an overall zinc effect on caries, it seems unlikely that any negative effects would be countered exactly by positive effects. Further mechanistic studies, complementing well-designed in vitro and in situ caries studies, should lead to further understanding of the zinc-enamel interactions relevant to demineralisation and remineralisation.
van Palenstein Helderman, W H; van't Hof, M A; van Loveren, C
This study aimed to select past caries experience variables as caries predictors and to compare their prognostic accuracy with the variables used in a method of caries prognosis developed in a Swiss child population. The data used for the analyses originated from an 8-year longitudinal study starting in 1980 on caries of 7.5-year-old Dutch children. Stepwise logistic regression analyses provided predictor variables. The newly introduced variables D23fi, D(123)i and D23pifi were interchangeable and the most powerful caries predictors. For the sake of uniformity and ease of application, D23fi (number of fissures of the permanent first molar with non-cavitated or cavitated caries lesions) was chosen as the first variable in the logistic regression equations. The gain in accuracy of the second and third predictor variables (number of sound primary molars and the number of buccal and lingual smooth surfaces of the permanent first molar with non-cavitated or cavitated caries) in the regression equations was limited. The D1 condition of surfaces could be omitted from the prediction models. The present forced three-predictor-regression equations for 7.5-, 9.5- and 11.5-year-old children were evaluated to assess their prognostic performance by using the area under the ROC curve as a measure of prognostic quality. For the present regression equations, the area under the ROC curve was 81-87%, which was higher compared to the Swiss regression equations for caries prognosis.
Vielkind, Paul; Jentsch, Holger; Eschrich, Klaus; Rodloff, Arne C; Stingu, Catalina-Suzana
This study investigated the prevalence of Actinomyces spp. in shallow, deep and very deep pockets of patients with chronic periodontitis compared to healthy controls and correlated the results with clinical status. Twenty patients with chronic periodontitis and 15 healthy subjects were enrolled in this study. Clinical indices were recorded in a six-point measurement per tooth. From each patient samples of supra and subgingival plaque were taken separately from teeth with shallow, deep and very deep pockets. Samples of supragingival plaque and sulcular microflora were collected from the healthy subjects. All the samples were cultivated on different media at 37̊C in an anaerobic atmosphere for 7 days. All the suspect colonies were identified using a rapid ID 32 A system (bioMèrieux) and MALDI-TOF-MS analysis using an Autoflex II Instrument (Bruker Daltonics) together with in house developed identification software and a reference spectra database. A total of 977 strains were identified as Actinomyces. Actinomyces naeslundii/oris/johnsonii (430 isolates) was the most prevalent species and was found in all patients and in almost all of the healthy subjects. Significant differences (p=0.003) between the groups were found for Actinomyces odontolyticus/meyeri and Actinomyces israelii which were associated with periodontitis patients. Actinomyces dentalis was found in higher percentage (p=0.015) in the periodontitis group. Actinomyces gerencseriae and Actinomyces massiliensis were significantly more often found supragingivally than subgingivally (p=0.004, p=0.022, respectively) in the periodontitis group. Whether some Actinomyces species, definitely important plaque formers, are actively involved in the pathogenicity of chronic periodontitis needs further investigation.
Martin, R.R.; Naftel, S.J.; Nelson, A.J.; Edwards, M.; Mithoowani, H.; Stakiw, J.
Periodontitis is a serious disease that affects up to 50% of an adult population. It is a chronic condition involving inflammation of the periodontal ligament and associated tissues leading to eventual tooth loss. Some evidence suggests that trace metals, especially zinc and copper, may be involved in the onset and severity of periodontitis. Thus we have used synchrotron X-ray fluorescence imaging on cross sections of diseased and healthy teeth using a microbeam to explore the distribution of trace metals in cementum and adhering plaque. The comparison between diseased and healthy teeth indicates that there are elevated levels of zinc, copper and nickel in diseased teeth as opposed to healthy teeth. This preliminary correlation between elevated levels of trace metals in the cementum and plaque of diseased teeth suggests that metals may play a role in the progress of periodontitis.
Suvan, J; Petrie, A; Moles, D R; Nibali, L; Patel, K; Darbar, U; Donos, N; Tonetti, M; D'Aiuto, F
Body mass index (BMI) and obesity are associated with the prevalence, extent, and severity of periodontitis. This study investigated the predictive role of overweight/obesity on clinical response following non-surgical periodontal therapy in patients with severe periodontitis. Two hundred sixty adults received an intensive course of non-surgical periodontal therapy. Periodontal status at baseline and 2 months was based upon probing pocket depths (PPD), clinical attachment levels (CAL), and whole-mouth gingival bleeding (FMBS) as assessed by two calibrated examiners. Generalized estimating equations (GEE) were used to estimate the impact of BMI and overweight/obesity on periodontal treatment response while controlling for baseline status, age, smoking status (smoker or non-smoker), and full-mouth dental plaque score. BMI (continuous variable) and obesity (vs. normal weight) were associated with worse mean PPD (p < .005), percentage of PPD > 4 mm (p = .01), but not with FMBS (p > .05) or CAL (p > .05) at 2 months, independent of age, smoking status, or dental plaque levels. The magnitude of this association was similar to that of smoking, which was also linked to a worse clinical periodontal outcome (p < .01). BMI and obesity appear to be independent predictors of poor response following non-surgical periodontal therapy.
Patil, Vijayetha P.; Gokhale, Neeraja; Acharya, Anirudh; Kangokar, Praveenchandra
Introduction The prevalence of periodontitis is significantly higher among people with poorly controlled diabetes mellitus. Majority of tissue destruction in periodontitis is considered to be the result of an aberrant inflammatory/immune response to microbial plaque and involve prolonged release of reactive oxygen species (ROS). There is increased evidence for compromised antioxidant capacity in periodontal tissues and fluids which may be an added factor for tissue damage in periodontitis. Aim To study the possible role of Reactive oxygen species (ROS) and antioxidant status in blood among chronic periodontitis patients with and without Type 2 Diabetes mellitus. Materials and Methods The study comprised of total 100 subjects among which 25 were normal healthy controls, 25 were gingivitis patients, 25 were chronic periodontitis patients (CP) and 25 were having chronic periodontitis with type 2 diabetes (CP with DM). ROS levels were determined as MDA (Malondialdehyde) and antioxidant status as plasma total antioxidant capacity (TAC), vitamin C and erythrocyte Superoxide dismutase (SOD) and catalase activity. Results There was significant increase in MDA levels in all the patient groups compared with healthy controls (p<0.05). The decrease in TAC, Vitamin C and SOD levels among CP with DM patients as compared to controls was highly significant (p<0.01). There was a positive correlation between the probing pocket depth and MDA levels among periodontitis patients with diabetes (r=0.566, p=0.003). Conclusion There is increased oxidative stress in chronic periodontitis with and without type 2 diabetes indicating a common factor involvement in tissue damage. More severe tissue destruction in periodontitis is associated with excessive ROS generation which is positively correlated in type 2 diabetic subjects. PMID:27190790
Palys, Michael D.; Haffajee, Anne D.; Socransky, Sigmund S.; Giannobile, William V.
Crevicular fluid pyridinoline cross-linked carboxyterminal telopeptide of type 1 collagen (ICTP) is predictive for future alveolar bone loss in experimental periodontitis in dogs. The present study sought to relate ICTP to a panel of subgingival species in subjects exhibiting various clinical presentations such as health (n=7), gingivitis (n=8) and periodontitis (n=21). 28 subgingival plaque and GCF samples were taken from mesiobuccal sites in each of 36 subjects. The presence and levels of 40 subgingival taxa were determined in plaque samples using whole genomic DNA probes and checkerboard DNA-DNA hybridization. GCF ICTP levels were quantified using radioimmunoassay (RIA). Clinical assessments made at the same sites included: BOP, gingival redness, plaque, pocket depth, and attachment level. Differences among ICTP levels in the 3 subject groups were sought using the Kruskal-Wallis test. Relationships between ICTP levels and clinical parameters as well as subgingival species were determined by regression analysis. The results demonstrated significant differences among disease categories for GCF ICTP levels for healthy (1.1+0.6 pg/site (mean±SEM)) gingivitis (14.8±6.6 pg/site) and peridontitis subjects (30.3+5.7 pg/site) (p=0.0017). ICTP levels related modestly to several clinical parameters. Regression analysis indicated that ICTP levels correlated strongly with mean subject levels of several periodontal pathogens including B. forsythus, P. gingivalis, P. intermedia, P. nigrescens and T. denticola (p<0.01). The data indicate that there is a positive relationship between the putative bone resorptive marker ICTP and periodontal pathogens. PMID:9846794
Casanova-Rosado, Alejandro José; Medina-Solís, Carlo Eduardo; Casanova-Rosado, Juan Fernando; Vallejos-Sánchez, Ana Alicia; Maupomé, Gerardo; Avila-Burgos, Leticia
The objectives of the present study were to establish dental caries prevalence (percentage with caries) and experience in the primary and permanent dentition (dmft and DMFT) of 6 to 13-year-old schoolchildren in Campeche, Mexico, and to estimate the contributing roles of the likely risk indicators. A cross-sectional study was carried out in 1,644 children aged 6-13 years. Self-administered questionnaires obtained information on social, economic, behavioral, and demographic variables. The primary dentition of 1,309 children and the permanent dentition of 1,640 children were evaluated in the oral examinations. The main outcome measures were DMFT, dmft, and SiC indices. Data were modeled using logistic regression analysis. The overall caries prevalence was 77.4%, 73.6% in the primary dentition (61.6% in 6-year-olds), and 49.4% in the permanent dentition. The dmft and DMFT indices were 2.85+/-2.73 and 1.44+/-2.05, respectively (DMFT = 3.11+/-2.62 in 12-year-olds). The SiC index was 6.05 at 12 years of age. Associated variables to dental caries in both dentitions were presence of enamel defects, presence of dental plaque, low socio-economic status, female sex, and older age. Mother's schooling was negatively associated (OR = 0.95) with caries in primary dentition. Caries experience in the primary dentition (OR = 6.02) was positively associated with caries in the permanent dentition. Dental caries status in these Mexican children was closer to the goals proposed by the WHO/FDI for 2000 than previous studies. This study has identified clinical, socio-economic, and behavioral determinants for dental caries in primary and permanent dentition on Mexican schoolchildren.
Noce, Erica; Rubira, Cassia Maria Fischer; da Silva Rosa, Odila Pereira; da Silva, Salete Moura Bonifácio; Bretz, Walter Antonio
OBJECTIVE: To evaluate the moment of streptococcus mutans (SM) acquisition, caries development and their associate variables along 23 months, in first-born children of low socioeconomic status families, starting at 7 months of age. METHOD: The sample was chosen based on highly SM-colonized mothers, including all members of 14 families living in the same houses. The study included 14 mothers, 14 fathers and 14 first-borns and 8 relatives (mostly grandparents). Initial clinical examinations and radiographs determined the caries indices and periodontal conditions of the adults. SM count in all adults was made in the first 2 visits. The children were examined for SM count, number of teeth and number of carious lesions, in 4 visits. RESULTS: SM prevalence was high in the adults, being absent in only one of the parents. SM was found in 1, 2, 3 and 10 children in the first, second, third and fourth visits. Dental caries was detected in only 3 children in the last visit (at 30 months), who presented significantly higher SM scores than the children without caries in the same visit. CONCLUSION: A low income social condition and mothers highly colonized by SM do not mean necessarily early SM colonization and high caries activity in children with oral homecare. Caries development is significantly associated with high SM scores in the children.
Demmer, R.T.; Jacobs, D.R.; Singh, R.; Zuk, A.; Rosenbaum, M.; Papapanou, P.N.; Desvarieux, M.
Periodontitis and type 2 diabetes mellitus are known to be associated. The relationship between periodontal microbiota and early diabetes risk has not been studied. We investigated the association between periodontal bacteria and prediabetes prevalence among diabetes-free adults. ORIGINS (the Oral Infections, Glucose Intolerance and Insulin Resistance Study) cross sectionally enrolled 300 diabetes-free adults aged 20 to 55 y (mean ± SD, 34 ± 10 y; 77% female). Prediabetes was defined as follows: 1) hemoglobin A1c values ranging from 5.7% to 6.4% or 2) fasting plasma glucose ranging from 100 to 125 mg/dL. In 1,188 subgingival plaque samples, 11 bacterial species were assessed at baseline, including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Actinomyces naeslundii. Full-mouth clinical periodontal examinations were performed, and participants were defined as having no/mild periodontitis vs. moderate/severe periodontitis per the definition of the Centers for Disease Control and Prevention / American Academy of Periodontology. Modified Poisson regression evaluated prediabetes prevalence across bacterial tertiles. Prevalence ratios and 95% confidence intervals for third vs. first tertiles are presented. All analyses were adjusted for cardiometabolic risk factors. All results presented currently arise from the baseline cross section. Prediabetes prevalence was 18%, and 58% of participants had moderate/severe periodontitis. Prevalence ratios (95% confidence intervals) summarizing associations between bacterial levels and prediabetes were as follows: A. actinomycetemcomitans, 2.48 (1.34, 4.58), P = 0.004; P. gingivalis, 3.41 (1.78, 6.58), P = 0.0003; T. denticola, 1.99 (0.992, 4.00), P = 0.052; T. forsythia, 1.95 (1.0, 3.84), P = 0.05; A. naeslundii, 0.46 (0.25, 0.85), P = 0.01. The prevalence ratio for prediabetes among participants with moderate/severe vs. no/mild periodontitis was 1.47 (0.78, 2.74), P
Cortés-Vieyra, Ricarda; Rosales, Carlos; Uribe-Querol, Eileen
Oral tissues are constantly exposed to damage from the mechanical effort of eating and to microorganisms, mostly bacteria. In healthy gingiva tissue remodeling and a balance between bacteria and innate immune cells are maintained. However, excess of bacteria biofilm (plaque) creates an inflammation state that recruits more immune cells, mainly neutrophils to the gingiva. Neutrophils create a barrier for bacteria to reach inside tissues. When neutrophils are insufficient, bacteria thrive causing more inflammation that has been associated with systemic effects on other conditions such as atherosclerosis, diabetes, and cancer. But paradoxically when neutrophils persist, they can also promote a chronic inflammatory state that leads to periodontitis, a condition that leads to damage of the bone-supporting tissues. In periodontitis, bone loss is a serious complication. How a neutrophil balance is needed for maintaining healthy oral tissues is the focus of this review. We present recent evidence on how alterations in neutrophil number and function can lead to inflammatory bone loss, and how some oral bacteria signal neutrophils to block their antimicrobial functions and promote an inflammatory state. Also, based on this new information, novel therapeutic approaches are discussed.
Cortés-Vieyra, Ricarda; Rosales, Carlos
Oral tissues are constantly exposed to damage from the mechanical effort of eating and to microorganisms, mostly bacteria. In healthy gingiva tissue remodeling and a balance between bacteria and innate immune cells are maintained. However, excess of bacteria biofilm (plaque) creates an inflammation state that recruits more immune cells, mainly neutrophils to the gingiva. Neutrophils create a barrier for bacteria to reach inside tissues. When neutrophils are insufficient, bacteria thrive causing more inflammation that has been associated with systemic effects on other conditions such as atherosclerosis, diabetes, and cancer. But paradoxically when neutrophils persist, they can also promote a chronic inflammatory state that leads to periodontitis, a condition that leads to damage of the bone-supporting tissues. In periodontitis, bone loss is a serious complication. How a neutrophil balance is needed for maintaining healthy oral tissues is the focus of this review. We present recent evidence on how alterations in neutrophil number and function can lead to inflammatory bone loss, and how some oral bacteria signal neutrophils to block their antimicrobial functions and promote an inflammatory state. Also, based on this new information, novel therapeutic approaches are discussed. PMID:27019855
Kinane, D F
Epidemiological studies demonstrate a high prevalence of advanced destruction but also that relatively few individuals in each age group account for most of the advanced periodontal disease. The available data suggest that three quarters of advanced periodontal disease could be prevented by targeting an effective preventive strategy on the 28% of individuals especially at risk. Questions remain regarding: 1) whether an acceptable cost-effective preventive strategy can be devised; and 2) whether it is possible to establish a simple method of identifying the 'at risk' group. The various risk factors are numerous and include systemic diseases, smoking, drug therapy, hormonal disturbances and genetic factors as well as the more mundane factors such as plaque control and socio-economic and education and attitude factors. Aside from these factors, many patients present with periodontal disease and have no discernible predisposition other than possibly genetic, for which we can not currently test, and for the vast majority of patients there would appear to be no other alternative to periodic thorough examination for all patients, early treatment of all periodontal lesions and appropriate dental health education.
Lobo Pereira, J. A.; Ferreira, Maria Cristina; Oliveira, Teresa
Multivariate statistical analysis is indispensable to assess the associations and interactions between different factors and the risk of periodontitis. Among others, regression analysis is a statistical technique widely used in healthcare to investigate and model the relationship between variables. In our work we study the impact of socio-demographic, medical and behavioral factors on periodontal health. Using regression, linear and logistic models, we can assess the relevance, as risk factors for periodontitis disease, of the following independent variables (IVs): Age, Gender, Diabetic Status, Education, Smoking status and Plaque Index. The multiple linear regression analysis model was built to evaluate the influence of IVs on mean Attachment Loss (AL). Thus, the regression coefficients along with respective p-values will be obtained as well as the respective p-values from the significance tests. The classification of a case (individual) adopted in the logistic model was the extent of the destruction of periodontal tissues defined by an Attachment Loss greater than or equal to 4 mm in 25% (AL≥4mm/≥25%) of sites surveyed. The association measures include the Odds Ratios together with the correspondent 95% confidence intervals.
Oh, Min; Braun, Thomas M.; Ramseier, Christoph A.; Sugai, Jim V.; Giannobile, William V.
Aim Assess the ability of a panel of gingival crevicular fluid (GCF) biomarkers as predictors of periodontal disease progression (PDP). Materials and Methods 100 individuals participated in a 12-month longitudinal investigation and categorized into 4 groups according to their periodontal status. GCF, clinical parameters, and saliva were collected bi-monthly. Sub-gingival plaque and serum were collected bi-annually. For 6 months, no periodontal treatment was provided. At 6-months, patients received periodontal therapy and continued participation from 6-12 months. GCF samples were analyzed by ELISA for MMP-8, MMP-9, OPG, CRP and IL-1β. Differences in median levels of GCF biomarkers were compared between stable and progressing participants using Wilcoxon Rank Sum test (p=0.05). Clustering algorithm was used to evaluate the ability of oral biomarkers to classify patients as either stable or progressing. Results Eighty-three individuals completed the 6-month monitoring phase. With the exception of GCF C-reactive protein, all biomarkers were significantly higher in the PDP group compared to stable patients. Clustering analysis showed highest sensitivity levels when biofilm pathogens and GCF biomarkers were combined with clinical measures, 74% (95% CI = 61,86). Conclusions Signature of GCF fluid-derived biomarkers combined with pathogens and clinical measures provides a sensitive measure for discrimination of PDP (ClinicalTrials.gov NCT00277745). PMID:24303954
Whyte, A; Bonastre, C; Monteagudo, L V; Les, F; Obon, J; Whyte, J; Tejedor, M T
To evaluate the potential health issues associated with periodontal disease (PD) in dogs, 1004 teeth from 25 dogs were examined. The dogs were randomly selected, aged 2-14 years, and had at least 95% of their teeth at the first PD stage. Significant positive correlations between plaque grade (PG) and gum inflammation, gingival regression, periodontal pocket, age and serum alanine aminotransferase (ALT) activity were identified. In contrast, PG was negatively correlated to total platelet count. Altogether, these findings suggest that prevention and therapy at the first PD stages can have an important impact on the general health condition of dogs.
Zero, Domenick T
While our knowledge of the dental caries process and its prevention has greatly advanced over the past fifty years, it is fair to state that the management of this disease at the level of the individual patient remains largely empirical. Recommendations for fluoride use by patients at different levels of caries risk are mainly based on the adage that more is better. There is a general understanding that the fluoride compound, concentration, frequency of use, duration of exposure, and method of delivery can influence fluoride efficacy. Two important factors are (1) the initial interaction of relatively high concentrations of fluoride with the tooth surface and plaque during application and (2) the retention of fluoride in oral fluids after application. Fluoride dentifrices remain the most widely used method of delivering topical fluoride. The efficacy of this approach in preventing dental caries is beyond dispute. However, the vast majority of currently marketed dentifrice products have not been clinically tested and have met only the minimal requirements of the FDA monograph using mainly laboratory testing and animal caries testing. Daily use of fluoride dental rinses as an adjunct to fluoride dentifrice has been shown to be clinically effective as has biweekly use of higher concentration fluoride rinses. The use of remineralizing agents (other than fluoride), directed at reversing or arresting non-cavitated lesions, remains a promising yet largely unproven strategy. High fluoride concentration compounds, e.g., AgF, Ag(NH3)2F, to arrest more advanced carious lesions with and without prior removal of carious tissue are being used in several countries as part of the Atraumatic Restorative Treatment (ART) approach. Most of the recent innovations in oral care products have been directed toward making cosmetic marketing claims. There continues to be a need for innovation and collaboration with other scientific disciplines to fully understand and prevent dental caries
The occurrence of chronic inflammatory periodontal disease due to dental plaque in adults over 30 years of age was noticed in 47.2% of the 3,742 subjects studied, representing a 64.7 million people population in the 50 states of the U.S. and the District of Columbia. The methods used by the authors were uniquely precise and the results brought us to great insight on the correlation between orthodontic treatment and periodontal health, which is described below.
Harris, Stephen; Croft, Julie; O’Flynn, Ciaran; Deusch, Oliver; Colyer, Alison; Allsopp, Judi; Milella, Lisa; Davis, Ian J.
Periodontitis is the most frequently diagnosed health problem in cats yet little is known about the bacterial species important for the disease. The objective of this study was to identify bacterial species associated with health, gingivitis or mild periodontitis (<25% attachment loss) in feline plaque. Knowledge of these species is a first step in understanding the potential for improving oral health of cats via dietary interventions that alter the proportions of influential species. Subgingival plaque samples were collected from 92 cats with healthy gingiva, gingivitis or mild periodontitis. Pyrosequencing of the V1-V3 region of the 16S rDNA from these plaque samples generated more than one million reads and identified a total of 267 operational taxonomic units after bioinformatic and statistical analysis. Porphyromonas was the most abundant genus in all gingival health categories, particularly in health along with Moraxella and Fusobacteria. The Peptostreptococcaceae were the most abundant family in gingivitis and mild periodontitis. Logistic regression analysis identified species from various genera that were significantly associated with health, gingivitis or mild periodontitis. The species identified were very similar to those observed in canine plaque in the corresponding health and disease states. Such similarities were not observed between cat and human at the bacterial species level but with disease progression similarities did emerge at the phylum level. This suggests that interventions targeted at human pathogenic species will not be effective for use in cats but there is more potential for commonalities in interventions for cats and dogs. PMID:26605793
Harris, Stephen; Croft, Julie; O'Flynn, Ciaran; Deusch, Oliver; Colyer, Alison; Allsopp, Judi; Milella, Lisa; Davis, Ian J
Periodontitis is the most frequently diagnosed health problem in cats yet little is known about the bacterial species important for the disease. The objective of this study was to identify bacterial species associated with health, gingivitis or mild periodontitis (<25% attachment loss) in feline plaque. Knowledge of these species is a first step in understanding the potential for improving oral health of cats via dietary interventions that alter the proportions of influential species. Subgingival plaque samples were collected from 92 cats with healthy gingiva, gingivitis or mild periodontitis. Pyrosequencing of the V1-V3 region of the 16S rDNA from these plaque samples generated more than one million reads and identified a total of 267 operational taxonomic units after bioinformatic and statistical analysis. Porphyromonas was the most abundant genus in all gingival health categories, particularly in health along with Moraxella and Fusobacteria. The Peptostreptococcaceae were the most abundant family in gingivitis and mild periodontitis. Logistic regression analysis identified species from various genera that were significantly associated with health, gingivitis or mild periodontitis. The species identified were very similar to those observed in canine plaque in the corresponding health and disease states. Such similarities were not observed between cat and human at the bacterial species level but with disease progression similarities did emerge at the phylum level. This suggests that interventions targeted at human pathogenic species will not be effective for use in cats but there is more potential for commonalities in interventions for cats and dogs.
Gurav, Abhijit N
Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the “sixth” major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A “two way” relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients. PMID:26962409
Gurav, Abhijit N
Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the "sixth" major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A "two way" relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.
Teles, R.P.; Gursky, L.C.; Faveri, M.; Rosa, E.A.; Teles, F. R. F.; Feres, M.; Socransky, S.S.; Haffajee, A.D.
Aim To examine relationships between subgingival biofilm composition and levels of gingival crevicular fluid (GCF) cytokines in periodontal health and generalized aggressive periodontitis (GAP). Materials and methods Periodontal parameters were measured in 25 periodontally healthy and 31 GAP subjects. Subgingival plaque and GCF samples were obtained from 14 sites from each subject. 40 subgingival taxa were quantified using checkerboard DNA-DNA hybridization and the concentrations of 8 GCF cytokines measured using Luminex. Cluster analysis was used to define sites with similar subgingival microbiotas in each clinical group. Significance of differences in clinical, microbiological and immunological parameters among clusters was determined using the Kruskal-Wallis test. Results GAP subjects had statistically significantly higher GCF levels of interleukin-1β (IL-1β) (p<0.001), granulocyte-macrophage colony-stimulating factor (GM-CSF) (p<0.01), and IL-1β/IL-10 ratio (p<0.001) and higher proportions of Red and Orange complex species than periodontally healthy subjects. There were no statistically significant differences in the mean proportion of cytokines among clusters in the periodontally healthy subjects, while the ratio IL-1β/IL-10 (p<0.05) differed significantly among clusters in the aggressive periodontitis group. Conclusions Different subgingival biofilm profiles are associated with distinct patterns of GCF cytokine expression. Aggressive periodontitis subjects were characterized by a higher IL-1β/IL-10 ratio than periodontally healthy subjects, suggesting an imbalance between pro- and anti-inflammatory cytokines in aggressive periodontitis. PMID:20447254
Tooth brushing is considered a superior technique for reducing plaque accumulation. Chemical agents may be used to reduce plaque accumulation on tooth surfaces since many owners may not be willing or able to brush their dog's teeth. Following a professional teeth cleaning procedure, a dental gel containing chlorhexidine was applied in 11 dogs BID for 7-days, while 11 other dogs received a control dental gel applied in the same manner. Dogs in the treatment group had significantly less plaque accumulation during the trial period compared with dogs in the control group. The dental gel applied in the study reported here decreases plaque accumulation in the short-term and may be beneficial in reducing the severity of gingivitis and associated periodontal disease if provided on a long-term basis.
Mehr, Atabak Kashefi; Anush, Keivan
Background It was presented that Trichomonas tenax is one of the parasites which is responsible for oral infection. This study was considered to estimate the prevalence of this parasite in oral cavity of Down syndrome patients with periodontal lesions and in healthy population from welfare organization in Tabriz, Iran. Materials and Methods In the case-control study, 52 patients with periodontal disease (case group) and 52 individuals with healthy gingiva (control group) selected for the study. Examination was done by dental mirror and periodontal probe. After using plaque detector tablets, sampling was done by entering sterile paper into periodontal pocket for 20 seconds. The amount of plaque was measured by plaque index. Finally samples sent to laboratory for prepared PCR reaction. Results In the case group, 14 patients were infected and in the control group 5 individuals. Percentage of infection in case group was 18.8% and in the control group was 3% that difference was statically significant. Plaque index in the case group was 72 ± 10.2 and in the control group was 68 ± 11.4 and difference between two groups was not significant. Conclusion Parasitic infections in Down syndrome were higher than healthy children while plaque index was not significantly different between the two groups. Therefore follow-up of orders are necessary in control of parasitic infection in Down syndrome that have intrinsic defect of immune systems. PMID:26393213
Mobley, Connie C
Promotion of sound dietary practices is an essential component of caries management, along with fluoride exposure and oral hygiene practices. Scientific discoveries have lead to better understanding of the caries process, the ever-expanding food supply, and the interaction between the two. Fermentable carbohydrates interact dynamically with oral bacteria and saliva, and these foods will continue to be a major part of a healthful diet. Dental health professionals can serve their patients and the public by providing comprehensive oral health care and by promoting lifestyle behaviors to improve oral and general health within the time constraints of their practice. Dietary advice given should not contradict general health principles when providing practical guidance to reduce caries risk. The following principles should guide messages: * Encourage balanced diets based on moderation and variety as depicted by the Food Guide Pyramid and the Dietary Guidelines for Americans to provide a sound approach. Avoid references to "bad" foods and focus on "good" diets that include a variety of foods. * Give examples of how combining and sequencing foods can enhance mastication, saliva production, and oral clearance at each eating occasion. Combining dairy foods with sugary foods, raw foods with cooked, and protein-rich foods with acidogenic foods are all good examples. Suggest that eating and drinking be followed by cariostatic foods such as xylitol chewing gum. * Drink water to satisfy thirst and hydration needs as often as possible. Restrict consumption of sweetened beverages to meal and snack times when they can be combined with other cariostatic foods. * When a patient reports excessive dietary intake of a fermentable carbohydrate to the point of displacing other important foods in the diet, identify alternatives that will help the patient maintain or achieve a healthy body weight, oral health status, and a nutrient-dense intake.
Turnbull, Robert S.
In Part IV of this article, the author describes two periodontal infections, acute necrotizing ulcerative gingivitis (trench mouth) and periodontal abscess, both acute painful conditions for which patients may seek advice from their family physician rather than their dentist. PMID:21253201
Shanbhag, Vagish K L
Dental caries is a widely prevalent infectious disease afflicting the humans worldwide. Each year oral infections such as dental caries, periodontal diseases and oral candidiasis significantly adds to the economic burden of the world. Though there are standard management techniques for these diseases; they do have side effects and are not cost effective. Ayurveda is a traditional Indian system of medicine that is being practiced in the Indian peninsula since ages. Among the various herbal medicines in ayurveda, triphala occupies a royal position due to its wide beneficial systemic actions. Triphala is a mixture of fruits of Terminalia bellirica, Terminalia chebula and Emblica officinalis. The antimicrobial actions of triphala are well documented in the literature. However availability of review articles regarding triphala as an antimicrobial against oral infections is limited. Need was felt to review this aspect of triphala. The present article reviews the use of triphala and its constituents in the prevention and control of dental caries and other common oral infections. Thorough review of the literature indicated that triphala can be effectively used to manage dental caries, gingival and periodontal diseases. Further it can also be utilized as a root canal irrigant and against oral candida species.
Chaffee, Benjamin W.; Cheng, Jing; Featherstone, John D. B.
Few studies have evaluated clinical outcomes following caries risk assessment in large datasets that reflect risk assessments performed during routine practice. OBJECTIVE From clinical records, compare 18-month caries incidence according to baseline caries risk designation. METHODS For this retrospective cohort study, data were collected from electronic records of non-edentulous adult patients who completed an oral examination and caries risk assessment (CRA) at a university instructional clinic from 2007 to 2012 (N=18,004 baseline patients). The primary outcome was the number of new decayed/restored teeth from the initial CRA to the ensuing oral examination, through June 30, 2013 (N=4468 patients with follow-up). We obtained doubly-robust estimates for 18-month caries increment by baseline CRA category (low, moderate, high, extreme), adjusted for patient characteristics (age, sex, payer type, race/ethnicity, number of teeth), provider type, and calendar year. RESULTS Adjusted mean decayed, restored tooth (DFT) increment from baseline to follow-up was greater with each rising category of baseline caries risk, from low (0.94), moderate (1.26), high (1.79), to extreme (3.26). The percentage of patients with any newly affected teeth (DFT increment >0) was similar among low-risk and moderate-risk patients (cumulative incidence ratio, RR: 1.01; 95% confidence interval, CI: 0.83, 1.23), but was increased relative to low-risk patients among high-risk (RR: 1.28; 95% CI: 1.10, 1.52), and extreme-risk patients (RR: 1.52; 95% CI: 1.23, 1.87). CONCLUSIONS These results lend evidence that baseline caries risk predicts future caries in this setting, supporting the use of caries risk assessment to identify candidate patients for more intensive preventive therapy. PMID:25731155
Hägi, Tobias T; Laugisch, Oliver; Ivanovic, Aleksandar; Sculean, Anton
The goal of regenerative periodontal therapy is to completely restore the tooth's supporting apparatus that has been lost due to inflammatory periodontal disease or injury. It is characterized by formation of new cementum with inserting collagen fibers, new periodontal ligament, and new alveolar bone. Indeed conventional, nonsurgical, and surgical periodontal therapy usually result in clinical improvements evidenced by probing depth reduction and clinical attachment gain, but the healing occurs predominantly through formation of a long junctional epithelium and no or only unpredictable periodontal regeneration. Therefore, there is an ongoing search for new materials and improved surgical techniques, with the aim of predictably promoting periodontal wound healing/regeneration and improving the clinical outcome. This article attempts to provide the clinician with an overview of the most important biologic events involved in periodontal wound healing/ regeneration and on the criteria on how to select the appropriate regenerative material and surgical technique in order to optimize the clinical outcomes.
Naqvi, A.Z.; Hasturk, H.; Mu, L.; Phillips, R.S.; Davis, R.B.; Halem, S.; Campos, H.; Goodson, J.M.; Van Dyke, T.E.; Mukamal, K.J.
Periodontitis is a common chronic inflammatory disease initiated by bacteria, resulting in bone resorption, tooth loss, and systemic inflammation. Long-chain omega-3 fatty acids such as docosahexaenoic acid (DHA) reduce periodontitis in animals. We aimed to determine whether DHA supplementation with low-dose aspirin would reduce periodontitis in humans. We conducted a double-blind placebo-controlled parallel trial lasting 3 mo. Fifty-five adults with moderate periodontitis were randomized to 2,000 mg of DHA or identical soy/corn oil capsules. All participants received 81 mg of aspirin but received no other treatments. We analyzed the primary outcome of per-pocket change in pocket depth using mixed models among teeth with pocket depth ≥5 mm. Secondary outcomes assessed with generalized estimating equations included gingival index, plaque index, and bleeding on probing. Gingival crevicular fluid samples were analyzed for changes in high-sensitivity C-reactive protein (hsCRP) and interleukins 6 and 1β (IL-6 and IL-1β). Plasma was analyzed for changes in systemic inflammatory markers, including hsCRP. We confirmed adherence with erythrocyte fatty acid measurement. Forty-six participants completed the trial. While similar at baseline, the proportion of DHA in red blood cell plasma membranes increased from 3.6% ± 0.9% to 6.2% ± 1.6% in the intervention group but did not change among controls. DHA supplementation decreased mean pocket depth (–0.29 ± 0.13; p = .03) and gingival index (–0.26 ± 0.13; p = .04). Plaque index and bleeding on probing did not change. Significant adjusted differences were found between DHA and control for both gingival crevicular fluid hsCRP (–5.3 ng/mL, standard error [SE] = 2.4, p = .03) and IL-1β (–20.1 pg/mL, SE = 8.2, p = .02) but not IL-6 (0.02 pg/mL, SE = 0.71, p = .98) or systemic hsCRP (–1.19 mg/L, SE = 0.90, p = .20). In this randomized controlled trial, aspirin-triggered DHA supplementation significantly improved
Marchesan, J T; Morelli, T; Moss, K; Barros, S P; Ward, M; Jenkins, W; Aspiras, M B; Offenbacher, S
The purpose of this study was to evaluate the microbial community (MC) composition as it relates to salivary metabolites and periodontal clinical parameters in a 21-d biofilm-overgrowth model. Subjects (N = 168) were enrolled equally into 5 categories of periodontal status per the biofilm-gingival interface classification. Microbial species within subgingival plaque samples were identified by human microbiome identification microarray. Whole saliva was analyzed by liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry for metabolite identification. Phylum was grouped into MCs according to principal component analysis. Generalized linear and regression models were used to examine the association among MC, species, periodontal clinical parameters, and salivary metabolome. Multiple comparisons were adjusted with the false discovery rate. The study population was distributed into 8 distinct MC profiles, designated MC-1 to MC-8. MC-2 explained 14% of the variance and was dominated by Synergistetes and Spirochaetes. It was the only community structure significantly associated with high probing depth (P = 0.02) and high bleeding on probing (P = 0.008). MC-2 was correlated with traditional periodontal pathogens and several newly identified putative periodontal pathogens: Fretibacterium fastidiosum, Fretibacterium sp. OT360/OT362, Filifactor alocis, Treponema lecithinolyticum, Eubacterium saphenum, Desulfobulbus sp./OT041, and Mogibacterium timidum. Synergistetes phylum was strongly associated with 2 novel metabolites-cyclo (-leu-pro) and cyclo (-phe-pro)-at 21 d of biofilm overgrowth (P = 0.02). In subjects with severe periodontitis (P2 and P3), cyclo (-leu-pro) and cyclo (-phe-pro) were significantly associated with increased changes in probing depth at 21 d of biofilm overgrowth (P ≤ 0.05). The analysis identified a MC dominated by Synergistetes, with classic and putative newly identified pathogens/pathobionts associated with clinical disease
Caufield, P.W.; Schön, C.N.; Saraithong, P.; Li, Y.; Argimón, S.
Lactobacilli have been associated with dental caries for over a century. Here, we review the pertinent literature along with findings from our own study to formulate a working hypothesis about the natural history and role of lactobacilli. Unlike most indigenous microbes that stably colonize a host, lactobacilli appear to be planktonic, opportunistic settlers that can gather and multiply only in certain restrictive niches of the host, at least within the oral cavity. We postulate that the following essential requirements are necessary for sustained colonization of lactobacilli in humans: 1) a stagnant, retentive niche that is mostly anaerobic; 2) a low pH milieu; and 3) ready access to carbohydrates. Three sites on the human body meet these specifications: caries lesions, the stomach, and the vagina. Only a handful of Lactobacillus species is found in caries lesions, but they are largely absent in caries-free children. Lactobacilli present in caries lesions represent both a major contributor to caries progression and a major reservoir to the gastrointestinal (GI) tract. We extend the assertion from other investigators that lactobacilli found in the GI tract originate in the oral cavity by proposing that lactobacilli in the oral cavity arise from caries lesions. This, in turn, leads us to reflect on the health implications of the lactobacilli in the mouth and downstream GI and to ponder whether these or any of the Lactobacillus species are truly indigenous to the human GI tract or the oral cavity. PMID:25758458
Jansen, J; Pilot, T; Corba, N
The purpose of this study was to evaluate histologically the extent and characteristics of the penetration of a periodontal probe during clinical assessment of loss of periodontal attachment in three different situations: (1) experimental mild gingivitis, (2) experimental severe periodontal inflammation and (3) experimental moderate periodontal inflammation. Mild gingivitis was obtained by merely allowing plaque to accumulate on the teeth. Severe periodontal inflammation was created using copper bands for a period of 3 weeks followed by placement of cotton ligatures for another 11 weeks. Moderate periodontal inflammation group was obtained by allowing the experimental defects to recover for a period of 3 to 31 weeks. At different times gutta percha imitations of a thin periodontal probe were inserted into the pockets using a gentle but unknown force. Histologic observation in 30 specimens showed that epithelium was always present around the probe tip, in most instances forming a continuous layer of epithelial cells. Histometrical analysis showed that in mild gingivitis the probe tip failed to reach the apical termination of the junctional epithelium (mean = -0.84 mm). In severe periodontal inflammation the tip of the probe went past this point (mean = +0.50 mm), while in moderate periodontal inflammation the probe tip came closest to the apical termination of the junctional epithelium (mean = -0.05 mm). It is concluded that the epithelial lining of a pocket stays intact, even in severe periodontal inflammation where the probe tip is situated apical to the apical termination of the junctional epithelium, indicating that during clinical probing the periodontal tissues are compressed and displaced but not perforated. It is also concluded that in beagle dogs the extent of probe penetration in experimentally inflamed periodontal tissues is dependent upon the degree of inflammation.
... about 30 seconds. Then rinse your mouth with water and examine your teeth. Any red-stained areas are plaque. A small dental mirror may help you check all areas. The second method uses a plaque light. ... your mouth gently with water. Examine your teeth and gums while shining an ...
Sakalauskiene, Jurgina; Kubilius, Ricardas; Gleiznys, Alvydas; Vitkauskiene, Astra; Ivanauskiene, Egle; Šaferis, Viktoras
Background The aim of the study was to analyze how metabolic control of type 1 diabetes is related to clinical and microbiological periodontal parameters. Material/Methods The study involved 56 subjects aged from 19 to 50 years divided into 2 groups: healthy subjects (the H group), and diabetic (type 1 diabetes) patients with chronic untreated generalized periodontitis (the DM group). The glycosylated hemoglobin value (HbA1c) was determined using the UniCel DxC 800 SYNCHRON System (Beckman Coulter, USA), and the concentration in blood was measured by the turbidimetric immunoinhibition method. A molecular genetic assay (Micro-IDent plus, Germany) was used to detect periodontopathogenic bacteria in plaque samples. Periodontitis was confirmed by clinical and radiological examination. Results Fusobacterium nucleatum, Capnocytophaga species, and Eikenella corrodens were the most frequently found bacteria in dental plaque samples (77.8%, 66.7%, and 33.4%, respectively), whereas Aggregatibacter actinomycetemcomitans was identified 40.7% less frequently in the DM group than in the H group. The strongest relationship was observed between the presence of 2 periodontal pathogens – F. nucleatum and Capnocytophaga spp. – and poorer metabolic control in type 1 diabetes patients (HbA1c) and all clinical parameters of periodontal pathology. Conclusions Periodontal disease was more evident in type 1 diabetic patients, and the prevalence of periodontitis was greatly increased in subjects with poorer metabolic control. PMID:25294115
Agrawal, Raina; Gupta, Jagriti; Gupta, Krishna Kumar; Kumar, Vinod
Aims and Objectives: The aim of this study was to evaluate and correlate the relationship between mast cells counts and different stages of human periodontal diseases. Materials and Methods: The study sample comprised 50 patients, which were divided into three groups, consisting of 10 cases of clinically healthy gingival tissues (control group) 20 cases of dental plaque-induced gingivitis with no attachment loss and 20 cases of localized chronic periodontitis (LCP) characterized by the loss of periodontal support. The samples for control group were obtained during tooth extractions for orthodontic reasons. The specimens were immediately fixed in 10% neutral buffered formalin. Conclusion: In this study, LCP cases had higher mast cell counts compared to gingivitis sites or healthy tissues. Increased mast cell counts in the progressing sites of periodontal diseases may indicate the importance of these cells in the progression of chronic periodontitis. PMID:27194868
The Pioneer F spacecraft, destined to be the first man made object to escape from the solar system into interstellar space, carries this pictorial plaque. It is designed to show scientifically educated inhabitants of some other star system, who might intercept it millions of years from now, when Pioneer was launched, from where, and by what kind of beings. (Hopefully, any aliens reading the plaque will not use this knowledge to immediately invade Earth.) The design is etched into a 6 inch by 9 inch gold-anodized aluminum plate, attached to the spacecraft's attenna support struts in a position to help shield it from erosion by interstellar dust. The radiating lines at left represents the positions of 14 pulsars, a cosmic source of radio energy, arranged to indicate our sun as the home star of our civilization. The '1-' symbols at the ends of the lines are binary numbers that represent the frequencies of these pulsars at the time of launch of Pioneer F relative of that to the hydrogen atom shown at the upper left with a '1' unity symbol. The hydrogen atom is thus used as a 'universal clock,' and the regular decrease in the frequencies of the pulsars will enable another civilization to determine the time that has elapsed since Pioneer F was launched. The hydrogen is also used as a 'universal yardstick' for sizing the human figures and outline of the spacecraft shown on the right. The hydrogen wavelength, about 8 inches, multiplied by the binary number representing '8' shown next to the woman gives her height, 64 inches. The figures represent the type of creature that created Pioneer. The man's hand is raised in a gesture of good will. Across the bottom are the planets, ranging outward from the Sun, with the spacecraft trajectory arching away from Earth, passing Mars, and swinging by Jupiter.
Shimomura-Kuroki, Junko; Yamashita, Kie; Shimooka, Shohachi
Periodontal disease is a multiple factor disease caused by genetic factors, environmental factors, and periodontal bacteria (periodontal pathogens). The present study aimed to elucidate the risk factors for periodontal disease in Japanese adolescents. Subjects (11-16 years old) were classified into three groups: localized aggressive periodontitis (LAP), periodontal attachment loss (PAL), and periodontally healthy (PH) groups. Genomic DNA isolated from the buccal mucosa was used for single-nucleotide polymorphism analyses of the candidate genes (interleukin-1alpha-889; interleukin-1alpha +4845; interleukin-1beta +3954; an immunoglobulin G Fc gamma receptor, FcgammaRIIa-R/H131; and a human leukocyte antigen class II allele, HLA-DQB1) of aggressive periodontitis. Subgingival plaque samples obtained from the same subjects were used for 16S rRNAbased polymerase chain reaction analysis of five important periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Tannerella forsythia). Tannerella forsythia was detected in the deepest periodontal pockets in all subjects in the LAP and PAL groups. The prevalence of an atypical BamHI restriction site in HLA-DQB1 of the LAP group was significantly higher than that in the PH and PAL groups. Furthermore, all subjects who had the atypical BamHI restriction site in HLA-DQB1 had T. forsythia infection. These results suggested that T. forsythia is associated with periodontal disease in Japanese adolescents and also suggested that HLA-DQB1 is related to LAP and is associated with T. forsythia infection.
Kanth, M Rajini; Prakash, A Ravi; Sreenath, G; Reddy, Vikram Simha
Introduction Dental caries and periodontal diseases are the most common oral diseases seen globally, both in developed and developing countries. Oral microorganisms that is gram positive and gram negative bacteria are known to be involved in causation of these diseases. Nowadays commercially available dentrifices and mouth rinses are known to contain ingredients that can alter the oral microbial flora and have undesirable side effects such as vomiting, diarrhoea, disarrangement of oral, intestinal flora and tooth staining. Naturally available plant products are known to be less harmful with fewer side effects and also economical for the patient. Aim The aim of this study was to determine the antimicrobial properties of 10 naturally available plant products against oral microorganisms causing caries and to check the efficacy of these products in-vitro and to use these in mouth washes and dentrifices. Materials and Methods Sample of caries material was scrapped out from the extracted teeth and transferred to liquid broth, streaked over the agar media to allow for the growth of microorganisms. Plant products like clove oil, neem, ginger-garlic paste, tea tree oil, ginger, garlic, cinnamon oil, green tea, eucalyptus oil and turmeric were used. Antimicrobial efficacy of these products, was estimated by measuring zones of inhibition in the nutrient agar media. Results Clove oil was the most effective of all products against microorganisms causing caries with zone of inhibition - 30mm followed by ginger-garlic paste - 25mm, Neem - 15mm, tea tree oil - 15mm. Conclusion Based on the above results, it can be inferred that these natural products have the maximum efficacy against microorganisms and can be recommended in dentifrices, mouth rinses, topical gels, etc. PMID:28209019
Herrera, MS; Medina-Solis, CE; Islas-Granillo, H; Lara-Carrillo, E; Scougall-Vilchis, RJ; Escoffié-Ramírez, M; la Rosa-Santillana, R De; Avila-Burgos, L
ABSTRACT Objective: To identify the sociodemographic, socio-economic, clinical and behavioural factors that modify the experience of decayed, missing and filled teeth (DMFT) and caries prevalence in Nicaraguan children 9-12 years old. Subjects and Methods: We conducted a cross-sectional study in 800 school children 9-12 years old in the city of León, Nicaragua. The clinical oral examinations to identify caries experience were undertaken by two trained and certified examiners. Sociodemographic, socio-economic and behavioural data were collected using questionnaires. Negative binomial regression (NBR) and binary logistic regression (BLR) models were used to model caries experience and caries prevalence, respectively. Results: Mean DMFT index was 0.98 ± 1.74 and caries prevalence (DMFT > 0) was 37.9%. In the NBR model, the categories that increase the expected DMFT mean were: older age, female gender, presence of plaque, and if the school children received curative and curative/preventive dental care in the last year. In the BLR model, the odds of presenting with caries in the permanent dentition were increased in older children, those from large families, mothers with a positive dental attitude, and those school children who received curative and curative/preventive dental care in the last year. Conclusions: Using different models, we identified several sociodemographic, socio-economic, clinical and behavioural factors that modify the experience (NBR) and prevalence (BLR) of dental caries. PMID:25867561
Fishbein, Michael C
The lesion responsible for the overwhelming majority of acute coronary events is plaque disruption or erosion with superimposed thrombosis. The term "vulnerable plaque" has been used to describe those atherosclerotic plaques that are particularly susceptible to disruption. Vulnerable plaques are generally characterized as those having a thin inflamed fibrous cap over a very large lipid core. However, only a small percentage of such plaques rupture, and plaques with different characteristics may also rupture and thrombose. Most autopsy, intravascular ultrasound, and recent computed tomography angiographic studies of coronary arteries reveal large plaques at sites of rupture. While angiographic data are said to show less severe narrowing at sites of plaque rupture, actual review of data indicates that, even angiographically, more than 50% of plaques have greater than 75% cross-sectional area stenosis at sites of plaque rupture. If plaque rupture is more common at the shoulder region of a plaque, one could envision that this would be at a peripheral site of the plaque where the plaque may not be as large or occlusive. New knowledge about vulnerable plaques is emerging through the evolution of novel techniques used to study plaques in vivo. These methods combine sophisticated imaging techniques, often in conjunction with molecular biomarkers, that provide new insights into plaque biology. Since atherosclerotic coronary artery disease is such a widespread and fatal disease, it is important that we continue to strive for a greater understanding of the nature of the vulnerable plaque. Only then can rational interventions for this disorder be developed and implemented.
... cleaning and oral exam. Some people who have periodontal disease may require more frequent cleanings. Solutions you slosh ... Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ... microbiology. In: Newman MG, Takei HH, Klokkevold PR, ...
Victor, Ligia Valéria; Cortelli, Sheila Cavalca; Aquino, Davi Romeiro; de Carvalho Filho, Jonas; Cortelli, José Roberto
This cross-sectional study evaluated the periodontal status and the presence of periodontopathogens in 132 young, black ethnic subjects who live in Salvador/Bahia-Brazil and have never smoked. Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Plaque Index (PI) and Gingival Index (GI) were measured and analyzed by ANOVA and Wilcoxon tests (p<0.05) according to gender and age. The presence of A.actinomycetemcomitans, P.gingivalis, E.corrodens and F.nucleatum was determined by PCR and was analyzed by ANOVA, Wilcoxon, Student-t tests (p<0.05). Mean values of PPD and CAL were 2.18 and 1.0mm, respectively. Clinical parameters did not show differences between subjects of varying gender and age. The microbial prevalence was observed to be 95.45% for E.corrodens followed by F.nucleatum with 68.18%, A.actinomycetemcomitans with 45.45% and P gingivalis with 40.9%. An association between the presence of pathogens and gender and age was not observed (p<0.05). PPD, CAL and PI were not associated with P.gingivalis; however, GI appeared in higher frequencies among subjects without P.gingivalis. In this young, black ethnic, Brazilian population, a high percentage (96.96%) of subjects harbored at least one selected periodontal pathogen, but most subjects showed a healthy periodontal status. Further investigations are required to evaluate the actual influence of the presence of these bacterial species. PMID:24031206
Mohamed, Hasaan Gassim; Idris, Shaza Bushra; Mustafa, Manal; Ahmed, Mutaz Faisal; Åstrøm, Anne Nordrehaug; Mustafa, Kamal; Ibrahim, Salah Osman
This study compared the influence of type 2 diabetes on the occurrence of six periodontal pathogens in plaque samples of patients with and without chronic periodontitis. Levels of salivary MMP-8, MMP-9, RANKL, and OPG were also investigated. The study enrolled 31 patients with type 2 diabetes and chronic periodontitis (DM + CP), 29 with chronic periodontitis (CP), and 20 with type 2 diabetes (DM). Questionnaire-guided interviews were conducted and plaque index, bleeding on probing, and pocket depth were recorded. Polymerase chain reaction (PCR) was utilized to determine the prevalence of the bacteria. The levels of salivary molecules were determined by enzyme immunosorbent assay (ELISA). The CP group had the highest prevalence of P. gingivalis (81.5%), followed by the DM + CP (59.3%) and DM (55.0%) groups (P > 0.05). Similar trends were observed for P. intermedia and T. denticola. The prevalence of T. forsythia was 100% in both periodontitis groups compared to 90% in the DM group. There were no significant differences between the groups regarding the concentrations of MMP-8, MMP-9, or OPG. RANKL concentrations were below the detection limit. Our data show that type 2 diabetes has no significant influence on the prevalence of the investigated periodontal pathogens, or the levels of salivary MMP-8, MMP-9, and OPG. PMID:26989414
Mohamed, Hasaan Gassim; Idris, Shaza Bushra; Mustafa, Manal; Ahmed, Mutaz Faisal; Åstrøm, Anne Nordrehaug; Mustafa, Kamal; Ibrahim, Salah Osman
This study compared the influence of type 2 diabetes on the occurrence of six periodontal pathogens in plaque samples of patients with and without chronic periodontitis. Levels of salivary MMP-8, MMP-9, RANKL, and OPG were also investigated. The study enrolled 31 patients with type 2 diabetes and chronic periodontitis (DM + CP), 29 with chronic periodontitis (CP), and 20 with type 2 diabetes (DM). Questionnaire-guided interviews were conducted and plaque index, bleeding on probing, and pocket depth were recorded. Polymerase chain reaction (PCR) was utilized to determine the prevalence of the bacteria. The levels of salivary molecules were determined by enzyme immunosorbent assay (ELISA). The CP group had the highest prevalence of P. gingivalis (81.5%), followed by the DM + CP (59.3%) and DM (55.0%) groups (P > 0.05). Similar trends were observed for P. intermedia and T. denticola. The prevalence of T. forsythia was 100% in both periodontitis groups compared to 90% in the DM group. There were no significant differences between the groups regarding the concentrations of MMP-8, MMP-9, or OPG. RANKL concentrations were below the detection limit. Our data show that type 2 diabetes has no significant influence on the prevalence of the investigated periodontal pathogens, or the levels of salivary MMP-8, MMP-9, and OPG.
Gupta, G; Mansi, B
Gingival and Periodontal diseases represent a major concern both in dentistry and medicine. The majority of the contributing factors and causes in the etiology of these diseases are reduced or treated with ozone in all its application forms (gas, water, oil). The beneficial biological effects of ozone, its anti-microbial activity, oxidation of bio-molecules precursors and microbial toxins implicated in periodontal diseases and its healing and tissue regeneration properties, make the use of ozone well indicated in all stages of gingival and periodontal diseases. The primary objective of this article is to provide a general review about the clinical applications of ozone in periodontics. The secondary objective is to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. This objective would be of importance to future researchers in terms of what has been tried and what the potentials are for the clinical application of ozone in Periodontics.
Gupta, G; Mansi, B
Gingival and Periodontal diseases represent a major concern both in dentistry and medicine. The majority of the contributing factors and causes in the etiology of these diseases are reduced or treated with ozone in all its application forms (gas, water, oil). The beneficial biological effects of ozone, its anti-microbial activity, oxidation of bio-molecules precursors and microbial toxins implicated in periodontal diseases and its healing and tissue regeneration properties, make the use of ozone well indicated in all stages of gingival and periodontal diseases. The primary objective of this article is to provide a general review about the clinical applications of ozone in periodontics. The secondary objective is to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. This objective would be of importance to future researchers in terms of what has been tried and what the potentials are for the clinical application of ozone in Periodontics. PMID:22574088
Pires, Juliana Rico; dos Santos, Isac Pinheiro; de Camargo, Lilian Flosi; Zuza, Elizangela Partata; de Toledo, Benedicto Egbert Corrêa; Monteiro, Sally Cristina Moutinho
Background: Obesity is a chronic inflammatory condition that has been associated to a risk factor for the development of periodontitis and cardiovascular disease; however, the relationship still needs to be clarified. The objective of this study was to evaluate the cardiovascular risk in obese patients with chronic periodontitis. Materials and Methods: A total of 87 obese patients were evaluated for anthropometric data (body mass index [BMI], waist circumference, body fat), systolic blood pressure (SBP) and diastolic blood pressure (DBP), cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL), triglycerides, glycemia and periodontal parameters (visible plaque index (VPI), gingival bleeding index (GBI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment level (CAL)). Results: Patients were divided into two groups according to the periodontal characteristics found: Group O-PD: Obese patients with chronic periodontitis (n = 45), 22 men and 23 women; and Group O-sPD: Obese patients without chronic periodontitis (n = 42), 17 men and 25 women. Patients had a BMI mean of 35.2 (±5.1) kg/m2 . Group O-PD showed a similarity between the genders regarding age, SBP, DBP, cholesterol, HDL, GBI, VPI, PPD ≥4 mm and CAL ≥4 mm. O-PD women showed greater glycemia level and smoking occurrence, but O-PD men presented a 13% - risk over of developing coronary artery disease in 10 years than O-PD women, 9% - risk over than O-sPD men and 15% - risk over than O-sPD women, by the Framingham Score. Conclusions: It was concluded that obesity and periodontal disease are cardiovascular risk factors and that the two associated inflammatory conditions potentially increases the risk for heart diseases. PMID:24744538
Kennedy, Rebekah; Lappin, David Francis; Dixon, Padraic Martin; Buijs, Mark Johannes; Zaura, Egija; Crielaard, Wim; O'Donnell, Lindsay; Bennett, David; Brandt, Bernd Willem; Riggio, Marcello Pasquale
Equine periodontal disease is a common and painful condition and its severe form, periodontitis, can lead to tooth loss. Its aetiopathogenesis remains poorly understood despite recent increased awareness of this disorder amongst the veterinary profession. Bacteria have been found to be causative agents of the disease in other species, but current understanding of their role in equine periodontitis is extremely limited. The aim of this study was to use high-throughput sequencing to identify the microbiome associated with equine periodontitis and oral health. Subgingival plaque samples from 24 horses with periodontitis and gingival swabs from 24 orally healthy horses were collected. DNA was extracted from samples, the V3-V4 region of the bacterial 16S rRNA gene amplified by PCR and amplicons sequenced using Illumina MiSeq. Data processing was conducted using USEARCH and QIIME. Diversity analyses were performed with PAST v3.02. Linear discriminant analysis effect size (LEfSe) was used to determine differences between the groups. In total, 1308 OTUs were identified and classified into 356 genera or higher taxa. Microbial profiles at health differed significantly from periodontitis, both in their composition (p < 0.0001, F = 12.24; PERMANOVA) and in microbial diversity (p < 0.001; Mann-Whitney test). Samples from healthy horses were less diverse (1.78, SD 0.74; Shannon diversity index) and were dominated by the genera Gemella and Actinobacillus, while the periodontitis group samples showed higher diversity (3.16, SD 0.98) and were dominated by the genera Prevotella and Veillonella. It is concluded that the microbiomes associated with equine oral health and periodontitis are distinct, with the latter displaying greater microbial diversity.
Tomita, Sachiyo; Komiya-Ito, Akiyo; Imamura, Kentaro; Kita, Daichi; Ota, Koki; Takayama, Saori; Makino-Oi, Asako; Kinumatsu, Takashi; Ota, Mikio; Saito, Atsushi
This study aimed to investigate the prevalence and levels of major periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia in subgingival plaque samples of a group of Japanese patients with aggressive periodontitis (AgP) and chronic periodontitis (CP). A total of 40 patients with clinical diagnosis of AgP or CP and 10 periodontally healthy volunteers were subjected to clinical and microbiological analysis. Subgingival plaque samples were analyzed for A. actinomycetemcomitans, P. gingivalis and T. forsythia with a real-time polymerase chain reaction (PCR) technique. The prevalence of P. gingivalis and T. forsythia was relatively high in patients with periodontitis: over 60% of AgP or CP patients harbored these pathogens whereas they were not detected in the subgingival plaque samples from periodontally healthy individuals. P. gingivalis and T. forsythia were relatively frequently detected together in AgP and CP patients. No significant differences in the prevalence or level of the 3 pathogens were found between periodontitis groups. The proportion of T. forsythia was approximately 4-fold higher in CP group than in AgP group (P = 0.02). In periodontitis patients, a significant positive correlation was found between periodontal parameters (probing depth and clinical attachment level) and the numbers of total bacteria, P. gingivalis and T. forsythia. No distinct pattern of the subgingival profile of these pathogens was discerned between the two disease entities, except for the difference in the proportion of T. forsythia. The red complex bacteria, P. gingivalis and T. forsythia were highly prevalent in this population of Japanese AgP and CP patients, collaborating their roles in periodontitis.
Bascones-Martínez, Antonio; Arias-Herrera, Santiago; Criado-Cámara, Elena; Bascones-Ilundáin, Jaime; Bascones-Ilundáin, Cristina
Diabetes is considered to be a genetically and environmentally based chronic metabolic and vascular syndrome caused by a partial or total insulin deficiency with alteration in the metabolism of lipids, carbohydrates and proteins culminating with different manifestations in different organisms. In humans hyperglycemia is the main consequence of defects in the secretion and/or action of insulin, and its deregulation can produce secondary lesions in various organs, especially kidneys, eyes, nerves, blood vessels and immune systems. Periodontal disease is an entity of localized infection that involves tooth-supporting tissues. The first clinical manifestation of periodontal disease is the appearance of periodontal pockets, which offer a favorable niche for bacterial colonization. The etiology of periodontal disease is multifactorial, being caused by interactions between multiple micro-organisms (necessary but not sufficient primary etiologic factors), a host with some degree of susceptibility and environmental factors. According to current scientific evidence, there is a symbiotic relationship between diabetes and periodontitis, such that diabetes is associated with an increased incidence and progression of periodontitis, and periodontal infection is associated with poor glycaemic control in diabetes due to poor immune systems. Hence, for a good periodontal control it is necessary to treat both periodontal disease and glycaemic control.
This position paper addresses the role of systemic antibiotics in the treatment of periodontal disease. Topical antibiotic therapy is not discussed here. The paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology. The document consists of three sections: 1) concept of antibiotic periodontal therapy; 2) efficacy of antibiotic periodontal therapy; and 3) practical aspects of antibiotic periodontal therapy. The conclusions drawn in this paper represent the position of the American Academy of Periodontology and are intended for the information of the dental profession.
Song, H Jung
This article reviews periodontal disease and gingival disease and also explores issues relating to mucogingival defects such as gingival hyperplasia, gingival recession, and exposure of impacted canines.
Reid, M. A.; Post, R. E.; Soltis, D.
Plaque formed in porous plastic by electroless plating. Lightweight plaque prepared by electroless plating of porous plastic contains embedded wire or expanded metal grid. Plastic may or may not be filled with soluble pore former. If it contains soluble pore former, treated to remove soluble pore former and increase porosity. Porous plastic then clamped into rig that allows plating solutions to flow through plastic. Lightweight nickel plaque used as electrode substrate for alkaline batteries, chiefly Ni and Cd electrodes, and for use as electrolyte-reservoir plates for fuel cells.
Mortazavi, Shiva; Noin, Sogol
Background: Consistency, backing process and content differences could influence cariogenic potential of foods. The aim was to compare plaque pH changes following consumption of two types of bread with different physical characteristics. Methods: In this clinical trial, interproximal plaque pH of 10 volunteers with high risk of dental caries (saliva Streptococcus mutans > 105, high dental caries experience, and average DMFT =6.10 ± 1.56) was measured. Plain traditionally backed “Sangak bread” and soft bulky “Baguette bread” and %10 sucrose solution were tested in a cross over designed experiment. Baseline plaque pH was recorded and followed by 1, 5, 10, 15, 20, and 30 minutes intervals. Data was analyzed using ANOVA and Tukey test (α = 0.05). Results: Sucrose solution caused the most pronounced pH and ΔpH drop from 7.15 ± 0.33 at baseline to 6.78 ± 0.29. Means plaque pH of 10% sucrose solution and Baguette were not statistically different at 1, 20 and 30 minutes (P > 0.05). Mean plaque pH of Sangak and Baguette showed significant differences at 0, 1, 20 and30 minutes (P <60; 0.05). Sucrose solution caused a dramatic plaque pH drop during first 10 minutes and then within 30 minutes returned to baseline pH. For two bread samples within first 10 minutes, pH increased and then started to decrease during tenth to fifteenth minutes. Conclusion: During all experiment phases, the mean pH of Baguette with less consistency and carbohydrate content and higher rate of starch gelatination was lower compared to Sangak. PMID:22013467
Baab, David; Weinstein, Philip
Development of a course designed to help dental students integrate interpersonal and clinical skills to help periodontal patients accept and adhere to long-term self-care regimens is described. An algorithm illustrates to students the process of plaque control and the patient's role. (MSE)
Marquez, Ignacio Christian
Although the band of keratinized tissue and attached gingiva is determined genetically, it may be affected by the presence of plaque-associated inflammation or by the action of certain mechanical interventions. This article reviews variations in the width of keratinized tissue and attached gingiva and their clinical significance regarding periodontal/peri-implant health.
Karikoski, A; Ilanne-Parikka, P; Murtomaa, H
We assessed the effects of oral self-care on periodontal health indicators among adults with diabetes. The sample consisted of 120 dentate individuals, all of whom were regular patients at the Salo Regional Hospital Diabetes Clinic in southwest Finland. Clinical periodontal examination included identification of visible plaque, the presence of calculus, and use of the Community Periodontal Index of Treatment Needs (CPITN). A questionnaire focused on self-treatment, self-prevention, and self-diagnosis of oral diseases, utilization of dental services, and patients' knowledge and attitudes towards oral health. The New Century model of oral health promotion was used as a theoretical framework for analysis of determinants of oral self-care. Although individuals aged 40 years or older were more frequent interdental cleaners, significantly better oral health indicators were found among younger patients. Women reported brushing their teeth more frequently, and differences in plaque and calculus indices were significantly lower than those of men. Self-reported good oral condition was strongly associated with frequent dental visits and less plaque and calculus. No missing teeth and age less than 40 years were predictors of lower plaque, calculus, and CPITN scores. A significant association was found only between frequent dental visits and reduced amount of calculus. Self-reported frequency of oral health habits among adults with diabetes seemed to have little effect on periodontal health indicators. Adults with diabetes should benefit from comprehensive oral self-care, and more attention is needed for improving the quality and outcome of these habits.
Sunkara, Musalaiah Svv; Pantareddy, Indeevar; Sudhakar, Sankaran
Backgound and Aim Allopathic medications used for periodontal disease are known to be associated with various side effects. Hence a search for naturotherapies are on the rise. Among the natural pharmacons available aloevera and propolis are considered to be effective and free from adverse effects. Taking this into account, the present study was done to compare the plaque inhibiting efficacies of Aloe vera and Propolis tooth gels in patients with chronic periodontitis. Materials and Methods Forty patients diagnosed with chronic periodontitis were randomly allocated to groups A and B containing 20 patients each. Patients in group A were advised to use Aloe vera tooth gel while those in group B were advised to use Propolis tooth gel. Clinical and microbiologic parameters using Polymerase chain reaction (PCR) were recorded at baseline and after 3 months. Results Student t-test was performed for all the obtained results. In the Aloe vera group, comparison of baseline PCR and after 3 month results showed reduction only in P. gingivalis (p=0.001), where as statistically significant reduction in all the three red complex microorganisms was seen in propolis group. All the clinical parameters (Plaque Index, Gingival Index, Bleeding on Probing, Probing pocket Depth, and Clinical Attachment Level) in both the groups showed statistically significant reductions after 3 months. Conclusion Propolis showed a statistically significant reduction in plaque, microbiologic and clinical parameters. However, clinical trials of longer durations with larger sample sizes are required to evaluate the efficacy. PMID:26501001
Edgar, W M
The prevalent use of chewing gum has prompted interest in its dental effects. Important defining aspects are the ability to use sugar substitutes in gum manufacture and the prolonged stimulation of a protective flow of saliva. The main sugar substitutes used are sorbitol and xylitol. Because it is not fermented by oral bacteria, xylitol is considered to be non-cariogenic, and while sorbitol in solution can be fermented slowly by mutants streptococci, chewing sorbitol-sweetened gum does not cause a fall in plaque pH. Effects of chewing sugar-free gum on the ability of plaque to form acid from sucrose are equivocal, although the tendency is for the plaque acidogenicity to be reduced with the use of xylitol gum for 2-3 weeks, due to its inhibitory effects on mutants streptococci. Gum-chewing also stimulates a protective salivary flow when used after an acidogenic stimulus, and may enhance salivary function, especially in subjects with low flow rates. Sorbitol and xylitol gums have similar beneficial effects in promoting enamel remineralisation in short-term in-situ experiments. Clinical trials indicate that xylitol gum has a useful anticaries role, superior to the effects of sorbitol gum. In conclusion, both sorbitol and xylitol chewing gums are non-cariogenic in contrast to sugared gum, and exhibit beneficial anticaries properties through salivary stimulation. In addition, xylitol's antibacterial properties seem likely to lead to caries reductions superior to the more modest reductions with sorbitol gum.
Khammissa, Razia; Feller, Liviu; Altini, Mario; Fatti, Paul; Lemmer, Johan
The effect of HIV infection on the prevalence and the rate of progression of chronic periodontitis is not clear. The aim of this study was to compare parameters associated with the severity of chronic periodontitis in terms of periodontal probing depths, gingival recession, plaque indexes, and bleeding indexes of HIV-seropositive subjects and healthy age-matched control subjects, and of HIV-seropositive subjects on highly active antiretroviral therapy and those not receiving such treatment. Two cohorts of subjects with chronic periodontitis were recruited for this study over a period of six months. There were 30 HIV-seropositive subjects, and 30 control subjects. Periodontal probing depths, gingival marginal recession, plaque indexes, and bleeding indexes were compared by HIV serostatus, the use of highly active antiretroviral therapy, and CD4+ T-cell counts. All participants were black persons between the age of 18 and 45 and were of a similar socioeconomic status and age. The results of this study indicate that chronic periodontitis in HIV-seropositive subjects is similar in terms of mean periodontal probing depth, gingival marginal recession, plaque index, and bleeding index to that in healthy age-matched control subjects, and a low CD4+ T-cell count does not appear to be a risk factor for increased severity of chronic periodontitis. PMID:22970354
Rudney, J D
Dental plaque is being redefined as oral biofilm. Diverse overlapping microbial consortia are present on all oral tissues. Biofilms are structured, displaying features like channels and projections. Constituent species switch back and forth between sessile and planktonic phases. Saliva is the medium for planktonic suspension. Several major functions can be defined for saliva in relation to oral biofilm. It serves as a medium for transporting planktonic bacteria within and between mouths. Bacteria in transit may be vulnerable to negative selection. Salivary agglutinins may prevent reattachment to surfaces. Killing by antimicrobial proteins may lead to attachment of dead cells. Salivary proteins form conditioning films on all oral surfaces. This contributes to positive selection for microbial adherence. Saliva carries chemical messengers which allow live adherent cells to sense a critical density of conspecifics. Growth begins, and thick biofilms may become resistant to antimicrobial substances. Salivary macromolecules may be catabolized, but salivary flow also may clear dietary substrates. Salivary proteins act in ways that benefit both host and microbe. All have multiple functions, and many do the same job. They form heterotypic complexes, which may exist in large micelle-like structures. These issues make it useful to compare subjects whose saliva functions differently. We have developed a simultaneous assay for aggregation, killing, live adherence, and dead adherence of oral species. Screening of 149 subjects has defined high killing/low adherence, low killing/high adherence, high killing/high adherence, and low killing/low adherence groups. These will be evaluated for differences in their flora.
Lu, Huaixiu; Xu, Minguang; Wang, Feng; Liu, Shisen; Gu, Jing; Lin, Songshan; Zhao, Lisheng
Periodontitis is a common chronic inflammatory disease. Recent studies have shown that chronic stress (CS) might modulate periodontal disease, but there are few models of CS-induced periodontitis, and the underlying mechanisms are unclear. The present study established a rat model of periodontitis associated with CS induced by nylon thread ligatures. The severity of periodontitis was evaluated in this model by radiographic and pathological examination. The inflammatory reaction indicated by the elevated serum levels of interleukin (IL)-1β, IL-6 and IL-8 was assessed by enzyme-linked immunosorbent assay. Toll-like receptor-4 (TLR4) and glucocorticoid receptor-α (GR-α) expressions were detected by reverse transcriptase-PCR and western blotting. Open-field tests and serum corticosterone were used to evaluate CS. The results showed that CS induced behavioral changes and increased corticosterone levels of the animals with periodontitis. CS stimulation markedly increased alveolar bone loss, periodontal pocket depth and the number of plaques. It also enhanced the inflammatory reaction. These results suggest that CS accelerated the ligature-induced pathological changes associated with periodontitis. Further analysis of the mechanisms involved showed that GR-α expression was significantly downregulated in periodontal tissues of the animals undergoing CS. Blocking GR-α signaling in lipopolysaccharide and corticosteroid-treated human periodontal ligament fibroblast cells in vitro significantly upregulated the expression of p-Akt (protein kinase B) and TLR4, promoted nuclear factor-κB activity and increased levels of IL-1β, IL-6 and IL-8. This research suggests that CS might accelerate the pathological progression of periodontitis by a GR-α signaling-mediated inflammatory response and that this may be a potential therapeutic target for the treatment of periodontal disease, particularly in patients with CS.
Gupta, Namita; Gupta, N D; Gupta, Akash; Khan, Saif; Bansal, Neha
Periodontitis is an inflammatory disease of the periodontium. Any imbalance between the matrix metalloproteinases (MMPs) secreted by neutrophils and tissue inhibitors initiates the destruction of collagen in gum tissue, leading to chronic periodontitis. This study aimed to correlate salivary levels of MMP-8 and periodontal parameters of chronic periodontitis to establish MMP-8 as a noninvasive marker for the early diagnosis of chronic periodontitis. The study involved 40 subjects visiting the periodontic OPD of Dr. Ziauddin Ahmad Dental College and Hospital, located in Aligarh, U.P., India, from 2011 to 2012. The subjects were divided into two groups: group I consisted of 20 periodontally healthy subjects (controls) while group II consisted of 20 patients with chronic periodontitis. Chronic periodontitis was assessed on the basis of several periodontal parameters, including pocket probing depth (PPD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). Around 3ml of unstimulated and whole expectorated saliva was collected for MMP-8 estimation by ELISA using Quantikine human total MMP-8 immunoassay kits. Data were analyzed using STATISTICA (Windows version 6) software. Salivary MMP-8 levels of groups I and II were 190.91 ± 143.89 ng/ml and 348.26 ± 202.1 ng/ml, respectively. The MMP-8 levels and periodontal status (PPD, CAL, GI, and PI) of groups I and II showed positive and significant correlations (for PPD, r = 0.63, P < 0.001; for CAL, r = 0.54, P < 0.001; for GI, r = 0.49, P < 0.001; and for PI, r = 0.63, P < 0.001). The results of this study demonstrate elevated concentrations of MMP-8 in individuals with chronic periodontitis.
Saxer, U P; Menghini, G; Bohnert, K J; Ley, F
In this study on 60 adult subjects, the effective of Parodontax, a dentifrice containing herbal ingredients and sodium bicarbonate abrasive, was compared to a non-marketed new toothpaste containing herbal ingredients and calcium hydrogen phosphate as the abrasive. Plaque, gingivitis and gingival bleeding parameters were scored. The periodontal probe bleeding index of Ainamo and Bay was modified to score slight and moderate bleeding. In this first four-week period all subjects used the new toothpaste. After this period the new toothpaste produced a significant decrease (p<0.01) in gingivitis and bleeding on probing, but no effect on plaque was observed. During the second period of eight weeks the subjects were randomly divided into two groups, one using Parodontax and the other group continuing with the new toothpaste. The study design was a double-blind procedure. At the end of the 12-week study period the plaque index showed no changes in both groups. The gingivitis and bleeding indices decreased significantly (p<0.001) by 40% in both groups compared to the baseline examination.
Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece
This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836
Frencken, Jo E; Peters, Mathilde C; Manton, David J; Leal, Soraya C; Gordan, Valeria V; Eden, Ece
This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the 'surgical' care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing.
A bronze plaque erected to the memory of N.-L. de La Caille near the site of his observatory in Central Cape Town, has been stolen by metal thieves. It was designed by the famous architect Sir Herbert Baker.
Holcombe, Lucy J.; Patel, Niran; Colyer, Alison; Deusch, Oliver; O’Flynn, Ciaran; Harris, Stephen
Periodontal disease (PD) is a significant problem in dogs affecting between 44% and 63.6% of the population. The main etiological agent for PD is plaque, a microbial biofilm that colonizes teeth and causes inflammation of the gingiva. Understanding how this biofilm initiates on the tooth surface is of central importance in developing interventions against PD. Although the stages of plaque development on human teeth have been well characterized little is known about how canine plaque develops. Recent studies of the canine oral microbiome have revealed distinct differences between the canine and human oral environments and the bacterial communities they support, particularly with respect to healthy plaque. These differences mean knowledge about the nature of plaque formation in humans may not be directly translatable to dogs. The aim of this study was to identify the bacterial species important in the early stages of canine plaque formation in vivo and then use isolates of these species in a laboratory biofilm model to develop an understanding of the sequential processes which take place during the initial colonization of enamel. Supra-gingival plaque samples were collected from 12 dogs at 24 and 48 hour time points following a full mouth descale and polish. Pyrosequencing of the 16S rDNA identified 134 operational taxonomic units after statistical analysis. The species with the highest relative abundance were Bergeyella zoohelcum, Neisseria shayeganii and a Moraxella species. Streptococcal species, which tend to dominate early human plaque biofilms, had very low relative abundance. In vitro testing of biofilm formation identified five primary colonizer species, three of which belonged to the genus Neisseria. Using these pioneer bacteria as a starting point, viable two and three species communities were developed. Combining in vivo and in vitro data has led us to construct novel models of how the early canine plaque biofilm develops. PMID:25463050
Wang, Jinfeng; Qi, Ji; Zhao, Hui; He, Shu; Zhang, Yifei; Wei, Shicheng; Zhao, Fangqing
Although attempts have been made to reveal the relationships between bacteria and human health, little is known about the species and function of the microbial community associated with oral diseases. In this study, we report the sequencing of 16 metagenomic samples collected from dental swabs and plaques representing four periodontal states. Insights into the microbial community structure and the metabolic variation associated with periodontal health and disease were obtained. We observed a strong correlation between community structure and disease status, and described a core disease-associated community. A number of functional genes and metabolic pathways including bacterial chemotaxis and glycan biosynthesis were over-represented in the microbiomes of periodontal disease. A significant amount of novel species and genes were identified in the metagenomic assemblies. Our study enriches the understanding of the oral microbiome and sheds light on the contribution of microorganisms to the formation and succession of dental plaques and oral diseases. PMID:23673380
Assessment of the periodontium has relied exclusively on a variety of physical measurements (e.g., attachment level, probing depth, bone loss, mobility, recession, degree of inflammation, etc.) in relation to various case definitions of periodontal disease. Periodontal health was often an afterthought and was simply defined as the absence of the signs and symptoms of a periodontal disease. Accordingly, these strict and sometimes disparate definitions of periodontal disease have resulted in an idealistic requirement of a pristine periodontium for periodontal health, which makes us all diseased in one way or another. Furthermore, the consequence of not having a realistic definition of health has resulted in potentially questionable recommendations. The aim of this manuscript was to assess the biological, environmental, sociological, economic, educational and psychological relationships that are germane to constructing a paradigm that defines periodontal health using a modified wellness model. The paradigm includes four cardinal characteristics, i.e., 1) a functional dentition, 2) the painless function of a dentition, 3) the stability of the periodontal attachment apparatus, and 4) the psychological and social well-being of the individual. Finally, strategies and policies that advocate periodontal health were appraised. I'm not sick but I'm not well, and it's a sin to live so well. Flagpole Sitta, Harvey Danger PMID:26390888
Larjava, Hannu; Koivisto, Leeni; Heino, Jyrki; Häkkinen, Lari
Cell surface integrin receptors mediate cell adhesion, migration and cellular signaling in all nucleated cells. They are activated by binding to extracellular ligands or by intracellular proteins, such as kindlins that engage with their cytoplasmic tails. Cells in the periodontal tissues express several integrins with overlapping ligand-binding capabilities. A distinct phenotype in the periodontium has only been described for knockouts or mutations of three integrin subunits, α11, β6 and β2. Integrin α11β1 appears to have some regulatory function in the periodontal ligament of continuously erupting incisors in mice. Integrin αvβ6 is expressed in the junctional epithelium (JE) of the gingiva. Animals deficient in this receptor develop classical signs of periodontal disease, including inflammation, apical migration of the JE and bone loss, suggesting that it plays a role in the regulation of periodontal inflmmation, likely through activation of transforming growth factor-β1. Lack of integrin activation in the JE is also associated with periodontitis. Patients with kindlin-1 mutations have severe early-onset periodontal disease. Finally, patients with mutations in the leukocyte-specific β2 integrin subunit have severe periodontal problems due to lack of transiting neutrophils in the periodontal tissues.
Suzuki, Jun-Ichi; Sato, Hiroki; Kaneko, Makoto; Yoshida, Asuka; Aoyama, Norio; Akimoto, Shouta; Wakayama, Kouji; Kumagai, Hidetoshi; Ikeda, Yuichi; Akazawa, Hiroshi; Izumi, Yuichi; Isobe, Mitsuaki; Komuro, Issei
There is a deep relationship between cardiovascular disease and periodontitis. It has been reported that myocardial hypertrophy may be affected by periodontitis in clinical settings. Although these clinical observations had some study limitations, they strongly suggest a direct association between severity of periodontitis and left ventricular hypertrophy. However, the detailed mechanisms between myocardial hypertrophy and periodontitis have not yet been elucidated. Recently, we demonstrated that periodontal bacteria infection is closely related to myocardial hypertrophy. In murine transverse aortic constriction models, a periodontal pathogen, Aggregatibacter actinomycetemcomitans markedly enhanced cardiac hypertrophy with matrix metalloproteinase-2 activation, while another pathogen Porphyromonas gingivalis (P.g.) did not accelerate these pathological changes. In the isoproterenol-induced myocardial hypertrophy model, P.g. induced myocardial hypertrophy through Toll-like receptor-2 signaling. From our results and other reports, regulation of chronic inflammation induced by periodontitis may have a key role in the treatment of myocardial hypertrophy. In this article, we review the pathophysiological mechanism between myocardial hypertrophy and periodontitis.
Khanal, S; Acharya, J
Oral health is an essential component of health throughout life. There has been a decline in dental caries and periodontal disease in developed countries which can be attributed to the implementation of preventive programmes but in developing countries dental diseases are still on the rise. Therefore this cross sectional study was carried out to assess the prevalence of dental caries and oral hygiene practices among 12 to 15 years old children. Self administered close ended questionnaires were used to assess the oral hygiene practice. The overall dental caries prevalence was 58.3% and the mean DMFT score was 1.2 (± 1.79) and the deft score was 0.6 (± 1.24). Majority of the children (84.1%) presented with the practice of brushing their teeth once everyday using tooth brush and toothpaste. Regular dental check up was very poor (5.6%) but 77.4% reported that they visited a dentist in case of pain or presence of stains in the teeth. Females (63.4%) and children studying in higher secondary class (74.2%) showed a "good" level of oral hygiene practice than males and children in secondary class respectively. Children having "good" practice presented with "low" dental caries severity. The utilization of dental services was poor in the children, therefore highlighting the necessity to implement preventive programmes is important which would help in reducing the incidence of the dental caries as well as aiding in prompt treatment of dental caries at its initial stages.
Indurkar, Maya Sanjeev; Verma, Renu
Background: Several chemotherapeutic agents have been developed to prevent gingivitis and its progression into periodontitis. In this present study, the efficacy of ozonated oil and chlorhexidine gel was assessed and compared on plaque induced gingivitis. Aim: To evaluate the effect of ozonated oil on plaque induced gingivitis and to compare its efficacy with chlorhexidine gel. Materials and Methods: A total of 20 subjects, aged from 18 to 65 years, with plaque-induced gingivitis were selected from the outpatient Department of Periodontology, Government Dental College and Hospital, Aurangabad, for this study. They were divided randomly into the test or ozonated oil group (Group I) and the control or chlorhexidine gel group (Group II) with 10 subjects in each group. Subjects were randomly assigned to massage their gingiva thrice a day for 3 weeks with ozonated oil (test), and chlorhexidine gel (control). Plaque index and gingival index scores were recorded for the 20 subjects at baseline and after 3 weeks. Results: Ozonated oil (Group I) and chlorhexidine gel (Group II) groups showed statistically significant differences with respect to plaque index and gingival index, from the baseline to 3 weeks (P < 0.001 in both). But the difference between Group I and Group II, at the end of the study period, was not statistically significant with respect to the plaque index and gingival index. Conclusions: The ozonated oil and chlorhexidine gel, both can be used as an effective agent in maintaining and improving gingival health. PMID:27041835
Hugoson, A; Schmidt, G
The aim of this investigation was to induce alveolar bone defects experimentally in dogs and to study the effects of mechanical tooth cleaning on their subsequent development. Thirty premolars from four beagle dogs were used. Bone defects were created by surgically exposing the adjacent alveolar bone and applying steel or silk ligatures around the roots of the chosen teeth. After 8 weeks the ligatures were removed. Dental plaque was allowed to accumulate on 20 premolars whereas daily plaque elimination by toothbrushing was carefully performed on 10 premolars. After 1, 3, and 6 months of plaque accumulation, gingival inflammation, periodontal pocket depth, gingival recession and the radiographically observed degree of bone destruction were registered. Histological examination was performed in conjunction with the registrations made 6 months after removal of the ligatures. The clinical, radiographic and histologic findings all confirm that a regeneration of the experimentally induced destruction of the periodontal tissues had taken place. This reaction was most evident in teeth exposed to mechanical plaque control. The remaining bone defects were consistently accompanied by recession of the gingival margin.
Lindinger, Michael I
The results of an exploratory, multicenter clinical study confirmed the hypothesis that a novel, natural, and safe oral care product (OCP) reduced the rate of plaque formation on teeth of dogs consuming the OCP (antimicrobial plant-derived enzymes, organic matcha green tea, cultured dextrose, sodium bicarbonate, and ascorbic acid) compared to controls. Healthy dogs without periodontitis, of varying breeds, sex, and age, were recruited and enrolled, using nonrandomized stratification methods, into a control and treatment groups. Treatment group dogs drank only water into which OCP was suspended, for 28 days. Control group dogs drank their normal household water. On day 0 all teeth were cleaned by a veterinarian and gingivitis was assessed. On days 14, 21, and 28 plaque index, plaque thickness, gingivitis, freshness of breath, and general health were assessed. Over the 28 days of study, dogs on the OCP had significant reduction in plaque index and plaque thickness compared to controls. By day 14 OCP reduced plaque formation by 37%; the 28-day reduction in plaque index and coverage averaged 22% with no measurable gingivitis or calculus. Conclusion. Using the OCP attenuated dental plaque formation when consumed as normal drinking water and in the absence of other modes of oral care.
The results of an exploratory, multicenter clinical study confirmed the hypothesis that a novel, natural, and safe oral care product (OCP) reduced the rate of plaque formation on teeth of dogs consuming the OCP (antimicrobial plant-derived enzymes, organic matcha green tea, cultured dextrose, sodium bicarbonate, and ascorbic acid) compared to controls. Healthy dogs without periodontitis, of varying breeds, sex, and age, were recruited and enrolled, using nonrandomized stratification methods, into a control and treatment groups. Treatment group dogs drank only water into which OCP was suspended, for 28 days. Control group dogs drank their normal household water. On day 0 all teeth were cleaned by a veterinarian and gingivitis was assessed. On days 14, 21, and 28 plaque index, plaque thickness, gingivitis, freshness of breath, and general health were assessed. Over the 28 days of study, dogs on the OCP had significant reduction in plaque index and plaque thickness compared to controls. By day 14 OCP reduced plaque formation by 37%; the 28-day reduction in plaque index and coverage averaged 22% with no measurable gingivitis or calculus. Conclusion. Using the OCP attenuated dental plaque formation when consumed as normal drinking water and in the absence of other modes of oral care. PMID:27867678
Tooth brushing is considered a superior technique for reducing plaque accumulation. Other methods of maintaining oral hygiene have been investigated since many owners may not be willing or able to brush their dog's teeth. Following a professional teeth cleaning procedure, 11 dogs were offered a rawhide dental chew BID for 7-days, while 11 other dogs were fed the same diet without receiving the chew device. Dogs in the treatment group had significantly less plaque formation during the trial period compared with dogs in the control group. The rawhide dental chew provided in the study reported here decreases plaque formation in the short-term and may be beneficial in the prevention of progressive periodontal disease associated with attachment loss if provided on a long-term basis.
Bertoncini, C. A.; Hinders, M. K.
Periodontal disease, commonly known as gum disease, affects millions of people. The current method of detecting periodontal pocket depth is painful, invasive, and inaccurate. As an alternative to manual probing, an ultrasonographic periodontal probe is being developed to use ultrasound echo waveforms to measure periodontal pocket depth, which is the main measure of periodontal disease. Wavelet transforms and pattern classification techniques are implemented in artificial intelligence routines that can automatically detect pocket depth. The main pattern classification technique used here, called a binary classification algorithm, compares test objects with only two possible pocket depth measurements at a time and relies on dimensionality reduction for the final determination. This method correctly identifies up to 90% of the ultrasonographic probe measurements within the manual probe's tolerance.
Levrini, Luca; Novara, Francesca; Margherini, Silvia; Tenconi, Camilla; Raspanti, Mario
Background Advances in orthodontics are leading to the use of minimally invasive technologies, such as transparent removable aligners, and are able to meet high demands in terms of performance and esthetics. However, the most correct method of cleaning these appliances, in order to minimize the effects of microbial colonization, remains to be determined. Purpose The aim of the present study was to identify the most effective method of cleaning removable orthodontic aligners, analyzing the growth of dental plaque as observed under scanning electron microscopy. Methods Twelve subjects were selected for the study. All were free from caries and periodontal disease and were candidates for orthodontic therapy with invisible orthodontic aligners. The trial had a duration of 6 weeks, divided into three 2-week stages, during which three sets of aligners were used. In each stage, the subjects were asked to use a different method of cleaning their aligners: 1) running water (control condition); 2) effervescent tablets containing sodium carbonate and sulfate crystals followed by brushing with a toothbrush; and 3) brushing alone (with a toothbrush and toothpaste). At the end of each 2-week stage, the surfaces of the aligners were analyzed under scanning electron microscopy. Results The best results were obtained with brushing combined with the use of sodium carbonate and sulfate crystals; brushing alone gave slightly inferior results. Conclusion On the basis of previous literature results relating to devices in resin, studies evaluating the reliability of domestic ultrasonic baths for domestic use should be encouraged. At present, pending the availability of experimental evidence, it can be suggested that dental hygienists should strongly advise patients wearing orthodontic aligners to clean them using a combination of brushing and commercially available tablets for cleaning oral appliances. PMID:26719726
Hayakawa, Hiroki; Ota, Kei; Ida, Atsushi; Fujinami, Koushu; Furusawa, Masahiro; Makiishi, Takemi; Nikaido, Masahiko; Ichinohe, Tatsuya; Saito, Atsushi
The aim of the present study was to investigate the profile of surgical periodontal therapy performed at the Suidobashi Hospital of Tokyo Dental College, during the period of April 2010 through March 2011. A total of 112 periodontal surgeries in 69 patients (mean age: 51.4 years; 28 men and 41 women) were registered for the data analysis. The surgical interventions performed by 17 dentists comprised 79 cases of open flap debridement, 27 cases of periodontal regenerative therapy with enamel matrix derivative and 6 cases of periodontal plastic surgery. Eighty percent of the surgical sites were in the molar region and 41 cases had furcation involvement. In these patients, an improvement in oral hygiene status was observed prior to surgery: the mean plaque score of 45% at initial visit was significantly reduced to 31% after initial periodontal therapy (p<0.01). At sites that subsequently received open flap debridement or periodontal regenerative therapy, the mean probing depth and clinical attachment level after initial therapy was 6.4 mm and 7.6 mm, respectively. These values were significantly lower than those at initial visit (p<0.01). Lower prevalence of sites with positive bleeding on probing was observed after initial therapy. The initial periodontal therapy performed was considered to be effective in improving the periodontal condition of the sites prior to surgery. More effort, however, is indicated in improvement of patient oral hygiene status.
Chen, Xi; Wu, Guofeng; Feng, Zhihong; Dong, Yan; Zhou, Wei; Li, Bei; Bai, Shizhu; Zhao, Yimin
Periodontal disease is considered as a widespread infectious disease and the most common cause of tooth loss in adults. Attempts for developing periodontal disease treatment strategies, including drug delivery and regeneration approaches, provide a useful experimental model for the evaluation of future periodontal therapies. Recently, emerging advanced biomaterials including hydrogels, films, micro/nanofibers and particles, hold great potential to be utilized as cell/drug carriers for local drug delivery and biomimetic scaffolds for future regeneration therapies. In this review, first, we describe the pathogenesis of periodontal disease, including plaque formation, immune response and inflammatory reactions caused by bacteria. Second, periodontal therapy and an overview of current biomaterials in periodontal regenerative medicine have been discussed. Third, the roles of state-of-the-art biomaterials, including hydrogels, films, micro/nanofibers and micro/nanoparticles, developed for periodontal disease treatment and periodontal tissue regeneration, and their fabrication methods, have been presented. Finally, biological properties, including biocompatibility, biodegradability and immunogenicity of the biomaterials, together with their current applications strategies are given. Conclusive remarks and future perspectives for such advanced biomaterials are discussed.
Roman-Torres, Caio V.G; Neto, José S; Souza, Marcio A; Schwartz-Filho, Humberto O; Brandt, William C; Diniz, Ricardo E.A.S
aim of this study was to evaluate the efficacy of periodontal scaling and oral hygiene instruction for patients with mild chronic periodontitis and rheumatoid arthritis through clinical periodontal parameters and laboratory tests for CRP (C- reactive protein) and ESR (erythrocyte sedimentation rate). Twelve individuals with rheumatoid arthritis and 12 healthy individuals were evaluated, with a mean age of 45.38 and 46.75 respectively, all female and with mild, chronic periodontitis. The participants were evaluated clinically and periapical radiographs were taken (T1), after which periodontal treatment was instituted. After ninety days (T2), new clinical and laboratory data were obtained. Probing depth, bleeding index, and plaque indexes were observed in both groups, and the results demonstrated reductions but no statistical differences. Laboratory tests for CRP and ESR produced higher values for the rheumatoid arthritis group with T1- T2 reductions on the average, but the values were still higher than in the health group. We conclude that periodontal therapy in patients with rheumatoid arthritis and mild chronic periodontitis showed a improvement in the periodontal clinical parameters and laboratory tests that were evaluated. PMID:26140059
Chaturvedi, Thakur Prasad; Srivastava, Ruchi; Srivastava, Anand Kumar; Gupta, Varun; Verma, Pushpendra Kumar
Aim: Prevention of periodontal disease progression is the primary goal of periodontal therapy. When conventional therapy is found to be inadequate in achieving periodontal health in chronic periodontitis, local antimicrobial agents are used as an adjunct to scaling and root planing (SRP), which produces encouraging results. In the present study, an attempt was made to develop a low-dose controlled-release delivery system for the treatment of periodontal infections. A new sustained release drug system of poly e-caprolactone (PCL) nanofibers containing metronidazole (MET) was successfully electrospun and evaluated clinically for periodontal diseases. The retentive nanofibres were shown to provide a controlled delivery of the drugs. Materials and Methods: Nanofibers were prepared with MET in PCL by electrospinning technique. The drug-coated nanofibers provided sustained effect up to a period of 11 days (264 h) and followed first-order release. Forty sites in seven patients (four females and three males) with chronic periodontitis (5–8 mm probing depth) were allocated in two experimental treatment groups: Group A treated with SRP + MET nanofibers and Group B treated with SRP alone (control group). All these patients were evaluated clinically for probing depth (PD), plaque index (PI), and gingival index (GI). Results: Both the treatment groups were found to be efficacious in the treatment of periodontal disease as demonstrated by improvement in PD, PI, and GI. Conclusion: Combination of SRP + MET nanofibers (Group A) resulted in added benefits, compared to the control group. PMID:23580938
Heikkinen, Anna Maria; Pitkäniemi, Janne; Kari, Kirsti; Pajukanta, Riitta; Elonheimo, Outi; Koskenvuo, Markku; Meurman, Jukka H
The aim of our study was to investigate how teenage smoking affects the prevalence of periodontal bacteria and periodontal health with the hypothesis that smoking increases the prevalence of the bacteria. Oral health of 264 adolescents (15- to 16-year-olds) was clinically examined, and their smoking history was recorded. The participants also filled in a structured questionnaire recording their general health and health habits. Pooled subgingival plaque samples were taken for polymerase chain reaction analysis of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens, and Treponema denticola. The prevalence of P. intermedia (21% vs. 4%, p = 0.01) and T. forsythia and T. denticola (23% vs. 8%, p < 0.05, for both) was higher among female smokers than among non-smokers. T. forsythia and T. denticola were more often associated with bleeding on probing (29% vs. 12%; 25% vs. 10%, respectively) and deep pockets (25% vs. 15%; 23% vs. 10%, respectively) with smokers than non-smokers. Among the girls, a significant association was found between pack-years and the prevalence of P. nigrescens (p < 0.007). In both genders, A. actinomycetemcomitans and P. gingivalis were rare in this study. To conclude, periodontal bacteria were associated with higher periodontal index scores among all teenage smokers. Smoking girls harbored more frequently certain periodontal bacteria than non-smokers, but this was not seen in boys. Hence, our study hypothesis was only partly confirmed.
Latif, Sajith Abdul; Vandana, K. L.; Thimmashetty, J.; Dalvi, Priyanka Jairaj
Aim: This study aims to explore the clinical, microbiological, and biochemical impact of azithromycin (AZM) buccal patch in chronic generalized patients as a monotherapy as well as an adjunct to nonsurgical therapy. Materials and Methods: A parallel design was used forty periodontitis patients were randomly allocated into five groups, namely Group 1 scaling root planing (SRP) alone, Group 2 (SRP + AZM patch group), Group 3 (SRP + AZM tablet group), Group 4 (AZM patch monotherapy), and Group 5 (AZM tablet as monotherapy). Plaque index, gingival bleeding index, modified gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and 21 and 90 days. Subgingival pooled plaque sample was collected to assess periodontopathogens like Porphyromonas gingivalis and Prevotella intermedia (Pi) by anaerobic culture method. Tumor necrosis factor alpha (TNF-α) was also evaluated at baseline and 21 days. Periodontal maintenance was performed in Group 1 until 90th day, and clinical parameter was assessed at the end of 90th day. Results: SRP + AZM tablets showed greater reduction in clinical parameters (P < 0.05) AZM as monotherapy did not offer clinical benefits over SRP. Baseline data were compared at the end, i.e., 90th day a significant reduction in plaque scores, gingival bleeding, and PPD was observed however no significant gain in the clinical attachment was observed. Conclusion: The monotherapy resulted in no improvement of periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients. PMID:27127325
Background Cement dust contains heavy metals like nickel, cobalt, lead and chromium, pollutants hazardous to the biotic environment, with adverse impact for vegetation, human and animal health and ecosystems. Objective To investigate if long term exposure to cement dust can affect the periodontal health and affect the outcome of non-surgical periodontal therapy. Methods A total of sixty subjects were included in this study. Forty patients with chronic periodontitis were grouped into; Group I comprised of 20 patients with chronic periodontitis working in the Portland Cement Company and Group II comprised of 20 patients with chronic periodontitis who does not work in cement factories nor live near any of them. Twenty healthy subjects were included in this study as healthy control group (Group III). Clinical parameters including gingival index (GI), plaque index (PI), pocket depth (PD) and clinical attachment loss (CLA) were scored for all patients before and after periodontal therapy. All patients received non-surgical periodontal therapy together with strict oral hygiene program for one month. Gingival crevicular fluid (GCF) samples were collected from both groups at baseline and one month after periodontal therapy. Real time PCR (RT-PCR) was used to analyze the GCF samples for detection and assessment of the levels of IL-1β and TNFα. Results The two studied groups responded well to non-surgical periodontal treatment and there was no significant difference between GI and GII (P>0.05). The levels of TNFα was higher in GI than in GII before and after periodontal therapy (P<0.05). The levels of IL-1β did not show any significant difference between the two groups at base line (P>0.05), but represented with a highly significant difference between G1 and GII after periodontal therapy (P<0.001). A significant positive correlation was found between the levels of both IL-1β and TNFα and all the clinical parameters in GI before and after periodontal therapy and in GII
Traumatic tooth fractures, dental caries, and overzealous tooth preparations can lead to the loss of coronal tooth structure, thus complicating the definitive prosthetic plan. Although exposure of additional clinical tooth structure by surgical crown lengthening is often recommended, such an approach is usually discouraged because of the possible adverse periodontal changes to the adjacent teeth and compromised esthetics, especially in the presence of an otherwise intact arch. This article discusses the application of orthodontic extrusion to conservatively restore a single tooth with minimal coronal tooth structure in the esthetic zone. A detailed description of the prosthetic approach used before, during, and after orthodontic therapy is presented.
Janakiram, Chandrashekar; Deepan Kumar, C. V.; Joseph, Joe
Xylitol is a sugar alcohol having the properties that reduce levels of mutans streptococci (MS) in the plaque and saliva. To assess the role of xylitol in preventing dental caries. Systematic review and meta-analysis developed by Cochrane cooperation were adapted. Electronic search was carried out in PubMed through the period up to 2014. Included clinical studies were done on (1) humans (2) participants include both individuals and as pairs (mother-child) (3) participants using orthodontic appliances (4) xylitol dispensed in any form (5) compare the effect of xylitol on dental caries and on other phenotype that determines the preventive effect on dental caries, such as decayed, missing, and filled (DMF/dmf) and salivary or plaque MS level. Twenty articles of the 477 articles initially identified. Among 20 studies indexed, 16 articles were accessed, systematically reviewed, and the meta-analysis was carried out. The evaluation of quality of the studies was done using risk of bias assessment tool. The quality of the studies was high risk and unclear risk for six and five trials. The meta-analysis shows a reduction in DMF/dmf with the standard mean (SM) of −1.09 (95% confidence interval [95% CI], −1.34, −0.83) comparing xylitol to all controls. The effect of DMF/dmf reduction by xylitol to fluoride varnish was with the SM of −1.87 (95% CI, −2.89, −0.84). The subgroup analysis, there was a reduction in MS count with SM of 0.30 (95% CI, 0.05, 0.56) when compared with all other caries preventive strategies; however, it was insignificant. Xylitol was found to be an effective strategy as self-applied caries preventive agent. PMID:28250669
Backlund, C.J.; Sergesketter, A.R.; Offenbacher, S.; Schoenfisch, M.H.
Current treatments for periodontitis (e.g., scaling/root planing and chlorhexidine) have limited efficacy since they fail to suppress microbial biofilms satisfactorily over time, and the use of adjunctive antimicrobials can promote the emergence of antibiotic-resistant organisms. Herein, we report the novel application of nitric oxide (NO)-releasing scaffolds (i.e., dendrimers and silica particles) as anti-periodontopathogenic agents. The effectiveness of macromolecular NO release was demonstrated by a 3-log reduction in periodontopathogenic Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis viability. In contrast, Streptococcus mutans and Streptococcus sanguinis, caries-associated organisms, were substantially less sensitive to NO treatment. Both dendrimer- and silica-based NO release exhibited substantially less toxicity to human gingival fibroblasts at concentrations necessary to eradicate periodontopathogens than did clinical concentrations of chlorhexidine. These results suggest the potential utility of macromolecular NO-release scaffolds as a novel platform for the development of periodontal disease therapeutics. PMID:25139363
Fontana, C. R.; Abernethy, A. D.; Som, S.; Ruggiero, K.; Doucette, S.; Marcantonio, R. C.; Boussios, C. I.; Kent, R.; Goodson, J. M.; Tanner, A. C. R.; Soukos, N. S.
Background and Objective Photodynamic therapy (PDT) has been advocated as an alternative to antimicrobial agents to suppress subgingival species and treat periodontitis. Bacteria located within dense biofilms, such as those encountered in dental plaques, have been found to be relatively resistant to antimicrobial therapy. In the present study, we investigated the ability of PDT to affect bacteria resistant in biofilms by comparing the photodynamic effects of methylene blue (MB) on human dental plaque microorganisms in planktonic phase and in biofilms. Material and Methods Dental plaque samples were obtained from 10 subjects with chronic periodontitis. Suspensions of plaque microorganisms from 5 subjects were sensitized with MB (25 μg/ml) for 5 minutes followed by exposure to red light. Multi-species microbial biofilms developed from the same plaque samples were also exposed to MB (25 μg/ml) and the same light conditions as their planktonic counterparts. In a second set of experiments, biofilms were developed with plaque bacteria from 5 subjects and sensitized with 25 and 50 μg/ml MB followed by exposure to light as above. After PDT, survival fractions were calculated from colony-forming unit counts. Results In suspension, PDT produced approximately 63% killing of bacteria. In biofilms, the effect of PDT resulted in much lower reductions of microorganisms (32% maximal killing). Conclusion Oral bacteria in biofilms are less affected by PDT than bacteria in planktonic phase. The antibacterial effect of PDT is reduced in biofilm bacteria but not to the same degree as has been reported for treatment with antibiotics under similar conditions. PMID:19602126
Krausz, E; Einy, S; Aizenbud, D; Levin, L
Orthodontic treatment poses a significant challenge in patients suffering from periodontal disease. Providing orthodontic treatment to periodontal patients should be carefully planned and performed in a tight collaboration between the orthodontist and periodontist. Resolution and stabilization of the periodontal condition is a pre-requisite for orthodontic treatment initiation. Careful oral hygiene performance and highly frequent recall periodontal visits are also crucial. Pre- or post- orthodontic periodontal surgery might help providing better treatment outcomes.
Kunin, Anatoly A.; Shumilovitch, Bogdan R.; Stepanov, Nicolay N.
Favorable clinical data at the absence of positive dynamics microbiological research findings in the treatment of caries and their complications give a reason to consider the treatment insufficiently effective and it is necessary to reduce the terms of an additional prophylactic observation and an antirelapse treatment of the disease. That is why researchers all over the world search for new effective methods of influence on the microflora of carious foci. Using the experience of the treatment of 40 patients with caries, 40 patients with chronic pulpitis, and 40 with chronic periodontitis high bactericidal properties of low intensive laser radiation are shown. If after the traditional treatment of foci microflora was inoculated in 62.3% of the cases, after the laser therapy session -- in 26.3% of the cases. The efficiency, ease of handling, and low expenditure of time allow us to recommend this method for a massive use in the treatment of caries and their complications.
Berg, Joel H
The number of new technologies emerging each year in the realm of dental caries management is growing at an exponential rate. Examining the patent literature, one can see that this growth rate will likely continue, with the outcome that dentistry will see an expanded growth in managing dental caries by risk assessment with medicinal therapeutic interventions. Restorative dentistry solutions, treating the results of dental caries, will continue to grow, while technologies to identify the caries process at its earliest stages will soon invade practices everywhere. The most interesting aspect of these changes will be how industry responds to the inexorable, yet slow change in dental professional demand for these new technologies, while trying to be the "first to market" within the various categories of this business opportunity. This paper will take a close look at how businesses with the core competence to be key players in this emerging growth category will assess the marketplace, and match up their business interests with the changing needs of the dental profession. The paper will also address the strategic planning and business processes that the dental industry will undertake to bring new technologies to market, and how these technologies will be positioned to health care professionals and consumers. The results of the key interactions between industry and the dental profession will determine the extent to which dental caries is managed as a disease, in addition to being managed by surgical restorative interventions. PMID:16934123
Khosropanah, Hengameh; Karandish, Maryam; Ziaeyan, Mazyar; Jamalidoust, Marzieh
Background: Although studies focused mainly on the identification of periopathogenic bacteria, recent reports have suggested that various herpes viruses may also be involved in the occurrence and progression of different forms of periodontal diseases. Objectives: This study aimed to compare the prevalence and load of Epstein-Barr Virus (EBV) and Human Cytomegalovirus (HCMV) in subgingival tissue specimens between chronic periodontitis and healthy sites. Patients and Methods: A total of 60 samples from the systematically healthy patients with chronic periodontitis participated in this study (mean age, 35 ± 7). Clinical periodontal evaluation included the plaque index (PI) (Loe and Silness), bleeding on probing (BOP) (O’Leary), bleeding index, periodontal pocket depth (PPD) and clinical attachment level measurement. Tissue specimens harvested from > 6 mm periodontal pockets and from ≤ 3 mm sulcus depth in a quadrant of the same patient using periodontal curettes. Moreover, the unstimulated whole saliva was gathered as a shedding medium. A Taq-man Real-Time Polymerase Chain Reaction assay was used to identify genomic copies of periodontal HCMV and EBV. Data were analyzed by the Wilcoxon-signed ranks and Friedman tests using the SPSS 16 software. Results: Out of 60 samples of subgingival tissues taken from the patients with chronic periodontitis, EBV count was the highest in saliva and the least in the tissue sample with PD < 3 mm (P < 0.05). The highest HCMV count was in saliva and tissue samples with PD > 6 mm (P < 0.05). Conclusions: According to the results of this study, quantification of HCMV and EBV observed in this study is high in periodontal tissue samples of severe chronic periodontitis. PMID:26322203
Kumar, Santhosh; Dagli, Rushabh J; Dhanni, Chandrakant; Duraiswamy, Prabu
It is evident from literature that an increased body mass index (BMI) may be a potential risk factor for periodontitis. Association between BMI and periodontitis has been ascribed to unhealthy dietary patterns with insufficient micronutrients and excess sugar and fat content. The present study population has been plagued by unhealthy nutritional practices, hence the present study intended to assess the relation between BMI and periodontal status among green marble mine laborers of Kesariyaji, in the Udaipur district of Rajasthan, India. The study sample comprised of 513 subjects aged 18-54 years, drawn using the stratified cluster sampling procedure. BMI was calculated as the ratio of the subject's body weight (in kg) to the square of their height (in meters). Periodontal status was recorded using the Community Periodontal Index (CPI). Binary multiple logistic regression analysis was executed to assess the relation between body mass index and periodontitis. The dependent variable for logistic regression analysis was categorized into control group (scores 0 - 2 of the CPI) and periodontitis group (scores 3 and 4 of the CPI). The overall prevalence of periodontal disease was 98.2%. Caries status and mean number of teeth present deteriorated with the poor periodontal status. Subjects had an increased risk of periodontitis by 57% for each 1kg/m(2) increase in the body mass index, which means that a higher body mass index could be a potential risk factor for periodontitis among the adults aged 18 to 54 years. In conclusion, evaluation of the body mass index could be used in periodontal risk assessment.
Annegarn, H. J.; Jodaikin, A.; Cleaton-Jones, P. E.; Sellschop, J. P. F.; Madiba, C. C. P.; Bibby, D.
PIXE analysis has been applied to a set of twenty human teeth to determine trace element concentration in enamel from areas susceptible to dental caries (mesial and distal contact points) and in areas less susceptible to the disease (buccal surfaces), with the aim of determining the possible roles of trace elements in the curious process. The samples were caries-free anterior incisors extracted for periodontal reasons from subjects 10-30 years of age. Prior to extraction of the sample teeth, a detailed dental history and examination was carried out in each individual. PIXE analysis, using a 3 MeV proton beam of 1 mm diameter, allowed the determination of Ca, Mn, Fe, Cu, Zn, Sr and Pb above detection limits. As demonstrated in this work, the enhanced sensitivity of PIXE analysis over electron microprobe analysis, and the capability of localised surface analysis compared with the pooled samples required for neutron activation analysis, makes it a powerful and useful technique in dental analysis.
Rohini, G.; Kalaivani, S.; Kumar, Vipin; Rajasekar, S. A.; Tuckaram, Jaishree; Pandey, Vinisha
Introduction: Psychological conditions, particularly psychosocial stress have been implicated as risk indicators of periodontal disease. Stress increases cortisol production from the adrenal cortex by stimulating an increase in the release of ACTH from the pituitary gland. Increased cortisol production suppresses the immune response and increases the potential of periodontal tissue destruction. Aim: The aim of the present study was to estimate and compare the serum cortisol levels in periodontally diseased patients and periodontally healthy individuals. Materials and Methods: Total of 45 subjects were recruited for this study and were categorized into three groups. Group I - Comprised of aggressive periodontitis patients (n = 15), Group II - Chronic periodontitis patients (n = 15), and Group III - Healthy controls (n = 15). Serum samples were collected from each of the groups and cortisol levels were determined using cortisol immunoassay kit. Clinical examination covered probing depth, gingival index (GI), gingival recession, plaque index, and clinical attachment level. The statistical analysis was done using nonparameteric t-test and Spearman's rank correlation coefficient. Results: With respect to cortisol, the levels were higher in Group-I compared to the other groups. On comparison of mean cortisol levels among the groups, the values were statistically significant between Group-I and Group-III. Group-I showed a significant negative correlation between cortisol levels and GI. Conclusion: Within the limits of the study serum cortisol levels was higher in the chronic periodontitis group compared to the other groups. Positive correlation was found between the cortisol levels and other clinical parameters except for the GI. PMID:26538897
Rechmann, P.; Liou, Shasan W.; Rechmann, Beate M.; Featherstone, John D.
Gingivitis due to microbial plaque and calculus can lead over time if left untreated to advanced periodontal disease with non-physiological pocket formation. Removal of microbial plaque in the gingivitis stage typically achieves gingival health. The SOPROCARE camera system emits blue light at 450 nm wavelength using three blue diodes. The 450 nm wavelength is located in the non-ionizing, visible spectral wavelength region and thus is not dangerous. It is assumed that using the SOPROCARE camera in perio-mode inflamed gingiva can easily be observed and inflammation can be scored due to fluorescence from porphyrins in blood. The assumption is also that illumination of microbial plaque with blue light induces fluorescence due to the bacteria and porphyrin content of the plaque and thus can help to make microbial plaque and calculus visible. Aim of the study with 55 subjects was to evaluate the ability of the SOPROCARE fluorescence camera system to detect, visualize and allow scoring of microbial plaque in comparison to the Turesky modification of the Quigley and Hein plaque index. A second goal was to detect and score gingival inflammation and correlated the findings to the Silness and Löe gingival inflammation index. The study showed that scoring of microbial plaque as well as gingival inflammation levels similar to the established Turesky modified Quigley Hein index and the Silness and Löe gingival inflammation index can easily be done using the SOPROCARE fluorescence system in periomode. Linear regression fits between the different clinical indices and SOPROCARE scores in fluorescence perio-mode revealed the system's capacity for effective discrimination between scores.
Sadeghi, Mehran M; Glover, David K; Lanza, Gregory M; Fayad, Zahi A; Johnson, Lynne L
Identifying patients at high risk for an acute cardiovascular event such as myocardial infarction or stroke and assessing the total atherosclerotic burden are clinically important. Currently available imaging modalities can delineate vascular wall anatomy and, with novel probes, target biologic processes important in plaque evolution and plaque stability. Expansion of the vessel wall involving remodeling of the extracellular matrix can be imaged, as can angiogenesis of the vasa vasorum, plaque inflammation, and fibrin deposits on early nonocclusive vascular thrombosis. Several imaging platforms are available for targeted vascular imaging to acquire information on both anatomy and pathobiology in the same imaging session using either hybrid technology (nuclear combined with CT) or MRI combined with novel probes targeting processes identified by molecular biology to be of importance. This article will discuss the current state of the art of these modalities and challenges to clinical translation.
Kumawat, Ramniwas M.; Ganvir, Sindhu M.; Hazarey, Vinay K.; Qureshi, Asifa; Purohit, Hemant J.
Background: The detection frequency of Porphyromonas gingivalis and Treponema denticola in chronic periodontitis (CP) and aggressive periodontitis (AgP) is not explored well in Indian population. Aim: The study was undertaken to detect P. gingivalis and T. denticola in CP as well as in AgP patients using polymerase chain reaction (PCR), and to determine the relationship between the frequency of these two microorganisms and the severity of clinical periodontal parameters. Materials and Methods: Subgingival plaque samples were collected from ninety participants (thirty CP patients, thirty AgP patients, and thirty healthy participants) and the aforementioned two microorganisms were detected using PCR. Results: However, when CP and AgP were compared for the detection frequency of two microorganisms, no statistically significant difference was noted. A statistically significant increase in the number of bacteria-positive sites increased as the score of plaque index (PI), gingival index (GI), and clinical attachment level of CP and AgP patients increased. Coexistence of P. gingivalis and T. denticola was frequently observed in deep periodontal pockets. Conclusions: Study findings suggest that P. gingivalis and T. denticola are significantly associated with the severity of periodontal tissue destruction. Statistically significant association exists between clinical periodontal parameters such as PI, GI, periodontal pocket depth (PPD), and clinical attachment loss and presence of both the microorganisms. PMID:27994415
Preus, H; Gjermo, P
The development of prepubertal periodontitis in Papillon-Lefévre syndrome (PLS) has been studied in 2 siblings, 12 and 8 years of age, since they were 5 and 3 years of age, respectively. Results of the treatment which comprised mechanical and chemical plaque control as well as systemic tetracycline medication, are reported. Extraction of temporary teeth, resulting in edentulousness prior to eruption of permanent teeth in the youngest child seemed to prevent destructive periodontitis from developing in the permanent dentition. After institution of continuous tetracycline medication in the oldest child at the age of 10 years, periodontitis with attachment loss did not occur in new sites. The possible rôle of specific micro-organisms in the progression of PLS-periodontitis is discussed.
Maeda, Sachiko; Maeda, Yoshinobu; Ono, Yoshihiro; Nakamura, Kimio; Matsui, Tokuo
Patients with a compromised periodontal condition and a breakdown in occlusal support may require periodontal and prosthodontic treatment in conjunction with orthodontic treatment. Orthodontic treatment of these patients is possible and would involve removal of inflammation and occlusal interference and provision of an environment for proper restorative rehabilitation. A different approach to the orthodontic treatment of these patients is required in terms of treatment manner, stabilizing anchorage systems, force systems, retention, and plaque control during treatment. This report describes the case of a 49-year-old woman with severely compromised periodontal tissues, multiple missing teeth, and malocclusion. Highly esthetic and functional results were achieved by treatment with orthodontics as well as periodontal therapy, including guided tissue regeneration and implant restoration with sinus lift.
Sharma, Shivani; Malhotra, Sumit; Baliga, Vidya; Hans, Manoj
Bacterial plaque has been implicated as the primary etiologic factor in the initiation and progression of periodontal disease. Anatomic factors (such as enamel pearls) are often associated with advanced localized periodontal destruction. The phenomenon of ectopic development of enamel on the root surface, variedly referred to as enameloma, enamel pearl, enamel drop or enamel nodule, is not well-understood. Such an anomaly may facilitate the progression of periodontal breakdown. A rare case of enamel pearl on the lingual aspect of mandibular central incisor associated with localized periodontal disease is presented. Removal and treatment of enamel pearl along with possible mechanisms to account for the pathogenesis of ectopic enamel formation are also discussed. PMID:24554894
Newman, M G; Hulem, C; Colgate, J; Anselmo, C
Selected anaerobic, capnophilic and facultative bacteria isolated from patients with various forms of periodontal health and disease were tested for their susceptibility to antibiotics and antimicrobial agents. Specific bactericidal and minimum inhibitory concentrations were compared to disc zone diameters, thereby generating new standards for the potential selection of antimicrobial agents.
Leonhardt, Åsa; Carlén, Anette; Bengtsson, Lisbeth; Dahlén, Gunnar
The aim was to compare the detection frequency of periodontopathogens by using the Pado Test 4.5 and checkerboard DNA-DNA hybridization technique in chronic periodontitis patients. Thirty patients with chronic periodontitis were tested cross-sectionally with DNA/RNA oligogenomic probe method (IAI Pado Test 4.5) and DNA/DNA whole genomic probe (checkerboard) method. Samples were taken by two paper points at the deepest site in each of the four quadrants and pooled into one sample for each of the two methods. The samples were sent to the two laboratories (IAI, Zuchwil, Switzerland, and Oral Microbiology Laboratory, University of Gothenburg, Sweden) and were analyzed in a routine setting for the presence and amount of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. While Pado Test 4.5 detected the four periodontal pathogens in 11 (36.7%) of the patients, the checkerboard method showed presence in all patients (100%) using the lower score (Score 1 corresponding to 104 bacterial cells) and 16 (53.3%) using a higher treshold (score 3 corresponding to between >105 and 106 cells). The results of the present study showed low agreement for a positive microbiological outcome using the two diagnostic methods. It was also concluded that microbiological analysis in practice should include a larger number of bacterial species to better serve as markers for a diseased associated flora in chronic periodontitis cases. PMID:21769304
Joshi, Vinayak Mahableshwar; Bhat, Kishore Gajanan; Kugaji, Manohar Suresh; Ingalgi, Preeti Shivaji
Background: Aggregatibacter actinomycetemcomitans (Aa), an important primary periodontal pathogen, is known for its strong virulence characteristics that cause periodontal disease. We investigated Aa occurrence in Indian individuals using culture and 16 s rDNA polymerase chain reaction (PCR). Materials and Methods: A cross-sectional study with 100 participants each in the healthy and chronic periodontitis (CP) groups was conducted. The subgingival plaque was collected and immediately plated on selective media for Aa. The remaining plaque samples were used for DNA extraction. PCR was performed using specific primers for Aa. Statistical Analysis Used: The detection of bacteria and the clinical parameters between the groups were compared using the Mann–Whitney U-test. For assessing the agreement between the results of anaerobic culture and PCR, Kappa analyses were performed. Results: Aa levels using culture and PCR was 51% and 69% in the CP group and 12% and 30% in the healthy group, respectively. The two groups showed significant differences (P < 0.00001). The detection accuracy of culture and PCR was assessed, and the coefficient of accuracy (k) was highly significant in the healthy (0.3103; P < 0.0001) and CP groups (0.1536; P < 0.0497). Conclusions: Aa was predominantly found in the CP group compared with the healthy group, which is consistent with previous findings. Our results showed that both techniques can be used for detecting Aa. An ideal technique for detecting subgingival microorganisms should be carefully selected depending on the scope of the intended future work. PMID:27143824
Signoretto, Caterina; Bianchi, Franco; Burlacchini, Gloria; Sivieri, Francesca; Spratt, Dave; Canepari, Pietro
Caries and gingivitis are the most prevalent oral infectious diseases of humans and are due to the accumulation of dental plaque (a microbial biofilm) on the tooth surface and at the gingival margin, respectively. Several in vitro and in vivo studies have shown that many natural components of foods and beverages inhibit the adhesion of and/or exert activity against oral bacteria. These biological activities have mainly been attributed to the polyphenol fraction. In order to explore the possibility that diet can alter the dental plaque community, in this study we evaluated the composition of the microbiota of supra- and subgingival plaque samples collected from 75 adult subjects with different drinking habits (drinkers of coffee, red wine, or water for at least 2 years) by analyzing the microbial population through the separation of PCR-amplified fragments using the denaturing gradient gel electrophoresis (DGGE) technique. The mean numbers of bands of the DGGE profiles from all three categories were evaluated. There were no significant differences between the two kinds of plaque collected from the control group (water drinkers), and this group showed the highest number of bands (supragingival plaque, 18.98 +/- 3.16 bands; subgingival plaque, 18.7 +/- 3.23 bands). The coffee and wine drinker groups generated the lowest numbers of bands for both supragingival plaque (coffee drinkers, 8.25 +/- 3.53 bands; wine drinkers, 7.93 +/- 2.55 bands) and subgingival plaque (coffee drinkers, 8.3 +/- 3.03 bands; wine drinkers, 7.65 +/- 1.68 bands). The differences between coffee drinkers or wine drinkers and the control group (water drinkers) were statistically significant. A total of 34 microorganisms were identified, and the frequency of their distribution in the three subject categories was analyzed. A greater percentage of subjects were positive for facultative aerobes when supragingival plaque was analyzed, while anaerobes were more frequent in subgingival plaque samples. It
Nogueira Moreira, A; Fernández Canigia, L; Furman, C; Chiappe, V; Marcantoni, M; Bianchini, H
The aim of this study was to carry out a microbiological evaluation of sites with and without clinical evidence of moderate and severe periodontitis and their correlation with clinical parameters. A total of 52 disease sites and 10 healthy sites were selected according to clinical criteria. The following clinical indexes were measured for all the sites: plaque index, gingival index, blood on probing, depth on probing and insertion level. Samples of subgingival plaque were collected for culture and for differential counts of microbial morphotypes. In disease sites the most frequently isolated were: Prevotella intermedia/nigrescens (65%), Porphyromonas gingivalis (23%), Actinobacillus actinomycetemcomitans (23%), Fusobacterium nucleatum (10%) and Peptostreptococcus sp. (31%). The aerobic gram-positive microflora was predominant in healthy sites. Significant differences were observed in microbial morphotypes between healthy and disease sites: cocci 18.71% and 78.90%, motile rods 46.12% and 16.70%, total spirochetes 26.48% and 2.80%, respectively. The presence of motile rods, spirochetes and P. intermedia/nigrescens were the parameters with most sensitivity to suspect periodontal disease. There were significant differences in the subgingival microflora between healthy and disease sites in patients with moderate and severe periodontitis.
Cary Potter was President of the National Association of Independent Schools from 1964-1978. As he leaves NAIS he gives his views on education, on independence, on the independent school, on public responsibility, on choice in a free society, on educational change, and on the need for collective action by independent schools. (Author/RK)
Stork, Willis; La Grange, Gerald N.
The chairman of the Board of Directors of the National Association of Independent Schools from 1973-1976 along with the chairman of NAIS from 1966-1970 both give informative and positive evaluations of the contribution made to NAIS by the retiring president of NAIS, Cary Potter. (RK)
Kopp, Svenja L.; Ramseier, Christoph A.; Ratka-Krüger, Petra; Woelber, Johan P.
Aim: Periodontal therapy is highly dependent on a patient's long-term adherence with regard to oral hygiene, diet, and regular check-ups at the dentist. Motivational Interviewing (MI) is a client-centered, directive method for encouraging a patients' behavioral health change. The aim of this systematic review was to reveal the effects of MI as an adjunct to periodontal therapy. Methods: Three databases (PubMed, Cochrane Library, and Web of Science) were reviewed for randomized controlled clinical trials. Articles were included when using MI as an adjunct to periodontal therapy and presenting clinical periodontal and oral hygiene related parameters. Two authors independently coded the relevant articles. Results: The search yielded 496 articles. After analysis and exclusion, a total of five papers could be included. The quality of the articles ranged between 72–88%. The two independent raters showed a high inter-rater reliability (Cohens-Kappa = 0.89). In two studies MI showed a significant positive effect on bleeding on probing and plaque values. One study showed improvement of self-efficacy in interdental cleaning. Two studies showed no influence of MI on periodontal parameters of the patients. Conclusion: The use of MI as an adjunct to periodontal therapy might have a positive influence on clinical periodontal parameters (plaque values, gingival, and periodontal inflammation) and psychological factors related to oral hygiene (self-efficacy). Due to the low body of evidence further studies are needed. Future studies should include fidelity measures of the applied MI, a high number of counselors, several MI sessions, and long-term study follow-up to show potential effects. PMID:28293208
Singer, R E; Moss, K; Kim, S J; Beck, J D; Offenbacher, S
In a previous report, we demonstrated the inverse association of high serum 8-isoprostane levels, a marker for oxidative stress, with decreased serum IgG antibodies to oral bacteria. The association between increased serum IgG with increased plaque and periodontitis (increased probing depths) was attenuated by high systemic oxidative stress. Other investigations have reported a role for systemic oxidative stress as a stimulus of hepatic C-reactive protein (CRP) response. These observations led us to hypothesize that the reported relationship of periodontitis to elevated serum CRP, a systemic inflammatory marker, may be modified by oxidative stress and that the levels of serum antibodies to oral bacteria might be an intermediary explanatory variable linking the association of systemic oxidative stress, periodontal disease, and levels of CRP. This hypothesis was explored as a secondary analysis of the Dental ARIC (Atherosclerosis Risk in Communities) study using serum levels of CRP, serum IgG levels to 16 oral organisms, serum levels of 8-isoprostane, and periodontal status. The findings indicate periodontitis is associated with high CRP in the presence of elevated oxidative stress that serves to suppress the IgG response. Only within the highest 8-isoprostane quartile was periodontitis (pocket depth) associated with increased serum CRP levels (P = 0.0003). Increased serum IgG antibody levels to oral bacteria were associated with lowered serum CRP levels. Thus, systemic oxidative stress, which has been demonstrated to be associated with increased levels of CRP in other studies, appears to be associated with the suppression of bacterial-specific IgG levels, which in the presence of periodontal disease can result in an enhanced systemic CRP response. Conversely, individuals with increased serum IgG antibodies to plaque bacteria exhibit lowered serum CRP levels. These 2 factors, oxidative stress and the serum IgG response, appear to function in opposing directions to
Preza, Dorita; Olsen, Ingar; Willumsen, Tiril; Boches, Susan K.; Cotton, Sean L.; Grinde, Bjørn; Paster, Bruce J.
Purpose The present study used a new 16S rRNA-based microarray with probes for over 300 bacterial species better define the bacterial profiles of healthy root surfaces and root caries (RC) in the elderly. Materials Supragingival plaque was collected from 20 healthy subjects (Controls) and from healthy and carious roots and carious dentin from 21 RC subjects (Patients). Results Collectively, 179 bacterial species and species groups were detected. A higher bacterial diversity was observed in the Controls as compared to Patients. Lactobacillus casei/paracasei/rhamnosus and Pseudoramibacter alactolyticus were notably associated with most root caries samples. Streptococcus mutans was detected more frequently in the infected dentin than in the other samples, but the difference was not significant. Actinomyces were found more frequently in Controls. Conclusion Actinomyces and S. mutans may play a limited role as pathogens of RC. The results from this study were in agreement with those of our previous study based on 16S rRNA gene sequencing with 72% of the species being detected with both methods. PMID:19039610
Edwards, Paul C; Kanjirath, Preetha
This article presents an overview of common and/or significant diseases of the oral cavity that the family physician is likely to encounter, with an emphasis on pathogenesis, recognition, complications, and management. Topics reviewed include the sequelae of dental caries, periodontal disease, and trauma. Prevention and early intervention strategies are emphasized. Recent updates and practical issues for the family physician are highlighted.
Perdikogianni, Hariklia; Papaioannou, William; Nakou, Melachrini; Oulis, Constantine; Papagiannoulis, Liza
Objective. To evaluate the oral hygiene and the periodontal condition of children and adolescents with cleft lip and/or palate (CLP). Methods. Forty-one children and adolescents, 4-18 years, with CLP and 41 normal controls participated. Clinical parameters examined were the plaque and gingival index and Community Periodontal Index of Treatment Needs. For teeth in the cleft area, probing pocket depth, bleeding on probing, and tooth mobility were also evaluated. Samples of subgingival plaque were collected from 21 randomly selected patients of each group. Results. The CLP group had generally poorer oral hygiene (plaque index significantly higher) compared with the control. Children in both groups presented mild degree of gingivitis. Teeth in the cleft area had significantly higher pocket probing depth and tooth mobility, compared with corresponding teeth in the control group. The microbial analysis did not reveal significant differences in the composition of the subgingival microbiota between groups. Teeth in the cleft presented higher isolation frequencies and mean percentages of periodontopathic bacteria. Conclusion. Youngsters with CLP showed poor oral hygiene and worse periodontal condition, compared with controls. The above results advocate their participation in an intensive preventive dental programme that should start at an early age, possibly decreasing the risk of future periodontal disease.
Background The Dai people, one of the ethnic minorities in China, have a population of 1,260,000. They have the same origin as one of the main ethnic groups of Laos and Thailand. Most of the Dai live in Yunnan province, which is located in the less-developed southwestern part of China. This study aimed to describe the oral health status of Dai preschool children in China and the factors that influence their oral health status. Methods An oral health survey was performed between 2011 and 2012 to select Dai five-year-old children using multi-stage stratified sampling in Yunnan. Their dental caries experience was measured using the “dmft” index, and severe caries was assessed using the “pa” index, which is modified from the “pufa” index. Oral hygiene status was assessed using the visual plaque index (VPI). A questionnaire to study the children’s socio-demographic background and oral health-related behaviours was completed by the children’s parents. Results A total of 833 children were examined. Their caries prevalence was 89% and 49% of the children had carious tooth with pulp involvement. The mean (SD) dmft score was 7.0 (5.3). Higher dmft scores were found among children who were girls, were currently bottle-fed, took daily sweet snacks, had higher VPI scores, and had visited a dentist within the last year. Conclusions The caries prevalence and experience of the five-year-old Dai children in Yunnan, China was high, and almost half had severe caries. The caries experience was associated with gender, snack habits, dental visit habits, and oral hygiene status. PMID:24279504
k 7RD-A157 116 PHARMRCOLOGY’ OF PERIODONTAL DISEASE(U) UNIVERSITY OF i/ I HEALTH SCIENCES/CHICAGO MEDICAL SCHOOL DEPT OF I PHARMACOLOGY S F HOFF 24...University of Health Sciences/The Chicago Medical School Department of 3333 Green Bay Road Telephone Pharmacology North Chicago, Illinois 60064...Region Bethesda, MD 20814-5044 • .RE: Annual Letter Report , ONR Contract #N00014-84-K-0562 " Pharmacology of Periodontal Disease" Dear Capt. Hancock
Benatti, Bruno Braga; Silvério, Karina Gonzales; Casati, Márcio Zaffalon; Sallum, Enílson Antônio; Nociti, Francisco Humberto
Experimental studies have shown that the potential of periodontal regeneration seems to be limited by the regenerative capacity of the cells involved. The regeneration of damaged periodontal tissues is mediated by various periodontal cells and is regulated by a vast array of extracellular matrix informational molecules that induce both selective and nonselective responses in different cell lineages and their precursors. In this paper, we first review periodontal ligament tissue and its different cell subpopulations including fibroblasts and paravascular stem cells, and their functions during the development and homeostasis of periodontal tissues. Because conventional periodontal regeneration methods remain insufficient to obtain a complete and reliable periodontal regeneration, the concept of periodontal tissue engineering has been based on the generation of the conditions necessary to improve the healing of periodontal tissues. Additionally, the potential of periodontal ligament cells for use in periodontal tissue engineering to overcome the limitations of conventional periodontal regenerative therapies is discussed, followed by an update of the recent progress and future directions of research utilizing periodontal ligament cells for predictable periodontal regeneration.
Ercan, Nuray; Erdemir, Ebru Olgun; Ozkan, Serdar Yucel; Hendek, Meltem Karsiyaka
Objective: In general, chemical plaque agents have been used in mouthwashes, gels, and dentifrices. In some situations, application of mouthwashes and dentifrices can be difficult. Therefore, different approaches for oral health-care have been needed. The aim of this study was to evaluate the effect of propolis chewing-gum compared to propolis-containing mouthwash on gingival inflammation and plaque accumulation on patients that refrained from daily oral hygiene procedures for 5 days. Materials and Methods: 10 college students with systemically healthy and very good oral hygiene and gingival health were included in this randomized, single-blind, crossover 5-day plaque regrowth with a 3-day washout period clinical study. After plaque scores were reduced to zero, participants were asked to refrain from oral hygiene procedures and allocated to either propolis mouthwash or chewing-gum group. Chewing-gum was performed after meals 3 times a day for 20 min mouthwash group was instructed to rinse mouthwash 2 times a day for 1 min. On day 5, the clinical periodontal measurements containing plaque and gingival indexes were taken from the participants. Results: The both plaque and gingival indexes of propolis mouthwash group were significantly lower than that of the propolis chewing-gum group (P = 0.005). Conclusion: It was demonstrated that the propolis mouthwash was more effective than the propolis chewing gum on the plaque inhibition and the gingival inflammation. PMID:26038663
Gao, Lizeng; Liu, Yuan; Kim, Dongyeop; Li, Yong; Hwang, Geelsu; Naha, Pratap C; Cormode, David P; Koo, Hyun
Dental biofilms (known as plaque) are notoriously difficult to remove or treat because the bacteria can be enmeshed in a protective extracellular matrix. It can also create highly acidic microenvironments that cause acid-dissolution of enamel-apatite on teeth, leading to the onset of dental caries. Current antimicrobial agents are incapable of disrupting the matrix and thereby fail to efficiently kill the microbes within plaque-biofilms. Here, we report a novel strategy to control plaque-biofilms using catalytic nanoparticles (CAT-NP) with peroxidase-like activity that trigger extracellular matrix degradation and cause bacterial death within acidic niches of caries-causing biofilm. CAT-NP containing biocompatible Fe3O4 were developed to catalyze H2O2 to generate free-radicals in situ that simultaneously degrade the biofilm matrix and rapidly kill the embedded bacteria with exceptional efficacy (>5-log reduction of cell-viability). Moreover, it displays an additional property of reducing apatite demineralization in acidic conditions. Using 1-min topical daily treatments akin to a clinical situation, we demonstrate that CAT-NP in combination with H2O2 effectively suppress the onset and severity of dental caries while sparing normal tissues in vivo. Our results reveal the potential to exploit nanocatalysts with enzyme-like activity as a potent alternative approach for treatment of a prevalent biofilm-associated oral disease.
Shue, Li; Yufeng, Zhang; Mony, Ullas
Periodontal disease is characterized by the destruction of periodontal tissues. Various methods of regenerative periodontal therapy, including the use of barrier membranes, bone replacement grafts, growth factors and the combination of these procedures have been investigated. The development of biomaterials for tissue engineering has considerably improved the available treatment options above. They fall into two broad classes: ceramics and polymers. The available ceramic-based materials include calcium phosphate (eg, tricalcium phosphate and hydroxyapatite), calcium sulfate and bioactive glass. The bioactive glass bonds to the bone with the formation of a layer of carbonated hydroxyapatite in situ. The natural polymers include modified polysaccharides (eg, chitosan,) and polypeptides (collagen and gelatin). Synthetic polymers [eg, poly(glycolic acid), poly(L-lactic acid)] provide a platform for exhibiting the biomechanical properties of scaffolds in tissue engineering. The materials usually work as osteogenic, osteoconductive and osteoinductive scaffolds. Polymers are more widely used as a barrier material in guided tissue regeneration (GTR). They are shown to exclude epithelial downgrowth and allow periodontal ligament and alveolar bone cells to repopulate the defect. An attempt to overcome the problems related to a collapse of the barrier membrane in GTR or epithelial downgrowth is the use of a combination of barrier membranes and grafting materials. This article reviews various biomaterials including scaffolds and membranes used for periodontal treatment and their impacts on the experimental or clinical management of periodontal defect. PMID:23507891
RIVERA, CÉSAR; MONSALVE, FRANCISCO; SUAZO, IVÁN; BECERRA, JAVIERA
This study aimed to examine the effect of chronic restraint stress (RS) on the severity of experimental periodontal disease in rats. A total of 32 male Sprague Dawley (SD) rats were divided into four groups: i) Rats receiving two treatment regimens, chronic stress induced by movement restriction in acrylic cylinders for 1–1.5 h daily and induction of experimental periodontal disease, using a nylon ligature which was placed around the first left mandibular molars (n=8); ii) induction of periodontal disease, without RS (n=8); iii) RS (n=8) and iv) control (n=8). After 15 days, blood samples were obtained, and blood glucose levels and the corticosterone concentration were measured as stress markers. The severity of periodontal disease was analyzed according to the level of gingival and bone inflammation, leading to compromise of the teeth involved. Chronic stress was induced with movement restriction (P≤0.05, Mann-Whitney U-test) and increased the severity (P≤0.05, Mann-Whitney U-test) of experimental perio dontal disease in rats, according to the level of gingival and bone inflammation around the first left mandibular molars. The results of the present study showed that RS modulates periodontal inflammation and that the rat model described herein is suitable for investigating the association between stress and periodontal disease. PMID:23226743
Lilledahl, Magnus B.; de Lange Davies, Catharina; Haugen, Olav A.; Svaasand, Lars O.
Multiphoton microscopy is a techniques that fascilitates three dimensional imaging of intact, unstained tissue. Especially connective tissue has a relatively strong nonlinear optical response and can easily be imaged. Atherosclerosis is a disease where lipids accumulate in the vessel wall and there is a thickening of the intima by growth of a cap of connective tissue. The mechanical strength of this fibrous cap is of clinically importance. If the cap ruptures a thrombosis forms which can block a coronary vessel and therby causing myocardial infarction. Multiphoton microscopy can be used to image the fibrous cap and thereby determine the thickness of the cap and the structure of the connective fibres. This could possibly be developed into a diagnostic and clincal tool to monitor the vulnerability of a plaque and also to better understand the development of a plaque and effects of treatment. We have collected multiphoton microscopy images from atherosclerotic plaque in human aorta, both two photon excited fluorescens and second harmonic generated signal. The feasability of using this technique to determine the state of the plaque is explored.
Padmalatha, GV; Bavle, Radhika M; Satyakiran, Gadavalli Vera Venkata; Paremala, K; Sudhakara, M; Makarla, Soumya
Introduction: Periodontal diseases, if left untreated, can lead to tooth loss and affect at least one tooth in 80% of adults worldwide, with the main cause being a bacterial plaque. Among subgingival plaque bacterial species, Porphyromonas gingivalis has been implicated as a major etiological agent causing tooth loss. Diabetics and smokers are two patient groups at high risk for periodontal disease. The increase in the number of this organism with the coexistence of other pathogenic microbes leads to rapid destruction of the periodontium, premature loss of teeth and also because of its virulence has implications in systemic pathology. Our aim was to observe the involvement of P. gingivalis in diabetes mellitus (DM) patients associated with periodontitis with and without tobacco-associated habits and to compare them with periodontitis patients having no other systemic pathologies. Materials and Methods: Subgingival plaque samples from a total of seventy subjects were included in the study. DNA was isolated from the collected sample and was quantified using spectrophotometer for standardizing the polymerase chain reaction. The quantity of the isolated DNA was checked in a ultraviolet-visible spectrophotomer. Statistics: One-way ANOVA and Tukey's multiple post hoc procedures were carried out. Results: The maximum score of P. gingivalis was seen in periodontitis patients having DM, whereas the least score was seen in periodontitis patients having DM with tobacco smoking habit compared to the other groups. Conclusion: P. gingivalis count is significantly reduced in periodontitis patients having DM with smoking habit; it is concluded that P. gingivalis might not be a key causative organism responsible for the periodontal destruction in case of smokers despite the DM condition. The decrease in counts may be attributed to change in the local environment like chemical (tobacco nitrosamines) and physical changes preventing the growth of P. gingivalis. PMID:27721606
Tang, Jun; Lobatto, Mark E; Hassing, Laurien; van der Staay, Susanne; van Rijs, Sarian M; Calcagno, Claudia; Braza, Mounia S; Baxter, Samantha; Fay, Francois; Sanchez-Gaytan, Brenda L; Duivenvoorden, Raphaël; Sager, Hendrik; Astudillo, Yaritzy M; Leong, Wei; Ramachandran, Sarayu; Storm, Gert; Pérez-Medina, Carlos; Reiner, Thomas; Cormode, David P; Strijkers, Gustav J; Stroes, Erik S G; Swirski, Filip K; Nahrendorf, Matthias; Fisher, Edward A; Fayad, Zahi A; Mulder, Willem J M
Inflammation drives atherosclerotic plaque progression and rupture, and is a compelling therapeutic target. Consequently, attenuating inflammation by reducing local macrophage accumulation is an appealing approach. This can potentially be accomplished by either blocking blood monocyte recruitment to the plaque or increasing macrophage apoptosis and emigration. Because macrophage proliferation was recently shown to dominate macrophage accumulation in advanced plaques, locally inhibiting macrophage proliferation may reduce plaque inflammation and produce long-term therapeutic benefits. To test this hypothesis, we used nanoparticle-based delivery of simvastatin to inhibit plaque macrophage proliferation in apolipoprotein E deficient mice (Apoe(-/-) ) with advanced atherosclerotic plaques. This resulted in rapid reduction of plaque inflammation and favorable phenotype remodeling. We then combined this short-term nanoparticle intervention with an eight-week oral statin treatment, and this regimen rapidly reduced and continuously suppressed plaque inflammation. Our results demonstrate that pharmacologically inhibiting local macrophage proliferation can effectively treat inflammation in atherosclerosis.
Tang, Jun; Lobatto, Mark E.; Hassing, Laurien; van der Staay, Susanne; van Rijs, Sarian M.; Calcagno, Claudia; Braza, Mounia S.; Baxter, Samantha; Fay, Francois; Sanchez-Gaytan, Brenda L.; Duivenvoorden, Raphaël; Sager, Hendrik B.; Astudillo, Yaritzy M.; Leong, Wei; Ramachandran, Sarayu; Storm, Gert; Pérez-Medina, Carlos; Reiner, Thomas; Cormode, David P.; Strijkers, Gustav J.; Stroes, Erik S. G.; Swirski, Filip K.; Nahrendorf, Matthias; Fisher, Edward A.; Fayad, Zahi A.; Mulder, Willem J. M.
Inflammation drives atherosclerotic plaque progression and rupture, and is a compelling therapeutic target. Consequently, attenuating inflammation by reducing local macrophage accumulation is an appealing approach. This can potentially be accomplished by either blocking blood monocyte recruitment to the plaque or increasing macrophage apoptosis and emigration. Because macrophage proliferation was recently shown to dominate macrophage accumulation in advanced plaques, locally inhibiting macrophage proliferation may reduce plaque inflammation and produce long-term therapeutic benefits. To test this hypothesis, we used nanoparticle-based delivery of simvastatin to inhibit plaque macrophage proliferation in apolipoprotein E–deficient mice (Apoe−/−) with advanced atherosclerotic plaques. This resulted in the rapid reduction of plaque inflammation and favorable phenotype remodeling. We then combined this short-term nanoparticle intervention with an 8-week oral statin treatment, and this regimen rapidly reduced and continuously suppressed plaque inflammation. Our results demonstrate that pharmacologically inhibiting local macrophage proliferation can effectively treat inflammation in atherosclerosis. PMID:26295063
Jiang, Shan; Gao, Xiaoli; Jin, Lijian; Lo, Edward C. M.
Dental caries (tooth decay) is an infectious disease. Its etiology is not fully understood from the microbiological perspective. This study characterizes the diversity of microbial flora in the saliva of children with and without dental caries. Children (3–4 years old) with caries (n = 20) and without caries (n = 20) were recruited. Unstimulated saliva (2 mL) was collected from each child and the total microbial genomic DNA was extracted. DNA amplicons of the V3-V4 hypervariable region of the bacterial 16S rRNA gene were generated and subjected to Illumina Miseq sequencing. A total of 17 phyla, 26 classes, 40 orders, 80 families, 151 genera, and 310 bacterial species were represented in the saliva samples. There was no significant difference in the microbiome diversity between caries-affected and caries-free children (p > 0.05). The relative abundance of several species (Rothia dentocariosa, Actinomyces graevenitzii, Veillonella sp. oral taxon 780, Prevotella salivae, and Streptococcus mutans) was higher in the caries-affected group than in the caries-free group (p < 0.05). Fusobacterium periodonticum and Leptotrichia sp. oral clone FP036 were more abundant in caries-free children than in caries-affected children (p < 0.05). The salivary microbiome profiles of caries-free and caries-affected children were similar. Salivary counts of certain bacteria such as R. dentocariosa and F. periodonticum may be useful for screening/assessing children’s risk of developing caries. PMID:27898021
Albush, Muhammad M.; Razan, Khattab K.; Raed, Al Dieri M.
Background: Periodontal debridement has an impact on the vascular thrombotic markers in healthy individuals. This study aimed to investigate changes in several vascular thrombotic markers after surgical and non-surgical periodontal debridement in hypertensives with periodontitis. Materials and Methods: 40 hypertensives, 27 males and 13 females, 37-68 year old, mean 51.2 years, with moderate to severe periodontitis, were divided into two groups, (n = 20 for each); the first received comprehensive one session non-surgical periodontal debridement, (pockets 4-6 mm), while the second received comprehensive supragingival scaling with surgical debridement at one quadrant, (Pockets > 6 mm). Periodontal parameters included; plaque index (PI), gingival inflammation (GI), bleeding on probing (BOP), pocket probing depth (PPD). Vascular thrombotic tests included; platelets count (Plt), fibrinogen (Fib), Von Willebrand factor antigen activity (vWF:Ag), and D-dimers (DD). Results: PI, GI, BOP, PPD, decreased significantly (P = 0.001) after 6 weeks of periodontal debridement in both groups, while BOP and PPD remained higher in the surgical one (P < 0.05). Thrombotic vascular markers changes through the three-time intervals were significant in each group (P = 0.001), and time-group interception effect was significant for vWF:Ag (P = 0.005), while no significant differences between groups after treatment (P > 0.05). Conclusion: Periodontal debridement, surgical and non-surgical, improved the periodontal status in hypertensives. Periodontal treatment activated the coagulation system in hypertensives and recessed later while the treatment modality did not affect the degree of activation. PMID:24049332
Greghi, Sebastião Luiz Aguiar; de Resende, Maria Lúcia Rubo; Sant’Ana, Adriana Campos Passanezi; Damante, Carla Andreotti
The aim of this systematic literature review was to evaluate which type of periodontal preventive and therapeutic approaches presents superior outcomes in patients with Down syndrome (DS). Studies reporting different methods of periodontal care from DS patients were considered eligible. Included clinical studies should indicate at least two periodontal parameters in different periods of assessment. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Electronic search according to the PICO search, with both Key-words and MESH terms were conducted in MEDLINE, EMBASE and CENTRAL databases until March 2016. Manual search was conducted in four journals, namely Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and Special Care in Dentistry and their electronic databases were searched. Electronic and manual search resulted in 763 papers, and of them 744 were excluded after title/abstract assessment. The full text of 19 potentially eligible publications was screened and 9 studies met inclusion criteria. The results demonstrated the importance to introduce youngest DS patients in preventive programs, as well as participation of parents, caregivers or institutional attendants in supervising/performing oral hygiene. In studies with higher frequency of attendance, all age groups presented superior preventive and therapeutic results, irrespective of the therapeutic approach used (surgical/nonsurgical/periodontal care program). The important factors for reducing periodontal parameters were the frequency of the appointments and association with chlorhexidine/plaque disclosing agents as adjuvant treatment. This systematic review demonstrated that early introduction in periodontal care, participation of parents/caregivers/institutional attendants, frequency of attendance and association with chemical adjuvants (independently of the periodontal treatment adopted) seems to
Shi, Quan; Zhang, Bin; Huo, Na; Cai, Chuan; Liu, Hongchen; Xu, Juan
Background and Objective: Many clinical researches have been carried out to investigate the relationship between myocardial infarction (MI) and periodontitis. Despite most of them indicated that the periodontitis may be associated with an increased risk of MI, the findings and study types of these studies have been inconsistent. The goal of this meta-analysis was to critically assess the strength of the association between MI and periodontitis in case-control studies. Methods: PubMed and the Cochrane Library were searched for eligible case-control studies reporting relevant parameters that compared periodontal status between MI and control subjects. The odds ratios (ORs) and 95% confidence intervals (CIs) from each study were pooled to estimate the strength of the association between MI and periodontitis. The mean differences and 95% CIs for periodontal-related parameters were calculated to determine their overall effects. Results: Seventeen studies including a total of 3456 MI patients and 3875 non-MI control subjects were included. The pooled OR for the association between MI and periodontitis was 2.531 (95% CI: 1.927-3.324). The mean differences (95% CIs) for clinical attachment loss, probing depth, bleeding on probing, plaque index, and the number of missing teeth were 1.000 (0.726-1.247), 1.209 (0.538-1.880), 0.342 (0.129-0.555), 0.383 (0.205-0.560), and 4.122 (2.012-6.232), respectively. Conclusion: With the current evidence, the results support the presence of a significant association between MI and periodontitis. Moreover, MI patients had worse periodontal and oral hygiene status and fewer teeth than did control subjects. More high-quality and well-designed studies focusing on the casual relationship between MI and periodontitis should be conducted in the future.
Rai, Balwant; Kaur, Jasdeep
Salivary flow rate, immunoglobulin, and periodontal status were affected during a simulated Skylab mission. The effect is more prominent after long-duration space flights and can persist for several weeks after landing. The objective of this study was to determine the effect of a simulated Mars environment on periodontal status and levels of salivary microorganisms and immunoglobulins in the human oral cavity. Twelve healthy male volunteers were studied before, at 1 and 2 weeks, and after completion of a mission in an isolated, confined simulated Mars environment at the Mars Desert Research Station, USA. We conducted a current stress test, measured salivary immunoglobulin, cortisol, α-amylase, salivary flow rate, and levels of plaque and salivary microbes, and assessed clinical periodontal parameters (probing depth, bleeding on probing, and clinical loss of attachment). Salivary IgG levels and Streptococcus mutans activity were significantly higher at 1 week. Values for clinical periodontal parameters (probing depth, bleeding on probing, and clinical loss of attachment) significantly differed at 1 week. Stress might be caused by the difficulty of the mission rather than the isolated environment, as mission duration was quite short. Periodontal condition might worsen due to poor oral hygiene during the mission. The present findings show that all periodontal conditions and levels of oral bacteria and stress after completion of the simulated Mars mission differed from those at baseline. To verify the relationship between stress status and periodontal health in simulated Mars missions, future studies using larger patient samples and longer follow-up will be required.
Bhusari, Prashant A.; Chopra, Rajan
Periodontal health reflects a balance between harmful and protective elements in the gingival marginal area. The total plaque mass, specific periodontopathogens, the tooth morphology, and local environmental factors may challenge this balance. The periodontal ligament attachment loss shifts this balance adversely toward the periodontal disease. Objectives The aim of this retrospective study was to determine the significance of proximal root grooves as a risk factor in the periodontal attachment loss; the effect of their dimensions and locations has been evaluated. Materials and methods One hundred (100) extracted formalin stored single rooted permanent anterior teeth were studied by staining with 0.1% toludine blue to visualize attached periodontal ligament remnants. On each tooth, the loss of attachment was measured from the cemento–enamel junction to the most coronal level of the stained periodontal ligament remnants. Results The prevalence of proximal root grooves was found to be 81% and a statistically significant greater loss of attachment was present on grooved than on non-grooved surfaces (p < 0.01). Conclusions Generally, there was direct relationship between groove location, its dimensions, and maximum loss of attachment. The results suggest that proximal root grooves should be considered in periodontal diagnosis, prognosis, and treatment planning. PMID:23960505
Background The purpose of this study was to compare two biochemical markers, which have been previously used to determine the degrees of alveolar bone destruction, in evaluating periodontal disease severity. Methods The WF6 epitope of chondroitin sulfate (CS) and the alkaline phosphatase (ALP) levels were determined in gingival crevicular fluid (GCF) samples collected from patients with various degrees of disease severity, including ten patients with gingivitis (50 gingivitis sites) and 33 patients with chronic periodontitis (including gingivitis, slight, moderate, and severe periodontitis sites; n = 50 each), as well as from ten healthy volunteers (50 healthy sites) by Periopaper strips. The levels of CS and ALP were measured by an ELISA and a fluorometric assay, respectively. Results The results demonstrated low levels of CS and ALP in non-destructive and slightly destructive periodontitis sites, whereas significantly high levels of these two biomolecules were shown in moderately and severely destructive sites (p < 0.05). Although a significant difference in CS levels was found between moderate and severe periodontitis sites, no difference in ALP levels was found. Stronger correlations were found between CS levels and periodontal parameters, including probing depth, loss of clinical attachment levels, gingival index and plaque index, than between ALP levels and these parameters. Conclusions It is suggested that the CS level is a better diagnostic marker than the ALP level for evaluating distinct severity of chronic periodontitis. PMID:25174345
Brede, Olivier; Wilde, Claudia; Krause, Felix; Frentzen, Matthias; Braun, Andreas
The aim of the study was to assess the ability of a fluorescence based optical system to detect secondary caries. The optical detecting system (VistaProof) illuminates the tooth surfaces with blue light emitted by high power GaN-LEDs at 405 nm. Employing this almost monochromatic excitation, fluorescence is analyzed using a RGB camera chip and encoded in color graduations (blue - red - orange - yellow) by a software (DBSWIN), indicating the degree of caries destruction. 31 freshly extracted teeth with existing fillings and secondary caries were cleaned, excavated and refilled with the same kind of restorative material. 19 of them were refilled with amalgam, 12 were refilled with a composite resin. Each step was analyzed with the respective software and analyzed statistically. Differences were considered as statistically significant at p<0.05. There was no difference between measurements at baseline and after cleaning (Mann Whitney, p>0.05). There was a significant difference between baseline measurements of the teeth primarily filled with composite resins and the refilled situation (p=0.014). There was also a significant difference between the non-excavated and the excavated group (Composite p=0.006, Amalgam p=0.018). The in vitro study showed, that the fluorescence based system allows detecting secondary caries next to composite resin fillings but not next to amalgam restorations. Cleaning of the teeth is not necessary, if there is no visible plaque. Further studies have to show, whether the system shows the same promising results in vivo.
Thneibat, Amenah; Fontana, Margherita; Cochran, Michael A; Gonzalez-Cabezas, Carlos; Moore, B Keith; Matis, Bruce A; Lund, Melvin R
The antimicrobial and anticariogenic properties of a copper varnish (experimental mixture of Doc's Best Red Copper cement and Copalite varnish, Cooley and Cooley, Ltd, Houston, TX, USA: designated in this study as "Copper Seal") on the root surface were evaluated in an in vitro microbial caries model. Fifty-six human root specimens were prepared from anterior teeth and randomly divided into four groups: Groups 1 and 3-Copper Seal; Group 2-chlorhexidine varnish, the positive control (Cervitec, Ivolcar Vivadent, Schaan, Liechtenstein) and Group 4-a negative control that received no treatment. The varnishes were painted in Groups 1, 2 and 3, then visually removed after 24 hours in Group 1. The specimens were demineralized in a microbial caries model for five days. Plaque was collected from the specimens to obtain bacterial colonization numbers, then the specimens were sectioned and analyzed for lesion extent using Confocal Laser Scanning microscopy. There were no significant differences (p>0.05) among the four groups in terms of bacterial count. Regarding caries lesion development, the group with copper varnish visually removed (Group 1) and the non-treated group (Group 4) had significantly greater total area caries lesions and total lesion fluorescence than the copper varnish without removal group (Group 3) and the chlorhexidine group (Group 2). Therefore, it was concluded that copper and chlorhexidine varnishes have anticariogenic effects on root surfaces, as tested in this model.
Hewko, Mark D.; Choo-Smith, Lin-P'ing; Ko, Alex C.; Leonardi, Lorenzo; Dong, Cecilia C.; Cleghorn, Blaine; Sowa, Michael G.
Early dental caries result from destruction of the tooth's outer mineral matrix by acid-forming bacteria found in dental plaques. Early caries begin as surface disruptions where minerals are leached from the teeth resulting in regions of decreased mineral matrix integrity. Visually, these early carious regions appear as white spots due to the higher backscattering of incident light. With age these areas may become stained by organic compounds. Optical coherence tomography (OCT) examination of human teeth demonstrates a difference in penetration depth of the OCT signal into the carious region in comparison with sound enamel. However, while OCT demonstrates a structural difference in the enamel in the region of the caries, this technique provides little insight into the source of this difference. Raman spectroscopy provides biochemical measures derived from hydroxyapatite within the enamel as well as information on the crystallinity of the enamel matrix. The differences in the biochemical and morphological features of early caries and intact sound enamel are compared. Histological thin sections confirm the observations by OCT morphological imaging while Raman spectroscopy allows for biochemical identification of carious regions by a non-destructive method. Visual examination and conventional radiographic imaging of the intact tooth are used in clinical assessment prior to optical measurements. The combination of OCT, Raman spectroscopy and thin section histology aid in determining the changes that give rise to the visual white spot lesions.
Dens, F L; Boute, P; Vinckier, F; Declerck, D
In this study we demonstrated that caries prevalence and Plaque Index in long-term event-free pediatric oncology patients are related to Streptococcus mutans, Lactobacillus counts and buffer capacity obtained by chairside saliva tests. The scores showed a significant correlation between the microbiological findings and caries experience in both groups. The results were compared with a control group. A similarity in the results was found between the study and control groups. In a subgroup consisting of children who were diagnosed with cancer maximum two years before oral examinations, no significant differences with a control group was noticed. In this study we did not find any evidence of long-term effects on the studied salivary caries risk factors in children who are long-term event-free after cytotoxic treatment. Chairside tests seem to be useful in this patient group: they provide us information which can contribute to the determination of the individual caries risk, and help to motivate the patient and health care workers to maintain optimal oral hygiene.
Moreira, Carlos Heitor Cunha; Zanatta, Fabricio Batistin; Antoniazzi, Raquel; Meneguetti, Priscila Ceolin; Rösing, Cassiano Kuchenbecker
When dealing with patients with periodontal disease of variable severities, dentists must often choose between treating and restoring the involved tooth or indicating its extraction. Different criteria have been adopted in this decision-making process. The purpose of this study was to evaluate the criteria adopted by dentists to indicate the extraction of teeth with periodontitis. Dentists were interviewed at their private practices in three cities of the state of Rio Grande do Sul, Brazil. The evaluated criteria included severity of attachment loss, tooth mobility, furcation involvement, prosthetic planning, periodontal-endodontic lesion, possible systemic involvement due to the presence of periodontitis, referral to a periodontist for evaluation, radiographic bone loss greater than 50%, presence of extensive caries, socio-economic and cultural status of the patient, among others. The most often adopted criteria to indicate the extraction of periodontally affected teeth were the presence of mobility (37.5%), severity of attachment loss (24.3%) and radiographic bone loss greater than 50% (21.2%). The results of the present study demonstrated the difficulties faced by dentists to indicate the extraction of teeth with severe attachment loss, in addition to the establishment of an adequate prognosis. Aspects associated with the past disease were still the most often reported to indicate the extraction of teeth for periodontal reasons. PMID:19089175
Raitapuro-Murray, T.; Molleson, T. I.; Hughes, F. J.
Objective The aim of this study was to investigate the prevalence of moderate to severe periodontitis in an ancient British cohort c. 200-400 AD. Design Observational study to assess periodontal and other oral disease parameters. Setting Natural History Museum, London. Subjects and methods 303 skulls from a Romano-British burial site in Poundbury, Dorset were examined for evidence of dental disease. Main outcome measures The primary outcome measure was presence of moderate to severe periodontitis. Secondary outcomes included: amount of horizontal bone loss; prevalence of ante-mortem tooth loss; and presence of other dental pathologies. Results The overall prevalence of moderate to severe periodontitis was just greater than 5%. The prevalence rate remained nearly constant between ages 20 to 60, after which it rose to around 10%. The number of affected teeth increased with age. Horizontal bone loss was generally minor. Caries was seen in around 50% of the cohort, and evidence of pulpal and apical pathology was seen in around 25%. Conclusions The prevalence of moderate to severe periodontitis was markedly decreased when compared to the prevalence in modern populations, underlining the potential importance of risk factors such as smoking and diabetes in determining susceptibility to progressive periodontitis in modern populations. PMID:25342357
Sugawara, Atsunori; Sato, Soh
Periodontal diseases result from inflammation by bacterial infection in plaques, leading to tooth loss. However, regenerative approaches with periodontal tissue regeneration by guided tissue regeneration and enamel matrix derivative are not yet well established. Tissue regeneration requires three factors: cells, scaffold, and growth factors. Dedifferentiated fat cells (DFATs) are pluripotent with the same differentiation capacities as mesenchymal stem cells (MSCs). Access to MSCs is limited, whereas donor cells for DFATs are abundant in adipose tissues and can be non-invasively obtained. Therefore, we tested DFATs as a new source for periodontal tissue regeneration in an experimental periodontal tissue loss model in rats by transplanting DFATs on an atelocollagen scaffold using DFATs isolated from Sprague-Dawley (SD) rats expressing green fluorescent protein (GFP). GFP-DFAT cells were transplanted on the palatal side of the upper left first molar in SD rats and detected by H&E staining, GFP, and proliferating cell nuclear antigen (PCNA) expression. DFAT differentiation was also evaluated in three-dimensional cultures. GFP positive cells were detected in the regenerated tissue by the DFATs/scaffold mixture at 4 weeks after transplantation, and PCNA-positive cells were significantly increased in the periodontal ligament along the new bone in the DFATs/scaffold group more than in the scaffold-only group, suggesting that DFATs differentiate in the same manner as MSCs and regenerate in the defective areas. Consistent with previous reports, DFATs differentiation was slower than that with stem cells. The present study demonstrates that DFATs are pluripotent and an effective new source of cells for periodontal tissue regeneration.
Xiao, Jin; Moon, Yonghwi; Li, Lihua; Rustchenko, Elena; Wakabayashi, Hironao; Zhao, Xiaoyi; Feng, Changyong; Gill, Steven R.; McLaren, Sean; Malmstrom, Hans; Ren, Yanfang; Quivey, Robert
Introduction Candida albicans has been detected together with Streptococcus mutans in high numbers in plaque-biofilm from children with early childhood caries (ECC). The goal of this study was to examine the C. albicans carriage in children with severe early childhood caries (S-ECC) and the maternal relatedness. Methods Subjects in this pilot cross-sectional study were recruited based on a convenient sample. DMFT(S)/dmft(s) caries and plaque scores were assessed during a comprehensive oral exam. Social-demographic and related background information was collected through a questionnaire. Saliva and plaque sample from all children and mother subjects were collected. C. albicans were isolated by BBL™ CHROMagar™ and also identified using germ tube test. S. mutans was isolated using Mitis Salivarius with Bacitracin selective medium and identified by colony morphology. Genetic relatedness was examined using restriction endonuclease analysis of the C. albicans genome using BssHII (REAG-B). Multilocus sequence typing was used to examine the clustering information of isolated C. albicans. Spot assay was performed to examine the C. albicans Caspofungin susceptibility between S-ECC children and their mothers. All statistical analyses (power analysis for sample size, Spearman’s correlation coefficient and multiple regression analyses) were implemented with SAS 9.4 Results A total of 18 S-ECC child-mother pairs and 17 caries free child-mother pairs were enrolled in the study. Results indicated high C. albicans carriage rate in the oral cavity (saliva and plaque) of both S-ECC children and their mothers (>80%). Spearman’s correlation coefficient also indicated a significant correlation between salivary and plaque C. albicans and S. mutans carriage (p<0.01) and caries severity (p<0.05). The levels of C. albicans in the prepared saliva and plaque sample (1ml resuspension) of S-ECC children were 1.3 ± 4.5 x104 cfu/ml and 1.2 ± 3.5 x104 cfu/ml (~3-log higher vs. caries
Gao, Zilong; Lv, Juan; Wang, Min
Abstract Some controversies still exist between the detection of Epstein–Barr virus (EBV)'s DNA and risks of periodontal diseases. Hence, a comprehensive meta-analysis on all available literatures was performed to clarify the relationship between EBV and preidontitis. A comprehensive search was conducted within the PUBMED, EMBASE, and WANFANG databases up to October 10th, 2016 according to inclusion and exclusion criteria and finally 21 case–control literatures were obtained. The outcomes including odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the strength of associations. Publication bias was determined by Begg or Egger test. Sensitivity analysis was used to investigate reliability and stability of the results. According to the data from included trials, the association between overall increased risks of periodontitis and the detection of EBV was significant (OR = 6.199, 95% CI = 3.119–12.319, P < 0.001). In the disease-type analysis, the pooled ORs for chronic periodontitis and aggressive periodontitis were 6.586 (95% CI = 3.042–14.262, P < 0.001) and 8.361 (95% CI = 2.109–33.143, P = 0.003), respectively. In the subgroup analysis of ethnicity, our results suggested that high EBV-detecting frequencies were correlated with increased risks of periodontitis in Asians, Europeans, and Americans (P < 0.001). Subgroup analysis by the sample type showed that subgingival plaque (SgP) samples and tissue samples were available for EBV detecting (P < 0.001). Detecting EBV of samples in ≥5 (6) mm sites of periodontal pockets were easier than in ≤3-mm sites (P = 0.023). This meta-analysis indicates that high frequent detection of EBV correlates with increased risk of periodontal diseases. SgP and tissue are available for detecting EBV in patients of periodontitis. At last, our results suggest that detecting EBV of samples in =5 (6) mm sites of periodontal pockets are more sensitive than in ≤3
Reynolds, Mark A.; Dawson, Dolphus R.; Novak, Karen F.; Ebersole, Jeffrey L.; Gunsolley, John C.; Branch-Mays, Grishondra L.; Holt, Stanley C.; Mattison, Julie A.; Ingram, Donald K.; Novak, M. John
Objective Dietary caloric restriction (CR) has been found to reduce systemic markers of inflammation and may attenuate the effects of chronic inflammatory conditions. The purpose of this study was to examine the effects of long-term CR on naturally occurring chronic inflammatory periodontal disease in a nonhuman primate model. Methods The effects of long-term CR on extent and severity of naturally occurring chronic periodontal disease, local inflammatory and immune responses, and periodontal microbiology, were evaluated in a cohort of 81 (35 female and 46 male; 13–40 years of age) rhesus monkeys (M. mulatta) with no previous exposure to routine oral hygiene. The CR monkeys had been subjected to 30% CR for 13–17 years relative to control-fed (CON) animals starting at 3–5 years of age. Clinical and laboratory parameters were submitted to analysis of covariance, including Tukey's test for post hoc comparisons, linear regression analysis, and nonparametric correlation analysis. Results Same sex CR and CON monkeys exhibited comparable mean scores for plaque index, calculus index, and bleeding on probing. Among CON animals, males showed significantly greater periodontal breakdown, as reflected by higher mean clinical attachment level (CAL) and periodontal probing depth (PD) scores, than females (p ≤ 0.05). CR males had significantly less periodontal pocketing compared to CON males (p ≤ 0.05). CR males demonstrated a significantly lower IgG antibody response and lower levels of IL-8 and β-glucuronidase in gingival crevicular fluid compared to control males. A similar but nonsignificant reduction was found for IL-1β in CR male monkeys. In contrast, CR females exhibited mean PD and CAL scores comparable to CON females. CR females had a lower IgG antibody response but comparable levels of inflammatory markers in GCF compared to CON females. The CR diet had no demonstrable effects on the periodontal microbiota in male or female monkeys. Conclusion Males exhibited
Background The effects of tongue cleaning on reconstruction of bacterial flora in dental plaque and tongue coating itself are obscure. We assessed changes in the amounts of total bacteria as well as Fusobacterium nucleatum in tongue coating and dental plaque specimens obtained with and without tongue cleaning. Methods We conducted a randomized examiner-blind crossover study using 30 volunteers (average 23.7 ± 3.2 years old) without periodontitis. After dividing randomly into 2 groups, 1 group was instructed to clean the tongue, while the other did not. On days 1 (baseline), 3, and 10, tongue coating and dental plaque samples were collected after recording tongue coating score (Winkel tongue coating index: WTCI). After a washout period of 3 weeks, the same examinations were performed with the subjects allocated to the alternate group. Genomic DNA was purified from the samples and applied to SYBR® Green-based real-time PCR to quantify the amounts of total bacteria and F. nucleatum. Results After 3 days, the WTCI score recovered to baseline, though the amount of total bacteria in tongue coating was significantly lower as compared to the baseline. In plaque samples, the bacterial amounts on day 3 and 10 were significantly lower than the baseline with and without tongue cleaning. Principal component analysis showed that variations of bacterial amounts in the tongue coating and dental plaque samples were independent from each other. Furthermore, we found a strong association between amounts of total bacteria and F. nucleatum in specimens both. Conclusions Tongue cleaning reduced the amount of bacteria in tongue coating. However, the cleaning had no obvious contribution to inhibit dental plaque formation. Furthermore, recovery of the total bacterial amount induced an increase in F. nucleatum in both tongue coating and dental plaque. Thus, it is recommended that tongue cleaning and tooth brushing should both be performed for promoting oral health. PMID:24423407
Chronic periodontitis is a destructive disease that affects the supporting structures of the teeth including periodontal ligament, cementum, and alveolar bone. If left untreated, patients may lose multiple teeth and extensive prosthetic treatment will be required. In order to re-engineer lost tooth-supporting tissues, various therapeutic modalities have been used clinically. Periodontal regeneration procedures including guided tissue regeneration have achieved substantial effects. However, there are several issues to be solved. They are highly technique-sensitive, applicable to limited cases which are susceptible to treatment, and supposed to have relatively low predictability. Therefore, it is necessary to develop new approaches to improve the predictability and effectiveness of regenerative therapies for periodontal tissues. Recently, the concept of tissue engineering has been introduced to restore lost tissues more effectively where the biological process of healing is mimicked. To achieve this, integration of three key elements is required: progenitor/stem cells, growth factors and the extracellular matrix scaffold. Although it has been shown that implantation of bone marrow-derived mesenchymal stem cells into periodontal osseous defects induced regeneration of cementum, periodontal ligament and alveolar bone in dogs, further extensive preclinical studies are required. On the other hand, application of growth factors, particularly basic fibroblast growth factor in the treatment of human periodontitis, is promising and is now in clinical trial. Furthermore, the rate of release of growth factor from the scaffold also can profoundly affect the results of tissue engineering strategies and the development of new materials is expected. In addition, as tissue regenerative potential is negatively regulated by aging, the effects of aging have to be clarified to gain complete regeneration.
Pereira, A C; Castellanos, R A; da Silva, S R; Watanabe, M G; Queluz, D P; Meneghim, M C
A total of 104 elderly persons between the ages of 60 and 89 were examined at the "Geraldo de Paula Sousa" Health Center, São Paulo, State of São Paulo. The state of their oral health was very poor, insofar as 4.29 (71.5%) of the sextants were shown to be null, while 0.12 and 0.13 sextants showed deep periodontal pockets > or = 6 mm in the ages from 60-70 and more than 70 years of age, respectively. The level of knowledge about periodontal disease and dental plaque was very deficient; only about 52% of the population under study reported having visited a dentist in the last two years. We conclude that greater odontological attention is needed for the elderly age group, as there are no large-scale community service centers in Brazil for this population group.
Calderaro, Débora Cerqueira; Ferreira, Gilda Aparecida; Corrêa, Jôice Dias; Mendonça, Santuza Maria Souza; Silva, Tarcília Aparecida; Costa, Fernando Oliveira; Lúcio Teixeira, Antônio
The aim of this study was to compare the frequency and severity of chronic periodontitis (CP) in systemic lupus erythematosus (SLE) patients with individuals without rheumatic diseases. Seventy-five patients with SLE were compared to 75 individuals without rheumatic diseases (control group) matched for age, educational level, and income. The activity of SLE was assessed with the Systemic Lupus Erythematosus Disease Activity Index 2000. Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus evaluated SLE-related damage. Dental evaluation included measuring plaque index and parameters of periodontal disease (probing depth, clinical attachment level, and bleeding on probing). Fifty-one (68 %) SLE patients and 42 (56 %) control individuals had CP (p = 0.13). Periodontal status was similar in both groups. Considering only individuals with CP, SLE patients were younger than controls (40.7 ± 9.8 versus 46.14 ± 12.5 years of age, p = 0.02). CP was not associated with activity or therapeutics in SLE patients. Severity of periodontal parameters was similar in SLE patients and control subjects; however, CP occurred earlier in SLE patients.
Katti, Sandeep S; Chava, Vijay Kumar
Background: The aim of the study was to study the clinical effects of ozonated water on periodontal tissues. Materials & Methods: In the present study 30 subjects were selected with age ranging from 20 to 60 yearsand pocket depth of ≥5mm. Two sites were selected in each patient whichwere divided into two groups. Group 1(control group-irrigation with saline) and Group 2(study group-irrigation with ozonized water) and clinical parameters were recorded at baseline, 15 days and 30 days. Results: When the comparison of mean values of Plaque Index and Gingival Index between the groups and at different time intervals were made, statistically significant difference were observed at 30 days at 5% level. When the mean values of clinical attachment level on mesial and distal site was compared between the groups, statistical significance was observed at 5% level and 1% level respectively.Similarly statistical significance at 5% level was observed at 15 and 30 days on buccal site. Conclusion: Subgingival irrigation with ozonized water is beneficial adjunct treatment modality to enhance periodontal health with significant role in periodontal therapy. How to cite this article: Katti SS, Chava VK. Effect of Ozonised water on Chronic Periodontitis - A Clinical Study. J Int Oral Health 2013;5(5):79-84. PMID:24324309
Polson, A M; Subtelny, J D; Meitner, S W; Polson, A P; Sommers, E W; Iker, H P; Reed, B E
This study evaluated the clinical periodontal status of persons who had completed orthodontic therapy at least 10 years previously (study) and compared the findings to those of adults with untreated malocclusions (control). Subjects in the study (n = 112; 63 female subjects, 49 male subjects; mean age 29.3 +/- 4.2 [SD] years) and control (n = 111; 62 female subjects, 49 male subjects; mean age 32.9 +/- 6.5 years) populations underwent a comprehensive periodontal examination that consisted of measurements taken at six points around the circumference of each tooth: (1) plaque, (2) visual inflammation, (3) bleeding after probing, (4) pocket depth, (5) gingival recession, and (6) loss of connective tissue attachment. Data from the individual measuring points were organized into 14 different combinations of either tooth types or surface locations; each was subjected to a four-way ANOVA partitioned on group (study vs. control), sex, socioeconomic status, and malocclusion type. The results showed that differences in age distribution within the groups were affecting the comparisons between the groups. Consequently, the groups were balanced for age and analyses were done to investigate group differences by means of multiple regression techniques. The comparisons showed no significant differences between the groups for any of the periodontal variables. It was concluded that orthodontic treatment during adolescence had no discernible effect upon later periodontal health.
Bhatia, Madhu; Pentyala, Kishore Babu; Urolagin, Sarvesh Basavaraj; K B, Menaka; Bhoi, Shreedevi
Aims and objectives: The aim of the present study was to evaluate the clinical and microbiological efficacy of locally delivered 1% curcumin gel as an adjunct to scaling and root planing in the treatment of chronic periodontitis. Materials and Methods: The study group consisted of 25 patients, belonging to both sex, aged between 21-45 years. All patients diagnosed as chronic periodontitis with periodontal pockets of depth >5mm bilaterally were randomly selected. A split mouth design was followed and the patients received a complete prophylaxis including scaling and root planing. Examination of plaque index, bleeding index, probing pocket depth and clinical attachment level were measured for each patient. The test group received 1% curcumin gel along with scaling and root planing whereas the control group received scaling and root planing alone followed by microbiological samples taken at baseline, 1, 3 and 6 months interval. Results: The 1% curcumin gel appeared to provide significant improvements in clinical parameters. Microbiological counts of Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and capnocytophaga showed significant reduction in periopathogens at the test sites after six months when compared with that of control sites. Conclusion: Locally delivered 1% curcumin gel was more effective in inhibiting the growth of oral bacteria when used as an adjunct to SRP in the treatment of chronic periodontitis. PMID:25654035
Priyanka, Goguladinne Naga Deepthi; Radhakrishna, Ambati Naga; Ramakrishna, Juvva; Jyothi, Velagapudi
Introduction The hormonal fingerprint is the ratio between 2nd and 4th digit lengths. It was evidenced in the medical scenario that it can be used as an indirect marker in many diseases like Coronary Heart Disease (CHD) and metabolic syndromes. As far as dentistry is concerned very few studies in the literature have been done to evaluate the influence of hormonal fingerprint on oral health, thus provoking us to formulate new method for predicting dental caries and malocclusion and its association with Body Mass Index (BMI). Aim The purpose of this retrospective study was to highlight the role of new biological marker–Hormonal fingerprints in the early detection of malocclusion, caries, the influence of BMI on malocclusion and caries. We also attempted to study the correlation of BMI with hormonal fingerprints. Materials and Methods A total of 300 children were randomly selected from both sexes of age group 10-15 years. The hormonal fingerprint was made by measuring the length ratio of the index and ring finger with the help of digital Vernier caliper. Anthropometric measures (weight in kilograms and height in metres) for the calculation of BMI were recorded. Caries assessment was done using standard mouth mirrors and Community Periodontal Index probes. DMFT index was followed for assessment of caries according to the WHO assessment form, 1997. Occlusal characteristics of the children evaluated were molar relation, anterior and posterior cross bite, open bite, deep bite, lower anterior crowding. All the factors were recorded by two investigators. Results The results of the study showed that majority of the children among study population were having 2D:4D <1. The rate of occurrence of malocclusion was increasing with increase in the value of 2D:4D ratio with a statistically significant p-value of <0.001. Higher BMI values were associated with normal occlusal conditions (p= 0.041) and lower 2D:4D ratio (p= 0.037). High caries experience was noticed in children with
Hellqvist, Lena; Rolandsson, Margot; Hugoson, Anders; Lingström, Peter; Birkhed, Dowen
The aim of this study was to investigate the effects of the Swedish moist powder tobacco product known as "snus" on dental caries and to measure the pH fall in dental plaque. The subjects comprised male and female adults between 26 and 62 years of age (n = 102), all habitual snus users for ≥ 10 years. The control group (n = 101) consisted of similar individuals in terms of gender, age and educational level but with no tobacco use for ≥ 10 years. A clinical and radiographic examination and a questionnaire were completed. The pH fall after a sucrose rinse was estimated in situ in 10 randomly selected subjects per group. The salivary secretion rate was higher in snus users than non-users (2.5 vs 2.2 ml/min, p = 0.005).There was no statistically significant difference regarding salivary buffer capacity. No differences were found between the two groups in terms of the plaque index, primary or secondary enamel and dentine caries, DFS and salivary counts of mutans streptococci or lactobacilli. The pH fall was somewhat more pronounced among non-users compared with snus users (NS). Snus users had a lower intake of snacks between meals and a less frequent intake of cookies (p = 0.000). Furthermore, snus users had a mean gingival index (± SD) for the whole dentition of 20.4 ± 18.2, while the index for non-users was 14.4 ± 13.9 (p = 0.09); the corresponding values for teeth 13-23 were 14.9 ± 20.6 and 7.7 ± 11.9 respectively (p = 0.003). To conclude, this clinical study revealed no statistically significant differences in caries prevalence between snus users and non-users and only minor differences regarding different caries associated factors.
This article describes the clinical and therapeutic aspects of multi-caries in young children. These rampant cervical caries usually begin with the eruption of the first teeth. Two typical cases are presented in which the prolonged use of nursing bottle at bedtime and the use of pacifiers dipped into honey are responsible for the development of multi-caries. Although such patient can be treated successfully, efforts should be made to promote preventive measures and parents education.
Brown, Wendy Y; McGenity, Phil
This study evaluated the effectiveness of a newly developed dental hygiene chew for dogs, with and without a natural antimicrobial additive, compared with a reference diet. Efficacy was determined by measuring the severity of gingivitis and the accumulation of dental plaque and calculus in dogs after 4-weeks of being fed the different dietary regimens. Dogs fed a single daily dental chew had significantly less gingivitis (P = 0. 02), plaque (P = 0. 0004), and calculus (P = 0.0001) compared with dogs in the control group that were fed an identical diet but received no chews. The inclusion of the antimicrobial agent did not improve the efficacy of the product. The dental hygiene chews tested in this study have potential to help reduce the incidence of periodontal disease in dogs.
Simonetti D'Arca, A; Marino, F; Rosica, L
Caries is a disease which on the basis of numerous epidemiological data it should be possible to control. The preventive interventions which have proved to have the greatest effect on the diffusion of this disease are essentially: fluoroprophylaxis, oral hygiene, food hygiene and periodic dental examination. The common denominator, which has the greatest effect on success, is a good level of health education of the populations affected by the programme, with specific reference to the teeth. The importance of the diet as a possible element predisposing to caries is an ascertained fact by now, and in fact it is well known that the greatest cariogenic effect is achieved after eating foods containing large quantities of fermentable sugars at irregular intervals throughout the day, especially in the form of products of high density and viscosity. The proposal to replace sugar with substitutive sweeteners such as: xilitol, sorbitol, licasin, talin, palatinit and, more recently, aspartame does not completely solve the problem; and apart from this the clearcut reduction of caries achieved in different European and non-European countries does not appear to be directly connected with a drop in sugar consumption, while more and more importance is ascribed to individual food choices. Oral hygiene procedures aim not only at the cleaning of teeth but also, to some extent, controlling the bacterial plaque. For this reason these are sometimes included among anticaries interventions; however opinions differ in this regard, with a clear prevalence of negative views. The question changes radically if we combine with mechanical procedures alone the use of fluoride-based toothpastes, which are recognised, in combination with other interventions, as playing a fundamental role in the rapid decline of caries in industralised countries. Toothpaste is considered as an excellent vehicle for the topical application of fluoride since it comes into contact with the teeth is slight
Xu, Hockin H. K.; Moreau, Jennifer L.; Sun, Limin; Chow, Laurence C.
Objectives The main challenges facing composite restorations are secondary caries and bulk fracture. The objectives of this study were to synthesize novel nanoparticles of amorphous calcium phosphate (NACP), develop NACP nanocomposite with calcium (Ca) and phosphate (PO4) ion release to combat caries, and investigate the effects of NACP filler level and glass co-filler reinforcement on composite properties. Methods NACP (diameter = 116 nm) were synthesized via a spray-drying technique for the first time. Since the local plaque pH in the oral cavity can decrease to 5 or 4, photo-activated composites were tested with immersion in solutions of pH 7, 5.5, and 4. Composite mechanical properties as well as Ca and PO4 ion release were measured vs. pH and filler level. Results Increasing the NACP filler level increased the ion release. At 28 d and pH 4, the Ca release was (4.66 ± 0.05) mmol/L at 20% NACP, much higher than (0.33 ± 0.08) at 10% NACP (p < 0.05). Decreasing the pH increased the ion release. At 20% NACP, the PO4 release at 28 d was (1.84 ± 0.12) mmol/L at pH 4, higher than (0.59 ± 0.08) at pH 5.5, and (0.12 ± 0.01) at pH 7 (p < 0.05). However, pH had little effect on composite mechanical properties. Flexural strength at 15% NACP was (96 ± 13) MPa at pH 4, similar to (89 ± 13) MPa at pH 5.5, and (89 ± 19) MPa at pH 7 (p > 0.1). The new NACP nanocomposites had strengths that were 2-fold those of previous calcium phosphate composites and resin-modified glass ionomer control. Significance NACP composites were developed for the first time. Their strengths matched or exceeded a commercial composite with little ion release, and were 2-fold those of previous Ca-PO4 composites. The nanocomposite was “smart” as it greatly increased the ion release at a cariogenic pH 4, when these ions would be most needed to inhibit caries. Hence, the new NACP composite may be promising for stress-bearing and caries-inhibiting restorations. PMID:21514655
Addy, M; Griffiths, G; Dummer, P; Kingdom, A; Shaw, W C
Numerous factors may affect the distribution of plaque and gingivitis in any individuals mouth. Of considerable importance must be the oral hygiene habits of each person, which will be influenced by compliance and dexterity with tooth cleaning methods. The pattern of gingivitis seen at a young age may, with time, reflect the eventual distribution of attachment loss. This in part, could explain the considerable variation in chronic periodontal disease seen between individuals and at different sites within the same mouth. This study reports the baseline data for the distribution of plaque and gingivitis in 1105, 11-12-year-old children in South Wales. The children were selected by disproportionate stratified random sampling and examined by a multidisciplinary group with the long-term aim of evaluating the importance of malocclusion to dental health and psychosocial variables. Toothbrushing frequency had a very low but significant correlation with the distribution of plaque and gingivitis, accounting therefore for only a small % of the variance in the group. For the total group and right-handed toothbrushers, buccal plaque and gingivitis was significantly increased on right contralateral teeth. No specific pattern for plaque and gingivitis distribution by side was seen for 100 left-handed toothbrushers. Plaque and gingivitis also showed significant differences dependent upon arch, tooth number, and surface. The population is being followed at 4-year intervals to monitor the pattern of periodontal disease with time and correlate changes with these baseline findings.
Wang, Lin; Xie, Xianju; Weir, Michael D; Fouad, Ashraf F; Zhao, Liang; Xu, Hockin H K
The objectives of this study were to: (1) develop a new bioactive dental bonding agent with nanoparticles of amorphous calcium phosphate and dimethylaminohexadecyl methacrylate for tooth root caries restorations and endodontic applications, and (2) investigate biofilm inhibition by the bioactive bonding agent against eight species of periodontal and endodontic pathogens for the first time. Bonding agent was formulated with 5 % of dimethylaminohexadecyl methacrylate. Nanoparticles of amorphous calcium phosphate at 30 wt% was mixed into adhesive. Eight species of biofilms were grown on resins: Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Parvimonas micra, Enterococcus faecalis, Enterococcus faecium. Colony-forming units, live/dead assay, biomass, metabolic activity and polysaccharide of biofilms were determined. The results showed that adding dimethylaminohexadecyl methacrylate and nanoparticles of amorphous calcium phosphate into bonding agent did not decrease dentin bond strength (P > 0.1). Adding dimethylaminohexadecyl methacrylate reduced the colony-forming units of all eight species of biofilms by nearly three orders of magnitude. The killing efficacy of dimethylaminohexadecyl methacrylate resin was: P. gingivalis > A. actinomycetemcomitans > P. intermedia > P. nigrescens > F. nucleatum > P. micra > E. faecalis > E. faecium. Dimethylaminohexadecyl methacrylate resin had much less biomass, metabolic activity and polysaccharide of biofilms than those without dimethylaminohexadecyl methacrylate (P < 0.05). In conclusion, a novel dental adhesive was developed for root caries and endodontic applications, showing potent inhibition of biofilms of eight species of periodontal and endodontic pathogens, and reducing colony-forming units by three orders of magnitude. The bioactive adhesive is promising for tooth root restorations to provide
Ay, Zuhal Yetkin; Oruçoğlu, Aslihan; Kilinç, Gizem; Oztürk, Mine; Kilbaş, Aynur; Uskun, Ersin; Bozkurt, Fatma Yeşim; Canatan, Duran
Cardiac symptoms and premature death from cardiac causes are still suggested to be a major problem in thalassemic patients. One of the main reasons for the cardiovascular events in thalassemia major (TM) patients has suggested having iron overload, in addition to other reasons such as hypoxia, abnormal lipoproteins levels, atherosclerotic conditions, etc. This study aims to investigate whether the periodontal health has an impact on the blood lipid levels. Twenty-four TM patients and sex-matched controls (C) enrolled to this study. The measurements of the periodontal parameters (gingival index, plaque index, bleeding on probing, probing depth, and clinical attachment level) were recorded. Besides, in venous blood samples the lipid profile was investigated. All of the periodontal parameters were significantly higher in TM group than in C group (P<0.05). Triglyceride and cholesterol/high density lipoprotein ratio had significant positive correlations with the periodontal parameters (P<0.05). Multiple regression analyses present significant associations between gingival index, plaque index scores, and the cholesterol/high density lipoprotein ratio (P<0.001). Our study results showed that the lipid profile of TM patients might be affected by their periodontal health. Further studies are needed to determine the lipid profile involvement magnitude and the cardiovascular disease risk caused by the periodontal health of TM patients.
Kinumatsu, Takashi; Umehara, Kazuhiro; Nagano, Kyosuke; Saito, Atsushi
We report a patient with severe chronic periodontitis requiring regenerative periodontal surgery and different types of prosthesis in the maxillary and mandibular regions. The patient was a 57-year-old woman who presented with the chief complaint of occlusal pain. An initial clinical examination revealed that 73% of sites had a probing depth of ≥4 mm, and 60% of sites exhibiting bleeding on probing. Radiographic examination revealed vertical bone defects in the molar region and widening of the periodontal ligament space around teeth #17 and 24. Initial periodontal therapy was implemented based on a clinical diagnosis of severe chronic periodontitis. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using enamel matrix derivative was performed on #14, 15, and 35-37. Tunnel preparation was performed on #46 as it had a 2-wall vertical bony defect and Degree 3 furcation involvement. Other sites with residual periodontal pockets were treated by modified Widman flap surgery. After a re-evaluation, functional rehabilitation was implemented with a removable maxillary partial denture and a fixed mandibular bridge. No further deterioration was observed in the periodontal condition of most of the teeth during a 2-year period of supportive periodontal therapy (SPT). The patient is currently still undergoing SPT and some minor problems remain. However, the results suggest that treatment and subsequent maintenance for severe periodontitis with traumatic occlusion can be successful as long as the appropriate periodontal and prosthodontic treatment is planned and careful SPT carried out.
Cifcibasi, Emine; Ciblak, Meral; Kiran, Bayram; Badur, Selim; Firatli, Erhan; Issever, Halim; Cintan, Serdar
The objective of this study was to determine the phenotypic profile of blood mononuclear cells, specifically CD8+/CD28+ cells, in patients with generalized aggressive periodontitis (GAgP) and chronic periodontitis (CP) in peripheral blood and in blood obtained from periodontal defect site which might contribute to tissue damage. 13 GAgP, 11 chronic periodontitis (CP) and 5 healthy controls (H) were included in the study. Plaque index (PI), bleeding on probing (BoP), periodontal probing depth (PPD) and clinical attachment level (CAL) were recorded. Blood from the base of periodontal defect site and peripheral blood from the antecubital vein were obtained. Relative counts of CD45+, CD3+, CD4+, CD8+/CD28+, CD8+/CD28−, CD19+, CD16+/CD56+/CD3, CD3+/CD16+/CD56+ receptors were determined with two color flow cytometry using monoclonal antibodies. BoP, PPD and CAL were significantly higher in both periodontitis groups than healthy controls (p <0.05). Activated cytotoxic T cells, CD8+/CD28+ cells, were significantly elevated in GAgP and CP groups compared to HC both in blood obtained from defect site and blood obtained from systemic circulation (p <0.05). GAgP and CP patients have an increased levels of activated cytotoxic T cells as a result of inflammation which may cause severe tissue damage that lead to severe and rapid loss of periodontal tissues. PMID:25788457
SANT’ANA, Adriana Campos Passanezi; de CAMPOS, Marinele R.; PASSANEZI, Selma Campos; de REZENDE, Maria Lúcia Rubo; GREGHI, Sebastião Luiz Aguiar; PASSANEZI, Euloir
Objectives The aim of this study was to evaluate the effects of non-surgical treatment of periodontal disease during the second trimester of gestation on adverse pregnancy outcomes. Material and Methods Pregnant patients during the 1st and 2nd trimesters at antenatal care in a Public Health Center were divided into 2 groups: NIG – "no intervention" (n=17) or IG- "intervention" (n=16). IG patients were submitted to a non-surgical periodontal treatment performed by a single periodontist consisting of scaling and root planning (SRP), professional prophylaxis (PROPH) and oral hygiene instruction (OHI). NIG received PROPH and OHI during pregnancy and were referred for treatment after delivery. Periodontal evaluation was performed by a single trained examiner, blinded to periodontal treatment, according to probing depth (PD), clinical attachment level (CAL), plaque index (PI) and sulcular bleeding index (SBI) at baseline and 35 gestational weeks-28 days post-partum. Primary adverse pregnancy outcomes were preterm birth (<37 weeks), low birth weight (<2.5 kg), late abortion (14-24 weeks) or abortion (<14 weeks). The results obtained were statistically evaluated according to OR, unpaired t test and paired t test at 5% significance level. Results No significant differences were observed between groups at baseline examination. Periodontal treatment resulted in stabilization of CAL and PI (p>0.05) at IG and worsening of all periodontal parameters at NIG (p<0.0001), except for PI. Significant differences in periodontal conditions of IG and NIG were observed at 2nd examination (p<0.001). The rate of adverse pregnancy outcomes was 47.05% in NIG and 6.25% in IG. Periodontal treatment during pregnancy was associated to a decreased risk of developing adverse pregnancy outcomes [OR=13.50; CI: 1.47-123.45; p=0.02]. Conclusions Periodontal treatment during the second trimester of gestation contributes to decrease adverse pregnancy outcomes. PMID:21552714
Fröhlich, Hanna; Herrmann, Kristina; Franke, Jennifer; Karimi, Alamara; Täger, Tobias; Cebola, Rita; Katus, Hugo A.; Zugck, Christian
Periodontal disease has been associated with an increased risk of cardiovascular events. The purpose of our study was to investigate whether a correlation between periodontitis and chronic heart failure exists, as well as the nature of the underlying cause. We enrolled 71 patients (mean age, 54 ± 13 yr; 56 men) who had stable chronic heart failure; all underwent complete cardiologic and dental evaluations. The periodontal screening index was used to quantify the degree of periodontal disease. We compared the findings to those in the general population with use of data from the 4th German Dental Health Survey. Gingivitis, moderate periodontitis, and severe periodontitis were present in 17 (24%), 17 (24%), and 37 (52%) patients, respectively. Severe periodontitis was more prevalent among chronic heart failure patients than in the general population. In contrast, moderate periodontitis was more prevalent in the general population (P <0.00001). The severity of periodontal disease was not associated with the cause of chronic heart failure or the severity of heart failure symptoms. Six-minute walking distance was the only independent predictor of severe periodontitis. Periodontal disease is highly prevalent in chronic heart failure patients regardless of the cause of heart failure. Prospective trials are warranted to clarify the causal relationship between both diseases. PMID:27547136
Aral, Cüneyt A; Köseoğlu, Serhat; Sağlam, Mehmet; Pekbağrıyanık, Tuğba; Savran, Levent
Periostin, an extracellular matrix protein functioning as an important structural mediator and adhesion molecule, has been shown to be an important regulator of connective tissue integrity. This study aimed to evaluate the levels of periostin in chronic periodontitis (CP) and aggressive periodontitis (AgP) compared to non-periodontitis (NP). Individuals were submitted to gingival crevicular fluid (GCF) and saliva sampling. Periodontal examination consisted of plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL) measurements. Assays for periostin were performed by an enzyme-linked immunosorbent assay. Periodontitis patients presented more severe clinical indices compared to the NP group (p < 0.001). The mean GCF level of periostin was lowest in the AgP group as compared to the other groups and was lower in the CP group as compared to the NP group (p < 0.001). Increased levels of periostin were observed in the saliva of patients with AgP as compared to the CP and NP groups (p < 0.05). There was a negative relationship between GCF periostin levels and clinical parameters (p < 0.01), whereas a positive correlation was observed between salivary periostin levels and full-mouth GI and CAL scores (p < 0.01). To our knowledge, this is the first report investigating periostin levels in GCF and saliva in aggressive periodontitis. The results suggest that subjects with CP and AgP exhibit a different periostin profile. Periostin in GCF may have a protective role against periodontal disease. Furthermore, salivary periostin concentrations may have a promising diagnostic potential for the aggressive forms of periodontal disease.
Doufexi, Aikaterini-Ellisavet; Kalogirou, Fotini
Background The real clinical utility of genetic testing is the prognostic value of genetic factors in the clinical outcome of periodontal treatment and the tooth survival. A meta-analysis was undertaken to estimate the effect of a susceptible genotype to periodontitis on the clinical outcomes of non-surgical periodontal therapy and the tooth survival. Material and Methods A systematic search of MEDLINE-Pubmed, Cochrane Library and Scopus was performed. Additionally, a hand search was done in three journals. No specific language restriction was applied. Two reviewers screened independently titles and abstracts or full text copies. Quality assessment of all the included studies was held. Results Initial screening of electronic databases resulted in 283 articles. Ten studies met the inclusion criteria, nine of them examined the clinical outcome, while the other one investigated the tooth survival in susceptible individuals after non-surgical periodontal therapy. Eight of included studies were selected for the meta-analysis. IL-1 positive genotypes increase the risk of tooth loss, while no association found between the bleeding on probing (BOP), clinical attachment loss (CAL) and plaque index (PI) with the genotype status. Probing pocket depth (PPD) reduction in the first three months and in long-term results found to have a significant association with the genotype. Conclusions There is no difference in the clinical measurements after non-surgical periodontal treatment, apart from PPD. More publications are needed to identify a cause-effect relationship. Key words:Periodontal disease, periodontitis, periodontal therapy, clinical outcome, tooth loss, susceptibility, polymorphism, genotype, meta-analysis, systematic review. PMID:26595831
Elavarasu, Sugumari; Naveen, Devisree; Thangavelu, Arthiie
Laser is one of the most captivating technologies in dental practice since Theodore Maiman in 1960 invented the ruby laser. Lasers in dentistry have revolutionized several areas of treatment in the last three and a half decades of the 20(th) century. Introduced as an alternative to mechanical cutting device, laser has now become an instrument of choice in many dental applications. Evidence suggests its use in initial periodontal therapy, surgery, and more recently, its utility in salvaging implant opens up a wide range of applications. More research with better designs are a necessity before lasers can become a part of dental armamentarium. This paper gives an insight to laser in periodontics.
Kwon, Jee Eun; Mintz, Gary S.; Hong, Young Joon; Lee, Sung Yun; Kim, Ki Seok; Hahn, Joo-Yong; Kumar, Kaup Sharath; Won, Hoyoun; Hyeon, Seong Hyeop; Shin, Seung Yong; Lee, Kwang Je; Kim, Tae Ho; Kim, Chee Jeong; Kim, Sang Wook
Background and Objectives We assessed plaque erosion of culprit lesions in patients with acute coronary syndrome in real world practice. Subjects and Methods Culprit lesion plaque rupture or plaque erosion was diagnosed with optical coherence tomography (OCT). Intravascular ultrasound (IVUS) was used to determine arterial remodeling. Positive remodeling was defined as a remodeling index (lesion/reference EEM [external elastic membrane area) >1.05. Results A total of 90 patients who had plaque rupture showing fibrous-cap discontinuity and ruptured cavity were enrolled. 36 patients showed definite OCT-plaque erosion, while 7 patients had probable OCT-plaque erosion. Overall, 26% (11/43) of definite/probable plaque erosion had non-ST elevation myocardial infarction (NSTEMI) while 35% (15/43) had ST elevation myocardial infarction (STEMI). Conversely, 14.5% (13/90) of plaque rupture had NSTEMI while 71% (64/90) had STEMI (p<0.0001). Among plaque erosion, white thrombus was seen in 55.8% (24/43) of patients and red thrombus in 27.9% (12/43) of patients. Compared to plaque erosion, plaque rupture more often showed positive remodeling (p=0.003) with a larger necrotic core area examined by virtual histology (VH)-IVUS, while negative remodeling was prominent in plaque erosion. Overall, 65% 28/43 of plaque erosions were located in the proximal 30 mm of a culprit vessel-similar to plaque ruptures (72%, 65/90, p=0.29). Conclusion Although most of plaque erosions show nearly normal coronary angiogram, modest plaque burden with negative remodeling and an uncommon fibroatheroma might be the nature of plaque erosion. Multimodality intravascular imaging with OCT and VH-IVUS showed fundamentally different pathoanatomic substrates underlying plaque rupture and erosion. PMID:27482258
Chatterjee, Anirban; Kandwal, Abhishek; Singh, Nidhi; Singh, Amit
Background: Deficiency of Co-Q10 has been found to be responsible for periodontal destruction; therefore, this study was undertaken to evaluate the anti-gingivitis effect of Co-Q10 on plaque induced gingivitis. Materials and Methods: Thirty subjects with plaque induced gingivitis were enrolled in a split mouth randomized controlled trial. For each subject, scaling was randomly performed for any two quadrants, followed by the topical application of Co-Q10 randomly in a previously scaled and as an unscaled quadrant for a period of 28 days. Four treatment options were planned: option A: scaling only; option B: Co-Q10 along with scaling; option C: Co-Q10. Results: Marked reduction in gingival, bleeding, and plaque scores were recorded at the sites where C0-Q10 was applied. Mean±S.D of aforementioned periodontal parameters at 28th day showed significant reduction for option A, B, and C when compared with baseline. Conclusion: Promising results were obtained after the solitary application of Co-Q10 as well as when it was used as an adjunct to scaling and root planing for treatment of plaque induced gingivitis. PMID:23493408
Chiranjeevi, Tikka; Prasad, Osuru Hari; Prasad, Uppu Venkateswara; Kumar, Avula Kishor; Chakravarthi, Veeraraghavulu Praveen; Rao, Paramala Balaji; Sarma, Potuguchi Venkata Gurunadha Krishna; Reddy, Nagi reddy Raveendra; Bhaskar, Matcha
Periodontitis have been referred to as the sixth complication of diabetes found in high prevalence among diabetic patients than among healthy controls. The aim of the present study was to examine the periodontal disease status among collected dental plaque samples. Chromosomal DNA was isolated and amplified by universal primers. The DNA was sequenced for bacterial confirmation and phylogenetic analysis performed for the evolutionary relationship with other known pathogens. No amplification products were observed in groups labeled non periodontal and non Diabetes (NP&ND) and non Periodontal and Diabetes (NP&D). But in the case of Periodontal and non Diabetes (P&ND) groups 22 amplified products were observed. In case of Periodontal and Diabetes (P&D), 32 amplified products were positive for microbes. Among the four microbial groups, Treponemadenticola, and Tannerella forsythia were found to be prevalent in P&D. The phylogenetic analysis of 16s rRNA of Treponemadenticola showed the relationship with other Treponema oral pathogen species and with the Spirochaetazuelaera. Tannerella forsythia shows its evolutionary relationship only with four oral pathogens (Macellibacteroidesfermentans, Porphyromadaceae bacterium, Parabacteroidesmeredae and Bacillus fosythus). Prevotellaintermedia also showed its evolutionary relationship only with Prevotella Spcs while Fusobacterium revealed close evolutionary relationship only with Porpiromonasgingivalis. PMID:24966528
Ngom, Papa Ibrahima; Benoist, Henri Michel; Soulier-Peigue, Delphine; Niang, Awa
The aim of this article is to review evidence on the reciprocal relationships between orthodontics and periodontics. Normal intra-arch and inter-arch relationships have long been considered as an anatomic prerequisite for the preservation of dental health and function. Certain malocclusion traits are associated with difficulties in maintaining good oral hygiene and as a consequence to poor periodontal condition. Therefore, proper alignment of the teeth provided by orthodontic treatment may promote good control of soft deposit and calculus and subsequent periodontal inflammation. The tendency of orthodontic appliances, particularly the brackets and bands to promote the accumulation of plaque and thus increasing the risk of developing localized periodontal disease must however be constantly emphasized. Periodontitis involves progressive loss of the alveolar bone around the teeth, pathological tooth migration and gingival recession with pathological tooth migration and gingival recession as a possible outcome. The effectiveness of orthodontics in conjunction with periodontics in the management of these esthetic and functional defects is highlighted in this review.
Rahiminejad, Mohammad Ehsan; Moaddab, Amirhossein; Zaryoun, Hassan; Rabiee, Soghra; Moaddab, Arta; Khodadoustan, Amin
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, affecting 4-18% of them. Previous studies also showed that periodontal diseases are associated with different components of the metabolic syndrome. The aim of this study is to determine the association between PCOS and periodontal diseases. Materials and Methods: A total of 196 women (98 with PCOS and 98 healthy controls) were enrolled. PCOS diagnosis was confirmed by history, clinical signs, physical examination, laboratory parameters, and ultrasound studies. Both cases and controls were examined by the same periodontist. Periodontal parameters including bleeding on probing (BOP), probing depth, clinical attachment loss (CAL), plaque index, and tooth loss were investigated in all participants. Pregnant women, smokers, individuals with a history of malignancy or osteoporosis, and those taking prophylactic antibiotics for dental procedures or receiving periodontal treatment during the 6-month period before examination were excluded. Data were analyzed using t-test, Chi-square test, and linear regression. Statistical significance was set at P < 0.05. Results: CAL and sites with BOP were significantly higher in women with PCOS (P < 0.05). However, no significant difference was observed in the tooth loss rate between PCOS and non-PCOS participants (P = 0.384). Conclusion: The prevalence of periodontal disease seems to be higher in women with PCOS. This may be related to the role of chronic systemic inflammation in the pathophysiology of both PCOS and periodontal diseases. PMID:26759585
Surya, Chamarthi; Swamy, Devulapally Narasimha; Chakrapani, Swarna; Kumar, Surapaneni Sunil
Background: Cigarette smoking is an established and modifiable risk factor for periodontitis. Periodontitis appears to be dose-dependent on smoking. The purpose of this study was to assess a reliable marker of tobacco smoke exposure (salivary cotinine) chairside and to confirm the quantitative association between smoking and chronic periodontitis. Materials and Methods: Saliva samples from 80 males, aged 30–60 years, with chronic periodontitis, were evaluated chairside using NicAlert™ cotinine test strips (NCTS). Patients were divided into two groups: A (cotinine negative) and B (cotinine positive). Plaque index (PI), Gingival index (GI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and gingival recession (GR) were compared between the two groups and among the subjects of group B. Results: Comparison showed that the severity of PPD (P<0.001), CAL (P<0.001), and GR (P<0.001) was more in group B than in group A. Severity of all periodontal parameters increased with increased salivary cotinine among the subjects in group B. Conclusion: Quantitative direct association can be established between salivary cotinine and the severity of periodontitis. Immunochromatography-based cotinine test strips are a relatively easy method for quantification of salivary cotinine chairside. Immediate and personalized feedback from a chairside test can improve compliance, quit rates, and ease reinforcing smoking cessation. PMID:23492903
Ilie, O; van Turnhout, A G; van Loosdrecht, M C M; Picioreanu, C
Using a one-dimensional mathematical model that couples tooth demineralisation and remineralisation with metabolic processes occurring in the dental plaque, two mechanisms for subsurface lesion formation were evaluated. It was found that a subsurface lesion can develop only as the result of alternating periods of demineralisation (acid attack during sugar consumption) and remineralisation (resting period) in tooth enamel with uniform mineral composition. It was also shown that a minimum plaque thickness that can induce an enamel lesion exists. The subsurface lesion formation can also be explained by assuming the existence of a fluoride-containing layer at the tooth surface that decreases enamel solubility. A nearly constant thickness of the surface layer was obtained with both proposed mechanisms. Sensitivity analysis showed that surface layer formation is strongly dependent on the length of remineralisation and demineralisation cycles. The restoration period is very important and the numerical simulations support the observation that often consumption of sugars is a key factor in caries formation. The calculated profiles of mineral content in enamel are similar to those observed experimentally. Most probably, both studied mechanisms interact in vivo in the process of caries development, but the simplest explanation for subsurface lesion formation remains the alternation between demineralisation and remineralisation cycles without any pre-imposed gradients.
Soo, Y S; Morgan, M V
An oral health status survey was conducted on 818 adolescents aged 12 to 16 years in a non-fluoridated area in rural Victoria. The prevalence and severity of dental caries experience was found to increase with age. The occlusal surface was the predominant surface affected by dental caries for all age groups. Filled surfaces represented the largest component of the DMFS index and were responsible for the increasing dental caries experience with age. Fewer fissure sealants were present with increasing age and second molars were sealed less often than the first molars. Although no difference was evident in the total caries experience between those with and without access to public dental services, a statistical difference was found to exist in unmet need between these two groups. Untreated caries levels were significantly higher in health card holders. The provision of preventive and dental treatment services to this group should be a priority in the future.
A proposal is presented for Periodontics II, a course offered at the Community College of Philadelphia to give the dental hygiene/assisting student an understanding of the disease states of the periodontium and their treatment. A standardized course proposal cover form is given, followed by a statement of purpose for the course, a list of major…
Passanezi, Euloir; Damante, Carla Andreotti; de Rezende, Maria L Rubo; Greghi, Sebastião L Aguiar
About 50 years ago, lasers started to be used in periodontal treatment following evidence that wounds produced in animals healed more quickly after being irradiated with low-intensity lasers. Increased production of growth factors, stimulated mainly by red and infrared lasers, may participate in this process by influencing the behavior of various types of cells. High-intensity lasers have been used as an alternative to nonsurgical periodontal therapy in root biomodification and to reduce dentin hypersensivity; low-intensity lasers are frequently employed to improve tissue repair in regenerative procedures and in antimicrobial photodynamic therapy. Despite the abundance of promising data on the advantages of their use, there is still controversy regarding the real benefits of lasers and antimicrobial photodynamic therapy in periodontal and peri-implant treatment. A huge variation in the parameters of laser application among studies makes comparisons very difficult. An overview of the current concepts and findings on lasers in periodontal therapy is presented with emphasis on data collected from Latin-American researchers.
Shanmugam, Nesan; Román-Rego, Ana; Ong, Peter; Kaski, Juan Carlos
Coronary artery disease is the major cause of death in the western world. The formation and rapid progression of atheromatous plaques can lead to serious cardiovascular events in patients with atherosclerosis. The better understanding, in recent years, of the mechanisms leading to atheromatous plaque growth and disruption and the availability of powerful HMG CoA-reductase inhibitors (statins) has permitted the consideration of plaque regression as a realistic therapeutic goal. This article reviews the existing evidence underpinning current therapeutic strategies aimed at achieving atherosclerotic plaque regression. In this review we also discuss imaging modalities for the assessment of plaque regression, predictors of regression and whether plaque regression is associated with a survival benefit.
Páramo, José A; Civeira, Fernando
As it is well-known, a thrombus evolving into a disrupted/eroded atherosclerotic plaque causes most acute coronary syndromes. Plaque stabilization via reduction of the lipid core and/or thickening of the fibrous cap is one of the possible mechanisms accounted for the clinical benefits displayed by different anti-atherosclerotic strategies. The concept of plaque stabilization was developed to explain how lipid-lowering agents could decrease adverse coronary events without substantial modifications of the atherosclerotic lesion ('angiographic paradox'). A number of imaging modalities (vascular ultrasound and virtual histology, MRI, optical coherence tomography, positron tomography, etc.) are used for non-invasive assessment of atherosclerosis; most of them can identify plaque volume and composition beyond lumen stenosis. An 'aggressive' lipid-lowering strategy is able to reduce the plaque burden and the incidence of cardiovascular events; this may be attributable, at least in part, to plaque-stabilizing effects.
Klepac-Ceraj, Vanja; Patel, Niraj; Song, Xiaoqing; Holewa, Colleen; Patel, Chitrang; Kent, Ralph; Amiji, Mansoor M.; Soukos, Nikolaos S.
Background and Objectives Photodynamic therapy (PDT) is increasingly being explored for treatment of oral infections. Here, we investigate the effect of PDT on human dental plaque bacteria in vitro using methylene blue (MB)-loaded poly(lactic-co-glycolic) (PLGA) nanoparticles with a positive or negative charge and red light at 665 nm. Study Design/Materials and Methods Subgingival plaque samples were obtained from 14 patients with chronic periodontitis. Suspensions of plaque microorganisms from seven patients were sensitized with anionic, cationic PLGA nanoparticles (50 μg/ml equivalent to MB) or free MB (50 μg/ml) for 20 min followed by exposure to red light for 5 min with a power density of 100 mW/cm2. Polymicrobial oral biofilms, which were developed on blood agar in 96-well plates from dental plaque inocula obtained from seven patients, were also exposed to PDT as above. Following the treatment, survival fractions were calculated by counting the number of colony-forming units. Results The cationic MB-loaded nanoparticles exhibited greater bacterial phototoxicity in both planktonic and biofilm phase compared to anionic MB-loaded nanoparticles and free MB, but results were not significantly different (p>0.05). Conclusion Cationic MB-loaded PLGA nanoparticles have the potential to be used as carriers of MB for PDT systems. PMID:22057487
Parker, Dennis L.
SYNOPSIS There has been significant progress made in 3D carotid plaque magnetic resonance imaging techniques in recent years. 3D plaque imaging clearly represents the future in clinical use. With effective flow suppression techniques, choices of different contrast weighting acquisitions, and time-efficient imaging approaches, 3D plaque imaging offers flexible imaging plane and view angle analysis, large coverage, multi-vascular beds capability, and even can be used in fast screening. PMID:26610656
Baelum, Vibeke; Pongpaisal, S; Pithpornchaiyakul, W; Pisuithanakan, S; Teanpaisan, Rawee; Papapanou, Panos N; Dahlen, Gunnar; Ole, Fejerskov
This study describes the tooth mortality and the prevalence and severity of dental caries among 30- to 39- and 50- to 59-year-old rural Thais from the Province of Songhkla, Thailand. Three hundred and sixty-three persons were given a clinical examination, including assessment of dental status, dental caries, and periodontal recordings. Information on religious faith, smoking, and betel use was obtained by means of an interview. The prevalence of edentulism was low (<2% among 50- to 59-year-olds). The mean number of teeth present was high, 29.4 among the 30- to 39-year-olds and 24.3 among the 50- to 59-year-olds. The prevalence of caries was high (91% among 30- to 39-year-olds and 84% among 50- to 59-year-olds). The mean DFT values were 5.7 and 5.8, respectively, and a substantial part of the DFT consisted of deep dentin lesions. The results did not corroborate the hypothesis that persons of Muslim faith have worse dental conditions than do Thai Buddhist or that dental disease levels are higher among the Thai population than among other Southeast Asian populations.
Falsetta, Megan L.; Klein, Marlise I.; Colonne, Punsiri M.; Scott-Anne, Kathleen; Gregoire, Stacy; Pai, Chia-Hua; Gonzalez-Begne, Mireya; Watson, Gene; Krysan, Damian J.; Bowen, William H.
Streptococcus mutans is often cited as the main bacterial pathogen in dental caries, particularly in early-childhood caries (ECC). S. mutans may not act alone; Candida albicans cells are frequently detected along with heavy infection by S. mutans in plaque biofilms from ECC-affected children. It remains to be elucidated whether this association is involved in the enhancement of biofilm virulence. We showed that the ability of these organisms together to form biofilms is enhanced in vitro and in vivo. The presence of C. albicans augments the production of exopolysaccharides (EPS), such that cospecies biofilms accrue more biomass and harbor more viable S. mutans cells than single-species biofilms. The resulting 3-dimensional biofilm architecture displays sizeable S. mutans microcolonies surrounded by fungal cells, which are enmeshed in a dense EPS-rich matrix. Using a rodent model, we explored the implications of this cross-kingdom interaction for the pathogenesis of dental caries. Coinfected animals displayed higher levels of infection and microbial carriage within plaque biofilms than animals infected with either species alone. Furthermore, coinfection synergistically enhanced biofilm virulence, leading to aggressive onset of the disease with rampant carious lesions. Our in vitro data also revealed that glucosyltransferase-derived EPS is a key mediator of cospecies biofilm development and that coexistence with C. albicans induces the expression of virulence genes in S. mutans (e.g., gtfB, fabM). We also found that Candida-derived β1,3-glucans contribute to the EPS matrix structure, while fungal mannan and β-glucan provide sites for GtfB binding and activity. Altogether, we demonstrate a novel mutualistic bacterium-fungus relationship that occurs at a clinically relevant site to amplify the severity of a ubiquitous infectious disease. PMID:24566629
Iwasaki, Kengo; Komaki, Motohiro; Yokoyama, Naoki; Tanaka, Yuichi; Taki, Atsuko; Honda, Izumi; Kimura, Yasuyuki; Takeda, Masaki; Akazawa, Keiko; Oda, Shigeru; Izumi, Yuichi; Morita, Ikuo
Periodontal disease is characterized by the destruction of tooth supporting tissues. Regeneration of periodontal tissues using ex vivo expanded cells has been introduced and studied, although appropriate methodology has not yet been established. We developed a novel cell transplant method for periodontal regeneration using periodontal ligament stem cell (PDLSC)-transferred amniotic membrane (PDLSC-amnion). The aim of this study was to investigate the regenerative potential of PDLSC-amnion in a rat periodontal defect model. Cultured PDLSCs were transferred onto amniotic membranes using a glass substrate treated with polyethylene glycol and photolithography. The properties of PDLSCs were investigated by flow cytometry and in vitro differentiation. PDLSC-amnion was transplanted into surgically created periodontal defects in rat maxillary molars. Periodontal regeneration was evaluated by microcomputed tomography (micro-CT) and histological analysis. PDLSCs showed mesenchymal stem cell-like characteristics such as cell surface marker expression (CD90, CD44, CD73, CD105, CD146, and STRO-1) and trilineage differentiation ability (i.e., into osteoblasts, adipocytes, and chondrocytes). PDLSC-amnion exhibited a single layer of PDLSCs on the amniotic membrane and stability of the sheet even with movement and deformation caused by surgical instruments. We observed that the PDLSC-amnion enhanced periodontal tissue regeneration as determined by micro-CT and histology by 4 weeks after transplantation. These data suggest that PDLSC-amnion has therapeutic potential as a novel cell-based regenerative periodontal therapy.
Morris, A J; Steele, J; White, D A
Periodontal disease continues to be a major concern for dentists and patients. This paper reports the findings of the 1998 UK Adult Dental Health survey in relation to plaque, calculus, periodontal pocketing and loss of attachment. It is apparent from this study that moderate periodontal disease remains commonplace amongst UK adults and that the associated risk factors of plaque and calculus are in abundance, even amongst those who profess to be motivated about their oral health and attend the dentist regularly. The continued high prevalence of disease needs to be seen in the context of the far larger number of people who are now potentially at some risk, particularly in the older age groups, because of improvements in tooth retention. However, the cumulative effect of disease means that control of the periodontal diseases, even mild and slowly progressing disease, will be a key issue if large numbers of teeth are to be retained into old age. If that level of control is to be achieved we need a widespread improvement in our management of the disease, particularly in our ability to improve the oral cleanliness of the UK population.
Luzzi, Lucinara Ignez Tavares; Greghi, Sebastião Luiz Aguiar; Passanezi, Euloir; Sant'ana, Adriana Campos Passanezi; Lauris, José Roberto Pereira; Cestari, Tânia Mary
Given that tobacco smoking habit is a risk factor for periodontal diseases, the aim of this study was to compare clinical periodontal aspects between smokers and non-smokers. The clinical status were assessed in 55 patients, 29 smokers and 26 non-smokers, aged 30 to 50 years, with mean age of 40. The clinical parameters used were: probing depth (PD), plaque index (PI), gingival index (GI), clinical attachment level (CAL), gingival recession (GR) and gingival bleeding index (GBI) for arches (upper and lower) and teeth (anterior and posterior). Tooth loss was also evaluated in both groups. Multiple regression analysis showed: tendency of greater probing depth and clinical attachment level means for smokers; greater amount of plaque in smokers in all regions; greater gingival index means for non-smokers with clinical significance (p<0.05) in all regions. Although, without statistical significance, the analysis showed greater gingival bleeding index means almost always for non-smokers; similar gingival recession means in both groups and tendency of upper tooth loss in smokers and lower tooth loss in non-smokers. The findings of this study showed that clinical periodontal parameters may be different in smokers when compared to non-smokers and that masking of some periodontal signs can be a result of nicotine's vasoconstrictor effect. PMID:19089190
Moore, W E; Holdeman, L V; Cato, E P; Smibert, R M; Burmeister, J A; Palcanis, K G; Ranney, R R
Statistical comparisons of the floras associated with juvenile periodontitis, severe periodontitis, and moderate periodontitis indicated that differences in the bacterial compositions of affected sites in these populations were not statistically significant. The subgingival flora of affected juvenile periodontitis sites was statistically significantly different from the adjacent supragingival flora and from the subgingival floras of people with healthy gingiva and of children with developing (experimental) gingivitis. However, the subgingival flora of affected juvenile periodontitis sites was not significantly different from the flora of sites with gingival index scores of 1 or 2 in adults with developing (experimental) gingivitis. Of 357 bacterial taxa among over 18,000 isolates, 54 non-treponemal species, 2 treponemal species, and mycoplasma were most associated with diseased periodontal sulci. These species comprised an increasing proportion of the flora during developing gingivitis and constituted over half of the cultivable flora of diseased sites. PMID:3988344
Mesquita-Guimarães, Késsia Suênia Fidelis; De Rossi, Andiara; Freitas, Aldevina Campos; Nelson-Filho, Paulo; da Silva, Raquel Assed; de Queiroz, Alexandra Mussolino
Objective. This case report describes the changes in caries risk and activity and dental treatment of a 9-year-old patient who presented with signs and symptoms of Niemann-Pick disease type C (NPC). Treatment. The preventive dental treatment included instructions to caregivers for oral hygiene and diet. A calcium hydroxide pulpotomy and restorative dental treatments were performed in a dental office with desensitization techniques and behavioral management. The patient was attended every 3 months for the control of dental plaque biofilm, for topical fluoride application, and for observing the pulpotomized tooth. Results. The bacterial plaque biofilm was being adequately controlled by the caregiver. After 2 years, the clinical and radiographic examination of the pulpotomized tooth showed the absence of internal root resorption and bone rarefaction, and clinical examination showed tooth sensitivity, dental pain, and gingival swelling. Conclusion. The pulpotomy prevented clinical and radiographic success. Dentists must be aware of and be able to identify systemic and local aspects associated with caries risk of children with NPC disease. Furthermore, dentists must employ stringent preventive measures and provide instructions to caregivers to reduce caries risk. PMID:25685563
Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria
Objectives To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Design Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. Settings and participants The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Outcome measures Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Results Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem
Alves, Ricardo C; Félix, Sérgio A; Rodriguez-Archilla, Alberto; Oliveira, Pedro; Brito, José; dos Santos, José Martins
Background: Menopause is associated with important systemic and oral changes. Many researchers have tried to evaluate the influence of hormonal changes associated with menopause in the periodontium, however results are contradictory. Objective: Evaluate the possible effects of menopause on the severity of periodontal disease and tooth loss, by considering several general, oral and periodontal parameters. Methods: 102 women with chronic periodontitis, and at least six teeth, were divided into two groups: a study group (SG) consisting of 68 menopausal women and a control group (CG) consisting of 34 premenopausal women. The participants had extensive anamnesis, made by a single senior periodontologist, which collected demographic data, medical and gynaecological history and habits. Additionally, oral and periodontal parameters including: number of teeth, plaque index, presence of calculi, probing depth, bleeding on probing, gingival recession and attachment loss were recorded. The following statistical tests were used: Chi-square, Fisher’s t-test for independent samples, non-parametric Wilcoxon-Mann-Whitney, and linear multiple regression. Results: The number of teeth was significantly lower in postmenopausal women (SG 10.8 ± 5.9, CG 6.8 ± 4.6), however, after adjusting for age, smoking and plaque index, the difference was no longer statistically significant (P=0.169). The attachment loss was slightly higher in the study group, although the difference is not significant (SG 4.31 ± 1.08, CG 4.05 ± 1.28). Conclusions: Menopause does not appear to significantly influence the severity of periodontal disease and tooth loss. Other factors may exert a greater influence on the progression of periodontal disease rather than menopause itself. PMID:26379957
Opal, S; Garg, S; Jain, J; Walia, I
This article reviews the literature on genetic aspects of dental caries and provides a framework for the rapidly changing disease model of caries. The scope is genetic aspects of various dental factors affecting dental caries. The PubMed database was searched for articles with keywords 'caries', 'genetics', 'taste', 'diet' and 'twins'. This was followed by extensive handsearching using reference lists from relevant articles. The post-genomic era will present many opportunities for improvement in oral health care but will also present a multitude of challenges. We can conclude from the literature that genes have a role to play in dental caries; however, both environmental and genetic factors have been implicated in the aetiology of caries. Additional studies will have to be conducted to replicate the findings in a different population. Identification of genetic risk factors will help screen and identify susceptible patients to better understand the contribution of genes in caries aetiopathogenesis. Information derived from these diverse studies will provide new tools to target individuals and/or populations for a more efficient and effective implementation of newer preventive measures and diagnostic and novel therapeutic approaches in the management of this disease.
Burke, J.A.; Mulcahy, D.
A single overlay plaque assay was designed and evaluated for infectious hematopoietic necrosis virus. Epithelioma papillosum carpio cells were grown in normal atmosphere with tris(hydroxymethyl)aminomethane- or HEPES (N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid)-buffered media. Plaques were larger and formed more quickly on 1- to 3-day-old cell monolayers than on older monolayers. Cell culture medium with a 10% addition of fetal calf serum (MEM 10) or without serum (MEM 0) were the most efficient virus diluents. Dilution with phosphate-buffered saline, saline, normal broth, or deionized water reduced plaque numbers. Variations in the pH (7.0 to 8.0) of a MEM 0 diluent did not affect plaque numbers. Increasing the volume of viral inoculum above 0.15 ml (15- by 60-mm plate) decreased plaquing efficiency. Significantly more plaques occurred under gum tragacanth and methylcellulose than under agar or agarose overlays. Varying the pH (6.8 to 7.4) of methylcellulose overlays did not significantly change plaque numbers. More plaques formed under the thicker overlays of both methylcellulose and gum tragacanth. Tris(hydroxymethyl)aminomethane and HEPES performed equally well, buffering either medium or overlay. Plaque numbers were reduced when cells were rinsed after virus adsorption or less than 1 h was allowed for adsorption. Variation in adsorption time between 60 and 180 min did not change plaque numbers. The mean plaque formation time was 7 days at 16 degrees C. The viral dose response was linear when the standardized assay was used.
Clark, Melinda B; Slayton, Rebecca L
Dental caries remains the most common chronic disease of childhood in the United States. Caries is a largely preventable condition, and fluoride has proven effectiveness in the prevention of caries. The goals of this clinical report are to clarify the use of available fluoride modalities for caries prevention in the primary care setting and to assist pediatricians in using fluoride to achieve maximum protection against dental caries while minimizing the likelihood of enamel fluorosis.
Vahabi, Surena; Rostamian, Abdolrahman; Baniebrahimi, Ghazaleh
Background: Rheumatoid arthritis (RA) is the most prevalent chronic inflammatory disease of the joints. It is correlated with periodontal disease due to similar factors that exist in both diseases. The present study assessed the relationship of periodontal disease with RA and juvenile idiopathic arthritis (JIA). Materials and Methods: In this case-control study, 30 RA and 30 JIA patients along with similar number of matched controls were selected among patients referred to Imam Khomeini Hospital, Tehran, Iran. Periodontal parameters including pocket depth (PD), clinical attachment level (CAL), O’Leary and Bay plaque index (PI) and bleeding on probing (BOP) were determined in cases and controls. Erythrocyte sedimentation rate, number of painful and inflamed joints and severity of disease were evaluated in RA and JIA patients. Mann-Whitney U-test nonparametric, Spearman and Pearson's correlation coefficients, and Chi-square tests were used as statistical analysis (α = 0.05). Results: PD (4.17 vs. 3.6 mm; P < 0.0001), CAL (4.89 vs. 4.18 mm; P < 0.002), percentage of sites with PD >4 mm (58.83% vs. 44.33%; P < 0.002), percentage of sites with CAL >3 mm (74.13% vs. 64.4%; P < 0.001), percentage of sites with BOP (9.67% vs. 6.87%; P < 0.0001) and PI index (85.73% vs. 80.63%; P < 0.0001) were significantly higher in RA patients than controls. In this group, direct and significant correlations were found between serologic findings, disease severity and number of painful and inflamed joints with periodontal factors. In JIA patients, no significant relationships were found between JIA findings and periodontal parameters. Conclusion: Considering the limitations of this study, there was a relationship between RA and periodontal disease. Severity of periodontal disease increases in patients with RA, while no increased risk of periodontal disease or its severity was observed among JIA patients. PMID:26759590
Kesić, Ljiljana; Mihailović, Dragan; Jovanović, Goran; Antić, Slobodan; Brkić, Zlata
Abstract Background Diabetes mellitus (DM) increases the risk of periodontitis, and severe periodontitis often coexists with severe DM. The proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection and gingival inflammation is essential for achieving long-term control of DM. The purpose this study is to evaluate the effects of low-level laser therapy (LLLT) by exfoliative cytology in patients with DM and gingival inflammation. Subjects and Methods Three hundred patients were divided in three equal groups: Group 1 consisted of patients with periodontitis and type 1 DM, Group 2 of patients with periodontitis and type 2 DM, and Group 3 of patients with periodontitis (control group). After oral examination, smears were taken from gingival tissue, and afterward all of the patients received oral hygiene instructions, removal of dental plaque, and full-mouth scaling and root planing. A split-mouth design was applied; on the right side of jaws GaAlAs LLLT (670 nm, 5 mW, 14 min/day) (model Mils 94; Optica Laser, Sofia, Bulgaria) was applied for five consecutive days. After the therapy was completed, smears from both sides of jaws were taken. The morphometric analysis was done using the National Institutes of Health Image software program and a model NU2 microscope (Carl Zeiss, Jena, Germany). Results Investigated parameters were significantly lower after therapy compared with values before therapy. After therapy on the side subjected to LLLT, there was no significantly difference between patients with DM and the control group. Conclusions It can be concluded that LLLT as an adjunct in periodontal therapy reduces gingival inflammation in patients with DM and periodontitis. PMID:22928615
Hossain, Abu Nasir Mohammad Nazmul; Sampaio, Fabio Correia; von der Fehr, Frithjof Ramm; Arneberg, Pål
The aim of this study was to evaluate the effects of school-based fluoride rinsing and tablet programs on plaque fluoride levels. A total of 42 children (8-9 years) were selected from two neighboring schools in Dhaka, Bangladesh. After caries recordings, vestibular plaque samples from the maxillary central incisors and mandibular first molars were collected and frozen on day 0 (baseline). The subjects of one school (rinsing group, n = 15) rinsed with 0.05% NaF, while those from the other school (tablet group, n = 16) used a 0.5 mg F tablet on the 5 school days during a 3-week period. The surfaces were sampled on the first and last school day every week. The fluoride and protein contents of each sample were analyzed using micro-techniques. The median plaque fluoride levels were 9.1 ppm at baseline in the rinsing group and 2.5 ppm in the tablet group (P < 0.05). This difference could in part be related to reported fluoride toothpaste usage. After 4 days on the fluoride programs, plaque fluoride levels in the rinsing group increased to 27.3, 24.5 and 14.2 ppm in the 3 consecutive weeks. The corresponding values after tablet usage were 8.0, 6.5 and 7.1 ppm, respectively. After 3 days without fluoride during the weekends, levels declined towards baseline values in both groups. Hence, the plaque fluoride levels in 8 to 9-year-old Bangladeshi children were increased by both rinsing and tablet programs, but the effect was not detectable 3 days later.
Szafranski, Szymon P.; Wos-Oxley, Melissa L.; Vilchez-Vargas, Ramiro; Jáuregui, Ruy; Plumeier, Iris; Klawonn, Frank; Tomasch, Jürgen; Meisinger, Christa; Kühnisch, Jan; Sztajer, Helena; Pieper, Dietmar H.
The oral microbiome plays a key role for caries, periodontitis, and systemic diseases. A method for rapid, high-resolution, robust taxonomic profiling of subgingival bacterial communities for early detection of periodontitis biomarkers would therefore be a useful tool for individualized medicine. Here, we used Illumina sequencing of the V1-V2 and V5-V6 hypervariable regions of the 16S rRNA gene. A sample stratification pipeline was developed in a pilot study of 19 individuals, 9 of whom had been diagnosed with chronic periodontitis. Five hundred twenty-three operational taxonomic units (OTUs) were obtained from the V1-V2 region and 432 from the V5-V6 region. Key periodontal pathogens like Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia could be identified at the species level with both primer sets. Principal coordinate analysis identified two outliers that were consistently independent of the hypervariable region and method of DNA extraction used. The linear discriminant analysis (LDA) effect size algorithm (LEfSe) identified 80 OTU-level biomarkers of periodontitis and 17 of health. Health- and periodontitis-related clusters of OTUs were identified using a connectivity analysis, and the results confirmed previous studies with several thousands of samples. A machine learning algorithm was developed which was trained on all but one sample and then predicted the diagnosis of the left-out sample (jackknife method). Using a combination of the 10 best biomarkers, 15 of 17 samples were correctly diagnosed. Training the algorithm on time-resolved community profiles might provide a highly sensitive tool to detect the onset of periodontitis. PMID:25452281
Venkatesh, M P; Kumar, T M Pramod; Avinash, B S; Kumar, G Sheela
Periodontitis is an inflammatory condition affecting teeth resulting in progressive destruction of periodontal ligaments, resorption of alveolar bone and loss of teeth. Treatment of periodontitis includes surgical and non surgical management. Systemic antibiotics are also used for the treatment of periodontitis. The aim of this research was to formulate smart gel system of azithromycin (AZT) and to evaluate in vitro and in vivo for non-surgical treatment of chronic periodontitis. Azithromycin dihydrate, used systemically in the treatment of periodontitis, was formulated into smart gels using biodegradable, thermosensitive polymer Pluronic® F-127 (PF-127) and Hydroxy Ethyl Cellulose (HEC) as copolymer. The prepared smart gels were evaluated for sterility, content uniformity, gelation temperature and time, syringeability, rheological behavior, in vitro diffusion and in vivo efficacy in human patients. The prepared smart gels were clear and transparent, sterile, thermoresponsive and injectable. Viscosity of gels increased with increase in concentration of polymer/co-polymer and also with temperature. They gelled in short response time below the body temperature. In vitro release studies showed controlled drug release which was influenced significantly by the properties and concentration of PF-127 and HEC. In vivo efficacy studies showed a significant improvement (p <0.001) in clinical parameters such as gingival index, probing pocket depth, clinical attachment level, bleeding index and plaque index. The developed azithromycin smart gel system is a novel approach for the treatment of chronic periodontitis since it reduces the dose and side effects, bypasses the usual surgical procedures and improves patient compliance.
Fried, Daniel; Bühler, Christopher M.; Ngaotheppitak, Patara; Darling, Cynthia L.
Dental enamel manifests high transparency in the near-IR (NIR). Our previous work demonstrated that NIR light at 1310-nm is ideally suited for the transillumination of interproximal dental caries (dental decay in between teeth) and that it can also be used to image decay in the pits and fissures of the occlusal (biting) surfaces of posterior teeth where most new dental decay occurs. Early occlusal lesions cannot be detected by x-rays during the early stages of lesion development due to the overlapping topography of the crown of the tooth. Stains and non-calcified plaque are not visible in the NIR enabling better discrimination of demineralized areas. We also demonstrate that interproximal lesions can be imaged from the occlusal surface (from above). Moreover, multiple illumination and detector angles can be exploited for optimal contrast between caries and sound tissue. These measurements suggest that NIR imaging offers significant advantages over the conventional visual, tactile and radiographic caries detection methods and other optical caries detection and imaging techniques.
Jensen, M E; Wefel, J S
This two-part study was undertaken to examine the effects of processed cheese on human plaque pH and de- and remineralization of enamel and root lesions in a human in situ caries model system. In the first part of the study the selected processed cheese (Kraft American Singles Processed Cheese Food) was eaten alone and followed by a 10% sucrose rinse after the acidogenicity of the plaque was demonstrated. A 10% sucrose rinse alone resulted in a mean minimum pH of 4.26. The cheese alone showed a mean minimum pF of 6.32 and cheese followed by sucrose resulted in a mean minimum pH of 6.48. The plaque pH of cheese eaten alone stayed at pH above 5.7 (the "safe for teeth" level). Cheese consumption also prevented the acid challenge when followed by sucrose. The second part of the study utilized the thin-sections of artificially created caries-like lesions on enamel and root, and sound root sections. One-month periods were used in a cross-over design to examine the effect of eating the cheese q.i.d. Polarized light microscopy was used to determine changes in the size of lesion areas. The addition of the processed cheese to the diet resulted in statistically significant reductions in enamel lesion size as well as a reduction in progression of root lesions. Lesions created on the sound root surfaces were approximately one-third the size of those created during the control period. This study indicates that processed cheese is hypoacidogenic, anti-acidogenic, and prevents demineralization as well as enhances remineralization.
Soeroso, Y; Akase, T; Sunarto, H; Kemal, Y; Salim, R; Octavia, M; Viandita, A; Setiawan, J; Bachtiar, BM
Background The aim of this study was to evaluate the clinical and microbiological effects of local application minocycline HCl 2% gel, used as an adjunct to scaling and root planing (SRP) for treatment of chronic periodontitis (CP). CP is an inflammation of periodontal tissue that is caused mainly by bacterial infection, where periodontal destruction such as loss of attachment and bone destruction occurred. Methods A total of 81 subjects with moderate to severe periodontitis whose baseline clinical attachment loss (CAL) was ≥4 mm were randomly assigned to receive SRP alone (control group, N=39) or SRP followed by four times of local application of minocycline HCl gel (Periocline) once a week (test group, N=42). Pocket depth, CAL, and papilla bleeding index were examined at baseline, 21 days, 2, 3, and 6 months. Subgingival plaque samples were collected with sterile curettes and were analyzed by real-time polymerase chain reaction for the presence of three periodontal pathogens (Porphyromonas gingivalis [P.g.], Tannerella forsythia [T.f.], and Treponema denticola [T.d.]) at baseline, 2, 3, and 6 months. Results The number of bacteria was reduced in both groups at 2 months after baseline (SRP treatment). The changes (2–6 months) in T.d. and T.f. counts in the test group were significantly lower than those in the control group. In the control group, a significant regrowth of P.g., T.f., and T.d. was observed from 2 to 6 months and of P.g. and T.f. from 3 to 6 months. On the other hand, in the test group, the number of the three bacteria did not significantly increase during the 6-month period. Conclusion The results showed that local application of minocycline, used as an adjunct to SRP, was effective for suppressing regrowth of periodontal pathogens, suggesting its risk reduction of recurrent periodontal pathogens in CP. PMID:28331333
Effect of Supragingival Irrigation with Aerosolized 0.5% Hydrogen Peroxide on Clinical Periodontal Parameters, Markers of Systemic Inflammation, and Morphology of Gingival Tissues in Patients with Periodontitis
Žekonis, Gediminas; Žekonis, Jonas; Gleiznys, Alvydas; Noreikienė, Viktorija; Balnytė, Ingrida; Šadzevičienė, Renata; Narbutaitė, Julija
Background Various studies have shown that non-surgical periodontal treatment is correlated with reduction in clinical parameters and plasma levels of inflammatory markers. The aim of this study was to evaluate the effect of long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide as maintenance therapy followed by non-surgical periodontal treatment on clinical parameters, plasma levels of inflammatory markers, and morphological changes in gingival tissues of patients with periodontitis. Material/Methods In total, 43 patients with chronic periodontitis were randomly allocated to long-term maintenance therapy. The patients’ periodontal status was assessed using clinical parameters of approximal plaque index, modified gingival index, bleeding index, pocket probing depth, and plasma levels of inflammatory markers (high-sensitivity C-reactive protein and white blood cell count) at baseline and after 1, 2, and 3 years. The morphological status of gingival tissues (immediately after supragingival irrigation) was assessed microscopically. Results Complete data were obtained on 34 patients. A highly statistically significant and consistent reduction was observed in all long-term clinical parameters and plasma levels of inflammatory markers. Morphological data showed abundant spherical bubbles in gingival tissues. Conclusions 1. The present study showed that non-surgical periodontal treatment with long-term weekly supragingival irrigations with aerosolized 0.5% hydrogen peroxide improved clinical periodontal status and plasma levels of inflammatory markers and may be a promising method in periodontology. 2. We found that supragingival irrigation with aerosolized 0.5% hydrogen peroxide created large numbers of spherical bubbles in gingival tissues. PMID:27743448
Arnold, Wolfgang H.; Meyer, Ann-Kathrin; Naumova, Ella A.
Background: Low viscosity resin infiltration of initial caries lesions is a modern microinvasive method to treat initial cries lesions. However, only scarce information is available about the long-term surface alterations of infiltrated lesions. Methods: Twenty-eight premolar teeth exhibiting non-cavitated initial caries lesions (International Caries Detection and Assessment System (ICDAS code 1&2)) were divided into two groups, one of which was infiltrated with resin, and the other remained untreated. The teeth underwent two thermocycling procedures. The surface roughness was determined quantitatively, and the results were evaluated statistically. In addition, the surfaces of the lesions were investigated by scanning electron microscopy (SEM), and the surface was analyzed visually with respect to surface irregularities. Results: The results showed a reduction in the surface roughness that was significant after 2500 thermocycles compared to the untreated surface. In the control specimens, no change in the surface roughness was found. The qualitative SEM data also showed a smooth surface after thermocycling, which supported the statistical findings. Conclusion: After thermocycling, resin-infiltrated enamel surfaces become smoother and had no additional risk for plaque accumulation. PMID:27733877
Vieira, Alexandre R.; Modesto, Adriana; Marazita, Mary L.
The NIH Consensus Development Program released a statement in 2001 (NIH Consensus Statement, 2001) and listed six major clinical caries research directions. One of these directions was the need for genetic studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. This last decade has seen a steep increase in studies investigating the presence of genetic factors influencing individual susceptibility to caries. This review revisits recent caries human genetic studies and provides a perspective for future studies in order to fulfill their promise of revolutionizing our understanding of and the standard of care for the most prevalent bacteria-mediated non-contagious disease in the world. PMID:24853115