The effects of orthodontic treatment on periodontal health among the orthodontic patients attending Kulliyyah Of Dentistry (KOD) IIUM specialist clinic

Background: Orthodontic treatment requires remodeling of the periodontal tissues, including the periodontal ligament fibers and alveolar bone in order to straighten the misaligned teeth. The effect of orthodontic treatment is apparent esthetically but the effect to theperiodontal health is still in debate. Objective:To investigate the effect of orthodontic treatment on the periodontal condition among the orthodontic patients attending Kulliyyah of Dentistry (KOD), IIUM. Methodology: A quasi-experimental study was done among 11 patients scheduled for orthodontic treatment (sample group) at the Orthodontic Specialist Clinic, KOD. Those that fulfill the inclusion and exclusion criteria were selected; 11 patients who are waiting for orthodontic treatment were included as control (control group).The periodontal health of each patient was examined clinically using WHO 621 probe around the teeth and scored by using the Basic Periodontal Examination (BPE) method. The BPE readings were taken again 6 months after the beginning of orthodontic treatment.Baseline risk ratio(RR) before orthodontic treatment and that of six months after treatment were measured and compared. Results:The baseline RR between the sample group and the control group are: Sextant1 (S1): 0.562; Sextant2 (S2): 0.421; Sextant3 (S3): 2.250; Sextant4 (S4): 5.000; Sextant5 (S5): 3.600; Sextant6 (S6): 2.857. Conclusion: After 6 months of undergoing orthodontic treatment, there is no significant difference in the effect of orthodontic treatment on periodontal condition, except in Sextant 2. Keywords :BPE, Orthodontic treatment, WHO 621 probe, Periodontium, OR

Saving the questionnaire periodontally compromised teeth in the aesthetic zone: a case report

Introduction: The persistence of bleeding periodontal pockets that associated with intra-bony defects (IBD) increases the risk of tooth loss and is considered a clinical challenge. The prognosis of such teeth with grade II mobility and severe attachment loss (AL) is questionable according to McGuire 1991. Nevertheless proper periodontal treatment (PT) and supportive periodontal care might retain the periodontally compromised teeth. Case reports: A 35-year-old female with aggressive periodontitis was referred to the periodontics specialist clinic of IIUM. The full periodontal chart revealed grade II mobility of the upper central incisors (UCI) and pus discharge with deep propping depths and severe AL. The rapid rate of bone destruction affected the sites of the first and second molars as well. A combination of oral metronidazole and amoxicillin were prescribed for 7 days. Six weeks after the nonsurgical PT, the affected sites were reevaluated, and a decision of regenerative therapy was scheduled for the circumferential bone defects around the UCI. A papilla preservation technique was applied with bovine xenograft and resorbable barrier membrane. Splinting of the anterior teeth stabilized the wound healing, and a thorough professional and self-plaque control maintained a good oral hygiene post-surgical treatment. A significant probing reduction and attachment gain was achieved (PD: 8 mm at base line to 2 mm post treatment and maintained at 1 year). Comments: With proper flap design and regenerative treatment, deep IBD to the apex would not be an option for the extraction. The aggressive bone destruction as observed in CBCT was managed successfully

Saliva pH changes in patients with high and low caries risk after consuming organic (sucrose) and non-organic (maltitol) sugar

Introduction: Enamel demineralization is associated with decrease in saliva pH due to fermentation of sugar by oral commensal. Thus, exploring the changing pattern of saliva pH is meaningful in dental caries prevention. The aim of this study was to compare the changing pattern of saliva pH after consuming different types of sweeteners (sucrose and maltitol). Methods: It was a case-control study involving 14 male patients attending IIUM dental clinic who were selected with the intention of getting seven patients with high caries risk ( DMFT ≥6) and seven patients with low caries risk (DMFT ≤3) with initial saliva pH interval of 6.5 to7.5. Patients were asked to consume snacks containing 8 gram sucrose and 8 gram maltitol as sweeteners. The changing pH values of the saliva were measured by Waterproof pHTestr 10BNC (Oakton, Vernon Hills, USA) seven times consecutively at 0 (before snack consumption), and at 5, 10, 15, 20, 30 and 60 minutes after snack consumption. The pH values of saliva of patients with low and high caries risk after consuming sucrose and maltitol were statistically analized by using Anova and Tukey-HSD tests at α = 0.05. Result: There were significant differences in saliva pH changes between low-risk group and high-risk group after consuming sucrose and maltitol. Conclusion: The changing patterns of saliva pH in high-risk patients were lower than those of low-risk patients after consuming two types of snacks containing sucrose and maltitol. KEYWORDS: Saliva pH, sucrose, maltitol, susceptability, dental carie

Microbial contamination of dental radiology equipment

Objective: The aim of this study was to determine the quantity of colony forming units of microbial contamination present on the high touch areas of dental radiology equipment. Methodology: Swabs were taken from 4 high touch areas of the dental radiology equipment on 6 days. The swabs were sent to the laboratory in the transport medium(Broth Medium)and incubated for 48 hours at 37 °C, before being smeared on the nutrient and blood agar media for isolation of microorganisms for 72 hours at 37 °C. Quantification of Colony Forming Units (CFU) was undertaken to determine the quantity of microbial contamination. Results: All the high touch areas on the dental radiology equipment showed high CFU counts. The median (IQR) values between the 4 high touch areas of equipment were not significantly different for both the nutrient and blood agars. (NA P = 0.168, BA P = 0.270). Surface disinfection produced decreased microbial contamination. Conclusion: The results demonstrated the presence of high levels of bacterial contamination of the high touch areas of dental radiology equipment without proper disinfection

Microbial contamination of equipment in the dental laboratory

Objectives: To determine the extent of microbial contamination on the high touch areas of equipment in the dental laboratory. Method: A dental laboratory based cross-sectional study was carried out on four selected high touch areas, which were the vibrator (power switch), the cast trimmer (power switch) and the denture polisher (power switch & speed control knob). Sterile cotton swabs were used to swab these four areas, smeared onto nutrient agar media and then incubated for 72 hours. The colony forming units (CFU) were counted after 72 hours to determine the extent of microbial contamination. Sample collection was carried out for 3 consecutive days. As a control, the same areas were disinfected and samples were taken exactly as before. Investigation of similar procedure was carried out for another week. A total of 48 sample plates were collected, 24 before disinfection and another 24 after disinfection. Results: A before and after comparison of mean CFU count in the four high touch areas showed both speed control knob (216/54.33) and power switch (189.67/9.83) of the denture polishing machine had the highest CFU count, followed by the cast trimmer (68.17/18) and finally the vibrator (50/7). Before disinfection, the minimum, maximum and mean ± SD bacteria count in 24 plates were 19, 410 and 131.08 ± 105.77 respectively. The minimum, maximum and mean ± (SD) bacteria count in 24 plates after disinfection were 1, 102 and 21.96 ± 28.303 respectively. Reduction in mean of CFU count after surface disinfection using paired T-test was statistically significant (p<0.05). Conclusion: There is high level of bacterial contamination of the high touch areas in the absence of surface disinfection. Therefore, disinfection procedures as are conducted in dental clinic should be implemented in the dental laboratory. Keywords: Dental laboratory, High touch areas, Bacterial contamination, Disinfectio

The role of periodontal regeneration in the management of advanced periodontal defects. Series of case reports

Introduction: High prevalence of periodontitis has been reported in the 21st century. However, the traditional nonsurgical periodontal treatment results in healing by long junctional epithelium. Long-term stability of the teeth requires reconstruction of what have been lost from the soft and hard tissues of the periodontium. Case report: Clinical selection of 4 cases characterised by advanced periodontal defects were selected for this report. Case I, advanced bone loss at distal site of tooth 11 with pus discharge was presented with a history of root perforation during RCT. Case II, severe circumferential bone defect around teeth 11 and 21 with pus discharge and grade II mobility. Significant bone gain and pocket depth reduction were achieved and maintained for both cases at 12 and 6 months respectively after applying bone replacement xenograft and collagen barrier membrane. Case III, implant placement in a narrow ridge width at the extraction site of tooth 44 resulted in alveolar crestal bone dehiscence at the buccal aspect. Case IV, severe bone resorption in the buccal plate due to previous extraction of tooth 12 contraindicates direct implant placement. Substantial bone thickness was recorded in both cases as observed in CBCT 12 months post surgical regenerative treatment providing adequate support for dental implant. Conclusion: Since patients prefer the option of maintaining their teeth over extraction and replacement by dental implants compared to dentures, the regenerative periodontal therapy would offer promising potential for successful periodontal reconstruction even in advanced periodontal defects

Immunohistochemical detection of nerve growth factor and its receptors in the rat periodontal ligament during tooth movement

Objectives Nerve growth factor (NGF) and its receptors, p75 and tyrosine receptor kinase A (Trk A), have been shown to increase following trauma. The aims of this study were to examine changes in the detection of NGF and its receptors during orthodontic tooth movement in the rat, and the effects of anti-NGF on these changes. Design Orthodontic separators were placed between the right maxillary first and second molars of Sprague–Dawley rats which were equally divided into two groups. Animals from the second group were injected with anti-NGF. The left sides served as controls, and animals were sacrificed at 0, 3, 7 and 14 days. Results Results of immunohistochemical localisation for p75, Trk A, calcitonin gene-related peptide (CGRP) and NGF showed staining intensity increased at day 3, with a peak at day 7 and decreasing intensity at day 14. Anti-NGF injected animals showed reduced staining at all observation periods. Conclusion Data suggest that orthodontic injury induces NGF production, leading to sprouting and invasion by CGRP-positive nerve fibers and that injection of anti-NGF reduces NGF tissue levels and prevents innervation by CGRP-positive fibers