A COMPARISON OF THE EFFECTIVENESS OF THE “TOOTHKEEPER’ AND A TRADITIONAL DENTAL HEALTH EDUCATION PROGRAM

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66303/1/j.1752-7325.1975.tb04031.x.pd

The relation of preventive dental behaviors to periodontal health status

. Current recommendations for periodontal health maintenance emphasize toothbrushing, flossing and periodic dental checkups. The purposes of this study were to examine (1) the effects of these practices on periodontal health and (2) the relationships of demographic and socioeconomic variables with these behaviors and with periodontal health. Adults ( n = 319) in the Detroit, Michigan tri-county area were asked how frequently they performed the 3 preventive behaviors. Levels of plaque, gingivitis, calculus, and periodontal attachment were then assessed during in-home dental examinations. There were no statistically significant differences in these health measures between those with acceptable and unacceptable brushing behavior. About 20% of the subjects reported acceptable flossing behavior, and these individuals had significantly less plaque and calculus than other participants. Over 3/4 of subjects reported having a dental checkup at least 1 × a year, and these persons were found to have significantly less plaque, gingivitis, and calculus compared to less frequent attenders. Acceptable brushing behavior was not associated with any particular demographic or socio-economic characteristic, while differences in acceptable flossing behavior were found among age groups. Frequencies of yearly dental checkups varied significantly within every demographic and socioeconomic characteristic.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75510/1/j.1600-051X.1994.tb00303.x.pd

Bacterial morphotype grading for periodontal disease assessment

BACKGROUND: Listgarten and Hellden (1978) used darkfield microscopy of wet mounts to differentiate between healthy and periodontally diseased sites in the mouth by expressing the different bacterial morphotypes observed as a percentage of the total number of bacteria counted. This method of periodontal disease assessment gained favour as a diagnostic tool but presented with the limitation of immediate examination to determine the number of motile rods present and an inability to distinguish between gingivitis and periodontitis. Grading of bacterial morphotypes into several distinct categories of health or disease (Ison and Hay, 2002), simplified the scoring system of Gram-stained smears for the diagnosis of bacterial vaginosis (Nugent et al. 1991). The application of a similar grading system using stained smears rather than wet mounts could be advantageous to the diagnosis of periodontal disease. OBJECTIVES/AIMS: This study tested the hypothesis that stained smears of dental plaque collected from the gingival crevice of individuals with varying probing pocket depths (PD) may provide a grading system for periodontal disease assessment. MATERIALS AND METHODS: Subgingival plaque samples were collected from 49 patients, stained with a silver stain and the proportions of each bacterial morphotype graded relative to their respective PD measurements. RESULTS: This technique allowed for a grading system of I–IV, with grade I indicating health and grade IV indicating severe periodontal disease. DISCUSSION: Stained smear examination eliminates the time restriction for motile rod enumeration and allows for storage of smears for future reference. CONCLUSION: Standardization of the microscopic areas to be evaluated or examined will facilitate the agreement of cut-off values for the diagnosis of periodontal disease.This material is based on work partially supported financially by the National Research Foundation (NRF) of South Africa

The effects of periodontal therapy on serum antibody (IgG) levels to plaque microorganisms *

The influence of periodontal therapy on serum antibody titers to selected periodontal disease-associated microorganisms was assessed in 23 patients having chronic inflammatory periodontal disease (CIPD), The immunoglobulin G (IgG) titers were dÉtÉrmined by the micro ELISA technique in serum samples obtained prior to treatment; following a hygienic phase which included scaling, root planing, and oral hygiene instruction; following surgical treatment; and one year and two years following hygienic phase (maintenance phase). Considerable individual variability existed in the magnitude of immune response to specific bacterial preparations. Significant reductions in the mean antibody titers were seen to A. viscosus. S. sanguis. F. nucleatum, S, spuligena, B. gingivalis. B. interme-dius. B. melaninogeniem, T. vincentii , and T denticola by the end of the second year of maintenance. There was no consistent response to Capnucytophaga. When individual patient responses were examined. 6 of the 23 were found to have elevated titers to at least one of the microorganisms in the interval between pretreatment and the end of the hygienic phase; however, in all but one case, the titers at the end of the second year of maintenance were below pretreatment levels. Antibody levels to bacteria such as S. sanguis were modified during therapy. This would indicate that immune responses to microbes not generally considered to be “periodontal pathogens” may be modified by adjuvant activity associated with subgingival plaque or changes in the environment of the sulcus and that subsequent changes in titer do not necessarily reflect a role of that microorganism in the disease process.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75110/1/j.1600-051X.1988.tb02127.x.pd

Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial

Objectives: The aim of this study was to evaluate the effects of Lactobacilli reuteri (Prodentis) alone and in combination with scaling and root planing (SRP) in a double blind, randomized, placebo-controlled clinical trial of volunteers with chronic periodontitis. Methods: Thirty, otherwise systemically healthy, chronic periodontitis patients (19 males and 11 females, aged between 34 and 50 years) were included. The study period was 42 days. ‘Split-mouth’ design was used for the SRP, which was performed on day 0; two quadrants (either right or left) were treated with SRP whereas the remaining two quadrants were left untreated. The participants received a toothbrush, toothpaste, and brushing instructions. L. reuteri Prodentis lozenges (1×108 CFU DSM17938 + 1×108 CFU ATCC PTA 5289) or the corresponding placebo lozenges were taken twice daily from day 21 to day 42. Statistical analysis was done for comparisons of clinical parameters (Plaque Index (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), probing pocket depth (PPD), clinical attachment level (CAL)) and microbiological levels of the pathogens Aggregibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi). All p-values less than 0.05 were considered significant. Assessments were made on day 0 before SRP treatment, on day 21 before administration of the lozenges, and on day 42. Results: At day 42, the PI, GI, and GBI were significantly reduced by all treatment modalities. When ranked, the amount of PI, GI and GBI reduction by the different treatments was SRP + Prodentis > Prodentis > SRP + placebo > placebo; all differences were statistically significant. For PPD and CAL, the best result was obtained with the SRP + Prodentis treatment. PPD was reduced from 5.08±0.75 to 3.78±0.61 mm (p<0.001) and CAL from 3.93±0.93 to 2.85±0.74 mm (p<0.001). Prodentis, either alone or following SRP, reduced Aa, Pi, and Pg by 1 log10 unit (p<0.01). The SRP + placebo combination did not significantly affect the levels of the pathogens. Conclusion: The present randomized controlled trial confirms the plaque inhibition, anti-inflammatory, and antimicrobial effects of L. reuteri Prodentis. L. reuteri Prodentis probiotic can be recommended during non-surgical therapy and the maintenance phase of periodontal treatment. Considering the beneficial effects of probiotics, this therapy could serve as a useful adjunct or alternative to periodontal treatment when SRP might be contraindicated. Further studies are required in this direction

The effect of periodontal therapy on lymphocyte blastogenesis to plaque associated microorganisms

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66105/1/j.1600-0765.1983.tb00340.x.pd

Expression of caspase-3, p53 and Bcl-2 in generalized aggressive periodontitis

BACKGROUND: Apoptosis, or programmed cell death is a form of physiological cell death. It is increased or decreased in the presence of infection, inflammation or tissue remodelling. Previous studies suggest that apoptosis is involved in the pathogenesis of inflammatory periodontal disease. The aim of the present study was to investigate the clinical features and known indicators of apoptosis (p53, Bcl-2, Caspase-3) in patients with generalized aggressive periodontitis (GAP) METHODS: Eight patients with GAP, who had sites with probing depths (PD) > 5 mm, and 10 periodontally-healthy persons were included in the study. Clinical examinations and PD were performed, and the plaque index and gingival index were recorded. Gingival tissues biopsies were obtained from active site of each patient and from healthy individuals. The expression of caspase-3, Bcl-2, and p53 was evaluated by immunohistochemistry RESULTS: There were no significant differences between GAP and control group with respect to levels of caspase-3 and p53 expression (P > 0.05). Contrary, the frequency of grade 3 expression of Bcl-2 was higher in GAP group than the control group. CONCLUSION: The higher frequency of Bcl-2 expression in GAP group indicates and delayed apoptosis can lead to increasing resident inflammatory cells in periodontal tissues and resulting in progressive periodontal destruction

Analysis of proliferative activity in oral gingival epithelium in immunosuppressive medication induced gingival overgrowth

BACKGROUND: Drug-induced gingival overgrowth is a frequent adverse effect associated principally with administration of the immunosuppressive drug cyclosporin A and also certain antiepileptic and antihypertensive drugs. It is characterized by a marked increase in the thickness of the epithelial layer and accumulation of excessive amounts of connective tissue. The mechanism by which the drugs cause gingival overgrowth is not yet understood. The purpose of this study was to compare proliferative activity of normal human gingiva and in cyclosporine A-induced gingival overgrowth. METHODS: Gingival samples were collected from 12 generally healthy individuals and 22 Cyclosporin A-medicated renal transplant recipients. Expression of proliferating cell nuclear antigen was evaluated in formalin-fixed, paraffin-embedded gingival samples using an immunoperoxidase technique and a monoclonal antibody for this antigen. RESULTS: There were differences between the Cyclosporin A group and control group in regard to proliferating cell nuclear antigen and epithelial thickness. In addition, the degree of stromal inflammation was higher in the Cyclosporin A group when compared with the control group. CONCLUSION: The results suggest that the increased epithelial thickness observed in Cyclosporin A-induced gingival overgrowth is associated with increased proliferative activity in keratinocytes

Oral health status of 12-year-old school children in Khartoum state, the Sudan; a school-based survey

<p>Abstract</p> <p>Background</p> <p>Few studies have investigated the prevalence of dental caries among school children in the past decades in Sudan rendering it difficult to understand the status and pattern of oral health.</p> <p>Methods</p> <p>A school-based survey was conducted using stratified random cluster sampling in Khartoum state, Sudan. Data was collected through interviews and clinical examination by a single examiner. DMFT was measured according to WHO criteria. Gingival index (GI) of Loe & Silness and Plaque index (PI) of Silness & Loe were used.</p> <p>Results</p> <p>The mean DMFT for 12-year-olds was found to be 0.42 with a significant caries index (SiC) of 1.4. Private school attendees had significantly higher DMFT (0.57) when compared to public school attendees (0.4). The untreated caries prevalence was 30.5%. In multivariate analysis caries experience (DMFT > 0) was found to be significantly and directly associated with socioeconomic status. The mean GI for the six index teeth was found to be 1.05 (CI 1.03 – 1.07) and the mean PI was 1.30 (CI 1.22 – 1.38).</p> <p>Conclusion</p> <p>The prevalence of caries was found to be low. The school children with the higher socioeconomic status formed the high risk group.</p

The effects on chronic periodontitis of a subgingivally-placed redox agent in a slow release device

Adjunctive chemical agents can reduce the need for meticulous plaque control. The aim of this investigation was to evaluate the periodontal treatment potential of subgingival application of the redox agent methylene blue in a slow release device. This randomized, single-blind, split-mouth study included 18 patients aged 35- 57 years, with chronic adult periodontitis, pocketing of at least 5mm and radiographic evidence of regular bone loss. All experimental sites received subgingival debridement at day 0. Test sites received 32% w/w methylene blue in the slow release device at days 0 and 28. Clinical examination and microbiological sampling were performed at days 0, 7, 28, 56 and 84. Clinical improvements were seen in both groups, but test sites showed consistently greater improvements, some of which were statistically significant (as determined by between-group comparisons utilising SNDs). Significant between-group differences in relation to baseline levels were seen in bleeding index at days 7 and 56, in probable pocket depth at day 56 and for the Perioscan BANA test at day 7. This pilot study thus showed that adjunctive methylene blue in a slow-release device can produce greater clinical and microbiological improvements than subgingival debridement alone.peer-reviewe