Practices and beliefs among Malaysian dentists and periodontists towards smoking cessation intervention

This study compared the attitudes, practices and perceived barriers among Malaysian dentists and periodontists towards smoking cessation interventions (SCI) for patients. A self-administered questionnaire, which covered respondents beliefs, practices as well as barriers and limitations towards SCI, were posted to 289 dentists from four Malaysian states and 35 Malaysian periodontists. In all, 236 (82) dentists and 26 (80) periodontists responded. More periodontists than dentists routinely record patient's smoking status at first visit (89.3 vs 19.1) (pp<0.001), recommend nicotine replacement aids (37 vs 16.3) (p=0.031), refer to smoking cessation clinics (40.7 vs 14) (p=0.001), followed-up smoking cessation with patients (70.4 vs 11.3) (pp<0.001) and described themselves as being committed to patients' SCI (81.5 vs 53.4) (p=0.013). Limitations faced by dentists as compared to periodontists in SCI were due to insufficient time (pp<0.001) and fear it will affect dentist-patient relationship (p=0.034). The findings in this study emphasize the importance of SCI and the need for further training in SCI among Malaysian periodontists and government dentists. Copyright Reserved © 2007 Sains Malaysiana

Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report

The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of 'Gamadent' toothpaste compared to a placebo toothpaste. 'Gamadent' toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the 'Gamadent' toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P < 0.005) and GI (P < 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P < 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P < 0.001), between the test and control sites. In conclusion, 'Gamadent' toothpaste provided noteworthy benefits, producing statistically significant improvement in all clinical parameters compared to the placebo during the healing phase after conventional initial therapy

Effectiveness of pre-procedural rinsing with essential oils-based mouthrinse to reduce aerosol contamination of periodontitis patients

This research aims to evaluate the effectiveness of pre-procedural rinsing using essential oils-mouthwash (Listerine®) in reducing bioaerosol contamination in a dental clinic. Thirty (30) subjects who consisted of those receiving treatment for periodontitis problems were randomly assigned to rinse with either 20 mL of Listerine® or 20 mL of placebo as control rinse. Every subject was instructed to gargle using the rinse for 1 min. Microbial samples of environmental air and saliva were collected before and after the rinse. All samples were further analyzed for total plate counts to measure the microbial level. Rinsing using Listerine® showed significant reduction in the level of microbial load in saliva compared to the control mouthrinses. Analysis done at three defined distance intervals from the operating site showed the level of bioaerosol contamination was highest at distance nearest to the treatment point of 1 ft. Based on counts of cfu, there was higher presence of microbial contaminant in bioaerosols of the control-rinsed group compared to the test-rinsed group using Listerine®. Therefore, it can be concluded that rinsing using Listerine® was effective towards reducing the microorganisms in saliva and oral cavity in general

Influence of abutment design on clinical status of peri-implant tissues

Objective: To compare the clinical soft tissue responses around implant tooth-supported 3-unit bridges using tapered abutments with those using butt-joint abutments. Methods: In a split-mouth design study, 8 mm Ankylos (Dentsply Friadent, Germany) implants were placed in the second mandibular molar region of 8 adult Macaca fascicularis monkeys about I month after extraction of all mandibular molars. After 3 months of submerged healing, 3-unit metal bridges were constructed. Clinical data was collected by the author who was blind to the abutment selections. Implants were clinically evaluated using Waite plaque index, sulcus bleeding index, probing pocket depth (PPD), probing attachment loss (PAL), and width of keratinized mucosa at baseline (BL) and 3-month and 6-month intervals. Stability of the implant was assessed using Periotest device at BL and after 6 months. Results: At BL, all the clinical variables did not differ statistically between the tapered and the butt-joint groups except for PPD (P < 0.05), where the meat? PPD was greater in the butt-joint group (2.75 +/- 1.02 mm) as compared with the tapered group (1.97 +/- 0.65 mm). At the 3-month assessment, there was no difference in all clinical variables. After 6-month loading, no significant difference between these 2 groups was detected in all these variables, with the exception of PAL (P = 0.05) where mean PAL was greater for implants with the butt-joint abutments (0.91 +/- 0.86 mm) in comparison with the tapered abutments (0.50 +/- 0.88 mm), and mean Periotest values (PTVs) that indicate the tapered-abutment implants (PTV = -4.5 +/- 1.60) were more stable than butt-joint-abutment implants (PTV = -1.5 +/- 3.59) with P < 0.05. Conclusions: The differences in these mucogingival responses between these 2 groups at BL (during seating of abutments, especially of butt-joint abutments) and after 6-month loading indicated enhanced peri-implant soft tissue stability around the tapered abutments of this system. There was also enhanced-PTV in the test group for clinical mobility assessment after 6-month loading. (Implant Dent 2009; 18:438-446

Qat Chewing and Periodontal Pathogens in Health and Disease: Further Evidence for a Prebiotic-Like Effect

Aim. Qat chewing has been reported to induce subgingival microbial shifts suggestive of prebiotic-like properties. The objective here was to assess the effect of qat chewing on a panel of classical and new putative periopathogens in health and periodontitis. Materials and Methods. 40 qat chewers and 40 nonchewers, equally stratified by periodontal health status, were recruited. Taqman, real-time PCR was used to quantify total bacteria, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Parvimonas micra, Filifactor alocis, Synergistetes, and TM7s in pooled subgingival biofilm samples. Differences in microbial parameters between the study groups were analysed using ordinal regression. Results. In health, the qat chewers harboured significantly lower relative counts of P. gingivalis, T. forsythia, Synergistetes, and TM7s after adjustment for multiple comparisons ( ≤ 0.007). At nominal significance level, they also carried lower counts of TM7s and P. micra ( ≤ 0.05). In periodontitis, the chewers had lower counts of all taxa; however, only T. denticola withstood correction for multiple comparisons ( ≤ 0.0063). Conclusions. Qat chewing is associated with lower proportions of periopathogens, particularly in subjects with healthy periodontium, which supports previous reports of its prebiotic-like properties. This potentially beneficial biological effect can be exploited by attempting to isolate the active fraction

Salivary Proteins Associated with Periodontitis in Patients with Type 2 Diabetes Mellitus

The objective of this study was to investigate the salivary proteins that are associated with periodontitis in patients with Type 2 diabetes mellitus (T2DM). Volunteers for the study were patients from the Diabetic Unit, University of Malaya Medical Centre, whose periodontal status was determined. The diabetic volunteers were divided into two groups, i.e., patients with periodontitis and those who were periodontally healthy. Saliva samples were collected and treated with 10% TCA/acetone/20 mM DTT to precipitate the proteins, which were then separated using two-dimensional polyacrylamide gel electrophoresis. Gel images were scanned using the GS-800TM Calibrated Densitometer. The protein spots were analyzed and expressed in percentage volumes. The percentage volume of each protein spot was subjected to Mann-Whitney statistical analysis using SPSS software and false discovery rate correction. When the expression of the salivary proteins was compared between the T2DM patients with periodontitis with those who were periodontally healthy, seven proteins, including polymeric immunoglobulin receptor, plastin-2, actin related protein 3, leukocyte elastase inhibitor, carbonic anhydrases 6, immunoglobulin J and interleukin-1 receptor antagonist, were found to be differentially expressed (p < 0.01304). This implies that the proteins may have the potential to be used as biomarkers for the prediction of T2DM patients who may be prone to periodontitis

Socket preservation using acellular dermal matrix allograft in combination with xenograft for dental implant placement in Anterior Maxilla: a case report

The collapse of alveolar ridge following tooth extraction is a physiological process which may complicate subsequent implant placement and restoration especially in the aesthetic zone. This case report describes the use of an acellular dermal matrix graft (Alloderm®, Biohorizon, USA) in combination with bovine bone graft (Bio-Oss®, Geistlich, Switzerland) immediately after tooth extraction for soft and hard tissue augmentation prior to implant placement in the anterior maxilla. The eighth year follow-up demonstrated an acceptable aesthetic outcome indicating that this approach may be employed where tooth extraction is indicated and replacement with implant-supported prosthesis is anticipated particularly in the anterior aesthetic zone region

02-40

Abstract: The aim of this randomised, parallel, double-blind study, in which 28 adult patients diagnosed with chronic gingivitis or early stages of chronic periodontitis were recruited, was to evaluate the efficacy of &apos;Gamadent&apos; toothpaste compared to a placebo toothpaste. &apos;Gamadent&apos; toothpaste has all the basic constituents of a toothpaste with the addition of a sea cucumber extract (SCE) of the species Stichopus sp. 1 to improve the healing potential of tissues. The placebo has the same basic constituents minus the extract. Out of the 28 patients, 14 were placed in the test group who used the &apos;Gamadent&apos; toothpaste, and 14 patients were placed in the control group (2 control subjects defaulted and were excluded), who brushed using the placebo toothpaste. The longitudinal study was carried out over a period of 3 months with assessments made at baseline, 1 month, 2 months and 3 months after conventional therapy at the baseline visit. The clinical parameters used during the trial were Plaque Index (PI), Gingival Index (GI), Papilla Bleeding Index (PBI) and Probing Pocket Depth (PPD). A predetermined number of sites on a molar, premolar, canine and an incisor were examined and evaluated in each quadrant. After the baseline assessment, the patients had full mouth scaling and debridement as well as oral hygiene instructions. Patients were instructed to brush their teeth twice a day with the toothbrush provided (Oral-B plus, size 35) and toothpaste (test or control), using the Bass technique. At the 1-month assessment, there were significant mean reductions to baseline mean values in PI (P &lt; 0.005) and GI (P &lt; 0.001) in the test group as compared to the control group. At the end of the 2-month interval, significant reductions were observed in PI, PBI and PPD (P &lt; 0.001). By the end of 3 months, there were significant differences in the mean reduction of all the parameters i.e. PI, PBI, GI and PPD (P &lt; 0.001), between the test and control sites

Clinical outcomes of lithium disilicate single crowns after a mean duration of 3 years - A retrospective study

Purpose: To investigate the clinical performance and clinical survival rate of lithium disilicate-based core ceramic (IPS e.max Press) utilised in single crowns and to the accompanying periodontal health status. Materials and Methods: A total of 47 patients with 88 IPS e.max Press single crowns were examined at the Faculty of Dentistry, University of Malaya, using modified United States Public Health Service evaluation criteria (USPHS). These 88 crowned teeth included 19 vital and 69 nonvital teeth that were restored with different post and core materials. The periodontal status was compared using the plaque index (PI), gingival recession (GR), modified papillary bleeding index (MPBI) and probing pocket depth (PPD) between the crowned teeth and contralateral control (sound) teeth. Results: About 96.6% of the crowns exhibited satisfactory clinical performance. The mean survival rate at three years was 97.7%, and 100% at two years with a low incidence of fractures. There were no staitistically significant differences in the mean gingival recession (p = 0.182) and mean plaque scores (p = 0.102) between crowned and control teeth. The crowned teeth had higher mean MPBI (p = 0.000) and PPD (p = 0.051) compared to the contralateral sound teeth. Periodontal response in relation to subgingival crown margins, was statistically significantly lower regarding pocket depths (p = 0.01) and bleeding on probing (p = 0.00). Conclusion: IPS e.max Press crowns exhibited satisfactory clinical performance with high survival rate. No dentinal sensitivity was recorded. Plaque retention and gingival recession were similar to contralateral control teeth. Poor periodontal health was related to the subgingival crown margins

An epidemiological survey of oral mucosal lesions among elderly Malaysians

A house to house random survey on elderly subjects was undertaken in the District of Klang in Malaysia. The objective of this study was to investigate the prevalence of oral mucosal lesions (OML) among the elderly in this area. The primary units in the sampling frame were the Enumeration Blocks (EBs) as defined under the population census. All households of the selected EBs were considered as sampling units and members aged 60 and above were considered as respondents. There was a slight preponderance of females, with the Malays comprising the majority of the subjects. Of the 486 respondents, mean aged 69.1 +/- 7.3 yr, 111 had at least one oral mucosal lesion, a prevalence of 22.8. A total of 145 lesions were detected. The prevalence of OML was highest among Indians and least among the Chinese. The most common finding was tongue lesions, recording a prevalence of 10.7, followed by oral pigmentation (4.9) and white lesions (4.3). Denture related lesions were comparatively low at 2.5. Two cases of oral cancer if representative would give a relatively high prevalence of 0.