Effect of galium arsenide diode laser on human periodontal disease: Aa microbiological and clinical study

Background and Objective: The present study is aimed to describe short-term results on selected microbiological and clinical parameters obtained by treatment with soft laser in conjunction with methylene blue and/or mechanical subgingival debridement in human periodontal disease. Study Design/Materials and Methods: Ten patients, in whom each dental quadrant was randomly designated to receive one of four types of treatment procedures, were included in the study. Groups of quadrants received: scaling/root planing (SRP); laser application (L); SRP combined with L (SRP/L); oral hygiene instructions (OHI). Four single rooted teeth (one in each quadrant), having an interproximal site with a probing depth of 4 mm mesio-buccally, were selected in each patient. The selected teeth were first assessed for microbiological (one site/tooth) and then for clinical variables (six sites/tooth). Supragingival irrigation with methylene blue was performed prior to laser application. The microbiological (proportions of obligate anaerobes) and clinical measurements (plaque and gingival indices, bleeding on probing, probing pocket depth) were evaluated over a period of 32 days. Results: Only the SRP/L and SRP groups provided significant reductions in the proportions of obligate anaerobes before and after treatments with no significant differences in between. Parallel to the microbiological changes, both SRP/L and SRP resulted in similar clinical improvements, whereas L alone revealed a limited effect similar to OHI. Conclusion: Within the limits of this study, methylene blue/soft laser therapy provided no additional microbiological and clinical benefits over conventional mechanical debridement. (C) 2002 Wiley-Liss, Inc

Investigation of bacteremia after toothbrushing in orthodontic patients

Objective: The aim of this study was to investigate the occurrence rate of bacteremia following toothbrushing with toothpastes composed of several antibacterial agents and compare the results with the conventional oral hygiene maintaining methods in orthodontic patients. Methods: This clinical study included 100 adult orthodontic patients who were divided into 4 groups. Each group comprised of 25 patients, wearing fixed orthodontic appliances. In the first group, bacteremia was assessed after toothbrushing without using any toothpaste. In the second group, a 0.2% chlorhexidine gluconate mouthrinse was used before brushing with no toothpaste. In the third group, subjects brushed with a commonly used toothpaste which did not include an additional antimicrobial agent. The fourth experimental group used toothpaste which included tea tree oil, clove oil, peppermint oil and bisabolol as antimicrobial elements. Pre- and post-brushing blood samples were obtained using a strict aseptic technique. All samples were microbiologically evaluated using blood culture bottles. Results: Toothbrushing in orthodontic patients yielded to an increase in the occurrence rate of bacteremia when using normal toothpaste or no toothpaste at all. Conclusions: The use of chlorhexidine mouthwash before toothbrushing, and brushing with antimicrobial toothpaste did not show a statistically significant difference in preventing the occurrence of bacteremia (p > 0.05). (Korean J Orthod 2009;39(3):177-184

In vitro effects of clarithromycin on human polymorphonuclear leukocyte functions

Background: It has been shown that antibacterial agents affect polymorphonuclear leukocytes (PMNs), which are active in the body's first line of defense, in different ways. However, few studies have investigated the effects of tablet dosage forms as opposed to pure powder forms. There is a need to demonstrate the clinical relevance of previous results with commercially available products. Methods: We examined the effects of clarithromycin solutions, prepared separately from either pure powder or commercially available tablets (250 mg), on human PMNs. The in vitro effects of each solution, adjusted to therapeutic concentration (1 mg/l), on PMN adherence, chemotaxis, phagocytosis, candidacidal capacity and superoxide production were studied. Results: Solutions prepared from pure clarithromycin powder did not affect the adherence, phagocytosis or superoxide production of PMNs, but did inhibit (p < 0.05) chemotaxis and candidacidal capacity. By contrast, a decrease (p < 0.05) in all functions except phagocytosis was observed with solutions prepared from the tablet dosage form of clarithromycin. Conclusion: The results of this study suggest that the tablet dosage form of clarithromycin may have a more pronounced inhibitory effect on human PMN functions than solutions prepared from the pure powder form. Copyright (C) 2000 S. Karger AG, Basel

A clinical and microbiological evaluation of systemic and local metronidazole delivery in adult periodontitis patients

The present study describes results on selected clinical and microbiological parameters obtained by treatment with local (Elyzol) and systemic (Flagyl) use of metronidazole alone and/or mechanical subgingival debridement in adult periodontitis. Patients were randomly divided into local and systemic treatment groups each comprising 5 individuals in each of whom 4 sites (one site/ quadrant) with a probing depth of > or = 5 mm were selected and treated with separate treatment modalities. The overall treatment design provided 6 different test groups. Groups of quadrants received: (1) scaling and root planing; (2) local metronidazole treatment; (3) systemic metronidazole treatment; (4) local metronidazole combined with scaling and root planing; (5) systemic metronidazole combined with scaling and root planing; (6) no treatment. The microbiological and clinical effects of treatment modalities were monitored over a period of 42 days. All treatments resulted in clinical improvements (gingivitis, probing pocket depth, attachment level) except for the untreated group. Parallel to the clinical changes, all treatments reduced the number of total bacteria and proportions of obligately anaerobic microorganisms. Although both of the combined treatment groups responded to therapy with better resolution of infection that the pure mechanical and pure metronidazole treatments, local metronidazole in combination with scaling and root planing seems to be more effective in terms of producing both clinical and microbial improvements

Microbiological features and crevicular fluid aspartate aminotransferase enzyme activity in early onset periodontitis patients

Gingival crevicular fluid (GCF) reflects the immune and inflammatory reactions and the specific host-microbe interactions that lead to periodontal diseases. Aspartate aminotransferase enzyme (AST) is one of the components of GCF that is released as a result of cell death. In this study, periodontal sites (4 sites/patient) with a probing depth of > or =5 mm in early onset periodontitis (EOP) patients were first examined for the AST levels in GCF by the Periogard periodontal tissue monitor. To be eligible for the study, each of the patients had at least 1 AST positive site with clinical inflammatory changes (AST+, CIC+) and 1 AST negative site with no or minimum clinical inflammatory changes (AST-, CIC-). In 15 EOP patients who met the entry criteria, 30 AST+, CIC+ sites (1st group) and 19 AST-, CIC- sites (2nd group) were evaluated for microbiological variables. Certain microbial species, including Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Prevotella intermedia were detected more frequently (p<0.001, p<0.001 and p<0.05, respectively) in the 1st group, while gram-positive facultative organisms such as Actinomyces species were found more often (p<0.001) in the 2nd group. Parallel to the AST levels, the 2nd group had a lower number of total bacteria and proportion of obligate anaerobic and capnophilic micro-organisms than the first group (p<0.05 and p<0.05, respectively). Within the scope of this study, AST activity and microbiological data were found in agreement in the examined groups. These findings are encouraging and indicate the need for further studies to evaluate the ability of the AST test to differentiate the microbial flora of progressing sites and those that are inflamed, but not progressing

Phospholipase activity of Candida albicans isolates from patients with denture stomatitis: The influence of chlorhexidine gluconate on phospholipase production

Background and objectives: The extracellular phospholipases of Candida albicans are considered to play a significant role in the pathogenesis of human infections. Therefore 23 clinical oral isolates of C. albicans from patients with denture stomatitis and 22 commensal oral isolates obtained from the palatal mucosa of healthy subjects were assayed for phospholipase activity. It is generally accepted that chlorhexidine gluconate is an appropriate adjunct or an alternative to antimycotic therapy in the management of oral candidiasis. However, the intraoral concentrations of this antiseptic fluctuate considerably due to the dynamics of the oral cavity. So the second main objective of this study was to investigate the effect of brief exposure (30 min) to two sub-therapeutic concentrations (0.002% and 0.0012%) of chlorhexidine gluconate on the value of phospholipase production (Pz) of C. albicans. Method: An in vitro phospholipase production was done by plate assay method using an egg yolk-agar medium. Results: No significant differences were found in the number of C. albicans isolates producing phospholipase between two groups. However, the mean value of Pz produced by the isolates from patients with denture stomatitis was significantly (p < 0.05) higher than the commensals. Exposure of the isolates to 0.002% and 0.0012% chlorhexidine led to a significant (p < 0.001 and p < 0.01, respectively) reduction in the amount of phospholipase. Conclusion: The results of this study imply that sub-therapeutic levels of chlorhexidine may modulate candidal phospholipase activity, thereby suppressing pathogenicity of C. albicans. (c) 2006 Elsevier Ltd. All rights reserved

Distribution and phospholipase activity of Candida species in different denture stomatitis types

The aim of this study was to evaluate the correlation between frequency and phospholipase activity of Candida species and denture stomatitis according to Newton's classification. Seventy-five complete denture wearers were evaluated for the presence of yeasts on the palatal mucosa by culture method. In addition, the number of yeast isolates producing phospholipase and amount of this enzyme were determined using egg yolk agar plate method. According to Newton's classification, 25 denture wearers were with healthy palatal mucosa while 50 were with any types of denture stomatitis. The frequency of yeasts was linked to whether subjects had Type II or Type III, but not Type I denture stomatitis. Candida albicans was the most frequently isolated species in denture wearers with and without clinical signs of denture stomatitis and it was the only species produced phospholipase. Although the amount of phospholipase produced by the C. albicans isolates from denture wearers in control and Type II and III DS groups was not significantly different, there was statistically significant difference in the number of C. albicans isolates producing phospholipase between patients with and without clinical signs of DS