Detection of Helicobacter pylori using PCR in dental plaque of patients with and without gastritis

Objectives: Helicobacter pylori (H. pylori) accounts for gastritis, peptic ulcer and is a probable cause of gastric cancer. Since its detection in the oral cavity, concerns have been raised about dental plaque as a reservoir for reinfection. The aim of this study was to detect the organism in the dental plaque and to determine the association, if any, between H. pylori gastritis and dental plaque contamination causing H. pylori. Study design: A polymerase chain reaction-based method was used for detection of H. pylori in clinical specimens. Supra and subgingival samples were collected from 67 patients with chronic periodontitis, 23 of whom were also suffering from gastritis. The data were analyzed with Chi square and Fisher exact test and the statistical significance was set to 0.05. Results: H. pylori was scarce in patients with periodontitis(5.9%). There was a significant association between the presence of H. pylori in the dental plaque and gastritis (p=0.012). Conclusions: Although rarely seen, H. pylori infected dental plaque may be a source for reinfection. It is therefore suggested that professional plaque removal and oral hygiene procedures be performed, along with the antibiotic treatment of H. pylori

A comparative study of the long term results of root coverage with connective tissue graft or enamel matrix protein: 24-month results

Background: The objective of this study was to compare the 24 month results of coronally advanced fl ap + enamel matrix derivates (EMD+CAF) and CAF+ connective tissue graft (CTG+CAF) in the treatment of Miller Class I recession defects.Methods: Twelve patients with bilateral gingival recessions were treated with EMD+CAF or CTG+CAF. Vertical recession depth (VRD), keratinized tissue width (KTW), clinical attachment level (CAL), and clinical probing depth (CPD) were measured preoperatively, 1 and 2 years post surgery. A paired t-test and independent t-test were used to compare differences for the measured characters within and between groups, respectively.Results: After 24 months a signifi cant decrease in VRD was observed in CAF + EMD (3.33±0.30 mm) and CAF + CTG (4.5 ± 0.28 mm) treated sites. There was also a signifi cant increase in KTW (0.83±0.23 mm versus 2.08±0.14 mm in EMD+CAF and CTG+CAF sites, respectively). The gain in CAL was 3.54 ± 0.38 mm and 4.45±0.30 mm in EMD+CAF and CTG+CAF group, respectively. There were signifi cant differences between the treatments for VRD, CAL, and KTW at the end of study.Conclusions: The CTG+CAF procedure seems to provide better long-term results than the EMD+CAF in obtaining root coverage, increasing the KTW and CAL gain

Amlodipine-induced gingival hyperplasia

Drug-induced gingival hyperplasia is a serious concern both for the patient and the clinician. A 45 year-old Caucasian male patient with hypertension, who received amlodipine (10 mg/day, single dose orally) for two months, sought medical attention because of the new-onset gingival enlargement. On clinical examination a generalized and firm overgrowth of the gingival throughout the maxilla and the mandible were evident. The lack of gingival inflammation and purulent discharge were other features of the clinical scenario. Histological assessment of the biopsy specimen revealed the hyperplasia of connective tissue, epithelial acanthosis, and elongated rete ridges along with few inflammatory cells. The histological and the clinical evidences were consistent with amlodipine-induced gingival hyperplasia. We believe that the present report indicates the most rapidly developed case of amlodipine-induced gingival hyperplasia reported to date. The related literature is reviewed and the underlying pathogenic mechanisms of this rare side-effect are discussed here

Comparison of salivary level of leptin in chronic periodontitis patients and healthy controls

Objectives Periodontal disease is an inflammatory condition of the tooth-supporting structures. Leptin is a hormone produced by the human body under different circumstances such as infection. It affects the production of cytokines, phagocytosis and the inflammation process. This study aimed to compare the salivary level of leptin in chronic periodontitis (CP) patients and healthy controls.Methods In this case-control study, saliva samples were collected from 43 subjects including 22 CP patients and 21 healthy controls. The salivary level of leptin was determined using the ELISA. Data were analyzed by the independent t-test.Results Despite the presence of leptin in the saliva of CP patients and healthy controls, no significant difference was noted in its salivary concentration between the two groups (p>0.05).Conclusion The salivary level of leptin in CP patients was not significantly different from that in healthy controls. Further studies with larger sample size are required to confirm the results of this stud

The Clinical Evaluation of the Effects of Low-Level Laser Therapy on the Donor and Recipient Sites of the Free Gingival Graft: A Case Series

Introduction: Free gingival grafting is among the most foreseeing procedures for increasing the zone of keratinized attached gingiva and enhancing soft tissue around the teeth and dental implants. Nowadays low-level laser therapy (LLLT) is a promising approach in providing patients with more pleasing results in terms of esthetics and comfort. This study aims to investigate the effects of LLLT on gingival recessions treated with free gingival graft (FGG).Methods: This case series was conducted on 12 individuals requiring a bilateral gingival graft in the mandibular region. There was a 30-day interval between the two operations. The test side was selected randomly and irradiated by a low-level laser (LLL) just before surgery. The patients did not know which side was irradiated. LLLT was applied to the donors’ as well as recipients’ site immediately after the operation and 48 hours later. The patients were instructed to record their post-operative pain in a visual analogue scale (VAS) 3 and 24 hours and 7 days after the surgical procedure. The clinical photographs were taken immediately and 30 days after surgical treatment were graded by three experienced periodontists for color matching to adjacent tissues.Results: Ten individuals could finish the study. The test group presented significantly better shade matching and wound healing at the palatal donor site on days 7, 14 and 21. There was a significant reduction in postoperative pain after 24 hours (P = 0.007). No statistically significant difference was found between both groups in terms of clinical periodontal indices.Conclusion: LLLT could reduce post-operative pain 24 hours after surgical treatment. Furthermore, the application of LLLT could improve the donors’ site healing and the recipients’ site color matching

Assessment of Sterility and Residual Solvents Agents in Antler-derived and Bovine Xenograft Bone Substitutes: An In-vitro Study

Objectives This study aimed to assess and compare the results of sterility and residual solvent testing in a newly developed antler-derived xenograft versus a bovine-derived xenograft. Methods First, test and control samples were prepared using thermal and chemical procedures, involving immersion in deionized water for 24 hours, drying, boiling in sterile water, chemical treatment with chloroform and methanol, and heating at 650°C in a furnace. Next, they were sterilized via gamma radiation at 25 kGy. The sterility test was then performed based on the ISO 11737-2:2019 standard, using the direct inoculation method. Finally, residual solvent testing was carried out via gas chromatography-mass spectrometry. Results The sterility test showed no evidence of bacterial or fungal growth in any of the samples during 14 days of incubation. Also, residual solvent testing indicated no sign of residual solvents in the samples. Conclusion Antler-derived xenograft was safe to use in terms of the sterility and removal of residual solvents. Further studies should be carried out regarding other important laboratory tests as well as the animal and clinical studies

A clinical evaluation of anatomic features of gingiva in dental students in Tabriz, Iran

Background and aims. The anatomical features of gingiva are important in appropriate periodontal treatment planning. This study was designed to determine the anatomic features of gingival in a group of dental students in Tabriz, Iran.
 Materials and methods. One-hundred healthy subjects (aged 20-24 years old) with no history of periodontal or orthodontic treatment and a gingival index of zero or one were included. The following measurements were made using a periodontal probe: the distance between the gingival margin and base of gingival sulcus (depth of sulcus); the distance between the gingival margin and mucogingival junction (keratinized gingiva); and the distance between base of gingival sulcus and mucogingival junction (attached gingiva). Existence of free gingival groove was also recorded by observation. Mean values of collected data were calculated.
 Results. The widest attached gingiva and keratinized gingiva on the buccal aspect was seen in upper lateral incisor and their minimum in lower premolars. The maximum depth of sulcus on the buccal surface was recorded in upper right molar and its minimum on the buccal surface was found in lower left canine. All of the studied students had free gingival groove on the buccal or oral aspect of at least one tooth.
 Conclusion. The anatomic features found in this study were similar to those of the previous studies. However, mild variations with regard to race differences were observed

Assessment of the etiologic factors of gingival recession in a group of patients in Northwest Iran

Background and aims. Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran.
 Materials and methods. In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis.
 Results. Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05). The type of occlusion, axial inclination of teeth, existence of prosthesis, frenal attachment, and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05).
 Conclusions. Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR

Endocarditis Prophylaxis in Cardiac Patients: Knowledge among General Dental Practitioners in Tabriz

<p><strong><em>Background and aims.</em></strong><strong><em> </em></strong>Dental procedures injuring oral tissues may induce bacterial release to blood stream that can cause infective endocarditis in susceptible patients. The aim of this study was to determine the level of knowledge of general dental practitioners (GDPs) in Tabriz, Northwest of Iran, regarding endocarditis prophylaxis in cardiac patients receiving dental treatments.</p> <p><strong><em>Materials and methods.</em></strong><strong> </strong>This was a cross-sectional, descriptive, analytical study that included 150 GDPs. All practitioners were given a self-administered questionnaire which consisted of three parts assessing their knowledge of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis. Statistical analysis of data was carried out using independent <em>t</em>-test, one-way ANOVA and chi-square test.</p> <p><strong><em>Results.</em></strong><strong> </strong>The level of knowledge among GDPs in three areas of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis were 63.7%, 66.8% and 47.7%, respectively. Their overall level of knowledge regarding endocarditis prophylaxis was 59%. Association of the level of knowledge with age and practice period was statistically significant (P < 0.05). However, the level of knowledge was not significantly associated with gender or university of graduation in either of three areas evaluated (P > 0.05).</p> <p><strong><em>Conclusion.</em></strong><em> </em>According to our results, the knowledge of endocarditis prophylaxis among GDPs in Tabriz was in a moderate level. Regarding the importance of endocarditis prophylaxis in susceptible patients, it should be more emphasized in the curriculum of dental schools and continuing dental education programs.</p&gt

Assessment of Intra- and Inter-examiner Reproducibility of Probing Depth Measurements with a Manual Periodontal Probe

<p><strong>Background and aims.</strong> The main purpose of this study was to assess intra- and inter-examiner reproducibility of probing depth measurements with a manual periodontal probe. </p><p><strong>Materials and methods.</strong> In this study, 32 dental students in Tabriz Faculty of Dentistry with normal periodontium were evaluated. Each tooth of the upper right quadrants, except the third molars, was examined. Probing depths were measured in 6 surfaces of each tooth (mesiofacial, midfacial, distofacial, mesiolingual, midlingual and distolingual). Each patient was examined by two examiners (two periodontists) in two sessions with an interval of 7-10 days. A total of 218 teeth and 1295 surfaces were examined. </p><p><strong>Results.</strong> Intra-examiner measurements showed no statistically significant differences, while the differences of inter-examiner measurements were statistically significant. Intra-examiner reproducibility was more than the inter-examiner one. Measurements for anterior region, facial and mid-facial/mid-lingual surfaces were more reproducible than posterior, lingual and proximal surfaces. </p><p><strong>Conclusion.</strong> Probing depth measurements with a conventional probe have an appropriate reproducibility in clinical settings, although variations between examiners may affect the reproducibility, especially when great accuracy is required.</p&gt