Evaluation of the distance between the central teeth after frenectomy: a randomized clinical study.

PURPOSE: The present study aimed to evaluate the periodontal status and the distance between the teeth one year after frenectomy in patients with abnormal frenums in the maxillary and mandibular midline. MATERIALS AND METHODS: This study included 50 patients (24 men and 26 women) between the ages of 13 and 53 who have frenum-induced diastemas between the incisors. The abnormal frenums were removed via conventional frenectomy. The distances between the teeth before and one year after the surgery were measured with a caliper. To determine the periodontal status, the pocket depth, plaque index, and bleeding on probing were measured from four surfaces. In addition, the amount of attached gingiva and degree of gingival recession were recorded and were statistically analysed. RESULTS: A significant decrease in the distance between teeth before and after frenectomy was observed (p<0.05). There was a statistically significant difference in the amount of gingival attachment, pocket depth, degree of gingival recession, plaque index, and bleeding on probing (p<0.05). CONCLUSION: The removal of abnormal frenums with frenectomy can contribute to the reduction in the distance between the teeth. In addition, frenectomy increases the amount of gingiva and decreases the depth of the pocket, gingival recession, amount of plaque, and bleeding.

The effect of leukocyte-platelet-rich fibrin on bone morphogenetic protein-2 and insulin-like growth factor-1 levels in patients with chronic periodontitis: a randomized split mouth clinical trail.

The present study evaluates the effects of leukocyte-platelet-rich fibrin (L-PRF) combined with open flap debridement (OFD) on clinical parameters and growth factors levels (GFL) in chronic periodontitis (CP) patients. This trial was registered at clinicaltrials.gov as NCT02594605. 16 patients (32 sites) with chronic periodontitis who had at least two areas of horizontal bone loss, were treated with OFD alone or L-PRF with OFD (OFD + L-PRF). GFL in gingival crevicular fluid (GCF) were analyzed at baseline, 1 week, 2 weeks and 4 weeks after operation. Probing depth (PD) and clinical attachment level (CAL) were measured at baseline and 6 months postoperatively. PD reduction and CAL gain were significantly higher in the OFD + L-PRF sites than in OFD sites. OFD + L-PRF group showed significantly increased bone morphogenetic protein-2 and insulin-like growth factor-1 at 2 weeks compared with baseline. L-PRF combined with OFD significantly increases GFL and thus, it enhances the periodontal healing on CP patients.

Advantages of Autologous Platelet-Rich Fibrin Membrane on Gingival Crevicular Fluid Growth Factor Levels and Periodontal Healing: A Randomized Split-Mouth Clinical Study.

BACKGROUND: This study evaluates contributions of platelet-rich fibrin (PRF) combined with conventional flap surgery on growth factor levels in gingival crevicular fluid (GCF) and periodontal healing. METHODS: Twenty-six patients (52 sites) with chronic periodontitis were treated either with autologous PRF with open flap debridement (OFD+PRF) or OFD alone. Growth factor levels in GCF at baseline and 2, 4, and 6 weeks after surgery were analyzed, and clinical parameters such as probing depth (PD), relative clinical attachment level (rCAL), and gingival margin level (GML) at baseline and 9 months after surgery were measured. RESULTS: Mean PD reduction and rCAL gain were significantly greater in OFD+PRF sites than in OFD sites. Mean GML change was -0.38 + 0.10 mm in OFD sites and 0.11 + 0.08 mm in the test group; difference between the two groups was statistically significant (P <0.05). Both groups demonstrated increased expression levels of fibroblast growth factor-2, transforming growth factor-ß1, and platelet-derived growth factor-BB at 2 weeks compared with baseline, followed by reductions at 4 and 6 weeks. The OFD+PRF group showed significantly higher growth factor levels compared with the OFD group at 2 and 4 weeks. CONCLUSION: PRF membrane combined with OFD provides significantly higher GCF concentrations of angiogenic biomarkers for ≈2 to 4 weeks and better periodontal healing in terms of conventional flap sites.

The modelling of interactions between organs and medical tools: a volumetric mass-spring chain algorithm.

This paper adds volume deformation capability to the mass-spring chain method using tetrahedral elements in order to obtain more realistic deformations, which occur during the interactions between medical tools and soft tissues. The mass-spring chain method originally does not consider volume information and performs deformation by moving and deforming individual springs of a deformable model. However, most of the applications in computer graphics require volume modelling using tetrahedrons. In the proposed method, the deformation algorithm loops through tetrahedrons and performs deformation based on defined rules similar to those of the original mass-spring chain method. This method can handle not only ordinary deformation applications but also those with topology changes, such as cutting and tearing, as it does not rely on any pre-computed quantities. A method to preserve the volume and the shape of the tetrahedral elements is also developed. In order to speed up the new version of the algorithm, a tetrahedral propagation for deformation is developed. The detailed implementation of the algorithm and the various applications of the organ-surgery tool interactions are presented. The paper also provides the animations of the different models obtained by the proposed method.

Increased salivary levels of 8-hydroxydeoxyguanosine may be a marker for disease activity for periodontitis.

BACKGROUND: 8-hydroxydeoxyguanosine (8-OHdG) is commonly used as a marker to evaluate oxidative DNA damage in disorders including chronic inflammatory diseases such as inflammatory periodontal pathologies. In the current study we hypothesized that the level of 8-OHdG in saliva increases by the periodontal destruction severity determined by clinical parameters as clinical attachment level (CAL). MATERIALS AND METHODS: A cross-sectional study was conducted on a sum of 60 age gender balanced; chronic periodontitis (CP) (n=20), chronic gingivitis (CG) (n=20) and healthy (H) (n=20) individuals. Clinical periodontal parameters and salivary 8-OHdG levels were evaluated. RESULTS: The mean 8-OHdG level in the saliva of the CP group was significantly higher than H and CG groups (p< 0.001). Statistically significant correlation was only observed between the salivary levels of 8-OHdG and age (p< 0.05), probing depth (PD) and CAL (p< 0.001) in CP group. However, when CP patients were classified according to their CAL levels (CAL⩾ 3 mm (n=11) and CAL<3 mm (n=9)) statistically significant correlation was only observed between the salivary levels of 8-OHdG and CAL ⩾ 3 mm patients (p< 0.001). CONCLUSION: We suggest that elevated salivary levels of 8-OHdG may be a marker for disease activity and it may reflect indirectly disease severity parameters such as CAL.

Immunohistochemical and Stereologic Analysis of NF-κB Activation in Chronic Periodontitis.

OBJECTIVES: Nuclear factor kappa B (NF-κB) is a member of the transcription factor family, and it plays a key role in coordinating the expression of genes in many chronic inflammatory diseases. This study investigated the cytoplasmic and nuclear activation of (NF-κB) and the cytoplasmic expression of inhibitor kappa B (IκB) in gingival tissues of subjects who had chronic periodontitis. METHODS: Thirty-five patients were included in this study; 17 patients had chronic periodontitis, and 18 were healthy. Gingival tissues were obtained from each individual and then stained immunohistochemically. The obtained sections were examined under a stereomicroscope, and the numerical density values of the stained cells were computed using the stereologic method. A one-way analysis of variance (ANOVA) and a multiple range least significant difference (LSD) were used for intergroup comparisons (P=0.05). RESULTS: According to the immunohistochemical analysis of the cytoplasmic positive cells stained with IκB, statistically significant differences were found between the case and control groups. When comparing the cytoplasmic and nuclear positive immunoreactivity of p50 and p65, statistically significant differences were found between the diseased and control groups. Statistically significant correlations were also found between the clinical periodontal scores and the immunohistochemical results of the diseased subjects. CONCLUSIONS: It was shown that NF-κB was highly activated in subjects who had chronic periodontitis, compared to healthy controls. The findings of this study can be useful in planning new treatment strategies for periodontal diseases. Further investigations are needed to understand more about the signaling mechanisms of inflammatory mediators and their interactions with NF-κB in chronic periodontitis.

Evaluation of oral malodour in left- and right-handed individuals.

Halitosis is a common social problem in the worldwide population. It is frequently associated with oral hygiene performance, so it may depend on the hand skill and cognitive ability of individuals. This study aimed to determine the relationship between handedness and pathologic oral halitosis. The study included a total of 1510 participants, and daily oral hygiene activities, hand preference, VSCs scores (volatile sulphur compounds) and clinical oral indices such as plaque index (PI) and tongue coating index (TCI) of each individual were recorded. Results of this study showed that there were no statistically significant differences between right- and left-handers (Groups I and II, respectively) according to age and oral hygiene practices. But it was found that PI and TCI were statistically higher in Group I with respect to Group II (Table 1). VSC scores, PI, and TCI were statistically higher in men compared to women (p<.01) (Table 2). There were statistically significant differences between women and men in the right-handed participant group (p<.01), while there were no statistically significant differences among the left-handers (p> .05) (Figure 1). Furthermore, statistically significant correlations were found between VSC scores and individual oral hygiene indices (p<.01) (Table 3). The lower halimetric values and clinical indices in left-handed individuals may be related with their oral healthcare and daily brushing habits. But unless detailed neurological investigations are undertaken, it cannot be suggested that the left-handers have better coordination and better-developed spatial abilities in oral hygiene procedures than the right-handers.

Root surface biomodification with Nd:YAG laser for the treatment of gingival recession with subepithelial connective tissue grafts.

BACKGROUND/AIM: Root surface biomodification has been used to treat gingival recession and periodontitis. The principle for this procedure is that removing the smear layer from the root surfaces exposes collagen fibers, which leads to improved healing. Clinical studies generally have failed to find any improvement in clinical parameters when using such procedures, however. The aim of this study was to evaluate and compare the outcome of gingival recession therapy using the subepithelial connective tissue graft (SCTG) with or without Nd:YAG laser application for root surface biomodification. MATERIALS AND METHODS: Thirty-four teeth in 17 patients with Miller Class 1 and 2 recession were treated with SCTG with (test group) or without (control group) the application of Nd:YAG laser (1 W, 10 Hz, 100 mj, 60 s, 1064 nm). Clinical attachment level (CAL), recession depth (RD), recession width (RW), and probing depth (PD) were measured at baseline and six months postsurgery. RESULTS: Both treatments yielded significant improvements in terms of RD and RW decrease and CAL gain compared to baseline values. For test and control groups, the average root coverage was 33% and 77%, respectively (p < 0.05), and the complete root coverage was 18% and 65%, respectively (p < 0.05). The control group showed a greater reduction in RD and RW compared with the test group (p < 0.05). CONCLUSIONS: The use of Nd:YAG laser as a root surface biomodifier negatively affected the outcome of root coverage with the SCTG.

Increased levels of 8-hydroxydeoxyguanosine and malondialdehyde and its relationship with antioxidant enzymes in saliva of periodontitis patients.

OBJECTIVES: The aim of this study was to evaluate 8-hydroxydeoxyguanosine (8-OHdG) and Malondialdehyde (MDA) levels, and superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in whole saliva of patients with chronic periodontitis. Moreover, the relationship among the oxidative damage biomarkers, antioxidant enzymes activities and clinical periodontal status were investigated. METHODS: Whole saliva samples were collected from 30 patients with chronic periodontitis and 30 periodontally healthy control. To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level, and probing depth were measured. The salivary 8-OHdG level was measured using the ELISA method. SOD and GPx activities and MDA levels were determined spectrophotometrically. RESULTS: Higher salivary 8-OHdG and MDA levels (P<.001), and lower salivary SOD and GPx activities (P<.05) were detected in periodontitis patients compared to the healthy controls. Additionally, there were significant negative correlations between salivary levels of 8-OHdG and both salivary SOD and GPx activities as well as between salivary levels of MDA and both salivary SOD and GPx activities (P<.001). CONCLUSIONS: Higher salivary 8-OHdG and MDA levels and lower salivary antioxidant activities seem to reflect increased oxygen radical activity during periodontal inflammation.

Increased salivary level of 8-hydroxydeoxyguanosine is a marker of premature oxidative mitochondrial DNA damage in gingival tissue of patients with periodontitis.

INTRODUCTION: Oxidative stress may contribute to the pathogenesis of periodontitis. However, the detailed molecular mechanism remains unclear. Both 8-hydroxydeoxyguanosine (8-OHdG) and mitochondrial DNA (mtDNA) deletion have been reported as early oxidative DNA damage markers. In this study, 8-OHdG levels in saliva and mtDNA deletions in gingival tissue of patients with chronic periodontitis (CP) were evaluated. MATERIALS AND METHODS: Gingival tissue and whole saliva samples were collected from 32 patients with CP and 32 healthy control subjects. To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level (CAL), and probing depth (PD) were measured. Using the ELISA and polymerase chain reaction methods, the salivary 8-OHdG levels and the 7.4-kbp and 5-kbp mtDNA deletions were examined. RESULTS: The 5-kbp mtDNA deletion was detected in 20 of the 32 periodontitis patients (62.5%), but was not detected in the healthy controls. The mean value of 8-OHdG in the saliva of the periodontitis patients with deleted mtDNA was significantly higher than in the patients with non-deleted mtDNA (p<0.01). Also, significant correlation was found between the occurrence of the 5-kbp mtDNA deletion and salivary 8-OHdG levels (p<0.01). Similar correlations were detected between salivary 8-OHdG levels and age, PD, and CAL (p<0.01, p<0.05). CONCLUSION: Increased oxidative stress may lead to premature oxidative DNA damage in the gingival tissue of periodontitis patients and the salivary 8-OHdG level may signify premature oxidative mtDNA damage in diseased gingival tissue.

Total antioxidant capacity and antioxidant enzymes in serum, saliva, and gingival crevicular fluid of preeclamptic women with and without periodontal disease.

BACKGROUND: The aim of this study was to investigate the total antioxidant capacity, superoxide dismutase and glutathione peroxidase activities, and malondialdehyde levels in serum, saliva, and gingival crevicular fluid (GCF) in preeclamptic and normotensive pregnant women with and without periodontal disease. METHODS: Forty pregnant women, consisting of 10 preeclamptic subjects with periodontal disease, 10 preeclamptic periodontally healthy subjects, 10 normotensive subjects with periodontal disease, and 10 normotensive periodontally healthy subjects, were included in this study. After clinical measurement and samplings, total antioxidant capacity, superoxide dismutase, glutathione peroxidase activities, and malondialdehyde levels in serum, saliva, and GCF of preeclamptic and normotensive pregnant women were determined, and the data were tested by non-parametric tests. Total antioxidant capacity of the clinical samples was measured using a novel automated colorimetric measurement method. Superoxide dismutase and glutathione peroxidase activities and malondialdehyde levels were determined spectrophotometrically. RESULTS: Superoxide dismutase and glutathione peroxidase activities in GCF and serum and total antioxidant capacity in saliva, GCF, and serum were the lowest in preeclamptic women with periodontal disease. However, serum and GCF levels of malondialdehyde were the highest in this group of pregnant women. CONCLUSIONS: Systemic and local antioxidant and total antioxidant capacities are affected by periodontal disease in addition to the impact of preeclamptic status. Similar comments may be made for the increases in systemic and local malondialdehyde levels.

The relationship between teething and handedness.

The aim of this study was to evaluate the role of tooth eruption sequences as an indicator of handedness. The investigation was carried out on 92 healthy children. The questionnaire form was filled out for each child. The form consisted of two parts. In the first part there were questions to determine the demographic features of the children. The second part consisted of the questions to clarify the eruption time and sequence of first primary teeth. Hand preference was evaluated by placing colored pencils directly in front of the child, who was asked to write an "X" on a piece of paper with each pencil. According to left-, right-, and indetermined handedness, all children regardless of sex were divided into three groups. The data were analyzed for statistical evaluation using tests for the difference between two population propositions. The mean eruption time of the first tooth in children was 7.5 +/- 1.7 months. The eruption time was found similar in both groups. No statistically significant difference was determined between the teeth eruption time and handedness (p >.05). The first tooth erupted was generally the lower central incisor. There was no difference tooth eruption and sex, gestation week (p >.05). No statistically significant difference was found between the teeth eruption time and sequence of the primary teeth (p >.05). There was statistically significant difference between sequence of the tooth eruption and handedness (p <.001). Consequently, the tooth eruption sequences may play an important role as an indicator in handedness.

New evidence of premature oxidative DNA damage: mitochondrial DNA deletion in gingival tissue of patients with periodontitis.

BACKGROUND: Overproduction of reactive oxygen species (ROS) causes increased oxidative stress in gingival tissue. It has been generally accepted that increased oxidative stress might contribute to additional damage of lipids, proteins, and DNA molecules. The mitochondrial DNA (mtDNA) mutation is a superb biomarker of oxidative damage. The aim of the present study was to investigate the mtDNA deletions in the gingival tissue of patients with periodontitis and to explain the correlations between mtDNA deletion in gingival tissue and clinical parameters of periodontitis and age. METHODS: Gingival tissue and blood samples were collected from 30 patients with chronic periodontitis (CP group) and 30 healthy control subjects (H group). To determine the clinical condition of each subject, the plaque index, gingival index, clinical attachment level, and probing depth were measured. Using the polymerase chain reaction (PCR) method, we examined the 7.4- and 5-kbp mtDNA deletions in tissue and blood samples. Three different pairs of PCR primers were used in this study. RESULTS: In this study, we did not detect any deletions in blood DNA samples in either the CP or H group. Also, the 7.4-kbp mtDNA deletion was not detected in gingival tissues of subjects. However, the 5-kbp mtDNA deletion was detected in 24 of the 30 subjects (80%) in the CP group and was not detected in the H group (0%). Significant correlations were found between the occurrence of the 5-kbp mtDNA deletion and all clinical parameters (P <0.01). A similar correlation was found between the occurrence of the 5-kbp mtDNA deletion and age (P <0.05). CONCLUSIONS: The overproduction of ROS by activated polymorphonuclear leukocytes in chronic inflammation may lead to premature oxidative damage of the mtDNA. In this study, the occurrence of the 5-kbp mtDNA deletion in 24 periodontitis subjects may be evidence of premature oxidative DNA damage.

Content and composition of fatty acids in normal and inflamed gingival tissues.

The balance of essential fatty acid is important for good health and normal development. Essential fatty acids (EFA) are the precursors of prostaglandins (PGs), thromboxanes and leukotrienes (LT). The aim of this clinical study was to determine the total fatty acid level of polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), saturated fatty acids (SFA) and each fatty acids level of inflamed and normal gingival tissues. Twenty-seven subjects were included the present study. Nineteen samples of inflamed human gingival tissue (nine of fibrous hyperplasia (FH), ten of peripheral giant cell granuloma (PGCG) and eight samples of normal human gingival tissue were analyzed. The characteristics of inflammation were assessed histologically. Variance analyses were performed to assess the differences among tissues. The total cellular fatty acid profiles of the tissues in inflamed human gingival tissue and in eight samples of normal human gingival tissue were determined by gas chromatography using Sherlock microbial identification system (MIS) software (Microbial ID, Newark, DE, USA) with a database of FAME profiles for eukary. PUFAs, MUFAs, and SFAs were quantified by Sherlock microbial identification system (MIS) or database gas chromatography (DGC). There were statistically significant differences between the concentrations in inflamed (FH, PGCG) and healthy gingival tissues for PUFA and MUFA (P<0.001, P<0,011, respectively). There were statistically significant differences among the concentrations in FH, PGCG, and healthy gingival tissues for SFA (P<0.0001). Arachidonic acid, docosahexaenoic acid, linoleic acid were increased in inflamed tissue. The results of this study showed that unsaturated fatty acids (PUFA and MUFA) significantly increased in inflamed gingival tissues.

Periodontal disease as a risk factor for pre-eclampsia: a case control study.

OBJECTIVE: To investigate the association between periodontal disease and pre-eclampsia, while controlling known risk factors for pre-eclampsia. METHODS: A matched case-control study was carried out on 41 pre-eclamptic women and 41 normotensive, healthy, pregnant, control women. The pre-eclamptic women and controls were individually matched for age, gravidity, parity, smoking and prenatal care. The number of teeth and the number of restorations and decay on all tooth surfaces, and clinical periodontal parameters, excluding third molars were determined within 48 h before delivery. The relation of independent variables to pre-eclampsia was assessed using conditional multiple logistic regression analysis on subject-based data. RESULTS: There were no statistically significant differences in mean percentages of sites with plaque between groups. The mean probing depth (PD) and mean clinical attachment level (CAL) for pre-eclamptic patients were significantly greater compared to those of normotensive patients (P < 0.01). The percentage of sites exhibiting bleeding on probing (BOP) (P < 0.05), the number of sites with PD >/= 4 mm and with CAL >/= 3 mm was significantly higher among pre-eclamptic patients than those with normotensive patients (P < 0.01). Conditional multiple logistic regression analysis indicated that periodontal disease and triglycerides level were significantly associated with pre-eclampsia. Other independent variables (maternal body weight and serum total cholesterol level) did not appear to be associated with pre-eclampsia. Conditional multiple logistic regression results showed that pre-eclamptic patients were 3.47 (95% CI = 1.07-11.95) times more likely to have periodontal disease than normotensive patients. CONCLUSION: The present study shows that maternal periodontal disease during pregnancy is associated with an increased risk for the development of pre-eclampsia. The higher incidence of periodontal disease parameters in pre-eclamptic group would suggest a possible role for periodontal disease in the development of pre-eclampsia. The nature both of periodontitis and pre-eclampsia is multifactorial, and caution should be exercised when implicating periodontal disease in causation of pre-eclampsia.

Prevalence and handedness correlates of recurrent aphthous stomatitis in the Turkish population.

OBJECTIVES: The present study was designed to determine the relationship between recurrent aphthous stomatitis (RAS) and handedness, and to assess the prevalence of RAS in the Turkish population. METHODS: The present study was conducted among 11,360 persons (5,705 males and 5,655 females) with a mean age of 30.4 years. A questionnaire focusing on handedness was administered to these patients. Handedness was assessed according to the Edinburgh Handedness Inventory. The diagnosis of RAS was made on the basis of clinical appearance, location, and the patient's health history. RAS information of patients was collected by means of a data form specifically designed for this study. Subjects were informed about RAS. We took anamneses and filled out the investigation forms. Apart from patients with registration of current aphthae (average point prevalence, APP), patients who had a past two-year history (self-reported two-year prevalence, SRTP) of the lesion were also included in this study. Data were analyzed using the chi-square and logistic regression tests. RESULTS: The prevalence of RAS (APP) was 2.7 percent and that of a history of RAS (SRTP) 22.8 percent. Thus, the total prevalence (APP+SRTP), including present lesions and a two-year history (SRTP), was 25.5 percent. Adjusted results showed that females, left-handers, 10-30-year-olds, and nonsmokers were 1.53, 1.69, 2.05, and 1.61 times more likely to have RAS (APP+SRTP) than males, right-handers, 31-50-year-olds, and smokers, respectively (P<.0001). CONCLUSION: The present study suggests that left-handedness appears to be a predictor factor for RAS.

Streptococcal gingivitis: a report of case with a description of a unique gingival prosthesis.

Acute streptococcal gingivitis is an acute inflammation of the oral mucosa. Specific bacterial infections of the gingiva may be due to neisseria gonorrhea, treponema pallidum, streptococci, and other organisms. Streptococcal infections are seen rarely. This case report describes a patient who presented with severe gingival inflammation and pain that was diagnosed as an acute streptococcal infection. Bacterial cultures were obtained from the lesion, and biopsies were obtained from the gingiva of lower incisors for histopathologic evaluation. The patient was successfully treated using conventional periodontal therapy (scaling, root planning, curettage) and antibacterial agents. The reconstructive phase for this patient consisted of the fabrication of a heat-cured acrylic gingival facade to mask the gingival recession. The treatment of acute gingivostomatitis is of importance because of the possibility of systemic secondary infections. When esthetics is important, a gingival prostheses can be considered. The differential diagnosis, etiology, and treatment of acute streptococcal gingivitis are discussed and the literature is reviewed in this report.

Effect of handedness on learning subgingival scaling with curettes: a study on manikins.

The aim of the present study was to evaluate the influence of systematic manikin-head training and the effectiveness of subgingival scaling applied with hand instruments (curettes) by right- and left-handed dental students on dental chairs (traditional) designed for right-handers. A questionnaire focusing on handedness was administered to 69 voluntary dental students in the third class at the School of Dentistry during pre-participation examination. Handedness was assessed using the Turkish version of the Edinburgh Handedness Inventory. Then, 18 dental students were specially selected in 2 equal groups according to hand preference: consistent right-handers with Geschwind Scores of +100 (5 female and 4 male) and consistent left-handers with Geschwind Scores of -100 (5 female and 4 male). These two untrained dental student groups received 10 weeks manikin-head training. Subgingival scaling was performed with hand instruments (Gracey curettes) in manikin-head mounted on right-sided dental chairs. At 6 test days each dental student had to instrument 12 test teeth. Effectiveness of subgingival scaling was evaluated by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. Statistical analysis was carried out with SPSS. Two groups were statistically compared on all test days. The yet-untrained left-handed dental students begin with a relatively high the mean score of 2.25, compared to the yet-trained right-handed dental students with 1.93, which was statistically significant (p > .05). The right-handed dental students reached the mean score of 0.53, whereas the left-handed dental students reached the mean score of 0.87 on test day 6. Significant differences in the mean scores were found between the two groups for overall surfaces (p < .05), the distal surfaces (p < .01), lingual surfaces (p < .01), and each group of teeth (p < .05). But there was no statistically significant difference between the 2 groups of students on all test day, except for test day 3 in terms of the mean scores for the facial and mesial surfaces (p > .05). Learning success was observed a high level in both groups through systematical training (p < .0001). The present study has documented that the left-handed dental students were less successful than the right-handed dental students in subgingival scaling, except for mesial and facial surfaces. However although training on right-sided chairs, they were quite similar to their right-handed counterparts in terms of learning success.

Effect of tongue brushing on oral malodor in adolescents.

BACKGROUND: Halitosis is a common problem in humans, and is a social and psychological handicap for those affected by it. Halitosis has a positive correlation with the accumulation of bacterial plaque in the oral cavity. AIMS: The aim of the present study was to determine the effect of tongue brushing on oral malodor in adolescents. METHODS: The subjects of the investigation were 28 adolescents who had oral malodor and whose average age was 16 +/- 0.12 years. Subjects were chosen to participate in the study if they had an established routine of oral care, and did not have systemic or periodontal disease or dentures (such as fixed prosthesis or partial and total dentures). The subjects with oral malodor were randomly assigned into two groups. Individuals in the first group received instructions regarding professional procedures of oral care from a periodontist. In addition, individuals in this group had the surface of their tongue cleaned using a hard toothbrush, wetted with 0.12% chlorhexidine gluconate. Individuals in the second group (control) underwent the same professional procedures of oral care executed by the same periodontist, however, they did not have their tongues cleaned. Oral malodor of individuals was then evaluated for all individuals using the organoleptic method. The pH of the subjects tongues were recorded before and after treatment. The results of the oral malodor test were compared between the two groups. RESULTS: The results of the study found that oral malodor scores obtained by an organoleptic method was more severe in the second group than the first group, and statistical differences were found between the two groups (P < 0.001). CONCLUSION: These results revealed that accumulation of bacterial plaque on the tongue is an important factor for oral malodor in the adolescents. Oral malodor levels were significantly reduced after cleaning the surface of the tongue. Thus, tongue care shouldn't be neglected in order to avoid oral malodor.

The normal and pathological pigmentation of oral mucous membrane: a review.

Pigmentation is both the normal and abnormal discoloration of oral mucous membrane. Pigmentation has multifactorial etiology. Most of the pigmentation is physiologic but sometimes it can be a precursor of severe diseases. Melanin pigment irregularities and color changes of the oral tissues could provide significant diagnostic evidence of both local and systemic disease. The differential diagnosis, clinical, etiology, and histopathological features of pigmentation are discussed and the current literature is reviewed.