Evaluation of probiotics' efficiency on cariogenic bacteria: randomized controlled clinical study.

BACKGROUND: Probiotics are live beneficial bacteria to human health and their efficiency on oral health is still being investigated. The purpose of this study was to evaluate the level of Streptococcus mutans and Lactobacillus species with and without the use of probiotics for six-months after the treatment of all dental caries under general anesthesia. METHODS: Fifty-eight pediatric patients without any systemic diseases, whose dental treatments were completed under general anesthesia (GA), were included in the study. The patients were recruited in two-groups; Group A: Patients started using probiotics after GA and Group B: Patients did not use probiotics after GA. Saliva samples were taken from all patients on the day before GA (T0), at one-month (T1), three-month (T2) and six-month (T3) follow-up after GA. The counts of cariogenic bacteria were determined by the analysis of saliva samples using real-time polymerase chain reaction. Statistical significance level was accepted as p < 0.05. RESULTS: There was statistically significant difference between Group A and B for T0, T1, T2 and T3 regarding S. mutans (p = 0.001, p = 0.04, p = 0.04, p = 0.03; p < 0.05). However, there was no statistically significant difference between groups regarding Lactobacillus species (p ≥ 0.05). CONCLUSIONS: Probiotic use and treatment of all caries significantly reduced the level of S. mutans but not Lactobacillus species. Furthermore, S. mutans decreased after cessation of probiotics, but it was not statistically significant. TRIAL REGISTRATION: Study was registered as "Effects of Probiotics on Streptococcus mutans and Lactobacillus species" with the registration number of NCT05859646 (16/05/2023) at https://www. CLINICALTRIALS: gov Protocol Registration and Results System.

Anti-microbial efficiency of gaseous ozone's combined use with fluoride and chlorhexidine on time-related oral biofilm: an in situ study on pediatric patients.

Oral biofilm formation is the main reason for both caries progression and soft tissue diseases. Preventing the formation and promotion of biofilm has been known as the first attempt to prevent the development of caries and soft tissue problems in the oral cavity. The present study aimed to assess the effect of ozone and its combined use with chlorhexidine (CHX) and fluoride on the complex biofilm formation of pediatric patients under in situ conditions. Extracted bovine teeth were sterilized and cut into 2 × 3 mm2 sections. The samples were placed in removable maxillary plates and 10 healthy individuals (6 boys, 4 girls; aged 7-14 years) were asked to wear these plates for 6, 24 and 48 hours. Afterwards, the tooth samples were removed, and anti-plaque agents were applied to the time-related plaque formation. Plaque thickness and viable bacterial percentages were detected by confocal laser scanning microscopy. All materials used in the study decreased the plaque formation and the percentage of viable microorganisms compared with the control group (physiological saline). In 6- and 24-hour biofilm evaluations, ozone-CHX was the most effective group in decreasing the plaque thickness (P > 0.05). Ozone-CHX and Ozone-Fluoride groups were found to be better in 48-hour biofilm assessments in caries-free group (P > 0.05). Ozone-CHX group showed a better inhibitory effect on the viability of microorganisms in 6-, 24- and 48-hour biofilm formations (P < 0.05). Although CHX has been known as the gold standard for inhibiting the oral biofilm formation, according to the results of the study, gaseous ozone and its combined use with CHX have shown better results in reducing the biofilm thickness and viable bacterial percentages of in situ formed time-related biofilm formation in pediatric patients. The use of gaseous ozone can be preferred in clinical conditions in pediatric patients instead of the CHX agents.

Comparison of the plaque regrowth inhibition effects of oil pulling therapy with sesame oil or coconut oil using 4-day plaque regrowth study model: A randomized crossover clinical trial.

OBJECTIVES: The aim of this study was to compare the plaque-inhibiting effects of oil pulling therapy with sesame oil or coconut oil using 4-day plaque regrowth study model. METHODS: This clinical observer-masked, randomized, crossover designed study involved 24 participants. The participants received professional prophylaxis in the preparatory period and after that subjects started to use the allocated mouthrinse (coconut oil or sesame oil). On day 5, periodontal clinical parameters including plaque index (PI), gingival index (GI), stain index (SI) and bleeding on probing (BOP) were recorded. Subjects underwent a 14-day wash out period and then used the other mouthrinse for 4 days. RESULTS: Oil pulling therapy with coconut oil or sesame oil exhibited similar plaque regrowth inhibition (PI = 1.60 ± 0.28 and 1.49 ± 0.22, for oil pulling with coconut oil and sesame oil, respectively) and tooth staining (SI = 0.20 ± 0.11 and 0.21 ± 0.09, for oil pulling with coconut oil and sesame oil, respectively.) In addition, GI and BOP were similar in both groups (GI = 0.61 ± 0.19 and 0.69 ± 0.16; BOP = 0.09 ± 0.24 and 0.03 ± 0.03 for oil pulling with coconut oil and sesame oil, respectively). CONCLUSIONS: Oil pulling therapy with coconut or sesame oil showed similar results in terms of plaque regrowth inhibition and tooth staining. According to the present results, both coconut oil and sesame oil can be used for oil pulling therapy with the aim of plaque regrowth inhibition.

Attitudes and emotional status of parents regarding traumatic dental injuries.

BACKGROUND/AIMS: Traumatic dental injuries have different effects on children and their parents, depending on the type of trauma and whether it is in primary or permanent teeth. Parents do not always seek immediate intervention for their children after each traumatic dental injury unless accompanied by conditions such as pain or bleeding that will increase emotional stress. The aim of this study was to evaluate the emotional status of parents and parents' attitudes toward urgent intervention for different traumatic dental injuries in both primary and permanent teeth. MATERIAL AND METHODS: A questionnaire consisting of two parts was designed with a reliability coefficient of 0.87 according to the results of a pilot study. The questionnaire was sent to parents as a Google Form via online communication methods such as WhatsApp and e-mail. The first part included questions about the demographic data of the parents and children, and the second part consisted of images of traumatic dental injuries of primary and permanent teeth with questions to evaluate the emotional state of the parents and awareness of the necessity for urgent intervention. The Visual Analog Scale (VAS) was used to evaluate the emotional state, and "Absolutely yes;" "Yes;" "I don't have an idea;" "No;" and "Absolutely no" statements were used to evaluate parents' attitudes about urgent intervention. Categorical variables were shown as numbers and percentages and analyzed with Pearson chi-square. Statistical significance was evaluated for p < .05, and correlations between variables were calculated with Pearson correlation. RESULTS: The survey was completed by 845 parents. All traumatic injuries except extrusion (p = .202; p ≥ .05) had statistically different VAS scores for primary and permanent teeth (p < .05). Parents' attitudes for urgent intervention were statistically significant for all traumatic injuries (p < .05) except 4-mm intrusion (p = .062; p ≥ .05), alveolar fracture (p = .282; p ≥ .05), complicated crown fracture (p = .136; p ≥ .05), and non-traumatized healthy teeth (p = .110; p ≥ .05). CONCLUSIONS: Traumatic dental injuries with excessive bleeding or tissue loss affect the emotional status of parents more than simple injuries, and they prefer to refer to dentists immediately. Parents responded with higher VAS scores and stronger desires for urgent intervention for permanent teeth injuries compared with primary teeth injuries which shows that parents still do not care about primary teeth as much as permanent teeth.

Efficacy of oil pulling therapy with coconut oil on four-day supragingival plaque growth: A randomized crossover clinical trial.

OBJECTIVES: The aim of this study was to evaluate the plaque-inhibiting effects of oil pulling using 4- day plaque regrowth study model compared to 0.2% chlorhexidine gluconate (CHX) containing mouthrinse. DESIGN: The study was an observer-masked, randomized, cross-over design clinical trial, involving 29 volunteers to compare 0.2% CHX and oil pulling therapy in a 4- day plaque regrowth model. After the preparatory period, in which the subjects received professional prophylaxis, the subjects commenced rinsing with their allocated rinsed. On day 5 plaque index (PI), gingival index (GI), stain index (SI), bleeding on probing (BOP) were recorded from the subjects. Each participant underwent a 14- day wash out period and then used the other mouthrinse for four days. RESULTS: Oil pulling therapy presented similar inhibitory activity on plaque regrowth compared with CHX (PI = 1.67 ±â€¯0.24, 1.61 ±â€¯0.20, respectively) with less staining (SI = 0.21 ±â€¯0.13, 0.47 ±â€¯0.27, respectively). In addition, GI and BOP was similar in both groups (p > 0.05). CONCLUSION: Oil pulling with coconut oil seems to have similar plaque inhibition activity as CHX. In addition it caused less tooth staining than CHX. These findings suggest that oil pulling therapy may be an alternative to CHX rinse.

Resistance to leakage of various thicknesses of apical plugs of Bioaggregate using liquid filtration model.

AIM: The aim of this study was to compare the resistance to leakage of different thicknesses of Bioaggregate (BA) and 4-mm-thick white mineral trioxide aggregate (WMTA) in an apexification model using liquid filtration. METHODS: 32 extracted mandibular premolar teeth were sectioned at the cemento-enamel junction and 3-4 mm from the tooth apex to obtain 12-mm-long root segments. The apical and coronal thirds were prepared with size two through six Gates Glidden burs. The teeth were divided into four groups according to material and thickness, as follows: Group 1: 2-mm BA; Group 2: 4-mm BA; Group 3: 12-mm (total length) BA; Group 4: 4-mm WMTA (control). The empty parts of the roots in Groups 1, 2, and 4 were filled with gutta-percha and root canal sealer, and leakage was measured using fluid filtration. The data were analyzed using the Kruskal-Wallis H-test. RESULTS: No statistical differences in microleakage were observed between Groups 1, 2, and 4 (P > 0.05). Group 3 (roots filled completely with BA) showed significantly less leakage than the other groups tested (P < 0.01). CONCLUSIONS: The findings of this study showed that 12 mm of BA exhibited the best resistance to leakage. At the same time, 2-4 mm of BA showed similar results when compared to 4-mm MTA. In light of these results, this study suggests that BA may be a good candidate for further clinical studies when used as an apical barrier for apexification.