A pro-inflammatory diet is associated with an increased odds of periodontitis: finding from a case-control study.

OBJECTIVE: This study aimed to evaluate the inflammatory effect of diet using the dietary Inflammatory Index (DII) on the odds of periodontitis. We hypothesized that a diet with high DII scores (a pro-inflammatory diet) is associated with high chronic and systematic inflammation resulting in periodontitis. Periodontitis is one of the most common inflammatory diseases that affect the tissues around the tooth and results from the interaction of bacterial infection and the host immune response. The DII shows the association between different food components and the level of specific inflammatory biomarkers. METHOD: The food intake of 87 cases with diagnosed periodontitis and 87 control was assessed using a 163-item valid food frequency questionnaire (FFQ). The DII was calculated based on the FFQ data. Logistic and linear regression models adjusting for multivariable confounders were used to investigate the odds ratio (OR) and 95% confidence intervals (CI) of developing periodontitis. RESULTS: There was a significant difference between the mean intake of micronutrients and food groups, including saturated fatty acids (SFAs), iron, magnesium, manganese, vitamin C, crude fiber, selenium, chromium, whole fiber, caffeine, dairy, and meat, between patients with periodontitis and the control group (p-value˂0.05). DII scores in this study ranged from -3.13 to + 0.99. However, the periodontitis OR in the raw and multivariable-adjusted models was not statistically significant (multivariable-adjusted OR tertiles 1 vs. tertiles 3 = 2.00, 95%CI: 0.4-90.42, p-value = 0.08). A similar result was also observed in the continuous model of DII (multivariable-adjusted OR DII continuous = 1.93, 95%CI: 0.30-98.79, p-value = 0.05). CONCLUSION: Although the OR was not statistically significant in crude models, a significant trend was found in multivariable-adjusted models. The results were promising since this is the first study to examine the association between diet-induced inflammation and dental disease. It is advisable to conduct additional studies with high sample sizes and other designs, such as prospective studies.

Periostin level in gingival crevicular fluid in periodontal disease: a systematic review and meta-analysis.

BACKGROUND: Periostin, a secreted adhesion molecule, is a matricellular protein secreted most in periodontal ligament and periosteum. Periostin is also needed for integrity and maturation of periodontal tissue. This meta-analysis was conducted to compare the gingival crevicular fluid (GCF) periostin levels in subjects having periodontal disease and healthy periodontium. METHODS: In this meta-analysis, three international database including PubMed, Scopus and Web of Science were searched and 207 studies retrieved. Also, the Google Scholar was searched to find more related studies (two studies were found). To assess the risk of bias of included studies, the Newcastle-Ottawa assessment scale adapted for case-control was used. Finally, required data was extracted and included into analysis. All statistical analysis were done using Stata software. RESULTS: Eight studies were included in this meta-analysis. Results showed that GCF periostin level is significant lower in chronic periodontitis group compare to healthy people (the standardized mean difference (SMD) = -3.15, 95% CI = -4.45, -1.85, p < 0.001). The syntheses of studies shown a significant decrease in the periostin level of chronic periodontitis patients compared to the gingivitis patients (SMD = -1.50, 95%CI = -2.52, -0.49, P = 0.003), while the mean level of periostin between the gingivitis patients and healthy group has no significant difference (SMD = -0.88, 95%CI = -2.14, 0.38, P = 0.173). CONCLUSION: The mean concentration of GCF periostin in people with chronic periodontitis significantly decreased compared to people with gingivitis and also compared to healthy people, while no significant difference was observed between the two groups with gingivitis and healthy people. Therefore, this marker may be used as a diagnostic criterion for the disease, which requires further studies.

Effects of laser irradiation and tooth mousse on tooth hypersensitivity after office bleaching: A non-randomized clinical trial.

Background: This study aimed to assess the effect of laser irradiation and Tooth Mousse on tooth hypersensitivity (TH) after office bleaching (OB). Materials and Methods: This clinical trial, parallel-design split-mouth nonrandomized was conducted on 30 patients requiring OB. After scaling and fabrication of a custom tray, 35% hydrogen peroxide was applied on all teeth, and 940 nm diode laser (10 W, Class IV, 110-240 V) was irradiated to the upper and lower right quadrants. Laser in off mode was used for the left quadrants. Bleaching agent was then reapplied. After completion of bleaching, a custom tray containing tooth Mousse was placed on the maxillary arch while the tray was used without the paste for the mandibular arch. A visual analog scale was used to assess the degree of TH at 15 min and 24 h after OB. Data were compared using t-test, paired t-test, and analysis of variance. Significance level was set at α = 0.05. Results: Comparison of TH at 15 min and 24 h after OB showed a significantly lower TH score in the left upper quadrant (tooth Mousse alone) than right upper quadrant (both laser and Tooth Mousse) (P < 0.05). The TH score in the right upper quadrant was significantly lower than that in the right lower quadrant (laser only) (P < 0.05). The mean TH score in the left upper quadrant was insignificantly lower than that in the left lower quadrant (no intervention) (P > 0.05). Conclusion: The use of 940 nm diode laser for OB increases the postoperative TH. The application of Tooth Mousse can effectively decrease TH after OB with/without laser irradiation.

Which audio distraction technique is more effective for reduction the pain and anxiety of pediatric dental patients; "music" or "kids-story"? A randomized split-mouth crossover clinical trial.

OBJECTIVE: Control of pain, fear, and anxiety of children during dental procedures is a major challenge in pediatrics. This study aimed to compare the effect of audio distraction by music and audio-story on pain and anxiety of children during dental treatment. METHODS: This randomized crossover clinical trial evaluated 60 systemically healthy children between 4 and 8 years, who were candidates for pulpotomy and steel crown of bilateral primary maxillary first or second molars. The patients were randomly divided into two groups of music-story (M first), and story-music (S first) according to the sequence of receipt of the distraction techniques with a split-mouth design. The level of pain and anxiety of patients was measured using physiological scales such as pulse rate (PR), sound-eye-motor (SEM) and faces pain rating (FPR). The pkcross package in Stata software version 14 was used to assess the treatment effect, period effect, sequence effect and carryover effect. RESULTS: In each group, 28 cases were included in the analysis. The difference in PR was not significant at the onset and termination of each treatment session between two distraction techniques and also, the mean FPR (P = 0.55) and SEM (P > 0.99) scores were not significantly different between the two groups. CONCLUSIONS: The "audio-story" and "music" distraction techniques were not significantly different for pediatrics relieving during LA administration. Thus, considering the equal efficacy of the two techniques, dental clinicians can use any of the two to distract children. REGISTRATION INFORMATION: The study registered in the Iranian Registry of Clinical Trials (IRCT20190702044077N1).

The Rate of Demineralization in the Teeth Prepared by Bur and Er:YAG Laser.

Introduction: The present in vitro study evaluated the recurrence rate of caries following cavity preparations with bur (conventional technique) and irradiation by Erbium:Yttrium- Aluminum-Garnet (Er:YAG) laser through micro hardness test. Methods: A total of 72 human extracted molars were randomly divided into 3 groups and class 5 cavities were prepared on them with 3 different methods: G1) conventional bur, G2) Er:YAG laser irradiation alone and G3) laser irradiation + laser treatment. The specimens were immersed in the artificial caries solution with pH of 2.0 and 5.0 (12 days) and then immersed in re-mineralizing solution with pH of 7.0 (25 days). The specimens were longitudinally sectioned and their Vickers micro hardness was determined. Data were statistically analyzed by means of three-way analysis of variance (ANOVA) and Tukey multiple comparisons tests. Results: The micro hardness of the samples was affected by substrate type (enamel and dentin) and low values were achieved in dentin (P<0.001). Moreover, no significant difference was observed between preparation methods by bar and laser irradiation alone (P ≤0.499). Although laser irradiation + laser treatment decreased micro hardness of enamel compared to other methods. In dentin samples, different methods of preparation showed no significant effect on micro hardness (P ≤0.874). Conclusion: Due to the similar values of micro hardness following G1 and G2, it seems that Er:YAG laser alone is as much effective as the conventional bur to prevent recurrence caries. However, because of the high prices of laser instruments, bur preparations can be done commonly.

Comparison of Dentin Permeability After Tooth Cavity Preparation with Diamond Bur and Er:YAG Laser.

OBJECTIVES: The aim of this study was to compare the permeability of dentin after using diamond bur and Er:YAG laser. MATERIALS AND METHODS: Seventy-two recently extracted, intact, and restoration-free human permanent molars were used in this study. The samples were randomly divided into three groups of 24 each and class I cavities were prepared as follows. Group 1: High speed diamond bur with air and water spray. Group 2: Er:YAG laser. Group 3: Er:YAG laser followed by additional sub-ablative laser treatment. Each group consisted of two subgroups with different cavity depths of 2mm and 4mm. The entire cavity floor was in dentin. Two samples from each subgroup were observed under scanning electron microscope (SEM). The external surfaces of other samples were covered with nail varnish (except the prepared cavity) and immersed in 0.5% methylene blue solution for 48 hours. After irrigation of samples with water, they were sectioned in bucco-lingual direction. Then, the samples were evaluated under a stereomicroscope at ×160 magnification. The data were analyzed using two-way ANOVA and Tukey's HSD test. RESULTS: Two-way ANOVA showed significant difference in permeability between groups 2 and 3 (laser groups with and without further treatment) and group 1 (bur group). The highest permeability was seen in the group 1. There was no significant difference in dentin permeability between groups 2 and 3 and no significant difference was observed between different depths (2mm and 4mm). CONCLUSION: Cavities prepared by laser have less dentin permeability than cavities prepared by diamond bur.