Utilizing Oral Neutrophil Counts as an Indicator of Oral Inflammation Associated With Periodontal Disease: A Blinded Multicentre Study.

BACKGROUND: Periodontal diseases are chronic inflammatory conditions that require early screening for effective long-term management. Oral neutrophil counts (ONCs) correlate with periodontal inflammation. This study investigates a point-of-care test using a neutrophil enzyme activity (NEA) colorimetric strip for measuring periodontal inflammation. METHODS: This prospective study had two phases. Phase 1 validated the relationship between ONCs and periodontal inflammation with 90 participants. Phase 2 examined the test's applicability in a real-world setting through a multicentre clinical trial with 375 participants at four sites. ONCs were quantified in oral rinses using laboratory-based methods, and the NEA strip was used for ONC stratification. Clinical measures included bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (CAL). RESULTS: ONCs were significantly elevated in patients with Grade B periodontitis and deep periodontal pockets (PD ≥ 5 mm, CAL ≥ 5 mm). The NEA strip accurately classified patients into high or low ONC categories, showing 80% sensitivity, 82.5% specificity and an AUC of 0.89. It also assessed the effectiveness of periodontal therapy in reducing ONC and inflammation. The test was user-friendly, with no reported discomfort among patients. CONCLUSION: The NEA strip is a user-friendly and rapid screening tool for detecting high ONCs associated with periodontal inflammation and for evaluating the effectiveness of periodontal therapy.

Laser tongue debridement for oral malodor-A novel approach to halitosis.

STUDY OBJECTIVE: Malodor is a multifactorial condition with oral pathology representing the main culprit and the tongue being the first to second contributor to the malodor. Bacterial load can represent a quantifiable measure regardless of the original pathology. We hypothesize that reduction in malodor can be represented by tongue changes both in appearance, bacterial and biofilm load reduction (measured by CFU and volatile gases measurement), organoleptic measurement and subjective improvement. METHODS: A randomized controlled prospective study under IRB approval. Diagnostic criteria for enrollment and follow up were organoleptic test by 2 judges, Halimeter reading, tongue colors changes HALT questionnaire and direct aerobic and anaerobic tongue cultures measured by CFU. Patients were treated with laser tongue debridement (LTD) with an Er,Cr:YSGG solid state laser has been shown to be effective in biofilm reduction. RESULTS: 54 patients recruited with 35 available for follow up. Improvement was observed on all objective and QOL subjective parameters. Treatment was tolerated well with minimal discomfort. CONCLUSIONS: The tongue is proven to be a major contributor to oral malodor and must be addressed in treatment protocol. LTD significantly reduces malodor by subjective and objective criteria. While impossible to determine whether the tongue serves as a bacterial reservoir or is the origin for oral bacteria it is clear that LTD improves oral hygiene and reduces malodor. LTD is safe and easy to perform. We encourage LTD to be a crucial part of any oral malodor treatment protocol. TRIAL REGISTRATION: clinical trials, NCT04120948. Registered 25 September 2019 - Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S00098SX&selectaction=Edit&uid=U0000W0Y&ts=51&cx=-elnx7e.

Laser technology to manage periodontal disease: a valid concept?

UNLABELLED: Present day dental lasers can create oral environments conducive for periodontal repair. BACKGROUND AND PURPOSE: With the bacterial etiology of periodontitis and the resulting host inflammatory reaction, clinicians continue to search for therapeutic modalities to assist in the non-surgical management of periodontal disease. Traditional chairside therapies consist of mechanical debridement with manual and/or ultrasonic instrumentation with the objective of removing calculus, biofilm, and endotoxin from tooth root surfaces. Decreasing the microbial stimuli and associated end products decreases the inflammatory reaction and allows the host an opportunity to regenerate tissue through wound healing. The purpose of this article is to examine whether dental lasers, which have been in use for the past 3 decades, may augment traditional non-surgical periodontal therapy. METHODS: Review of research publications related to lasers and non-surgical periodontics with attention focused on systematic studies. CONCLUSIONS: Studies utilizing laser technology may demonstrate positive effects on 1) selectively decreasing the biofilm environment, 2) removing calculus deposits and neutralizing endotoxin, 3) removing sulcular epithelium to assist in reattachment and decreased pocket depth, and 4) biostimulation for enhanced wound healing. Comparisons of studies to determine the difference between lasers and their respective effects on the periodontium are difficult to assess due to a wide variation of laser protocols.

Laser-Assisted Esthetic Crown Lengthening: Open-Flap Versus Flapless.

This study compares the clinical outcomes of Er,Cr:YSGG (2,780 nm) laser-assisted open-flap (OF) and flapless (FL) esthetic crown lengthening (ECL) for the treatment of altered passive eruption. Thirty-six healthy patients requiring ECL were randomly divided into two groups: OF and FL. Gingivectomy and ostectomy were performed with an Er,Cr:YSGG laser in both groups. The periodontal condition and gingival margin level (GML) were assessed at baseline, immediately postsurgery, and at 1, 3, and 9 months postsurgery. The effect of periodontal phenotype and tooth location on GML and supracrestal gingival tissue dimension were evaluated. A significant difference was detected in the mean of GML at all time points, except between 3 and 9 months. The main tissue rebound after 9 months was 0.25 ± 0.3 mm in the OF group and 0.26 ± 0.3 mm in the FL group (no significant difference) and was significantly higher in thick periodontal phenotypes. Er,Cr:YSGG laser-assisted ECL is a predictable technique that achieved similar outcomes using flap and flapless approaches, providing esthetic and restorative opportunities for clinicians.

The Effect of an Er,Cr:YSGG Laser in the Management of Intrabony Defects Associated with Chronic Periodontitis Using Minimally Invasive Closed Flap Surgery. A Case Series.

Aims: This is an extended case series of patients treated with an Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser as an adjunct to scaling for the management of intrabony defects. Materials & methods: 46 patients with 79 angular intrabony defects associated with pocket depths of >5mm, and a mean age of 53 ± 9 years presenting with chronic periodontitis were included in the analysis. All patients underwent a localized minimally invasive closed flap surgery utilizing Er,Cr:YSGG laser therapy. Final radiographs and pocket depths were compared to pretreatment measurements with a time period of 8 ± 3 months. Results: Treatment resulted in significant overall pocket depth reduction. The mean pre-op probing depth was 8.1 ± 1.9mm, reducing to 2.4 ± 0.9mm post-treatment. Bony infill of the defects was visible radiographically and there was an increase in overall radiographic coronal osseous height compared to a pre-treatment baseline. Radiographs of 15 of the defects were available for further measurements after >12 months, and showed in these sites there was a significant reduction in intrabony defect depth, but no change in suprabony bone height. 9 of the 15 sites showed 50% or more, bony infill of the intrabony defect. Conclusions: The results demonstrate that the utilization of an Er,Cr:YSGG laser in a closed flap approach with chronic periodontitis may be of significant clinical benefit. Further studies using this laser surgical protocol are required to test these observations in well-designed randomized controlled trials.

Reduction in dental hypersensitivity with nano-hydroxyapatite, potassium nitrate, sodium monoflurophosphate and antioxidants.

OBJECTIVE: This clinical study aimed to evaluate effectiveness of a commercially available toothpaste containing potassium nitrate, sodium monoflurophosphate, and nano-hydroxyapatite as well as antioxidants phloretin, ferulic acid and silymarin in reducing dental hypersensitivity in adults. METHODS: The clinical trial enrolled patients with a history of dentin hypersensitivity. A test toothpaste was introduced into the daily routine, which included initial instruction on usage. Patients completed a five-question visual analog scale (VAS) at the inception/baseline, after two days and after two weeks of using the toothpaste to determine their level of tooth sensitivity at baseline with the use of the toothpaste over time. RESULTS: Patients that had significant sensitivity at baseline had a range of 52% to 76 % improvement after 48 hours and a range of 70% to 84% improvement after two weeks. CONCLUSION: A toothpaste containing potassium nitrate, sodium monoflurophosphate, and nano-hydroxyapatite plus antioxidants phloretin, ferulic acid and silymarin applied daily significantly decreased tooth pain of dentin hypersensitivity within a two-day and two-week time period. CLINICAL SIGNIFICANCE: Based on the clinical study results, a daily application of a toothpaste containing potassium nitrate, sodium monofluorophosphate, and nano-hydroxyapatite plus antioxidants phloretin, ferulic acid and silymarin can significantly and quickly reduce tooth pain of dentin hypersensitivity.

Caffeine impairs the acquisition and retention, but not the consolidation of Pavlovian conditioned freezing in mice.

RATIONALE: The psychoactive substance, caffeine, may improve cognitive performance, but its direct impact on learning and memory remains ill defined. Conflicting reports suggest that caffeine may impair as well as enhance Pavlovian fear conditioning in animals and its effect may vary across different phases of learning. OBJECTIVES: The purpose of this study is to dissect the effect of a motor-stimulant dose of caffeine (30 mg/kg intraperitoneal (i.p.)) on acquisition, retrieval or consolidation of conditioned fear in C57BL/6 mice. METHODS: Fear conditioning was evaluated in a conditioned freezing paradigm comprising 3 tone-shock pairings and a two-way active avoidance paradigm lasting two consecutive days with 80 conditioning trials per test session. RESULTS: Conditioning to both the discrete tone-conditioned stimulus (CS) and the context was markedly impaired by caffeine. The deficits were similarly evident when caffeine was administered prior to acquisition or retrieval (48 and 72 h after conditioning); and the most severe impairment was seen in animals given caffeine before acquisition and before retrieval. A comparable deficit was observed in the conditioned active avoidance test. By contrast, caffeine administered immediately following acquisition neither affected the expression of tone freezing nor context freezing. CONCLUSIONS: The present study challenges the previous report that caffeine primarily disrupts hippocampus-dependent conditioning to the context. At the relevant dose range, acute caffeine likely exerts more widespread impacts beyond the hippocampus, including the amygdala and striatum that are anatomically connected to the hippocampus; together, they support the acquisition and retention of fear memories to discrete stimuli as well as diffused contextual cues.

Self-Similarity Simplification Approaches for the Modeling and Analysis of Rockwell Hardness Indentation.

The indentation process of pressing a Rockwell diamond indenter into inelastic material has been studied to provide a means for the analysis, simulation and prediction of Rockwell hardness tests. The geometrical characteristics of the spheroconical-shaped Rockwell indenter are discussed and fit to a general function in a self-similar way. The complicated moving boundary problem in Rockwell hardness tests is simplified to an intermediate stationary one for a flat die indenter using principle of similarity and cumulative superposition approach. This method is applied to both strain hardening and strain rate dependent materials. The effects of different material properties and indenter geometries on the indentation depth are discussed.

Evaluation of a topical gel containing a novel combination of essential oils and antioxidants for reducing oral malodor in dogs.

OBJECTIVE: To evaluate the effectiveness of a topically applied gel containing essential oils (menthol and thymol) and polyphenolic antioxidants (phloretin and ferulic acid) for reducing halitosis in dogs. ANIMALS: 20 dogs. PROCEDURES: A blinded crossover clinical trial was conducted. Dogs received a dental cleaning and examination (periodontal examination including periodontal probing and assessments of plaque, calculus, and gingivitis). Owners then applied a gel (active or placebo) to oral soft tissues twice daily for a 4-week period. Teeth of the dogs were cleaned again, and owners applied the other gel for a 4-week period. Clinicians scored halitosis immediately after the initial cleaning and at 4 and 8 weeks, and owners scored halitosis weekly. RESULTS: Halitosis assessment by clinicians revealed that both groups had improvement in halitosis scores. Two dogs were removed because of owner noncompliance. In the active-to-placebo group (n = 9), halitosis was significantly reduced during application of the active gel but increased during application of the placebo. Seven of 9 owners reported increased halitosis when treatment was changed from the active gel to the placebo. In the placebo-to-active group (n = 9), halitosis decreased during application of the placebo and continued to decrease during application of the active gel. Seven of 9 owners reported a decrease in halitosis with the active gel. CONCLUSIONS AND CLINICAL RELEVANCE: An oral topically applied gel with essential oils and polyphenolic antioxidants applied daily after an initial professional dental cleaning decreased oral malodor in dogs.

Viability of Escherichia coli ATCC 8739 in Nutrient Broth, Luria-Bertani Broth and Brain Heart Infusion over 11 Weeks.

BACKGROUND: Escherichia coli is a widely studied prokaryotic system. A recent study had demonstrated that reduced growth of E. coli after extended culture in Luria-Bertani broth is a result of depletion of fermentable sugars but able to sustain extended cell culture due to the presence of amino acids, which can be utilized as a carbon source. However, this had not been demonstrated in other media. The study aimed to determine the growth and viability of E. coli ATCC 8739 in 3 different media, Nutrient Broth (NB), Brain Heart Infusion (BHI) and Luria-Bertani Broth (LB) over 11 weeks. METHODS: Growth of E. coli ATCC 8739 was determined by optical density. Viability was determined by serial dilution/spread-plate enumeration. After 11 weeks, the media were exhausted by repeated culture. Glucose was added to the exhausted media to determine whether glucose is the growth-limiting factor. RESULTS: Our results showed that cell density in all 3 media increased to about 1 × 10(9) cells/ml by the end of week 1, from the inoculation density of 2.67 × 10(5) cells/ml, peaked at about 1 × 10(13) cells/ml at week 4, before declining to about 5 × 10(7) cells/ml at week 7. Cell density is highly correlated to genomic DNA content (r(2) = 0.93) but poorly correlated to optical density (r(2)< 0.2). Our results also showed that the spent media were able to support further growth after glucose-supplementation. CONCLUSION: NB, LB and BHI are able to support extended periods of culture and glucose depletion is the likely reason for declining cell growth.

Lasers and the treatment of chronic periodontitis.

For many intraoral soft-tissue surgical procedures the laser has become a desirable and dependable alternative to traditional scalpel surgery. However, the use of dental lasers in periodontal therapy is controversial. This article presents the current peer-reviewed evidence on the use of dental lasers for the treatment of chronic periodontitis.