Effect of periodontal treatment on glycated haemoglobin and metabolic syndrome parameters: A randomized clinical trial.

AIM: To assess the effect of periodontal treatment on HbA1c and diagnostic parameters of patients with metabolic syndrome (MetS). MATERIALS AND METHODS: One hundred and fifty-eight patients with MetS and moderate and severe periodontitis were included. They were randomized into a test group (n = 79), which received non-surgical periodontal treatment, and a control group (n = 79), which received no treatment. Medical treatment was delivered to both groups. Clinical periodontal, anthropometric and serological parameters were assessed at baseline, 3 and 6 months. The main outcome was glycated haemoglobin (HbA1c) levels, and the secondary outcomes were changes in the MetS parameters, C-reactive protein (CRP) and HOMA indexes. RESULTS: Significant reductions in all periodontal parameters were observed in the test group, compared with the control group, at 3 and 6 months (p < .001). HbA1c levels, MetS parameters, CRP and HOMA indexes showed no significant differences between the test group and the control group at 3 and 6 months. CONCLUSIONS: Periodontal treatment led to a substantial reduction in periodontal inflammation, although there was no significant effect on the parameters used for MetS diagnosis in patients with early diagnosed and well-controlled MetS.

Efficacy of ozonated water mouthwash on early plaque formation and gingival inflammation: a randomized controlled crossover clinical trial.

OBJECTIVES: To evaluate the effect of ozonated water in early plaque formation and gingival inflammation. MATERIALS AND METHODS: This was a randomized, controlled, double-blind, crossover clinical trial with two experimental periods of 96 h each, with 10 washout days between them. The sample consisted of 42 dental students divided into Test Group, mouthwash of ozonated water, and Control Group, bidistilled water mouthwash. The participants were instructed not to perform oral hygiene and used the assigned mouthwash under supervision once a day. For the investigation of the initial subgingival biofilm formation, the Plaque Free Zone Index was used at 24, 48, 72, and 96 h. The volume of gingival crevicular fluid, a questionnaire for taste perception assessment, and analysis of the adverse effects were also carried out. RESULTS: The percentage of conversion scores 0 and 1 to 2 of PFZ Index, the main outcome, for all dental surfaces showed no statistical difference between Test and Control groups, with 19.07 and 19.79, respectively. Also, there was not a significant difference in the score frequencies at each time point. Evaluation of GCF demonstrated that both groups had an increase in volume during experimental periods and that there was no statistically significant difference among groups. Test group had worse evaluation of taste perception and more adverse effects. CONCLUSIONS: Ozonated water seems not to affect the formation of supra and subgingival biofilms, as well as gingival inflammation. CLINICAL SIGNIFICANCE: Mouthwash with ozonated water once a day do not affect supra and subgingival biofilm formation.

Effect of mHealth in improving oral hygiene: A systematic review with meta-analysis.

AIM: To evaluate the effectiveness of mobile applications and text messages, compared with conventional oral hygiene instructions, for improving oral health knowledge and/or reducing gingival inflammation, when delivered to adolescents, adults and mothers of young children. METHODS: Randomized clinical trials evaluating the use of mobile applications or text messages related to oral hygiene and/or oral health education were screened. A search was performed in the Medline-PubMed, Scopus and Embase databases and the grey literature. The eligible studies comprised those related to plaque, gingival bleeding and/or oral health knowledge as outcomes. The risk of bias was assessed with the Cochrane tool and the GRADE system. Two meta-analyses were carried out. RESULTS: Among the fifteen studies selected, twelve (80%) used text messages and thirteen (87%) showed better results when mobile technology was used. The pooled SMD for the dental plaque index (n = 10 studies) was -9.43 (95% CI -14.36 to -4.495; I2  = 99%, p < 0.001), and that of gingival bleeding (n = 7 studies) was -8.54 (95% CI -13.16 to -3.91; I2  = 99%, p < 0.001), indicating significant improvement in dental plaque control and gingival bleeding for groups that received the mobile health (mHealth) strategy. CONCLUSION: mHealth can be used as an adjunct component in managing gingivitis, acquiring oral health knowledge and improving oral hygiene.

Factors associated with pain and analgesic consumption following non-surgical periodontal therapy under local anaesthesia and carried out by dental students.

AIM: Evaluate factors associated with pain and analgesic consumption following non-surgical periodontal therapy. MATERIALS AND METHODS: The sample consisted of 218 patients with chronic periodontitis, submitted to non-surgical scaling and root planing under local anaesthesia at a public dental service in southern Brazil. The data collection instruments included a demographic questionnaire, as well as State-Trait Anxiety Inventory, Corah's Dental Anxiety Scale, Visual Analogue Scale, Numerical Rating Scale and Verbal Rating Scale. The presence and intensity of pain were evaluated at 2, 6, 12, 24 and 48 hr after scaling and root planing. RESULTS: A total of 52.3% of the patients reported mild intensity pain at some point during the 48 hr after scaling and root planing with local anaesthesia. Smoking (PR = 1.47; 95% CI = 1.16-1.65), severe periodontal inflammation (PR = 1.31; 95% CI = 1.09-1.58) and dental anxiety (PR = 1.24; 95% CI = 1.03-1.49) were associated with postoperative pain after adjusting for age, gender and state and trait anxiety scores. Moreover, 46.8% of the subjects used analgesics at some time during the 48-hr follow-up period and dental anxiety was the only factor associated with postoperative analgesic use. CONCLUSIONS: Smoking, severe periodontal inflammation and dental anxiety were identified as factors associated with pain after non-surgical scaling and root planing with local anaesthesia. Dental anxiety was also a factor associated with postoperative analgesic use.

The effect of statins on periodontal treatment-a systematic review with meta-analyses and meta-regression.

OBJECTIVE: This study aimed to systematically review clinical trials about the effect of statins as adjunct to mechanical periodontal therapy, on probing pocket depth, clinical attachment level, and intrabony defects, in comparison to mechanical periodontal therapy alone or in association with placebo. MATERIAL AND METHODS: Three databases were searched for controlled clinical trials that used any locally delivered or systemically statin as a sole adjunctive therapy to mechanical periodontal treatment. Weighted mean differences between baseline and 6 months after periodontal treatment for clinical attachment level (CAL), probing pocket depth (PPD), and intrabony defect (IBD) were calculated. A high heterogeneity was detected. Therefore, a meta-regression adjusted for type of statin and year of publication was performed. RESULTS: Fifteen studies were included in the systematic review, and ten studies were included in the meta-analysis. In the meta-regression, the adjunct use of simvastatin, rosuvastatin, and atorvastatin additionally reduced PPD in comparison to mechanical periodontal therapy and a placebo gel (2.90 ± 0.35, 3.90 ± 0.77, 3.06 ± 0.71 mm, respectively; p < 0.05). Regarding the resolution of IBD, simvastatin and rosuvastatin significantly improved in comparison to control group (0.89 ± 0.35 and 1.93 ± 0.77 mm, respectively; p < 0.05). No statistically significant difference was found between the statins for both PPD and IBD (p < 0.05). Regarding CAL gain, simvastatin provided a statistically significant improvement as compared to the control group (2.02 ± 0.79 mm; p = 0.043). CONCLUSIONS: The use of statins, used as sole adjuncts to mechanical periodontal treatment, improved the periodontal parameters. In the quantitative analyses, simvastatin was the only drug that showed additional benefits in all evaluated parameters. CLINICAL RELEVANCE: Statins promote significantly clinical periodontal improvements when administered in association with non-surgical scaling and root planning (SRP), when compared to SRP alone or in association with a placebo.

Metabolic syndrome as a risk indicator for periodontal disease and tooth loss.

OBJECTIVES: The aim of the present study was to evaluate the association of metabolic syndrome (MS) with periodontitis (PE) and tooth loss (TL). MATERIALS AND METHODS: A cross-sectional study was conducted with 363 individuals who underwent full-mouth periodontal examination, and the association between MS and PE was evaluated considering three outcomes: severe periodontitis, mean probing depth ≥2.4 mm, and mean clinical attachment loss ≥2.0 mm. The prevalence ratio (PR) between MS and PE was calculated using a model adjusted for gender, age, smoking, years of education, and socioeconomic status. RESULTS: The adjusted model showed a PR for severe periodontitis of 1.17 (95 % CI 0.83-1.65). There was no significant association between MS and PE defined as mean probing depth ≥2.4 mm. MS was significantly associated with PE defined as mean attachment loss ≥2 mm in individuals aged 41-60 years (PR 1.47, 95 % CI 1.05-2.06). In addition, MS was associated with TL (>6 teeth) (PR 1.23, 95 % CI 1.02-1.49) for all ages, both in crude and adjusted analyses. CONCLUSIONS: We concluded that there is a weak association of MS with both attachment loss and TL. CLINICAL RELEVANCE: Patients with MS seem to have a higher risk of attachment loss and tooth loss and should be screened for periodontal disease.

Periodontal treatment outcomes during pregnancy and postpartum.

OBJECTIVE: This study was conducted to compare periodontal therapy outcomes during pregnancy and after delivery. MATERIALS AND METHODS: One hundred nine pregnant women up to the 20th gestational week (GW) were randomized into two groups: the test group (comprehensive periodontal therapy during pregnancy) and the control group (comprehensive periodontal therapy after delivery). Periodontal examinations comprised plaque index (PI), gingival index (GI), periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival crevicular fluid (GCF) volume. After baseline examination, women in the test group received periodontal treatment up to the 24th GW. The final examination was performed at the 26th to the 28th GW. Women in the control group were treated 30 days after delivery and reexamined 30 days after treatment. RESULTS: Periodontal therapy significantly reduced periodontal inflammation in both groups. The mean percentage of sites with BOP was reduced from 49.14 % (±22.49) to 11.10 % (±7.84) and from 45.71 % (±17.86) to 8.07 % (±5.21) in the test and control groups, respectively (p = 0.95). No statistically significant differences were observed between groups concerning PI, GI, PPD, CAL, and GCF. The reduction in mean percentage of sites with BOP stratified for initial PPD ≥4 mm was higher in the control group (p < 0.01), but no differences were seen regarding GCF in these sites. CONCLUSIONS: Hormonal changes during pregnancy do not interfere in treatment outcomes in women with widespread gingival inflammation and limited periodontal destruction. The role of these hormonal changes in pregnant women with different disease patterns remains uncertain. CLINICAL RELEVANCE: Periodontal health can be reestablished irrespective of the hormonal challenge that takes place during pregnancy.

Early supra- and subgingival plaque formation in experimental gingivitis in smokers and never-smokers.

PURPOSE: To evaluate supragingival and subgingival plaque formation on the dentogingival area in smokers and never smokers using the experimental gingivitis model and a plaque scoring system that considers the presence of an area free of plaque between plaque and the gingival sulcus called the plaque free zone (PFZ). MATERIALS AND METHODS: Male volunteers, 9 current smokers and 10 never-smokers, refrained from oral hygiene procedures in the maxillary incisors and canines (test teeth) for 25 days. Under conditions of clinically healthy gingiva (phase 1) and gingival inflammation (phase 2), the supragingival plaque formation pattern was observed for 4 days in the dentogingival area. Gingival crevicular fluid was also measured. Plaque was dyed with fucsine and its presence was recorded by a calibrated examiner based on a 3-criteria scoring system: 0 - absence of stained plaque; 1 - presence of stained plaque and supragingival PFZ; 2 - presence of stained plaque and absence of PFZ, indicating that subgingival plaque formation has taken place. RESULTS: In both phases, smokers presented a significantly lower relative frequency of sites with subgingival plaque compared to never-smokers (P < 0.001). Mean gingival crevicular fluid was significantly higher in the presence of gingival inflammation for both groups (P = 0.001), whereas smokers demonstrated a significantly lower frequency of gingival bleeding than did non-smokers (23.6% vs 66.1%; P < 0.001). CONCLUSION: Smokers presented significantly lower percentages of sites with subgingival plaque in all experimental periods and presented less gingival inflammation as shown by GBI and gingival crevicular fluid quantification.

Association among pain, masticatory performance, and proinflammatory cytokines in crevicular fluid during orthodontic treatment.

INTRODUCTION: Orthodontic patients usually complain about masticatory limitations associated with the activation of fixed appliances. The aim of this investigation was to evaluate whether orthodontic pain reflects differences in the objective evaluation of mastication and in the levels of proinflammatory cytokines in the crevicular fluid of patients undergoing orthodontic treatment. METHODS: Twenty patients with malocclusions requiring orthodontic treatment were included in this prospective study. Their pain experience, masticatory performance, and levels of interleukin 1-beta and prostaglandin E2 in crevicular fluid were evaluated at 3 times: before bracket placement, 24 hours after archwire placement, and 30 days after the initial appointment. All variables were compared with those of a control group of 25 subjects with normal occlusion. RESULTS: The masticatory performance of the patients was significantly reduced at 24 hours after bracket placement, the period in which they reported higher values of pain and had higher levels of interleukin 1-beta. The levels of prostaglandin E2 did not change in the periods evaluated, and there were no correlations between the levels of cytokines and the functional limitations observed. The only significant correlation was between pain and decreased masticatory performance. CONCLUSIONS: The masticatory performance of orthodontic patients is significantly reduced only during the period of greatest pain. However, these alterations did not correlate with any measurement of interleukin 1-beta or prostaglandin E2 in the crevicular fluid, suggesting that these solitary measurements are inadequate to predict the temporary pain and masticatory limitations experienced by patients undergoing orthodontic treatment.

Effect of nonsurgical periodontal therapy and strict plaque control on preterm/low birth weight: a randomized controlled clinical trial.

OBJECTIVE: This randomized controlled clinical trial was carried out to assess the effect of comprehensive nonsurgical periodontal treatment and strict plaque control performed during pregnancy on the reduction of preterm and/or low birth weight rates (PTLBW). MATERIAL AND METHODS: Three hundred and three women were randomly allocated to receive periodontal treatment either during pregnancy (n = 147, test group) or after delivery (n = 156, control group). During pregnancy, the control group received only one session of supragingival scaling and oral hygiene instruction. In contrast, the test group received comprehensive periodontal treatment including multiple sessions of scaling and root planing, oral hygiene instructions, and frequent maintenance visits. RESULTS: At baseline, periodontal inflammation was observed in approximately 50% of sites and attachment loss affected <15% of sites. Compared to controls, women in the test group had significant reductions in the percentage of sites with plaque (48.5% vs. 10.3%, p < 0.001), gingival bleeding (23.3% vs. 2.5%, p < 0.001), calculus (21.3% vs. 4.1%, p < 0.001), bleeding on probing (38.1% vs. 2.6%, p < 0.001) and probing depth ≥3 mm (19.97% vs. −2.45%, p < 0.001). No significant differences were observed between the groups in the occurrence of PT (11.7% vs. 9.1%, p = 0.57), LBW (5.6 % vs. 4.1%, p = 0.59), and PTLBW (4.15% vs. 2.60%, p = 0.53). CONCLUSIONS: Comprehensive periodontal treatment and strict plaque control significantly improved periodontal health; however, no reduction of PTLBW rates was observed. Thus, remaining periodontal inflammation posttreatment cannot explain the lack of effect of periodontal treatment on PTLBW. Clinical relevance This study demonstrated that periodontal diseases may be successfully treated during pregnancy. Our results do not support a potential beneficial effect of periodontal treatment on PTLBW.

Relationship between cytokine levels in serum and gingival crevicular fluid (GCF) in pregnant women.

BACKGROUND: Periodontal disease has been linked to systemic diseases/disorders and a low-grade systemic inflammatory status originated from periodontitis has been proposed as a possible explanation for this association. This study evaluates the relationship, early in pregnancy, between gingival crevicular fluid (GCF) and serum levels of a panel of cytokines that have been implicated in PTB and periodontal disease. METHODS: One hundred pregnant women aged 18-35 years old with a gestational age up to 20 weeks were included (mean±SD gestational age:16.1±3.5 weeks). Four periodontal sites per subject were randomly selected for GCF collection. Serum and GCF levels of IL-1ß, IL-6, IL-8, IL-10, IL-12p70 and TNF-α were analyzed using a cytometric bead array. Regression and correlation analyses were used to assess the relationship between serum and GCF cytokine levels. RESULTS: Participants had widespread periodontal inflammation but limited periodontal destruction. Cytokine levels were significantly higher in GCF than serum for all cytokines but IL-10. GCF levels had small but significant effect on serum levels for IL-10 (ß=0.34±0.09, p<0.01), IL-12p70 (ß=0.48±0.08, p<0.01) and TNF-α (ß=0.29±0.09, p<0.01). Periodontal probing depth and bleeding on probing were significantly associated with GCF levels for IL-1ß, IL-6 and IL-8; however, they had negligible effect on serum cytokine levels. Correlation between GCF and serum levels was non-significant, except for IL-12p70, which showed a significant but small correlation between the two sources (r=0.32, p=0.001). CONCLUSIONS: GCF cytokine levels were not strongly associated with serum cytokine levels in pregnant women with widespread periodontal inflammation but limited periodontal destruction.

Oral condition as a predictor of risk for malnutrition during hospitalization: A cross-sectional study.

BACKGROUND: Malnutrition and poor oral health are common conditions in patients in the hospital. Both conditions are associated with poor systemic health. The present study aimed to assess the relationship between the oral condition and the nutrition status of individuals admitted to a large tertiary hospital. METHODS: This cross-sectional study evaluated 364 patients who received a comprehensive dental examination at their hospital bed. An examiner recorded visible plaque index, gingival bleeding index, plaque retentive factors, probing depth, clinical attachment loss, bleeding on probing, number of existing teeth, and prosthesis use. Medical status was assessed by the Charlson Comorbidity Index. The nutrition status was evaluated by the Subjective Global Assessment. Crude and adjusted prevalence ratios were estimated by Poisson regression analysis with robust variance. RESULTS: Patients with moderate to severe malnutrition presented worse oral hygiene (55.83 ± 25.16 vs 64.90 ± 24.28; P < 0.001), more gingival inflammation (24.31 ± 24.13 vs 33.43 ± 27.36; P < 0.001), higher levels of attachment loss (4.22 ± 1.81 vs 4.80 ± 1.83; P < 0.001), and a lower mean number of teeth (14.58 ± 7.45 vs 10.94 ± 6.85; P < 0.001) than patients without malnutrition. In the multivariable analysis, the number of teeth and higher comorbidity index were associated with malnutrition. CONCLUSIONS: Poor oral health and medical condition were associated with malnutrition in this single-institution study, and oral condition may be considered an indicator of malnutrition in patients in the hospital. The implications of this study include the need to raise awareness among health professionals of the importance of oral health and nutrition status in adults.

Prevalence of tooth loss and associated factors in institutionalized adolescents: a cross-sectional study.

This study aimed to assess the prevalence of tooth loss and associated factors in institutionalized adolescents. This cross-sectional study included 68 male adolescents incarcerated from Socio-Educational Assistance Center (CASE) aged between 15 and 19 years. Questionnaires were applied individually to assess sociodemographical, economical, medical, behavioral and oral health self-perception variables. All present teeth were evaluated by Decay, Missing, Filling (DMF) Index. The prevalence of tooth loss was analyzed in individuals with ≥1 tooth loss. Associations between tooth loss and exposure variables studied were analyzed by Poisson Regression with robust variance estimation. The prevalence of tooth loss was 47.06%. First molars in the mandible and maxilla and central incisor in the maxilla were the most absent teeth. In the multivariate model, number of decayed teeth, and those that reported daily use of medication were associated with higher tooth loss. Besides, tooth loss was associated with decayed tooth and daily use of medication. Oral health promotion and treatment should be implemented in these institutions to reduce the prevalence of dental loss in these adolescents.

Relationship of nutritional status and oral health in elderly: Systematic review with meta-analysis.

This systematic review aimed to compare the nutritional status and oral health in older adults individuals. Three databases (Medline-Pubmed, Scopus and EMBASE) were searched up to October 28th 2016 for studies that performed the Subjective Global Assessment (SGA) or the Mini Nutritional Assessment (MNA) and an oral examination performed by a dental professional, either dental hygienist or a dentist. Both observational and interventional studies were screened for eligibility. Meta-analyses were performed comparing the malnourished/at risk of malnutrition and the normal nutrition subjects with three oral health parameters (edentulism, use of prosthesis and mean number of present teeth). Twenty-six studies were included in the systematic review, of which 23 were cross-sectional. It was showed that well-nourished subjects had a significantly higher number of pairs of teeth/Functional Teeth Units (FTU) in comparison to individuals with risk of malnutrition or malnutrition. The meta-analyses showed no statistically significant association between edentulism and use of prosthesis, as the pooled Relative Risk were, respectively, 1.072 (95% CI 0.957-1.200, p = 0.230) and 0.874 (95% CI 0.710-1.075, p = 0.202). On the other hand, the pooled Standard Mean Difference of mean number of present teeth were -0.141 (95% CI -0.278 to -0.005, p = 0.042) in subjects with at risk of malnutrition/malnourished. FTU and mean number of teeth present were significantly associated with nutritional status. Furthermore, more longitudinal studies in this field are needed.

Fixed and on-demand regimens of acetaminophen in periodontal surgery: randomized clinical trial

Aim: to evaluate the clinical efficacy of an acetaminophen analgesic by comparing its prescription in fixed versus ondemand schedules after periodontal surgery. The hypothesis of the study was that the fixed regimen would be more effective than the on-demand regimen for postoperative analgesics following periodontal surgery. Methods: An open randomized clinical trial was conducted. The 68 patients who needed total flap surgery to restore supracrestal tissue attachment or surgical treatment of periodontitis were randomized". Visual Analogue Scale was used to assess pain. The fixed group (n = 34) received 500 mg of acetaminophen every 4 hours for 2 days. The on-demand group (n = 34) was instructed to use the acetaminophen "as needed," at intervals of no less than 4 hours between doses. Ibuprofen was the rescue medication for both groups. Pain scores and medication use were recorded 2, 6, 12, 24 and 48 hours after the surgical procedure. The study was registered at the Brazilian Registry of Clinical Trials under RBR-7wv259. Results: The two groups did not differ in relation to the frequency or the intensity of pain in a 48-hour period (n=20 in the fixed group, and n=22 in the on-demand group), or even in the intention-to-treat (n=34 in each group). Individuals who experienced moderate to severe pain used rescue medication more frequently in both groups. No adverse events were reported. Conclusion: Both regimens were effective in controlling postoperative pain after periodontal surgery

Association between metabolic syndrome and periodontitis: a systematic review and meta-analysis.

The aim of the present study was to evaluate the association between metabolic syndrome (MS) and periodontitis (PD), through a systematic review and meta-analysis. Original observational studies assessing the association between MS and PD in adults, published before May 11th (2017), were identified through electronic searches of MEDLINE, EMBASE and Cochrane Library databases. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used. For studies to be included, they had to mention the criteria used to diagnose MS and to have used at least one clinical measure to diagnose PD. There was no language restriction. Three reviewers independently identified eligible studies for possible inclusion in the systematic review and meta-analysis. The quality of the studies was evaluated by the Newcastle-Ottawa scale for observational studies. A random model meta-analysis was conducted. The strategies used to investigate heterogeneity were sequential analysis, subgroup analysis, univariate meta-regression and sensitivity analysis. Thirty-three studies met the inclusion criteria for the systematic review, and 26 had enough information to be included in the meta-analysis, totaling 52,504 patients. MS and PD were associated with an odds ratio of 1.38 (95%CI 1.26-1.51; I2 = 92.7%; p < 0.001). Subgroup analysis showed that complete periodontal examination (I2 = 70.6%; p < 0.001) partially explained the variability between studies. The present findings suggest an association between MS and PD. Individuals with MS are 38% more likely to present PD than individuals without this condition. Prospective studies should be conducted to establish cause and effect relations between MS and PD.

Oral health related quality of life among pregnant women: a randomized controlled trial.

The aim of the present study was to compare negative impacts of oral conditions in Oral Heath Related Quality of Life (OHRQoL) assessed by the Oral Health Impact Profile-14 (OHIP-14) scores in pregnant women receiving or not comprehensive periodontal treatment. This randomized controlled clinical trial included pregnant women aged between 18 and 35 years old. Participants were randomized in a test group with 96 and a control group with 114 women. Patients in the test group received comprehensive periodontal treatment, supra and subgingival scaling and root-planning and periodontal maintenance appointments. The OHIP-14 was applied before and after treatment. The primary outcome was changes in OHIP-14 scores after follow-up period. The impact of having received or not comprehensive periodontal treatment on the change of the OHIP-14 scores was also investigated. Both groups showed significant reduction in OHIP-14 scores and effect size for the test group was 0.60 and 0.36 for the control group. Multinomial logistic regression analysis showed that participants of the control group had 5.9-fold odds (CI 95% 1.88-18.52) of worsening in OHIP-14 scores and their perception of oral conditions in relation to test group. Comprehensive periodontal treatment during pregnancy can reduce the negative impacts in OHRQoL.

Comparative analysis between hard- and soft-filament toothbrushes related to plaque removal and gingival abrasion.

OBJECTIVE: The aim of this split-mouth, examiner-blind study was to compare the dental plaque removal and incidence of gingival abrasion associated with the use of hard- and soft-filament toothbrushes. METHODOLOGY: The test group consisted of 20 non-dental students, mean age 25 years. After a three-day period of plaque accumulation following the use of a disclosing solution, the Quigley-Hein Plaque Index was recorded, while the presence of gingival abrasion was measured from photographs. Pairs of quadrants 1-3 and 2-4 were allocated to supervised brushing with hard- or soft-filament toothbrushes for 30 seconds, limited to the buccal aspects of the teeth. Plaque levels and gingival abrasion were again assessed. Initial and final values of the plaque index and the mean number of abrasions were compared with the Friedman and Wilcoxon tests (p < or = 0.05). RESULTS: Plaque indices were reduced significantly from a baseline of 4.12 in both groups to 1.21 after the use of hard-filament toothbrushes, and to 1.67 after the use of soft-filament toothbrushes. The use of hard-filament toothbrushes resulted in a significantly higher mean number of lesions when compared to the soft-filament toothbrushes; 11.6 and 7.9, respectively (p = 0.018). CONCLUSION: Hard-filament toothbrushes remove more plaque than soft filament brushes, but also cause a higher number of gingival abrasions.

A clinical trial testing the efficacy of an ionic toothbrush for reducing plaque and gingivitis.

OBJECTIVE: This study was designed to assess the efficacy of an ionic toothbrush on reducing plaque and gingivitis. METHODOLOGY: Twenty first-year dental students were included in the study. Ten individuals were randomly assigned to use either an ionic or a conventional toothbrush. Two periods of 28 days each were used with each brush, with a wash-out period of 14 days. A calibrated examiner used the Quigley-Hein Plaque Index (QHI) and Gingival Bleeding Index (GBI) on six sites per tooth, on all teeth, both pre- and post-brushing. The examiner was unaware of the toothbrush used by the subjects. Means were calculated, and for intra and inter-group comparisons a paired sample t-test was used (alpha = 0.05). RESULTS: On buccal-lingual surfaces, both toothbrushes significantly reduced plaque; there was no statistically significant difference between the two toothbrushes (1.56 and 1.52 for ionic and conventional toothbrushes, respectively). In interdental spaces, an increase of QHI was detected for both brushes, but without significant differences between them. For the GBI on buccal/lingual surfaces, no significant differences were detected between toothbrushes. The GBI did not significantly change for either toothbrush on interdental surfaces during the study period. CONCLUSION: The ionic and the conventional toothbrushes did not present statistically significant differences on plaque and gingival bleeding reductions.