A Randomized Clinical Study of the Plaque Removal Efficacy of a Novel Manual Toothbrush With Micro-Pulse Bristles on Fixed Orthodontic Patients.

Background Fixed orthodontic appliances on tooth surfaces, such as brackets and bands, complicate oral hygiene and increase plaque accumulation, contributing to gingivitis, periodontitis, and tooth decay. While manual toothbrushes are an essential part of oral hygiene, there is little clinical evidence to demonstrate how effective manual toothbrushes with novel designs are at removing plaque from orthodontic patients. This study aims to evaluate three types of manual toothbrushes (Pulsar, conventional flat trim (C-TB), and orthodontic type (O-TB)) for their efficacy in plaque removal among patients undergoing fixed orthodontic treatment. Methodology The study followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. It was a three-treatment, three-period, examiner-blinded crossover clinical trial conducted with a single brushing exercise. Twenty-four subjects were randomized to one of three different bristle designs (Pulsar, C-TB, and O-TB). The primary outcome measure was the difference (baseline minus post-brushing) in plaque scores assessed using the Turesky-Modified Quigley-Hein Plaque Index during each study period. Results Of the 27 subjects enrolled in the study, 24 met the inclusion criteria and completed all three periods of the study. The mean age was 19.58 ± 1.55 years, with a range of 18-23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value <0.001). The treatment differences were statistically significant (p-value <0.001), favoring the C-TB toothbrush and the O-TB over the Pulsar design. On the contrary, the difference between the O-TB and C-TB types was not statistically significant. Conclusions C-TB and O-TB remove significantly more plaque than Pulsar toothbrushes after a single brushing exercise. Nevertheless, the C-TB tested in this study was more effective in removing dental plaque than the O-TB in patients wearing fixed orthodontic appliances. Considering the limitations of this study, additional research is required before evidence-based advice concerning the relative performance of the Pulsar toothbrushes in fixed orthodontic patients can be proven.

Risk indicators of aggressive periodontitis in a Jordanian population.

BACKGROUND: Knowledge of the risk indicators of aggressive periodontitis (AgP) will help clinicians to better diagnose the disease, put a treatment plan that involves modification of modifiable risk indicators, understand non-modifiable risk indicators, and may potentially serve as an aid in developing preventive programs. The objective of the present study was to assess risk indicators of aggressive periodontitis (AgP) in Jordan including socio-demographic factors, oral hygiene habits, smoking, family history and parents' consanguinity. METHODS: A total of 162 patients (81 AgP and 81 controls), attending the Periodontology clinic at Jordan University of Science and Technology, Dental Teaching Centre, were interviewed and examined. All AgP subjects had full periodontal and radiographic examination. The data recorded included socio-demographic and economic variables, oral hygiene and smoking habits, family history and parents' consanguinity. RESULTS: Most AgP patients were young females, had ≤12 years of education, lived in urban areas and brushed their teeth ≥ once daily. Risk indicators of AgP included: age > 35 years, female gender and positive family history. CONCLUSIONS: Risk indicators associated with AgP in this study population were: age > 35 years, female gender and positive family history of periodontal disease.

Association of vitamin D receptor gene polymorphisms with chronic and aggressive periodontitis in Jordanian patients.

Vitamin D acts through binding with vitamin D receptor (VDR) and is responsible for regulating bone metabolism and mineralization; it also suppresses the immune system. The aim of this study was to investigate if VDR gene polymorphisms are associated with chronic periodontitis (CP) and aggressive periodontitis (AgP) in a Jordanian population. A total of 99 patients with CP, 63 patients with AgP, and 126 controls were genotyped using PCR-restriction fragment length polymorphism (RFLP) for BsmI, ApaI, and TaqI single nucleotide polymorphisms (SNPs). The association was determined after correcting for confounding factors using multivariate logistic regression analysis. Estimation of haplotype frequencies was carried out using the EH program, and haplotypes were constructed using the phase 2.1 program. After correcting for confounding factors, multivariate logistic regression analysis revealed that inheritance of the BsmI bb genotype or the ApaI aa genotype was associated with increased risk of developing CP (OR = 2.4 and OR = 3.4, respectively) but with reduced risk of developing AgP (OR = 0.4 and OR = 0.3, respectively). This was further supported by association of the ba haplotype with CP but not with AgP. This study supports an association of VDR gene polymorphisms with CP and AgP in a Jordanian population; however, the pattern of association was different between the two diseases.

Investigation of the interleukin-1 gene cluster polymorphisms in Jordanian patients with chronic and aggressive periodontitis.

OBJECTIVE: Interleukin-1 (IL-1) is a proinflammatory cytokine that is highly elevated in response to bacterial biofilms and is a potential risk factor for periodontal diseases. IL-1 gene polymorphisms have been associated with the IL-1 level. The aim of this study was to investigate if IL-1 gene cluster polymorphisms are associated with chronic (CP) and aggressive (AgP) periodontitis in a Jordanian population. METHODS: A total of 100 CP, 80 AgP patients and 80 controls were genotyped using PCR for IL-1RN-86-bp VNTR and PCR-RFLP for IL-1A-889, IL-1B-511, -35, +3953, and IL-1RN +8006, +9589, +11100 SNPs. The distribution of alleles and genotypes between groups was compared using χ(2) analysis. Estimation of haplotype frequencies was carried out using the EH programme. RESULTS: The IL-1RN8006 SNP and the IL-1RN-VNTR were associated with CP but not with AgP. The C allele and TC genotype of IL-1RN8006 were increased in CP (P(corr)=0.002, 0.00026 respectively). The A1 allele and A1/A1 genotype of the IL1-RN-VNTR were significantly increased in CP (P(corr)=0.0007, <0.0001 respectively). The CA1 haplotype formed by both markers was present in 29 CP patients but not in any of the controls (P<0.0001). No significant differences were found in the distribution of allele and genotype frequencies of the other markers between CP and AgP cases and controls. CONCLUSIONS: IL-1RN 8006 and IL-1RN VNTR were associated with CP but not AgP in a Jordanian population, whilst other investigated markers in IL-1A, IL-1B and IL-1RN were not associated with either CP or AgP.

The association of aggressive and chronic periodontitis with systemic manifestations and dental anomalies in a jordanian population: a case control study.

BACKGROUND: The relationship between dental anomalies and periodontitis has not been documented by earlier studies. Although psychological factors have been implicated in the etiopathogenesis of periodontitis, very little information has so far been published about the association of anxiety and depression with aggressive periodontitis. The aim of this study was to investigate the association of chronic periodontitis and aggressive periodontitis with certain systemic manifestations and dental anomalies. METHODS: A total of 262 patients (100 chronic periodontitis, 81 aggressive periodontitis and 81 controls), attending the Periodontology clinics at Jordan University of Science and Technology, Dental Teaching Centre) were included. All subjects had a full periodontal and radiographic examination to assess the periodontal condition and to check for the presence of any of the following dental anomalies: dens invaginatus, dens evaginatus, congenitally missing lateral incisors or peg-shaped lateral incisors. Participants were interrogated regarding the following: depressive mood, fatigue, weight loss, or loss of appetite; and their anxiety and depression status was assessed using the Hospital Anxiety and Depression (HAD) scale. RESULTS: Patients with aggressive periodontitis reported more systemic symptoms (51%) than the chronic periodontitis (36%) and control (30%) patients (p < 0.05). Aggressive periodontitis patients had a higher tendency for both anxiety and depression than chronic periodontitis and control patients. Dental anomalies were significantly (p < 0.05) more frequent among both of chronic and aggressive periodontitis patients (15% and 16%, respectively), compared to controls. CONCLUSION: In this group of Jordanians, systemic symptoms were strongly associated with aggressive periodontitis, and dental anomalies were positively associated with both aggressive and chronic periodontitis.

Salivary tumors in north Jordanians: a descriptive study.

OBJECTIVE: To evaluate the types and distribution of tumors of salivary glands in north Jordanians. STUDY DESIGN: The records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients who were treated for salivary gland tumors from 1991 to 2002. The tumors were analyzed for age of patient, sex of patient, tumor site, and tumor type. RESULTS: One hundred two true neoplasms (70% benign and 30% malignant) were found. The most frequent benign and malignant neoplasms found were pleomorphic adenoma (54%) and adenoid cystic carcinoma (13%), respectively. The most common major and minor salivary gland sites were the parotid (51%) and palatal glands (20%), respectively. Although most of major gland tumors were adenomas, carcinomas of the minor glands were only slightly less frequent than adenomas. The most frequent malignant parotid tumors were adenoid cystic carcinoma and mucoepidermoid carcinoma. The most frequent minor salivary gland malignant tumors were palatal adenoid cystic carcinoma. Age ranged from 1 to 94 (mean 40) years, with a male to female ratio of 1:1.2. CONCLUSION: North Jordanians with salivary gland tumors were found to have similar characteristics with patients of other countries with regard to tumor type, tumor site distribution, and age and sex of patients.

Biopsied gingival lesions in northern Jordanians: A retrospective analysis over 10 years.

The frequency and distribution of 183 consecutive cases of biopsied gingival lesions from northern Jordanians are presented here. Lesions were analyzed for age and sex of subject and location and type of lesion. Neoplasms accounted for 9% of biopsies (7% benign, 3% malignant). The most frequent neoplasm was peripheral ossifying fibroma. The maximum number of benign neoplasms occurred in patients aged 20 to 39 years, and malignant neoplasms did not occur in patients younger than 30 years. Nonneoplastic lesions accounted for 91% of cases; they comprised nine types, with pyogenic granuloma being the most frequent. The frequency and distribution of gingival lesions in north Jordan are similar to those found in other countries. Additional nationwide multicenter studies are needed to describe all aspects of epidemiology of gingival lesions in Jordan.

Ameloblastoma in young Jordanians: a review of the clinicopathologic features and treatment of 10 cases.

PURPOSE: We sought to descriptively review the clinicopathologic features and surgical treatment of ameloblastoma in children and young adults of Jordan. PATIENTS AND METHODS: Data were collected from the records of patients treated at the Oral and Maxillofacial Surgery Unit of Jordan University of Science and Technology between 1989 and 2002. RESULTS: Ten patients (4 males and 6 females) were included in the review. All of the cases involved the mandibular molar-ramus region. The most common presenting sign was that of a painless swelling. In 5 of the patients, a multilocular radiolucent radiographic appearance was seen; the remaining 5 cases had a large unilocular radiolucent appearance. While 2 tumors were devoid of microcystic regions, 2 exhibited only a few scattered cystic foci, and 6 were entirely cystic (unicystic). Cases with a unilocular radiographic appearance were treated by surgical enucleation plus rotary instrument peripheral ostectomy. Cases with a multilocular radiographic appearance were treated by surgical resection without a continuity defect. During the follow-up period (average of 7.6 years), no recurrence or metastasis was detected. All patients had desirable postoperative function and appearance. CONCLUSION: The clinicopathologic patterns of ameloblastoma in these young Jordanians were found to be similar to those of other whites. In this case series, minimal surgical treatment of mandibular ameloblastoma resulted in no recurrence and excellent postoperative function and appearance.