Gingival pigmentation: Concurrent assessment of distribution, intensity, and extent in a black population.

OBJECTIVE: To evaluate prevalence, distribution, intensity and extent of physiologic gingival melanin pigmentation (GMP) in black individuals. MATERIALS AND METHODS: For this cross-sectional study, GMP was evaluated on digital images by three calibrated examiners, according to de Krom (distribution), DOPI (intensity) and Melanin Index (extent) classifications. Descriptive statistics, Wilcoxon, Mann-Whitney, Kruskal-Wallis, Two-way ANOVA, chi square, and K-means cluster analysis were used. RESULTS: Seventy participants were recruited. The most prevalent GMP categories were: de Krom category 2 (34.3%), DOPI heavy intensity (57.2%), and Melanin index Degree IV (50%). Significant inter-group differences were found for age (p < 0.05) but not gender (p > 0.05). Significant correspondence/overlap was observed between classifications (p > 0.05). Three GMP clusters were identified: Cluster 1 (27%; n = 19) had mild asymmetric and interspersed pigmentation; Cluster 2 (46%; n = 32) had heavy pigmentation in one long continuous ribbon, with pink marginal gingiva; and Cluster 3 (27%; n = 19) had heavy pigmentation in one long continuous ribbon, symmetric, and uniform. CONCLUSIONS: There may be overlap among GMP classification systems. In black individuals, the predominant GMP presentation is one of a broad zone of heavily pigmented attached gingiva, in a continuous strip from central incisors to canines, symmetrical across the midline, and with pink free marginal gingiva. CLINICAL RELEVANCE: This is the first study to analyze distribution, intensity, and extent of gingival melanin pigmentation in the same population and to integrate the various classification systems through cluster analysis. The novel findings provide a foundation for patient assessment and counseling and for future studies.

Evaluation of three soft manual toothbrushes in relation to gingival abrasion: a crossover randomized clinical trial / Avaliação de três escovas de dentes manuais macias em relação à abrasão gengival: um ensaio clínico randomizado cruzado

Purpose: The aim of this study was to evaluate gingival abrasion of soft toothbrushes. Material and Methods: This randomized, crossover, blind study tested three commercially available manual soft toothbrushes: CURAPROX® 5460 (CPX), Colgate Slim Soft (COG) and ORAL-B® Indicator 30 Plus (ORB). Fifteen men and 15 women were randomly divided into 3 groups (N=10), who used all the brushes in three consecutive stages of 14 days each. Plaque index (PI), gingival index (GI), and gingival abrasion (GA) were assessed at the end of each experimental stage. Participants were also scored their perception of brush comfort, trauma, and cleanliness with visual analog scales (VAS). Friedman nonparametric test was used to analyze the data (p≤0.05). Results: No statistically significant differences were found among the tested brushes for any of the studied variables. When present, gingival abrasion lesions were mostly small (<2 mm). There was no difference between PI and GI between the 3 brushes. However, in patients' perception, CPX had significantly higher scores for comfort, while COG presented higher scores for trauma and ORB for cleanliness. Conclusion: The results indicate that all the tested brushes were similar concerning gingival abrasion and plaque control. However, patients reported different levels of satisfaction concerning their use. When recommending a soft toothbrush, clinicians should take into consideration individual patient requirements, and provide instructions of use based on the specific characteristics of each brush. (AU)

Objetivo: O objetivo deste estudo foi avaliar a abrasão gengival de escovas dentais macias. Material e Métodos: Este estudo randomizado, cruzado e cego testou três escovas manuais macias comercialmente disponíveis: CURAPROX® 5460 (CPX), Colgate® Slim Soft (COG) e ORAL-B® Indicator 30 Plus (ORB). Quinze homens e 15 mulheres foram aleatoriamente divididos em 3 grupos (N = 10), que utilizaram todas as escovas em três estágios consecutivos de 14 dias cada. Índice de placa (IP), índice gengival (IG) e abrasão gengival foram avaliados no final de cada estágio experimental. Os participantes também pontuaram quanto à sua percepção de conforto, trauma e limpeza das escovas com escalas analógicas visuais (EVA). Os dados foram analisados com o teste não paramétrico de Friedman (p≤0,05). Resultados: Não foram encontradas diferenças estatisticamente significativas entre as escovas testadas em relação à abrasão gengival. Quando presentes, as lesões de abrasão gengivais eram em sua maioria pequenas (<2 mm). Não houve diferença entre o IP e IG apresentados pelas 3 escovas. Porém, na percepção dos pacientes, a CPX apresentou escores significativamente maiores para conforto, enquanto a COG apresentou maior trauma e a ORB maior sensação de limpeza. Conclusão: Os resultados indicam que as escovas testadas foram semelhantes quanto à abrasão gengival e controle de placa. No entanto, os pacientes relataram diferentes níveis de satisfação em relação ao seu uso. Ao recomendar uma escova de dentes macia, os dentistas devem levar em consideração os requisitos individuais do paciente e fornecer instruções de uso com base nas características específicas de cada escova. (AU)

Effect of using the New Glass Fiber Pin in Resin Composite Restorations.

AIM: The purpose was to compare the fracture strength between restorations containing the metal pin (MP) and those containing the glass fiber pin (GFP). MATERIALS AND METHODS: Forty-five healthy bovine anterior teeth were used in this study. A preparation of 4 mm × 4 mm was created on the incisal surface of each tooth. All teeth were prepared in the same way. The teeth were randomly divided into three groups (n = 15): group I-control: teeth restored with resin composite (RC) only, without reinforcement; group II-Each tooth was restored with a MP and RC; group III-Each tooth was restored with a GFP and RC. The specimens were left in an oven at a temperature of 37°C for 24 hours before performing the fracture strength tests. The fracture strength test was performed in a universal test machine at an angle of 90°. RESULTS: The Tukey test (p ≤ 0.05) showed that for the variable maximum force (kgf), there was no statistically significant difference among the groups (p = 0.272). The chi-square test showed that groups II and III presented over 70% of cohesive-adhesive type fractures when compared with group I (over 70% of adhesive fractures), and this difference was statistically significant (p < 0.05). CONCLUSION: The pins tested did not increase the fracture resistance of the restorations (RC) in comparison with group I (without reinforcement); however, with the use of the MP and GFP, there was a predominance of cohesive-adhesive fractures (groups II and III). CLINICAL SIGNIFICANCE: Evaluate if the new GFP can generate greater resistance to fracture of RC restorations.

Reliability of self-reported toothbrushing frequency as an indicator for the assessment of oral hygiene in epidemiological research on caries in adolescents: a cross-sectional study.

BACKGROUND: In the present state of knowledge regarding the etiology of dental caries, it is unacceptable for studies addressing factors associated with this outcome to disregard oral hygiene. Simple, valid methods are needed for the assessment of oral hygiene in adolescents to allow this condition to be properly investigated in epidemiological studies on caries and assist in the establishment of health promotion measures. The aim of the present study was to test the hypothesis that the self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices in epidemiological studies on dental caries in adolescents. METHODS: A cross-sectional study was conducted with a representative sample (n = 589) of 12-year-old school children in a medium-sized city in southern Brazil. A detailed questionnaire addressing socio-demographic and economic characteristics was sent to primary caregivers. Adolescents answered a brief self-administered questionnaire on behavioral characteristics, including toothbrushing frequency and sugar intake. Samples of stimulated saliva were collected from the adolescents and evaluated for levels of mutans streptococci and lactobacilli using Dentacult kits I and II, respectively. Examiners who had undergone a training and calibration exercise (kappa > 0.81) performed the clinical examination of the adolescents. Caries experience was assessed using the decayed, missing and filled teeth index. Oral hygiene was determined using the Simplified Oral Hygiene Index and the Visible Plaque Index. RESULTS: When the oral hygiene variables were used alone in the multiple models, significant associations with dental caries were found. When Simplified Oral Hygiene Index and/or Plaque Index were used together with toothbrushing frequency in the same model, only the latter was significantly associated with dental caries. A significant association was also found between self-reported toothbrushing frequency and the clinical indices. CONCLUSION: Based on the present findings, self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices, which facilitates data collection in epidemiological studies addressing dental caries in adolescents.