Effect of Plant-Based Mouthwash (Morinda citrifolia and Ocimum sanctum) on TNF-α, IL-α, IL-ß, IL-2, and IL-6 in Gingival Crevicular Fluid and Plaque Scores of Patients Undergoing Fixed Orthodontic Treatment.

Background and Objectives: To investigate the antiplaque properties of two plant-based mouthwashes, Morinda citrifolia (MC) and Ocimum sanctum (OS), and their effect on TNF-α, IL-α, IL-ß, IL-2, and IL-6 in gingival crevicular fluid (GCF) of patients undergoing fixed orthodontic treatment. Materials and Methods: Seventy-five individuals were recruited according to defined inclusion and exclusion criteria. This study was structured into two distinct phases. Phase I was a combination of toothbrushing using toothpaste containing fluoride (Protocol A), while Phase II toothbrushing included fluoride toothpaste and use of a mouthwash (Protocol B). For Phase II, individuals participating in this study were allocated into different groups through a randomization process: Group 1-0.12% CHX, Group 2-5% MC, and Group 3-4% OS. Each individual's Phase I and Phase II scores were assessed. GCF was measured in three phases to determine the level of inflammatory biomarkers. The paired t-test evaluated the disparities between the pre- and post-plaque index. Categorical data were subjected to crosstab analysis to assess qualitative variables. The mean values of cytokine levels were presented. An unpaired t-test was employed to assess the levels of cytokines between individuals in Phase I and Phase II. Results: Toothbrushing, fluoride toothpaste, and the supplementary use of mouthwash (Phase II) resulted in mean plaque scores significantly lower than group A (p < 0.001). Cytokines TNF-α, IL-α, and IL-ß demonstrated a significant downward trend in herbal mouthwash users. Conclusions: In conjunction with fluoridated toothpaste and brushing, OS and MC can serve as a viable alternative to conventional synthetic mouthwash CHX. This combination demonstrates reducing mean plaque scores and diminishing the levels of cytokines TNF-α, IL-α, and IL-ß.

Photobiomodulation in acceleration of orthodontic tooth movement: A systematic review and meta analysis.

BACKGROUND: Photobiomodulation therapy, a non invasive method with no adverse effects, has been used to accelerate tooth movement in orthodontia. However, the specific characteristics of laser settings used in studies documented have reported varied inconsistent conflicting results. OBJECTIVES: We decided to undertake a systematic review to eliminate this inconsistency by quantifying the literature studies that indicated the link between photobiomodulation and acceleration of tooth movement and to assess if there is any association of photobiomodulation therapy in accelerating tooth movement. SEARCH STRATEGY: We systematically searched for articles of existing literatures on Photobiomodulation therapy and acceleration of tooth movement over Cochrane library, Pubmed central, EMBASE, Scopus and Web of sciences from 2000 to 2017. Mesh search terms using various descriptors were used to identify the studies. SEARCH CRITERIA: We included randomized control trial and clinical control trail studies that used Ga-Al-As diode laser and Oseeopulse laser with specific characteristics and company specifications, addressing relevant efficiency and safety outcomes. DATA COLLECTION AND ANALYSIS: Eligible studies were reviewed and data was extracted on a standard from. We used Cochrane review manager software (Revman version 5.3) to assess the qualities of each included trials. Data were analyzed using an inverse variance method with random effects model effect. RESULTS: We observed a statistical significant difference between the photobiomodulation therapy compared to non laser group in the acceleration of tooth movement (Mean difference 0.59 (95%CI- 0.24 to 0.95) I2 95%). However, these results need caution while generalizing in clinical practice due to the large amount of heterogeneity across the studies. CONCLUSION: Findings of the current systematic review suggest a possible benefit with photobiomodulation therapy and tooth movement in orthodontia. However these findings need to be further validated in larger trials using specific standardized characteristics of laser settings to uniform the methodological design that can be used in routine clinical practice.

Influence of phototherapy on adhesive strength and microleakage of bleached enamel bonded to orthodontic brackets: An in-vitro study.

AIM: The aim of the present in-vitro study was to explore bleached enamel reversal with phototherapy (Er,Cr:YSGG) when using two dissimilar bonding system to bond brackets on microleakage and shear bond strength. MATERIAL AND METHODS: Amongst one twenty samples, ninety samples were bleached using 35% hydrogen peroxide. After the bleaching procedure, the teeth were randomly divided into three groups according to surface conditioning treatment (n = 30 each). Group 1: treated with Er,Cr:YSGG (ECL) Group 2: 10% sodium ascorbate (SA) and Group 3: Bleached only (BO). Based on the type of adhesive, specimens were further classified into eight subgroups. In subgroup 1,2,3 and no treatment (NT) (n = 15) adhesive Transbond XT was applied on already etched surface and these subgroups were named as NT-TEP, BO-TEP, ECL-TEP and SA-TEP. Similarly, in subgroup 5,6,7 and NT specimens (n = 15) were conditioned with Transbond Plus self-etching primer and these subgroups were named as NT-SEP, BO-SEP, ECL-SEP and SA-SEP. Samples from each subgroup were exposed to increasing load for evaluation of shear bond strength. Microleakage among subgroups were tested by immersing samples in Methylene blue prior one day. Analysis of variance and Tukey multiple comparisons test was used to assess data. RESULTS: The maximum and minimum bond strength was observed in group NT-TEP [17.14(2.54)] and BO-SEP [6.14(0.215)] respectively. Samples conditioned with phototherapy ECL-TEP [16.14(1.231)] exhibited comparable bond strength to specimens conditioned with sodium ascorbate (SA-TEP) [16.72(1.298)]. Similarly, bond strength values of ECL-SEP [13.43(0.921)] and SA-SEP were comparable. The highest microleakage score was demonstrated in BO-SEP [83.21(38.21)] whereas, the lowest microleakage scores were displayed in NT-TEP [23.73(13.45)]. CONCLUSION: Er,Cr:YSGG phototherapy reversal on bleached enamel with etch and rinse adhesives has a potential to be used in clinical settings alternate to conventional sodium ascorbate when bonding orthodontic brackets.

Anti-plaque Efficacy of Herbal Mouthwashes Compared to Synthetic Mouthwashes in Patients Undergoing Orthodontic Treatment: A Randomised Controlled Trial.

PURPOSE: The present study compared the antiplaque effects of two herbal mouthwashes containing Salvadora persica and Azadirachta indica, respectively, with two synthetic mouthwashes containing either chlorhexidine or cetylpyridinium. MATERIALS AND METHODS: In this triple-blind, randomised controlled trial, 100 patients undergoing orthodontic treatment underwent scaling and polishing at baseline to obtain a plaque score of zero. In the first phase, they were given oral hygiene instructions and were provided with a standard toothpaste to be used twice daily for a period of three weeks. In the second phase, following scaling and polishing, they were randomly allocated to 4 groups according to 4 different types of mouthwash (A: chlorhexidine; B = cetylpyridinium; C = extracts of Salvadora persica miswak; D: extract of Azadirachta indica miswak) along with previously taught toothbrushing protocol for three more weeks. Plaque accumulation was scored three times according to the Modified Bonded Bracket Plaque Index: at the start, after the toothbrush-toothpaste trial, and at the end of mouthwash trial. The paired t-test was used to compare the pre-plaque and post-plaque indices in all groups. Analysis of mean differences of post-plaque indices between and within groups was performed using the post-hoc Tukey test. Qualitative variables were compared by Crosstab. RESULTS: Eighty participants completed the study - 63 females and 17 males. There was a statistically significant decrease in mean plaque scores after using mouthwashes in all four groups at follow-up when compared to the baseline plaque score (p = 0.001). The greatest reduction of plaque score was found in group C (extract of Salvadora persica) when compared with group A, chlorhexidine (p = 0.016). CONCLUSION: Compared to other mouthwashes, Salvadora persica miswak-based mouthwash showed a maximum reduction in the plaque scores among orthodontic patients.