A comparative study to evaluate the effects of antibiotics, plant extracts and fluoride-based toothpaste on the oral pathogens isolated from patients with gum diseases in Pakistan / Um estudo comparativo para avaliar os efeitos de antibióticos, extratos vegetais e creme dental à base de flúor sobre os patógenos orais isolados de pacientes com doenças gengivais no Paquistão

Oral diseases caused by various microorganisms are common around the world. Scientific research has now been focusing on novel medicines to overcome bacterial resistance and antibiotics side effects; therefore, the current study was designed to assess the efficacy of certain antibiotics, toothpaste, and medicinal plant extracts (Ajuga bracteosa and Curcuma longa) versus the bacterial pathogens isolated from the human oral cavity. A total of 130 samples were collected from Khyber Teaching Hospital Peshawar, Pakistan, among those 27 species isolated, and eight bacterial species were identified from the samples. Among all the bacterial species, Staphylococcus aureus (29.62%) and Proteus mirabilis (22.2%) were found to be more prevalent oral pathogens. In comparison, the least pervasive microbes were Proteus vulgaris, Shigella sonnei, Escherichia coli and Aeromonas hydrophila. The study also suggested that dental problems were more prevalent in males (41-50 years of age) than females. Among the eight antibiotics used in the study, the most promising results were shown by Foxicillin against A. hydrophila. The survey of TP1 revealed that it showed more potent antagonist activity against Proteus vulgaris as compared TP2 and TP3 that might be due to the high content of fluoride. The Curcuma longa showed more significant activity than Ajuga bracteosa (Stem, leaves and root) extracts. The data obtained through this study revealed that antibiotics were more effective for oral bacterial pathogens than toothpaste and plant extracts which showed moderate and low activity, respectively. Therefore, it is suggested that the active compounds in individual medicinal plants like Curcuma longa and Ajuga bracteosa could replace the antibiotics when used in daily routine as tooth cleansers or mouth rinses.

As doenças bucais causadas por vários microrganismos são comuns em todo o mundo. A pesquisa científica agora tem se concentrado em novos medicamentos para superar a resistência bacteriana e os efeitos colaterais dos antibióticos; portanto, o presente estudo foi desenhado para avaliar a eficácia de certos antibióticos, pasta de dente e extratos de plantas medicinais (Ajuga bracteosa e Curcuma longa) contra os patógenos bacterianos isolados da cavidade oral humana. No total, 130 amostras foram coletadas do Khyber Teaching Hospital Peshawar, Paquistão, entre essas, 27 espécies foram isoladas e oito espécies bacterianas foram identificadas a partir das amostras. Entre todas as espécies bacterianas, Staphylococcus aureus (29.62%) e Proteus mirabilis (22.2%) foram os patógenos orais mais prevalentes. Em comparação, os micróbios menos difundidos foram Proteus vulgaris, Shigella sonnei, Escherichia coli e Aeromonas hydrophila. O estudo também sugeriu que os problemas dentários eram mais prevalentes em homens (41-50 anos de idade) do que em mulheres. Entre os oito antibióticos usados no estudo, os resultados mais promissores foram mostrados pelo Foxicillin contra A. hydrophila. A pesquisa de TP1 revelou que ele mostrou atividade antagonista mais potente contra Proteus vulgaris em comparação a TP2 e TP3, o que pode ser devido ao alto teor de flúor. A Curcuma longa apresentou atividade mais significativa em relação aos extratos de Ajuga bracteosa (caule, folhas e raiz). Os dados obtidos neste estudo revelaram que os antibióticos foram mais eficazes para os patógenos bacterianos orais do que os dentifrícios e os extratos vegetais que apresentaram atividade moderada e baixa, respectivamente. Portanto, sugere-se que os compostos ativos em plantas medicinais individuais como Curcuma longa e Ajuga bracteosa possam substituir os antibióticos quando usados na rotina diária como limpadores de dentes ou enxaguatórios bucais.

Comparison of Nd:YAG Laser and Surgical Stripping for Treatment of Gingival Hyperpigmentation: A Clinical Trial.

OBJECTIVE: The objective of this study is to evaluate and compare surgical stripping and neodymium-doped: yttrium, aluminum garnet (Nd:YAG) laser techniques for gingival depigmentation and to evaluate their effect on repigmentation. BACKGROUND DATA: Gingival depigmentation is often associated with repigmentation. Recurrence of pigmentation differs according to different treatment modalities. MATERIALS AND METHODS: In this study, 40 maxillary sites from 20 patients presenting bilateral melanin gingival hyperpigmentation were selected. Contralateral quadrants in the maxilla were randomly assigned to receive Nd:YAG laser at 3 W, 30 mJ per pulse, with contact mode, and with a handpiece with a 300 µm diameter optic fiber and surgical stripping. Plaque index, Dummett Oral Pigmentation Index (DOPI), Hedin melanin index, size of pigmented area, time interval and extent of repigmentation, time taken for each of the procedures, assessment of pain, intraoperative bleeding index, and patient preference were compared from baseline to 6 months. RESULTS: Comparison between Nd:YAG laser and surgical stripping group for plaque index, DOPI, Hedin index, size of pigmented area, time interval, and extent of repigmentation, at 6 months was statistically nonsignificant. Intergroup comparison for time taken, pain, and patient preference was statistically significant. Intragroup comparison for Nd:YAG laser and surgical stripping at 6 months for DOPI, Hedin index, and size of pigmented area was statistically significant. CONCLUSIONS: From the present study it can be concluded that Nd:YAG laser can be used as an alternative technique for gingival depigmentation. However, surgical stripping continues to remain as a cost-effective procedure.

Cytological assessment of healing palatal donor site wounds and grafted gingival wounds after application of ozonated oil: an eighteen-month randomized controlled clinical trial.

OBJECTIVE: The present study was undertaken to assess the therapeutic effects of topical ozonated oil on early healing of free gingival graft surgical sites. STUDY DESIGN: Twenty subjects were entered into this triple-blinded, randomized, placebo-controlled clinical trial, designed to evaluate the efficacy of ozonated oil on free gingival graft surgical wounds. Subjects were assigned to either the ozone group, in which ozonated oil was applied to the surgical wound, or the control group, in which non-ozonated oil was used as a control. Patients were postoperatively evaluated by cytological analysis. Cytological analysis consisted of the keratinisation and superficial cell indices measured at baseline, after 24 h, on the 3rd, 7th, 14th and 21st day and 2, 3, 8 and 18 months postoperatively. RESULTS: Cytological results showed that there was a significant (p < 0.001) improvement in epithelial healing by the 7th, 14th and 21st day and 2, 3 and 8 months postoperatively in the ozone group compared to the control group. CONCLUSION: The present study showed significant improvement in epithelial healing and gingival health after topical application of ozone-treated plant oil to gingival surgical sites.

Amlodipine and nifedipine used with cyclosporine induce different effects on gingival enlargement.

BACKGROUND: Gingival enlargement (GE) is a frequent side effect associated with the administration of cyclosporine (CsA) and the calcium channel blockers (CCB). The aims of this study were to determine and compare GE prevalence and severity in 3 groups of renal transplant recipients who had been medicated with CsA versus CsA in combination with nifedipine versus CsA in combination with amlodipine. PATIENTS AND METHODS: A cohort of 93 patients included 31 medicated with CsA, 31 with CsA plus nifedipine, and 31 with CsA plus amlodipine. The presence and severity of GE were assessed using the index developed by Harris and Ewart. RESULTS: There were significant differences in GE prevalence and GE severity among the 3 groups. A greater proportion (90.3%) of the CsA-nifedipine group was categorized as having GE compared with the CsA-amlodipine group (58.1%) or the CsA group (51.6%). A greater percentage of subjects in the CsA-nifedipine group displayed severe GE (22.6%) when compared with the CsA (0%) or the CsA-amlodipine group (16.1%). CONCLUSION: The prevalence and severity of GE in subjects maintained on CsA-nifedipine was significantly greater than that among subjects treated with CsA-amlodipine or CsA only. The GE prevalence and severity was greater in the CsA-amlodipine group than the CsA group. This observation should lead clinicians to avoid the use of these drugs together with CsA or to choose amlodipine instead of nifedipine.

The mechanism of gingiva metallic pigmentations formation.

The occurrence of blue-grey areas in the soft tissue represents one of the problems affecting patients whose teeth have been restored using metallic materials. It is generally accepted that it is caused by mechanical penetration of a metallic material into the soft tissue. Several facts indicate that this mechanism is not general. The aim of the study was to determine an alternative mechanism of the origin of pigmentations, based on the corrosion interaction of metallic materials used in prosthodontics with the oral environment. The study was comprised of an analysis of pigment particles, determination of exposure conditions of metallic materials in vivo and laboratory evaluation of corrosion properties of the studied materials. Particles containing silver, sulphur and/or selenium could be seen in ultra-thin sections in the lamina propria gingivae. Comparison of the corrosion laboratory results with the results of in vivo measurements indicated the intensification of corrosion under these conditions. Amalgams and silver-containing alloys used for teeth restorations may release silver under the conditions of the oral cavity. The formation of soluble silver compounds in the sulcular area or in a crevice between the crown and the cast post-and-core reconstruction facilitates their transport to the soft tissue and subsequent deposition.

Reduction of micronuclei in oral lichen planus supplemented with beta-carotene.

An elevated frequency of micronucleated exfoliated cells (MEC) in atrophic and erosive oral lichen planus (OLP) has been reported. To evaluate the effects of supplemental beta-carotene (BC) on MEC frequency in OLP lesions, we performed an open trial in 20 patients with atrophic and/or erosive OLP. Each patient received 15 mg of BC four times daily for 3 months. The frequency of MEC in both lesions and adjacent normal mucosa in each patient was evaluated and compared before and after supplementation. Serum levels of BC and retinol were also determined. After BC supplementation, all patients had higher levels of serum BC and retinol. The MEC frequency in OLP lesions was significantly reduced (P < 0.01). No significant changes were seen in the MEC frequency in adjacent normal mucosa. BC supplementation thus significantly reduces MEC frequency in atrophic and erosive OLP.

The anti-inflammatory mechanism of 635 nm light-emitting-diode irradiation compared with existing COX inhibitors.

BACKGROUND AND OBJECTIVES: Inhibition of cyclooxygenase (COX) and prostaglandin E(2) (PGE(2)) protects cells against cell injury in specific pathophysiological situations: inflammation and oxidative stress. Although the anti-inflammatory effects have been reported in clinical fields for specific wavelength irradiation during wound healing, the physiological mechanism has not been clarified yet. The aim of the present study is to investigate the anti-inflammatory mechanism of 635 nm light-emitting-diode (LED) irradiation compared with existing COX inhibitors. STUDY DESIGN/MATERIALS AND METHODS: The present study investigated anti-inflammatory effects of 635 nm irradiation on PGE(2) release, COX and phospholipase A(2) (PLA(2)) expression, and reactive oxygen species (ROS) dissociation in arachidonic acid (AA)-treated human gingival fibroblast (hGF). These results were compared with their existing COX inhibitors: indomethacin and ibuprofen. The PGE(2) release was measured by enzyme immunoassay, the COX expression was measured by western blot and reverse transcriptase polymerase chain reaction (RT-PCR), and ROS level was measured by flow cytometry, laser scanning confocal microscope and RT-PCR. RESULTS: Results showed that 635 nm irradiation and existing COX inhibitors inhibit expression of COX and PGE(2) release. Unlike indomethacin and ibuprofen, 635 nm irradiation leads to a decrease of ROS levels and mRNA expression of cytosolic phospholipase A(2) (cPLA(2)) and secretary phospholipase A(2) (sPLA(2)). CONCLUSION: Taken together, 635 nm irradiation, unlike indomethacin and ibuprofen, can directly dissociate the ROS. This inhibits cPLA(2), sPLA(2), and COX expression, and results in the inhibition of PGE(2) release. Thus, we suggest that 635 nm irradiation inhibits PGE(2) synthesis like COX inhibitor and appears to be useful as an anti-inflammatory tool.

Carcinoma epidermoide gingival: estudio clínico y factores pronósticos / Squamous cell carcinoma of the gingivae: a clinical an epidemiologic study

Objetivo: La encía es la tercera localización más frecuente del carcinoma de células escamosas intraoral, constituyendo el 10 por ciento de estos tumores. El propósito de este estudio fue evaluar nuestros resultados en el tratamiento quirúrgico de este tumor. Diseño: Se llevó a cabo un estudio retrospectivo de 33 carcinomas de células escamosas gingivales tratados quirúrgicamente entre 1980 y 1999 en el Hospital Universitario de La Princesa. Se realizó análisis descriptivo. La supervivencia fue calculada mediante curvas de Kaplan-Meier, y el significado de los diferentes factores en el pronóstico fue analizado con el test log-rank. Resultados: El grupo de estudio mostró una preponderancia masculina con un 6 por ciento de pacientes menores de 40 años. En el estudio anatomopatógico, se apreció afectación cervical en 19 casos. Se presentó recidiva en 17 casos, principalmente a nivel local. El margen positivode resección no se relacionó con un peor pronóstico. La presencia de ganglios cervicales influyó de manera estadísticamente significativa sobre la supervivencia de los pacientes. Conclusiones: El diagnóstico de este tumor se realiza habitualmente en estadios avanzados. El mayor número de recidivas ser presenta durante los primeros años después de la cirugía. Para esta localización, la tasa de supervivencia a los 5 años es menor del 50 por ciento de los casos (AU)

Scanning electron microscopic description of cellular activity and mineral changes in feline odontoclastic resorptive lesions.

The cellular activity and changes in mineral composition of dental tissues involved in feline odontoclastic resorptive lesions were investigated. Teeth with at least 1 lesion (n = 10) were extracted from 10 different cats that were presented primarily for chronic gingivostomatitis and/or severe periodontal disease. Scanning electron microscopic methods were used to determine the presence of resorptive cells in 8 teeth while 2 teeth were evaluated for pathologic changes in dental mineral composition. Observations were complicated by the presence of organic wear on the dental surfaces, however resorptive cells could be clearly identified in feline odontoclastic resorptive lesions. Resorptive cells had morphologic features indicative of "osteoclast-like" cells or odontoclasts. Resorptive cell activity created a resorption area of darker dentin continuous with physiologic dentin. The darker dentin area seemed poorly mineralized and showed a significantly lower calcium/phosphorous ratio compared with adjacent physiologic denting in 1 tooth. A significantly higher level of magnesium combined with available carbonate ions may have increased the solubility in areas of darker dentin.

Clinical evaluation of the gingiva around single-crystal sapphire endosseous implant after experimental ligature-induced plaque accumulation in monkeys.

This study was performed to evaluate clinical changes of the gingiva with plaque accumulation around the single-crystal sapphire implant. Four implants were inserted into mandibular and maxillary edentulous regions, and the superstructure was inserted 1 month after insertion of the implants in each of nine monkeys. Plaque control was maintained for 3 months after insertion to set up the baseline. Plaque was allowed to accumulate on one side by placing the ligature around the implant and natural teeth without any plaque control, and on the other side plaque control was continued for 9 months. Both the implant and natural teeth on the ligature side showed a significant increase in the clinical parameters of plaque index, gingival index, and probing depth. No significant difference was obtained between the implant and natural teeth. These findings indicate that plaque control is of great importance for maintaining the health of peri-implant gingiva.

Detection of selenium in generalized and localized argyria: report of four cases with X-ray microanalysis.

Electron microscopic and X-ray microanalytic studies were performed on four cases of argyria; one generalized and three localized. Deposition of electron dense granules was predominantly found on elastic fibers and around basal laminas of secretory portions of eccrine glands, although the amount of deposition was much less in the case of generalized argyria. In all four cases, X-ray microanalysis revealed that the depositions consisted mainly of silver, selenium, and sulfur. The importance of selenium in the detoxification of heavy metals was discussed.

[Gingival hyperpigmentation caused by dental restorations: the mechanism of detoxification using selenium]. / Hyperpigmentations gingivales issues de reconstitutions dentaires: mécanisme de détoxication par le sélénium.

X-ray microanalysis and electron diffraction made on granular metallic deposits of the gingival lamina propria, inducing partial periodontal tattoos, demonstrated that these deposits consisted of crystalline particles combining silver, sulphur and selenium. The role of selenium precipitating of silver and other metals as well as its role in detoxication are discussed.

Unusual pigmentation of the gingiva. Report of two different types.

Two unusual types of oral mucosal pigmentation are reported. The first type is due to the use of an oral hygiene aid that is obtained from the bark of a plant, Juglans regia, that is known as Derum or Dendasa. The second type is that of a self-induced tattoo of the buccal maxillary gingiva created with soot obtained from burned wood in clay ovens.