Novel PAradigm to improve Inflammatory burden in end stage Renal disease (rePAIR): study protocol for a randomized controlled trial.

BACKGROUND: Given the importance of inflammation as a predictor of poor outcomes in End Stage Renal Disease (ESRD), reductions in inflammatory biomarkers have been proposed as a critical target in this population. This study targets chronic periodontitis, an oral inflammatory disease of microbial etiology causing persistent inflammation in ESRD. Unlike the previously reported episodic periodontal interventions, we propose to control periodontal inflammation with a continuous maintenance and oral health behavior modifications. We hypothesize that this strategy will improve systemic inflammation and oxidative stress, oral health and quality of life within the 6-month observation period. METHODS: The rePAIR (novel PAradigm to improve Inflammatory burden in ESRD) study is a pilot and feasibility, parallel-arm, and randomized controlled clinical trial that will recruit 72 ESRD subjects with periodontitis in a model of computerized block randomization. This trial aims to compare the effect of standard-of-care vs. repeated non-surgical periodontal therapy on systemic and oral inflammatory burden. This trial will recruit ESRD adult patients with periodontitis older than 21 years old with a minimum of 12 teeth and no history of periodontal treatment within a year. The trial will examine serum C-reactive protein (CRP) (primary outcome) as a biomarker of inflammation as well as interleukin-6 (IL-6), F2 isofurans and F2 isoprostanes (secondary outcomes) and compare their difference between groups from baseline to 6 months. The trial will also compare the difference between groups in patient-centered and clinical oral outcomes from baseline to 6 months. DISCUSSION: The trial follows a rigorous and transparent study design capturing elements such as pre-specified eligibility criteria, pre-specified primary and secondary outcomes, detailed intervention description to allow replication, intervention random allocation and concealment, blinding in outcome assessment, appropriate sample size calculations, explanation of interim analysis, as per CONSORT Guidelines. Further, gender diversity is secured not only at recruitment but also throughout the trial and during the analysis. Therefore, treatment response outcomes will be examined per gender category. In order to manage anticipated problems, the protocol has included alternative approaches. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03241511 . Registered on 7 August 2017.

Bizarre tooth surface loss and the Miswak stick.

Tooth surface loss can present in a variety of ways, some of which can appear rather strange on first examination. This case report demonstrates an unusual presentation of tooth surface loss (TSL) and its subsequent treatment. This loss of hard dental tissue appeared to be affecting the whole of the patient's remaining dentition, both lingually and buccally. Detailed questioning revealed the origins of this problem which turned out to be due to excessive use of an intra-oral Miswak chewing stick. Cinical Relevance: This article will enable clinicians to understand the importance of specific, targeted history-taking, involving a rare case of tooth surface loss as well as the use of minimally destructive restoration composites and a fibre-reinforced composite bridge.

Atividade da própolis sobre as bactérias isoladas da cavidade bucal / Effects of propolis on bacteria isolated from oral cavity

A própolis é conhecida desde a antiguidade por suas propriedades antibacterianas, cicatrizantes, antifúngicas, entre outras. Neste estudo foi pesquisada a atividade da própolis sobre bactérias recém-isoladas da cavidade bucal: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mutans e Lactobacillus sp. As amostras foram semeadas em meio de cultura adequado a cada tipo de bactéria, e contendo própolis em concentraçöes que variavam de 1 a 10mg/ml. Foi observada atividade antibacteriana evidente sobre as bactérias citadas acima, na seguinte ordem de sensibilidade: S. mutans > Lactobacillus sp > S. aureus > S. epidermidis.

El problema de la seguridad en la aplicación de un colutorio de clorhexidina al 0,1 por ciento Oralgene / Safety problems in the aplications of 0,1 percent chlorhexidine mouthrinses, oralgene

Se realizó un estudio clínico de seguimiento de 55 pacientes alumnos de la Facultad de Odontología de la Universidad de Chile, con un promedio de edad de 22 años, los cuales realizaron 2 colutorios diarios con una solución de digluconato de clorhexidina al 0,1 por ciento como coadyuvante de su higiene bucal habitual durante un período de 8 semanas. Fueron observados y evaluados los efectos colaterales causados por la droga a través del examen clínico y su anamnesis. Al final del período experimental se analizó estadísticamente la posibilidad de tinción en piezas dentarias, lengua y obturaciones de resina compuesta y descriptivamente la sensación de quemadura, sequedad bucal, alteración del gusto y sabor amargo

A retrospective study on the relationship between miswak chewing stick and periodontal health.

Chewing sticks have been used for centuries as a tooth cleaning device. One of the most commonly used types is known as the miswak. Despite its wide use, few studies have examined its effects on the gingival health. The purpose of this study is to examine the relationship between miswak and gingival health in terms of pocket depths, periodontal disease severity and gingival recession. The incisors, canines and premolars were examined in a total of 264 patients who were seen for routine periodontal treatment. Information regarding the use of the miswak, oral hygiene habits, as well as clinical measurements of pocket depth, periodontal disease and gingival recession were obtained from patients charts. Patients were divided into two groups: a miswak group and a Toothbrush group. The results of this study indicated that the use of miswak may influence periodontal health and may be considered as a factor contributing to gingival recession. It is suggested that additional research is needed to examine the relationship between miswak and periodontal health.