The effectiveness of microneedling technique using coconut and sesame oils on the severity of gingival inflammation and plaque accumulation: A randomized clinical trial.

OBJECTIVES: In our research, we evaluated the effect of coconut and sesame oils using the microneedling technique on gingival inflammation and plaque accumulation among patients with gingivitis by creating microholes in the gingiva to facilitate the concentration and entrance of the oils through gingival tissues. MATERIALS AND METHODS: Twenty-four patients with clinically diagnosed plaque-induced gingivitis were selected from Vision dental hospital, Riyadh, KSA, and assigned to one of three groups randomly; group A consisted of eight participants who were treated with dermapen and topical coconut oil, group B had eight participants who were treated with dermapen and topical sesame oil, and group C involved eight patients who received periodontal mechanical treatment only. Postintervention gingival status and plaque status for all participants were assessed using a modified average gingival index and a plaque index at Weeks 1, 2, and 4. RESULTS: Groups A and B experienced highly significant reductions in gingival indices, while group C showed reduced scores but was not significantly notable. On the contrary, the three studied groups exhibited no significant difference in the reduction of plaque indices when compared altogether. CONCLUSION: Our study demonstrated an effective novel technique that revealed a noticeable improvement in gingival status and a reduction in the average gingival index and plaque index.

A visual evaluation of oral plaque removal utilizing an adjunct enzyme pre-rinse in orthodontic subjects.

OBJECTIVE: To determine if an adjunct proteolytic pre-rinse along with contemporary methods of dental cleaning may more effectively remove visual plaque in subjects with fixed orthodontic appliances. MATERIALS AND METHODS: Forty-three orthodontic subjects, ages 10 to 25, completed this single site, double-blind, crossover clinical trial. Subjects randomly received bromelain enzyme or a powdered-sugar placebo pre-rinse, followed by manual tooth brushing and use of a Waterpik. Subjects received the alternate pre-rinse during the subsequent visit. Baseline and residual plaque accumulation were recorded via disclosing tablet and digital photography. A single, blinded examiner scored visual plaque scores from randomized photographs. Treatment effects on composite plaque score were evaluated using repeated-measures analysis of variance. A 5% significance level was used for all tests. RESULTS: No significant differences in plaque scores were noted at baseline or post-rinse between the enzyme and placebo. The changes from baseline to post-rinse (P = .190), post-brushing (P = .764), and post-Waterpik (P = .882) were not significantly different between interventions. Significant reduction in plaque scores were observed in both arms of the study after brushing (P < .01) and waterjet use (P < .01). Neither age (P = .220) nor gender (P = .449) impacted plaque scores. CONCLUSIONS: Use of a bromelain enzyme pre-rinse alone did not significantly enhance plaque removal. A significant reduction in retained plaque was observed with the application of brushing and or Waterpik.

Orally administered ovine serum immunoglobulins modulate dental plaque in cats.

The effects of orally administered ovine serum immunoglobulin on dental plaque and associated oral immunity in cats were investigated. The two treatment groups consisted of 1) cats that were fed unsupplemented kibble (control diet) and 2) cats that were fed the same kibble but coated with a freeze-dried ovine serum immunoglobulin preparation (ovine Ig) (test diet). The adult cats were randomly allocated to one of the two diets (n = 15) and received their respective kibble for a 28-day experimental period. When compared to the ovine Ig-supplemented kibble, cats consuming the unsupplemented kibble had significantly (p < 0.05) higher dental plaque scores. Cat IgA and IgG concentrations in the saliva and serum were significantly (p < 0.05) higher for cats fed the unsupplemented kibble when compared to cats receiving the ovine Ig supplement. Similarly, myeloperoxidase activity in the saliva was significantly (p < 0.05) higher for cats fed the unsupplemented kibble when compared to cats receiving the Ig-supplement. Orally administered ovine serum Ig positively influenced oral health and oral immunity in cats as evidenced by preventing an increase of dental plaque formation, salivary and serum IgA and IgG concentrations and salivary myeloperoxidase activity.

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.

Can babies oral wipes with fluoride and/or calcium glycerophosphate prevent cariogenic demineralization? An in-vitro study.

BACKGROUND: The difficulties in reaching a good level of oral hygiene in young babies can be partly overcome with the use of baby oral wipes, which have been shown to effectively remove plaque from deciduous teeth. The presence of fluoride and calcium in these wipes could also prevent further demineralization of the teeth, as well as promote remineralization. The aim of this study is, therefore, was to analyze the preventive effect of OW containing F and CaGP on cariogenic demineralization in vitro. METHODS: For this, seventy enamel samples were treated with OW soaked in solutions containing different F concentrations (250 ppm; 500 ppm and 1500 ppm) with or not with 0.13% CaGP and distilled water for the control group. The samples were submitted to an 8-day cariogenic pH cycling. The experimental solutions were applied twice per cycle, by immersing a dry inert oral tissue into 4 mL of the solution and rubbing it over the enamel surface. Enamel microhardness was measured initially and after the experimental cycles. Environmental scanning electron microscope was taken to visualize and quantify elements on the enamel surface. RESULTS: No significant difference was observed (P=0.694), but when the groups containing CaGP were compared to the negative control solution, a significant difference was found. CONCLUSIONS: The presence of 0.13% CaGP and fluoride in concentrations greater than 500 ppm were able to provide protection of dental enamel against demineralization.

Manejo odontológico del paciente con hipoacusia neurosensorial profunda bilateral / Dental management of patients with bilateral profound sensorineural hearing loss

Introducción: la hipoacusia es la disminución de la agudeza auditiva o de la capacidad para captar el sonido; esta puede ser neurosensorial, conductiva o mixta. La hipoacusia neurosensorial resulta de alteraciones en el oído interno, nervio auditivo o en los núcleos auditivos del tronco cerebral. El manejo de estos pacientes requiere disposición, conocimientos y calidez para el correcto desarrollo de la atención estomatológica. Objetivo: reportar el manejo odontológico de un paciente con hipoacusia neurosensorial profunda bilateral. Presentación del caso: paciente femenino de 7 años y 10 meses de edad con diagnóstico de hipoacusia neurosensorial profunda bilateral, quien acude a consulta por presentar dolor. A la inspección física, paciente mesofacial, perfil convexo. Intraoralmente se observan tejidos blandos clínicamente sanos, alteraciones de número y posición, caries moderada e higiene deficiente. Durante la inspección clínica la paciente se mostró poco cooperadora (Frankl II). El plan de tratamiento consistió en prevención, operatoria, ortopedia y cirugía. Para el manejo del paciente se incluyó un lenguaje de señas básico con uso de careta y sin cubreboca, modelado con otros pacientes. Se modificó la técnica decir, mostrar y hacer por mostrar/oler, tocar y hacer. Conclusiones: el odontopediatra debe tener las competencias necesarias para la atención integral de pacientes con capacidades diferentes. El manejo de la conducta y el cuidado multidisciplinario del paciente en edades tempranas es fundamental para el éxito del tratamiento. En el caso clínico que se presenta se resalta la efectividad del manejo conductual modificado, lo cual incrementó la posibilidad de éxito de la rehabilitación dental del paciente, así como de su seguimiento(AU)

Introduction: hearing loss is reduced auditory acuity or a decrease in the ability to perceive sound. It may be sensorineural, conductive or mixed. Sensorineural hearing loss results from alterations in the inner ear, the auditory nerve or the auditory brainstem nuclei. Dental management of these patients requires willingness, knowledge and warmth on the part of the dental practitioner. Objective: report the dental management of a patient with bilateral profound sensorineural hearing loss. Case presentation: a female patient aged 7 years and 10 months diagnosed with bilateral profound sensorineural hearing loss attends consultation for dental pain. At physical inspection, it is observed that the patient is mesofacial with a convex profile. Intraoral examination found clinically healthy soft tissue, tooth alterations in number and position, moderate decay and poor hygiene. During clinical inspection, the patient was uncooperative (Frankl II). Treatment consisted in prevention, restoration, orthopedics and surgery. Management of the patient included use of basic sign language and a mask without the practitioner wearing a facemask, and modeling with other patients. The technique of say, show and do was replaced by show / smell, touch and do. Conclusions: pediatric dentists should have the skills required for the comprehensive care of patients with different capabilities. Behavior management and multidisciplinary care of very young patients is essential for a successful treatment. The clinical case herein presented highlights the effectiveness of modified behavior management, which increased the chances of success in the patient's dental rehabilitation and follow-up(AU)

Manejo odontológico del paciente con hipoacusia neurosensorial profunda bilateral / Dental management of patients with bilateral profound sensorineural hearing loss

Introducción: la hipoacusia es la disminución de la agudeza auditiva o de la capacidad para captar el sonido; esta puede ser neurosensorial, conductiva o mixta. La hipoacusia neurosensorial resulta de alteraciones en el oído interno, nervio auditivo o en los núcleos auditivos del tronco cerebral. El manejo de estos pacientes requiere disposición, conocimientos y calidez para el correcto desarrollo de la atención estomatológica. Objetivo: reportar el manejo odontológico de un paciente con hipoacusia neurosensorial profunda bilateral. Presentación del caso: paciente femenino de 7 años y 10 meses de edad con diagnóstico de hipoacusia neurosensorial profunda bilateral, quien acude a consulta por presentar dolor. A la inspección física, paciente mesofacial, perfil convexo. Intraoralmente se observan tejidos blandos clínicamente sanos, alteraciones de número y posición, caries moderada e higiene deficiente. Durante la inspección clínica la paciente se mostró poco cooperadora (Frankl II). El plan de tratamiento consistió en prevención, operatoria, ortopedia y cirugía. Para el manejo del paciente se incluyó un lenguaje de señas básico con uso de careta y sin cubreboca, modelado con otros pacientes. Se modificó la técnica decir, mostrar y hacer por mostrar/oler, tocar y hacer. Conclusiones: el odontopediatra debe tener las competencias necesarias para la atención integral de pacientes con capacidades diferentes. El manejo de la conducta y el cuidado multidisciplinario del paciente en edades tempranas es fundamental para el éxito del tratamiento. En el caso clínico que se presenta se resalta la efectividad del manejo conductual modificado, lo cual incrementó la posibilidad de éxito de la rehabilitación dental del paciente, así como de su seguimiento(AU)

Introduction: hearing loss is reduced auditory acuity or a decrease in the ability to perceive sound. It may be sensorineural, conductive or mixed. Sensorineural hearing loss results from alterations in the inner ear, the auditory nerve or the auditory brainstem nuclei. Dental management of these patients requires willingness, knowledge and warmth on the part of the dental practitioner. Objective: report the dental management of a patient with bilateral profound sensorineural hearing loss. Case presentation: a female patient aged 7 years and 10 months diagnosed with bilateral profound sensorineural hearing loss attends consultation for dental pain. At physical inspection, it is observed that the patient is mesofacial with a convex profile. Intraoral examination found clinically healthy soft tissue, tooth alterations in number and position, moderate decay and poor hygiene. During clinical inspection, the patient was uncooperative (Frankl II). Treatment consisted in prevention, restoration, orthopedics and surgery. Management of the patient included use of basic sign language and a mask without the practitioner wearing a facemask, and modeling with other patients. The technique of say, show and do was replaced by show / smell, touch and do. Conclusions: pediatric dentists should have the skills required for the comprehensive care of patients with different capabilities. Behavior management and multidisciplinary care of very young patients is essential for a successful treatment. The clinical case herein presented highlights the effectiveness of modified behavior management, which increased the chances of success in the patient's dental rehabilitation and follow-up(AU)

Adjunct Antimicrobial Therapy and Periodontal Surgery to Treat Generalized Aggressive Periodontitis: A Case Report.

Here we report a case of generalized aggressive periodontitis treated with periodontal therapy including adjunct antimicrobial therapy and periodontal surgery. The patient was a 22-year-old woman who presented with the chief complaint of gingival recession. Baseline examination revealed generalized plaque deposition and gingival inflammation. Thirty-nine percent of the sites had a probing depth (PD) of 4-6 mm and 2% a PD of ≥7 mm; 63% exhibited bleeding on probing (BOP). Radiographic examination revealed vertical bone loss in the molars and horizontal bone loss in other teeth. Microbiological examination of subgingival plaque revealed the presence of Aggregatibacter actinomycetemcomitans and Tannerella forsythia. Oral health-related quality of life was assessed as a measure of patient-reported outcome. Based on a clinical diagnosis of generalized aggressive periodontitis, initial periodontal therapy and adjunct antimicrobial therapy were implemented. After reducing inflammation and subgingival bacteria, open flap debridement was performed for teeth with a PD of ≥4 mm. Reevaluation showed no sites with a PD of ≥5 mm, a minimal level of BOP, and a marked reduction in the level of the targeted periodontal pathogens. The patient's oral health-related quality of life was slightly worsened during supportive periodontal therapy (SPT). Implementation of adjunct antimicrobial therapy targeting periodontal pathogens and subsequent periodontal surgery resulted in improvement in periodontal and microbiological parameters. This improvement has been adequately maintained over a 2-year period. However, additional care is necessary to further improve the patient's oral health-related quality of life during SPT.

Patients receiving comprehensive periodontal treatment have better clinical outcomes than patients receiving conventional periodontal treatment.

BACKGROUND/PURPOSE: In Taiwan, more than 90% of people aged 35-44 years have periodontal disease. To reduce periodontal disease in Taiwanese people, the National Health Insurance (NHI) system included the comprehensive periodontal treatment project (CPTP) in 2010. The CPTP mainly emphasizes oral hygiene instruction, plaque control, and check-up compliance, with the goal of providing complete, continual, and high-quality periodontal care to patients. The purpose of this study was to assess whether the patients receiving comprehensive periodontal treatment had better clinical outcomes than those receiving conventional periodontal treatment. METHODS: Secondary data exploration was conducted in this study. Based on NHI data, patients who had participated in the CPTP and completed the three-stage periodontal treatments between 2011 and 2012 were recruited in the experimental group (65,342 patients). The patients who had not participated in the CPTP but had received conventional periodontal treatment during the same period were selected in the control group (106,740 patients). Using the four parameters (re-treatment, endodontic therapy, surgical restoration, and tooth extraction) as prognostic indicators, we performed logistic regression analyses to evaluate whether patients in the experimental group had better clinical outcomes than those in the control group. RESULTS: We found that patients participating in the CPTP for 545 days had substantially lower rates of re-treatment, endodontic therapy, surgical restoration, and tooth extraction than those in the control group (p < 0.001). CONCLUSION: We conclude that the patients receiving comprehensive periodontal treatment have better clinical outcomes than the patients receiving conventional periodontal treatment.

Non-conventional therapeutics for oral infections.

As our knowledge of host-microbial interactions within the oral cavity increases, future treatments are likely to be more targeted. For example, efforts to target a single species or key virulence factors that they produce, while maintaining the natural balance of the resident oral microbiota that acts to modulate the host immune response would be an advantage. Targeted approaches may be directed at the black-pigmented anaerobes, Porphyromonas gingivalis and Prevotella intermedia, associated with periodontitis. Such pigments provide an opportunity for targeted phototherapy with high-intensity monochromatic light. Functional inhibition approaches, including the use of enzyme inhibitors, are also being explored to control periodontitis. More general disruption of dental plaque through the use of enzymes and detergents, alone and in combination, shows much promise. The use of probiotics and prebiotics to improve gastrointestinal health has now led to an interest in using these approaches to control oral disease. More recently the potential of antimicrobial peptides and nanotechnology, through the application of nanoparticles with biocidal, anti-adhesive and delivery capabilities, has been explored. The aim of this review is to consider the current status as regards non-conventional treatment approaches for oral infections with particular emphasis on the plaque-related diseases.

Phototargeting human periodontal pathogens in vivo.

The effects of blue light at 455 nm were investigated on the bacterial composition of human dental plaque in vivo. Eleven subjects who refrained from brushing for 3 days before and during phototherapy participated in the study. Light with a power density of 70 mW/cm(2) was applied to the buccal surfaces of premolar and molar teeth on one side of the mouth twice daily for 2 min over a period of 4 days. Dental plaque was harvested at baseline and again at the end of 4 days from eight posterior teeth on both the exposed side and unexposed sides of the mouth. Microbiological changes were monitored by checkerboard DNA probe analysis of 40 periodontal bacteria. The proportions of black-pigmented species Porphyromonas gingivalis and Prevotella intermedia were significantly reduced on the exposed side from their original proportions by 25 and 56 %, respectively, while no change was observed to the unexposed side. Five other species showed the greatest proportional reduction of the light-exposed side relative to the unexposed side. These species were Streptococcus intermedius, Fusobacterium nucleatum ss. vincentii, Fusobacterium nucleatum ss. polymorphum, Fusobacterium periodonticum, and Capnocytophaga sputigena. At the same time, the percentage of gingival areas scored as being red decreased on the side exposed to light from 48 to 42 %, whereas the percentage scored as red increased on the unexposed side from 53 to 56 %. No adverse effects were found or reported in this study. The present study proposes a new method to modify the ecosystem in dental plaque by phototherapy and introduces a new avenue of prophylactic treatment for periodontal diseases.

The influence of prebrushing mouthwashes on plaque removal in children.

PURPOSE: The purpose of this study was to verify the influence of prebrushing mouthwashes on dental plaque removal in children. METHODS: This study had a double-blind, randomized, controlled, crossover, 25-day experimental design, including 38 12- to 14-year-olds. Four solutions were used as prebrushing mouthwashes (Colgate Plax Magic, Listerine Cool Blue Agent, water and dye, and water) by each participant with seven days' washout. The plaque index was evaluated before and after tooth-brushing during the experimental period. RESULTS: Intergroup comparisons showed no significant differences in plaque reduction among evaluated solutions (Friedman test, P>.78). Significantly more plaque was present before vs. after tooth-brushing (Wilcoxon rank test, P<.001), independent of the surface (buccal or lingual/palatal). CONCLUSION: Use of prebrushing mouthwashes by children does not influence plaque removal by tooth-brushing.

Survival of microorganisms on complete dentures following ultrasonic cleaning combined with immersion in peroxide-based cleanser solution.

OBJECTIVES: To compare ultrasonic cleaning combined with immersion in a commercially available peroxide-based cleanser solution (Polident(®) ) with other denture cleaning methods, we examined the quantity of micro-organisms that survived on dentures before and after various cleaning methods. SUBJECTS AND METHODS: One hundred complete dentures belonging to 50 nursing home residents (mean age, 84.6 years) were randomly assigned to five groups according to the cleaning method employed: (A) immersion in Polident(®) solution alone, (B) brushing with water, (C) ultrasonic cleaning with water, (D) method (A) followed by method (B) and (E) ultrasonic cleaning combined with immersion in Polident(®) solution. Before and after the dentures had been cleaned, denture biofilm was collected from the mucosal surface of each lateral half of the examined dentures. The collected micro-organisms were cultured, presumptively identified by standard methods and quantified. Comparisons between the five cleaning methods were carried out using the Kruskal-Wallis test and Dunn's multiple comparisons test. RESULTS: The denture cleaning methods involving the use of Polident(®) solution (methods A, D and E) were significantly more effective at denture disinfection than the other methods (p < 0.05); in particular, the quantity of Candida spp. was lowest after method E (median, 0.00; significantly lower than those observed after methods A, B and C; p < 0.05). CONCLUSION: It was concluded that ultrasonic cleaning combined with immersion in a peroxide-based cleanser solution effectively reduces the quantity of micro-organisms surviving on dentures and is a suitable method for elderly individuals who find brushing their dentures difficult.

Light-activated disinfection using a light-emitting diode lamp in the red spectrum: clinical and microbiological short-term findings on periodontitis patients in maintenance. A randomized controlled split-mouth clinical trial.

Eradication or suppression of pathogens is a major goal in periodontal therapy. Due to the increase in antibiotic resistance, the need of new disinfection therapies is raising. Photodynamic therapy (PDT) has demonstrated anti-infective potential. No data are available on the use of light-emitting diode (LED) lights as the light source in PDT. The aim of this study was to investigate the microbiological and clinical adjunctive outcome of a new photodynamic LED device, compared to scaling and root planing in periodontitis patients in maintenance [supportive periodontal therapy (SPT)]. In this masked, split-mouth design study, 30 treated chronic periodontitis subjects (mean age, 46.2 years; 13 males) in SPT were included. Two residual interdental sites with probing pocket depth (PPD) ≥ 5 mm in two opposite quadrants, with positive bleeding on probing (BOP) and comparable periodontal breakdown, were selected. PPD, BOP and subgingival microbiological samples for real-time PCR analysis (Carpegen® PerioDiagnostics, Carpegen GmbH, Münster, Germany) were recorded at baseline and 1 week after treatment. Scaling and root planing was performed under local anesthesia. Randomly one of the sites was selected to receive adjunctive photodynamic therapy by inserting a photosensitizer (toluidine blue O solution) and exposing it to a LED light in the red spectrum (Fotosan, CMS Dental, Copenhagen, Denmark), according to the manufacturer's instructions. After 1 week, 73 % of the control sites and 27 % of the test sites were still BOP+. These differences compared to baseline values and in-between groups were statistically significantly different (p < 0.001). Mean PPD decreased from 5.47 mm (±0.68) to 4.73 mm (±0.74, p < 0.001) in control sites and from 5.63 mm (±0.85) to 4.43 mm (±1.25, p < 0.001, test vs control p = 0.01) in the test group. Microbiologically, higher reductions of relative proportions of red complex bacteria were observed in test sites (68.1 vs. 4.1 %; p = 0.01). This study showed that adjunctive photodynamic treatment by LED light may enhance short-term clinical and microbiological outcome in periodontitis subjects in SPT.

Clinical and microbiological effects of ozone nano-bubble water irrigation as an adjunct to mechanical subgingival debridement in periodontitis patients in a randomized controlled trial.

AIM: Ozone nano-bubble water (NBW3) seems to be suitable as an adjunct to periodontal treatment owing to its potent antimicrobial effects, high level of safety, and long storage stability. The aim of the present study was to evaluate the clinical and microbiological effects of NBW3 irrigation as an adjunct to subgingival debridement for periodontal treatment. METHODS: Twenty-two subjects were randomly assigned to one of the two treatment groups: full-mouth mechanical debridement with tap water (WATER) or full-mouth mechanical debridement with NBW3 (NBW3). Clinical examination was performed at baseline and 4 and 8 weeks after treatment. Microbiological examination was carried out just before and after treatment and at 1 and 8 weeks posttreatment. RESULTS: There were significant improvements in all clinical parameters after 4 weeks in both groups. The reduction in the probing pocket depth and the clinical attachment gain after 4 and 8 weeks in the NBW3 group were significantly greater than those in the WATER group. Moreover, only the NBW3 group showed statistically significant reductions in the mean total number of bacteria in subgingival plaque over the study period. CONCLUSIONS: The present study suggests that subgingival irrigation with NBW3 may be a valuable adjunct to periodontal treatment. CLINICAL RELEVANCE: This study verified the potential of new antimicrobial agent, MNW3, as an adjunct to periodontal treatment.

A double-blind randomized placebo-controlled study on the clinical and microbial effects of an essential oil mouth rinse used by patients in supportive periodontal care.

AIM: This 3-month double-blind randomized placebo-controlled study evaluated the clinical and microbial effects of an essential oil mouth rinse used as an adjunct to mechanical plaque control by patients in supportive periodontal care. MATERIAL AND METHODS: Fifty patients were randomly allocated to an essential oil group (Listerine(®) Coolmint; Johnson & Johnson, New Brunswick, NJ, USA) or placebo group to rinse twice per day as an adjunct to mechanical plaque control. At baseline and after 3 months, plaque index (PI), gingivitis index (GI), probing pocket depth, bleeding on probing (BoP) and clinical attachment level were registered. Subgingival plaque samples were collected for the detection and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Micromonas micros, Prevotella intermedia, Fusobacterium genus and Streptococcus mutans by means of real-time PCR (qPCR). Patient's compliance, satisfaction and side effects were registered. RESULTS: Twenty-three patients in the essential oil group (mean age: 57) and 21 in the placebo group (mean age: 55) with acceptable oral hygiene at intake (mean PI <1.5 on a scale of 5) adhered to the study protocol. Gingivitis index, PI and BoP significantly reduced over time (P ≤ 0.029); however, between group analyses revealed no significant differences. There was no significant change over time neither in detection frequency nor load for any of the microbiota. Daily rinsing with an essential oil rinse was found safe and perceived beneficial by the patients. CONCLUSION: Patients in supportive periodontal care who are fairly compliant with oral hygiene may not benefit from additional mouth rinsing using an essential oil solution.

Influence of hygienic preparations with a 3% content of ethanol extract of Brazilian propolis on the state of the oral cavity.

BACKGROUND: One of the most important measures to be undertaken in order to fight gingivitis and periodontitis is maintenance of proper hygiene of the oral cavity. The research to improve the content of toothpaste has continued for many years so that they should become better in terms of therapeutic abilities. OBJECTIVES: The aim of this work was to determine and investigate the influence of the application of toothpaste and gel with 3% ethanol propolis extract on the state of the oral cavity. MATERIAL AND METHODS: The research group comprised 80 adult patients divided into two subgroups: Group I, which comprised 40 patients without pathological changes within the boundaries of the periodontium, and Group II, also 40 patients endangered with the occurrence of periodontitis caused by dental plaque and lack of proper hygiene of the oral cavity. Qualification for both groups was based on an interview and analysis of clinical documentation and assessment of adequate indices such as API, OHI and SBI. The patients underwent three examinations: initial, follow-up after 7 days and after 8 weeks since the beginning of the program. Moreover, the patients were instructed about hygienic procedures of the oral cavity. Four groups (T, G, CT, CG), 20 patients each, were created from research groups I and II. They used the following preparations: T--Dental Polis DX toothpaste with propolis content, G--Dental Polis DX toothpaste without propolis content, CT--Carepolis gel with propolis content, CG--Carepolis gel without propolis content. The patients were informed about the type of hygienic preparation they were given to use (whether it contained propolis or not). Moreover, they were interviewed for their subjective evaluation of the product received. RESULTS AND CONCLUSION: Results of the research show the effectiveness of hygienic preparations with 3% content of ethanol propolis extract in both groups of patients: without pathological changes within the boundaries of the periodontium and in the case of patients endangered with the occurrence of gingivitis caused by dental plaque

Integrated approach to outpatient dental treatment of a patient with cerebral palsy: a case report.

The large number of oral manifestations associated with motor disorders in patients with cerebral palsy (CP) makes the dentist an indispensable member of the multidisciplinary team caring for this population. This case report presents an 11-year-old girl with spastic CP who had severe motor impairment, and a description of her care illustrates the importance of integrated care for patients with CP who are receiving outpatient dental treatment. It was determined that the use of adaptations based on knowledge of CP supported the outpatient dental treatment. The integrated approach used during dental treatment enabled the application of knowledge from the fields of dentistry, physical therapy, and speech therapy to provide for a better quality of life for the patient and, consequently, the caregiver through the improvement in the patient's oral and general health.

Analysis of the effectiveness of different hygiene procedures used in dental prostheses.

PURPOSE: To compare the effectiveness of bacterial plaque removal of six denture hygiene procedures used by patients to clean their dentures. MATERIALS AND METHODS: Fifteen students randomly divided into groups G1, G2, G3, G4, G5 and G6 used maxillary intraoral appliances for 24 h without cleaning them. Afterwards, the appliances were submitted to the following procedures: P1: washing under running water for 20 s; P2 and P3: cleaning with alkaline peroxide (Corega Tabs®) for 5 and 30 min, respectively; P4: brushing with water and liquid soap for 40 s; P5: alkaline hypochlorite for 10 minutes; P6: home use chlorine solution (Q'boa® at 0.45% for 10 min), throughout a period of 6 consecutive weeks. The procedures followed a circulating scheme, so that all the appliances were submitted to all the hygiene methods studied. After the hygiene procedures, the appliances were stained, photographed and submitted to the weighing method. RESULTS: After ANOVA and Tukey's test, differences were observed: P5 = 0.73 ± 0.3 (b), P6 = 1.27 ± 0.4(b,c), P4 = 1.92 ± 0.5 (b,c), P3 = 2.24 ± 1.0 (b,c), P2 = 7.53 ± 2.5 (c) and P1 = 26.86 ± 15. 3 (a). CONCLUSION: From the results of the study, it could be concluded that the use of alkaline hypochlorite is the best way to remove bacterial plaque, followed by the home-use chlorine solution and brushing with water and liquid soap. Corega Tabs® must be used for 30 min of immersion to have a cleaning effectiveness similar to that of alkaline hypochlorite.