Detection of Helicobacter pylori using PCR in dental plaque of patients with and without gastritis.

OBJECTIVES: Helicobacter pylori (H.pylori) accounts for gastritis, peptic ulcer and is a probable cause of gastric cancer. Since its detection in the oral cavity, concerns have been raised about dental plaque as a reservoir for reinfection. The aim of this study was to detect the organism in the dental plaque and to determine the association, if any, between H. pylori gastritis and dental plaque contamination causing H.pylori. STUDY DESIGN: A polymerase chain reaction-based method was used for detection of H. pylori in clinical specimens. Supra and subgingival samples were collected from 67 patients with chronic periodontitis, 23 of whom were also suffering from gastritis. The data were analyzed with Chi square and Fisher exact test and the statistical significance was set to 0.05. RESULTS: H.pylori was scarce in patients with periodontitis(5.9%). There was a significant association between the presence of H.pylori in the dental plaque and gastritis (p=0.012). CONCLUSIONS: Although rarely seen, H.pylori infected dental plaque may be a source for reinfection. It is therefore suggested that professional plaque removal and oral hygiene procedures be performed, along with the antibiotic treatment of H.pylori.

A comparative study of the long term results of root coverage with connective tissue graft or enamel matrix protein: 24-month results.

BACKGROUND: The objective of this study was to compare the 24 month results of coronally advanced flap + enamel matrix derivates (EMD+CAF) and CAF+ connective tissue graft (CTG+CAF) in the treatment of Miller Class I recession defects. METHODS: Twelve patients with bilateral gingival recessions were treated with EMD+CAF or CTG+CAF. Vertical recession depth (VRD), keratinized tissue width (KTW), clinical attachment level (CAL), and clinical probing depth (CPD) were measured preoperatively, 1 and 2 years post surgery. A paired t-test and independent t-test were used to compare differences for the measured characters within and between groups, respectively. RESULTS: After 24 months, a significant decrease in VRD was observed in CAF + EMD (3.33+/- 0.30 mm) and CAF + CTG (4.5 +/- 0.28 mm) treated sites. There was also a significant increase in KTW (0.83+/- 0.23 mm versus 2.08+/- 0.14 mm in EMD+CAF and CTG+CAF sites, respectively). The gain in CAL was 3.54 +/- 0.38 mm and 4.45+/- 0.30 mm in the EMD+CAF and CTG+CAF groups, respectively. There were significant differences between the treatments for VRD, CAL, and KTW at the end of study. CONCLUSIONS: The CTG+CAF procedure seems to provide better long-term results than the EMD+CAF in obtaining root coverage, increasing the KTW and CAL gain.

Oral Health Knowledge and Attitudes of Community Health Workers in East Azerbaijan, Iran.

STATEMENT OF THE PROBLEM: Prevention is the key factor in acquiring dental and oral health. Community health workers, as a part of health care networks in Iran, play an important role in delivering primary care and their knowledge and attitude directly affect the population whom they interact with in their service scope. PURPOSE: The aim of this research was to evaluate the knowledge and attitude level of community health workers regarding oral health. MATERIALS AND METHOD: This descriptive analytical study was carried out on 1170 community health workers who were employed in health offices in East Azerbaijan to evaluate their knowledge and attitude level about oral health. Data were acquired through filled out questionnaires and were analyzed by SPSS software. RESULTS: There was no significant statistical relationship between knowledge and gender (p= 0.063), level of education (p= 0.08) and the period spent from the last continuing education course (p= 0.148).However, by increasing age (p= 0.016), work experience (p=0.083) and number of attended continuing education courses (p= 0.023), the knowledge scores were reduced. No statistically significant relationships were found between attitude and any of research variables. CONCLUSION: The level of knowledge and attitude of community health workers in East Azerbaijan regarding oral health was good. There was a reverse relationship between age, work experience, and frequency of participation in continuing education courses and knowledge scores which emphasizes the necessity of continuous training and revising the method of training in education of community health workers and other staffs of health care system.

Clinical comparison of coronally-advanced flap plus amniotic membrane or subepithelial connective tissue in the treatment of Miller's class I and II gingival recessions: A split-mouth study.

Background. The aim of the present study was to compare coronally advanced flap (CAF) plus amniotic membrane (AM) to CAF with connective tissue graft (CTG) in the treatment of Miller's class I and II gingival recessions. Methods. Eleven healthy subjects with thirty Miller's class І and ІІ gingival recessions ≥3 mm, were selevted for this research and randomly assigned to two groups in a split-mouth design. In the control group gingival recessions were treated with CAF and CTG; however, in the test group the lesions were treated with (AM) and CAF. The clinical parameters, including recession depth (RD), recession width (RW), keratinized tissue width (WKT), probing depth (PD) and clinical attachment level (CAL), were measured at baseline and 1, 3 and 6 months postoperatively. Statistical significance was set at P < 0.01. Results. Position changes of RD, RW, CAL, and MGJ were significant between baseline and one month after surgery (P < 0.01) in both the test and control groups and these values remained unchanged at 3- and 6-month follow-ups. There were no statistically significant differences in PD and WKT between baseline and 1-, 3- and 6-months intervals postoperatively. The mean root coverage values after 6 months were 75.5% and 63.1% for two groups, respectively. The mean recession depth reductions were 2.63±0.63 mm and 2±1.4 mm in the test and control groups, respectively. Conclusion. The results of this research showed that application of AM instead of connective tissue decreased surgical operation time and patient discomfort but the amount of root coverage was not significantly different between the two methods.

The Effects of One-Stage Full-Mouth Disinfection and Qua-drant-Wise Scaling and Root Planing on Serum Levels of IL-17 and IL-1ß and Clinical Parameters (A randomized Controlled Trial Study).

OBJECTIVE: One-stage full-mouth disinfection technique (FMD) has been introduced to avoid cross-contamination between the treated and untreated regions between treatment sessions. Considering the role of inflammatory mediators in periodontitis, the aim of the present study was to compare the effects of FMD with the quadrant-wise scaling and root planing (Q-SRP) on serum levels of IL-17 and IL-1ß in patients with moderate-to-severe chronic periodontitis. MATERIALS AND METHODS: Twenty patients with chronic periodontitis were selected randomly and based on inclusion criteria in each group. In order to evaluate the periodontal status, the clinical parameters of bleeding on probing (BOP), clinical attachment level (CAL), probing depth (PD) and modified gingival index (MGI) were measured and recorded before treatment and at 2- and 4-month intervals after treatment. Immunologic parameters of the study such as IL-17 and IL-1ß serum levels were determined by special laboratory kits at the same intervals. Data were analyzed by SPSS 15 statistical software. Statistical significance was defined at p<0.05. RESULTS: The results showed a decrease in the means of IL-17 and IL-1ß serum levels in both treatment modalities, with no statistically significant differences between the two study groups at the two time intervals (p>0.05). In the evaluation of periodontal parameters, all parameters exhibited clinical improvements in both groups, with no statistically significant differences between the two study groups (p>0.05). CONCLUSION: Based on the results of the present study it was concluded that both FMD and Q-SRP techniques result in improvements in periodontal indexes and decreases in the serum levels of IL-17 and IL-1ß inflammatory mediators.

Evaluation of alteration in mucogingival line location following use of subepithelial connective tissue graft.

AIM AND OBJECTIVE: The aim of this study is to evaluate the positional changes that occur in mucogingival line following the use of subepithelial connective tissue graft (SCTG). MATERIALS AND METHODS: In 19 Miller class I or II gingival recession defects, distance between mucogingival line (MGL) and cemento-enamel junction, also width of keratinized and attached gingiva, and clinical attachment level were measured. SCTG were used for covering the exposed roots. A fore mentioned parameters were repeated at 3, 6 and 12 months after surgery and alterations were measured. Paired t test was used to analyze the results. RESULTS: MGL had been moved in coronal direction (4.39 +/- 0.77 mm on average) during surgical approach. After 1 year, MGL shifted 2.11 +/- 0.7 mm apically. In accordance with this apical shift, a significant increase in the width of keratinized and attached gingival width (2.89 +/- 0.63 mm and 2.82 +/- 0.5 mm, respectively) was seen (P < 0.05). CONCLUSION: MGL tended to revert back to its original position following the use of SCTG, and this reversion is accompanied with an increase in the keratinized and attached gingival width.

Assessment of the etiologic factors of gingival recession in a group of patients in northwest iran.

BACKGROUND AND AIMS: Gingival recession (GR), a common problem in periodontium, is associated with various etiologic factors. There is controversy over the role and importance of these factors. The aim of this study was to evaluate the etiologic factors of GR in a group of subjects in Northwest Iran. MATERIALS AND METHODS: In this case-control study, patients referring to a university clinic (123 patients with GR and 123 patients without GR) were evaluated. Patients were examined by an experienced periodontist. A checklist assessing the history of systemic disease, smoking, radiotherapy, orthodontic treatment, chemical and mechanical trauma, tooth-brushing method, type of occlusion, axial inclination of tooth, width and thickness of keratinized gingiva, presence of calculus, prosthesis, faulty restorations and food impaction, and frenum pull was completed for each patient. Chi-square test was used for data analysis. RESULTS: Presence of calculus was significantly associated with GR in the evaluated patients (P = 0.000). Low width and thickness of keratinized gingiva, smoking and traumatic tooth brushing were other significant factors (P < 0.05). The type of occlusion, axial inclination of teeth, existence of prosthesis, high frenal attachment, radiotherapy, systemic diseases and chemical trauma were not significantly associated with GR in the evaluated patients (P > 0.05). CONCLUSION: Supra- and sub-gingival calculus, inadequate width and thickness of keratinized tissue, and incorrect tooth brushing techniques are most important etiologic factors of GR. Oral hygiene instructions including correct tooth brushing techniques as well as scaling and root planing with periodic recalls can play a significant role in prevention of GR.

Endocarditis Prophylaxis in Cardiac Patients: Knowledge among General Dental Practitioners in Tabriz.

BACKGROUND AND AIMS: Dental procedures injuring oral tissues may induce bacterial release to blood stream that can cause infective endocarditis in susceptible patients. The aim of this study was to determine the level of knowledge of general dental practitioners (GDPs) in Tabriz, Northwest of Iran, regarding endocarditis prophylaxis in cardiac pa-tients receiving dental treatments. MATERIALS AND METHODS: This was a cross-sectional, descriptive, analytical study that included 150 GDPs. All practitioners were given a self-administered questionnaire which consisted of three parts assessing their knowledge of cardiac diseases requiring prophylaxis, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis. Statistical analysis of data was carried out using independent t-test, one-way ANOVA and chi-square test. RESULTS: The level of knowledge among GDPs in three areas of cardiac diseases requiring prophylax-is, dental procedures requiring prophylaxis, and antibiotic regimen for endocarditis prophylaxis were 63.7%, 66.8% and 47.7%, respectively. Their overall level of knowledge regarding endocarditis prophylaxis was 59%. Association of the level of knowledge with age and practice period was statis-tically significant (P < 0.05). However, the level of knowledge was not significantly associated with gender or university of graduation in either of three areas evaluated (P > 0.05). CONCLUSION: According to our results, the knowledge of endocarditis prophylaxis among GDPs in Tabriz was in a moderate level. Regarding the importance of endocarditis prophylaxis in sus-ceptible patients, it should be more emphasized in the curriculum of dental schools and continuing dental education programs.

A Clinical Comparison of Cenobone (A Decalcified Freeze-dried Bone Allograft) with Autogenous Bone Graft in the Treatment of Two- and Three-wall Intrabony Periodontal Defects: A Human Study with Six-month Reentry.

BACKGROUND AND AIMS: Complete and predictable regeneration of tissue lost as a result of infection or trauma is the ultimate goal of periodontal therapy. Various graft materials have been successfully used in the treatment of intrabony defects. The purpose of this study was to evaluate the use of a decalcified freeze-dried bone allograft (Cerabone) with the autogenous bone graft as a gold standard in the treatment of human two- or three-wall intrabony periodontal defects. MATERIALS AND METHODS: This split-mouth study was done on 10 pairs of matched two- or three-wall intrabony periodontal defects with 5 mm or more probing depth and 3 mm or more depth of intrabony component following phase I therapy. In the control sites autogenous bone graft and in the test sites decalcified freeze-dried bone allograft were used. RESULTS: At baseline, no significant differences were found in terms of oral hygiene and defect charac-teristics. At six months, analysis showed a significant improvement in soft and hard tissue parameters for both treatment groups as compared to preoperative measurements. There were no statistical differ-ences in clinically-measured parameters between treatment groups after 6 months except for crestal resorption that increased significantly in control group (P = 0.25). Defect resolution and bone fill in the test and control groups were 2.5 ± 0.46 mm versus 2.7 ± 0.73 mm and 2 ± 0.62 mm versus 2.20 ± 0.52 mm, respectively. CONCLUSION: The results of this study demonstrated that both graft materials improved clinical parameters. The comparison of the two treatment groups did not show any significant differences in clinical parameters after six months. However, because of the limited amount of intra-oral donor bone, it is preferable to use decalcified freeze-dried bone allograft.

Assessment of Intra- and Inter-examiner Reproducibility of Probing Depth Measurements with a Manual Periodontal Probe.

BACKGROUND AND AIMS: The main purpose of this study was to assess intra- and inter-examiner reproducibility of probing depth measurements with a manual periodontal probe. MATERIALS AND METHODS: In this study, 32 dental students in Tabriz Faculty of Dentistry with normal periodontium were evaluated. Each tooth of the upper right quadrants, except the third molars, was examined. Probing depths were measured in 6 surfaces of each tooth (mesiofacial, midfacial, distofacial, mesiolingual, midlingual and distolingual). Each patient was examined by two examiners (two periodontists) in two sessions with an interval of 7-10 days. A total of 218 teeth and 1295 surfaces were examined. RESULTS: Intra-examiner measurements showed no statistically significant differences, while the differences of inter-examiner measurements were statistically significant. Intra-examiner reproducibility was more than the inter-examiner one. Measurements for anterior region, facial and mid-facial/mid-lingual surfaces were more reproducible than posterior, lingual and proximal surfaces. CONCLUSION: Probing depth measurements with a conventional probe have an appropriate reproducibility in clinical settings, although variations between examiners may affect the reproducibility, especially when great accuracy is required.