Evaluation of Toothpaste Containing Aqueous Saffron Stigma Extract on Gingival Indices in Patients with Marginal Generalized Plaque-Induced Gingivitis.

BACKGROUND: Gingivitis is an inflammatory disease involving the gums. Saffron contains various forms of flavonoids, glycosides, and anthocyanin compounds that are proven to have anti-inflammatory and antioxidant effects. This study evaluates the anti-inflammatory effects of Saffron stigma on gingival indices in patients with marginal generalized plaque-induced gingivitis. METHODS: For this study, we used toothpaste containing aqueous extract of Saffron stigma. Twenty-two patients with generalized marginal gingivitis were selected. Patients were randomly divided into two equal groups of test and placebo. In each group the pocket depth index (PD), gingival index (GI), plaque index (PI) and bleeding of probing index (BOP) were measured before and one month after use. Independent t-test, Mann-Whitney test and Wilcoxon test were used for statistical analysis (P<0.05). RESULTS: The comparison between gingival indices before and one month after toothpaste usage showed a significant decrease in some measured indices at the end of the study. Saffron stigma treated group had a significant difference in reducing GI and BOP indices in comparison with the placebo group (P<0.05). However, the difference for PD and PI indices was not statistically significant (P>0.05). CONCLUSION: In this study, it was found that using aqueous extract of Saffron stigma flower containing toothpaste might have a positive effect on some gingival indices in patients with gingivitis.

Effectiveness of Er:YAG laser-aided fiberotomy and low-level laser therapy in alleviating relapse of rotated incisors.

INTRODUCTION: In this study, we compared the effectiveness of laser-aided circumferential supracrestal fiberotomy (CSF) and low-level laser therapy (LLLT) with conventional CSF in reducing relapse of corrected rotations. METHODS: The study included 24 patients who were at the finishing stage of orthodontic treatment and had at least 1 maxillary incisor with 30° to 70° of rotation before starting therapy. The subjects were divided into 4 groups by treatment: conventional CSF, Er:YAG laser-aided CSF, LLLT, and control. After alginate impressions were taken, the archwire was sectioned from the experimental incisors, and they were allowed to relapse. The second impression was taken 1 month later, and the degree and percentage of relapse were calculated in photographs taken from the dental models. Gingival recession, pocket depth, and pain were also measured in the CSF groups. RESULTS: The mean percentages of relapse were 9.7% in the conventional CSF, 12.7% in the Er:YAG laser-aided CSF, 11.7% in the LLLT, and 27.8% in the control groups. Relapse was significantly greater in the control than the experimental groups (P <0.05), which were not statistically different from each other. The changes in sulcus depth and gingival recession were small and not significantly different among the CSF groups (P >0.05), but pain intensity was greater in subjects who underwent conventional CSF (P = 0.003). CONCLUSIONS: Er:YAG laser-aided CSF proved to be an effective alternative to conventional CSF in reducing rotational relapse. LLLT with excessively high energy density was also as effective as the CSF procedures in alleviating relapse, at least in the short term.

Evaluation of Cytotoxicity and Antimicrobial Activity of Experimental Composites Containing Chitosan-Silver Oxide Particles Against Two Main Pathogenic Bacteria in Periodontal Disease.

INTRODUCTION: Bacterial biofilm is known as the main cause of periodontal disease. Generally, the anaerobic Gram-negative, such as Porphyromonas gingivalis and Fusobacterium nucleatum, are considered the most identified bacteria. OBJECTIVE: This study aimed to investigate the antimicrobial effect and cytotoxicity of two experimental composites containing chitosan-silver oxide (CH-Ag2O) particles. MATERIALS AND METHODS: Four experimental groups, including Ag2O and CH, along with two composites of CH-Ag2O 20 and CH-Ag2O 60 mg, were prepared. Antimicrobial activity was performed against Porphyromonas gingivalis (ATCC#33277) and Fusobacterium nucleatum (ATCC#25586) using the agar dilution method. Moreover, the cytotoxicity assay was performed on human gingival fibroblasts (HGF) by the use of the MTT method. The obtained data were analyzed with descriptive methods, one-way ANOVA, and Tukey's LSD tests. RESULTS: The antibacterial activity of both composites was higher than both CH and Ag2O, and the greatest antibacterial properties were presented in CH-Ag2O 60. In all three measurements (24, 48, and 72h), the greatest cytotoxicity was seen in Ag2O, followed by CH, CH-Ag2O 20, and CH-Ag2O 60 in descending order, respectively. The cytotoxicity of these components was related to the concentration and not to the time of exposure. The results showed that Ag2O in 3.7 and 7.5 µg/ml concentrations and CH-containing groups in 250 and 500 µg/ml were toxic to the cultured HGF. CONCLUSION: The experimental composite containing CH-Ag2O 60 showed the greatest antibacterial properties against two periodontal pathogens evaluated. In order to clarify the clinical significance of composite cytotoxicity, further clinical studies are necessary.

Evaluating the Effect of Active Charcoal-Containing Toothpaste on Color Change, Microhardness, and Surface Roughness of Tooth Enamel and Resin Composite Restorative Materials.

Methods: Thirty-six bovine incisors and resin composite samples were prepared, stained with black tea, and then randomly divided into two groups. The samples were brushed with a charcoal-containing toothpaste (Colgate® MAX WHITE) and daily toothpaste (Colgate® Max Fresh) for 10,000 cycles. Before and after brushing cycles, color variables (ΔL, Δa, Δb), total color change (ΔE), plus Vickers microhardness were evaluated. Two samples of each group were prepared for surface roughness assessment via atomic force microscope. Data were analyzed by Shapiro-Wilk, Independent sample t-test and Mann-Whitney U tests. Results: According to the obtained results, ΔE and ΔL were significantly higher whereas Δa and Δb were noticeably lower in charcoal-containing toothpaste group in comparison with daily toothpaste in both composite and enamel samples. The microhardness of samples brushed with Colgate® MAX WHITE was significantly higher than that of Colgate® Max Fresh in enamel (P = 0.04), whereas no significant difference was found in composite resin samples (P = 0.23). Colgate® MAX WHITE enhanced the roughness of both enamel and composite surfaces. Conclusion: The charcoal-containing toothpaste could improve the color of both enamel and resin composite with no negative effect on microhardness. Nevertheless, its adverse roughening effect should be considered occasionally on composite restorations.

Effect of Bone Grafting on Hard and Soft Tissue Changes Following Immediate Implant Installation in Mandibular Molar Sites: A Double-Blind Randomized Clinical Trial.

This study investigated the effect of bone grafting on hard and soft tissue alterations after immediate implant insertion in mandibular molar sites. This randomized, double-blind clinical trial consisted of 30 healthy patients (17 women and 13 men aged 22-58 years) who required immediate implant installation to replace a first or second mandibular molar. Only subjects with a buccal gap between 2 and 4 mm were selected. The participants were randomly allocated to two groups. In the experimental group, the gap was augmented by an allograft, whereas in the control group no graft was applied. Marginal bone level, probing depth, keratinized gingival width, and bleeding on probing were assessed at the time of implant placement (T0), 1 month (T1), and 3 months (T2) after surgery. There was no significant difference in hard and soft tissue parameters between the grafted and nongrafted sites at any of the durations (P < 0.05). Bone level decreased significantly in both groups (P < 0.05). However, the amount of probing depth and the frequency of cases showing bleeding on probing did not alter over the experiment either in the test or in the control group (P > 0.05). Bone grafting simultaneously with immediate implant installation had no significant effect on hard and soft tissue outcomes when the buccal gap size was between 2 and 4 mm. Therefore, the use of a bone substitute is not mandatory up to the jumping distance of 4 mm in immediate implant surgery.

The Potential Role of Tea in Periodontal Therapy: An Updated Review.

Periodontal diseases are highly prevalent and can affect high percentage of the worlds' population. Oxidative stress and inflammation play an important role in the pathogenesis of periodontal diseases. Nowadays, more attention has been focused on the herbal remedies in the field of drug discovery. Green tea is an important source of polyphenol antioxidants. It has long been used as a beverage worldwide. The most interesting polyphenol components of green tea leaves that are related with health benefits are the catechins. Taken together, this review suggested that green tea, with its wide spectrum of activities, could be a healthy alternative for controlling the damaging reactions seen in periodontal diseases.

The Role of Type 2 Fibroblast Growth Factor in Periodontal Therapy.

The prevalence of periodontitis is around 20-50% in the global population. If it is not treated, it can cause tooth loss. Periodontal treatment aims at preserving the patient's teeth from various damages, including infection control and restoring lost periodontal tissue. The periodontium has great biological regenerative potential, and several biomaterials can be used to improve the outcome of periodontal treatment. To achieve the goal of periodontal tissue regeneration, numerous studies have used fibroblast growth factor 2 (FGF2) to stimulate the regeneration of both the soft tissue and bone. FGF2 induced a significant increment in the percentage of bone fill, bone mineral levels of the defect sites, length of the regenerated periodontal ligament, angiogenesis, connective tissue formation on the root surface, formation of dense fibers bound to the alveolar bone and newly synthesized cementum in teeth. This review will open further avenues to better understand the FGF2 therapy for periodontal regeneration.

Comparison of interdental papillae around single implants in the tissue-level (TL) and bone-level (BL) implants: A clinical trial.

Background: This study aimed to evaluate the effect of bone-level implants in comparison with tissue-level implants on dental papilla dimensions in single-tooth implants. Methods: In the present clinical trial, 50 patients, 24 females (48%) and 26 males (52%), were selected among patients requesting single implants in the posterior area of the jaws. The subjects were divided into two groups (n=25). The subjects in the first group were treated with a bone-level implant (Implantium, Dentium, Korea), and the subjects in the second group were treated with a tissue level implant (Implantium, Dentium, Korea). None of the implants were loaded during this period, and only the healing effect was measured. All the implants underwent one-stage surgery (none-submerged), and healing abutments were placed after implantation. The papilla heights in both the mesial and distal aspects of the adjacent teeth were measured. A periodontal probe was used to measure from the top of the papilla to the CEJ of the adjacent teeth in two time intervals. Descriptive statistics were performed using tables and Shapiro-Wilk, chi-squared, Mann-Whitney, and independent t-tests. Results: The findings showed that the interdental papilla in TL single implants performed better than that in BL implants at the three-month interval. This difference was statistically significant on the mesial aspect but not on the distal aspect. However, the difference was not clinically significant. Conclusion: A comparison of papilla dimensions in two implant types showed that papilla formation in TL implants was better than that in BL implants at the three-month postoperative interval.

Curcumin for the Management of Periodontal Diseases: A Review.

Periodontal disease is one of the most common causes of tooth loss among adults. Research shows that inflammation is one of the crucial components in the initiation and progression of periodontitis. Various herbal medicines have recently been receiving attention for the management of periodontitis owing to their general safety and efficacy. Curcumin, a bioactive polyphenol extracted from Curcuma longa, has been shown to possess antioxidant, antimicrobial, anti-inflammatory and analgesic properties. Several studies have assessed the efficacy of curcumin against periodontal diseases. These studies have shown equivalent or even higher efficacy of curcumin compared to the commonly used medications for the management of periodontitis such as chlorhexidine. Herein, we review the experimental and clinical findings on the anti-periodontitis effects of curcumin and the pharmacological mechanisms underlying these effects.

The effect of canine disimpaction performed with temporary anchorage devices (TADs) before comprehensive orthodontic treatment to avoid root resorption of adjacent teeth.

OBJECTIVE: The aim of this study was to evaluate the movement of impacted canines away from the roots of neighboring teeth before full-mouth bracket placement, performed by means of TADs to decrease undesired side effects on adjacent teeth. METHODS: The study sample consisted of 34 palatally impacted canines, being 19 in the experimental group and 15 in the control group. In the experimental group, before placement of brackets, the impacted canine was erupted by means of miniscrews. In the control group, after initiation of comprehensive orthodontics, canine disimpaction was performed by means of a cantilever spring soldered to a palatal bar. At the end of treatment, volume of lateral incisors and canine root resorption were measured and compared by means of a CBCT-derived tridimensional model. Visual Analogue Scale (VAS) score, bleeding on probing (BOP) and gingival index (GI) were recorded. Clinical success rate was also calculated. RESULTS: The volume of root resorption of lateral teeth in the control group was significantly greater than in the experimental group (p < 0.001). At the end of treatment, VAS score, GI and BOP were not significantly different between the two groups. CONCLUSION: Based on our results, it seems that disimpaction of canines and moving them to the arch can be done successfully carried out with minimal side effects by means of skeletal anchorage.

Synergic phototoxic effect of visible light or Gallium-Arsenide laser in the presence of different photo-sensitizers on Porphyromonas gingivalis and Fusobacterium nucleatum.

BACKGROUND: According to the development of resistant strains of pathogenic bacteria following treatment with antimicrobial chemotherapeutic agents, alternative approaches such as lethal photosensitization are being used. The aim of this study was to evaluate the effect of visible light and laser beam radiation in conjugation with three different photosensitizers on the survival of two main periodontopathogenic bacteria including Porphyromonas gingivalis and Fusobacterium nucleatum in different exposure periods. MATERIALS AND METHODS: In this in vitro prospective study, strains of P. gingivalis and F. nucleatum. were exposed to visible light at wavelengths of 440 nm and diode laser light, Gallium-Arsenide, at wavelength of 830 nm in the presence of a photosensitizer (erythrosine, curcuma, or hydrogen peroxide). They were exposed 1-5 min to each light. Each experiment was repeated 3 times for each strain of bacteria. Data were analyzed by two-ways ANOVA and least significant difference post-hoc tests. P < 0.05 was considered as significant. After 4 days the colonies were counted. RESULTS: Viability of P. gingivalis was reduced 10% and 20% subsequent to exposure to visible light and diode laser, respectively. The values were 65% and 75% for F. nucleatum in a period of 5-min, respectively. Exposure to visible light or laser beam in conjugation with the photosensitizers suspension caused significant reduction in the number of P. gingivalis in duration of 5-min, suggesting a synergic phototoxic effect. However, the survival rate of F. nucleatum following the exposure to laser with hydrogen peroxide, erythrosine and rhizome of Curcuma longa (curcumin) after 5-min was 10%, 20% and 90% respectively. CONCLUSION: Within the limitations of this study, the synergic phototoxic effect of visible light in combination with each of the photosensitizers on P. gingivalis and F. nucleatum. However, the synergic phototoxic effect of laser exposure and hydrogen peroxide and curcumin as photosensitizers on F. nucleatum was not shown.

Comparative study of 0.2% and 0.12% digluconate chlorhexidine mouth rinses on the level of dental staining and gingival indices.

BACKGROUND: Chlorhexidine (CHX) as a gold standard chemical agent appears to be the most effective antimicrobial agent for reduction of both plaque and gingivitis. The aim of this study was to compare the efficacy of two concentrations of digluconate chlorhexidine (CHX) solutions (0.12% and 0.20%) on gingival indices and the level of dental staining during 14 days. MATERIALS AND METHODS: in this double-blind controlled clinical trial study 60 patients with moderate to severe gingivitis aged 17-56 years were randomly selected and divided to three groups: Group I (placebo) Group II (0.12% CHX), and Group III (0.2% CHX). Patients rinsed their mouthwashes twice a day after brushing. Before the examination and after 14 days plaque index, gingival index, bleeding index, and stain index were evaluated. The data were analyzed by "Mann-Whitney" test and P value was 0.05. RESULTS: the results showed that plaque index and gingival index significantly reduced in Groups II and III in comparison with the placebo group (P < 0.0001). However, the two concentrations did not differ significantly from each other (P = 0.552). Same results were observed in term of gingival bleeding index with this different that 0.2% CHX was significantly more efficient than 0.12% CHX (P < 0.0001). CHX mouthrinse, both concentrations, significantly increased the dental staining level (intensity and area) in comparison with the placebo group. Remarkable difference also was seen between 2 CHX concentrations so that the 0.2% CHX caused much more staining on the teeth than 0.12% CHX. CONCLUSION: based on the results of this study we can conclude that the lower concentrations of CHX should be prescribed, decreasing side effects, since higher concentrations do not seem to be more effective in controlling dental plaque and gingivitis.

The effect of canine disimpaction performed with temporary anchorage devices (TADs) before comprehensive orthodontic treatment to avoid root resorption of adjacent teeth

ABSTRACT Objective: The aim of this study was to evaluate the movement of impacted canines away from the roots of neighboring teeth before full-mouth bracket placement, performed by means of TADs to decrease undesired side effects on adjacent teeth. Methods: The study sample consisted of 34 palatally impacted canines, being 19 in the experimental group and 15 in the control group. In the experimental group, before placement of brackets, the impacted canine was erupted by means of miniscrews. In the control group, after initiation of comprehensive orthodontics, canine disimpaction was performed by means of a cantilever spring soldered to a palatal bar. At the end of treatment, volume of lateral incisors and canine root resorption were measured and compared by means of a CBCT-derived tridimensional model. Visual Analogue Scale (VAS) score, bleeding on probing (BOP) and gingival index (GI) were recorded. Clinical success rate was also calculated. Results: The volume of root resorption of lateral teeth in the control group was significantly greater than in the experimental group (p < 0.001). At the end of treatment, VAS score, GI and BOP were not significantly different between the two groups. Conclusion: Based on our results, it seems that disimpaction of canines and moving them to the arch can be done successfully carried out with minimal side effects by means of skeletal anchorage.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar o uso de dispositivos de ancoragem temporária (DATs) para a movimentação de caninos impactados, afastando-os das raízes dos dentes vizinhos, antes da colagem dos braquetes em todos os dentes, com o objetivo de minimizar os efeitos colaterais indesejáveis nesses dentes adjacentes. Métodos: a amostra consistiu de 34 caninos impactados por palatino, sendo 19 no grupo experimental e 15 no grupo controle. No grupo experimental, antes da colagem dos braquetes, os caninos impactados foram tracionados utilizando-se mini-implantes. No grupo controle, após o início do tratamento ortodôntico, a desimpacção dos caninos foi realizada com uma mola em cantiléver soldada a uma barra transpalatina. Ao fim do tratamento, os valores referentes à reabsorção radicular nos incisivos laterais e caninos foram medidos e comparados por meio de modelos tridimensionais reconstruídos a partir de TCFCs. Foram também registrados os escores relativos à dor sentida pelos pacientes, usando uma escala visual analógica (VAS); além do Índice de Sangramento à Sondagem (ISS) e do Índice Gengival (IG). O índice de sucesso clínico também foi calculado. Resultados: o volume de reabsorção radicular nos incisivos laterais no grupo controle foi significativamente maior do que no grupo experimental (p < 0,001). Ao fim do tratamento, não houve diferença significativa entre os dois grupos quanto aos escores relativos à VAS, ao IG e ISS. Conclusão: esses resultados sugerem que a desimpacção de caninos e a movimentação deles para a arcada dentária podem ser realizadas, com sucesso e com mínimos efeitos colaterais, por meio da ancoragem esquelética.

Evaluation of Rosa damascena mouthwash in the treatment of recurrent aphthous stomatitis: a randomized, double-blinded, placebo-controlled clinical trial.

OBJECTIVE: As the exact etiology of recurrent aphthous stomatitis remains unknown, its treatment has primarily been palliative to relieve the pain, associated inflammation, and duration of the lesions by using antibacterial mouthrinses, analgesics, and immunomodulators. Nevertheless, no treatment has been universally effective in management of recurrent aphthous stomatitis, which necessitates the search for novel therapeutic agents. The aim of this study was to assess the clinical efficacy of the aqueous extract of Rosa damascena, which has reported anti-inflammatory and antinociceptive properties, in the treatment of recurrent aphthous stomatitis. METHOD AND MATERIALS: This was a randomized, double-blind, placebo-controlled investigation. Fifty patients were enrolled in this 2-week study; the clinical efficacy of the mouthwash on pain, size, and number of ulcers in the test group was compared with that of the placebo group on days 4, 7, 11, and 14. RESULTS: There were no statistically significant differences between baseline parameters. However, statistical analysis indicated a significant difference on days 4 and 7 between the placebo and test groups for all parameters. CONCLUSION: This study showed that mouthwash containing Rosa damascena extract was more effective than the placebo in the treatment of recurrent aphthous stomatitis.