Periodontal Evaluation for a New Alkasite Restorative Material in Noncarious Cervical Lesions: A Randomized-Controlled Clinical Trial.

OBJECTIVES: This study aims to evaluate the periodontal condition adjacent to Cention N (CN) restorations applied for noncarious cervical lesions (NCCL) compared with resin-modified glass ionomer cement (RM-GIC) restorations in terms of plaque accumulation, attachment loss, and gingival inflammation. MATERIALS AND METHODS: This is a double-blind split-mouth three-armed randomized-controlled clinical trial. The study arms are RM-GIC (FUJI II LC), CN + adhesive system, and CN + retentive groove. The study included 25 restorations per arm. Follow-ups were performed at 1 week, 3, 6, and 9 months after the application of the restorations. The periodontal condition was evaluated using the plaque index (PI), the bleeding on probing index (BOP), and the probing depth (PD). Appropriate tests were used to perform statistical analyses (α = 0.05). RESULTS: There was no significant difference between Cention N and RM-GIC regarding the studied variables. However, after the application of the restorations, it was noted that the PI and the PD mean values increased. The average increase after 9 months was 0.06 and 0.34 for PI and PD, respectively, with that of PD being significant. It was also noted that the percentage of positive BOP sites increased at the 1-week follow-up for all study groups and afterward dropped to near preintervention values at the 3-month and later follow-ups. CONCLUSIONS: The two ion-releasing materials Cention N and RM-GIC have a comparable and clinically acceptable effect on the gingival tissue when restoring NCCLs. The combined effect of the gingival retraction cord and the rubber dam clamp on the periodontal tissues might be more important to consider, especially in relation to the probing depth. Future long-term studies are needed to evaluate the effect of Cention N on the subgingival biofilm in comparison with nonion-releasing restorative materials, and subsequently, its effect on gingival inflammation. CLINICAL TRIAL REGISTRATION: This clinical trial was registered in clinicaltrial.gov clinical registry under protocol #NCT05593159.

Daily Probiotic Ayran Intake Reduces Gingival Inflammation: An Experimental Gingivitis Study.

PURPOSE: This study investigates the effects of daily consumption of a probiotic ayran drink on gingival inflammation and the development of experimental gingivitis. MATERIALS AND METHODS: This randomised, double-blind, placebo-controlled trial involved 54 volunteer students. The participants were randomly assigned to two groups: the control group received regular ayran for 42 days, while the test group received probiotic enriched ayran (including Lactobacillus acidophilus and Bifidobacterium bifidum) for 42 days twice a day. After 42 days, mechanical plaque control was stopped for 5 days. The plaque index (PI), gingival index (GI), probing bleeding (BOP), and probing depth (PPD) were measured at baseline, day 42, and day 47. At the same time, gingival crevicular fluid was taken for matrix metalloproteinase-8 examination. RESULTS: The mean scores of BOP, GI, PI, and MMP-8 levels increases in both groups following the 5-day experimental gingivitis period compared to baseline and day 42. Patients using probiotic ayran had significantly less PI, GI, BOP scores and MPP-8 values (p = 0.002; p 0.001; p 0.001; p = 0.001; p = 0.001, respectively) at day 47 compared to the control group. No statistically significant differences in probing pocket depth (PPD) were observed at any time point. CONCLUSION: The present study suggests that daily consumption of a probiotic ayran drink containing Lactobacillus acidophilus and Bifidobacterium bifidum statistically significantly lowers clinical and immunological markers of gingival inflammation.

Comparative assessment of medicinal plant extract efficacy against plaque and gingivitis: A case-control study.

Background: In the last quarter of the 20th century, dedicated efforts have been made to use phytochemicals in the prevention of periodontal diseases, but the darker side of the coin is that we have hardly encountered studies with a scientific basis to prove the specific role of phytochemicals against dental plaque. Objective: This study aimed to assess the antiplaque activity of Curcuma longa, Spilanthes acmella, and Quercus infectoria and to determine the antigingivitis activity of the extract, which shows high antiplaque potential. Materials and Methods: Sixteen volunteers were selected as subjects in this biphasic study. In the first phase, 10 volunteers were subjected to topical application of aqueous ethanolic extract (1%) of C. longa, Q. infectoria, and S. acmella on the labial/buccal and lingual/palatal surfaces of 28 teeth. In the second phase, the extract showing the highest efficacy was selected to assess its antigingivitis activity on all the surfaces of six mandibular anterior teeth of six gingivitis patients. The percentage plaque reduction was calculated by dividing the difference of the base and end scores by the baseline scores. Results: C. longa demonstrated superior results as it showed the maximum reduction in plaque formation. Antigingivitis activity of long-term topical application of 1% C. longa was depicted in independent clusters in different volunteers selected for the study. Only after 2 weeks, the treatment score was found to be statistically significant to depict optimal results. Conclusion: C. longa can be considered the best at reducing plaque. The antigingivitis activity of C. longa ranked reasonably satisfactory and comparable to the existing data for commercially available drugs.

Diet and Caries-associated Bacteria in Severe Early Childhood Caries An In vitro Study.

Background: Severe Early Childhood Caries (S-ECC) is a prevalent oral health issue among young children, often associated with specific caries-associated bacteria. This in vitro study investigates the impact of diet on the growth and activity of caries-associated bacteria in S-ECC. Materials and Methods: Plaque samples of Streptococcus mutans and Lactobacillus species were procured from laboratory. The samples were exposed to different dietary conditions, including high-sugar, high-carbohydrate, and control diets. The growth kinetics of caries-associated bacteria, including S. mutans and Lactobacillus species, were monitored using quantitative polymerase chain reaction (qPCR) and colony-forming unit (CFU) assays. Results: Under high-sugar conditions, the growth of S. mutans increased by 50% compared to the control group, as evidenced by qPCR analysis. Lactobacillus species also exhibited a significant increase in CFU counts in response to high-carbohydrate diets, showing a 40% rise compared to controls. Conclusion: This in vitro study highlights the influence of diet on the proliferation of caries-associated bacteria in severe early childhood caries. High-sugar and high-carbohydrate diets contribute to the growth and activity of S. mutans and Lactobacillus species, exacerbating the progression of dental caries in affected children.

An Institutional Survey to Assess and Create Awareness of Inter-dental Cleaning Aids among the Patients Visiting a Dental Hospital in Ahmedabad.

Objectives: To assess and evaluate the knowledge, awareness, and usage of inter-dental aids among the patients visiting a dental hospital. Materials and Methods: A cross-sectional descriptive study was conducted among patients using a questionnaire for evaluation of routine oral hygiene regimens. Results: 89% of patients brush their teeth only once a day. 77% of patients do not use any inter-dental aid, while 76% of patients are unaware about inter-dental aids. Conclusion: A very small part of the population is aware about the importance of using inter-dental aids in maintaining proper oral hygiene. Dentists play a key role in educating the society and encouraging them to use other aids apart from toothbrushes to prevent oral diseases.

Efficacy of antimicrobial peptide P113 oral health care products on the reduction of oral bacteria number and dental plaque formation in a randomized clinical assessment.

Background/purpose: Dental plaque is the main cause leading to the dental caries and periodontal diseases. The main purpose of this study was to test the efficacy of oral spray containing the antimicrobial peptide P-113 on the reduction of oral bacteria number and dental plaque formation in a randomized clinical assessment. Materials and methods: This study was divided into two parts. In Part A, we investigated the user experiences with the P-113 containing oral spray. In part B, 14 subjects in the experimental group used the P-113-containing oral spray, while 14 subjects in the control group used a placebo without the P-113 in a 4-week clinical trial. Participants were asked to use the P-113-containing oral spray or placebo 3 times per day and 5 times per use. Moreover, 3 check-ups and 2 washouts were carried out to evaluate the DMFT score, dental plaque weight, dental plaque index, and gingival index. Results: In part A, up to 91.8% of the subjects in the experimental group were satisfied with the use of the P-113-containing oral spray. In part B, based on our PacBio SMRT sequencing platform and DADA2 analysis, the numbers of Streptococcus and Porphyromonas in the experimental group were lower than those in the control group. In addition, decreased dental plaque weight, dental plaque index, and gingival index were all observed in the experimental group. Conclusion: The P-113-containing oral spray has the potential to reduce the dental caries and periodontal disease-related bacteria and to control the dental plaque formation.

Patients' Perspectives and Attitudes About the Relationship Between Fixed Orthodontic Treatment and Oral Hygiene.

AIM: The aim of this study was to evaluate patients' attitudes and perspectives on the relationship between fixed orthodontic treatment and oral hygiene. MATERIAL AND METHODS: The study included 175 patients undergoing fixed orthodontic treatment. Data was collected through questionnaires that included patient demographics, oral hygiene behaviours, perspectives on white spot lesions (WSL) and periodontal problems, and attitudes towards orthodontic treatment. The chi-square test was used to analyse the relationship between categorical data. The significance level was set at p<0.05. RESULTS: The mean age of the patients (109 males, 66 females) was 17.8±6.4 years. Most of the patients who received orthodontic treatment brushed their teeth twice a day. Traditional and orthodontic toothbrushes were preferred over electric ones. The most common oral hygiene tools were toothbrushes and interdental brushes. A total of 151 patients (86.28%) indicated that their primary source of oral hygiene guidance was the orthodontist. A total of 113 patients (64.57%) had no knowledge of dental plaque, while 117 patients (66.85%) had no knowledge of WSL. While 80 patients (84%) with knowledge about periodontal problems believed that the primary cause of periodontal problems was inadequate oral hygiene, 43 patients (74.85%) with knowledge about WSL attributed the main cause of WSL to the use of braces. Negative attitudes towards orthodontic treatment and oral hygiene were more prevalent among adolescents (p<0.05), with no difference in gender or treatment duration. Patients who received information about WSL and periodontal problems exhibited a more positive attitude towards treatment and oral hygiene (p<0.05). CONCLUSION: This study highlights the limited patient awareness of plaque and WSL during fixed orthodontic treatment. Physician guidance has a significant impact on patient attitudes, and specific educational programmes are required in orthodontic treatment.

Effectiveness of Chlorhexidine and Aloe Vera Mouthwash in Patients With Periodontal Disease: A Randomized Controlled Trial.

BACKGROUND: Aloe vera has gained significant attention in clinical research, and promoting natural substances is a prevailing trend in dentistry. AIM: This study compares the effectiveness of aloe vera mouthwash and 0.2% chlorhexidine gluconate mouthwash in reducing plaque accumulation and gingivitis. MATERIALS AND METHODS: A single-masked trial included 270 volunteers who were systemically healthy and aged between 18 and 45 years. The participants were randomly assigned to three groups: Group A (the test group) received aloe vera mouth rinse, Group B (the positive control group) received a placebo (distilled water), and Group C (the negative control group) received 0.2% chlorhexidine. Clinical indicators, which include the plaque index (PI) by Sillness and Loe in 1964 and the gingival index (GI) by Loe and Sillness in 1963, were evaluated at baseline, day 15, and day 30 for all three groups. Participants were directed to rinse their mouths with the specified mouthwash twice daily for 30 days. RESULTS: Significant reductions in the GI and PI were observed in both aloe vera and chlorhexidine mouthwashes, with a statistical significance of p<0.001. The placebo mouthwash also showed reductions in both the GI and PI, with a significance level of p<0.001. Post hoc analysis revealed no significant differences between the aloe vera and chlorhexidine groups for the GI and PI, with p-values of 0.6 and 0.8, respectively. CONCLUSION: Aloe vera has proven equally effective as chlorhexidine in reducing plaque and gingivitis. This makes it a viable alternative for treating and preventing gingivitis, appealing to those preferring natural, holistic oral care. Incorporating aloe vera mouthwash into daily routines offers an effective, natural solution for maintaining gum health.

Prevalence of inflammatory periodontal diseases.

BACKGROUND: Determining the prevalence of inflammatory periodontal diseases makes it possible to determine the age group most prone to them, which will help to implement correct treatment and prevention measures for persons of this group, aimed at increasing the level of individual and public health of the Republic of Kazakhstan. The purpose of the study was to determine the prevalence of inflammatory periodontal diseases among the population of the city of Astana according to several criteria and to compare data on the statistics of periodontitis incidence from the world and Kazakhstan. OBJECTIVE: The research was conducted using the methods of clinical examinations and statistical data processing. MATERIAL AND METHODS: The study involved 642 people aged 18 to 80 years who, within twelve months, applied to dental institutions in the city of Astana and were checked according to the inclusion and exclusion criteria. Clinical studies included determining the level of oral hygiene using the OHI-S simplified oral hygiene index and determining the condition of periodontal tissue using the CPITN periodontal disease treatment need index. RESULTS: It was found that the highest prevalence of various forms of gingivitis and periodontitis was observed in the 66-80 age group - 99% and 69%, respectively. The general distribution in all groups indicated a directly proportional relationship between the frequency of detection of inflammatory periodontal diseases and the age of the group participants. A comparison of data on the incidence of periodontal disease in the world and in Kazakhstan showed a 3.52% lower incidence rate in Kazakhstan compared to the world average. CONCLUSIONS: The use of regular and timely preventive and treatment measures for the population group most prone to inflammatory periodontal diseases will make it possible to improve the state of individual health of the population and, accordingly, raise the level of public health.

Periodontal health and oral hygiene of children with orofacial clefts in Eastern China.

To comparatively assess the periodontal condition and oral hygiene of children and adolescents at different ages presenting with different types of orofacial clefts (OFCs). A total of 1608 patients aged 6-18 years who had not previously undergone periodontal treatment were enrolled in this study. Participants were categorized into two age groups: 6-12 years (Group I) and 13-18 years (Group II). Participants in both age groups were further classified into one of the three OFC-type subgroups: cleft lip only (without or with alveolar cleft), cleft lip and cleft palate, and cleft palate only. Periodontal health was determined by evaluating plaque formation and gingival status with reference to the Silness and Loe plaque index (PI), Loe gingival index (GI), and community periodontal index (CPI). Periodontal health and oral hygiene were not significantly different between Groups I and II for cleft type (p > 0.05). A significant difference was not observed in PI for cleft type among the groups (p > 0.05). In Group II, GI and CPI were significantly higher than in Group I (p < 0.05). According to our results, cleft type does not influence periodontal health of children and adolescents with OFCs. Age, however, influences periodontal diseases' prevalence and severity.

DeepPlaq: Dental plaque indexing based on deep neural networks.

OBJECTIVES: The selection of treatment for dental plaque is closely related to the condition of the plaque on different teeth. This study validated the ability of CNN models in assessing the dental plaque indices. MATERIALS AND METHODS: In 70 (20 male and 50 female) healthy adults (18 to 55 years old), frontal and lateral view intraoral images (210) of plaque disclosing agent stained permanent and deciduous dentitions were obtained. A three-stage method was employed, where the You Look Only Once version 8 (YOLOv8) model was first used to detect the target teeth, followed by the prompt-based Segment Anything Model (SAM) segmentation algorithm to segment teeth. A new single-tooth dataset consisting of 1400 photographs was obtained after applying a two-stage method. Finally, a multi-class classification model DeepPlaq was trained and evaluated on the accuracy of dental plaque indexing based on the Quigley-Hein Index (QHI) scoring system. Classification performance was measured using accuracy, recall, precision, and F1-score. RESULTS: The teeth detector exhibited an accuracy (mean average precision, mAP) of approximately 0.941 ± 0.005 in identifying teeth with plaque disclosing agents. The maximum accuracy attained in the plaque indexing through DeepPlaq was 0.84 (probability that DeepPlaq scored identical to experts), and the smallest average scoring error was less than 0.25 on a 0 to 5 scale for scoring. CONCLUSIONS: A three-stage approach demonstrated excellent performance in detecting and segmenting target teeth, and DeepPlaq model also showed strong performance in assessing dental plaque indices. CLINICAL RELEVANCE: Application of artificial intelligence to the evaluation of dental plaque distribution could enhance diagnostic accuracy and treatment efficiency and accuracy.

Clinical Evaluation of the Effect of Nanohydroxyapatite Lozenge on the pH of Dental Plaque.

Purpose: This study investigated the influence of nanohydroxyapatite-containing (nanoHAP) lozenge on plaque pH following sucrose intake. Patients and Methods: Sixteen adult subjects were enrolled in this double-blind crossover study composed of four interventions: (1) 10% w/v sucrose solution, (2) 10% w/v sorbitol solution, (3) nanoHAP lozenge, and (4) 10% w/v sucrose solution challenge followed by nanoHAP lozenge. Following the determination of each subject's resting plaque pH, the pH was measured at different time intervals from 3 to 30 minutes from the start of intervention, with 7 days interval between the applications of different interventions. The data were analyzed using the analysis of variance and Tukey's test (α < 0.05). Results: While sorbitol produces no change in plaque pH, nanoHAP-lozenge increased the plaque pH from a baseline of 7.0 ± 0.3 (mean ± sd) to 7.8 ± 0.2 (mean ± sd) within 30 minutes. Sucrose lowered the plaque pH from a baseline of 7.0 ± 0.4 (mean ± sd) to the lowest minimum of 5.1 ± 0.1 (mean ± sd) at the 7th minute, rising above the critical pH of enamel dissolution (5.5) at 12th minute and the baseline pH in more than 30 minutes. With lozenge intervention following sucrose challenge, plaque pH rose to 5.5 in 8 min, and to the baseline pH in 24 min. The cH area (Hydrogen ion concentration area) produced by sucrose (1.82 sq. units) was significantly (p < 0.05) greater than that produced when sucrose was challenged with lozenge (0.48 sq. units). Conclusion: Nanohydroxyapatite-containing lozenge increased plaque pH, reduced plaque pH drop in the presence of sucrose, and facilitated the rapid recovery of plaque pH after sucrose intake.

Correlation between Periodontitis and Gastritis Induced by Helicobacter pylori: A Comprehensive Review.

The goal of this comprehensive review was to verify if the prevalence of Helicobacter pylori (Hp) bacteria in patients with dyspepsia is higher in the oral cavity of periodontal or non-periodontal patients. The bibliographic search was conducted on scientific studies published in PubMed, Cochrane Library, SciELO, and BVS. The focus question was: "In patients with dyspepsia and periodontitis, is the prevalence of Hp bacteria in the oral cavity higher than in patients with only dyspepsia or without any disease?" The inclusion criteria were human studies in English, Portuguese, or Spanish languages, published between 2000 and 2022, that included patients over the age of 18 and aimed to evaluate the presence of Hp bacteria in the oral cavity and in the protective mucosal layer of the gastric lining of patients with the diseases (periodontitis and dyspepsia) or without disease; clinical trials, randomized controlled clinical trials, comparative studies, case-control studies, cross-sectional studies, and cohort studies. The methodological quality evaluation of the included articles was performed using the Joanna Briggs Institute tools. The final scores could be of "Low" quality (at least two "no" [red] or ≥ five "unclear" found), "Moderate" quality (one "no" [red] was found or up to four "unclear" criteria were met), or "High" quality (all green [yes] or at maximum two "unclear"). Of 155 potentially eligible articles, 10 were included in this comprehensive review after the application of the eligibility criteria. The selected studies were scrutinized regarding the relationship between Hp colonization in the oral cavity and stomach, its impact on severity and complications of gastric infection, as well as the effect of the presence of oral and gastric Hp on dental and systemic parameters. Hp can colonize periodontal pockets regardless of its presence in the stomach. There was a higher prevalence of oral biofilm in dyspeptic patients with periodontal disease, and worse control of bleeding and low oral hygiene was observed in periodontal compared to non-periodontal patients. For que quality assessment, the scientific studies included presented low to moderate methodological quality. Conclusions: It is possible to conclude that Hp is a bacterium that can colonize dental plaque independently of the stomach and vice versa; however, when both diseases are found, its presence may be more significant. Supra and subgingival dental plaque may be a reservoir of Hp, suggesting that patients with gastric infections are more likely to have Hp in the oral cavity. The results must be carefully analyzed due to the limitations present in this review.

Essential genes for Haemophilus parainfluenzae survival and biofilm growth.

Haemophilus parainfluenzae (Hp) is a Gram-negative, highly prevalent, and abundant commensal in the human oral cavity, and an infrequent extraoral opportunistic pathogen. Hp occupies multiple niches in the oral cavity, including the supragingival plaque biofilm. Little is known about how Hp interacts with its neighbors in healthy biofilms nor its mechanisms of pathogenesis as an opportunistic pathogen. To address this, we identified the essential genome and conditionally essential genes in in vitro biofilms aerobically and anaerobically. Using transposon insertion sequencing (TnSeq) with a highly saturated mariner transposon library in two strains, the ATCC33392 type-strain (Hp 392) and oral isolate EL1 (Hp EL1), we show that the essential genomes of Hp 392 and Hp EL1 are composed of 395 (20%) and 384 (19%) genes, respectively. The core essential genome, consisting of 341 (17%) essential genes conserved between both strains, was composed of genes associated with genetic information processing, carbohydrate, protein, and energy metabolism. We also identified conditionally essential genes for aerobic and anaerobic biofilm growth, which were associated with carbohydrate and energy metabolism in both strains. RNAseq analysis determined that most genes upregulated during anaerobic growth are not essential for Hp 392 anaerobic survival. The completion of this library and analysis under these conditions gives us a foundational insight into the basic biology of H. parainfluenzae in differing oxygen conditions, similar to its in vivo habitat. This library presents a valuable tool for investigation into conditionally essential genes for an organism that lives in close contact with many microbial species in the human oral habitat.IMPORTANCEHaemophilus parainfluenzae is a highly abundant human commensal microbe, present in most healthy individuals where it colonizes the mouth. H. parainfluenzae correlates with good oral health and may play a role in preservation of healthy host status. Also, H. parainfluenzae can cause opportunistic infections outside of the oral cavity. To date, little is known about how H. parainfluenzae colonizes the human host, despite being such a frequent and abundant part of our human microbiome. Here, we demonstrate the creation and use of a powerful tool, a TnSeq library, used to identify genes necessary for both the outright growth of this organism and also genes conditionally essential for growth in varying oxygen status which it can encounter in the human host. This tool and these data serve as a foundation for further study of this relatively unknown organism that may play a role in preserving human health.

Comparison of the anti-plaque and anti-gingivitis efficacy of Chlorhexidine and Malva mouthwashes: Randomized crossover clinical trial.

OBJECTIVES: Although mechanical oral hygiene is widely practiced, it faces several challenges. Mouthwashes, such as chlorhexidine (CHX), are being explored as adjuncts to biofilm control, but their prolonged use has several side effects. Consequently, there is ongoing research into natural alternatives. This randomized crossover clinical study aimed to compare the antiplaque and antigingivitis efficacy of 0.12 % CHX and a 5 % Malva sylvestris. METHODS: Forty-four participants were involved in two phases, each comprising three stages with variations in the mouthwash solution used only. During the study, participants refrained from mechanical plaque removal for seven days. At first day, they received whole-mouth prophylaxis and oral health assessment. After three days, gingival inflammation assessment and prophylaxis in were performed in contralateral quadrants. Participants then used a randomly assigned mouthwash solution for four days. On the 7th day, they completed a questionnaire about their perception and appreciation of the mouthwash. Additionally, gingival inflammation and plaque index were also performed by a calibrated examiner. After a minimum 21-day washout period, participants entered the second phase, repeating the three stages. RESULTS: Results showed no statistically significant differences between the Malva sylvestris and CHX groups regarding inflammation and plaque formation. However, CHX demonstrated a significantly greater mean reduction (7th - 4th day) in gingival inflammation compared to Malva (p = 0.02) (0.01 ± 0.19 and 0.00 ± 0.19, respectively). Additionally, participants using CHX reported a more pleasant taste and considered higher plaque control perception (p < 0.05). CONCLUSIONS: In conclusion, both products exhibited similar antiplaque effects, but CHX outperformed Malva in controlling gingival inflammation. CLINICAL SIGNIFICANCE: Mouthwashes with Malva sylvestris may be a good alternative, in a short-term period, to control biofilm. However, lower antigingivitis efficacy may be expected when compared to chlorhexidine.

Dental prosthesis plaque index of Augsburger and Elahi: Expansion and standardisation in community-dwelling frail older people.

BACKGROUND: Inadequate daily oral hygiene care of dental prostheses could worsen general health of frail older people. The index of Augsburger and Elahi is often recommended to assess maxillary dental prosthesis plaque (DPP). OBJECTIVE: To assess the reliability of an expanded and standardised DPP index of Augsburger and Elahi in trained and untrained examiners, and to determine the applicability of the index in community-dwelling frail older people. METHODS: Ten community-dwelling frail older persons with complete and partial removable dental prostheses (RDPs) (mean ± SD age = 87.9 ± 8.4 years) participated. Seven persons were revisited after 3 months. The index was expanded with mandibular RDPs. Standardisation was achieved with a specially designed reference sheet. The RDPs were photographed after plaque colouring. Two trained examiners scored the photographs; thereafter, two untrained examiners. One trained examiner scored the photographs again after 3 weeks. Changes in DPP over the 3-month period were assessed with Wilcoxon signed-rank test. Inter- and intra-examiner reliability was assessed with intraclass correlation coefficients (ICCs). RESULTS: The DPP scores did not change significantly over time (Z = -0.594, p = 0.553). Inter-examiner reliability was excellent in the trained examiners (ICC = 0.859-0.947), and fair-to-good in the untrained examiners (ICC = 0.671-0.703). Intra-examiner reliability was excellent (ICC = 0.941-0.962). CONCLUSION: The proposed expansion and standardisation of the DPP index has an excellent inter- and intra-examiner reliability when performed by trained examiners, and a fair-to-good inter-examiner reliability by untrained examiners. Therefore, the index could be recommended for application in dental prostheses-wearing older persons and could be useful for awareness and education of professional and informal caregivers and the older persons themselves. TRAIL REGISTRATION: The Netherlands Trail Register NTR6159.

Microbiological and molecular profile of furcation defects in a population with untreated periodontitis.

AIM: To describe the microbiological composition of subgingival dental plaque and molecular profile of gingival crevicular fluid (GCF) of periodontal furcation-involved defects. MATERIALS AND METHODS: Fifty-seven participants with periodontitis contributed with a degree II-III furcation involvement (FI), a non-furcation (NF) periodontal defect and a periodontally healthy site (HS). Subgingival plaque was analysed by sequencing the V3-V4 region of the 16S rRNA gene, and a multiplex bead immunoassay was carried out to estimate the GCF levels of 18 GCF biomarkers. Aiming to explore inherent patterns and the intrinsic structure of data, an AI-clustering method was also applied. RESULTS: In total, 171 subgingival plaque and 84 GCF samples were analysed. Four microbiome clusters were identified and associated with FI, NF and HS. A reduced aerobic microbiota (p = .01) was detected in FI compared with NF; IL-6, MMP-3, MMP-8, BMP-2, SOST, EGF and TIMP-1 levels were increased in the GCF of FI compared with NF. CONCLUSIONS: This is the first study to profile periodontal furcation defects from a microbiological and inflammatory standpoint using conventional and AI-based analyses. A reduced aerobic microbial biofilm and an increase of several inflammatory, connective tissue degradation and repair markers were detected compared with other periodontal defects.

Clinical and microbial evaluation of mouthwash containing Achyranthes aspera and Trachyspermum ammi: A randomized controlled non-inferiority trial.

Objectives: Achyranthes aspera (Apamarga) and Trachyspermum ammi (Ajwain) have been used in many clinical conditions, and it displays valuable properties as an alternative to Chlorhexidine (CHX) in the management of gingivitis. Therefore, this study aims to assess the effect of Achyranthes aspera and Trachyspermum ammi (AA + TA) based herbal mouthwash, 0.2 % CHX, and placebo mouthwash on gingival health, plaque control and antibacterial activity against specific periodontal pathogens (Porphyromonas gingivalis and Tannerella forsythia) using quantitative real-time PCR (RT-PCR). Methods: This was a randomized controlled non-inferiority trial involving 108 children with plaque-induced gingivitis who were randomly assigned to three groups of 36 children each: Group A, AA + TA mouthwash; Group B, CHX mouthwash; and Group C, placebo mouthwash. Gingival index and plaque index were recorded at baseline, 7th and 21st day. RT-PCR was employed to determine the bacterial counts of each plaque sample at baseline and after 21 days. Results: All three groups exhibited a gradual and significant reduction in both gingival and plaque scores from baseline to days 7 and 21. However, the placebo group did not demonstrate a significant difference in scores between days 7 and 21. Furthermore, a significant reduction in bacterial counts of P. gingivalis and T. forsythia was observed in the groups receiving CHX and AA + TA mouthwash after 21 days of intervention compared to the placebo group. Conclusion: AA + TA mouthwash demonstrated non-inferiority in anti-gingivitis and anti-plaque properties compared to CHX, suggesting its potential suitability as an alternative to CHX when used in conjunction with mechanical plaque control measures.

Prevalence of dental caries and associated factors among primary school children in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Dental caries (decay or cavities) is the breakdown of teeth as a result of bacteria. Dental caries is one of the most preventable oral health problems and the most common chronic disease in primary school children. Poor dental and oral health affects the quality of children's lives. OBJECTIVES: The study aimed to synthesize the existing literature on the prevalence and associated factors of dental caries among primary school children in Ethiopia in 2024. METHODOLOGY: Studies were searched through the search engines of Google Scholar, PubMed, Scopus, MEDLINE, and the Cochrane Library. Searching was made using keywords and MeSH terms for dental caries, dental plaque, primary school children, and Ethiopia. Heterogeneity was assessed using the Cochran Q test and I2 statistics. A random-effects model with a 95% confidence interval was used for prevalence and odds ratio estimations. RESULT: The result of seven studies disclosed that the overall prevalence of dental caries in primary school children in Ethiopia was 35% (26-45%). high intake of sweets (OR = 2.71,95%CI:1.968-3.451), a poor habit of tooth cleaning (OR = 2.46; 95% CI: 2.761-5.045), Grade level 1-4(OR = 2.46; 95% CI: 1.523-3.397), having a history of toothache(OR = 2.99; 95% CI: 2.679-3.314), absence of toothpaste use(OR = 1.42; 95% CI: -1.278-4.109), reduction of the previous year's academic score(OR = 5.51; 95% CI: 1.952-9.066), had a significant microbial load(OR = 3.82, CI: 3.439-4.192) and have acid bacillary pH on their teeth(OR = 2.42, CI: 1.494-3.335) were independent variables associated with dental carries among primary school children. CONCLUSION: The overall prevalence of dental caries among primary school children in Ethiopia is 35%, ranging from 26 to 45%. However, variations in prevalence rates are observed based on sampling techniques. Studies using simple random sampling report a higher prevalence rate of 42%, while those employing multi-stage random sampling and systematic random sampling show lower rates of 30% and 35%, respectively. This indicates that the choice of sampling technique can impact reported prevalence rates, with simple random sampling yielding higher estimates compared to other methods.

A Three-Month Probiotic (the Streptococcus salivarius M18 Strain) Supplementation Decreases Gingival Bleeding and Plaque Accumulation: A Randomized Clinical Trial.

S. salivarius M18 administration has been proven to provide positive effects on periodontal health; however, there is still no consensus on the optimum duration of probiotic administration. This study aimed to evaluate the effect of three months of probiotic supplementation on bleeding on probing, signs of gingival inflammation, and dental biofilm. Sixty-two eligible individuals with gingivitis were enrolled in this placebo-controlled, double-blind trial and randomly allocated to the M18 or control groups. Primary outcomes were changes in gingival condition (gingival index, GI; gingival bleeding index, GBI) after 1, 2, and 3 months of lozenges administration and after a one-month washout. Secondary outcomes included changes in the Quigley-Hein plaque index (modified by Turesky et al.) after 1, 2, and 3 months of lozenges administration and after a washout. In total, 60 individuals completed the study (31 and 29 in the M18 group and the control group, respectively). No severe adverse events were reported. Probiotic supplementation resulted in a significant decrease in gingival bleeding at 1 month (effect size 1.09 [CI95%: 0.55-1.63]), 2 months (effect size 0.78 [CI95%: 0.26-1.30]), and 3 months (effect size 0.67 [CI95%: 0.15-1.18]) and a significant reduction in dental plaque accumulation at 2 months (effect size 0.63 [CI95%: 0.12-1.14]) and 3 months (effect size 0.55 [CI95%: 0.03-1.05]). A three-month supplementation with the probiotic resulted in a significant reduction in gingival bleeding and biofilm accumulation; however, a long-lasting effect is not expected, indicating the need for probiotic intake on a long-term basis.