Microbial contamination and plaque scores of nanogold-coated toothbrush.

OBJECTIVE: The study aimed to evaluate the microbial contamination and plaque scores of nanogold-coated and uncoated toothbrushes. METHODS: This study was designed as a single-centre, parallel, examiner-blinded, randomized, two-group clinical trial. Eighty-four participants were enrolled and randomly assigned to receive either a nanogold or uncoated toothbrush. Basic periodontal therapy was performed for all the recruited subjects, and plaque scores of zero were considered baseline values. All participants were instructed to follow a twice-daily brushing regimen without dentifrice and to refrain from other oral hygiene care during the one-week study period. Plaque levels were assessed after one week using the Turesky modification of the Quigley-Hein Plaque Index (TMQHPI). The bristles were tested for microbial contamination by viable cell counting. The recorded data were statistically analysed, and a P-value of <.05 was accepted as statistically significant. RESULTS: After one week of brushing without using toothpaste, the mean plaque index scores were 0.37 ± 0.07 in the nanogold group and 0.58 ± 0.10 in the uncoated group. A significant difference in the mean plaque scores was observed between the groups (P < .001). The mean colony-forming unit (CFU) was 21 ± 48.8 for the nanogold-coated group and 100 ± 128.4 for the uncoated group. The difference in the mean CFUs observed between the groups was significant (P = .014). CONCLUSION: The use of a nanogold-coated toothbrush demonstrated significantly lower bristle contamination and lower plaque scores after one week compared with uncoated toothbrushes without using dentifrice.

Role of Epithelial Mesenchymal Transition in Phenytoin Influenced Gingival Overgrowth in Children and Young Adults. A Preliminary Clinical and Immunohistochemical Study.

Objectives: To prove the role of epithelial mesenchymal transition (EMT) in the pathogenesis of phenytoin influenced gingival overgrowth (PIGO) in children and young adults. Study design: Thirty male individuals who are to start with oral phenytoin therapy were recruited for the study. All the 30 individuals underwent full mouth scaling and root planning and were then followed up for a period of one year at intervals of 3 months each. Based on the clinical gingival status they were divided into group1 (responders) individuals who showed gingival overgrowth (GO) and group 2 (non responders) individuals who do not show any GO. Gingival tissue samples were obtained from both the groups at the end of 1 year and subjected to immuno histochemical analysis for E-cadherin expression and histo-pathological for alteration in the basement membrane and confirmation of the fibrosis. Results: Decrease in expression of E cadherin, loss of basement membrane integrity and fibrosis were noted on responder group when compared to non responder group at p<0.001. Fibrosis was seen in the epithelial connective tissue junction. Conclusion: Decrease in cell adhesion, degradation of basement membrane and presence of fibrosis could suggest the role of EMT in the pathogenesis of PIGO.

Salivary Alkaline Phosphatase as a Noninvasive Marker for Periodontal Disease in Children with Uncontrolled Type 1 Diabetes Mellitus.

OBJECTIVE: The aim of this pilot study was to determine whether salivary alkaline phosphatase levels can be a non invasive marker for early inflammatory periodontal disease in children with uncontrolled type 1 diabetes mellitus. STUDY DESIGN: 10 healthy children (group 1), 10 children with recently diagnosed type 1 diabetes mellitus (group 2) and 10 children with type 1 diabetes mellitus for more than 4 years (group 3) were recruited for the study. All three groups were matched for age, gender and socioeconomic status. Periodontal health was assessed by plaque index, gingival index and probing pocket depth. Metabolic status was assessed by glycosylated hemoglobin levels, salivary alkaline phosphatase levels were determined by spectrophotometer. Data was analyzed by Kruskal Wallis ANOVA, Mann-Whitney U test and Spearman's rank correlation method. RESULTS: Salivary alkaline phosphatase levels correlated significantly with the periodontal parameters in the diabetic group. An increase in salivary alkaline phosphatase levels increased with increased values of gingival index and probing pocket depth. Group 3 showed greater correlation than group 2 and group 1. At p value p<0.05. CONCLUSION: The glycemic status of the children affects the periodontal disease parameters. Salivary alkaline phosphatase levels could be a useful tool in analyzing periodontal status of children with uncontrolled type I diabetes mellitus.

Management of a rare case of idiopathic multiple unerupted impacted permanent teeth in an adult female patient.

This clinical case report describes the multi-disciplinary approach in the management of an unusual presentation of idiopathic multiple unerupted impacted permanent teeth in a 20-year-old female patient. The case was unique in that, not only were there multiple missing permanent teeth, but also over retained deciduous teeth and attrited existing permanent teeth with loss of vertical dimension of occlusion. Since the patient was young, it was decided to retain all the erupted permanent teeth and extract the infected deciduous teeth with the objective of fabricating overlay complete dentures. This is a simple, reversible and an economical treatment modality, which satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated and, in addition, provides a stable occlusion.

Effectiveness of oral hygiene educational interventional programs on participants with Parkinson disease: a randomized controlled study.

OBJECTIVE: The objective was to evaluate oral health-related knowledge, and to compare the effectiveness of three different oral health education interventions (OHEI) on plaque removal in a cohort with Parkinson disease. METHOD AND MATERIALS: The three-arm, parallel-group, randomized controlled trial included 63 Parkinson disease stage 1 and 2 patients aged ≥ 40 years and scores ≥ 26 in both Montreal Cognitive Assessment test and Mini-Mental State Exam. These patients were allocated to three OHEI groups: lectures, presentation, and demonstration. The validated questionnaire assessed knowledge level at baseline (0), 1, 2, and 3 months. Oral hygiene at 0 and 3 months was assessed by the Plaque Index and the Patient Hygiene Performance Index (PHPI). Unstimulated whole saliva was collected to assess the salivary flow rate. RESULTS: Pairwise comparison using ANOVA showed a significant decrease in mean percentage knowledge 0, 1, 2, and 3 months in all three groups (P < .001). After Tukey post-hoc analysis the presentation group had significantly higher knowledge (P = .030). ANOVA showed that the percentage of knowledge decreased as time passed (P = .001). Comparison of means of Plaque Index and PHPI scores by MANOVA followed by Tukey post-hoc analysis showed significant decrease in Plaque Index scores from 0 to 3 months (P = .001). No significant change in the salivary flow rate was noted. CONCLUSION: Pictorial representation of OHEI is a better mode of intervention compared to lectures and demonstrations in Parkinson disease stage 1 and 2 patients. Despite the decline in knowledge with time, Plaque Index scores reduced significantly, implying that this form OHEI offers positive benefits.

Coefficient of variation of red cell distribution width has correlations to periodontal inflamed surface area in non-obese hypertensive patients.

Aims: To test the hypothesis that higher periodontal inflamed surface area (PISA) positively correlates with the coefficient of variation of red cell distribution width (RDW-CV) in non-obese hypertensive patients. Materials and methods: Hypertensive subjects aged between 40-60 years with and without periodontitis were enrolled for the study. They completed a structured questionnaire that included gender, height, weight, and other variables. Body mass index was calculated to exclude obese individuals. Clinical periodontal parameters were recorded. PISA was calculated, and participants were divided into four groups: Group 1: Non-hypertension without periodontitis, Group 2: Non-hypertensive with periodontitis, Group 3: Hypertensive without periodontitis, and Group 4: Hypertensive with periodontitis. The hematologic evaluation included red cell distribution width analysis. Results: ANOVA showed age and diastolic blood pressure were significantly related to RDW-CV at p < 0.001. Periodontal parameters showed significant association with RDW-CV in both hypertensive and non-hypertensive groups at p < 0.001. Pearson correlation test showed a significant association between RDW-CV and PISA. Multivariate regression models showed PISA to be a significant predictor for RDW-CV in the periodontitis group compared to a non-periodontitis group. Conclusions: The increase in the RDW-CV in the periodontitis group in both hypertensive and non-hypertensive indicates the independent role of increased inflammation on pathogenic alteration of red cell morphology.

Quantitative analysis of key periodontopathic bacteria in gestational diabetic and non-diabetic women.

PURPOSE: The aim of this study is to compare the periodontal status and quantify Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi) from plaque samples of both gestational diabetic mellitus (GDM) and non diabetic pregnant women. MATERIALS AND METHODS: Sixty first time pregnant women were selected after adjusting for age, duration of pregnancy and educational status. They were then categorized into gestational diabetic women (GDM) (Group A) and healthy pregnant women (non GDM) (Group B). Periodontal examination was done by assessing gingival index, periodontal disease index and probing depth. Microbial analysis on sub-gingival plaque was performed using polymerase chain reaction (PCR). Statistical analysis was done by student t test, chi square test and Fischer exact test. RESULTS: Group A showed higher gingival index, probing depth and periodontal disease index scores than group B at p < 0.001. Pg was detected in 80% of group A and 40% of group B. Amongst these; it was measured over 2.0 × 104 in 33% of group A, while in the group B it never scored more than 1.0 × 104. While Pi were also detected in 73% of group A women and 40% Group B women but quantification showed Pi > 2.0 × 104 in more number of group A women. CONCLUSION: This study showed that there is significant association between the severity of periodontal disease and increased levels of Pg and Pi in gestational diabetic women.

Impact of well-controlled type 2 diabetes mellitus on implant stability and bone biomarkers.

PURPOSE: To evaluate initial implant stability and initial healing around newly placed dental implants in well-controlled type 2 diabetes patients. MATERIALS AND METHODS: Forty patients requiring implant therapy comprising 15 nondiabetic and 25 diabetic patients were recruited for this prospective study. Implant stability quotient and bone biomarkers such as osteopontin, receptor activator of nuclear factor-kB ligand, and interleukin 8 were evaluated at baseline and 1 and 3 months using Osstell Mentor and enzyme-linked immunosorbent assay, respectively. RESULTS: Mean implant stability quotient values showed a statistically significant difference at each interval in both of the groups except between 1 and 3 months in the diabetic group. The percentage increase in implant stability quotient values was more in the nondiabetic (14.2%) than in the diabetic group (6.03%) from 1 to 3 months. Significant variations were observed in all three bone biomarkers between baseline and 3 months at P < .002 in both groups. In the diabetic group, receptor activator of nuclear factor-kB ligand showed a higher reduction from baseline to 3 months, whereas interleukin 8 showed a less significant decrease between baseline and 1 month. Changes in correlation between implant stability and bone biomarkers were noted in the initial period of healing between the two groups. CONCLUSION: Variations in the pattern of response of osteopontin, receptor activator of nuclear factor-kB ligand, interleukin 8, and initial implant stability are noted in well-controlled diabetic individuals.

A clinico-biochemical evaluation of the role of a herbal (Ayurvedic) immunomodulator in chronic periodontal disease: a pilot study.

BACKGROUND: Host modulation is fast gaining popularity as a preferred therapeutic modality for periodontal disease. Recent research in the medical field into herbal immunomodulators such as Septilin® has spurred an interest in evaluating its efficacy in periodontitis for the first time. AIM: The aim of the study was to assess the immunomodulatory effects of the herbal immunomodulator Septilin® (Himalaya Drug Company, Bangalore, India) when used as an adjunct to scaling and root planing in chronic periodontal disease. METHODS: Forty systemically healthy patients aged between 25 and 55 years of age and with chronic periodontitis were randomly divided into two groups. The test group was administered Septilin® tablets for two weeks following scaling and root planing whereas the control group was treated by scaling and root planing alone. Changes in gingival index (GI), gingival bleeding index (GBI), serum C-reactive protein (CRP) levels and salivary tumour necrosis factor-alpha (TNF-α) levels were assessed at day 0, at two weeks, and at three and six months. RESULTS: The GI and GBI showed a statistically significant reduction at two weeks, three months and six months (P<0.001) in both groups. Salivary TNF-α level reduction was significant in the test group only (P<0.001). No significant change was found in serum CRP levels in both groups (P>0.05). CONCLUSION: In this pilot evaluation, Septilin® was found to be a safe and effective immunomodulator as an adjunct to routine periodontal therapy. Further long-term studies to test Septilin® on larger sections of the population are recommended.

Effect of environmental tobacco smoke from smoker parents on gingival pigmentation in children and young adults: a cross-sectional study.

BACKGROUND: Non-smokers exposed to environmental tobacco smoke (ETS) absorb nicotine and other compounds just as smokers do, and as the exposure to ETS increases, the level of these harmful compounds in the body also increases. The ill effects of ETS range from gingival pigmentation to lung cancer and death. The exposure to ETS is difficult to quantitatively measure and has been approximated by self-reported estimates, primarily of the smoking history of spouses. However, the documentation of gingival pigmentation in non-smokers is meager and has remained contentious. We aimed to assess the effects of ETS from smoker parents on gingival pigmentation in children and young adults and assess the urine cotinine levels in these individuals. METHODS: A total of 153 non-smoking participants with ≥1 smoker parent were randomly selected from the outpatient Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Center, Bangalore, India. These participants were divided into three groups based on age, and the smoking history of parents was established by an interview with participants and parents. The degree of gingival pigmentation of participants was assessed by using the gingival pigmentation index and a standardized digital oral photograph. A urine analysis was conducted to assess levels of cotinine. The κ statistic was performed for interexaminer agreement, and χ(2) and Fisher exact tests were used for statistical analyses. RESULTS: The prevalence of gingival pigmentation in passive smokers was statistically significant (P <0.05). Increased levels of urinary cotinine were observed in all three groups with the highest levels in group 3 (19 to 24 years old). CONCLUSION: This study depicts the effects of ETS on gingival melanin pigmentation.