Safety and Clinical Evaluation of a Sonic Tongue Brush.

BACKGROUND: Tongue coating consists of oral bacteria, desquamated epithelium, blood cells, and food residues and is involved in periodontal disease, halitosis, and aspiration pneumonia. Recently, a tongue brush with sonic vibration was developed to clean the tongue. This comparative study examined the extent of tongue coating, its effects on the tongue, bacterial count particularly on the posterior dorsum of the tongue, and the degree of pain using a manual tongue brush and the newly developed sonic tongue brush. MATERIALS AND METHODS: Patients' extent of tongue coating and the quantity of bacteria were analysed before and after brushing with a sonic or manual nylon tongue brush. Moreover, the impressions of the dorsum linguae were obtained before and after brushing to establish models that were observed under a stereo microscope to evaluate tongue trauma. Pain caused during the use of these brushes was evaluated based on the numerical rating scale (NRS). RESULTS: The extent of tongue coating and number of bacteria decreased in both the sonic and manual nylon brush groups after tongue cleaning; however, no significant differences were noted. Tongue trauma evaluation revealed that the tongue surface was significantly scratched in the manual brush group compared with the sonic brush group. NRS-based pain evaluation revealed no significant differences. CONCLUSIONS: The sonic brush was equally effective in removing tongue coating and bacteria compared with the manual brush. As the sonic brush does not cause tongue trauma, it may be considered a safe and effective cleaning tool of the tongue.

Effects of One-Stage Full-Mouth Scaling and Root Planing with Azithromycin on Diabetes and Periodontal Disease: A Randomized Controlled Trial.

Recent reports show that hemoglobin A1c (HbA1c) can be lowered by improving chronic inflammation in periodontal patients with diabetes mellitus and that full-mouth scaling and root planing (FM-SRP), in combination with azithromycin (AZM) treatment, can reduce early periodontal inflammation. However, the association of FM-SRP and AZM with periodontitis and HbA1c in patients with diabetes is largely unknown. This study investigated periodontitis and HbA1c in patients with diabetes after receiving FM-SRP and AZM to evaluate which clinical parameters most reflect the diabetic condition. Fifty-one periodontal patients with diabetes mellitus were included in this study. In total, 25 patients were assigned to the FM-SRP group in which patients were treated with FM-SRP in combination with AZM, and 26 patients were assigned to the control group in which only supragingival calculus removal was performed along with the provision of oral hygiene instructions. We evaluated periodontal parameters (probing pocket depth, periodontal inflamed surface area (PISA), bleeding on probing), and periodontal bacteria and biochemical parameters (HbA1c, high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1)) at baseline (BL) and 1, 3, 6, and 9 months after treatment. Compared with BL values, the FM-SRP group showed improved clinical parameters, reduced periodontal pathogens, and significantly lower HbA1c. Inflammatory cytokines (hs-CRP, TNF-α, IL-6) were significantly reduced one month after treatment and remained low thereafter. MCP-1 did not change significantly during the experimental period. PISA showed a strong correlation with HbA1c, hs-CRP, and TNF-α. FM-SRP, in combination with AZM, produced clinical, microbiological, and HbA1c improvements in periodontal patients with previously diagnosed diabetes mellitus. Additionally, PISA was shown to be a useful index for assessing the diabetic status of patients with periodontal disease.

Effect of Nd: YAG laser irradiation to the temporomandibular joint on taste threshold.

BACKGROUND/PURPOSE: The tissue absorption laser has been clinically applied to alleviate pain in various areas. It is used for pain relief from temporomandibular disease (TMD) in dentistry. Although the facial and trigeminal nerves are distributed around the temporomandibular joint, the effects of laser irradiation and absorption on the neural functions have not been directly studied. In this study, the Nd:YAG laser was applied to an area where the facial nerve passes with photonic radiation for the treatment of TMD. MATERIALS AND METHODS: Ten volunteers including seven males and three females were selected as subjects. Nd:YAG laser was irradiated area included several internal and external standard and associated acupuncture points. The chorda tympani nerve, a branch of facial nerve is distributed to the front two thirds of the tongue and is associated with the sense of taste. We evaluated the effect of laser irradiation and absorption on the taste function by means of an electric taste meter. RESULTS: No significant difference was identified in the values between before and after laser irradiation (Wilcoxon signed-rank test). CONCLUSION: It was confirmed that there was no effect on taste function while applying Nd:YAG laser irradiation around the TMD joint.

Effects of Antimicrobial Photodynamic Therapy on Organic Solution and Root Surface In Vitro.

Antimicrobial photodynamic therapy (a-PDT) is attracting attention as a new form of dental treatment. While it is primarily applied to produce an antibacterial effect, it decreases lipopolysaccharide (LPS) and protease activity. Here, we evaluated differences in the antibacterial activity of a-PDT on three types of bacteria and the effects on the organic substances (i.e., albumin and LPS). Furthermore, we investigated the effects of a-PDT on root surfaces. A FotoSan630® and toluidine blue were used to perform a-PDT in this study. We measured its antimicrobial activity against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis. Antimicrobial testing revealed strong antimicrobial action and P. gingivalis, E. faecalis, and S. mutans were almost undetectable after 50, 120, and 100 s, respectively. In organic resolution tests, albumin was significantly decreased from 1 min after a-PDT application onward, while LPS significantly decreased at 5 min after the application. The root surfaces after a-PDT were confirmed to be cleaner than the controls without suffering any damage. Depending on the bacterial species, a-PDT exhibited antimicrobial activity against various types of bacteria and sensitivity differed. Moreover, we reported that a-PDT resolves protein and LPS, enabling the formation of a healthy root surface without any damage.

Effect of Azithromycin on Proinflammatory Cytokine Production in Gingival Fibroblasts and the Remodeling of Periodontal Tissue.

Previous reports have shown that azithromycin (AZM), a macrolide antibiotic, affects collagen synthesis and cytokine production in human gingival fibroblasts (hGFs). However, there are few reports on the effect of AZM on human periodontal ligament fibroblasts (hPLFs). In the present study, we comparatively examined the effects of AZM on hGFs and hPLFs. We monitored the reaction of AZM under lipopolysaccharide (LPS) stimulation or no stimulation in hGFs and hPLFs. Gene expression analyses of interleukin-6 (IL-6), interleukin-8 (IL-8), matrix metalloproteinase-1 (MMP-1), matrix metalloproteinase-2 (MMP-2), and Type 1 collagen were performed using reverse transcription-polymerase chain reaction (RT-PCR). Subsequently, we performed Western blotting for the analysis of the intracellular signal transduction pathway. In response to LPS stimulation, the gene expression levels of IL-6 and IL-8 in hGFs increased due to AZM in a concentration-dependent manner, and phosphorylation of nuclear factor kappa B (NF-κB) was also promoted. Additionally, AZM caused an increase in MMP-1 expression in hGFs, whereas it did not affect the expression of any of the analyzed genes in hPLFs. Our findings indicate that AZM does not affect hPLFs and acts specifically on hGFs. Thus, AZM may increase the expression of IL-6 and IL-8 under LPS stimulation to modify the inflammatory response and increase the expression of MMP-1 to promote connective tissue remodeling.

Organic resolution function and effects of platinum nanoparticles on bacteria and organic matter.

Rapid progress has been made in terms of metal nanoparticles studied in numerous fields. Metal nanoparticles have also been used in medical research, and antibacterial properties and anticancer effects have been reported. However, the underlying mechanism responsible for these effects has not been fully elucidated. Therefore, the present study focused on platinum nanoparticles (PtNPs) and examined their antibacterial properties and functional potential for decomposing organic matter, considering potential applications in the dental field. PtNPs were allowed to react with dental-related bacteria (Streptococcus mutans; Enterococcus faecalis, caries; Porphyromonas gingivalis, and endodontic and periodontal lesions). Antibacterial properties were evaluated by measuring colony formation. In addition, PtNPs were allowed to react with albumin and lipopolysaccharides (LPSs), and the functional potential to decompose organic matter was evaluated. All evaluations were performed in vitro. Colony formation in all bacterial species was completely suppressed by PtNPs at concentrations of >5 ppm. The addition of PtNPs at concentrations of >10 ppm significantly increased fragmentation and decomposition. The addition of PtNPs at concentrations of >125 pico/mL to 1 EU/mL LPS resulted in significant amounts of decomposition and elimination. The results revealed that PtNPs had antibacterial effects against dental-related bacteria and proteolytic potential to decompose proteins and LPS, an inflammatory factor associated with periodontal disease. Therefore, the use and application of PtNPs in periodontal and endodontic treatment is considered promising.

Biological responses following one-stage full-mouth scaling and root planing with and without azithromycin: Multicenter randomized trial.

BACKGROUND AND OBJECTIVE: Full-mouth scaling and root planing (FM-SRP) increases the systemic levels of inflammatory mediators via early inflammation but may be inhibited using an antimicrobial agent. This prospective intervention study evaluates the biological response and clinical effects of FM-SRP with and without systemically administered azithromycin (AZM). MATERIALS AND METHODS: A multicenter parallel randomized controlled and open-label trial. A central randomization center used computer-generated tables to allocate treatments. Sixty-three patients with moderate to severe generalized periodontitis (New American Academy of Periodontology Classification: Stage3 or 4, Grade B) were randomly assigned to receive FM-SRP with AZM (test group, n = 32) or FM-SRP without AZM (control group, n = 31). Clinical parameters and body temperature were measured, and subgingival plaque, peripheral blood, and gingival crevicular fluid were collected before and after treatment. Periodontopathic bacteria and IgG titers were measured by gingival crevicular fluid and peripheral blood. High-sensitivity assays were used to analyze systemic and local inflammatory markers, such as endotoxin, high-sensitive CRP (hs-CRP), and six inflammatory cytokines. Follow-up 6 weeks. RESULTS: The total number of bacteria and the number of Porphyromonas gingivalis and Prevotella intermedia were significantly lower in the test group after FM-SRP. IgG titers for P gingivalis significantly decreased after FM-SRP with AZM, and the body temperature increased significantly after FM-SRP without AZM. In the control group, serum hs-CRP, IFN-γ, IL-12p70, and IL-6 were significantly increased one day after treatment, but subsequently decreased below the original numerical value. In the test group, only hs-CRP showed a significant increase. CONCLUSIONS: FM-SRP resulted in similar improvements in clinical parameters with and without the use of AZM. Inflammatory mediators showed no difference between the two groups after FM-SRP treatment. The use of AZM was effective in preventing the elevation of body temperature after FM-SRP.

Effect of the Keratinized Mucosa Width on the Health Status of Periimplant and Contralateral Periodontal Tissues: A Cross-sectional Study.

INTRODUCTION: The purpose of this study was to examine whether the width of keratinized mucosa (WKM) is associated with the health status of tissue surrounding dental implants and the contralateral teeth. MATERIALS AND METHODS: Sixty patients who received implant-fixed unilateral prostheses in the premolar or molar region were recruited for the study. The following parameters were measured for each implant and contralateral tooth: WKM, gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), pus discharge, plaque accumulation (PA), gingival recession (GR), and difficulty of brushing. The effect of the WKM on the health status of the surrounding tissue was evaluated by comparing the different WKM groups (WKM < 2 mm vs WKM ≥ 2 mm). RESULTS: Implants with a WKM <2 mm demonstrated significantly greater PPD, PA, and a higher rate of BOP compared with implants with a WKM ≥2 mm. There was significantly greater GR in contralateral teeth with a WKM <2 mm compared with a WKM ≥2 mm. In addition, implant sites had a higher rate of BOP compared with the contralateral teeth. CONCLUSIONS: Inadequate keratinized mucosa decreased cleansibility of implant sites and increased mucosal inflammation. There is a possibility that PA in implant sites caused more pronounced inflammatory response compared to contralateral tooth.

One-stage full-mouth versus partial-mouth scaling and root planing during the effective half-life of systemically administered azithromycin.

BACKGROUND: One-stage full-mouth scaling and root planing (FM-SRP) in combination with systemically administered azithromycin was shown to be clinically and bacteriologically effective in the treatment of chronic periodontitis. However, FM-SRP requires 2 hours for completion. Azithromycin has a long half-life. Therefore, if SRP of the full mouth is performed within 7 days while an effective concentration of azithromycin remains in the gingiva, the effects may be the same as FM-SRP. The aim of this study was to compare the clinical and bacteriologic effects of FM-SRP and partial-mouth scaling and root planing (PM-SRP) in patients with chronic periodontitis, which was performed in three sessions within 7 days, during the effective half-life of systemically administrated azithromycin. METHODS: Thirty adult subjects with chronic periodontitis were randomly divided into three groups (FM-SRP, PM-SRP, and control). A clinical examination was conducted to record the probing depth, clinical attachment level gain, bleeding on probing, gingival index, and volume of gingival crevicular fluid; bacterial samples were obtained before treatment and 1, 3, 6, 9, and 12 months thereafter. Quantitative and qualitative analyses were performed using the polymerase chain reaction-Invader method. RESULTS: All clinical parameters showed better improvement in FM-SRP and PM-SRP groups compared to the control group, with no significant differences between the two test groups. Periodontal bacteria were well controlled in the two test groups, but they tended to increase gradually 3 months after treatment in the control group. CONCLUSION: PM- and FM-SRP demonstrated comparable clinical and bacteriologic results.

Drug concentration in inflamed periodontal tissues after systemically administered azithromycin.

BACKGROUND: Azithromycin is an azalide antibiotic, effective against a wide range of oral bacteria including periodontopathic bacteria. Azithromycin is taken up by phagocytes and is released into inflamed tissue over time. The concentration of azithromycin in inflamed periodontal tissues over time has not been studied. In this study, we determined the azithromycin concentration in the gingiva and inflammatory connective tissue of the periodontal pocket in periodontal patients who had been administered azithromycin systemically. We also evaluated the clinical and microbiologic effects of azithromycin. METHODS: Thirty-four patients with periodontitis were prescribed azithromycin 500 mg once daily for 3 days. During the 14-day study, clinical parameters (probing depth, gingival index, bleeding on probing, and gingival crevicular fluid level) were recorded, subgingival plaque was collected for bacteriologic examination, and the azithromycin concentration in the tissues lining the periodontal pocket was measured by agar diffusion bioassay. RESULTS: Clinical parameters significantly improved after administration of azithromycin. The total number of cultivated bacteria also significantly decreased by day 4 but slightly increased after day 7. Sustained reduction in levels of six periodontopathic bacteria was not apparent until day 14. On day 7, the azithromycin concentration in the tissues lining the periodontal pockets was 50% of that on day 4, and on day 14 only 20%. CONCLUSION: Azithromycin is detectable in inflamed periodontal tissues >or=14 days after systemic administration; it is associated with clinical and microbiologic improvement.

Effects of full-mouth scaling and root planing in conjunction with systemically administered azithromycin.

BACKGROUND: One-stage full-mouth disinfection (FMD), in which full-mouth scaling and root planing (SRP) is performed with adjunctive use of chlorhexidine, was introduced in 1995. There have been several reports on the effectiveness of this treatment protocol. However, FMD was reported to induce pyrexia frequently. We examined the effects of full-mouth SRP in conjunction with azithromycin administered orally before SRP to control the number of bacteria. The purpose of this study was to compare the effects of full-mouth SRP using azithromycin with conventional SRP. METHODS: Thirty-four subjects (17 in the test group and 17 in the control group) with severe chronic periodontitis were selected. The subjects of the test group had azithromycin 3 days before full-mouth SRP. Clinical parameters (probing depth [PD], gingival index [GI], bleeding on probing [BOP], and gingival crevicular fluid [GCF]), total number of bacteria, and number of black pigment-producing rods (BPRs) were evaluated at baseline and 5, 13, and 25 weeks after baseline. RESULTS: All clinical parameters improved in the test group more than in the control group. In the bacteriologic examination, the total number of bacteria did not change during the examination. In the test group, BPRs were not detected until 13 weeks. However, BPRs were detected in the control group by 13 weeks. CONCLUSION: It was shown that full-mouth SRP using systemically administered azithromycin was a clinically and bacteriologically useful basic periodontal treatment for severe chronic periodontitis.

Application of thermography in dentistry--visualization of temperature distribution on oral tissues.

The purpose of this study was to devise and propose appropriate conditions for the photographing of thermal images in the oral cavity and to evaluate which thermography techniques can be applied to dentistry by evaluating the differences in temperature among oral tissues. Thermal images of oral cavities of 20 volunteers in normal oral condition were taken according to the guidelines of the Japanese Society of Thermography, with five added items for oral observation. The use of a mirror made it possible to take thermal images of the posterior portion or palate. Teeth, free gingiva, attached gingiva and alveolar mucosa were identified on thermal images. There were differences in temperature between teeth, free gingiva, attached gingiva and alveolar mucosa. These were nearly in agreement with the anatomical view. Thermography need no longer be restricted to the anterior portion using a mirror, and can now be applied to the dental region.