[The Intensified Dental Preventive Programme in Rhineland-Palatinate: Investigations on first-grade school-children in 2013/2014]. / Die zahnärztliche selektive Intensivprophylaxe in Rheinland-Pfalz: Untersuchungen an Erstklässlern im Schuljahr 2013/2014.

Aim: For children and adolescents at increased risk of caries, the "Selective Intensive Prophylaxis" (SIP) programme was established in Rhineland-Palatinate in 2004, as well as in the most other German states. This study compares the results of the school dentists' evaluations of first grade school children in 2013/2014 participating in the "Selective Intensive Prophylaxis" (SIP) programme or the "Standard Programme" (SP). Methods: The d3mft/D3MFT index was recorded by school dentists according to the WHO criteria; caries was diagnosed if dentin was affected; no radiography or fiber-optic transillumination was used. The examinations were performed once under the SP and twice under the SIP. Children and parents were informed in case of a need for treatment and reminded if the did not see the family dentist. Out of the evaluated d3mft/D3MFT values, the Significant Caries Index (SiC) was calculated. Statistical computing was performed using SPSS 22.00. Results: Of all first graders, n=25 020 were evaluable for d3mft/D3MFT. Altogether n=1 164 first graders were included into the SIP in the 2013/2014 term; for n=1 002 of those, the results for both examinations were available. The caries experience of those pupils participating in the SIP was clearly higher than in the SP (41.8% naturally healthy vs. 61.7%, p<0.0001). There was significant difference between the first and second examination in the SIP, especially with respect to individual (16.0 vs. 23.0%, p<0.0001) and tooth-related (43.2 vs. 54.2%, p<0.0001) level of restoration. Conclusion: The results show that the SIP in Rhineland-Palatinate is conducted in a population with high caries experience. The significant difference concerning the dental restoration level, both individual- and teeth-related - leads to the conclusion that children frequently sought dental treatment if a need for treatment was diagnosed by the school dentist.

Effectiveness of a miswak extract-containing toothpaste on gingival inflammation: a randomized clinical trial.

OBJECTIVES: In this study, the efficacy of a miswak extract-containing toothpaste (Salvadora persica) on gingival inflammation was compared with that of a herbal and a conventional toothpaste. METHODS: Non-smoking outpatients with sulcus bleeding index (SBI) ≥25% and with periodontal pocket depths ≤3 mm were randomly selected and divided into three groups: M-group, miswak extract-containing toothpaste; P-group, herbal toothpaste; and C-group, conventional toothpaste. After instructing the patients to brush their teeth twice a day for 3 weeks with the assigned toothpaste using a flat-trimmed manual toothbrush, a thorough oral examination was performed by a calibrated examiner (EH). The primary outcome was the SBI after 21 days. Furthermore, the amount of plaque was measured by approximal plaque index (API). RESULTS: Sixty-six patients with a mean age of 57.8 ± 10.2 years were recruited and enrolled. After 3 weeks of brushing, all three patient groups showed a significant reduction in SBI. The P-group (SBI reduction: 17.1% ± 9.1) and the M-group (14.5% ± 8.1) showed the strongest effect followed by the C-group (9.4% ± 7.8). All three groups showed a significant reduction in API without significant differences between the groups. CONCLUSIONS: The use of each of the three tested toothpastes caused a significant reduction in gingival inflammation and amount of plaque. The miswak extract-containing toothpaste showed a similar effect as the herbal toothpaste and can be safely used for domestic oral hygiene in patients with gingivitis.

Braces versus Invisalign®: gingival parameters and patients' satisfaction during treatment: a cross-sectional study.

BACKGROUND: Fixed orthodontic appliances (FOA) temporarily interfere with periodontal health of patients, as the appliance complicates oral hygiene. The use of aligners in orthodontic therapy increased strongly during the last decade. In the literature, the reports about effects of aligner treatment on oral hygiene and gingival conditions are scarce. This cross-sectional study evaluated oral hygiene and patient's satisfaction during orthodontic treatment of patients with FOA or Invisalign®. METHODS: 100 patients (FOA = 50, Invisalign® = 50) were included who underwent orthodontic treatment for more than 6 months. Clinical examinations were performed to evaluate patients' periodontal condition and were compared with clinical data at the beginning of the orthodontic treatment. Oral hygiene, patients' satisfaction and dietary habits were documented by a detailed questionnaire. For statistical analysis, the Mann-Whitney U-Test and Fisher's Exact Test were used; as multiple testing was applied, a Bonferroni correction was performed. RESULTS: At the time of clinical examinations, patients with FOA were in orthodontic therapy for 12.9 ± 7.2 months, whereas patients with Invisalign® were in orthodontic therapy for 12.6 ± 7.4 months. Significantly better gingival health conditions were recorded in Invisalign® patients (GI: 0.54 ± 0.50 for FOA versus 0.35 ± 0.34 for Invisalign®; SBI: 15.2 ± 7.6 for FOA versus 7.6 ± 4.1 for Invisalign®), whereas the amount of dental plaque was also less but not significantly different (API: 37.7 % ± 21.9 for FOA versus 27.8 % ± 24.6 for Invisalign®). The evaluation of the questionnaire showed greater patients' satisfaction in patients treated with Invisalign® than with FOA. CONCLUSION: Patients treated with Invisalign® have a better periodontal health and greater satisfaction during orthodontic treatment than patients treated with FOA.

Clinical and transperineal ultrasound findings in females with stress urinary incontinence versus normal controls.

Study was aimed at comparing clinical and transperineal ultrasound findings of females with stress urinary incontinence and normal controls. Between 2004 and 2005, 40 women with stress urinary incontinence (mean age 47.5 years) diagnosed by history via ICIQ-SF (International consultation on Incontinence Questionnaire-Short Form) and 40 healthy female volunteers without any incontinence or LUTS (mean age 42.1 years) underwent transperineal ultrasonography for determination of posterior urethrovesical (beta) angle, bladder neck funneling and hypermobility of urethra. These findings were compared between patients and controls with regard to clinical data. Beta angle wider than 130 degrees, bladder neck funneling and hypermobility of urethra with transperineal ultrasonography were more common among cases than controls. LR (Likelihood Ratio) for urinary incontinence of these parameters was 2.5, 2.1 and 2, respectively. Perineal ultrasonography is highly associated with clinical findings. Hypermobility of urethra had highest sensitivity for diagnose of stress urinary incontinence but the specificity of bladder neck funneling in perineal sonography was higher.

Cephalosporin 3'-phloroglucide esters and 7-(phloroglucidamido) cephalosporins as novel antibacterial agents.

Two series of new phloroglucide derivatives were synthesized that possessed antibacterial activities. The first series includes cephalosporin 3'-phloroglucide esters 19 and 20, which were obtained by condensation of cephalosporin 16 with bioactive phloroglucides 14 and 15, respectively. They exhibited a dual mode of antibacterial action. In comparison with cephalosporins 26 and 27, bearing an acetoxy unit at the C-3' position, the bifunctional cephalosporins 19 and 20 showed a broadened spectrum of activity. Results from the consistent valence force field (CVFF) calculations indicate that the most stable conformational isomer of phenolic acid 14, holding a cis-syn-syn geometry, possessed a cavity. It provides an ideal environment to accommodate metal ions of holoenzymes. Phenolic keto acid 15, however, possessed a trans-anti-syn conformation, which allowed chelation between metal ions and the phenolic hydroxyl groups as well as the carbonyl functionalities. Our biological results show that the cavity formed in phloroglucides plays an important role. The second series includes 7-(phloroglucidamido)cephalosporins 24 and 25, which were synthesized by condensation of cephalosporin 21 with 14 and 15, respectively. Results from the CVFF calculations indicate that cephalosporin 24 also possessed a cavity. Unlike cephalosporin 3'-phloroglucide esters 19 and 20, cephalosporins 24 and 25 were found resistant to beta-lactamases from Staphylococcus aureus 95 and Pseudomonas aeruginosa 18S-H. These new compounds, however, showed notable activities against S. aureus FDA 209P, S. aureus 95, Candida albicans, P. aeruginosa 1101-75, and P. aeruginosa 18S-H.