Efficacy of 0.12% Chlorhexidine and Salvadora persica-based Mouthwash in Reducing Oral Candida Carriage and Periodontal Inflammation in Cigarette Smokers and Non-smokers after Non-surgical Periodontal Therapy.

PURPOSE: The present study assessed the efficacy of 0.12% chlorhexidine (CHX) and Salvadora persica-based mouthwashes (SPM) in reducing oral Candida carriage (OCC) and periodontal inflammation in cigarette smokers and non-smokers after non-surgical periodontal treatment (NSPT). MATERIALS AND METHODS: Self-reported cigarette smokers and non-smokers with periodontal inflammation as well as non-smokers with a healthy periodontal status were included. NSPT was performed in all participants. Based on the type of mouthwash, participants were randomly divided into three groups as follows: group 1: CHX; group 2: SPM; and group 3: distilled water (ddH2O) with mint flavour (control group). Clinical attachment loss (CAL), plaque index (PI), gingival index (GI), probing depth (PD), and marginal bone loss (MBL) were measured. Clinical periodontal parameters were re-assessed at a 6-week follow-up. Oral yeast samples were collected and identified using a concentrated oral-rinse culture technique and PCR, respectively. Clinical and laboratory-based investigations were done at baseline and after six weeks. Statistical significance was set at p < 0.05. RESULTS: At baseline, PI, MBL, PD and CAL were comparable in all participants. None of the patients had periodontitis at baseline. Post-operatively, CHX and SPM were more effective in reducing PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) in non-smokers than in the control group. The OCC was statistically significantly higher among smokers compared with non-smokers at baseline. At the 6-month follow-up, CHX was more effective than SPM in reducing OCC in non-smokers (p < 0.01). At the 6-week follow-up, there was no difference in OCC among cigarette smokers regardless of the type of mouthwash prescribed postoperatively. CONCLUSION: In cigarette smokers and non-smokers, CHX and SPM are effective in reducing periodontal soft-tissue inflammation after NSPT. Post-operative use of CHX is more effective than SPM in reducing OCC.

Short-term influence of antimicrobial photodynamic therapy as an adjuvant to mechanical debridement in reducing soft-tissue inflammation and subgingival yeasts colonization in patients with peri-implant mucositis.

OBJECTIVE: The objective of this short-term follow-up study was to evaluate the influence of antimicrobial photodynamic therapy (aPDT) as an adjuvant to mechanical debridement (MD) in reducing soft-tissue inflammation and subgingival yeasts colonization (SYC) in patients with peri­implant mucositis (PiM). METHODS: Individuals diagnosed with PiM were included. Demographic data was collected using a questionnaire. Peri-implant plaque index (PI), bleeding index (BI), probing depth (PD), crestal bone levels and SYC were measured at baseline. Therapeutically, these individuals were divided into test and control groups. In the control-group patients underwent MD and in the test-group patients underwent MD with adjunct single session of aPDT. Clinical peri­implant parameters and SYC were reassessed after 12-weeks. Correlation between age, gender and duration of implants with SYC and clinical peri­implant status was assessed using logistic regression models. P < 0.05 was selected as an indicator of statistical significance. RESULTS: The test and control-groups comprised of 24 and 23 individuals, respectively. In the test and control groups, toothbrushing twice daily was reported by 7 (29.2%) and 5 (21.7%) individuals, respectively. None of the individuals had ever used a dental floss. At baseline, there was no difference in peri­implant PI, BI, PD and CBL in the test and control groups. At follow-up, peri­implant PI (P < 0.01), BI (P < 0.01) and PD (P < 0.01) were significantly higher in the control compared with the test-group. At baseline, SYC in the test and control groups were 1865.3 ± 403.4 CFU/ml and 1963.7 ± 512.4 CFU/ml, respectively. At 90 days' follow-up, SYC in the test and control groups were 1472 ± 202.7 and 1538.4 ± 331.7 CFU/ml, respectively. There was no significant difference in SYC in both groups when baseline values were compared with 90 days' follow-up. CONCLUSION: One session of aPDT after MC with adjunct aPDT is effective in reducing soft tissue inflammation but not SYC in patients with PiM.

Effect of non-surgical periodontal therapy with adjunct photodynamic therapy on periodontal and glycemic statuses in prediabetic patients with periodontal disease.

OBJECTIVE: Studies have shown that non-surgical periodontal therapy (NSPT) helps reduce periodontal inflammation and glycemic levels in patients with type-2 diabetes mellitus; however, the role of NSPT with adjunct photodynamic therapy on glycemic status and periodontal parameters in prediabetic patients remains unclear. The aim of the present study was to assess the effect of NSPT with and without adjunct PDT on periodontal and glycemic statuses in prediabetic patients with periodontal disease. METHODS: Prediabetic (Group-1) and non-diabetic (Group-2) patients diagnosed with periodontal inflammation were included. In both groups, patients were randomly assigned to test and control-groups. In the test- and control groups, patients underwent NSPT with and without adjunct PDT, respectively. The following parameters were assessed at baseline and at four weeks' follow-up: plaque index (PI); gingival index (GI), probing depth (PD), clinical attachment loss (CAL) and hemoglobin A1c (HbA1c). Collection of demographic data and assessment of full mouth marginal bone loss was performed at baseline. Level of significance was set at P < 0.05. RESULTS: At baseline, there was no difference in PI, GI and PD among patients with and without prediabetes. At 3-weeks' follow up there was no difference in PI, GI and PD among patients without prediabetes. PI (P < 0.01), GI (P < 0.01) and PD (P < 0.01) were significantly higher in the control-group compared with the test-group at 3-weeks' follow-up in patients without prediabetes. The HbA1c levels were significantly higher in patients with prediabetes throughout the study duration compared with individuals without prediabetes. CONCLUSION: One session of NSPT with or without PDT reduce periodontal inflammation but do not influence glycemic levels in prediabetic patients.

Association of Peri-Implant Health Status With COVID-19.

OBJECTIVE: The aim of this research was to evaluate peri-implant health status in patients infected with COVID-19 and control patients (individuals without COVID-19). METHODS: This observational investigation was performed in adults with (test group) and without (control group) COVID-19 infection having at least 1 functional dental implant. Self-reported education status and daily frequency of toothbrushing and flossing was determined. A questionnaire was administered to record demographic data, brushing/flossing frequency, and education status. Periodontal examination comprised full-mouth assessment of clinical attachment loss (CAL), plaque index (PI), probing depth (PD), and gingival index (GI). Peri-implant PD, modified PI, and modified gingival index were recorded. Loss of marginal and crestal bone around teeth and implants was also measured. Significance level was established for P < .05. RESULTS: Seventy-three (41 males) and 71 (44 males) individuals were included in the test and control groups, respectively. Average ages of patients and controls were 44.6 ± 5.2 and 40.1 ± 3.1 years, respectively. University-level education was attained by 52 (75.3%) and 50 (70.4%) individuals in the test and control groups, respectively. Seventy (95.9%) and 68 (95.7%) patients and controls were brushing twice a day. Once-daily interproximal flossing was reported by 44 (60.3%) and 48 (67.6%) individuals in test and control groups. All participants had healthy periodontal and peri-implant tissues. CONCLUSIONS: The study indicated that there are no short-term adverse effects on the peri-implant tissues due to acute COVID-19 infection, and further well-controlled longitudinal studies are needed to evaluate the long-term effect of the infection on these tissues.

Levels of peri-implant sulcular fluid levels of soluble urokinase plasminogen activator receptor and TNF-α among cigarette smokers and non-smokers with peri-implantitis.

BACKGROUND: Soluble urokinase plasminogen activator receptor (suPAR) and tumor necrosis factor-alpha (TNF-α) are inflammatory biomarkers. No studies have yet assessed the suPAR levels in relation with TNF-α in the peri-implant sulcular fluid (PISF) among cigarette smokers and non-smokers with peri-implantitis. OBJECTIVE: The aim was to evaluate PISF levels of suPAR, and TNF-α among cigarette smokers and non-smokers with and without peri-implantitis. METHODS: Sixty male patients with peri-implantitis were included. There were 20 cigarette smokers and 20 and non-smokers with peri-implantitis (Groups 1 and 2), and 20 non-smokers without peri-implantitis (Group 3). Demographic data and information related to cigarette smoking was recorded. Peri-implant clinicoradiographic parameters (plaque index [PI], gingival index [GI], probing depth [PD] and crestal bone loss [CBL]) were assessed. The PISF samples were collected and levels of suPAR and TNF-α were measured. Sample-size estimation was performed and all parameters were statistically assessed. Level of significance was set at P< 0.05. RESULTS: Sixty individuals were included in Groups 1, 2 and 3 (20 in each). Peri-implant PI (P< 0.01), PD (P< 0.01) and mesial (P< 0.01) and distal (P< 0.01) CBL were significantly higher in Group 1 than in Groups 2 and 3. The PISF volume (P< 0.01) and suPAR (P< 0.01) and TNF-α levels (P< 0.01) were significantly higher in Groups 1 and 2 than in Group 3. There was no difference in PISF volume and suPAR and TNF-α levels between patients in Groups 1 and 2. In Group 2, there was a statistically significant correlation between peri-implant PD and PISF suPAR and TNF-α levels (P< 0.01). The suPAR and TNF-α levels are expressed in high concentrations in the PISF of smokers and non-smokers with peri-implantitis compared with non-smokers without peri-implantitis. CONCLUSION: In non-smokers, PISF suPAR and TNF-α levels are correlated with peri-implant PD.

Role of Chlorhexidine and Herbal Oral Rinses in Managing Periodontitis.

OBJECTIVE: The aim of this research was to assess the effect of 0.12% chlorhexidine (CHX) and a Salvadora persica-based mouthwash on whole salivary tumour necrosis factor-alpha (TNF-α) levels and periodontal inflammation in patients with type 2 diabetes mellitus (T2DM). METHODS: Patients with and without medically diagnosed T2DM were included. Patients' medical records were evaluated to confirm the diagnosis of T2DM. All patients underwent nonsurgical periodontal therapy (NSPT). Patients were divided into 2 subgroups. In the test and control group, patients were advised to rinse with an S persica-based mouthwash and a non-alcoholic 0.12% CHX after NSPT twice daily for 2 weeks, respectively. Demographic data were collected. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were measured, and whole salivary TNF-α levels were gauged at baseline and at 3-month follow-up. Haemoglobin A1c (HbA1c) levels were measured in all patients at baseline and at 3-month follow-up. Sample size estimation was done, and group comparison was performed. Level of significance was set at P < .01. RESULTS: Twenty-one nondiabetic individuals and 21 patients with T2DM were included. At baseline, there was no significant difference in clinical and radiographic periodontal parameters amongst in patients with and without T2DM. At 3-month follow-up, HbA1c, TNF-α, PI, PD, and clinical AL were comparable with their respective baseline values in the test and control groups amongst patients with T2DM. In nondiabetic individuals, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01), and TNF-α (P < .01) at 3-month follow-up in the test and control groups compared with their respective baseline scores. CONCLUSIONS: In the short term, NSPT with 0.12% CHX or S persica-based mouthwashes is more effective in reducing periodontal inflammation and whole salivary TNF-α levels in nondiabetic individuals than in patients with T2DM with periodontal inflammation.

Levels of whole salivary advanced glycation end products and interleukin-17 and peri-implant clinical and radiographic status in patients with osteoporosis at 6-years' follow-up.

BACKGROUND: There are no studies that have assessed advanced glycation end products (AGEs) and interleukin 17A (IL-17A) levels in whole saliva (WS) of patients with dental implants. The aim was to compare levels of AGEs and IL-17A in WS and peri-implant clinical and radiographic status of patients with and without osteoporosis at 6-years' follow-up. METHODS: Osteoporotic (Group-1) and systemically healthy controls (Group-2) having undergone dental implant therapy at least 5 years ago were included. A questionnaire was used to collect information about age, gender, duration and treatment of osteoporosis, number and duration of implants in function, and frequencies of toothbrushing, flossing and hygiene visits. Modified bleeding and plaque indies (mBI and mPI), peri-implant probing depth (PD) and crestal bone loss (CBL) were recorded. WS was collected and levels of AGEs and IL-17A were determined using enzyme linked immunosorbent assay. Sample-size estimation was done and statistical analyses were doing using the independent t- and Wilcoxon rank-sum tests. Statistical significance was marked for P-values that were below 0.01. RESULTS: In patients with (n = 24) and without (n = 27) osteoporosis, implants were in function for 6.3 ± 0.27 and 6.6 ± 0.5 years, respectively. There was no significant difference in peri-implant mBI, PD, mPI and CBL in both groups. Levels of AGE in patients with (119.6 ± 26.5 µg/ml) and without (91.5 ± 14.6 µg/ml) osteoporosis were comparable. Levels of whole salivary IL-17A in patients without and with osteoporosis were 4.6 ± 0.3 and 5.1 ± 0.8 pg/ml, respectively. Flossing of full mouth interproximal spaces once and twice daily toothbrushing daily was reported by 100% patients with osteoporosis. Among patients with osteoporosis 75% and 25% individuals were receiving professional dental prophylaxis every 4 and 6 months, respectively. CONCLUSION: Within the limitations of the present study osteoporotic patients are not at an increased risk of peri-implant diseases and can demonstrate salivary AGE and IL-17A levels comparable to non-osteoporotic individuals as long as oral hygiene is stringently maintained.

Mucoepidermoid Carcinoma of Minor Salivary Gland in a Patient with Asymptomatic Palatal Swelling - A Case Report.

Incidence of abundant minor salivary gland tissues in the posterior part of hard palate surges the likelihood of salivary gland neoplasm especially in this part of the oral cavity. Minor salivary gland tumor accounts for virtually 15% of all the salivary gland neoplasm, wherein mucoepidermoid carcinoma comprises of 35.9%. Current paper reports a case of mucoepidermoid carcinoma of the posterior part of the hard palate which was an incidental finding. It presented as well-defined smooth swelling, the preliminary radiographic investigation revealed no appreciable bony changes and offered an impression of a benign tumor. Histopathological investigation displayed features of mucoepidermoid carcinoma of intermediate grade. The lesion was surgically excised and the patient was under regular follow up for 3years. The paper focus on the magnitude of swift clinical diagnosis of specific lesions, so increasing the survival rate and reducing the morbidity.

Assessment of salivary alpha amylase and mucin-4 before and after non-surgical treatment of peri-implant mucositis.

BACKGROUND: The present study was based on the null hypothesis that there is no difference in clinicoradiographic parameters and whole salivary alpha amylase (AA) and mucin-4 levels before and after non-surgical mechanical debridement (NSMD) of patients with peri-implant mucositis (PM). The aim was to assess whole salivary AA and mucin-4 levels before and after treatment of PM. METHODS: Patients with PM (Group-1) and individuals without peri-implant diseases (Group-2) were included. Demographic data was collected and peri-implant modified plaque and bleeding indices (mPI and mBI, respectively), probing depth (PD) and crestal bone loss were measured at baseline. Levels of AA and mucin-4 were assessed in unstimulated whole saliva samples. All patients underwent full-mouth non-surgical periodontal therapy (NSPT) and NSMD; and clinical parameters and salivary biomarkers were re-assessed after 3 months. Level of significance was set at P < 0.01. RESULTS: Twenty-six and 32 individuals were included in groups 1 and 2, respectively. None of the participants had periodontitis. At baseline clinical periodontal parameters (PI [P < 0.001], GI [P < 0.001], clinical AL [P < 0.001] and PD [P < 0.001]) were significantly high in Group-1 than Group-2. At 3-month follow-up, there was a statistically significant reduction in clinical periodontal and peri-implant parameters (PI [P < 0.01], GI [P < 0.01], and PD [P < 0.01]) in Group-1 compared with their baseline values. At baseline, salivary AA levels were significantly high in Group-1 than Group-2 (P < 0.01). At 3-month follow-up, there was no significant difference in whole salivary AA levels among patients in groups 1 and 2. CONCLUSIONS: The AA and mucin-4 levels are potential biomarkers for evaluation of peri-implant diseases including PM. Mechanical instrumentation continues to be the most predictable treatment option for the management of peri-implant diseases.

The theory of reasoned action in describing tongue cleaning adherence among college going students of Indie: A model guided study.

Background: Just mere brushing of teeth is not enough for maintaining good oral health. Regular cleaning of tongue is equally important for maintaining good oral hygiene and to escape social embarrassment and personal discomfort, which could arise as a result of halitosis. Objective: To test the variables of Theory of Reasoned Action to explain the behavior of tongue cleaning among college going students of Udaipur city, Rajasthan, India. Material and methods: A descriptive cross-sectional survey was conducted amongst 756 college going students of Udaipur city, India using an online self-administered structured questionnaire which was designed based on our study objectives. Logistic regression analysis and structural equation modelling (SEM) were employed for statistical analysis. Confidence level and level of significance were set at 95% and 5% respectively. Results: Logistic regression analysis showed that with one unit increase in subjective norm, the tongue cleaning behavior odds increased significantly by 1.124. Also, the tongue cleaning behavior odds was 1.77 times significantly greater among those brushing their teeth twice a day than those brushing once a day. Structural Equation modelling also evidenced the significant direct effect of subjective norm on tongue cleaning behavior (ß = 0.2, p≤0.05). Conclusion: Our results highlighted the importance of subjective norms in espousing tongue cleaning preventive behaviour habit. It is thus recommended to highpoint the role of significant others in changing tongue cleaning behaviour.

Role of antimicrobial photodynamic therapy in reducing subgingival oral yeasts colonization in patients with peri-implant mucositis.

OBJECTIVE: The aim was to assess the role of antimicrobial photodynamic therapy (aPDT) in reducing subgingival oral yeasts colonization (OYC) in patients with peri-implant mucositis (PIM). METHODS: Patients diagnosed with PIM were included. Patient demographics were recorded and implant placement and prosthetic rehabilitation protocols were retrieved from patients' records. Peri-implant clinical parameters (modified plaque index [mPI], modified bleeding index [mBI] probing depth [PD]) and subgingival OYC and were assessed using standard techniques. All patients were randomly divided into test- and control-groups. In the test-group, patients underwent mechanical debridement (MD) of implant surfaces and supra and sub-gingival peri-implant sulci peri-implant immediately followed by a single session of aPDT. In the control-group, patients underwent MD alone. Peri-implant clinical parameters and OYC were re-assessed at 3-months' follow-up. Sample-size estimation was done on data from a pilot investigation and group-comparisons were done using the paired t- and Mann Whitney U-tests. Correlation between age, mPI, mBI, PD and OYC at baseline and 3-months' follow-up was assessed using regression analysis models. A statistically significant difference between the groups was recorded when P-values were less than 0.01. RESULTS: Thirty-four individuals (17 and 17 in the test- and control groups, respectively) were included. There was no significant difference in the mean age, scores of mPI, mBI, PD and OYC among patients in the test- and control-groups at baseline. At 3-months of follow-up, there was a statistically significant reduction in scores of mPI (P<0.001), mBI (P<0.001), PD (P<0.001) and OYC (P<0.001) among patients in the test- compared with the control-groups. There was no significant correlation between age, mPI, mBI, PD and OYC in both groups. CONCLUSION: In the short term, a single session of aPDT as an adjunct to MD is effective in reducing peri-implant soft tissue inflammation and OYC in patients with PIM.

Postoperative anti-inflammatory efficacy of 2% saline rinses and a herbal- mouthwash after non-surgical periodontal therapy for the management of periodontal inflammation in young adults with chlorhexidine allergy: A randomized controlled trial.

AIM: The present randomized controlled trial assessed the postoperative anti-inflammatory efficacy of 2% saline rinses (SR) and a herbal- mouthwash (HMW) after non-surgical periodontal therapy (NSPT) for the management of periodontal inflammation in patients with chlorhexidine (CHX) allergy. MATERIALS AND METHODS: Patients with periodontal inflammation with and without self-reported CHX allergy were included. All patients underwent non-surgical periodontal therapy (NSPT). Patients were randomly divided into three groups. In the SR and HMW groups, 2% SR and a HMW, respectively, were prescribed. In Group 3 (CHX-group), patients without CHX allergy were included and were prescribed 0.12% CHX. In all groups, plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and marginal bone loss were measured at baseline. Clinical periodontal parameters were re-assessed at 6-weeks' follow-up. p < 0.01 were considered statistically significant. RESULTS: Thirteen, 12, and 12 patients were included in the SR, HMW, and CHX groups, respectively. At baseline, clinical and radiographic periodontal parameters were comparable in all groups. In all groups, PI (p < 0.01), GI (p < 0.01), and PD (p < 0.01) were significantly higher at baseline than their respective values at 6 weeks of follow-up. There was no significant difference in clinical AL at all time intervals in all groups. There was no significant correlation between periodontal parameters and age, gender, and daily toothbrushing/flossing in all groups. CONCLUSION: In young adults with self-reported CHX allergy, herbal mouthwashes and/or 2% SR are suitable post-operative prescriptions after NSPT.

Efficacy of antimicrobial photodynamic therapy in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems.

OBJECTIVE: The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems (ENDS). METHODS: Self-reported ENDS users and non-users (individuals that reported to have never used any nicotinic product) were included. Demographic data was collected using a questionnaire. Patients were divided into 2 subgroups: (a) aPDT group; and (b) sham aPDT group. aPDT was performed using a curcumin-based photosensitizer that was exposed to a central wavelength of 660 nm and an estimated average fluency of 200 J/cm2. The system delivered light by uniform diffusion for 5 min. Sham aPDT was performed using a non-activated laser tip. Oral yeasts colony forming units were determined using standard techniques. Oral yeasts were assessed at baseline and at 3-months of follow-up. Level of significance was set at P<0.05. RESULTS: Twenty-three ENDS-users (19 males and 4 females) and 23 controls (17 males and 6 females) were included. ENDS-users were vaping for 8.3 ± 0.6 years and were using their ENDS devices 13.6 ± 2.7 times daily. Toothbrushing twice daily was reported by 8.7% and 21.7% of ENDS-users and controls, respectively. Tongue brushing was reported by none of the individuals. At baseline, oral yeasts CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls (Table 2; Figure 1). At 3-months of follow-up, CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls CONCLUSION: : A single session of aPDT is ineffective in reducing the oral yeasts CFU/ml in ENDS-users. Further studies are needed to assess the impact of multiple sessions of aPDT in reducing the oral yeasts CFU/ml in ENDS-users.

Effectiveness of antimicrobial photodynamic therapy as an adjunct to mechanical instrumentation in reducing counts of Enterococcus faecalis and Candida albicans from C-shaped root canals.

BACKGROUND/PURPOSE: The aim was to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical instrumentation (MI) in reducing Enterococcus faecalis (E faecalis) and Candida albicans (C albicans) counts from C-shaped root-canals. METHODS: Teeth with C-shaped canals as identified on cone beam computed tomographic images were included. Following incubation with E faecalis and C albicans, samples were divided into 4 groups a four follows: Group-1: MI with adjunct aPDT; Group-2: aPDT alone; Group-3: MI alone; and Group-4: no treatment. The pulp chambers of these teeth were exposed and coronal pulp was mechanically derided using sterile endodontic excavators. Using flexible files, all canals were debrided up to size #30 K-files with intermittent irrigation with 2.5% sodium hypochlorite irrigation. In Groups 1 and 3, methylene-blue was injected in all canals and aPDT was performed using a 600 nm diode laser. Sample-size estimation was done on data from a pilot investigation and group-comparisons were done using one way analysis of variance and Bonferroni post-hoc adjustment tests. P < .05 was considered statistically significant. RESULTS: Sixty periodontally hopeless mandibular second molars with C-shaped canals were included. There was a statistically significant reduction CFU/mL of E faecalis (P < .001) and C albicans (P < .001). At post-operative microbial assessments in Group-1. There was no difference CFU/mL of E faecalis and C albicans at post-operative microbial assessments in Groups 2-4. CONCLUSION: MI with adjunct aPDT is more effective in reducing count of E faecalis and C albicans from C-shaped root canals.

Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis.

BACKGROUND AND OBJECTIVE: The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS: Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. RESULTS: At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION: PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

Role of Chitosan in Remineralization of Enamel and Dentin: A Systematic Review.

AIM AND OBJECTIVE: The purpose of this research was to analyze the role of chitosan in the remineralization of enamel and dentin. MATERIALS AND METHODS: An electronic search was done for articles published from January 2009 to January 2020. A manual search was done from bibliographies of selected articles for relevant articles that were unexplored. Only in vitro studies conducted on the application of chitosan for remineralization of enamel and dentin were included in the study. RESULTS: Of the 162 articles that were searched, only 15 in vitro studies were selected for the study. These studies met the inclusion criteria and were published from January 2009 to January 2020. CONCLUSION: The review provides insight into the mechanism of remineralization of enamel and dentin. The properties of chitosan make it an ideal biomaterial that can be employed in the formulation of a novel remineralizing gel. However, more in vivo studies, clinical trials, and research are essential to transform chitosan-based remineralizing gels from research to clinical use. CLINICAL SIGNIFICANCE: This review article opens a new window of opportunities for remineralizing enamel and dentin which have been long considered a challenging job. HOW TO CITE THIS ARTICLE: Nimbeni SB, Nimbeni BS, Divakar DD. Role of Chitosan in Remineralization of Enamel and Dentin: A Systematic Review. Int J Clin Pediatr Dent 2021;14(4):562-568.

A Plausible Proposition of CCL20-Related Mechanism in Fusobacterium nucleatum-Associated Oral Carcinogenesis.

OBJECTIVE: The objective of this prospective observational case-control study is to evaluate the prevalence of Fusobacterium nucleatum in the tissues of oral squamous cell carcinoma (OSCC). Reconnoitering the CCL20-related mechanism of carcinogenesis in Fusobacterium nucleatum-positive OSCC is another objective. METHODOLOGY: Tissues from 50 OSCC patients and 30 healthy oral tissues were collected. The prevalence of Fusobacterium nucleatum was evaluated in both tumour and healthy tissue by polymerase chain reaction. The immunohistochemistry of OSCC tissues was conducted to evaluate the difference in the expression of CCL20 between Fusobacterium nucleatum-positive and -negative OSCC tissues. RESULTS: Fusobacterium nucleatum was significantly (p < 0.001) prevalent in OSCC tissues (74%), compared to healthy tissues (26%). No association of Fusobacterium nucleatum or CCL20 immuno-expression with any clinical or histopathological features of OSCC was observed. While the intensity of CCL20 immuno-expression did not differ (p = 0.053), the CCL20-positive cell population was significantly different (p = 0.034) between Fusobacterium nucleatum-positive and -negative OSCC. CONCLUSION: Fusobacterium nucleatum is possibly prevalent in oral cancer tissues in the Indian population. By using immunohistochemistry, this is the first study to propose that the carcinogenesis in Fusobacterium nucleatum-positive OSCC may be CCL20-related. The findings enrich the knowledge of mechanisms involved in Fusobacterium nucleatum-mediated oral carcinogenesis.

Photodynamic therapy and other pretreatment methods on epoxy-based glass fiber post on the push-out bond strength to radicular dentin.

AIM: To assess the push-out bond strength (PBS) of glass fiber post (GFP) conditioned using different surface treatment regimens bonded to radicular dentin MATERIAL AND METHODS: Sixty central incisors and canine were collected and disinfected. Decoronation following working length was determined using K-file. Rotary file system was used for cleaning and shaping. Canals of all samples were dried with paper points and obturated with gutta percha. Canal space was prepared with peso reamers. Now samples were randomly allocated into six groups based on pretreatment of GFP. Post in group 1 treated with 9% HFA+ Silane, post in group 2 surface treated with silane only, Post in group 3 surface treated with airborne particle (50 µm), group 4 post conditioned with photodynamic therapy (PDT), group 5 post pretreatment was performed with MBP and in group 6 GFP was not treated. Conditioned and non-conditioned posts were positioned in canal space and cemented. Tooth were sectioned coronally, middle and apically. Sections were positioned in universal testing machine (UTM) and debonded surfaces were evaluated for failure modes. The means and standard deviations of PBS were examined using one-way analysis of variance (ANOVA). RESULTS: Coronal third of group 3 in which posts were sandblasted using airborne Al2O3 particle presented the highest PBS (11.21±0.64 MPa). Whereas, an apical section of group 4 in which posts were treated with PDT exhibited the lowest bond integrity. CONCLUSION: Sandblasting using airborne particles (50 µm) and hydrogen peroxide (H3PO4) conditioned with GFP exhibited significantly higher bond strength as compared to the control. However, PDT decreases the PBS of fiber post with the root dentin.

Pediatric maxillofacial and dental trauma: A retrospective review of pediatric emergency management in Riyadh, Kingdom of Saudi Arabia.

BACKGROUND: Due to the high prevalence of oral and maxillofacial (OMF) trauma in city of Riyadh, a special focus on pediatric trauma is needed. The purpose of this audit was to assess the protocol followed by the OMF unit at King Khalid University Hospital (KKUH) on pediatric trauma patients. The trauma incidence, mechanism of injury, volume, the type of pediatric trauma operated and dental management were analyzed. MATERIALS AND METHODS: A quantitative retrospective review of 223 patients, at pediatric emergency unit of KKUH, Riyadh, KSA from January 2017 to July 2018, was done. The data retrieved included variables such as, age, gender, and cause of injury, site of injury, type of injury, and assessment of jaws, and teeth. Data regarding the type of investigations, treatment protocol, follow up visit, and dental management, were extracted from the medical records. RESULTS: Of the 223 pediatric patients presenting to the emergency unit, 116 (52%) were under the age of 5 years. A total of 64.4% of patients reported "self-fall" as the cause of injury. Soft-tissue injuries were common in 63 (56.8%) of patients in the form of lacerations 87 (41.2%). Involvement of the teeth in the injury was observed in 57 patients, in which 33 (57.9%) patients were reported to have tooth/teeth avulsions, 15 (26.3%) patients had luxation and 9 (15.8%) patients had crown fractures. 27 (47%) patients were referred to the pedodontist for a follow-up visit. CONCLUSIONS: It can concluded that clinicians facing maxillofacial trauma in an emergency department need to have access to useful and practice guidelines. The study also showed the need for more manpower-oriented training such as a pedodontist and a general dentist to join the OMFS team to manage pediatric patients. The regional referral hospitals should be equipped to decentralize the management of these patients to the Dental University Hospital.

The One-Year In Vivo Comparison of Lithium Disilicate and Zirconium Dioxide Inlays.

The objective of the present study was to evaluate the one-year clinical performance of lithium disilicate (LD) and zirconium dioxide (ZrO2) class II inlay restorations. Thirty healthy individuals who met the inclusion criteria were enrolled for the study. The patients were randomly divided into two study groups (n = 15): LD (IPS e.max press) and ZrO2 (Dentcare Zirconia). In the ZrO2 group, the internal surfaces of the inlays were sandblasted and silanized with Monobond N (Ivoclar, Leichsteistein, Germany). In the LD group, the internal surfaces of the inlays were etched with 5% hydrofluoric acid. The ceramic inlays were cemented with self-cure resin cement (Multilink N). Clinical examinations were performed using modified United State Public Health Codes and Criteria (USPHS) after 2 weeks, 4 weeks, 6 months and 1 year. The one-year survival rate was evaluated. In total, one failure was observed in the ZrO2 group. The survival probability after 1 year for the ZrO2 inlays was 93%, and for the LD inlays was 100%, which was statistically insignificant. The differences between both groups for most USPHS criteria (except for colour match) were statistically insignificant. Within the imitations of the present study, the lithium disilicate- and zirconia dioxide-based inlays exhibited comparable clinical performances. However, the colour and translucency match was superior for the lithium disilicate restorations.