Should finishing, polishing or glazing be performed after grinding YSZ ceramics? A systematic review and meta-analysis.

The present systematic review and meta-analysis aimed to assess the characteristics and consequences of post-processing methods after grinding procedures in YSZ ceramics on its surface roughness and flexural strength. The protocol of this review was made prospectively and is available online in the PROSPERO database (link). Literature searches on PubMed/MEDLINE, EMBASE, Lilacs, Web of Science and Scopus were conducted on December 2022 to select in vitro studies written in English, without publishing-date restrictions, that considered surface characteristics and mechanical properties of YSZ ceramics submitted to grinding and subsequent post-processing surface treatments as an attempt to revert the effect induced by grinding. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences (Rev-Man 5.1, random effects model, α= 0.05) were obtained by comparing flexural strength and surface roughness values of ground surfaces with at least one post-processing surface treatment (global analysis). Subgroup analyses were performed considering the most prevalent categories of post-processing methods. A total of 33 (out of 4032) studies were eligible and included in the analysis. In the global analysis, ground surfaces showed higher flexural strength than when post-processing methodologies were employed (p< 0.0001). The subgroup analysis showed that only polishing was able to enhance the flexural strength after grinding (p= 0.001); however, when other protocols were used, the ground surface was always superior in terms of flexural strength (p< 0.0001). Post-processing techniques in both the global and sub-group analyses were able to reduce the surface roughness after grinding in YSZ ceramics (p< 0.00001). High heterogeneity was found in all the meta-analyses. Concerning the risk of bias analysis, the included studies had mixed scores for the considered factors. In conclusion, in terms of improving flexural strength and restoring surface roughness after grinding, polishing protocols can be considered the best indication as post-processing treatment after YSZ ceramics adjustments/grinding.

Novel cinnamon-laden nanofibers as a potential antifungal coating for poly(methyl methacrylate) denture base materials.

OBJECTIVES: To modify the surface of denture base material by coating it with cinnamon-laden nanofibers to reduce Candida albicans (C. albicans) adhesion and/or proliferation. MATERIALS AND METHODS: Heat-cured poly(methyl methacrylate) (PMMA) specimens were processed and coated, or not, with cinnamon-laden polymeric nanofibers (20 or 40 wt.% of cinnamon relative to the total polymer weight). Scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR) analyses of the nanofibers were performed. Antifungal activity was assessed through agar diffusion and colony-forming unit (CFU/mL) assays. Representative SEM morphological analysis was carried out to observe the presence/absence of C. albicans on the fibers. Alamar blue assay was used to determine cell toxicity. Analysis of variance and the Tukey's test were used to analyze the data (α = 0.05). RESULTS: SEM imaging revealed nanofibers with adequate (i.e., bead-free) morphological characteristics and uniform microstructure. FTIR confirmed cinnamon incorporation. The cinnamon-laden nanofibers led to growth inhibition of C. albicans. Viable fungal counts support a significant reduction on CFU/mL also directly related to cinnamon concentration (40 wt.%: mean log 6.17 CFU/mL < 20 wt.%: mean log 7.12 CFU/mL), which agrees with the SEM images. Cinnamon-laden nanofibers at 40 wt.% led to increased cell death. CONCLUSIONS: The deposition of 20 wt.% cinnamon-laden nanofibers onto PMMA surfaces led to a significant reduction of the adhesive and/or proliferative ability of C. albicans, while maintaining epithelial cells' viability. CLINICAL RELEVANCE: The high recurrence rates of denture stomatitis are associated with patient non-adherence to treatments and contaminated prostheses use. Here, we provide the non-patients' cooperation sensible method, which possesses antifungal action, hence improving treatment effectiveness.

Association between oral health-related quality of life and periodontal status in patients with leukemia.

OBJECTIVE: The aim was to evaluate the association between oral health-related quality of life (OHRQol) and periodontal status in patients with leukemia. METHODS: A total of 55 patients with leukemia (42.09 ± 16.57 years, 27.3% females) answered the Oral Health Impact Profile, short version (OHIP-14) and underwent a periodontal examination. Associations between periodontal status and total mean OHIP-14 scores were analysed, and the prevalence of high scores was identified for each group. RESULTS: A total mean OHIP-14 score of 13.18 was observed for the entire sample. The corresponding total mean OHIP-14 scores for patients with moderate (n = 18), absent/mild (n = 24), and severe periodontitis (n = 13) were 17.11, 12.50, and 9.00 (P = 0.061), respectively. A higher prevalence of high scores was found for the 'feeling ill-at-ease' question (psychological discomfort domain) for absent/mild and moderate periodontitis patients, whereas those with severe periodontitis had higher prevalence on the 'feeling embarrassed' question (psychosocial disability domain). In the adjusted analysis, hospitalisation was associated with higher OHIP-14 scores (ß = 8.49; 95% CI 1.89-15.08; P = 0.013). Higher OHIP-14 scores were not significantly associated with either patients presenting >15% sites with gingival bleeding or those with moderate/severe periodontitis. CONCLUSION: Leukemia was associated with a negative influence on OHRQoL. However, this association was better explained by the patient's systemic condition than by an impact of its periodontal condition. Nonetheless, patients with leukemia presented with gingivitis and/or periodontitis, pointing to the need for oral health care for these individuals.

Effect of self-performed mechanical plaque control frequency on gingival health in subjects with a history of periodontitis: A Randomized Clinical Trial.

AIM: This randomized clinical trial evaluated the effect of the frequency of self-performed mechanical plaque control (SPC) on gingival health in subjects with a history of periodontitis. MATERIALS AND METHODS: Forty-two subjects participating in a routine periodontal maintenance program were randomized to perform SPC at 12-, 24- or 48-hr intervals. Plaque index (PlI) and gingival index (GI) were evaluated at baseline, and days 15, 30 and 90 of study. Probing depths, clinical attachment levels and bleeding on probing were assessed at baseline, days 30 and 90. Mixed linear models were used for the analysis and comparison of experimental groups. RESULTS: Mean GI at baseline remained unchanged throughout study (90 days) only in the 12-hr group (0.7 ± 0.1 versus 0.8 ± 0.1; p < .05). At the end of study, mean GI was significantly increased in the 48-hr group over that in the 12- and 24-hr groups. When GI = 2 scores were considered, only the 48-hr group failed to maintain gingival health throughout the study (18.8%). CONCLUSION: SPC performed at a 12- or 24-hr frequency appears sufficient to controlling gingival inflammation whereas this clinical status was not maintained using a 48-hr frequency in subjects with a history of periodontitis subject to a routine periodontal maintenance program (ClinicalTrials.gov: 50208115.9.0000.5346).

Validity of self-reported measures for periodontitis surveillance in a rural sample.

BACKGROUND: To evaluate the predictive performance of self-reported questions for periodontitis screening in a representative sample of a rural population. METHODS: Nine questions were compared with gold standard clinical examinations (probing six sites/tooth, full-mouth). Case definition for severe periodontitis was defined according to World Workshop (2017-WW) and Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). Diagnostic tests such as sensitivity (SN), specificity (SP), positive and negative predictive values were performed for all questions alone and grouped into models. Binary logistic regression modeling was used to derive parameter estimates for all variables in a given model and the area under ROC curve was calculated. RESULTS: Clinical examinations showed a prevalence of periodontitis in the sample (n = 585) of 99.4% and 86.3%, being 40.3% and 33.8% of severe disease according to 2017-WW and CDC/AAP case definitions, respectively. Individually, only the questions regarding the self-perception of teeth/gum health and loose and lost teeth were valid to predict severe periodontitis. The best logistic regression models combined sociodemographic variables and risk-factors with the self-reported measures of self-perception of gum disease, teeth/gum health, loose teeth and history of tooth loss. CONCLUSION: Predictive performance of these self-reported questions presented herein support its potential use for surveillance of severe periodontitis in rural populations with high periodontitis prevalence.

Adjunctive antimicrobial photodynamic therapy using methylene blue/ethanol formulation in experimental periodontitis in diabetic rats: short-term results.

The aim of this study was to evaluate the effect of an MB experimental formulation (ethanol 20%) in aPDT used as an adjuvant to scaling and root planing (SRP) in the periodontal treatment of diabetic rats. Forty male Wistar rats received streptozotocin-intraperitonial injections to induce diabetes. After 14 days, 5 animals were allocated in the non-ligate group (NLG), and 35 animals received ligature at the first right mandibular molar to induce periodontitis. After 7 days, the ligature was removed and the animals were randomized into 4 groups: LG (without treatment, n = 5), SRPG (SRP, n = 10), aPDTW (SRP+aPDT-MB/water, n = 10), and aPDTEt (SRP + aPDT-MB/water/ethanol/carboxymethylcellulose, n = 10). Animals were euthanized after 7 days. Data of bone loss (BL) area, degree of inflammatory cell response, and collagen fibers percentages were statistically analyzed (p < 0.05). Percentage of animals that presented mild and severe inflammatory infiltrate was 10% and 40% for SRPG, 20% and 30% for aPDTW, and 50% and 0% for aPDTEt, respectively. BL area (mm2) was statistically higher in the LG (0.39 ± 0.15) than NLG (0.05 ± 0.02). aPDTEt showed the lowest value of BL (0.08 ± 0.03), followed by aPDTW (0.21 ± 0.15) and SRPG (0.31 ± 0.18). Statistical differences were verified between aPDTEt and SRPG. In relation to the LG, aPDTEt, aPDTW, and SRPG recovered the equivalent 80%, 46%, and 20% of the BL. aPDTEt showed collagen content statistically higher than SRPG and LG, and presented higher mean values than NLG (p > 0.05). Our findings showed aPDTEt presented promising results. aPDT using MB/ethanol can have potential as an adjunctive periodontal treatment in diabetics.

Antimicrobial effect of methylene blue formulations with oxygen carrier at different pHs: preliminary study / Efeito antimicrobiano de formulações de azul de metileno com carreador de oxigênio em diferentes pHs: um estudo preliminar

Objective: Evaluate methylene blue (MB) formulations containing oxygen carrier at different pHs in antimicrobial photodynamic therapy (aPDT). Material and Methods: Biofilms of Pseudomonas aeruginosa PA01 formed over acrylics specimens during five days were treated with aPDT using different formulations: MB/pH 7.4; MB/pH 5.6; MB/carrier pH 7.4; MB/carrier pH 5.6. Biofilms not exposed to treatment were used as a control. Blind examiner for the experimental groups performed the counting of colonies per ml suspension (CFU/ml). Two-way ANOVA was used to determine the effect of factors solvent (carrier vs water) and pH (7.4 vs 5.6). One-way ANOVA and post-hoc Tukey's test was used to evaluate differences among the five groups (control; MB/carrier pH 7.4; MB pH 7.4; MB/carrier pH 5.6; MB pH 5.6). The Statistics 8.0 software was used (P <0.05). Results: All of photodynamic therapy groups showed significant reduction in P. aeruginosa compared to the control group. The solvent factor was not significant (P=0.18), while the pH factor presented statistical significance (P=0.01). When the carrier was used, MB formulation at pH 7.4 presented a statistically greater reduction of P. aeruginosa than the formulation with pH 5.6. Conclusion: The PDT using methylene blue formulations with oxygen carrier demonstrated potential for the treatment of localized infections by P. aeruginosa. MB formulations with oxygen carrier and pH 7.4 resulted in higher antimicrobial effect and should be considered for future studies with multispecies biofilms. (AU)

Objetivo: Avaliar formulações de azul de metileno (AM) contendo carreador de oxigênio a diferentes pHs na terapia fotodinâmica antimicrobiana (TFDa). Material e Métodos: Biofilmes de Pseudomonas aeruginosa PA01 formados sobre espécimes acrílicos durante cinco dias foram tratados com TFDa utilizando diferentes formulações: AM / pH 7,4; AM / pH 5,6; AM / carreadir pH 7,4; AM / carreador pH 5,6. Biofilmes não expostos ao tratamento foram utilizados como controle. Um examinador cego aos grupos experimentais realizou a contagem de colônias por ml de suspensão (UFC / ml). O teste Anova dois fatores foi utilizado para determinar o efeito dos fatores solvente (carreador vs água) e pH (7,4 vs 5,6). Anova um fator e teste post-hoc de Tukey foram utilizados para avaliar as diferenças entre os cinco grupos (controle; AM / carreador pH 7,4; AM pH 7,4; AM / carreador pH 5,6; AM pH 5,6). O software Statistics 8.0 foi utilizado (P <0,05). Resultados: Todos os grupos da terapia fotodinâmica mostraram uma redução significativa na P. aeruginosa em comparação ao grupo controle. O fator solvente não foi significante (P = 0,18), enquanto o fator pH apresentou significância estatística (P = 0,01). Quando o carreador foi utilizado, a formulação AM a pH 7,4 apresentou uma redução estatisticamente maior de P. aeruginosa do que a formulação com pH 5,6. Conclusão: A TFDa utilizando formulações de AM com carreador de oxigênio mostrou potencial para o tratamento de infecções localizadas por P. aeruginosa. As formulações de AM com carreador de oxigênio e pH 7,4 resultaram em maior efeito antimicrobiano e devem ser consideradas para futuros estudos com biofilmes multiespécie (AU)

Antimicrobial photodynamic therapy with photosensitizer in ethanol improves oxidative status and gingival collagen in a short-term in periodontitis.

BACKGROUND: This study evaluated the antimicrobial photodynamic therapy (aPDT) effects using the methylene blue (MB) in ethanol 20% on systemic oxidative status and collagen content from gingiva of rats with periodontitis. METHODS: Rats were divided into five experimental groups: NC (negative control; no periodontitis); PC (positive control; periodontitis without any treatment); SRP (periodontitis and scaling and root planing), aPDT I (periodontitis and SRP+aPDT+MB solubilized in water), and aPDT II (periodontitis and SRP+aPDT+MB solubilized in ethanol 20%). After 7days of removal of the ligature, the periodontal treatments were performed. At 7/15/30days, gingival tissue was removed for morphometric analysis. The erythrocytes were used to evaluate systemic oxidative status. RESULTS: PC group showed higher lipoperoxidation levels at 7/15/30days. aPDT indicated a protective influence in erythrocytes at 15days observed by the elevation in levels of systemic antioxidant defense. aPDT II group was the only one that restored the total collagen area in 15days, and recovered the type I collagen area at the same time point. CONCLUSIONS: aPDT as an adjunct to the SRP can induce the systemic protective response against oxidative stress periodontitis-induced and recover the gingival collagen, thus promoting the healing periodontal, particularly when the MB is dissolved in ethanol 20%.

Dental flossing as a diagnostic method for proximal gingivitis: a validation study.

This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey's post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001) and 50.7% (p < 0.001) of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p < 0.001) of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion.

Two previous clinical studies evaluated the effect of end-rounded versus tapered bristles of soft manual brushes on the removal of plaque and gingival abrasion. However, the combined effect of an abrasive dentifrice on these outcomes has yet to be understood. The purpose of the present study was to compare the incidence of gingival abrasion and the degree of plaque removal obtained after the use of toothbrushes with tapered or end-rounded bristles in the presence or absence of an abrasive dentifrice. The study involved a randomized, single-blind, crossover model (n = 39) with a split-mouth design. Subjects were instructed to refrain from performing oral hygiene procedures for 72 hours. Quadrants were randomized and subjects brushed with both types of toothbrushes using a dentifrice (relative dentin abrasion = ± 160). Plaque and gingival abrasion were assessed before and after brushing. After 7 days, the experiment was repeated without the dentifrice. The average reduction in plaque scores and the average increase in the number of abrasion sites were assessed by repeated-measures ANOVA and Bonferroni's post-hoc tests. End-rounded bristles removed significantly more plaque than tapered bristles, regardless of the use of a dentifrice. The dentifrice did not improve plaque removal. In the marginal area (cervical free gingiva), no difference in the incidence of gingival abrasion was detected between toothbrush types when used with a dentifrice (p ≥ 0.05). However, the dentifrice increased the incidence of abrasion (p < 0.001), irrespective of the toothbrush type tested. End-rounded bristles therefore removed plaque more effectively without causing a higher incidence of gingival abrasion when compared with tapered bristles. An abrasive dentifrice can increase the incidence of abrasion, and should be used with caution by individuals who are at risk of developing gingival recession.

Effect of self-performed mechanical plaque control frequency on gingival inflammation revisited: a randomized clinical trial.

AIM: To evaluate the effect of self-performed mechanical plaque control (SPC) frequency on gingival health. METHODS: Thirty-nine subjects exhibiting limited gingival inflammation and minimal clinical attachment loss were enrolled in a single-blind, parallel group, randomized clinical trial. The subjects that were divided into three groups were tasked to perform SPC (using tooth brush and dental floss) at 12, 24 or 48 h intervals. Gingival index (GI), plaque index (PlI), and gingival crevicular fluid (GCF) volume were evaluated at baseline and 30 days follow-up. Groups were compared using anova and Tukey. RESULTS: No significant differences in mean GI change were observed between the 12 and 24 h SPC intervals from baseline to 30 days (-0.06 ± 0.13 versus 0.05 ± 0.09; p = 0.11). In contrast, the 48 h interval had significantly higher mean GI change than the 12 and 24 h intervals (0.33 ± 0.17; p = 0.001). Similarly, mean PlI change was not significantly different between the 12 and 24 h SPC intervals (0.11 versus 0.28; p = 0.15), whereas SPC at 48 h-intervals yielded a significantly increased PlI (0.39; p = 0.001). CONCLUSIONS: Self-performed mechanical plaque control performed at 12 h or 24 h intervals appears sufficient to maintain gingival health in subjects with no or limited clinical attachment loss.

Antimicrobial photodynamic effect of phenothiazinic photosensitizers in formulations with ethanol on Pseudomonas aeruginosa biofilms.

BACKGROUND DATA: Methylene blue (MB) and toluidine blue (TB) are recognized as safe photosensitizers (Ps) for use in humans. The clinical effectiveness of the antimicrobial photodynamic therapy with MB and TB needs to be optimized, and ethanol can increase their antimicrobial effect. Formulations of MB and TB containing ethanol were evaluated for their ability to produce singlet oxygen and their antibacterial effect on Pseudomonas aeruginosa biofilms. METHODS: Photoactivated formulations were prepared by diluting the Ps (250 µM) in buffered water (pH 5.6, sodium acetate/acetic acid), 10% ethanol (buffer: ethanol, 90:10), or 20% ethanol (buffer: ethanol, 80:20). Biofilms also were exposed to the buffer, 10% ethanol, or 20% ethanol without photoactivation. Untreated biofilm was considered the control group. The production of singlet oxygen in the formulations was measured based on the photo-oxidation of 1,3-diphenylisobenzofuran. The photo-oxidation and CFU (log10) data were evaluated by two-way ANOVA and post-hoc Tukey's tests. RESULTS: In all the formulations, compared to TB, MB showed higher production of singlet oxygen. In the absence of photoactivation, neither the buffer nor the 10% ethanol solution showed any antimicrobial effect, while the 20% ethanol solution significantly reduced bacterial viability (P=0.009). With photoactivation, only the formulations containing MB and both 10% and 20% ethanol solutions significantly reduced the viability of P. aeruginosa biofilms when compared with the control. CONCLUSIONS: MB formulations containing ethanol enhanced the antimicrobial effect of the photodynamic therapy against P. aeruginosa biofilms in vitro.

Dental flossing as a diagnostic method for proximal gingivitis: a validation study

ABSTRACT This study evaluated the clinical diagnosis of proximal gingivitis by comparing two methods: dental flossing and the gingival bleeding index (GBI). One hundred subjects (aged at least 18 years, with 15% of positive proximal sites for GBI, without proximal attachment loss) were randomized into five evaluation protocols. Each protocol consisted of two assessments with a 10-minute interval between them: first GBI/second floss, first floss/second GBI, first GBI/second GBI, first tooth floss/second floss, and first gum floss-second floss. The dental floss was slid against the tooth surface (TF) and the gingival tissue (GF). The evaluated proximal sites should present teeth with established point of contact and probing depth ≤ 3mm. One trained and calibrated examiner performed all the assessments. The mean percentages of agreement and disagreement were calculated for the sites with gingival bleeding in both evaluation methods (GBI and flossing). The primary outcome was the percentage of disagreement between the assessments in the different protocols. The data were analyzed by one-way ANOVA, McNemar, chi-square and Tukey's post hoc tests, with a 5% significance level. When gingivitis was absent in the first assessment (negative GBI), bleeding was detected in the second assessment by TF and GF in 41.7% (p < 0.001) and 50.7% (p < 0.001) of the sites, respectively. In the absence of gingivitis in the second assessment (negative GBI), TF and GF detected bleeding in the first assessment in 38.9% (p = 0.004) and 58.3% (p < 0.001) of the sites, respectively. TF and GF appears to be a better diagnostic indicator of proximal gingivitis than GBI.

Combined effect of end-rounded versus tapered bristles and a dentifrice on plaque removal and gingival abrasion

Abstract Two previous clinical studies evaluated the effect of end-rounded versus tapered bristles of soft manual brushes on the removal of plaque and gingival abrasion. However, the combined effect of an abrasive dentifrice on these outcomes has yet to be understood. The purpose of the present study was to compare the incidence of gingival abrasion and the degree of plaque removal obtained after the use of toothbrushes with tapered or end-rounded bristles in the presence or absence of an abrasive dentifrice. The study involved a randomized, single-blind, crossover model (n = 39) with a split-mouth design. Subjects were instructed to refrain from performing oral hygiene procedures for 72 hours. Quadrants were randomized and subjects brushed with both types of toothbrushes using a dentifrice (relative dentin abrasion = ± 160). Plaque and gingival abrasion were assessed before and after brushing. After 7 days, the experiment was repeated without the dentifrice. The average reduction in plaque scores and the average increase in the number of abrasion sites were assessed by repeated-measures ANOVA and Bonferroni's post-hoc tests. End-rounded bristles removed significantly more plaque than tapered bristles, regardless of the use of a dentifrice. The dentifrice did not improve plaque removal. In the marginal area (cervical free gingiva), no difference in the incidence of gingival abrasion was detected between toothbrush types when used with a dentifrice (p ≥ 0.05). However, the dentifrice increased the incidence of abrasion (p < 0.001), irrespective of the toothbrush type tested. End-rounded bristles therefore removed plaque more effectively without causing a higher incidence of gingival abrasion when compared with tapered bristles. An abrasive dentifrice can increase the incidence of abrasion, and should be used with caution by individuals who are at risk of developing gingival recession.

The effect of smoking on bleeding on probing after nonsurgical periodontal therapy: a quasi-experimental study.

The objective of this study was to evaluate the effect of smoking on response to nonsurgical periodontal therapy using the primary outcome measure of bleeding on probing (BoP). An periodontist performed periodontal therapy on 11 smokers and 14 never smokers with periodontitis. Two examiners assessed visible plaque index, gingival bleeding index, probing pocket depth (PPD), BoP, suppuration on probing and clinical attachment level (CAL), at baseline and three months after therapy. BoP was categorized as 0 (absent), 1 (small bleeding point) and 2 (blood flow from the sulcus). Total BoP value was obtained by summing values of 1 and 2. All subjects had significant reductions in mean PPD and percentages of sites with BoP, with no difference between the groups. Only never smokers presented statistically significant CAL gain. BoP was significantly and consistently reduced at sites with initial PPDs of 1-3 mm and 4-6 mm in both groups. At sites with deep PPD ( ≥ 7mm), never smokers showed a greater mean reduction in the number of sites with BoP than did smokers (p < 0.05). Never smokers had significantly greater reduction in BoP 2 than smokers, at sites with moderate and deep baseline PPDs. The first group had a significant increase of BoP 1, at sites with initial PPDs of 4-6 mm. Thus, periodontal therapy reduced BoP in both groups. However, smoking could negatively affect the BoP reduction at deeper sites after nonsurgical periodontal therapy.

Use of cone beam imaging to assess inter-root distance in molar furcations.

This study used cone beam computed tomography (CBCT) to evaluate distances among root surfaces in molar furcations and assess the congruence between inter-root distances in molar furcations and curette blade widths. Distances among root surfaces at 1 and 3 mm from the fornix of molar furcations (points A and B, respectively) were measured with standardized CBCT images and analyzed using computer software. Periodontal curette widths were evaluated by digital caliper and stereomicroscope (magnification 10x). Forty CBCT images (containing a total of 141 molar teeth and 354 furcations) were evaluated; 19 furcations (5.4%) with fused molars were excluded. Mesial furcations of the first molars had the highest average inter-root distances (point A: 3.81 ± 0.87 mm; point B: 5.30 ± 0.92 mm), while buccal furcations of the maxillary second molars had the smallest average distances (point A: 1.49 ± 0.37 mm; point B: 1.90 ± 0.65 mm). Analysis of 107 curettes revealed statistically significant differences among curette types and manufacturers. Pearson's coefficient revealed a strong and significant correlation for curette measurement using digital caliper and stereomicroscope (r = 0.86, P < 0.01). In most cases, the curettes tested allowed access for scaling and root planing of teeth with furcation involvement.

Periodontal status and its correlation with haematological parameters in patients with leukaemia.

AIM: This cross-sectional study evaluated periodontal status in patients with leukaemia and its correlation with haematological parameters. METHODS: Patients with different types of leukaemia and minimum age of 14 years were eligible. Calibrated examiners assessed Seymour index (SI), plaque index (PlI), gingival index (GI), probing depth (PD), bleeding on probing (BOP) and clinical attachment loss (CAL) and performed an interview. Haematological parameters were obtained from haemogram performed on the same day of the periodontal examinations. RESULTS: Sixty-eight patients were evaluated, which corresponded to an 85% response rate. Periodontal parameters were in agreement with plaque accumulation (PlI 1.28 ± 0.5, GI 0.74 ± 0.4, PD 2.27 ± 0.6, BOP 33%, CAL 2.31 ± 1.6). PlI and CAL were statistically lower in acute leukaemia (1.13 ± 0.61 and 1.96 ± 1.7) in comparison with chronic leukaemia (1.46 ± 0.44 and 2.74 ± 1.4). Moreover, older age (95% confidence interval [CI]: 0.27-1.56), higher educational level (CI: -1.94 to -0.64) and smoker (CI: 0.39-1.96) were associated with CAL. Correlation between periodontal and haematological parameters was not observed. Correlations between GI x SI and PD x SI were statistically significant (r(S) = 0.390, p = 0.001; r(S) = 0.517, p = 0.000 respectively). CONCLUSIONS: Periodontal parameters were consistent with plaque accumulation and did not correlate with haematological parameters irrespective of the leukaemia type.

Effect of brushing with conventional versus whitening dentifrices on surface roughness and biofilm formation of dental ceramics.

The aim of this study was to evaluate the effect of conventional and whitening dentifrices on the weight loss, surface roughness, and early in situ biofilm formation on the surface of dental ceramics. Standardized feldspar ceramic specimens (Vita VM7 and Vita VM13) were submitted to the following experimental conditions: no brushing; brushing without a dentifrice; brushing with a conventional dentifrice; and brushing with a whitening dentifrice. A brushing machine was used to simulate brushing. The mass and surface roughness of all specimens from the test groups were evaluated prior to and after brushing. Ten participants used an oral device for eight hours to evaluate the biofilm formed in situ on the specimens. Scanning electron microscopy was used for qualitative and quantitative analysis of the biofilm. ANOVA and Tukey tests were used to analyze the results of weight loss, surface roughness, and presence of bacteria. A one-way Kruskal-Wallis test was used for bacterial colonization results. For both ceramics, brushing with a whitening dentifrice resulted in weight loss that was significantly greater when compared to brushing without a dentifrice or with a conventional dentifrice. Increased surface roughness was noticed on VM13 ceramic samples with both dentifrices, whereas only conventional dentifrice had a significant effect on the surface roughness of VM7 samples. For both VM7 and VM13, no difference was found between the experimental conditions with regard to the presence or number of bacteria. Cocci and short rods were the predominant microbial morphotypes. Granular or fibrillar acellular material partially covered the specimens. Brushing with a whitening dentifrice resulted in significant weight loss of ceramic restorations, while brushing with both conventional and whitening dentifrices can roughen ceramic surfaces. The increase in roughness was not clinically significant to contribute to increased biofilm formation.

Gingival inflammation and platelet count in patients with leukemia: preliminary results.

Leukemia has been associated with oral manifestations. However, the available literature on this topic consists of mostly reports of cases, without data about the periodontal parameters that may be under the influence of hematologic factors. The aim of this cross-sectional study was to assess the correlation between the Gingival Index and Bleeding on Probing with the platelet count in patients with leukemia. Patients with diagnosis of any kind of leukemia, at any stage of treatment, having a minimum age of 14 years, treated at the Department of Hematology-Oncology of the University Hospital of Santa Maria, Brazil, between December 2009 and March 2010, were assessed. Excluded patients were: edentulous, with orthodontic appliances, with psychomotor disturbances, requiring antibiotic prophylaxis for the examinations, or those using medications associated with gingival swelling. Two trained and calibrated examiners evaluated the Plaque Index, Gingival Index (GI), Probing depth, Bleeding on Probing (BOP), and Clinical Attachment Loss. Hematologic data were collected from a blood test performed on the same day as the periodontal examination. Thirty-seven patients (26 males), aged between 15 and 80 years (mean age 41.7 ± 18.31) were evaluated. Correlation between platelet count and BOP (p > 0.05), or between platelet count and GI (p > 0.05), were both weak (Pearson's correlation coefficient r = 0.171 and r = -0.003, respectively) and not statistically significant. It can be concluded from the preliminary results that the low platelet count was not correlated with the higher prevalence of gingival and periodontal bleeding in patients with leukemia.

Gingival inflammation and platelet count in patients with leukemia: preliminary results

Leukemia has been associated with oral manifestations. However, the available literature on this topic consists of mostly reports of cases, without data about the periodontal parameters that may be under the influence of hematologic factors. The aim of this cross-sectional study was to assess the correlation between the Gingival Index and Bleeding on Probing with the platelet count in patients with leukemia. Patients with diagnosis of any kind of leukemia, at any stage of treatment, having a minimum age of 14 years, treated at the Department of Hematology-Oncology of the University Hospital of Santa Maria, Brazil, between December 2009 and March 2010, were assessed. Excluded patients were: edentulous, with orthodontic appliances, with psychomotor disturbances, requiring antibiotic prophylaxis for the examinations, or those using medications associated with gingival swelling. Two trained and calibrated examiners evaluated the Plaque Index, Gingival Index (GI), Probing depth, Bleeding on Probing (BOP), and Clinical Attachment Loss. Hematologic data were collected from a blood test performed on the same day as the periodontal examination. Thirty-seven patients (26 males), aged between 15 and 80 years (mean age 41.7 ± 18.31) were evaluated. Correlation between platelet count and BOP (p > 0.05), or between platelet count and GI (p > 0.05), were both weak (Pearson's correlation coefficient r = 0.171 and r = -0.003, respectively) and not statistically significant. It can be concluded from the preliminary results that the low platelet count was not correlated with the higher prevalence of gingival and periodontal bleeding in patients with leukemia.