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1.
J Clin Sleep Med ; 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32536365

RESUMO

STUDY OBJECTIVES: To systematically survey the scientific literature concerning the effect of playing a wind instrument or singing on sleep, snoring, and/or OSA. METHODS: The PubMed, EMBASE, and Cochrane databases were searched up to December 2019. Observational studies and (R)CCTs that assessed sleep, snoring, or OSA as clinical outcome or via a questionnaire were included. For the individual studies, the potential risk of bias was scored. Data between oral musicians and controls was extracted. Descriptive analysis as well as meta-analysis were performed. RESULTS: Six eligible studies (5 cross-sectional, 1 RCT) were retrieved, with an estimated potential bias ranking from low to high. The sample sizes ranged from 25 to 1105 participants. Descriptive analysis indicated that players of a double-reed instrument have a lower risk of OSA, and that singers snore less as compared to controls. Playing a didgeridoo showed a positive effect on AHI, daytime sleepiness and partner's rating for sleep disturbance. The descriptive analysis could not be substantiated in the meta-analysis. The magnitude of the effect was zero to small and the generalizability was limited because of long (professional) rehearsal time or small sample size. CONCLUSIONS: Playing a wind instrument and singing may have a small but positive effect on sleep disorders. Taking into account the practicality and investment of (rehearsal) time, didgeridoo and singing are the most promising interventions to reduce OSA and snoring, respectively. However, the results of this review are based on few studies and the synthesis of the evidence is graded to have low certainty.

2.
Int J Dent Hyg ; 18(1): 27-43, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31054209

RESUMO

OBJECTIVES: To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores. MATERIAL AND METHODS: MEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed. RESULTS: Screening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [-0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [-0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [-0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [-0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [-3.98; -1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [-3.32; 3.55]). CONCLUSION: There is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.


Assuntos
Anti-Infecciosos Locais , Placa Dentária , Gengivite , Descoloração de Dente , Clorexidina , Humanos , Antissépticos Bucais
3.
Int J Dent Hyg ; 18(1): 17-26, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31050195

RESUMO

OBJECTIVES: In adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal? METHODS: MEDLINE-PubMed and Cochrane-CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley-Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta-analysis and subanalysis for brands and mode of action being oscillating-rotating (OR) and side-to-side (SS) were performed when feasible. RESULTS: Independent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was -0.14 (P < 0.001; 95%CI [-0.19; -0.09]) for the Q&HPI and -0.10 (P < 0.001; 95%CI [-0.14; -0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM -0.16 (P < 0.001; 95%CI [-0.22, -0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed -0.10 (P < 0.001; 95%CI [-0.15; -0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of -0.15 (P < 0.001; 95%CI [-0.22; -0.08]) and the Colgate SS for RMNPI showed a DiffM of -0.15 (P < 0.001; 95%CI [-0.18; -0.12]). CONCLUSION: There is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.


Assuntos
Placa Dentária , Escovação Dentária , Adolescente , Adulto , Índice de Placa Dentária , Desenho de Equipamento , Humanos , Índice Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego
4.
Int J Dent Hyg ; 18(1): 62-72, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31309703

RESUMO

OBJECTIVES: The purpose of this observational study was to investigate the relationship between tongue coating (thickness [Tc] and surface discoloration [Td]) and gender, plaque, gingivitis (bleeding on marginal probing [BOMP] and bleeding on pocket probing [BOPP]) and tongue cleaning behaviour. MATERIALS AND METHODS: A total of 336 participants were screened for this cross-sectional study, from which 268 (150 male, 118 female) were found to be eligible. Aspects of tongue coating were visually assessed. Additionally, BOMP, BOPP and the plaque index (PI) were scored. To ascertain the tongue cleaning behaviour, the Oral Hygiene Behavior questionnaire was used. RESULTS: Most tongue coating was found at the posterior sections of the tongue surface. A thin coating and white discoloration were most prevalent as highest score for both males (92.7%) and females (87.4%), as well as white discoloration for the whole group of participants (50.2%). A gender difference was observed for TC and Td (P < .001). Analysis did not reveal a relationship between Tc and PI and between Td and PI. Also, no relation was detected between tongue cleaning behaviour and Tc or Td. However, tongue cleaning was associated with lower BOMP and BOPP scores. CONCLUSION: BOMP, BOPP or PI score did not appear to be linked to Tc and Td. A significant gender difference was found for Tc and Td. Self-reported tongue cleaning behaviour was associated with slightly lower BOMP and BOPP scores.


Assuntos
Placa Dentária , Gengivite , Estudos Transversais , Índice de Placa Dentária , Feminino , Humanos , Masculino , Índice Periodontal , Língua , Adulto Jovem
5.
Int J Dent Hyg ; 17(4): 309-317, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30942938

RESUMO

OBJECTIVE: To evaluate the results of active non-surgical treatment in patients diagnosed with adult periodontitis treated in a specialized clinic for periodontology. MATERIAL & METHODS: In total, 1182 patients with adult periodontitis received active non-surgical therapy, which involved professional oral hygiene instruction, scaling and root planing, supragingival polishing and elective systemic antimicrobial medication. The results of this therapy were based on a full-mouth periodontal chart as assessed at the time of evaluation. Successful treatment as periodontal pocket depth (PPD) ≤5 mm was the main outcome parameter with bleeding on pocket probing as secondary outcome. Patient-related factors such as smoking and severity of periodontitis at baseline and site-related factors such as tooth type, furcation involvement and endodontic treatment were analysed. Possible relations with assessed parameters and the success of active periodontal therapy were evaluated. RESULTS: Overall 39% of the patients reached the successful treatment objective and a mean bleeding on pocket probing tendency of 14%. Treatment success appeared to be dependent on tooth type where the results at single-rooted front teeth (85%) and premolar teeth (78%) were more successful than at molar teeth (47%). Analysis revealed that in 55% of the cases furcation involvement at molars was associated with the absence of success. Endodontic treatment was associated with absence of success in 8%-11% of the cases. Smoking negatively influences successful treatment outcome (P < 0.001). CONCLUSION: Active non-surgical periodontal therapy in patients with adult periodontitis resulted in approximately one third of the cases in the success endpoint of PPD ≤ 5mm. Sub-analysis showed that the outcome appeared to be dependent on tooth type, furcation involvement, severity of periodontal disease at intake and smoking status.


Assuntos
Periodontite Crônica , Perda de Dente , Adulto , Raspagem Dentária , Seguimentos , Humanos , Índice Periodontal , Estudos Retrospectivos , Aplainamento Radicular , Resultado do Tratamento
6.
Periodontol 2000 ; 79(1): 221-232, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30892760

RESUMO

This paper focuses on plaque control and the management of gingivitis in adults and summarizes the evidence of commercially available dentifrices as gathered from existing systematic reviews. Three internet sources were used to search for appropriate papers (up to and including February 2017). The search strategy was designed to include any systematic review published on dentifrices that also included an evaluation of plaque and gingivitis scores. Characteristics of the individual reviews, such as methodological aspects, quantitative data and conclusions, were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Independent screening of 205 unique reviews resulted in 10 published and eligible systematic reviews. One publication evaluated the mechanical contribution of dentifrice to plaque removal. Eight papers were identified that evaluated the efficacy of a proposed single active ingredients, of which two reviewed more than one potentially active ingredient. One study compared two active ingredients. This meta-review appraised the current state of evidence and found that toothbrushing with a standard fluoride dentifrice does not provide an added effect for the mechanical removal of dental plaque. Evidence suggests that compared with a standard dentifrice, those containing triclosan or stannous fluoride have benefits with respect to gingival health and control of dental plaque.


Assuntos
Placa Dentária , Dentifrícios , Gengivite , Adulto , Análise de Variância , Método Duplo-Cego , Humanos , Índice Periodontal
7.
Front Microbiol ; 9: 381, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29559963

RESUMO

Background: The oral cavity harbors a complex microbial ecosystem, intimately related to oral health and disease. The use of polyol-sweetened gum is believed to benefit oral health through stimulation of salivary flow and impacting oral pathogenic bacteria. Maltitol is often used as sweetener in food products. This study aimed to establish the in vivo effects of frequent consumption of maltitol-sweetened chewing gum on the dental plaque microbiota in healthy volunteers and to establish the cellular and molecular effects by in vitro cultivation and transcriptional analysis. Results: An intervention study was performed in 153 volunteers, randomly assigned to three groups (www.trialregister.nl; NTR4165). One group was requested to use maltitol gum five times daily, one group used gum-base, and the third group did not use chewing gum. At day 0 and day 28, 24 h-accumulated supragingival plaque was collected at the lingual sites of the lower jaw and the buccal sites of the upper jaw and analyzed by 16S ribosomal rRNA gene sequencing. At day 42, 2 weeks after completion of the study, lower-jaw samples were collected and analyzed. The upper buccal plaque microbiota composition had lower bacterial levels and higher relative abundances of (facultative) aerobic species compared to the lower lingual sites. There was no difference in bacterial community structure between any of the three study groups (PERMANOVA). Significant lower abundance of several bacterial phylotypes was found in maltitol gum group compared to the gum-base group, including Actinomyces massiliensis HOT 852 and Lautropia mirabilis HOT 022. Cultivation studies confirmed growth inhibition of A. massiliensis and A. johnsonii by maltitol at levels of 1% and higher. Transcriptome analysis of A. massiliensis revealed that exposure to maltitol resulted in changes in the expression of genes linked to osmoregulation, biofilm formation, and central carbon metabolism. Conclusion: The results showed that chewing itself only marginally impacted the plaque microbiota composition. Use of maltitol-sweetened gum lowered abundance of several bacterial species. Importantly, the species impacted play a key role in the early formation of dental biofilms. Further studies are required to establish if frequent use of maltitol gum impacts early dental-plaque biofilm development.

8.
J Clin Periodontol ; 45(6): 650-662, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29125699

RESUMO

OBJECTIVES: Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes. METHODS: The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis was extracted or if possible calculated. RESULTS: From the 803 titles and abstracts that came out of the search, 27 papers met the initial criteria. Prevalence of diabetes was 13.1% among subjects with periodontitis and 9.6% among subjects without periodontitis. Based on subanalysis, for subjects with periodontitis, the prevalence of diabetes was 6.2% when diabetes was self-reported, compared to 17.3% when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries (17.2%, n = 18,002) and the lowest in studies describing populations from Europe (4.3%, n = 7,858). The overall odds ratio for patients with diabetes to be among subjects with periodontitis as compared to those without periodontitis was 2.27 (95% CI [1.90;2.72]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias. CONCLUSIONS: The overall prevalence and odds of having diabetes are higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe.


Assuntos
Diabetes Mellitus/epidemiologia , Periodontite/epidemiologia , Humanos , Prevalência
9.
Phys Ther ; 97(9): 904-914, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28969348

RESUMO

Background: Adjuvant endocrine therapy in breast cancer has increased survival rates; however, it is not without musculoskeletal side effects. Purpose: The purpose of this review was to systematically and critically appraise the available scientific evidence concerning the effect of adjuvant endocrine treatment on grip strength in women being treated for breast cancer. Data sources and study selection: The National Library of Medicine (MEDLINE-PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Excerpta Medical Database by Elsevier (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Physiotherapy Evidence Database (PEDro) were searched from inception to February 2017 for appropriate papers that could answer the focused question. The searches were independently screened by 2 reviewers. The data from 7 papers that met the eligibility criteria were processed for further analysis. Data extraction and synthesis: The collective data and the statistical analysis of all included studies were summarized and presented in a descriptive manner. If not provided, based on data from the individual included studies, a mean percent change in grip strength was calculated. The included studies evaluating aromatase inhibitors had inconclusive outcomes, and studies with a follow-up of 6 or 12 months showed a percent reduction in grip strength varying from 0.1% to 9.7%. None of the included studies showed a significant decrease in grip strength in tamoxifen users, with a percent reduction in grip strength varying from 1.4% to 2.2%. Limitations: The 7 studies included cohort studies lacking a control group. Conclusions: There is inconclusive evidence for a small decrease in grip strength in women treated for breast cancer who are also receiving aromatase inhibitors. In those that use tamoxifen, grip strength did not change significantly.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Antagonistas do Receptor de Estrogênio/uso terapêutico , Força da Mão/fisiologia , Tamoxifeno/uso terapêutico , Neoplasias da Mama/mortalidade , Quimioterapia Adjuvante , Feminino , Humanos , Taxa de Sobrevida
10.
J Clin Periodontol ; 44 Suppl 18: S106-S115, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28266115

RESUMO

AIM: Aim was to systematically review behavioural aspects in the prevention and control of dental caries and periodontal diseases at individual and population level. MATERIAL & METHODS: With regard to caries, MEDLINE/PubMed was searched on three subheadings focusing on early childhood, proximal and root caries. For periodontal diseases, a meta-review on systematic reviews was performed; thus, the search strategy included specific interventions to change behaviour in order to perform a meta-review on systematic reviews. After extraction of data and conclusions, the potential risk of bias was estimated and the emerging evidence was graded. RESULTS: Regarding early childhood, proximal and root caries, 28, 6 and 0 papers, respectively, could be included, which predominantly reported on cohort studies. Regarding periodontal diseases, five systematic reviews were included. High evidence of mostly high magnitude was retrieved for behavioural interventions in early childhood caries (ECC), weak evidence for a small effect in proximal caries and an unclear effect of specific informational/motivational programmes on prevention of periodontal diseases and no evidence of root caries. CONCLUSION: Early childhood caries can be successfully prevented by population-based preventive programmes via aiming at the change in behaviour. The effect of individual specific motivational/informational interventions has not yet been clearly demonstrated neither for the prevention of caries nor for periodontal diseases.


Assuntos
Cárie Dentária/prevenção & controle , Doenças Periodontais/prevenção & controle , Comportamento Social , Humanos
11.
ISME J ; 11(5): 1218-1231, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28072421

RESUMO

A dysbiotic state is believed to be a key factor in the onset of oral disease. Although oral diseases have been studied for decades, our understanding of oral health, the boundaries of a healthy oral ecosystem and ecological shift toward dysbiosis is still limited. Here, we present the ecobiological heterogeneity of the salivary ecosystem and relations between the salivary microbiome, salivary metabolome and host-related biochemical salivary parameters in 268 healthy adults after overnight fasting. Gender-specific differences in the microbiome and metabolome were observed and were associated with salivary pH and dietary protein intake. Our analysis grouped the individuals into five microbiome and four metabolome-based clusters that significantly related to biochemical parameters of saliva. Low salivary pH and high lysozyme activity were associated with high proportions of streptococcal phylotypes and increased membrane-lipid degradation products. Samples with high salivary pH displayed increased chitinase activity, higher abundance of Veillonella and Prevotella species and higher levels of amino acid fermentation products, suggesting proteolytic adaptation. An over-specialization toward either a proteolytic or a saccharolytic ecotype may indicate a shift toward a dysbiotic state. Their prognostic value and the degree to which these ecotypes are related to increased disease risk remains to be determined.


Assuntos
Metaboloma , Microbiota , Saliva/metabolismo , Saliva/microbiologia , Adolescente , Adulto , Bactérias/classificação , Bactérias/isolamento & purificação , Estudos Transversais , Disbiose , Ecossistema , Feminino , Humanos , Masculino , Adulto Jovem
12.
J Craniomaxillofac Surg ; 44(10): 1607-1617, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27622972

RESUMO

PURPOSE: The aim of the present study was to systematically assess the current evidence on the effect of nongrafted compared to graft-assisted maxillary sinus floor elevation on implant survival/failure, endosinus bone gain, crestal bone loss, and bone density around dental implants. MATERIALS AND METHODS: MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE databases were searched up to November 2015 for randomized controlled trials (RCTs) and controlled clinical trials-(CCTs), evaluating dental implants placed in combination with maxillary sinus elevation without and with bone grafting. Implant survival/failure served as the primary outcome, whereas endosinus bone gain, crestal bone loss, and bone density around dental implants were secondary outcomes. To assess possible bias, the Cochrane risk of bias tool was used. Data were extracted and a meta-analysis performed where appropriate. RESULTS: Independent screening of 3180 papers resulted in six eligible experiments. Heterogeneity was observed among experiments. One experiment showed low, three unclear, and two a high risk of bias. The assessed outcomes showed no significant long-term differences between groups. CONCLUSION: Within the limit of the current systematic review, nongrafted maxillary sinus floor elevation seems to be characterized by new bone formation and high implant survival rate comparable to bone-graft-assisted maxillary sinus floor augmentation. Further long-term studies are needed before definitive conclusions can be made.


Assuntos
Transplante Ósseo , Implantação Dentária Endo-Óssea , Levantamento do Assoalho do Seio Maxilar , Falha de Restauração Dentária , Humanos , Levantamento do Assoalho do Seio Maxilar/métodos , Resultado do Tratamento
13.
J Clin Periodontol ; 43(12): 1050-1058, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27513809

RESUMO

AIMS: The aim of this systematic review was to establish the efficacy of brushing with and without a dentifrice for dental plaque removal. MATERIALS AND METHODS: MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched. The inclusion criteria were randomized controlled trials and controlled clinical trials and subjects ≥18 years of age with good general health. Studies that evaluated the effect of toothbrushing with a dentifrice compared to brushing without a dentifrice were included. Data were extracted from the eligible studies, and a meta-analysis was performed where feasible. RESULT: The search was conducted until June 2016 and retrieved 10 eligible publications that included 20 comparisons. On average, 49.2% of plaque was removed when brushing was performed with a dentifrice, and 50.3% of plaque was removed when toothbrushing was performed without a dentifrice. The descriptive analysis indicated that the majority of the comparisons did not show an additional effect of dentifrice use. Regarding the meta-analysis of post-brushing scores, no significant difference was observed between toothbrushing with and without a dentifrice (DiffM 0.00, 95%CI [-0.05: 0.05], p = 0.91). The meta-analysis of incremental data (as means or percentages) supported and strengthened these findings. CONCLUSION: The cumulative evidence for this systematic review demonstrates that there is moderate certainty that toothbrushing with a dentifrice does not provide an added effect for the mechanical removal of dental plaque.


Assuntos
Placa Dentária , Índice de Placa Dentária , Dentifrícios , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Escovação Dentária , Cremes Dentais
14.
Dent Clin North Am ; 59(4): 799-829, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26427569

RESUMO

Also note that structured abstracts are not allowed per journal style: What is the effect of a mouthwash containing various active chemical ingredients on plaque control and managing gingivitis in adults based on evidence gathered from existing systematic reviews? The summarized evidence suggests that mouthwashes containing chlorhexidine(CHX) and essential oils (EO) had a large effect supported by a strong body of evidence. Also there was strong evidence for a moderate effect of cetylpyridinium chloride(CPC). Evidence suggests that a CHX mouthwash is the first choice, the most reliable alternative is EO. No difference between CHX and EO with respect to gingivitis was observed.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Placa Dentária/tratamento farmacológico , Gengivite/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Humanos , Saúde Bucal
15.
J Clin Periodontol ; 42(10): 908-13, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26212602

RESUMO

AIM: To evaluate the correlation between bleeding on marginal probing (BOMP) and bleeding on pocket probing (BOPP), and the correlation of both bleeding indices with plaque. MATERIALS AND METHODS: This cross-sectional study screened 336 participants, from which 268 were eligible for examination and analysis. Bleeding and plaque indices were assessed by single examiners, at six sites per tooth. RESULTS: The mean percentage of sites per individual with bleeding on marginal probing, bleeding on pocket probing and dental plaque were 19.9%, 51.2% and 32.2% respectively. In the quadrants where the margin was probed before the pocket, a 4.6 percentage points higher bleeding tendency with BOPP was observed (p < 0.05). At a site level, the correlation coefficients of plaque and bleeding on marginal probing and bleeding on pocket probing were 0.19 and 0.20 respectively. Both bleeding indices were also shown to be correlated (r = 0.89, fixed effect model). CONCLUSION: The prevalence of bleeding upon probing is influenced by the scoring method that is used for the diagnosis. Probing the bottom of the pocket results in significantly more bleeding than running a probe along the margin.


Assuntos
Hemorragia , Estudos Transversais , Placa Dentária/diagnóstico , Índice de Placa Dentária , Feminino , Gengivite/diagnóstico , Humanos , Masculino , Índice Periodontal , Adulto Jovem
17.
J Clin Periodontol ; 42 Suppl 16: S303-16, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25682952

RESUMO

FOCUSED QUESTION: What is the effect of a dentifrice (DF), a mouthwash (MW), tongue cleaning (TC), or any combination of these as adjunct to toothbrushing on intra-oral malodour and tongue coating as compared to toothbrushing alone in systemically healthy patients, when used for a minimum follow-up period of 2 weeks? MATERIAL AND METHODS: The MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were searched up to August 2014. Measurements of Volatile Sulphur Compounds and organoleptic scores of oral malodour were selected as outcome variables. Data were extracted and a descriptive analysis was performed. RESULTS: Independent screening of 1054 unique papers resulted in 12 eligible clinical trials with a medium-term (≥2 weeks) duration. The majority of studies provided a significant reduction in oral malodour when evaluating products with an active ingredient (incorporated into a DF or a MW) used adjunctively to toothbrushing. The added value of tongue cleaning over a MW was evaluated in one study. CONCLUSION: Due to very limited evidence, the potential effect of a specifically formulated dentifrice, a mouthwash or a tongue scraper for treating oral malodour is, in general, unclear. For mouthwashes containing the active ingredients chlorhexidine + cetylpyridinium chloride + zinc (CHX + CPC + Zn) and zinc chloride + cetylpyridinium chloride (ZnCl + CPC) most evidence was available. The strength of a recommendation to use these products was graded to be 'weak'.


Assuntos
Halitose/terapia , Dispositivos para o Cuidado Bucal Domiciliar , Dentifrícios/uso terapêutico , Seguimentos , Halitose/tratamento farmacológico , Humanos , Antissépticos Bucais/uso terapêutico , Língua/patologia , Escovação Dentária/métodos , Resultado do Tratamento
19.
J Clin Periodontol ; 42 Suppl 16: S77-91, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25597787

RESUMO

FOCUSED QUESTION: Based on evidence as presented in systematic reviews what is the efficacy and safety of available homecare toothbrush regimens for mechanical plaque removal on plaque and gingivitis in adults? MATERIAL & METHODS: Three Internet sources were used (up to and including August 2014) to search for appropriate papers that satisfied the study purpose. Plaque scores and gingivitis scores were considered to be the primary parameter of interest. Safety was considered an important facet in relation to efficacy. Data and conclusions as presented in the selected papers were extracted. The potential risk of bias was estimated and the emerging evidence was graded. RESULTS: Independent screening of 176 unique reviews resulted in 10 published and eligible systematic reviews. They were categorized into one review evaluating the effect of an oral hygiene instruction with a toothbrush on plaque and gingivitis scores, five evaluating the efficacy of manual and power toothbrushes and three reviews evaluating toothbrush safety and one evaluating toothbrush contamination. CONCLUSION: Tooth brushing is effective in reducing levels of dental plaque. With respect to gingivitis power toothbrushes have a benefit over manual toothbrushes. The greatest body of evidence was available for oscillating-rotating brushes. Tooth brushing generally can be considered safe for the teeth and their investing tissues.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Higiene Bucal , Autocuidado , Escovação Dentária/métodos , Índice de Placa Dentária , Humanos , Higiene Bucal/educação , Índice Periodontal , Escovação Dentária/instrumentação , Resultado do Tratamento
20.
J Clin Periodontol ; 42 Suppl 16: S92-105, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25581718

RESUMO

FOCUSED QUESTION: What is the effect of mechanical inter-dental plaque removal in addition to toothbrushing, on managing gingivitis using various formats of inter-dental self-care in adults based on evidence gathered from existing systematic reviews? MATERIAL & METHODS: Three Internet sources were searched by a strategy designed to include systematic reviews on inter-dental cleaning devices. Plaque and gingivitis scores were the primary parameters of interest. Characteristics of selected papers were extracted. The potential risk of bias was estimated and the acquired evidence was graded. RESULTS: Screening of 395 papers resulted in six systematic reviews. Two papers evaluated the efficacy of dental floss, two of inter-dental brushes (IDB), one of woodsticks and one of the oral irrigator. Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs in combination with toothbrushing reduce both plaque and gingivitis. CONCLUSION: Evidence suggests that inter-dental cleaning with IDBs is the most effective method for inter-dental plaque removal. The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal. All investigated devices for inter-dental self-care seem to support the management of gingivitis, however, to a varying extend.


Assuntos
Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Índice de Placa Dentária , Humanos , Índice Periodontal , Autocuidado , Escovação Dentária/métodos , Resultado do Tratamento
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