Periodontitis, dental plaque, and atrial fibrillation in the Hamburg City Health Study.

BACKGROUND/AIM: Atrial fibrillation (AF) is a major health problem and causes heart failure and stroke. Pathophysiological mechanisms indicate a link with oral health including periodontitis (PD), but supporting data are scarce. The aim was to investigate the link between features of oral health and the prevalence of AF. METHODS: This cross-sectional analysis of the Hamburg City Health Study included 5,634 participants with complete data on their PD and AF status. AF was assessed via self-reported questionnaire or medically diagnosed by standard 12-lead resting ECG. The oral health examination included full-mouth measurements of the dental plaque index (PI), the clinical attachment loss (CAL) at 6 sites per tooth, the bleeding on probing (BOP) and the decayed, missing and filled teeth (DMFT) index. Descriptive analyses for all variables stratified by the status of PD were performed. To test for an association between prevalent PD and prevalent AF, multivariable logistic regression models were used. Mediation analysis was used to test if interleukin-6 (IL-6) and/or C-reactive protein (CRP) mediated the association between PD and AF. RESULTS: Atrial fibrillation (prevalence: 5.6%) and the severity of PD (prevalence: moderate: 57.7%, severe: 18.9%) increased with age in men and women. Prevalent severe PD, CAL ≥3 mm, PI, and BOP were all associated with prevalent AF in unadjusted regression analysis. However, no association except for PI (odds ratio (OR): 1.22, 95% confidence interval (CI): 1.1-1.35, p<0.001) could be observed after adjusting for age, sex, high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), body mass index, diabetes, smoking, and educational level. Participants brushing their teeth at least twice daily had a lower AF prevalence compared with those brushing only once daily. Hs-CRP, IL-6, and the odds of AF increased as a function of PD severity grades in unadjusted analysis. However, neither the DMFT index nor IL-6 or CRP was associated with AF after adjusting for age and sex. Mediation analyses could not provide support for the hypothesis that IL-6 or CRP acted as mediator of the association between prevalent PD and prevalent AF. CONCLUSION: The study shows an association between prevalent AF and increased dental plaque levels indicated by a higher PI. In contrast, an association of prevalent PD with prevalent AF after adjustments for several confounders could not be demonstrated. Further studies are necessary to investigate the mechanisms underlying poor oral hygiene and AF as well as the influence of improved oral hygiene on AF onset.

A lingering mouthwash with sustained antibiotic release and biofilm eradication for periodontitis.

Dental plaque biofilms are believed to be one of the principal virulence factors in periodontitis resulting in tooth loss. Traditional mouthwashes are limited due to the continuous flow of saliva and poor drug penetration ability in the biofilm. Herein, we fabricated an antibiotic delivery platform based on natural polysaccharides (chitosan and cyclodextrin) as a novel mouthwash for the topical cavity delivery of minocycline. The penetration and residence mechanisms demonstrate that the platform can prolong the residence time up to 12 h on biofilms. Furthermore, sustained release can enhance the penetration of drugs into biofilms. In vitro antibiofilm experimental results indicated that the mouthwash effectively kills bacteria and eradicate biofilms. Effective treatment in vivo was confirmed by the significantly reduced dental plaque and alleviated inflammation observed in a rat periodontitis model. In summary, this novel platform can improve antibiofilm efficiency and prevent drugs from being washed away by saliva, which may provide benefits for many oral infectious diseases.

Eficácia de óleos vegetais no controle do biofilme dental: revisão integrativa / Efficacy of vegetable oils in control of dental biofilm: integrative review / Eficacia de los aceites vegetales en el control de biofilm dental: revision integrativa

Introdução:A terapia de bochecho com óleos vegetais é uma cultura tradicional na Índia com intuito de prevenir afecções bucais, como cárie e doença periodontal. Atualmente, com as mudanças nos padrões alimentares da sociedade, tem-se empregado com maior valor o uso de óleos naturais, já que estudos demonstram sua importância para saúde.Objetivo:Esta revisão integrativa teve como objetivo selecionar evidências que mostrassem a utilização de óleos vegetais, com ação antimicrobiana, no controle do biofilme dental. Metodologia:O levantamento bibliográfico foi realizado nos meses de julho e agosto de 2020, por meio de pesquisa por via eletrônica, consultando-se o banco de dados Pubmed e SciELO (Scientific Electronic Library Online). Foram utilizados os descritores: Óleos vegetais, agentes antimicrobianos, Placa dental, Odontologia preventiva e Odontologia, os descritores foram usados separadamente e em cruzamento com o operador boleano AND. Utilizou-se os seguintes critérios de inclusão: Estudos clínicos, artigos completos e disponíveis gratuitamente, publicados no período de 2010 a 2020 em português e/ou inglês, e indexados nas bases de dados já citadas. Foram excluídos os trabalhos de conclusão de curso, dissertações, teses, livros e capítulos de livros, além de artigos duplicados e que não abordaram o tema do estudo.Resultados:Atenderam os critérios da pesquisa 04 estudos do tipo clínico randomizado, os quais mostraram eficiência dos óleos vegetais utilizados no controle do biofilme dental. A realização de pesquisas envolvendo e motivando a industrialização de produtos naturaiscontribui para a Política Nacional de Práticas Integrativas e Complementares.Conclusões:Os artigos analisados mostraram eficácia na utilização de óleos vegetais no controle do biofilme dental, sendo esses aplicados clinicamente,não mostrando prejuízo aos participantes e indicados como coadjuvante na manutenção da saúde bucal (AU).

Introduction:Mouthwash therapy with vegetable oils is a traditional culture in India with the aim of preventing oral diseases, such as caries and periodontal disease. Currently, with the changes in the dietary patterns of society, the use of natural oils has been used with greater value, since studies demonstrate its importance for health.Objective:This integrative review aimed to select evidence that showed the use of vegetable oils, with antimicrobial action, in the control of dental biofilm. Methodology:Thebibliographic survey was carried out in July and August 2020, through electronic research, consulting the Pubmed and SciELO database (Scientific Electronic Library Online). The descriptors were used: Vegetable oils, antimicrobial agents, dental plaque, preventive dentistry and dentistry, the descriptors were used separately and in cross-section with the Boolean operator AND. The following inclusion criteria were used: Clinical studies, complete and freely available articles, published between 2010 and 2020in Portuguese and / or English, and indexed in the databases already cited. Course completion papers, dissertations, theses, books and book chapters were excluded, as well as duplicate articles that did not address the subject of the study. Results:Four studies of randomized clinical type met the research criteria, which showed efficiency of vegetable oils used in the control of dental biofilm. Conducting research involving and motivating the industrialization of natural products contributes to the National Policy on Integrative and Complementary Practices.Conclusions:The analyzed articles showed efficacy in the use of vegetable oils in the control of dental biofilm, which were applied clinically without showing any harm to the participants and indicatedas an adjunct in maintaining oral health (AU).

Introducción: La terapia de enjuague bucal con aceites vegetales es una cultura tradicional en India con el objetivo de prevenir enfermedades bucales, como caries y enfermedad periodontal. Actualmente, con los cambios en los patrones dietéticos de la sociedad, se ha utilizado con mayor valor el uso de aceites naturales, ya que los estudios demuestran su importancia para la salud. Objetivo: Esta revisión integradora tuvo como objetivo seleccionar evidencias que mostraran el uso de aceites vegetales, con acción antimicrobiana, en el control del biofilm dental.Metodología: El relevamiento bibliográfico se realizó en julio y agosto de 2020, mediante investigación electrónica, consultando la base de datos Pubmed y SciELO (Scientific Electronic Library Online). Se utilizaron los descriptores: Aceites vegetales, agentes antimicrobianos, placa dental, odontología preventiva y odontología, los descriptores se utilizaron por separado y en corte transversal con el operador booleano AND. Se utilizaron los siguientes criterios de inclusión: Estudios clínicos, artículos completos y de libre acceso, publicados entre 2010 y 2020 en portugués y / o inglés, e indexados en las bases de datos ya citadas. Se excluyeron trabajos de finalización de curso, disertaciones, tesis, libros y capítulosde libros, así como artículos duplicados que no abordaran el tema de estudio. Resultados: Cuatro estudios de tipo clínico aleatorizado cumplieron con los criterios de investigación, los cuales mostraron la eficiencia de los aceites vegetales utilizados enel control del biofilm dental. Realizar investigaciones que involucren y motiven la industrialización de productos naturales contribuye a la Política Nacional de Prácticas Integrativas y Complementarias.Conclusiones: Los artículos analizados mostraron eficacia en el uso de aceites vegetales en el control del biofilm dental, los cuales fueron aplicados clínicamente sin mostrar daño a los participantes e indicados como coadyuvante en el mantenimiento de la salud bucal (AU).

Bacterial diversity and prevalence of antibiotic resistance genes in the oral microbiome.

OBJECTIVES: This study aims to describe the oral microbiome diversity and prevalence of ARGs in periodontal health and disease. BACKGROUND: The human oral cavity harbors a complex microbial community known as the oral microbiome. These organisms are regularly exposed to selective pressures, such as the usage of antibiotics, which drive evolution and acquisition of antibiotic resistance genes (ARGs). Resistance among oral bacteria jeopardizes not only antibiotic therapy for oral infections, but also extra-oral infections caused by bacterial translocation. METHODS: We carried out a cross-sectional investigation. Saliva and subgingival plaque samples were collected during a clinical exam. 16S rRNA gene sequencing was performed to assess microbial diversity. Resistance genes were identified through PCR assays. RESULTS: Of the 110 participants, only 22.7% had healthy periodontium, while the majority was diagnosed with gingivitis (55.4%) and chronic periodontitis (21.8%). The composition of the oral microbiota differed from healthy and diseased samples, being Streptococcus spp. and Rothia spp. predominant in periodontal disease. Regarding ARGs, 80 (72.7%) samples were positive for at least one of genes screened, erm being the most frequent variant (58.2%), followed by blaTEM (16.4%), mecA (2.7%), pbp2b and aac(6 ') (1.8%). Neither genes coding resistance to carbapenems nor metronidazole were detected. CONCLUSIONS: Our findings indicate that there are no significant differences in terms of taxonomic enrichment between healthy and diseased oral microbiomes. However, samples retrieved from healthy patients had a more diverse microbial community, whereas diseased samples have lower taxonomic diversity. We have also identified clinically relevant ARGs, providing baseline information to guide antibiotic prescription in dentistry.

Monetary incentives for improving smartphone-measured oral hygiene behaviors in young children: A randomized pilot trial.

AIMS: To assess feasibility, acceptability, and early efficacy of monetary incentive-based interventions on fostering oral hygiene in young children measured with a Bluetooth-enabled toothbrush and smartphone application. DESIGN: A stratified, parallel-group, three-arm individually randomized controlled pilot trial. SETTING: Two Los Angeles area Early Head Start (EHS) sites. PARTICIPANTS: 36 parent-child dyads enrolled in an EHS home visit program for 0-3 year olds. INTERVENTIONS: Eligible dyads, within strata and permuted blocks, were randomized in equal allocation to one of three groups: waitlist (delayed monetary incentive) control group, fixed monetary incentive package, or lottery monetary incentive package. The intervention lasted 8 weeks. OUTCOMES: Primary outcomes were a) toothbrushing performance: mean number of Bluetooth-recorded half-day episodes per week when the child's teeth were brushed, and b) dental visit by the 2-month follow-up among children with no prior dental visit. The a priori milestone of 20% more frequent toothbrushing identified the intervention for a subsequent trial. Feasibility and acceptability measures were also assessed, including frequency of parents syncing the Bluetooth-enabled toothbrush to the smartphone application and plaque measurement from digital photographs. FINDINGS: Digital monitoring of toothbrushing was feasible. Mean number of weekly toothbrushing episodes over 8 weeks was 3.9 in the control group, 4.1 in the fixed incentive group, and 6.0 in the lottery incentive group. The lottery group had 53% more frequent toothbrushing than the control group and 47% more frequent toothbrushing than the fixed group. Exploratory analyses showed effects concentrated among children ≤24 months. Follow-up dental visit attendance was similar across groups. iPhone 7 more reliably captured evaluable images than Photomed Cannon G16. CONCLUSIONS: Trial protocol and outcome measures were deemed feasible and acceptable. Results informed the study protocol for a fully powered trial of lottery incentives versus a delayed control using the smart toothbrush and remote digital incentive program administration. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT03862443.

Four-day plaque regrowth evaluation of a peptide chewing gum in a double-blind randomized clinical trial.

OBJECTIVE: Antimicrobial peptide, KSL-W, formulated as an antiplaque chewing gum (APCG), was tested to evaluate the dental plaque inhibition activity and safety in an IRB approved and FDA regulated 4-day plaque regrowth clinical study. METHODS: This Phase 2 two-armed placebo-controlled, double blind, randomized (1:1), multiple dose, and single-center study was evaluated in a proof of concept for the APCG containing 30 mg antimicrobial peptide KSL-W. Twenty six generally healthy subjects were consented and randomized into the study. The subjects were administered a dose three times per day for four treatment days following a complete dental prophylaxis. Participants were prohibited from conducting oral hygiene care (teeth brushing, flossing, and/or mouth wash rinse) for the duration of the trial. Twelve to 16 hr prior to the baseline visit, the subjects were to abstain from oral hygiene care. The Quigley-Hein Turesky plaque index (QHT) score and the oral soft tissue clinical exams were obtained at both Day 0 and Day 4. RESULTS: All randomized study subjects that received either APCG or placebo gum completed the study with no significant adverse events recorded. The APCG significantly inhibited the regrowth of dental plaque over the course of 4 days. The whole mouth data demonstrated a difference in the QHT between the APCG and the placebo gum of 1.14 (SE = 0.27) and 95% confidence bounds of 0.58, 1.70 with a two-tailed P value of .0003. CONCLUSION: Considering the limited sample size, the proof of concept analysis in this Phase 2 study confirmed that APCG is effective against dental plaque formation and safe for human use. (ClinicalTrials.gov Study ID# NCT02864901).

Frequency of putative periodontal pathogens among type 1 diabetes mellitus: a case-control study.

OBJECTIVE: The aim of the present study is to compare and assess the risk of periodontitis due to the presence of four putative periodontopathic bacteria viz., Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens. To fulfil the above objective, polymerase Chain reaction using the primers targeting 16S rRNA gene of the bacterial species was performed with the subgingival plaque collected from the permanent first molars of type 1 diabetic children and age matched healthy children. RESULTS: The prevalence of periodontal pathogens in diabetic and healthy children was 6% and 16% for E. corrodens, 18% and 36% for C. rectus, 2% and 2% for P. intermedia, 4% and 0%, for P. nigrescens respectively. Statistically, significant difference was not observed for the prevalence of all the four periodontal pathogens between type 1 diabetic and healthy children (P = 1.00). The results of the present study thus reveal a negative correlation of type I diabetes to periodontitis in association to Eikenella corrodens, Campylobacter rectus, Prevotella intermedia and Prevotella nigrescens.

Controllable acidophilic dual-emission fluorescent carbonized polymer dots for selective imaging of bacteria.

Fluorescent materials can be powerful contrast agents in photoelectric devices and for bioimaging. As emerging fluorescent materials, carbonized polymer dots (CPDs) with high quantum yields (QYs), long-wavelength emission and multiple functions are highly desired. Despite great progress in the synthetic methods and QYs of CPDs, multiple emission of CPDs is challenging. Therefore, we developed CPDs with dual-emission fluorescence in terms of inherent blue and red emission. In addition, CPDs with sole blue emission (B-CPDs) and red emission (R-CPDs) were synthesized, respectively, by regulating the reaction conditions to control the quantitative structure and emission centers. The absolute QY of R-CPDs in water was 24.33%. These three types of CPDs with dual/sole emission could be used in optoelectronic and bioimaging applications. With different CPDs coated on a commercially available gallium nitride light-emitting diode chip as a color-conversion layer, LEDs with blue, yellow, and red emission were achieved. Benefiting from the different emission intensities and emission peaks of R/B-CPDs in different pH conditions, they were used (without further modification) to distinguish between Porphyromonas gingivalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus in dental plaque biofilms (the first time this has been demonstrated). These findings could enable a new development direction of CPDs based on the design of multi-emission centers.

The Biology of Streptococcus mutans.

As a major etiological agent of human dental caries, Streptococcus mutans resides primarily in biofilms that form on the tooth surfaces, also known as dental plaque. In addition to caries, S. mutans is responsible for cases of infective endocarditis with a subset of strains being indirectly implicated with the onset of additional extraoral pathologies. During the past 4 decades, functional studies of S. mutans have focused on understanding the molecular mechanisms the organism employs to form robust biofilms on tooth surfaces, to rapidly metabolize a wide variety of carbohydrates obtained from the host diet, and to survive numerous (and frequent) environmental challenges encountered in oral biofilms. In these areas of research, S. mutans has served as a model organism for ground-breaking new discoveries that have, at times, challenged long-standing dogmas based on bacterial paradigms such as Escherichia coli and Bacillus subtilis. In addition to sections dedicated to carbohydrate metabolism, biofilm formation, and stress responses, this article discusses newer developments in S. mutans biology research, namely, how S. mutans interspecies and cross-kingdom interactions dictate the development and pathogenic potential of oral biofilms and how next-generation sequencing technologies have led to a much better understanding of the physiology and diversity of S. mutans as a species.

Oral findings in children and adolescents with Prader-Willi syndrome.

OBJECTIVE: To assess the significance of changes in the saliva in the etiology of gingivitis and tooth wear in children and adolescents with Prader-Willi syndrome (PWS). MATERIALS AND METHODS: The study included 80 (2.8-18 years old; 39 girls and 41 boys): 40 in PWS group (mean age 8.0 ± 4.24 years) and 40 in control group (mean age 7.9 ± 4.12 years). General condition, oral para-functional habits, tooth wear (modified TWI), oral hygiene and gingival status (Plaque Index (PLI) and Gingival Index (GI)), localization of gingivitis, and salivary characteristics were assessed. The chi-square test, the Mann-Whitney U test, Spearman's rank correlation, and odds ratio based on logistic regression in a statistical analysis were applied. RESULTS: Chances of gingivitis were increased by low PLI (odds ratio (OR) = 32.53), low resting salivary flow (OR = 3.96), increased viscosity of saliva (OR = 3.54), and mouth breathing (OR = 8.17). For gingivitis in anterior regions, low PLI (OR = 107.67), low resting (OR = 5.73) and stimulated (OR = 1.86) salivary flow, increased viscosity of saliva (OR = 5.87), mouth breathing (OR = 10.00), and low stimulated salivary flow (OR = 3.18) were observed. Tooth wear rates were increased by teeth grinding (OR = 16.20), mouth breathing (OR = 4.33), increased viscosity of saliva (OR = 11.67) and low resting (OR = 6.07), and stimulated (OR = 4.22) salivary flow. CONCLUSIONS: In PWS, reduced salivary secretion, increased viscosity, of saliva and mouth breathing increase the risk of plaque-induced gingivitis and tooth wear. CLINICAL RELEVANCE: The prevention and treatment of tooth wear and gingivitis in PWS patients is necessary not only to treat bruxism and mouth breathing but also to limit the influence of negative changes of saliva.

Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly. / Associação entre fatores socioeconômicos, comportamentais, saúde geral e condição da mucosa bucal em idosos.

This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.

O objetivo deste estudo foi investigar a associação entre fatores socioeconômicos, comportamentais, saúde geral, saúde bucal e os desfechos de acúmulo de placa e condição de mucosa bucal em idosos. Este estudo transversal, conduzido entre 2004 e 2005, incluiu 785 idosos de Carlos Barbosa, RS. Questionários foram utilizados para coleta de dados socioeconômicos, comportamentais e estado de saúde. O exame físico das estruturas bucais e o Índice de Mucosa e de Placa de Henriksen (MPS) foram utilizados para categorizar os desfechos. Observou-se maior prevalência de acúmulo de placa moderado/grave entre os idosos mais velhos, do sexo masculino e com menor escolaridade. O uso de prótese dental total superior e renda de até 1 salário mínimo foram fatores de proteção para acúmulo de placa moderado/grave. Apenas as variáveis do primeiro bloco da estrutura conceitual, sexo masculino (OR = 2,13; IC95% = 1,26-3,61) e menor escolaridade (OR = 1,37; IC95% = 1,06-1,78) permaneceram associados como risco à presença de escore inaceitável do MPS. Os achados sugerem que idosos do sexo masculino e com menor escolaridade têm maior chance de saúde bucal precária, conforme o MPS.

Management and Histobacteriological Findings of Mucosal Fenestration: A Report of 2 Cases.

This article describes 2 unusual cases of mucosal fenestration associated with necrotic infected teeth, resulting in exposure of the root apex to the oral cavity. Both cases consisted of maxillary incisors with pulp necrosis and radiographic/tomographic evidence of apical periodontitis. Clinically, the root apex was exposed to the oral cavity through a fenestration in both bone and mucosa and covered with bacterial plaque and calculus. These teeth were treated by a combination of nonsurgical and surgical endodontic treatment. During surgery, the root apices were resected to within the alveolus and the fenestrated area covered by the flap. Specimens consisting of the root apex and surrounding soft tissues were subjected to histopathological and histobacteriological analyses. Histobacteriological analysis revealed extensive resorptive defects on the root apices filled with thick bacterial biofilm, irregular detachment of the cementum layers with consequent infection of the underlying spaces, and heavy infection in the apical foramina. The soft tissue specimens exhibited no or minimal inflammation. The 2 cases showed satisfactory postsurgical healing of the hard and soft tissues. Both cases of mucosal fenestration showed root apices covered with dense bacterial biofilms and associated with a bone crypt with no significant inflammatory tissue therein. The 2 cases were successfully treated by conservative approaches involving a combination of nonsurgical and surgical endodontic treatment with root-end resection.

Influence of the width of keratinized tissue on the development and resolution of experimental peri-implant mucositis lesions in humans.

OBJECTIVES: To analyze the influence of the width of keratinized mucosa (KM) on the development and resolution of experimental peri-implant mucositis lesions at abutments with different microstructures in humans. MATERIAL AND METHODS: In a randomized, controlled study, a total of 28 patients had received 28 target implants exhibiting a KM ≥2 mm. These were randomly connected with either partially microgrooved- (test) (n = 15) or machined (control) (n = 13) healing abutments. The study protocol included a wound healing period (WH) following implant placement (12 weeks), a plaque exposure phase (EP) of 21 days (EPd21) and a resolution phase (RP) including visits at 2, 4, and 16 weeks (RPw2; RPw4; RPw16) following plaque removal. Linear regression analyses were used to analyze the relationship between the width of KM and clinical outcomes (i.e., modified plaque index [mPI], modified gingival index [mGI], bleeding on probing [BOP], and probing depth [PD]). RESULTS: Mean and median KM values (end of WH) were 5.9 ± 2.6 and 5.0 mm (min: 2 mm; max: 10 mm; interquartile range: 5 mm) at test- and 5.5 ± 2.6 and 4.0 mm (min: 3 mm; max: 11 mm interquartile range: 4 mm) at control abutments. The linear regression analysis revealed significant correlations between the width of KM and mPI (test: RPw2; control: RPw16), mGI (test: RPw16), BOP (both: RPw16), and PD (test: RPw16; control: EPd21, RPw2, RPw4, RPw16) scores. CONCLUSION: The width of KM (≥2 mm) had some effects on the development (i.e., at 21 days) and resolution of experimental peri-implant mucositis lesions at both abutment types.

Plasma in Dentistry: Brief History and Current Status.

We briefly discuss the history of cold atmospheric plasma (CAP) applications in dentistry. The reasons for seeking innovative solutions in dentistry are reported, highlighting results showing the potential of plasma along with some still-open questions. Finally, we suggest the next steps on the road from the laboratory to the dental chair.

Oral health and hematopoietic stem cell transplantation: A longitudinal evaluation of the first 28 days.

BACKGROUND: Mucositis is well described after pediatric hematopoietic stem cell transplant (HSCT) but other aspects of oral health such as dental plaque and gingivitis are poorly understood. The aim of this study was to describe dental plaque, gingivitis, and mucositis early after HSCT. METHODS: We conducted a prospective longitudinal observational study to describe dental plaque, gingivitis, and mucositis in the peritransplant period. We conducted comprehensive oral evaluations that included the Miyazaki tongue coating, modified simplified oral hygiene, modified gingivitis of Suomi and Barbano, and mucosal ulceration indices at baseline on days 0, +7, +14, and +28. RESULTS: Data were collected from 19 patients with a median age of 8.0 years (5.1-12.8) at time of HSCT. Sixteen patients (85%) had plaque accumulation that progressively worsened, 16 (85%) developed severe gingival inflammation, 13 (68%) developed mucositis, and 11 (58%) had oral ulcerations. All oral indices worsened from baseline during the study period. Gingivitis and oral plaque persisted in most patients at day +28 while mucositis and oral ulcerations slightly improved. DISCUSSION: Gingivitis, dental plaque, mucositis, and oral ulcerations are common after HSCT. Additional studies are needed to ascertain methods that decrease plaque and gingivitis development and severity.

Associação entre fatores socioeconômicos, comportamentais, saúde geral e condição da mucosa bucal em idosos / Association between socioeconomic factors, behavioral, general health and oral mucosa status in elderly

Resumo O objetivo deste estudo foi investigar a associação entre fatores socioeconômicos, comportamentais, saúde geral, saúde bucal e os desfechos de acúmulo de placa e condição de mucosa bucal em idosos. Este estudo transversal, conduzido entre 2004 e 2005, incluiu 785 idosos de Carlos Barbosa, RS. Questionários foram utilizados para coleta de dados socioeconômicos, comportamentais e estado de saúde. O exame físico das estruturas bucais e o Índice de Mucosa e de Placa de Henriksen (MPS) foram utilizados para categorizar os desfechos. Observou-se maior prevalência de acúmulo de placa moderado/grave entre os idosos mais velhos, do sexo masculino e com menor escolaridade. O uso de prótese dental total superior e renda de até 1 salário mínimo foram fatores de proteção para acúmulo de placa moderado/grave. Apenas as variáveis do primeiro bloco da estrutura conceitual, sexo masculino (OR = 2,13; IC95% = 1,26-3,61) e menor escolaridade (OR = 1,37; IC95% = 1,06-1,78) permaneceram associados como risco à presença de escore inaceitável do MPS. Os achados sugerem que idosos do sexo masculino e com menor escolaridade têm maior chance de saúde bucal precária, conforme o MPS.

Abstract This study aimed to investigate the association between socioeconomic and behavioral factors, general health, oral health, and plaque accumulation and oral mucosa condition outcomes in the elderly. This is a cross-sectional study conducted from 2004 to 2005 with 785 elderly dwellers of the city of Carlos Barbosa (RS), Brasil. We used questionnaires to collect socioeconomic, behavior and health status data. The physical examination of the oral structures comprised the Mucosal-Plaque Index proposed by Henriksen (MPS). A higher prevalence of moderate/severe plaque accumulation was observed in the elderly group, in less educated male elderly. The use of full upper dentures and income under one minimum wage were protective factors for moderate/severe plaque accumulation. Only the variables of the first block of the conceptual structure, male gender (OR = 2.13; 95% CI 1.26-3.61) and lower education (OR = 1.37; 95% CI 1.06-1.78) remained associated with an unacceptable MPS score. The findings suggest that, as per MPS, less educated male elderly are more likely to have poor oral health.

Clinical validation and assessment of a modular fluorescent imaging system and algorithm for rapid detection and quantification of dental plaque.

BACKGROUND: Significant numbers of adults and children have untreated plaque due to poor oral hygiene and consequently suffer from associate dental and systemic diseases. METHODS: A handheld device equipped with 405 nm light-emitting diodes was constructed to examine the prevalence of red fluorescence signatures associated with dental plaque. This device was used for in vivo imaging of all four incisors and all four canines of twenty-eight consenting human subjects. The same areas were further imaged under white light illumination with a commercial image-processing based plaque-imaging device, and evaluated by a hygienist and dentist. A custom computer vision algorithm using pixel information was developed to calculate plaque coverage ratios ranging from 0 (no plaque) to 1 (complete plaque coverage) for images captured by both devices. RESULTS: The algorithm calculated red fluorescence-based plaque coverage ratios ranging from 0.011 to 0.211 for the subjects imaged. Clinical assessment and statistical analyses of associated plaque ratios of the 405 nm device images indicated high sensitivity and specificity in detecting dental plaque by the experimental device compared to the commercial reference device. CONCLUSIONS: The low-cost and open source 405 nm device and the associated computer vision algorithm successfully captured red fluorescence signatures associated with dental plaque and demonstrated comparable performance to a commercially available device. Therefore, a proof of concept validation was provided for the construction and application of a sensitive cost-effective plaque-detecting device. A miniaturized mobile adaptable version of the device was also provided, together with and a step-by-step guide for device assembly and webhost the associated software, to facilitate open-source access to a cost-effective at-home, in-clinic oral care technology. TRIAL REGISTRATION: ClinicalTrials.gov NCT03379337, December 19 2017. Retrospectively registered.

Metagenomic Analysis of Gingival Sulcus Microbiota and Pathogenesis of Periodontitis Associated with Type 2 Diabetes Mellitus.

Biofilm of the gingival sulcus from 22 patients with type 2 diabetes mellitus and periodontitis, 30 patients with periodontitis not complicated by diabetes mellitus (reference group), and 22 healthy volunteers without signs of gingival disease (control group) was studied by quantitative PCR. Quantitative analysis for the content of P. gingivalis, T. forsythia, A. ctinomycetemcomitans, T. denticola, P. intermedia, F. nucleatum/periodonticum, and P. endodontalis in the dental plaque was performed with a Dentoscreen kit. The presence of other bacterial groups was verified by metagenomic sequencing of the 16S rRNA gene to evaluate some specific features of the etiological factor for periodontitis in type 2 diabetes mellitus. Specimens of the Porphiromonadaceae and Fusobacteriaceae families were characterized by an extremely high incidence in combined pathology. The amount of Sphingobacteriaceae bacteria in the biofilm was shown to decrease significantly during periodontitis. Metagenomic analysis confirmed the pathogenic role of microbiota in combined pathology, as well as the hypothesis on a possible influence of periodontitis on the course and development of type 2 diabetes mellitus.

Effects of Nano-Hydroxyapatite/Polyetheretherketone-Coated, Sandblasted, Large-Grit, and Acid-Etched Implants on Inflammatory Cytokines and Osseointegration in a Peri-Implantitis Model in Beagle Dogs.

BACKGROUND This study explored the effects of nano-hydroxyapatite/polyetheretherketone (n-HA/PEEK)- coated sandblasted, large-grit, and acid-etched (SLA) implants on inflammatory cytokines and osseointegration in peri-implantitis model beagle dogs. MATERIAL AND METHODS Peri-implantitis models were established. Eight beagle dogs were randomly and evenly assigned into SLA tied, SLA + n-HA/PEEK tied, SLA untied, or SLA + n-HA/PEEK untied groups. A special periodontal probe was used to detect the plaque index (PLI), probing depth (PD), and modified Sulcus Bleeding Index (mSBI). Gingival crevicular fluid was collected and an ELISA kit was utilized to detect IL-1, IL-6, and IL-17 levels. The colony-forming units were counted and the maximum shear strength of implants was tested using the axial pullout test. HE staining was used to detect the inflammation of peri-implant bone tissues. Osseointegration was observed through toluidine blue staining. Bone-to-implant contact (BIC) was obtained through histological observation and the mineral apposition rate (MAR) was calculated after immune fluorescent double staining. RESULTS The SLA tied group demonstrated higher levels of PLI, PD, mSBI, IL-1, IL-6, and IL-17 and a higher degree of inflammation than the SLA + n-HA/PEEK tied group. The tied groups also displayed similar results over the untied groups at the same time point. The maximum shear strength, BIC, and MAR in the SLA tied group were significantly lower than in the SLA + n-HA/PEEK tied group. CONCLUSIONS Our findings demonstrate that SLA + n-HA/PEEK implants can promote osseointegration and relieve the inflammation response of peri-implantitis in beagle dogs.

Distribution of dental plaque and gingivitis within the dental arches.

Objective The natural accumulation of supragingival plaque on surfaces of human teeth is associated with gingival inflammation and the initiation of common oral diseases. This study evaluated the distribution of dental plaque and gingivitis scores within the dental arches after prophylaxis. Methods Adult subjects from the Dharwad, India area representing the general population who provided written informed consent were scheduled for screening. Healthy subjects over the age of 18 years, not currently requiring any medical or dental care, and presenting with a complement of at least 20 natural teeth were recruited for this parallel design study. Enrolled subjects (n = 41) underwent oral examinations for dental plaque (PI) and gingivitis (GI) using the Turesky modification of the Quigley-Hein and the Löe-Silness Index, respectively, at the baseline visit, followed by a whole mouth dental prophylaxis. Subjects were given fluoride toothpaste for twice daily oral hygiene for the next 30 days. Subjects were recalled on days 15 and 30 for PI and GI examinations identical to baseline. Results Analyses indicated that mean scores for PI and GI on either arch and the whole mouth were higher than 2 and 1, respectively, during all examinations. Anterior surfaces consistently exhibited lower PI scores than posterior regions of either arch, or the entire dentition. Regional GI differences within the dentition were similar to PI scores, with lower scores on anterior than posterior teeth. Prophylaxis reduced both the frequency and mean scores of both PI and GI, irrespective of arch, with lower scores observed on anterior than posterior regions during all recall visits. Molar and lingual regions consistently exhibited higher PI and GI scores compared with anterior surfaces. At all examinations, mean scores for both plaque and gingivitis were higher on approximal vestibular than mid-vestibular surfaces. Conclusions Differences observed in PI and GI within the dentition have several practical implications: (a) there are advantages of whole mouth assessments for oral health (b) a need for oral hygiene formulations to reduce the larger deposits of dental plaque in the posterior region and resultant gingival inflammation, and