Influence of NaHCO3 powder on color and roughness of the composite submitted to bleaching and euterpe oleracea / Influencia del polvo de NaHCO 3 en el color y rugosidad del composite sometido a blanqueo y euterpe oleracea

Aim: This study aims to evaluate the surface roughness and susceptibility to staining of bleached composite resin with 22% carbamide peroxide, as well as the effect of subsequent prophylaxis with NaHCO3 powder. Material and Methods: Forty disk-shaped (2 × 6 mm) specimens of composite resin (Z250 XT) were prepared. Half of the specimens were subjected to bleaching with 22% carbamide peroxide, and the other half were stored in artificial saliva. In sequence, all specimens were immersed in acai juice (Euterpe oleracea) for 4 h for 14 days, and subdivided into two groups. Group 1 samples were subjected to prophylaxis treatment, while group 2 samples were subjected to treatment with artificial saliva. Surface roughness (Ra) and color (ΔE*) were measured after polishing (T0), bleaching (T1), immersion in acai juice (T2), and application of NaHCO3 powder (T3) using a profilometer and a spectrophotometer. Results: Statistical analyses (analysis of variance and Tukey's test, p≤0.05) revealed that regarding color there was statistically significance for the factors in isolation, except for the factor bleaching. For both color and surface roughness there was statistically significant difference for the interaction, except for the interaction between NaHCO3 power and bleaching. Conclusion: The NaHCO3 air-powder polishing decreases the staining of the composite resin; however, it increases the surface roughness. With respect to the color variable, the whitening factor had no significant effect on the tested material; however, it increases surface roughness.

Objetivo: Este estudio tiene como objetivo evaluar la rugosidad de la superficie y la susceptibilidad a la tinción de la resina compuesta blanqueada con peróxido de carbamida al 22%, así como el efecto de la profilaxis posterior con polvo de NaHCO3. Material y Métodos: Se prepararon cuarenta especímenes en forma de disco (2 × 6 mm) de resina compuesta (Z250 XT). La mitad de los especímenes se sometieron a blanqueo con peróxido de carbamida al 22% y la otra mitad se almacenó en saliva artificial. En secuencia, todos los especímenes se sumergieron en jugo de acai (Euterpe oleracea) durante 4h durante 14 días, y se subdividieron en dos grupos. Las muestras del grupo 1 se sometieron a tratamiento profiláctico, mientras que las muestras del grupo 2 se sometieron a tratamiento con saliva artificial. La rugosidad de la superficie (Ra) y el color (ΔE*) se midieron después del pulido (T0), el blanqueo (T1), la inmersión en jugo de acai (T2) y la aplicación de polvo de NaHCO3 (T3) utilizando un perfilómetro y un espectrofotómetro. Resultados: Los análisis estadísticos (análisis de varianza y prueba de Tukey, p≤0.05) revelaron que en relación al color hubo significancia estadística para los factores en forma aislada, excepto para el factor blanqueamiento. Tanto para el color como para la rugosidad de la superficie hubo una diferencia estadísticamente significativa para la interacción, excepto para la interacción entre el poder de NaHCO3 y el blanqueo. Conclusión: El pulido al aire con polvo de NaHCO3 disminuye el manchado de la resina compuesta; sin embargo, aumenta la rugosidad de la superficie. Con respecto a la variable color, el factor de blanqueamiento no tuvo efecto significativo sobre el material ensayado; sin embargo, aumenta la rugosidad de la superficie.

The impact of timing and modalities of dental prophylaxis on the risk of 5-fluorouracil-related oral mucositis in patients with head and neck cancer: a nationwide population-based cohort study.

PURPOSE: This study investigated the impact of dental prophylaxis on 5-fluorouracil (5-FU)-related oral mucositis (OM) according to the head and neck cancer (HNC) locations and treatment times. METHODS: A total of 13,969 HNC participants, including 482 5-FU-related OM subjects and 13,487 comparisons were enrolled from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2008. All subjects were stratified into subgroups based on the times to perform chlorhexidine use, scaling, and fluoride application before 5-FU administration. The dental prophylaxis related to 5-FU-related OM was estimated by multiple logistic regression and represented with odds ratio (OR) and 95% confidence interval (CI). RESULTS: Fluoride gel application and scaling significantly impacted on OM development (p < 0.001), and the joint effect of fluoride gel and scaling induced 5-FU-related OM (OR = 3.46, 95% CI = 2.39-5.01). The risk of OM was raised 2.25-fold as scaling within 3 weeks before 5-FU-related chemotherapy (95% CI = 1.81-2.81), and a 3.22-fold increased risk of OM while fluoride gel was applied during 5-FU-related treatment (95% CI = 1.46-7.13). CONCLUSION: Dental prophylaxis significantly affected 5-FU-related OM in the HNC population. A short interval between dental scaling or fluoride application and 5-FU administration may be associated with higher prevalence of OM. Scaling simultaneously combined with chlorohexidine promoted 5-FU-related OM in specific HNC patients excluding the oral cancer and nasopharyngeal cancer population. Proper timing of the prophylactic dental treatments prior to 5-FU therapy could reduce the risk to develop 5-FU-related OM.

Adjunctive systemic antimicrobials for the non-surgical treatment of periodontitis.

BACKGROUND: Systemic antimicrobials can be used as an adjunct to mechanical debridement (scaling and root planing (SRP)) as a non-surgical treatment approach to manage periodontitis. A range of antibiotics with different dosage and combinations are documented in the literature. The review follows the previous classification of periodontitis as all included studies used this classification. OBJECTIVES: To assess the effects of systemic antimicrobials as an adjunct to SRP for the non-surgical treatment of patients with periodontitis. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases to 9 March 2020: Cochrane Oral Health's Trials Register, CENTRAL, MEDLINE, and Embase. The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. SELECTION CRITERIA: We included randomized controlled trials (RCTs) which involved individuals with clinically diagnosed untreated periodontitis. Trials compared SRP with systemic antibiotics versus SRP alone/placebo, or with other systemic antibiotics. DATA COLLECTION AND ANALYSIS: We selected trials, extracted data, and assessed risk of bias in duplicate. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using GRADE. MAIN RESULTS: We included 45 trials conducted worldwide involving 2664 adult participants. 14 studies were at low, 8 at high, and the remaining 23 at unclear overall risk of bias. Seven trials did not contribute data to the analysis. We assessed the certainty of the evidence for the 10 comparisons which reported long-term follow-up (≥ 1 year). None of the studies reported data on antimicrobial resistance and patient-reported quality of life changes. Amoxicillin + metronidazole + SRP versus SRP in chronic/aggressive periodontitis: the evidence for percentage of closed pockets (MD -16.20%, 95% CI -25.87 to -6.53; 1 study, 44 participants); clinical attachment level (CAL) (MD -0.47 mm, 95% CI -0.90 to -0.05; 2 studies, 389 participants); probing pocket depth (PD) (MD -0.30 mm, 95% CI -0.42 to -0.18; 2 studies, 389 participants); and percentage of bleeding on probing (BOP) (MD -8.06%, 95% CI -14.26 to -1.85; 2 studies, 389 participants) was of very low certainty. Only the results for closed pockets and BOP showed a minimally important clinical difference (MICD) favouring amoxicillin + metronidazole + SRP. Metronidazole + SRP versus SRP in chronic/aggressive periodontitis: the evidence for percentage of closed pockets (MD -12.20%, 95% CI -29.23 to 4.83; 1 study, 22 participants); CAL (MD -1.12 mm, 95% CI -2.24 to 0; 3 studies, 71 participants); PD (MD -1.11 mm, 95% CI -2.84 to 0.61; 2 studies, 47 participants); and percentage of BOP (MD -6.90%, 95% CI -22.10 to 8.30; 1 study, 22 participants) was of very low certainty. Only the results for CAL and PD showed an MICD favouring the MTZ + SRP group. Azithromycin + SRP versus SRP for chronic/aggressive periodontitis: we found no evidence of a difference in percentage of closed pockets (MD 2.50%, 95% CI -10.19 to 15.19; 1 study, 40 participants); CAL (MD -0.59 mm, 95% CI -1.27 to 0.08; 2 studies, 110 participants); PD (MD -0.77 mm, 95% CI -2.33 to 0.79; 2 studies, 110 participants); and percentage of BOP (MD -1.28%, 95% CI -4.32 to 1.76; 2 studies, 110 participants) (very low-certainty evidence for all outcomes). Amoxicillin + clavulanate + SRP versus SRP for chronic periodontitis: the evidence from 1 study, 21 participants for CAL (MD 0.10 mm, 95% CI -0.51 to 0.71); PD (MD 0.10 mm, 95% CI -0.17 to 0.37); and BOP (MD 0%, 95% CI -0.09 to 0.09) was of very low certainty and did not show a difference between the groups. Doxycycline + SRP versus SRP in aggressive periodontitis: the evidence from 1 study, 22 participants for CAL (MD -0.80 mm, 95% CI -1.49 to -0.11); and PD (MD -1.00 mm, 95% CI -1.78 to -0.22) was of very low certainty, with the doxycycline + SRP group showing an MICD in PD only. Tetracycline + SRP versus SRP for aggressive periodontitis: we found very low-certainty evidence of a difference in long-term improvement in CAL for the tetracycline group (MD -2.30 mm, 95% CI -2.50 to -2.10; 1 study, 26 participants). Clindamycin + SRP versus SRP in aggressive periodontitis: we found very low-certainty evidence from 1 study, 21 participants of a difference in long-term improvement in CAL (MD -1.70 mm, 95% CI -2.40 to -1.00); and PD (MD -1.80 mm, 95% CI -2.47 to -1.13) favouring clindamycin + SRP. Doxycycline + SRP versus metronidazole + SRP for aggressive periodontitis: there was very low-certainty evidence from 1 study, 27 participants of a difference in long-term CAL (MD 1.10 mm, 95% CI 0.36 to 1.84); and PD (MD 1.00 mm, 95% CI 0.30 to 1.70) favouring metronidazole + SRP. Clindamycin + SRP versus metronidazole + SRP for aggressive periodontitis: the evidence from 1 study, 26 participants for CAL (MD 0.20 mm, 95% CI -0.55 to 0.95); and PD (MD 0.20 mm, 95% CI -0.38 to 0.78) was of very low certainty and did not show a difference between the groups. Clindamycin + SRP versus doxycycline + SRP for aggressive periodontitis: the evidence from 1 study, 23 participants for CAL (MD -0.90 mm, 95% CI -1.62 to -0.18); and PD (MD -0.80 mm, 95% CI -1.58 to -0.02) was of very low certainty and did not show a difference between the groups. Most trials testing amoxicillin, metronidazole, and azithromycin reported adverse events such as nausea, vomiting, diarrhoea, mild gastrointestinal disturbances, and metallic taste. No serious adverse events were reported. AUTHORS' CONCLUSIONS: There is very low-certainty evidence (for long-term follow-up) to inform clinicians and patients if adjunctive systemic antimicrobials are of any help for the non-surgical treatment of periodontitis. There is insufficient evidence to decide whether some antibiotics are better than others when used alongside SRP. None of the trials reported serious adverse events but patients should be made aware of the common adverse events related to these drugs. Well-planned RCTs need to be conducted clearly defining the minimally important clinical difference for the outcomes closed pockets, CAL, PD, and BOP.

Investigation of the impact of the NICE guidelines regarding antibiotic prophylaxis during invasive dental procedures on the incidence of infective endocarditis in England: an electronic health records study.

BACKGROUND: Infective endocarditis is an uncommon but serious infection, where evidence for giving antibiotic prophylaxis before invasive dental procedures is inconclusive. In England, antibiotic prophylaxis was offered routinely to patients at risk of infective endocarditis until March 2008, when new guidelines aimed at reducing unnecessary antibiotic use were issued. We investigated whether changes in infective endocarditis incidence could be detected using electronic health records, assessing the impact of inclusion criteria/statistical model choice on inferences about the timing/type of any change. METHODS: Using national data from Hospital Episode Statistics covering 1998-2017, we modelled trends in infective endocarditis incidence using three different sets of inclusion criteria plus a range of regression models, identifying the most likely date for a change in trends if evidence for one existed. We also modelled trends in the proportions of different organism groups identified during infection episodes, using secondary diagnosis codes and data from national laboratory records. Lastly, we applied non-parametric local smoothing to visually inspect any changes in trend around the guideline change date. RESULTS: Infective endocarditis incidence increased markedly over the study (22.2-41.3 per million population in 1998 to 42.0-67.7 in 2017 depending on inclusion criteria). The most likely dates for a change in incidence trends ranged from September 2001 (uncertainty interval August 2000-May 2003) to May 2015 (March 1999-January 2016), depending on inclusion criteria and statistical model used. For the proportion of infective endocarditis cases associated with streptococci, the most likely change points ranged from October 2008 (March 2006-April 2010) to August 2015 (September 2013-November 2015), with those associated with oral streptococci decreasing in proportion after the change point. Smoothed trends showed no notable changes in trend around the guideline date. CONCLUSIONS: Infective endocarditis incidence has increased rapidly in England, though we did not detect any change in trends directly following the updated guidelines for antibiotic prophylaxis, either overall or in cases associated with oral streptococci. Estimates of when changes occurred were sensitive to inclusion criteria and statistical model choice, demonstrating the need for caution in interpreting single models when using large datasets. More research is needed to explore the factors behind this increase.

Short-term prophylaxis in patients with angioedema due to C1-inhibitor deficiency undergoing dental procedures: An observational study.

BACKGROUND: Patients affected by angioedema due to hereditary and acquired C1-inhibitor (C1-INH) deficiency (HAE and AAE, respectively) report trouble accessing dental care, due to the risk of a life-threatening oropharyngeal and laryngeal attack triggered by dental procedures. The aim of this study was to assess the identification of hurdles in receiving dental care, and the effectiveness of short-term prophylaxis (STP) in preventing angioedema attacks. In addition, the study evaluated the impact of dental care in angioedema disease. All patients affected by angioedema due to C1-INH deficiency who were treated in the dentistry outpatient department of ASST Fatebenefratelli Sacco hospital (Milan, Italy) between 2009 and 2017 were considered for the analysis. Data were collected from patients' records. RESULTS: Twenty-nine patients were analyzed (27 with HAE and 2 with AAE). Of these, 63.0% reported that they had previously experienced hurdles in accessing dental care. Among patients with pathological oral status, at the first visit, 59.26% patients had moderate-to-severe oral disease. Seventy-five dental procedures were performed in 20 patients. Sixty procedures were preceded by STP (58 with plasma-derived C1-INH and 2 with danazol) in patients with/without long-term prophylaxis (LTP). Post-procedural attacks occurred in two patients. One HAE patient undergoing a tooth extraction without STP/LTP experienced a laryngeal attack. The other post-procedural attack occurred in an AAE patient with anti-C1-INH antibodies with STP with pdC1-INH. The angioedema disease did not worsen in any patient after dental care, but improved in four of them. CONCLUSIONS: Most C1-INH-HAE patients reported hurdles in receiving dental care. STP protects against attacks after dental procedures. Treating oral diseases results in improvement in the frequency of attacks.

Protocolo de actuación en el tratamiento odontológicoquirúrgico en pacientes con angioedema hereditario. Revisión de la literatura / Management protocol of dental treatment in patients with hereditary angioedema. A literature review

El angioedema hereditario (AEH) es una enfermedad genética rara de transmisión autosómica dominante, en la que existe un déficit de la encima C1-INH. Cursa con episodios recurrentes y autolimitados de edema, causados por aumento de la permeabilidad vascular. Tiene unas importantes implicaciones para los profesionales de la salud bucodental, ya que determinados procedimientos odontológicos y quirúrgicos pueden desencadenar episodios de angioedema, potencialmente mortales al producirse edema en las vías respiratorias superiores. El objetivo de este trabajo es aportar información y recomendaciones a los odontólogos a la hora de tratar a estos pacientes con el fin de minimizar las complicaciones. Los resultados han aportado un total de 48 pacientes y se realizaron un total de 90 intervenciones, siendo el tratamiento más frecuente las extracciones dentales. El AEH tipo I es el más frecuente de los tres tipos con una incidencia de entorno al 85% y el tipo III es el menos común y conocido, ya que se ha identificado en los últimos años. La profilaxis a corto plazo es un método preventivo que ha de realizarse en todos los pacientes con AEH antes de cualquier intervención quirúrgica odontológica. El tratamiento de estos pacientes implica, en la mayoría de las ocasiones, una profilaxis a largo y corto plazo con el fin de disminuir los ataques. Siendo aconsejable realizar los procedimientos odontológicos-quirúrgicos en ambiente hospitalario

Hereditary angioedema (HAE) is a rare genetic disease of autosomal dominant transmission, in which there is a deficit of C1-INH enzyme. It runs with recurrent and self-limited episodes of edema to increase vascular permeability. There are some important complications for oral health professionals because many dental and surgical procedures can trigger angioedema episodes which can be a potentially life-threating condition due to edema in the upper respiratory tract. The objective of this research is to provide information and recommendations to dentists for treating these patients in order to minimize complications. 48 patients have been reported and a total of 90 interventions were performed, being extractions the most frequent treatment. HAE type 1 is the most frequent of the three types with an 85% of incidence, and type III is the least common and known, it has been identified in recent years. Shortterm prophylaxis is a preventive method that must be done in all HAE patients before any dental surgery. The treatment of these patients implies, in most cases, a long- and short-term prophylaxis in order to reduce attacks. It is recommended to realize dental-surgical procedures in a hospital environment

Inflammatory markers in the saliva of cerebral palsy individuals with gingivitis after periodontal treatment.

The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1ß, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1ß levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1ß and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1ß, IL-6 and IL-8.

Oral hygiene instructions and professional control as part of the treatment of desquamative gingivitis. Systematic review.

BACKGROUND: The aim of this present article was to evaluate the scientific evidence on the efficacy of daily hygiene and professional prophylaxis for treatment of desquamative gingivitis. MATERIAL AND METHODS: The present systematic review was conducted following the PRISMA protocol. Searches were carried out in Pubmed, Embase, Web of Science and Cochrane Library up to July 2018, randomized clinical trials and cohort studies on desquamative gingivitis (DG), and oral diseases joined to DG. RESULTS: After screening, we found that nine publications met the eligibility criteria eight cohort studies and one randomized control trial. The diagnosis of the diseases corresponded to oral lichen planus (n=185), mucous membrane pemphigoid (n=13); plasma cell gingivitits (n=15) and pemphigus vulgar (n=11). The follow-up was between a week and a year after instructing patients. Dental daily hygiene and professional prophylaxis, at least with supragingival scaling and polishing have significantly improved the extension of the lesion and reduced the activity of DG, and gingival bleeding in all patients. Furthermore, these techniques have also reduced pain and gingival plaque. CONCLUSIONS: In conclusion the studies presented support the efficacy of maintaining personal and professional oral hygiene in patients with GD, reducing the clinical signs of the disease, regardless of its pathogenesis.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study.

In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

Comparison of calculus detection among dental hygienists using an explorer and ultrasonic insert.

INTRODUCTION: Periodontal therapy disrupts the biofilm harbouring calculus that triggers inflammation. The explorer is primarily used for calculus detection, and the ultrasonic instrument is primarily used for calculus removal. The efficiency in dental hygiene care may improve if the ultrasonic instrument could be used in both calculus detection and removal. PURPOSE: The purpose of this study was to validate the effectiveness of calculus detection between the Thinsert® ultrasonic insert and the 11/12 explorer. METHODS: Upon IRB approval, this validation study involved three dental hygiene faculty from the Ohio State University Dental Hygiene Program and 30 patient participants from the Ohio State University community. Using both instruments, calculus was evaluated on Ramfjord index teeth and on four possible surfaces per tooth. Data were analysed to evaluate for interrater reliability, intrarater reliability, sensitivity, and specificity. RESULTS: For interrater reliability, the average measure of intraclass coefficient (ICC) value was 0.782 with a 95% confidence interval (CI) of 0.749-0.810 (F(1439, 2878)  = 4.852, P < 0.01). For intrarater reliability, mean Kappa averages were in the full agreement range (κ = 0.726, n = 2160, P < 0.01). When using the Thinsert® for calculus detection, the sensitivity was 75%, specificity was 97%, PPV was 81%, and NPV was 94%. CONCLUSION: Since calculus evaluation was comparable when using the ODU 11/12 explorer and the Thinsert®, efforts can be focused on developing the tactile sensitivity when using the Thinsert® ultrasonic instrument in the assessment, treatment, and maintenance of periodontal disease and the support of oral health. The efficiency in dental hygiene care may improve by using the Thinsert® ultrasonic instrument in both the detection and removal of calculus.

The underestimated problem of oral Candida colonization-An observational pilot study in one nursing home.

Objectives: Older people are at increased risk of intraoral yeast colonization. In this observational case series, we assessed Candida colonization among nine nursing home residents to investigate possible correlations with their individual characteristics, general health parameters, and oral care. We also described the effect of professional dental cleaning (PDC) including prosthesis cleaning on colonization cases. Materials and methods: General clinical and oral health was assessed in nine residents, and samples were taken from six oral mucosa sites or prosthetic surfaces. PDC was performed to achieve macroscopically clean results, and residents were re-examined 2 weeks later. Results: We found that six residents were intraorally colonized with Candida albicans; four also had Candida glabrata. Prostheses were particularly infected. Dementia, multimorbidity, and presence of prostheses reduced oral hygiene ability; requiring assistance for oral hygiene care was a risk indicator for Candida colonization. PDC reduced C. albicans (at the expense of increased C. glabrata) but was not optimal for maintaining Candida reduction. Conclusion: In this pilot study, Candida colonization is prevalent among nursing home residents, especially those with cognitive impairment, multimorbidity, or reduced oral hygiene capacity. Potential negative effects on general health necessitate diagnostic and therapeutic guidelines. PDC alone did not maintain the reduction in Candida colonization; additional methods for daily oral care are necessary.

Perioperative intervention by oral medicine team in cardiovascular surgery patients.

In brief, perioperative oral intervention consists of elimination of odontogenic foci and maintenance of oral hygiene in patients undergoing surgery. The importance of oral intervention before, during, and after medical treatments is well-known, especially in cancer patients, because odontogenic foci such as untreated deep dental caries or periodontitis can cause systemic infection in patients with myelosuppression resulting from chemotherapy. Although perioperative oral intervention is currently recommended for patients with cardiovascular disease, its efficacy in this population has not been established. This article consists of three sections: first, we review the current knowledge about the association between dental disease and cardiovascular disease to show the importance of oral hygiene maintenance and the risks of invasive dental procedures in patients with cardiovascular disease; second, we introduce pertinent, but limited evidence concerning the effect of oral care in preventing postoperative pneumonia; and finally, we present the optimal strategy for perioperative oral intervention in cardiovascular surgery patients.

Clinical evaluation of non-surgical cleaning modalities on titanium dental implants during maintenance care: a 1-year follow-up on prosthodontic superstructures.

OBJECTIVES: To investigate tissue health around implants with newly attached superstructures over 12 months of preventive maintenance appointments and instrumentation when necessary. MATERIAL AND METHODS: In a randomized, split-mouth study 32 implants (8 participants with 4 implants each) received followed-up care every 3 months after superstructure attachment. Implants and superstructures were randomly assigned to four treatment groups and treated if necessary: (1) titanium curettes (TC), (2) stainless steel ultrasonic tip (PS), (3) erythritol air-polishing powder (EP), or (4) rubber cup polishing (CON). Probing depths (PDs), bleeding on probing (BOP), modified gingival (mucosal) bleeding index (GBI) around implants, and full-mouth Plaque Control Record (PCR) were measured every 3 months. Clinical attachment levels (CALs) and height of keratinized mucosa (KM)/gingival margins (GMs) for implants/teeth and PD, BOP, and GBI for teeth were documented at baseline, 6 months, and 12 months. Matrix metalloproteinase 8 (MMP-8) and periopathogens were measured at baseline and 12 months. RESULTS: Participants exhibited minimal signs of periodontal inflammation with statistically significant PD improvement (3.0 ± 0.2 to 2.8 ± 0.3 mm; p = 0.022) and overall CAL (4.3 ± 0.8 to 4.0 ± 0.7 mm; p = 0.048) after 1 year. Implants showed no statistically significant differences (p > 0.05) between or within groups at baseline or 12 months for any parameter, except MMP-8 decreased significantly for PS (14.50 ± 17.58 to 4.63 ± 7.56 ng; p = 0.044), and after 12 months, PCR showed a significant difference between TC and PS (p = 0.018). CONCLUSIONS: Treatment was necessary as inflammation was observed around newly placed superstructures within the first year of maintenance care. All tested treatment modalities yielded comparable clinical improvements. CLINICAL RELEVANCE: Early assessment and diagnosis of mucositis and regular maintenance can promote long-lasting implant health.

Nine prophylactic polishing pastes: impact on discoloration, gloss, and surface properties of a CAD/CAM resin composite.

OBJECTIVES: To investigate discoloration reduction and changes of surface properties of a CAD/CAM resin composite after 14 days´ storage in red wine and polishing with nine different prophylactic polishing pastes (PPPs). MATERIALS AND METHODS: Rectangular discs (N = 172) were fabricated and polished (P4000) using GC Cerasmart (GC Europe) to investigate different polishing protocols with 1-4 related descending PPPs (22 in total): Cleanic/CLE-Kerr, CleanJoy/CLJ-Voco, Clean Polish/Super Polish/SPO-Kerr, Clinpro Prophy Paste/CPP-3M, Détartrine/DET-Septodont, Nupro/NUP-Dentsply Sirona, Prophy Paste CCS/CCS-Directa, Proxyt/PXT-Ivoclar Vivadent, and Zircate/ZIR Prophy Paste-Dentsply Sirona. Surface properties (roughness values (RV)/Ra, Rz, Rv, surface free energy (SFE), surface gloss (G), and discoloration (ΔE)) were analyzed before and after storage and additional polishing. Data were examined using Kolmogorov-Smirnov test, three-way ANOVA followed by Tukey-B post hoc, Mann-Whitney U, and Kruskal-Wallis H tests (α < 0.05). RESULTS: Regarding RV, CLE, followed by CCS, and CPP showed the highest values; the lowest presented SPO and DET (p < 0.001). No impact of PPP was observed on ΔE values (p = 0.160). The lowest SFE presented DET, followed by SPO; highest showed CCS followed by NUP and CPP (p < 0.001). Within G, lowest values were observed for CLE and NUP, followed by CCS, ZIP, and CLJ (p < 0.001); the highest presented SPO (p < 0.001). Polishing showed generally a positive impact on SFE values (p < 0.001-p = 0.007), except ZIP (p = 0.322) and CLE (p = 0.083). G increased and RV decreased after polishing (p < 0.001), except SPO, with no significant change for G (p = 0.786). CONCLUSIONS: Polishing with PPPs improves the surface properties and is generally recommended. The choice of PPP has a minor role in removing discolorations. Multi-step systems should be carried out conscientiously. CLINICAL RELEVANCE: The proper selection of PPP is essential for the clinical outcome of surface properties of prosthetic restorations. Not every polishing paste leads to the same final surface quality.

Inflammatory markers in the saliva of cerebral palsy individuals with gingivitis after periodontal treatment

Abstract The aim of this study was to evaluate the effect of periodontal treatment on the salivary cytokine levels and clinical parameters of individuals with cerebral palsy (CP) with gingivitis. A non-randomized, clinical trial was conducted in individuals diagnosed with spastic CP. Thirty-eight individuals were enrolled in the study and were categorized according to gingival index scores between 0-1 or 2-3, assigned to groups G2 or G1, respectively. Periodontal treatment comprised oral hygiene instructions, conventional mechanical treatment and 0.12% chlorhexidine applied as an adjunct. Clinical parameters and saliva samples were collected at baseline and at the 15-day follow-up visit. Bleeding on probing and periodontal screening and recording were determined. Non-stimulated saliva samples were obtained, and the salivary flow rate, the osmolality and the levels of cytokines IL-1β, IL-6, IL-8, IL-10, TNF-α and IL-12p70 were evaluated by a cytometric bead array. The Wilcoxon test, the Mann-Whitney test, Spearman correlation analysis, Poisson regression analysis and an adjusted analysis were performed (α = 0.05). The groups differed significantly in periodontal clinical parameters at baseline and at follow-up. Salivary flow rate and osmolality were similar in both groups at both timepoints. However, TNF-α and IL-1β levels were higher in G1 than in G2 at baseline. Mechanical treatment resulted in improved clinical parameters for both groups. Furthermore, mechanical treatment resulted in a significant reduction in salivary IL-1β and IL-8 levels for both groups after treatment. Periodontal treatment performed in individuals with CP and gingivitis reduces the levels of TNF-α, IL-1β, IL-6 and IL-8.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study

Abstract In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

[Clinical and laboratory grounding of using medication based on the antiseptic troklosene to treat patients with chronic generalized periodontitis of the ii and iii degrees of severity].

OBJECTIVE: Introduction: Periodontal diseases take second place in the world among dental diseases and tend to be ubiquitous regardless of age, sex and place of residence. According to the modern point of view inflammatory periodontal diseases refer to infectious chronic inflammatory diseases, therefore, the normalization of the microflora of the oral cavity is an essential condition for their rational therapy. The aim: To increase the effectiveness of conservative treatment of chronic generalized periodontitis of the II-nd and III-rd severity using the medication based on the antiseptic Troklosene. PATIENTS AND METHODS: Materials and methods: 34 patients of age 45 to 55 years who were diagnosed with chronic generalized periodontitis of the IIInd and IIIrd degree of severity were examined and treated. All patients reported signs of the disease for 3-15 years. Patients of the study group by simple randomization were divided into two subgroups, depending on the therapeutic treatment performed. The I-st subgroup -16 patients treated with the additional use of the medication based on the antiseptic Troklosene, the IInd subgroup - 18 patients who were treated without using this drug. RESULTS: Results: Analyzing the results after the treatment in the patients of the I -st and II -nd subgroup, they noted a decrease in PMA index, Green-Vermillion index, bleeding index. Pathological mobility of teeth decreased to the I degree. The hygienic condition of the oral cavity was characterized in patients of both subgroups after treatment as satisfactory. In patients of the Ist subgroup (with the additional use of the medication based on the antiseptic Troklosene), after the 5th visit there were signs of remission, and in the IInd subgroup (using standard base therapy), after 7 visits, there were signs of clinical remission. With the additional use of the drug based on the antiseptic Troklosene, in contrast to the traditional therapy, a change in the bacterial ratio of microorganisms occurred, which influenced a significant decrease in the total bacterial mass. CONCLUSION: Conclusion: The best results were obtained in the Ist subgroup, where along with the standard base therapy, the supplement of based on the antiseptic Troklosene was used additionally. Introduction to the treatment regimen for patients with chronic generalized periodontitis with II and III severity of the drug based on the antiseptic Troklosene contributed to a stable clinical effect, as evidenced by the dynamics of clinical indicators and the reduction in the number of visits. Also, a change in the bacterial ratio of microorganisms with a significant decrease due to Enterobacterium spp. is noted. To maintain this result, it is recommended to continue the use of the drug based on the antiseptic Troklosene with a frequency of 4 times per day within 7 days after the end of treatment.

Evaluación propia en mujeres gestantes al respecto de opiniones, hábitos y estado de su salud oral en una población del sur de Galicia / Self-assessment of opinions, habits and oral health status by pregnant women in the south of Galicia, Spain

Se ha constatado en el embarazo la asociación entre problemas de salud oral y complicaciones obstétricas. Por ello, el objetivo principal de este trabajo es evaluar en embarazadas la percepción de salud oral, hábitos y creencias relativas. Se diseñó un cuestionario para obtener información de las embarazadas que acudían a la consulta de Obstetricia del Hospital Comarcal Valdeorras y Odontología de atención primaria del Centro de Salud Valle Inclán (n=96). Se encontró que la percepción propia de muchas gestantes era padecer algún problema en la cavidad oral. Además, se reflejó que las gestantes tenían hábitos relativos a salud oral adecuados; en adición, creían que su embarazo iba a traer implícitamente problemas a su boca. Las gestantes son capaces de comprender la relación entre su salud oral, su salud sistémica y la de su futuro hijo. Se detectaron una serie de hábitos y creencias en las que sería conveniente incidir para reducir problemas sanitarios

An association has been found between oral health problems and obstetric complications during pregnancy. The main aim of this study was to assess the perception by pregnant women on their oral health and related habits and beliefs. A questionnaire was designed in order to obtain information from 96 pregnant women attending the Valdeorras Local Hospital and the primary health dental practice in the Valle Inclan Health Center. It was found that many pregnant women perceived they were suffering from some kind of problem affecting their mouth. It was shown that pregnant women had adequate habits regarding oral health, but they believed that their pregnancy would implicitly cause them to have mouth problems. Pregnant women are able to understand the impact of their oral health on their general well-being and the health of their unborn child. It has been detected that a series of habits and beliefs would ideally need to be acted upon in order to reduce health problems

Interdental Cleaning Is Associated with Decreased Oral Disease Prevalence.

The purpose of this study was to evaluate the associations between interdental cleaning behavior and the prevalence of caries and periodontal disease and numbers of missing teeth, with data from the National Health and Nutrition Examination Survey (2011 to 2012 and 2013 to 2014). Analysis included the following parameters: interproximal clinical attachment level (iCAL) ≥3 mm, interproximal probing depth (iPD) ≥4 mm, number of coronal and interproximal caries, number of missing teeth, ≥1 surfaces with coronal caries, and periodontal profile classes (PPCs). Chi-square was used for bivariate associations. Associations of interdental cleaning with outcomes were assessed with multiple linear regression and generalized logit regression, adjusting for age, race, sex, diabetes, smoking, education, dental visits, and sugar consumption. Nonusers had a significantly higher percentage of sites with iCAL ≥3 mm and iPD ≥4 mm as compared with individuals who used interdental cleaning devices ( P < 0.0001). Individuals with a higher frequency of cleaning (4 to 7×/wk) had a significantly lower extent of sites with iCAL ≥3 mm as compared with lower-frequency cleaning (1 to 3×/wk; P ≤ 0.05). Interdental cleaning users showed lower numbers of coronal caries, interproximal coronal caries, and missing teeth as compared with nonusers ( P < 0.0001). Nonusers had 1.73-times (95% confidence interval, 1.53 to 1.94) higher odds for having ≥1 surfaces of coronal caries as compared with interdental cleaning users, regardless of the weekly frequency. Individuals were less likely to be in diseased PPCs if they were interdental cleaning users. Low-frequency cleaners (1 to 3×/wk) had significantly greater odds (1.43; 95% confidence interval, 1.08 to 1.88) to have severe disease (PPC-G) versus health (PPC-A) than were high-frequency cleaners (4 to 7×/wk). Interdental cleaning users showed lower levels of periodontal disease and caries and lower numbers of missing teeth. Higher frequency of interdental cleaning was correlated with increased periodontal health. Individuals with severe periodontal disease could show additional oral health benefits by increasing cleaning frequency. The data support the use of interdental cleaning devices as an oral hygiene behavior for promoting health.

Effect of Dental Prophylaxis Techniques on the Surface Roughness of Resin Composites.

AIM: The aim of this study is to evaluate the effect of dental prophylaxis techniques on surface roughness of composite resins. MATERIALS AND METHODS: A total of 36 nanohybrid resin composite test specimens were fabricated and divided into three groups (n = 12). They were kept in distilled water at 37°C for 24 hours and submitted to the finishing and polishing technique. For the prophylactic techniques, in group G1, a mixture of pumice stone and distilled water was used with the aid of a rubber cup; in group G2, Herjos-F prophy paste was used with a rubber cup; and in group G3, a bicarbonate jet spray was used. Afterward, all the samples were repolished using the Soflex pop-on disks. A roughness meter was used to measure surface roughness at three points in time: Before the prophylactic techniques (1st evaluation), afterward (2nd evaluation), and following repeat polishing (3rd evaluation). RESULTS: It was found that roughness values changed significantly between the 1st and 2nd evaluations (p < 0.05) and between the 2nd and 3rd evaluations (p < 0.05), showing that the change in roughness depended on the type of prophylactic treatment. Roughness was significantly higher after the bicarbonate jet (p < 0.05). CONCLUSION: Prophylaxis using the sodium bicarbonate jet significantly altered the roughness of nanoparticle-reinforced resin. CLINICAL SIGNIFICANCE: Dental prophylaxis is the most common practice employed to remove bacterial plaque and other coatings. However, one side effect of the cleaning may be a rougher surface subject to degradation and staining. The correct use of prophylactic devices and avoiding prolonged use on resin restorations reduce surface roughness.