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1.
Wiad Lek ; 74(5): 1065-1068, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090265

RESUMO

OBJECTIVE: The aim: To study the clinical efficciency of the proposed scheme of gingivitis treatment in women with physiological course of pregnancy. PATIENTS AND METHODS: Materials and methods: Clinical approbation of the proposed complex of therapeutic and prophylactic measures was carried out in 32 pregnant women with gingivitis, aged 18 to 35 years. The efficiency of the treatment was assessed by the dynamics of the clinical picture, the index assessment of an oral hygiene and the periodontium condition in each trimester of pregnancy. RESULTS: Results: According to the data of performed observations, the high efficiency of the proposed treatment scheme is shown: 84.4% in the main group versus 46.9% in the control group. It has been clinically proven that the proposed scheme of inflammatory periodontal diseases treatment in terms of therapeutic efficiency exceeds the generally accepted basic treatment. CONCLUSION: Conclusions:The use of the proposed complex of therapeutic and prophylactic measures in the main group of patients contributed to the elimination of the inflammatory process in the periodontal tissues, suspended the progression of existing diseases, made it possible to prevent the emergence of new nosological forms, improved the condition of the oral hygiene, which makes it possible to recommend it for treatment of periodontal diseases in pregnant women.


Assuntos
Gengivite , Doenças Periodontais , Complicações na Gravidez , Feminino , Gengivite/prevenção & controle , Humanos , Doenças Periodontais/prevenção & controle , Periodonto , Gravidez , Complicações na Gravidez/prevenção & controle , Gestantes
2.
BMC Oral Health ; 21(1): 225, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33941170

RESUMO

BACKGROUND: To evaluate the success of plaque reduction after external toothbrushing by instructed laypeople versus dental professionals using either a manual or powered toothbrush. Longitudinal, randomized, parallel-group intervention study in periodontitis patients with reduced oral hygiene quality undergoing anti-infective therapy. Patients were randomly and equally assigned to one of four groups: laypeople using a manual or powered toothbrush or dental professionals using a manual or powered toothbrush. Plaque reduction (Quigley-Hein-Index (QHI), Marginal Plaque Index (MPI)), gingivitis (papilla bleeding index), and cleaning time (seconds) were investigated. RESULTS: Thirty-nine patients participated in the study. Neither the choice of toothbrush (p = 0.399) nor the use of a dental professional (p = 0.790) had a significant influence on plaque levels achieved. However, multivariate modeling indicated statistically significant differences in the external cleaning time between brushing groups, with longer time required by laypeople (p = 0.002) and longer use of the powered toothbrush (p = 0.024). CONCLUSION: When the ability to carry out personal oral hygiene is reduced, external brushing by dental professionals or instructed laypeople who meet previously defined criteria such as sufficient personal oral hygiene at home could help to fill the emerging dental care gap. A combination of oral hygiene approaches adapted to the individual needs of the patients in need of external help is necessary for optimum oral hygiene. TRIAL REGISTRATION: German Clinical Trials register ( https://www.germanctr.de ; number DRKS00018779; date of registration 04/11/2019).


Assuntos
Gengivite , Escovação Dentária , Índice de Placa Dentária , Desenho de Equipamento , Gengivite/prevenção & controle , Humanos , Higiene Bucal , Índice Periodontal , Método Simples-Cego
3.
Am J Dent ; 34(2): 87-90, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33940665

RESUMO

PURPOSE: To assess the gingivitis reduction efficacy of a novel stannous-containing fluoride dentifrice relative to a negative control. METHODS: 100 generally healthy adults with 10 or more gingival bleeding sites based on the Mazza Modification of the Papillary Bleeding Index (Mazza GI) were enrolled into a 2-week randomized, controlled, double-blind, single-center, two-treatment, parallel group clinical study. The subjects were randomly assigned to the stannous-containing dentifrice group (experimental group) or the sodium fluoride dentifrice group (negative control group). An oral examination and Mazza GI examination were conducted at Baseline, Day 3 and Week 2 post-baseline by a qualified dental examiner. RESULTS: 98 subjects completed the study. The experimental group provided a significant reduction in Mazza GI scores and number of bleeding sites relative to baseline at Day 3 and Week 2 (P< 0.0001). The negative control did not provide significant reductions versus baseline for either measure at either timepoint (P> 0.3). At Day 3, the experimental group provided a statistically significant reduction of Mazza GI scores and number of bleeding sites compared with the negative control group (P< 0.0001). At Week 2, the experimental group showed 24.11% lower Mazza GI scores and 54.81% fewer bleeding sites than the negative control group (P< 0.0001). CLINICAL SIGNIFICANCE: The results demonstrated that the novel stannous-containing fluoride dentifrice had a superior anti-gingivitis effect compared to the sodium fluoride negative control dentifrice, which was evident as quickly as 3 days after use and further improved after 2 weeks of usage.


Assuntos
Dentifrícios , Gengivite , Adulto , Dentifrícios/uso terapêutico , Fluoretos , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Índice Periodontal , Fluoretos de Estanho/uso terapêutico
4.
Am J Dent ; 34(2): 110-115, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33940670

RESUMO

PURPOSE: To evaluate the anti-gingivitis efficacy of two bioavailable stannous fluoride (SnF2) dentifrices versus a zinc/arginine dentifrice and a negative control dentifrice, and to compare the plaque control benefits. METHODS: This was a single-center, randomized, controlled, four-treatment, parallel-group, double-blind, 3-month clinical trial. Healthy adult subjects with gingivitis were randomly assigned to one of four different dentifrice treatment groups: SnF2 dentifrice A, SnF2 (1,100 ppm F) + sodium fluoride (350 ppm F) + sodium hexametaphosphate (Procter & Gamble); SnF2 dentifrice B, SnF2 (1,100 ppm F) + sodium fluoride (350 ppm F) + citrate (Procter & Gamble); Zn/Arg dentifrice, zinc/arginine + sodium fluoride (1,450 ppm F) (Colgate-Palmolive); negative control dentifrice, sodium monofluoro-phosphate (1,000 ppm F) + sodium fluoride (450 ppm F) (Colgate-Palmolive). Subjects brushed with their assigned treatment dentifrice and an assigned manual toothbrush (Oral-B Indicator) for 1 minute, twice daily, for the duration of the study. Gingivitis was assessed at Baseline and at Weeks 2, 4 and 12 by calculating the total number of gingival bleeding sites using the Gingival Bleeding Index, and plaque was assessed at Baseline and at Week 12 using the Turesky Modified Quigley-Hein Index. A repeated measures model was carried out across Weeks 2, 4, and 12 to determine bleeding efficacy (total number of bleeding sites). An ANCOVA with baseline plaque as the covariate was used to evaluate plaque efficacy at Week 12. RESULTS: 161 subjects were randomized (mean age= 38.8 years). 154 subjects completed the study and 153 had evaluable data at Week 12. The mean (SD) number of Baseline bleeding sites overall was 78.74 (31.16) with no significant difference between groups (P= 0.537). SnF2 dentifrice A significantly reduced the number of bleeding sites relative to the negative control dentifrice at Weeks 2, 4 and 12 by 15.4%, 13.7% and 17.2%, respectively. SnF2 dentifrice B significantly reduced the number of bleeding sites relative to the negative control dentifrice at Week 4 by 13.9% (P= 0.041). Relative to the Zn/Arg dentifrice, SnF2 dentifrice A produced significantly greater reductions in gingival bleeding sites at Weeks 2, 4 and 12 by 23.4%, 17.2% and 20.9%, respectively (P≤ 0.007). SnF2 dentifrice B produced significantly greater bleeding reductions versus the Zn/Arg dentifrice at Weeks 4 and 12 by 17.4% and 14.4%, respectively (P≤ 0.035). The Zn/Arg dentifrice did not differ significantly in the number of bleeding sites (P≥ 0.127) or plaque (P= 0.175) relative to the negative control dentifrice. Both SnF2 dentifrices significantly reduced plaque levels (P≤ 0.029) relative to both negative control dentifrice and Zn/Arg dentifrice at Week 12. All dentifrices were well tolerated. CLINICAL SIGNIFICANCE: Two different SnF2 dentifrices showed significantly reduced gingival bleeding and plaque levels relative to a Zn/arginine dentifrice.


Assuntos
Dentifrícios , Gengivite , Adulto , Arginina/uso terapêutico , Índice de Placa Dentária , Dentifrícios/uso terapêutico , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Índice Periodontal , Fluoretos de Estanho/uso terapêutico , Zinco
5.
Oral Health Prev Dent ; 19(1): 229-233, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33829720

RESUMO

PURPOSE: To assess the effectiveness of a 40% miswak compared to a 0.12% chlorhexidine mouthwash. MATERIALS AND METHODS: A total of 60 patients aged 20-55 years who attended the Periodontics Clinics at the College of Dentistry, Al-Iraqia University, Baghdad, Iraq, were allocated into 2 groups to use either 40% miswak mouthwash or 0.12% chlorhexidine gluconate Kin Gingival (Laboratorios KIN) twice daily for 2 months. Gingival, bleeding, and plaque indices were assessed. RESULTS: There were statistically significant differences between the effectiveness of miswak and chlorhexidine mouthwashes in terms of gingivitis. The means of gingival, bleeding, and plaque indices using miswak mouthwash were 1.2, 0.4, and 0.53, respectively, i.e. indicating lower effectiveness, than when 0.12% chlorhexidine mouthwash was used (0.87, 0.43, 0.23, respectively). CONCLUSION: Miswak mouthwash is a good oral hygiene agent especially for long-term use even if its efficacy is lower than chlorhexidine mouthwash.


Assuntos
Anti-Infecciosos Locais , Placa Dentária , Gengivite , Adulto , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Placa Dentária/tratamento farmacológico , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Pessoa de Meia-Idade , Antissépticos Bucais/uso terapêutico , Adulto Jovem
6.
Medicine (Baltimore) ; 100(10): e24924, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725852

RESUMO

ABSTRACT: Orthodontic treatment can lead to microbial-induced gingival inflammation and aseptic periodontal inflammations. The aim of this study was to investigate the relationship between salivary pro-inflammatory cytokines levels with gingival health status and oral microbe loads among patients undergoing orthodontic treatment.The present investigation was a cross-sectional study among a sample of 111 consecutive orthodontic patients (mean age 18.4 ±â€Š4.4 years). Clinical examinations were conducted to assess the gingival health status employing the Modified Gingival Index, Gingival Bleeding Index, and Plaque Index. Salivary microbiological assessments of total aerobic and anaerobic bacteria count, streptococci count, and lactobacilli count were undertaken. Saliva immunological assessments included Interleukin-1Beta (IL-1ß) and macrophage migration inhibitory factor (MIF) ELISA assays.The mean ±â€Šstandard deviation of salivary IL-1ß was 83.52 ±â€Š85.62 pg/ml and MIF was 4.12 ±â€Š0.96 ng/ml. Moderate positive correlations were found between salivary IL-1ß levels and total aerobic and anaerobic bacteria count, streptococci count, and lactobacilli count (r = 0.380-0.446, P < .001), and weak positive correlations between salivary MIF levels and total salivary aerobic and anaerobic bacteria counts (r = 0.249-0.306, P < .01) were observed. A positive correlation was found between salivary IL-1ß levels and Bleeding Index (r = 0.216, P < .05).The level of salivary IL-1ß positively correlates with oral bacterial load among orthodontic patients; the relationship between inflammatory cytokines and oral microflora deserved further study.


Assuntos
Gengivite/diagnóstico , Interleucina-1beta/análise , Aparelhos Ortodônticos/efeitos adversos , Saliva/química , Adolescente , Carga Bacteriana , Estudos Transversais , Feminino , Gengiva/imunologia , Gengiva/microbiologia , Gengivite/imunologia , Gengivite/microbiologia , Gengivite/prevenção & controle , Humanos , Interleucina-1beta/imunologia , Oxirredutases Intramoleculares/análise , Oxirredutases Intramoleculares/imunologia , Fatores Inibidores da Migração de Macrófagos/análise , Fatores Inibidores da Migração de Macrófagos/imunologia , Masculino , Microbiota/imunologia , Antissépticos Bucais/administração & dosagem , Adulto Jovem
7.
Compend Contin Educ Dent ; 42(2): e5-e9, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33740382

RESUMO

OBJECTIVE: To assess the anti-gingivitis and anti-plaque efficacy of a novel bioavailable stannous fluoride (SnF2) dentifrice to a negative control. METHODS: This was a 12-week randomized, controlled, double-blind, two-treatment, parallel group clinical study. One hundred generally healthy adults with evidence of plaque and gingivitis were enrolled into the study. Subjects were randomly assigned to one of two dentifrice treatments: (1) novel SnF2 dentifrice containing the amino acid glycine as a stabilizing chelant (Procter and Gamble) or (2) a negative control sodium monofluorophosphate dentifrice. Gingivitis was assessed using the Löe-Silness Gingivitis Index (LSGI) at baseline, Week 1, and Week 12 while plaque was evaluated according to the Turesky Modification of the Quigley-Hein Plaque Index at baseline and Week 12. RESULTS: One hundred subjects completed the trial. Subjects using the novel SnF2 dentifrice demonstrated statistically significantly fewer bleeding sites and a lower LSGI score versus those using the negative control as early as Week 1 (P less than .001). The benefit increased throughout the study, with the SnF2 dentifrice showing 33.4% fewer bleeding sites and a 16.5% lower LSGI score versus the negative control at Week 12 (P less than .001). Subjects with localized or generalized gingivitis (≥10% bleeding sites) had 6 times better odds of transitioning to generally healthy (less than 10% bleeding sites) after using the SnF2 dentifrice for 12 weeks versus the negative control. Plaque scores for the SnF2 dentifrice were also statistically significantly lower (P less than .001) than those for the negative control at Week 12. CONCLUSION: The novel SnF2 dentifrice with the amino acid glycine produced statistically significant improvements in gingival health that were seen as early as 1 week and numerically increased throughout the study.


Assuntos
Placa Dentária , Dentifrícios , Gengivite , Adulto , Índice de Placa Dentária , Dentifrícios/uso terapêutico , Método Duplo-Cego , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Fluoretos de Estanho/uso terapêutico
8.
Am J Dent ; 34(1): 54-60, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33544990

RESUMO

PURPOSE: This 6-month study compared the effects of a smart-connected oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations with those of a marketed smart-connected sonic rechargeable toothbrush for the reduction of gingivitis and plaque. METHODS: In this single-center, examiner-blind, two-treatment, open-label, parallel-group, randomized study, 110 adult subjects with evidence of gingivitis and plaque were randomized to use either the O-R brush (Oral-B iO) or the sonic brush (Philips Sonicare DiamondClean). Both groups were instructed to brush twice daily with a standard sodium fluoride dentifrice. Gingivitis and plaque were assessed at baseline, week 1, and week 24 using the Modified Gingival Index (MGI), Gingival Bleeding Index (GBI), and the Rustogi Modification of the Navy Plaque Index (RMNPI). Designation of gingivitis case status as "healthy" or " not healthy" was made according to the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. RESULTS: A significantly greater percentage of subjects in the O-R brush group versus the sonic brush group transitioned from " not healthy" to " healthy" gingivitis case status at week 24 (96.4% vs. 81.8%; P= 0.029). The O-R toothbrush produced a significantly greater reduction in adjusted mean MGI score, adjusted mean GBI score, and adjusted mean number of bleeding sites than did the sonic brush (week 24, by 32.6% for MGI score, by 23.7% for GBI score, and by 26.1% for number of bleeding sites, P< 0.001). After a single use on day 1, plaque removal was statistically significantly greater for the O-R brush compared to the sonic brush (P< 0.001); by week 24, the O-R brush demonstrated greater reductions in whole mouth plaque (24.6%), gingival margin plaque (61.9%) and approximal region plaque 25.8% (P≤ 0.007 for all) compared to the sonic brush. CLINICAL SIGNIFICANCE: This 6-month study provides evidence supporting use of a smart-connected O-R electric toothbrush with micro-vibrations for plaque removal and gingivitis reductions, resulting in transitions to a healthy gingival state.


Assuntos
Placa Dentária , Gengivite , Adulto , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Desenho de Equipamento , Gengivite/prevenção & controle , Humanos , Método Simples-Cego , Escovação Dentária
9.
Artigo em Inglês | MEDLINE | ID: mdl-33528457

RESUMO

The goal of this multicenter randomized controlled study was to evaluate the effectiveness of a newly developed ionic-sonic electric toothbrush in terms of plaque removal and reduction of gingival inflammation. A total of 78 subjects from three dental centers were invited to join the study. They were randomized to receive either a manual toothbrush (control group) or an ionic-sonic electric brush (test group). Full-mouth prophylaxis and oral hygiene instructions based on the stationary bristle technique were provided 1 week prior to the baseline visit. At baseline and at each follow-up appointment, Plaque Index (PI) and Gingival Index (GI) were recorded. In addition, probing depth (PD) and bleeding on probing were recorded at baseline and at the last appointment (week 5). At completion of the study, subjects in the test group were given a questionnaire regarding their satisfaction with the toothbrush. Sixty-four subjects completed the study (control: 28; test: 36). The mean age of the subjects was 36.90 ± 12.19 years. No significant difference between the baseline and 5-week PD was found. Plaque removal efficacy and reduction in gingival inflammation were more significant for the test group at week 2. Both the control and test groups showed statistically significant improvement in PI and GI from baseline to week 5. The ionic-sonic toothbrush was more effective than manual toothbrush after a 1-week application.


Assuntos
Gengivite , Escovação Dentária , Adulto , Índice de Placa Dentária , Desenho de Equipamento , Gengivite/prevenção & controle , Humanos , Inflamação , Pessoa de Meia-Idade , Método Simples-Cego , Adulto Jovem
10.
Nutrients ; 13(1)2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33430257

RESUMO

Flavan-3-ols and their oligomeric forms called proanthocyanidins are polyphenolic compounds occurring in several foodstuffs and in many medicinal herbs. Their consumption is associated with numerous health benefits. They exhibit antioxidant, anti-inflammatory, cytoprotective, as well as antimicrobial activity. The latter property is important in the prevention and treatment of periodontal diseases. Periodontitis is a multifactorial polymicrobial infection characterized by a destructive inflammatory process affecting the periodontium. Using non-toxic and efficient natural products such as flavanol derivatives can significantly contribute to alleviating periodontitis symptoms and preventing the disease's progress. Therefore, a comprehensive systematic review of proanthocyanidins and flavan-3-ols in the prevention and treatment of periodontitis was performed. The present paper reviews the direct antibacterial effects of these compounds against periodontic pathogens. The immunomodulatory effects, including animal and clinical studies, are included in a separate, parallel article. There is significant evidence supporting the importance of the antibacterial action exerted by proanthocyanidins from edible fruits, tea, and medicinal herbs in the inhibition of periodontitis-causing pathogens.


Assuntos
Antibacterianos/uso terapêutico , Flavonoides/farmacologia , Periodontite/tratamento farmacológico , Periodontite/prevenção & controle , Proantocianidinas/farmacologia , Animais , Anti-Inflamatórios , Antioxidantes , Flavonoides/química , Frutas/química , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Extratos Vegetais/farmacologia , Plantas Medicinais , Polifenóis/farmacologia , Taninos , Chá/química
11.
Monogr Oral Sci ; 29: 91-97, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427225

RESUMO

Caries and inflammatory periodontal diseases have a high prevalence worldwide. Although improvements in oral health status in our patients have been shown, there is still an increased demand for preventive measurements - especially in view of the systemic influence of the chronic disease periodontitis. The main focus of such measurements lies on an optimal biofilm management which can be divided into professional biofilm management and home care measurements. Since home care mechanical measurements such as toothbrushing and interdental cleaning are often insufficient or not on a regular basis, they can be supported by antibacterial agents which are able to inhibit or kill any oral microorganisms that remain. Besides a proven effect on plaque bacteria and gingival inflammation, agents should have a high substantivity in the oral cavity that outlast the short rinsing period. This chapter aims to present the background and rationale of using antibacterial mouth rinses, their common agents, to show sensible indications, and to evaluate the scientific evidence of their additional effect over toothbrushing alone.


Assuntos
Gengivite , Antissépticos Bucais , Biofilmes , Gengivite/prevenção & controle , Humanos , Inflamação , Antissépticos Bucais/uso terapêutico , Higiene Bucal , Escovação Dentária
12.
Monogr Oral Sci ; 29: 74-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33427231

RESUMO

The intraoral biofilm requires mechanical removal due to its physical properties. When exposed to the biofilm, interdental areas need special devices to be used. The most effective ones and the first choice are interdental brushes. However, they may not be adequate in the case of very narrow interdental spaces. Despite the difficulties in handling, dental floss may have some advantage in subgingival cleaning. Data are present for gingivitis and periodontitis, but almost no information has been published on gingivally healthy individuals. With respect to interdental caries there is evidence that floss only has a protective value when used professionally and without sufficient fluoridation. There are no such data available on interdental brushes.


Assuntos
Placa Dentária , Gengivite , Biofilmes , Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Humanos , Escovação Dentária
13.
Angle Orthod ; 91(2): 220-226, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378447

RESUMO

OBJECTIVES: To compare the effectiveness of metronidazole gel and mobile telephone short-message service (SMS) reminders on gingivitis in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: The trial was double blinded (patient and investigator), and only the clinical trial unit pharmacist was unblinded. Data were collected from patients undergoing fixed orthodontic treatment for at least 6 months. A total of 66 patients were randomly assigned to either 0.8% metronidazole gel (n = 22), SMS reminder and placebo gel (n = 22), or placebo (control) group only (n = 22). Gingival index (GI), bleeding index (BI), and orthodontic plaque index (OPI) were evaluated on several teeth at baseline (T0) and after 4 weeks (T1). Paired-sample t-tests were used to compare mean differences of indexes at T0 and T1 in the groups, and independent-sample t-tests were used to determine the effects of interventions compared with the controls. RESULTS: Data from 64 patients were analyzed; there were 2 dropouts. There were statistically significant (P < .05) reductions in GI, BI, and OPI scores from T0 to T1 for each intervention. However, there were no significant differences between each intervention and the control group. There were no adverse effects. CONCLUSIONS: The null hypothesis could not be rejected. There is no difference between interventions (application of 0.8% metronidazole gel and SMS reminder for reinforcing oral hygiene) in reducing gingival inflammation in orthodontic patients.


Assuntos
Gengivite , Metronidazol , Índice de Placa Dentária , Gengivite/tratamento farmacológico , Gengivite/prevenção & controle , Humanos , Higiene Bucal , Índice Periodontal
14.
J Am Dent Assoc ; 152(2): 105-114, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33358239

RESUMO

BACKGROUND: The authors of this study aimed to evaluate the clinical antiplaque and antigingivitis effects of 3 oral hygiene regimens: toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing cetylpyridinium chloride, zinc lactate, and fluoride (CPC + Zn + F) in an alcohol-free base; toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing essential oils (EO) in an alcohol-free base; and toothbrushing with manual toothbrush and standard fluoride toothpaste and manual toothbrush (control). METHODS: The participants (N = 120) were randomly assigned to study groups and followed the assigned regimens twice daily for 6 weeks. The participants were examined by a calibrated examiner for the Quigley-Hein plaque index (Turesky modification) and Löe-Silness gingival index at baseline, week 4, and week 6. Statistical analyses were performed separately for plaque and gingival indexes by means of analysis of variance, paired t test, and analysis of covariance (α = 0.05). RESULTS: At week 4, the CPC + Zn + F group presented additional reductions in dental plaque compared with EO and control groups of (21.4% [P < .001] and 31.4% [P < .001], respectively). After 6 weeks, these values were 26.7% (P < .001) and 44.8% (P < .001), respectively. For Löe-Silness gingival index, additional reduction in the CPC + Zn + F group compared with EO were 10.6% (P < .001) and 13.7% (P < .001) at 4 and 6 weeks, respectively. Compared with control, these reductions were 13.6% (P < .001) and 17.8% (P < .001), respectively. CONCLUSIONS: The regimen including a mouthrinse containing CPC + Zn + F presented higher antiplaque and antigingivitis effects than EO and control regimens. PRACTICAL IMPLICATIONS: A mouthrinse containing CPC + Zn + F is an effective protocol for the control of dental plaque and gingivitis.


Assuntos
Anti-Infecciosos Locais , Placa Dentária , Gengivite , Óleos Voláteis , Anti-Infecciosos Locais/uso terapêutico , Cetilpiridínio/uso terapêutico , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Gengivite/prevenção & controle , Humanos , Lactatos , Antissépticos Bucais/uso terapêutico , Óleos Voláteis/uso terapêutico , Escovação Dentária , Zinco/uso terapêutico
15.
Oral Health Prev Dent ; 18(1): 843-854, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33028052

RESUMO

PURPOSE: Currently, there is no consensus on recommendations for manual toothbrushing techniques between dentists, oral health therapists and dental companies. The aim of this systematic review is to identify and assess the quality of evidence of the effectiveness of manual toothbrushing techniques in the existing literature. METHODS: A broad search was conducted on the electronic databases Medline via Ovid, PubMed and EBSCO Dentistry & Oral Sciences. Included studies examined manual toothbrushing technique efficiency. Articles were assessed utilising the Cochrane Collaboration's tool for assessing risk of bias. Thirteen studies met the inclusion criteria and were included in this review. These included five randomised controlled trials (RCT), seven experimental non-randomised control studies and one in vitro study. RESULTS: Of the 3190 articles identified, 40 were relevant to manual toothbrushing and 13 were included in the final review. Studies indicating statistically significantly superior plaque removal for a given technique were Bass (one), modified Bass (one), Charter's (two), Fones (two), scrub (two), roll (one), modified Stillman (one), toothpick method (one). Four studies exhibited no statistically significant difference in effectiveness of plaque removal. Unfortunately, considerable variation was found between studies, making a definitive conclusion impossible in terms of an ideal manual toothbrushing technique that would promote plaque removal and reduce gingivitis. CONCLUSION: There is still insufficient evidence for suggesting that one toothbrushing method is more effective than another in plaque removal and reduction of gingivitis. Excessive variability in many aspects of the design and methodology of the selected studies hinder conclusions on an ideal manual toothbrushing technique. Experimental randomised controlled trials that follow the CONSORT guidelines are required to provide adequate-quality evidence and make any definitive conclusions on the relative effectiveness of manual toothbrushing techniques.


Assuntos
Placa Dentária , Gengivite , Assistência Odontológica , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Humanos , Saúde Bucal , Escovação Dentária
16.
Am J Dent ; 33(5): 258-264, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33017529

RESUMO

PURPOSE: To compare the effectiveness in reducing plaque and gingivitis of a fluoride toothpaste with 20% baking soda and a fluoride toothpaste control. METHODS: 159 subjects, who met the entry criteria, participated in this single-center, double-blind, randomized, parallel-group clinical study. Gingival Index (MGI), Gingival Bleeding Index (GBI), and Plaque Index (PI) were assessed after 4, 8, and 12 weeks use of the assigned test or control toothpaste. After 12 weeks, participants resumed 4 weeks of their customary oral hygiene after which they were re-evaluated using the same measures. RESULTS: Both toothpastes statistically significantly reduced MGI, GBI, and PI versus baseline at all-time points. Brushing with the 20% baking soda toothpaste statistically significantly reduced MGI, PI, and GBI compared to the control toothpaste at all time points. After 12 weeks, the reductions in MGI, PI, and GBI were 12.6%, 9.6%, and 44.2%, respectively. After the 4-week customary oral hygiene period, the benefits of the study period had begun to diminish, but statistically significant reductions in MGI and GBI for the test versus control were still evident. This 3-month clinical study shows that brushing with fluoride toothpaste containing 20% baking soda reduces dental plaque and concurrently reduces gingival inflammation and bleeding compared to toothpaste with fluoride alone. CLINICAL SIGNIFICANCE: Fluoride toothpaste with 20% baking soda has the potential to offer multiple oral health benefits when used as an adjunct to regular tooth brushing and, therefore, may be confidently recommended to patients.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Índice de Placa Dentária , Humanos , Bicarbonato de Sódio/uso terapêutico , Cremes Dentais/uso terapêutico
17.
Am J Dent ; 33(5): 265-272, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33017530

RESUMO

PURPOSE: To compare the effectiveness in reducing plaque and gingivitis of two fluoride toothpastes containing baking soda (35% and 20%) with a fluoride toothpaste control. METHODS: 319 subjects, who met entry criteria, participated in this single-center, three-cell, double-blind, randomized, parallel-group clinical study. Gingival Index (MGI), Gingival Bleeding Index (GBI), and Plaque Index (PI) were assessed at baseline, and after 6 weeks, 3 and 6 months. RESULTS: All three toothpastes significantly (P< 0.0001) reduced MGI, GBI, and PI versus baseline, and the two baking soda toothpastes significantly (P< 0.0001) reduced MGI, GBI, and PI compared to the fluoride control, at all three time points. After 6 months use, the 35% and 20% baking soda toothpastes had reduced MGI, GBI and PI by 15.0%, 46.9%, and 18.3%, and 9.4%, 25.9%, and 12.4%, respectively, compared to the control. In addition, the 35% baking soda toothpaste had reduced (P≤ 0.0005) MGI, GBI, and PI by 6.2%, 28.4%, and 6.8%, respectively, compared to the 20% baking soda toothpaste. This clinical study showed that brushing with fluoride toothpastes containing baking soda at 35% and 20% reduces plaque, gingival inflammation and bleeding more effectively than regular fluoride toothpaste. Further, it showed that 35% baking soda toothpaste was more effective in reducing these parameters than 20% baking soda toothpaste. CLINICAL SIGNIFICANCE: Fluoride toothpastes containing 20% or more baking soda can provide significant and meaningful gingival health benefits when used regularly as an adjunct to tooth brushing.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Índice de Placa Dentária , Humanos , Bicarbonato de Sódio , Cremes Dentais
18.
JMIR Mhealth Uhealth ; 8(8): e19433, 2020 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795985

RESUMO

BACKGROUND: Dental visits are unpleasant; sometimes, patients only seek treatment when they are in intolerable pain. Recently, the novel coronavirus (COVID-19) pandemic has highlighted the need for remote communication when patients and dentists cannot meet in person. Gingivitis is very common and characterized by red, swollen, bleeding gums. Gingivitis heals within 10 days of professional care and with daily, thorough oral hygiene practices. If left untreated, however, its progress may lead to teeth becoming mobile or lost. Of the many medical apps currently available, none monitor gingivitis. OBJECTIVE: This study aimed to present a characterization and development model of a mobile health (mHealth) app called iGAM, which focuses on periodontal health and improves the information flow between dentists and patients. METHODS: A focus group discussed the potential of an app to monitor gingivitis, and 3 semistructured in-depth interviews were conducted on the use of apps for monitoring gum infections. We used a qualitative design process based on the Agile approach, which incorporated the following 5 steps: (1) user story, (2) use cases, (3) functional requirements, (4) nonfunctional requirements, and (5) Agile software development cycles. In a pilot study with 18 participants aged 18-45 years and with different levels of health literacy, participants were given a toothbrush, toothpaste, mouthwash, toothpicks, and dental floss. After installing iGAM, they were asked to photograph their gums weekly for 4 weeks. RESULTS: All participants in the focus group believed in the potential of a mobile app to monitor gingivitis and reduce its severity. Concerns about security and privacy issues were discussed. From the interviews, 2 themes were derived: (1) "what's in it for me?" and (2) the need for a take-home message. The 5 cycles of development highlighted the importance of communication between dentists, app developers, and the pilot group. Qualitative analysis of the data from the pilot study showed difficulty with: (1) the camera, which was alleviated with the provision of mouth openers, and (2) the operation of the phone, which was alleviated by changing the app to be fully automated, with a weekly reminder and an instructions document. Final interviews showed satisfaction. CONCLUSIONS: iGAM is the first mHealth app for monitoring gingivitis using self-photography. iGAM facilitates the information flow between dentists and patients between checkups and may be useful when face-to-face consultations are not possible (such as during the COVID-19 pandemic).


Assuntos
Assistência Odontológica/métodos , Gengivite/prevenção & controle , Aplicativos Móveis , Fotografação , Telemedicina , Adolescente , Adulto , Infecções por Coronavirus/epidemiologia , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Satisfação do Paciente/estatística & dados numéricos , Projetos Piloto , Pneumonia Viral/epidemiologia , Pesquisa Qualitativa , Interface Usuário-Computador , Adulto Jovem
19.
Periodontol 2000 ; 84(1): 35-44, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32844413

RESUMO

It is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Doenças Periodontais/prevenção & controle , Dispositivos para o Cuidado Bucal Domiciliar , Humanos , Higiene Bucal , Escovação Dentária
20.
BMC Oral Health ; 20(1): 198, 2020 07 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650754

RESUMO

BACKGROUND: This systematic review of randomized clinical trials aimed to evaluate the available evidence regarding the efficacy of propolis-based mouthwash on dental plaque and gingival inflammation. METHODS: PubMed, Scopus, and Web of Science databases were searched up to November 2019. Clinical trials that evaluated the efficacy of propolis mouthwashes compared with chlorhexidine (CHX) were included. The primary outcomes comprised dental plaque and/or gingival inflammation. Two authors assessed the risk of bias using the Cochrane tool. Due to marked heterogeneity of the available data, studies were assessed qualitatively, and no metaanalysis was performed. RESULTS: Nine clinical trials, comprising 333 subjects, fulfilled the eligibility criteria. Most of the included studies showed high risk of bias. Overall, propolis mouthwashes showed good efficacy on plaque and gingivitis in all of the included studies. Out of the eight studies that reported on plaque index, 5 studies found equal efficacy of propolis and CHX in reducing plaque, two studies found superior efficacy in favor of CHX, while one study found superior efficacy in favor of propolis. Six studies assessed gingival inflammation outcome, four of which reported better results with propolis, while two studies reported comparable results. CONCLUSIONS: The results suggest that propolis-based mouthwashes have potential benefits in reducing plaque and gingival inflammation. However, methodological limitations along with small sample sizes in some of the included studies weaken the strength of the evidence. Therefore, further well-designed clinical trials with large sample sizes and adequate follow-up period are recommended to discern the efficacy of propolis mouthwash on plaque and gingivitis.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Placa Dentária/tratamento farmacológico , Gengivite/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Própole/uso terapêutico , Clorexidina/uso terapêutico , Estudos Cross-Over , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Método Duplo-Cego , Gengivite/prevenção & controle , Humanos , Inflamação/tratamento farmacológico , Método Simples-Cego
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