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1.
Braz Oral Res ; 34: e031, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32236326

RESUMO

Probiotic therapy is a viable alternative to chlorhexidine, a widely used antiseptic in dentistry that produces significant adverse effects. This systematic review aimed to analyze the effects of probiotics on experimental gingivitis in humans. Two independent reviewers conducted a comprehensive literature search until March 2019. Randomized clinical trials and controlled clinical trials were selected. Outcome data were extracted and critically analyzed. A total of five articles were included in the qualitative synthesis. No meta-analysis could be conducted due to the heterogeneity of the selected studies. The use of probiotics showed a slight improvement in clinical parameters. Changes in gingival crevicular fluid volume were lower in the presence of the probiotic than in the placebo group. All the studies showed that the immediate, positive effects of probiotics during the period of discontinued mechanical oral hygiene were due to the modulation of the host response, not the anti-plaque effect. Investigators should conduct randomized clinical trials to elucidate the mechanisms of probiotic action and develop improved delivery systems.


Assuntos
Gengivite/prevenção & controle , Imunomodulação , Probióticos/uso terapêutico , Feminino , Líquido do Sulco Gengival , Gengivite/fisiopatologia , Humanos , Masculino , Microbiota , Placebos
2.
Acta Odontol Scand ; 78(4): 265-274, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32285744

RESUMO

Objective: Power toothbrushes is considered an effective tool for maintaining oral health; however, its efficacy as compared to manual toothbrushes is still not completely clarified. This article aims to evaluate the efficacy of power toothbrushes compared with the manual toothbrushes in terms of plaque, gingivitis and bleeding reduction.Methods: An electronic search was performed on PUBMED, Web of Science, Wiley and Research Gate. Studies comparing the effectiveness of plaque, gingivitis and bleeding reduction between power and manual toothbrushes were included. Results and effect sizes analysis are presented as standard mean difference (SMD), and subgroup analysis stratified by mode of action of the power toothbrush was performed. Study quality and risk of bias were assessed using the Cochrane assessment tool.Results: A total of 21 randomized clinical studies were included. Power toothbrushes were significantly more effective in reducing plaque index (26 trials: SMD = 0.86, 95% CI: 0.58 to 1.14, I2 = 91.5%, p < .0001), gingival index (14 trials: SMD = 0.47, 95% CI: 0.12 to 0.82, I2 = 88.7%, p < .0001), and bleeding index (11 trials: SMD = 0.92, 95% CI: 0.43 to 1.40, I2 = 91.8%, p < .0001) compared with the manual toothbrushes, except that there was no significant differences between the oscillating-rotating toothbrushes and manual toothbrushes regarding gingivitis reduction (7 trials: SMD = 0.07, 95% CI: -0.20 to 0.33, I2 = 57.2%, p = .03).Conclusions: Power toothbrushes is more effective in reducing dental plaque, gingivitis and bleeding compared with the manual toothbrush.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Saúde Bucal , Escovação Dentária/instrumentação , Dispositivos para o Cuidado Bucal Domiciliar , Índice de Placa Dentária , Desenho de Equipamento , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Escovação Dentária/métodos
3.
Am J Orthod Dentofacial Orthop ; 157(2): 172-177, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32005468

RESUMO

INTRODUCTION: The aim of this study was to evaluate the impact of being overweight or obese while wearing orthodontic fixed appliances on the prevalence of gingivitis in adolescents. METHODS: A total of 334 adolescents, aged between 12 and 18 years, were recruited from 3 public schools in Cuiabá, Brazil. Participants were divided in dichotomized categories of body mass index (BMI) (under and normal weight or overweight and obesity) and fixed orthodontic appliance usage (yes or no). Gingival inflammation was evaluated by Löe & Silness index. Socioeconomic status was determined by the criteria of the Brazilian Association of Research Companies, and sugar consumption was assessed by a questionnaire of dietary habits. The statistical analysis was performed with P <0.05 considered significant. RESULTS: In a multivariate linear regression model, gingivitis was directly related to BMI (%) variation and orthodontic appliance use. In addition, excess weight seemed to be 2 times more relevant in predicting gingivitis than orthodontic fixed appliance usage. A strong positive correlation was observed between BMI (%) variation and gingival index (ρ = 0.97, P <0.001). CONCLUSIONS: Orthodontic fixed appliance usage and excess weight were associated with increased gingivitis in adolescents; BMI (%) variation was the most significant predictor of gingival inflammation.


Assuntos
Gengivite , Aparelhos Ortodônticos , Adolescente , Brasil/epidemiologia , Criança , Gengiva , Gengivite/epidemiologia , Gengivite/prevenção & controle , Humanos , Aparelhos Ortodônticos Fixos
4.
Eur Arch Paediatr Dent ; 21(1): 61-66, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31111439

RESUMO

PURPOSE: To evaluate the effect of two herbal mouthwashes containing aloe vera and tea tree oil, on the oral health of school children. METHODS: A double-blinded, placebo-controlled prospective interventional study was conducted in school children aged 8-14 years. The study participants were divided into four groups depending upon the mouthwash used: Group 1 (aloe vera), Group 2 (chlorhexidine), Group 3 (tea tree oil) and Group 4 (placebo). The variables studied included plaque index, gingival index and salivary Streptococcus mutans counts, which were recorded at baseline, 4 weeks after supervised mouth rinse and after 2 weeks of stopping the mouth rinse. RESULTS: A total of 89 boys and 63 girls were included. A statistically significant decrease in all variables was noted after the use of both the herbal preparations at the end of 4 weeks which was maintained after the 2-week washout period (p < 0.001). The difference in variables between groups using aloe vera, Tea tree oil and chlorhexidine, was not statistically significant. CONCLUSION: The use of aloe vera and tea tree oil mouthwashes can decrease plaque, gingivitis and S. mutans in the oral cavity in children. The activity of these two agents is comparable to that of chlorhexidine.


Assuntos
Aloe , Gengivite , Antissépticos Bucais , Saúde Bucal , Óleo de Melaleuca , Adolescente , Criança , Clorexidina , Placa Dentária/prevenção & controle , Feminino , Gengivite/prevenção & controle , Humanos , Masculino , Estudos Prospectivos , Óleo de Melaleuca/uso terapêutico
5.
J Vet Dent ; 36(2): 129-134, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31564198

RESUMO

BACKGROUND: Dental concerns are some of the most common health problems affecting companion animals. A variety of foods, treats, and chews comprising different mechanical and chemical technologies have been investigated as a means of promoting oral health. Here, we investigate the chemical technology, lactic acid added to a commercially available food, for its ability to inhibit dental plaque, calculus, and tooth stain accumulation in cats. METHODS: Two separate feeding trials assessed the utility of a nutritionally complete feline maintenance food supplemented with lactic acid to reduce oral substrate accumulation (dental plaque, calculus, and tooth stain) in cats. After a calibration study identified high and low dental plaque formers, 45 cats were randomized to 1 of 2 test groups (food with 1.2% lactic acid supplementation) or control (food without lactic acid supplementation) groups, stratified based on their calibration scores. Data were collected on a monthly basis for 3 months. The second study randomly assigned 24 cats to either the test or control groups for 1 year, with data collected at the 6- and 12-month time points. RESULTS: In the 3-month study, reductions in dental plaque, calculus, and tooth stain accumulations were observed at the 2-month assessment in both test groups compared with control (P < .05 for test group 2). The 1-year study showed that these reductions in oral substrate accumulation persisted through the 6- and 12-month time points (P < .05). CONCLUSIONS: Taken together, these studies demonstrate that lactic acid supplemented at 1.2% in a feline maintenance food significantly inhibits oral substrate accumulation.


Assuntos
Doenças do Gato/prevenção & controle , Placa Dentária/veterinária , Gengivite/veterinária , Ácido Láctico/farmacologia , Animais , Gatos , Corantes , Cálculos Dentários/prevenção & controle , Cálculos Dentários/veterinária , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Suplementos Nutricionais , Gengivite/prevenção & controle
6.
BMC Vet Res ; 15(1): 207, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226991

RESUMO

BACKGROUND: Periodontal disease is the most common oral disease of dogs and has been associated with systemic disease. The purpose of the present study was to determine the extent of periodontal disease in a population of Yorkshire terrier dogs with and without a tooth brushing regimen. Each dog was assessed under general anaesthesia two to five times between 37 and 78 weeks of age. The extent of gingivitis and periodontitis was ascertained for every tooth in the mouth. Gingivitis was measured using time to bleeding on probing, and periodontitis was based on extent of clinical attachment loss (probing depth, gingival recession and furcation exposure). RESULTS: Of the 49 dogs assessed at 37 weeks of age, 98% had at least one tooth or aspect with early periodontitis (PD2, < 25% attachment loss). The average percentage of teeth with periodontitis in the mouth was 29.6% with 95% confidence interval (23.6, 36.4). The odds of early periodontitis was 2.74 (2.23, 3.37) times higher at 78 weeks of age compared to 37 weeks of age. The canine teeth had a significantly higher probability of periodontitis compared to all other tooth types at both 37 and 78 weeks of age (p < 0.001). In addition, at the same time points, the incisors had a significantly higher probability of periodontitis compared to the molars and premolars (p < 0.001). CONCLUSIONS: Breeds of dog that are susceptible to developing periodontitis, such as Yorkshire terriers, require effective treatments for the prevention of periodontal disease from a young age. Although tooth brushing is one of the most effective methods when it comes to preventative homecare, this is not always realistic, as was found in this study. Therefore alternative ways to retard or prevent plaque accumulation that are practical for both dogs and their owners are required.


Assuntos
Doenças do Cão/epidemiologia , Gengivite/veterinária , Periodontite/veterinária , Escovação Dentária/veterinária , Fatores Etários , Animais , Estudos de Coortes , Doenças do Cão/prevenção & controle , Cães , Feminino , Gengivite/epidemiologia , Gengivite/prevenção & controle , Estudos Longitudinais , Masculino , Periodontite/epidemiologia , Periodontite/prevenção & controle , Prevalência , Distribuição Aleatória , Especificidade da Espécie
7.
Cochrane Database Syst Rev ; 4: CD012018, 2019 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-30968949

RESUMO

BACKGROUND: Dental caries (tooth decay) and periodontal diseases (gingivitis and periodontitis) affect the majority of people worldwide, and treatment costs place a significant burden on health services. Decay and gum disease can cause pain, eating and speaking difficulties, low self-esteem, and even tooth loss and the need for surgery. As dental plaque is the primary cause, self-administered daily mechanical disruption and removal of plaque is important for oral health. Toothbrushing can remove supragingival plaque on the facial and lingual/palatal surfaces, but special devices (such as floss, brushes, sticks, and irrigators) are often recommended to reach into the interdental area. OBJECTIVES: To evaluate the effectiveness of interdental cleaning devices used at home, in addition to toothbrushing, compared with toothbrushing alone, for preventing and controlling periodontal diseases, caries, and plaque. A secondary objective was to compare different interdental cleaning devices with each other. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched: Cochrane Oral Health's Trials Register (to 16 January 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2018, Issue 12), MEDLINE Ovid (1946 to 16 January 2019), Embase Ovid (1980 to 16 January 2019) and CINAHL EBSCO (1937 to 16 January 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication. SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared toothbrushing and a home-use interdental cleaning device versus toothbrushing alone or with another device (minimum duration four weeks). DATA COLLECTION AND ANALYSIS: At least two review authors independently screened searches, selected studies, extracted data, assessed studies' risk of bias, and assessed evidence certainty as high, moderate, low or very low, according to GRADE. We extracted indices measured on interproximal surfaces, where possible. We conducted random-effects meta-analyses, using mean differences (MDs) or standardised mean differences (SMDs). MAIN RESULTS: We included 35 RCTs (3929 randomised adult participants). Studies were at high risk of performance bias as blinding of participants was not possible. Only two studies were otherwise at low risk of bias. Many participants had a low level of baseline gingival inflammation.Studies evaluated the following devices plus toothbrushing versus toothbrushing: floss (15 trials), interdental brushes (2 trials), wooden cleaning sticks (2 trials), rubber/elastomeric cleaning sticks (2 trials), oral irrigators (5 trials). Four devices were compared with floss: interdental brushes (9 trials), wooden cleaning sticks (3 trials), rubber/elastomeric cleaning sticks (9 trials) and oral irrigators (2 trials). Another comparison was rubber/elastomeric cleaning sticks versus interdental brushes (3 trials).No trials assessed interproximal caries, and most did not assess periodontitis. Gingivitis was measured by indices (most commonly, Löe-Silness, 0 to 3 scale) and by proportion of bleeding sites. Plaque was measured by indices, most often Quigley-Hein (0 to 5). PRIMARY OBJECTIVE: comparisons against toothbrushing aloneLow-certainty evidence suggested that flossing, in addition to toothbrushing, may reduce gingivitis (measured by gingival index (GI)) at one month (SMD -0.58, 95% confidence interval (CI) -1.12 to -0.04; 8 trials, 585 participants), three months or six months. The results for proportion of bleeding sites and plaque were inconsistent (very low-certainty evidence).Very low-certainty evidence suggested that using an interdental brush, plus toothbrushing, may reduce gingivitis (measured by GI) at one month (MD -0.53, 95% CI -0.83 to -0.23; 1 trial, 62 participants), though there was no clear difference in bleeding sites (MD -0.05, 95% CI -0.13 to 0.03; 1 trial, 31 participants). Low-certainty evidence suggested interdental brushes may reduce plaque more than toothbrushing alone (SMD -1.07, 95% CI -1.51 to -0.63; 2 trials, 93 participants).Very low-certainty evidence suggested that using wooden cleaning sticks, plus toothbrushing, may reduce bleeding sites at three months (MD -0.25, 95% CI -0.37 to -0.13; 1 trial, 24 participants), but not plaque (MD -0.03, 95% CI -0.13 to 0.07).Very low-certainty evidence suggested that using rubber/elastomeric interdental cleaning sticks, plus toothbrushing, may reduce plaque at one month (MD -0.22, 95% CI -0.41 to -0.03), but this was not found for gingivitis (GI MD -0.01, 95% CI -0.19 to 0.21; 1 trial, 12 participants; bleeding MD 0.07, 95% CI -0.15 to 0.01; 1 trial, 30 participants).Very-low certainty evidence suggested oral irrigators may reduce gingivitis measured by GI at one month (SMD -0.48, 95% CI -0.89 to -0.06; 4 trials, 380 participants), but not at three or six months. Low-certainty evidence suggested that oral irrigators did not reduce bleeding sites at one month (MD -0.00, 95% CI -0.07 to 0.06; 2 trials, 126 participants) or three months, or plaque at one month (SMD -0.16, 95% CI -0.41 to 0.10; 3 trials, 235 participants), three months or six months, more than toothbrushing alone. SECONDARY OBJECTIVE: comparisons between devicesLow-certainty evidence suggested interdental brushes may reduce gingivitis more than floss at one and three months, but did not show a difference for periodontitis measured by probing pocket depth. Evidence for plaque was inconsistent.Low- to very low-certainty evidence suggested oral irrigation may reduce gingivitis at one month compared to flossing, but very low-certainty evidence did not suggest a difference between devices for plaque.Very low-certainty evidence for interdental brushes or flossing versus interdental cleaning sticks did not demonstrate superiority of either intervention.Adverse eventsStudies that measured adverse events found no severe events caused by devices, and no evidence of differences between study groups in minor effects such as gingival irritation. AUTHORS' CONCLUSIONS: Using floss or interdental brushes in addition to toothbrushing may reduce gingivitis or plaque, or both, more than toothbrushing alone. Interdental brushes may be more effective than floss. Available evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent. Outcomes were mostly measured in the short term and participants in most studies had a low level of baseline gingival inflammation. Overall, the evidence was low to very low-certainty, and the effect sizes observed may not be clinically important. Future trials should report participant periodontal status according to the new periodontal diseases classification, and last long enough to measure interproximal caries and periodontitis.


Assuntos
Cárie Dentária/prevenção & controle , Dispositivos para o Cuidado Bucal Domiciliar , Placa Dentária/prevenção & controle , Doenças Periodontais/prevenção & controle , Gengivite/prevenção & controle , Humanos , Saúde Bucal , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Haemophilia ; 25(4): 693-698, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30994256

RESUMO

INTRODUCTION: Severe plasminogen (PLG) deficiency causes ligneous conjunctivitis, a rare disease characterized by the growth of fibrin-rich pseudomembranes on mucosal surfaces; gums involvement leads to ligneous gingivitis (LG). Specific therapy for LG is not available yet. We report a prophylactic treatment with enoxaparin and fresh frozen plasma (FFP) for invasive dental procedures in a patient with LG, and a review of literature on LG treatment. METHODS: A 43-year-old female with LG was studied. In order to prevent LG recurrence after dental care, FFP before and the day after the procedure, and enoxaparin were administered in addition to proper minimally invasive dentistry techniques and implant surgery. RESULTS: Plasminogen deficiency was confirmed by reduced PLG antigen (25 µg/mL) and activity (20%) levels, and genetic analysis. PLG levels rose to 46% after FFP transfusion and returned to baseline after 48 hours. Minimally invasive dental procedures and implants were performed. Small gingival pseudomembranes developed soon thereafter in some cases but disappeared within a few weeks; no bleeding complications were observed. CONCLUSIONS: In our patient with LG, the adoption of combined haematological and dentistry protocols appeared to be safe and effective in preventing abnormal gingival pseudomembranes growth after dental interventions, maintaining a healthy periodontal condition.


Assuntos
Conjuntivite/complicações , Assistência Odontológica , Gengivite/complicações , Gengivite/prevenção & controle , Plasminogênio/deficiência , Dermatopatias Genéticas/complicações , Adulto , Enoxaparina/farmacologia , Feminino , Humanos , Plasma/metabolismo , Prevenção Secundária
9.
Indian J Dent Res ; 30(1): 61-66, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30900659

RESUMO

Aim: The aim of the study was to find out the effect of sugar-free chewing gums (xylitol and sorbitol) on plaque and gingivitis among 14-15-year-old school children. Materials and Methods: A single center, double-blind, randomized controlled trial was conducted on 14-15-year-old children. Sample size was determined to be 48. Participants were randomly allocated to test group (xylitol [n = 12], sorbitol [n = 12]) and control group (no gum, n = 24). Duration of the study was 14 days. Baseline assessment of plaque, gingival, and bleeding score, followed by oral prophylaxis. Selected children received daily two chewing gum (1.1 g each) to chew for 20 min postbreakfast and postlunch. Follow-up was done on 15th day. Analysis was done using independent t-test, ANOVA, and post hoc test. Significance level was kept at P < 0.05. Results: There was a significant reduction in plaque, gingival, and bleeding score in test group (P < 0.05) compared to control group. Conclusion: Sugar-free gum (xylitol and sorbitol) significantly reduced the plaque, gingival, and bleeding score.


Assuntos
Goma de Mascar , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Sorbitol/administração & dosagem , Xilitol/administração & dosagem , Adolescente , Método Duplo-Cego , Feminino , Humanos , Masculino , Instituições Acadêmicas , Fatores de Tempo
10.
Int J Dent Hyg ; 17(2): 99-116, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30734996

RESUMO

OBJECTIVE: To test the efficacy of a dentifrice containing baking soda (BS), compared with dentifrice without BS for controlling plaque and gingivitis. MATERIALS AND METHODS: MEDLINE-PubMed and Cochrane-CENTRAL were searched. The inclusion criteria were randomized controlled clinical trials including healthy participants aged 18 years or older. Studies were selected that compared the effect of toothbrushing with a dentifrice with and without BS on the clinical parameters of plaque and gingivitis. Data were extracted from the selected studies, and a meta-analysis was performed. RESULTS: The search retrieved 21 eligible publications. Among these papers, 43 comparisons were provided, with 23 involving a single-use design and 20 being evaluations with a follow-up. Negative controls were found, or positive controls for which various active ingredients had been used. The included studies showed a moderate overall potential risk of bias and considerable heterogeneity. The meta-analysis of plaque scores from the single-brushing experiments showed that BS dentifrice (BS-DF) was associated with significantly better outcomes than the negative control dentifrices (DiffM -0.20; P < 0.0001; 95% CI: [-0.27; -0.12]) or the positive control dentifrices (DiffM -0.18; P < 0.0001; 95% CI: [-0.24; -0.12]). This finding was only confirmed in studies that used a follow-up design as compared to a negative control (DiffM -0.19; P = 0.01; 95% CI: [-0.34; -0.04]). The indices of gingival bleeding also improved when the comparison was a negative control (DiffM -0.08; P = 0.02; 95% CI: [-0.16; -0.01] and (DiffM -0.13; P < 0.001; 95% CI: [-0.18; -0.08]. However, for the gingival index scores, the meta-analysis did not reveal any significant differences. CONCLUSION: BS-DF showed promising results with respect to plaque removal in single-use studies. However, the finding was partially substantiated in follow-up studies. Studies that assessed bleeding scores indicated that a small reduction can be expected from BS, relative to a control product.


Assuntos
Placa Dentária/prevenção & controle , Dentifrícios , Gengivite/prevenção & controle , Bicarbonato de Sódio , Escovação Dentária , Bases de Dados Bibliográficas , Placa Dentária/terapia , Gengivite/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Int J Dent Hyg ; 17(2): 117-129, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30609262

RESUMO

OBJECTIVES: The primary aim of this systematic review was to evaluate the effect of external tooth-bleaching products on plaque indices and to compare it to a placebo or a negative control. METHODS: A protocol was developed aimed to answer the next focused question: What is the effect of tooth bleaching compared to no treatment or a placebo, in subjects without periodontitis aged ≥18 years in the levels of plaque and gingivitis? Two electronic databases were used as sources in the search for studies satisfying the inclusion criteria: (a) The National Library of Medicine (MEDLINE via PubMed); (b) Cochrane Central Register of Controlled Trials. RESULTS: Only randomized controlled trials were included. The initial search found 382 potential publications. Seven of them were finally included, and six were used in the meta-analyses. The use of bleaching products showed higher reductions in plaque (n = 6; standardized mean difference [SMD] = 0.47; 95% confidence interval [CI] = 0.06, 0.88; P < 0.001) and gingivitis indices (n = 4; SMD = 0.47; 95% CI = 0.22, 0.73; P < 0.001), when compared to a control group (no treatment or placebo). CONCLUSIONS: External tooth bleaching is associated with statistically significant short-term reductions in plaque and gingivitis indices. However, no data were available to evaluate long-term effects.


Assuntos
Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Clareadores Dentários , Clareamento Dental , Bases de Dados Bibliográficas , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Clin Oral Investig ; 23(10): 3833-3842, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30673864

RESUMO

OBJECTIVES: To compare the efficacy of N-acetyl cysteine (NAC) mouthwash with chlorhexidine (CHX) in prevention and treatment of experimental gingivitis MATERIALS AND METHODS: Sixty subjects were assigned randomly and blindly into one of three equal groups: NAC, CHX, or placebo group. The study was conducted in two stages: preventive and treatment substudies. Professional prophylaxis was performed ahead of starting the preventive substudy. Then, the subjects were instructed to stop oral hygiene practices and begin rinsing twice/day with 15 ml of the assigned mouthwash (1.25% NAC, 0.2% CHX, or inert base). Plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were measured at baseline, 7, 14, and 21 days. The treatment substudy started on day 21 in which the subjects in the placebo group (now with established experimental gingivitis) were assigned to NAC (n = 10) or CHX (n = 10); the abovementioned indices were measured at 28 and 35 days. Efficacy of these interventions was compared. RESULTS: All groups accumulated plaque and developed some degree of gingivitis: full-blown in the placebo group and remarkably mild in the CHX group. NAC had slight preventive properties at days 14 and 21. In the treatment substudy, CHX was associated with remarkable reduction in plaque and gingivitis while NAC resulted in insignificant reductions. CONCLUSIONS: 1.25% NAC is marginally effective in prevention and treatment of experimental gingivitis. CLINICAL RELEVANCE: When compared with the placebo, NAC showed promising preventive and treatment effects of gingivitis that deserve further development and studies. TRIAL REGISTRATION: ISRCTN31352091.


Assuntos
Acetilcisteína/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Gengivite/tratamento farmacológico , Antissépticos Bucais/uso terapêutico , Índice de Placa Dentária , Feminino , Gengivite/prevenção & controle , Humanos , Masculino , Adulto Jovem
13.
Spec Care Dentist ; 39(2): 125-134, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30597580

RESUMO

AIM: This study aimed to assess the effectiveness of a novel health education method-Audio Tactile Performance (ATP) technique-in maintenance of gingival health and plaque removal efficacy among institutionalized visually impaired children of Bhubaneswar city. METHODS AND RESULTS: A parallel arm, single blinded randomized controlled trial was conducted among 10- to 15-year-old visually impaired children. Clinical examinations were done by the examiner blinded to group allocations. Oral health education materials (Braille and audio) were given to control group and ATP technique was given to test group. Clinical examinations for plaque and gingival scores were assessed at baseline, 30 days interval, and 90 days interval. The trial was registered with the Clinical Trial Registry of India (CTRI/2017/05/008551). In control group, a greater plaque reduction was observed at 30 days interval (3.58 ± 1.3) when compared to baseline (2.63 ± 2.02) and 90 days interval (3.14 ± 0.88), and this difference was statistically significant. For whole mouth, in test group, a greater reduction in gingival scores was observed at 90 days interval (2.65 ± 1.64) when compared to baseline (4.58 ± 1.63) and 30 days interval (1.23 ± 2.43), and this difference was statistically significant. CONCLUSION: ATP was found to be at par with the control group (Braille and audio aids).


Assuntos
Assistência Odontológica para Crianças/métodos , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Educação em Saúde Bucal/métodos , Institucionalização , Pessoas com Deficiência Visual , Adolescente , Criança , Feminino , Humanos , Índia , Masculino , Avaliação de Programas e Projetos de Saúde , Método Simples-Cego
14.
Clin Oral Investig ; 23(1): 21-32, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30535817

RESUMO

BACKGROUND: Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES: To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use. MATERIALS AND METHODS: A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature. RESULTS: From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29-86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects. CONCLUSION: Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy. CLINICAL RELEVANCE: Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Biofilmes/efeitos dos fármacos , Clorexidina/uso terapêutico , Implantação Dentária , Gengivite/prevenção & controle , Antissépticos Bucais/uso terapêutico , Doenças Periodontais/cirurgia , Infecção da Ferida Cirúrgica/prevenção & controle , Humanos
16.
Int J Dent Hyg ; 17(2): 153-160, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30375187

RESUMO

OBJECTIVE: To evaluate the efficacy of an oscillating-rotating (O-R) electric rechargeable toothbrush with a novel round brush head comprised of regular and tapered bristles in reducing plaque and gingivitis versus a manual toothbrush. METHODS: This was a randomized, examiner-blind, parallel group, five-week study. Participants with mild-to-moderate plaque and gingivitis received an oral examination and were evaluated for baseline plaque (Rustogi Modified Navy Index), gingivitis (Modified Gingival Index) and gingival bleeding (Gingival Bleeding Index). Qualifying participants were randomly assigned to the novel Oral-B sensitive brush head (EB60) on an Oral-B Vitality O-R handle (D12) or an ADA manual toothbrush. Participants brushed twice daily with the assigned brush and a standard fluoride dentifrice for 5 weeks before returning for an oral examination and plaque and gingivitis evaluations. RESULTS: A total of 150 participants were randomized to treatment and completed the study (mean age = 45.7 years). Both brushes demonstrated a statistically significant reduction in number of bleeding sites versus baseline (P < 0.001). At Week 5, the number of bleeding sites was reduced from baseline by 11.15 (52.2%) for the O-R brush and 5.04 (23.6%) for the manual brush. The treatment difference was statistically significant (P < 0.001). Significant reductions versus baseline (P < 0.001) were also seen for both brushes for MGI, GBI and Rustogi plaque measures (whole mouth, gingival margin and proximal), but the O-R brush produced significantly greater reductions versus the manual brush (P < 0.001). CONCLUSION: The O-R handle and round brush head with tapered and regular bristles produced greater plaque and gingivitis reductions than the manual brush.


Assuntos
Placa Dentária/prevenção & controle , Equipamentos e Provisões Elétricas , Gengivite/prevenção & controle , Escovação Dentária/métodos , Adolescente , Adulto , Dentifrícios , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
17.
Int J Dent Hyg ; 17(1): 16-26, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29405627

RESUMO

OBJECTIVES: To review the effectiveness of antiseptic oral sprays on oral health. METHODS AND MATERIALS: Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included. RESULTS: Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores. CONCLUSIONS: Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Clorexidina/administração & dosagem , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Sprays Orais , Adolescente , Adulto , Idoso , Criança , Bases de Dados Bibliográficas , Placa Dentária/diagnóstico , Índice de Placa Dentária , Feminino , Gengivite/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Índice Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
18.
Int J Dent Hyg ; 17(1): 3-15, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29512317

RESUMO

FOCUS QUESTION: What is the efficacy of a chlorhexidine (CHX) mouthwash (MW) containing sodium fluoride (NaF) compared to a CHX - MW alone on the parameters of plaque, gingivitis and discoloration? MATERIAL AND METHODS: MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE were searched for papers from inception to December 2017. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects with good general health and without removable prosthesis. Papers evaluating the effect of a MW containing CHX + NaF compared to a CHX alone were included. From the eligible studies, data were extracted, a descriptive analysis was performed and a meta-analysis when feasible. RESULTS: Independent screening of 412 unique papers resulted in 9 eligible publications presenting 10 clinical trials comparing the effect of CHX + NaF to CHX - MW and provided 13 comparisons. Five evaluated the MW as an adjunct to brushing and 8 were non-brushing comparisons of which 4 used an experimental gingivitis model. No significant difference was observed for plaque score reduction in the brushing studies the end scores (diffM; -0.04, P = .36; 95%CI: [-0.13, 0.05]) nor the differences (diffM; 0.11, P = .33; 95%CI: [-0.12, 0.24]). In the descriptive analysis, none of the experiments demonstrated a statistical significant difference regarding Gingival Index (GI), Bleeding Score and Discoloration Scores. For the GI, a meta-analysis of the difference of Means was not significant when included experimental gingivitis model studies end scores (0.01, P = .78; 95%CI: [-0.08, 0.11]) and the difference (0.01, P = .81; 9 5%CI: [-0.08, 0.10]) either for the end scores of brushing studies (diffM; -0.01, P = .82; 95%CI: [-0.10, 0.08]). CONCLUSION: From this study, it can be concluded that NaF and CHX may be present in the same MW without reducing CHX efficacy with respect to plaque and gingivitis scores. Moreover, no difference in the development of tooth discoloration was observed.


Assuntos
Clorexidina/administração & dosagem , Placa Dentária/prevenção & controle , Fluoretos/administração & dosagem , Gengivite/prevenção & controle , Antissépticos Bucais/administração & dosagem , Adulto , Bases de Dados Bibliográficas , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
19.
Clin Oral Investig ; 23(2): 651-659, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29740720

RESUMO

OBJECTIVES: The identification of predictors of supragingival biofilm accumulation may improve the results of therapeutic strategies for dental caries and periodontal diseases in general clinical practice. This study aimed to determine predictors of changes in visible plaque (VP) and gingival bleeding (GB) during integrated dental care. MATERIALS AND METHODS: A retrospective longitudinal study was conducted by a census of patients receiving integrated dental care in a general clinical practice ambulatory at the Federal University of Rio Grande do Sul (Brazil). The sample comprised 91 charts of patients attended over a 6-months period. Gender, age, patient's main complaint, oral hygiene pattern, and clinical data were recorded from charts for the last two dental visits in the ambulatory. Changes in VP and GB were modeled by multiple linear regression and beta coefficients (b) were reported. RESULTS: The mean follow-up time was 13 months. Significant reductions in VP (32.8 ± 27.9 to 17.4 ± 19.4%; p < 0.001) and GB (27.1 ± 23.8 to 18.5 ± 17.3%; p < 0.001) were observed. Higher plaque reductions were predicted by higher baseline VP levels (p = 0.02), shorter time (< 12 months) elapsed between VP recordings (b = 14.1%, p = 0.02), interproximal cleansing (b = 11.9%, p = 0.03), lower number of sessions for oral hygiene instruction (b = 13.7%, p = 0.02), and presence of pockets ≥ 6 mm (b = - 12.4%, p = 0.02). GB was predicted by time of follow-up > 12 months and baseline VP. CONCLUSIONS: Plaque and gingivitis improved in patients under integrated dental care. Factors related to motivation, oral hygiene practices, and baseline periodontal status might be used as predictors of VP and GB changes. CLINICAL RELEVANCE: Visible plaque and gingivitis reduced in a sample of patients treated under integrated dental care. Some predictors may determine for which patients the treatment may be maximize and those who will need greater efforts to achieve the therapeutic goal for oral hygiene.


Assuntos
Assistência Odontológica/métodos , Placa Dentária/prevenção & controle , Gengivite/prevenção & controle , Brasil/epidemiologia , Placa Dentária/epidemiologia , Feminino , Gengivite/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Higiene Bucal , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento
20.
Lasers Surg Med ; 51(3): 256-267, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30575059

RESUMO

OBJECTIVES: Poor oral hygiene during treatment with fixed appliances results in plaque accumulation. The presence of bacteria in the gingival crevice triggers an inflammatory reaction in the gingival tissues. The aim of this study was to compare the impact of two preventive treatments, photodynamic therapy (PDT), and ultrasonic scaler (US), on gingival health in patients under fixed orthodontic treatment. METHODS: Twenty orthodontic patients were randomly allocated to two groups: PDT or US. Each group received seven sessions [days 0, 15, 30, 45, 90 (3-months follow-up), 180 (6-months follow-up), 270 (9-months follow-up)] of experimental interventions, and clinical parameters [Plaque index(PI); gingival index(GI); probing depth(PD)], periodontopathogens [Agreggatibacter actinomycetemcomitans; Porphyromonas gingivalis; Prevotella intermedia; Micromonas micros; Fusobacterium nucleatum; Tannerella forsythia; Campylobacter rectus; Eikenella corrodens; Capnocytopaga sp.] and protein markers [IL-1ß;IL-1ra;IL-6;IL-10;TNF-α;FGF-2/FGF basic] were monitored at baseline and at 3, 6, and 9 months. ANOVA, Student's t-test with Bonferroni correction and ANOVA with multiple rank test were used to identify differences between groups (P < 0.05). RESULTS: Clinical assessments [PI, GI, and PD] yielded no differences (P > 0.05) between groups, which showed a major decrease at the start of the trial. Reductions in total colony forming units (log CFU reduction) were observed with both treatments, although to a greater extent in the PDT group, but with no differences between groups (P > 0.05). Similar reductions in log CFU counts of P. gingivalis, P. intermedia, and F. nucleatum were observed in both groups (P > 0.05). The two groups also showed similar trends for inflammatory mediators with decreased levels of IL-1ß, IL-10, and TNF-α, whereas IL-6 and IL-1ra levels remained stable and those of FGF-2 were increased after both interventions, with no differences (P > 0.05) between groups. CONCLUSION: Both PDT and US methods proved similar effectiveness for the treatment of gingival inflammation induced by fixed orthodontic appliances. Lasers Surg. Med. 51:256-267, 2019. © 2018 Wiley Periodicals, Inc.


Assuntos
Raspagem Dentária/métodos , Gengivite/prevenção & controle , Aparelhos Ortodônticos Fixos , Fotoquimioterapia , Terapia por Ultrassom , Adolescente , Criança , Feminino , Gengivite/microbiologia , Humanos , Masculino , Índice Periodontal
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