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1.
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
2.
Rev. cient. odontol ; 7(2): 52-63, jul.-dic. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1046650

RESUMO

Terminado el tratamiento de ortodoncia, el objetivo principal es mantener la estabilidad oclusal a largo plazo evitando la recidiva, y esto es posible utilizando una contención fija posortodoncia. El propósito de esta investigación fue evaluar los diferentes métodos que existen para el control de placa bacteriana en los pacientes con contención fija posortodoncia y como podrían afectar el estado de salud periodontal. Existen muchos estudios a corto y largo plazo sobre este tema, pero no hay uno que realmente indique que existen efectos negativos. Sin embargo, se conoce que estos pacientes tienen tendencia a acumular una mayor cantidad de placa bacteriana, lo que conlleva a que haya un mayor riesgo de formación de cálculo, inflamación gingival, recesión gingival, caries lingual e interproximal, y enfermedad periodontal. Por eso, la mayoría de estudios resaltan como factor determinante la buena higiene oral para garantizar la salud periodontal y acudir a las citas control con el ortodoncista para evaluar el estado físico de la aparatología, a fin de evitar posibles fracturas o fallas en el sistema de adhesión de la contención fija y darle un tratamiento inmediato si esto ya hubiera ocurrido. La literatura no indica una técnica oral específica para los pacientes con contención fija posortodoncia, pero sí señala que se puede lograr una buena salud periodontal si el paciente mantiene una higiene oral adecuada y cómo el ortodoncista juega un rol importante motivando al paciente para lograrla.(AU)


The main objective following orthodontic treatment is to maintain long-term occlusal stability to avoid recurrence, and this is possible using post orthodontic fixed containment. The purpose of this study was to evaluate the different methods used for the control of bacterial plaque in patients with post orthodontic fixed containment and how these methods affect periodontal health status. There are many short- and long-term studies in this regard, but none have described negative effects. However, it is known that these patients tend to accumulate a greater amount of bacterial plaque, leading to a greater risk of calculus formation, gingival inflammation, gingival recession, lingual and interproximal caries, and periodontal disease. The refore, most studies have described good oral hygiene as the determinant factor for ensuring adequate periodontal health. They also report the need for patients to attend control appointments with their orthodontist to evaluate the state of the aprotology, avoiding possible fractures or failures in the adhesion system of the fixed retainer and receiving immediate treatment when this occurs. While the literature does not indicate a specific oral hygiene technique for patients with post orthodontic fixed containment, it does indicate that good periodontal health can be achieved if adequate oral hygiene is maintained and the important role orthodontists play in motivating the patients to achieve this. (AU)


Assuntos
Humanos , Masculino , Feminino , Higiene Bucal , Ortodontia , Escovação Dentária , Placa Dentária/prevenção & controle
4.
Braz Oral Res ; 33(suppl 1): e074, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576958

RESUMO

Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.


Assuntos
Interface Osso-Implante , Implantes Dentários/efeitos adversos , Peri-Implantite/prevenção & controle , Periodontite/prevenção & controle , Estomatite/prevenção & controle , Interface Osso-Implante/diagnóstico por imagem , Placa Dentária/prevenção & controle , Humanos , Higiene Bucal , Peri-Implantite/etiologia , Índice Periodontal , Periodontite/etiologia , Radiografia Dentária , Fatores de Risco , Estomatite/etiologia
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.
Mater Sci Eng C Mater Biol Appl ; 104: 109916, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31499946

RESUMO

Composite resins (CRs) are widely used as dental restorative materials for caries treatment. They cause problems of secondary caries since Streptococcus mutans stays in the dental plaque, which the surface exists and produces acidic compounds during metabolism. The dental plaque depositions are induced by the protein adsorption on the surface. Therefore, suppression of protein adsorption on the surface of the CRs is important for inhibiting the formation of plaque and secondary caries. In this study we developed a surface treatment to provide an antibiofouling nature to the CRs by chemical reaction with 2-methacryloyloxyethyl phosphorylcholine (MPC) polymers in the oral cavity during dental treatment. To carry out the photochemical reaction on the remaining polymerizable groups of CRs, we synthesized the MPC polymer with a polymerizable group in the side chain. The MPC polymer could bind on the surfaces of the CRs chemically under dental treatment procedures. The treated surface showed significant resistance to oral protein adsorption and bacterial adhesion even when the surface was brushed with a toothbrush. Thus, we concluded that the photochemical reaction of the MPC polymer with the CRs in the oral cavity was good for making an antibiofouling surface and preventing secondary caries.


Assuntos
Resinas Acrílicas/farmacologia , Resinas Compostas/farmacologia , Placa Dentária/prevenção & controle , Metacrilatos/farmacologia , Fosforilcolina/análogos & derivados , Polímeros/farmacologia , Poliuretanos/farmacologia , Incrustação Biológica , Mucinas/metabolismo , Fósforo/análise , Fosforilcolina/farmacologia , Espectroscopia Fotoeletrônica , Polímeros/síntese química , Polímeros/química , Espectroscopia de Prótons por Ressonância Magnética , Silício/análise , Espectroscopia de Infravermelho com Transformada de Fourier , Streptococcus mutans/efeitos dos fármacos , Propriedades de Superfície
7.
Arq Bras Cir Dig ; 32(2): e1437, 2019 Aug 26.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31460597

RESUMO

BACKGROUND: The bariatric surgery may have negative repercussions on oral conditions. AIM: To evaluate the impact of oral health educational/preventive program developed with patients submitted to gastroplasties. METHOD: The sample consisted of 109 patients randomly allocated to two groups: intervention group (IG), where they participated in the oral health promotion program that include multiple educational-preventive approaches; control group (CG), where they received usual care from the bariatric clinic staff, without participation in the program. The oral conditions investigated in the pre-operative and postoperative periods of one month (1M) and six months (6M) were: dental caries, periodontal disease, tooth wear, dental plaque and salivary flow. RESULTS: After bariatric surgery, patients in IG presented: fewer changes in enamel (6M: p=0.004), dentin (6M: p=0.005) and gingival bleeding (6M: p<0.0001), reduction in plaque index (1M, 6M: p<0.0001) and increased salivary flow (6M: p=0.039), when compared with CG. Incipient tooth wear was recorded in both groups (6M: p=0.713). CONCLUSION: There was a positive impact of the implemented program in the prevention of the main oral health problems in patients who underwent gastroplasties, contributing to their quality of life.


Assuntos
Cárie Dentária/prevenção & controle , Placa Dentária/prevenção & controle , Educação em Saúde/métodos , Obesidade Mórbida/cirurgia , Saúde Bucal/educação , Higiene Bucal/educação , Adolescente , Adulto , Feminino , Gastroplastia , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Fatores Socioeconômicos , Adulto Jovem
8.
Nursing ; 49(8): 56-60, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31343536

RESUMO

An effective means of maintaining oral health is imperative for the health of long-term-care patients. This article assesses oral hygiene using an electric toothbrush compared with a manual toothbrush.


Assuntos
Placa Dentária/prevenção & controle , Equipamentos e Provisões Elétricas , Escovação Dentária/instrumentação , Cuidadores , Humanos , Assistência de Longa Duração , Higiene Bucal/métodos , Instituições Residenciais
9.
Am J Dent ; 32(2): 69-73, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31094140

RESUMO

PURPOSE: This laboratory study compared a newly designed GUM oscillating-rotating power toothbrush with a unique head design that combines both standard nylon filament and extremely tapered filaments to the Oral-B oscillating-rotating-pulsating power toothbrush with the Precision Clean head and to the Oral-B Compact 35 Indicator manual toothbrush for their ability to reach and remove artificial plaque deposits from hard-to-reach interproximal and subgingival sites. METHODS: Interproximal access efficacy (IAE) was evaluated using an artificial plaque substrate placed around simulated teeth. Subgingival access efficacy (SAE) was determined by using simulated gingiva prepared with a 0.2 mm space between the gingiva and artificial plaque substrate covering the simulated teeth. Results were recorded on the same artificial plaque substrate placed under the gingiva and around the simulated teeth. RESULTS: The overall IAE value for the new GUM oscillating-rotating power head indicated that it was significantly more effective compared to the Oral-B power and manual toothbrushes in interproximal access (P< 0.001). The mean value for SAE for the new and commercially available power products also were significantly more effective compared to the manual toothbrush in subgingival access (P< 0.001). CLINICAL SIGNIFICANCE: The presence of dental plaque at interproximal and subgingival sites will result in the development of gingivitis if not removed regularly and thoroughly. The demonstrated superior ability of the oscillating-rotating power toothbrush head to reach deeper into those sites versus the manual brush indicates that when used properly, the unique oscillating-rotating head with extremely tapered bristles may be effective for the treatment and prevention of gingivitis.


Assuntos
Placa Dentária , Dente , Escovação Dentária , Placa Dentária/prevenção & controle , Desenho de Equipamento , Gengiva , Humanos , Escovação Dentária/instrumentação
10.
Artigo em Inglês | MEDLINE | ID: mdl-31056889

RESUMO

Dental biofilm is a complex, organized microbial community that is the primary etiologic factor for plaque, the most frequently occurring oral contamination for gingivitis, dental caries and periodontal diseases. In dentistry, calculus is a form of hardened dental plaque, caused by precipitation of calcium (Ca) and phosphorous (P) ions deposited from saliva and gingival crevicular fluid. Although the dental biofilm cannot be eliminated, it can be controlled with comprehensive mechanical and chemotherapeutic oral hygiene practices. Chemotherapeutic agents have difficulty penetrating the polysaccharide matrix to reach and affect the microorganisms. The purpose of the present study was to evaluate the anti-calculus efficiency of a mouthwash containing an association of sodium tripolyphosphate, tetrapotassium pyrophosphate, sodium bicarbonate and citric acid in patients affected with gingivitis.


Assuntos
Cálculos Dentários/prevenção & controle , Gengivite/terapia , Antissépticos Bucais/uso terapêutico , Cárie Dentária/prevenção & controle , Placa Dentária/prevenção & controle , Humanos
11.
BMC Oral Health ; 19(1): 64, 2019 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-31029127

RESUMO

BACKGROUND: The plant Salvadora persica (miswak) has a long history of use in oral hygiene. Associations between the use of Salvadora persica and decreased oral bacteria numbers and plaque scores have been reported. This systematic review and meta-analysis assessed the ability of Salvadora persica mouthrinses to reduce plaque/cariogenic bacteria, in comparison to that of chlorhexidine and/or placebo rinses. METHODS: A comprehensive literature search for clinical trials reporting the use of Salvadora persica rinses as an antibacterial and/or antiplaque agent in comparison with chlorhexidine and/or placebo rinses was conducted, with no restriction to language. MEDLINE-PubMed, Cochrane Central Register of Controlled Trials, Wiley Online Library, ScienceDirect, and Google Scholar databases were searched to include all articles published up to December 2018. Based on inclusion/exclusion criteria, data were extracted from the identified reports by two independent reviewers. The primary and secondary outcomes measured from the eligible studies were mean plaque scores and mean cariogenic bacterial counts, respectively. Risk of bias of these studies was assessed. A statistical test of homogeneity was used to determine if the results of the separate studies could be combined. Based on the chi-square test, an inconsistency coefficient was computed (I2 statistic). Sensitivity analyses using subgroups and homogeneity evaluation were conducted. RESULTS: A total of 1135 potentially eligible articles were identified, of which 19 were eventually included in the qualitative analysis whereas 18 were included in the quantitative meta-analysis. The meta-analysis showed that Salvadora persica rinses exhibited strong antiplaque effects (P < 0.00001, MD: 0.46, and 95% CI: 0.29 to 0.63). In addition, it had statistically significant anti-streptococcal (P < 0.0001, MD: -1.42, and 95% CI: -2.08 to - 0.76) and anti-lactobacilli effects (P < 0.00001, MD: -1.12, and 95% CI: -1.45 to - 0.79) when compared to placebo. However, its effects were inferior compared to those by chlorhexidine rinse (P = 0.04, MD: 0.19, and 95% CI: 0.01 to 0.37). Subgroup analyses yielded results similar to those prior to subgrouping. CONCLUSION: The use of Salvadora persica extract was associated with a significant reduction in the plaque score and cariogenic bacterial count. Although, this reduction was lower than that achieved with the gold standard chlorhexidine mouthwash, Salvadora persica-containing rinse could be considered as a suitable oral hygiene alternative for use in individuals of all ages, socioeconomic backgrounds, and health conditions especially as a long-term measure due to its efficacy, safety, availability, cost-effectiveness, and ease of use.


Assuntos
Anti-Infecciosos Locais/farmacologia , Infecções Bacterianas/tratamento farmacológico , Clorexidina/farmacologia , Placa Dentária/prevenção & controle , Antissépticos Bucais/farmacologia , Higiene Bucal/métodos , Extratos Vegetais/farmacologia , Salvadoraceae/química , Anti-Infecciosos , Cárie Dentária/prevenção & controle , Humanos , Testes de Sensibilidade Microbiana , Extratos Vegetais/administração & dosagem
12.
J Mater Sci Mater Med ; 30(4): 45, 2019 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-30929087

RESUMO

Dental caries is primarily caused by pathogenic bacteria infection, and Streptococcus mutans is considered a major cariogenic pathogen. Moreover, antimicrobial peptides have been considered an alternative to traditional antibiotics in treating caries. This study aimed to design a tooth-binding antimicrobial peptide and evaluate its antimicrobial efficacy against S. mutans. An antimicrobial peptide of polyphemusin I (PI) was modified by grafting a tooth-binding domain of diphosphoserine (Ser(p)-Ser(p)-) to create the peptide of Ser(p)-Ser(p)-polyphemusin I (DPS-PI). PI and DPS-PI were synthesized by Fmoc solid-phase peptide synthesis. The minimum inhibitory concentration of PI and DPS-PI against S. mutans were tested. Scanning electron microscopy (SEM) were used to observe the growth of S. mutans on PI and DPS-PI treated enamel surfaces. The growth of S. mutans was evaluated by optical density (OD) at 590 nm. Inhibition of dental plaque biofilm development in vivo were investigated. The cytocompatibility to bone mesenchymal stem cells (BMSCs) was tested. The MIC of PI and DPS-PI were 40 and 80 µg/ml, respectively. SEM images showed that S. mutans were sparsely distributed on the DPS-PI treated enamel surface. OD findings indicated that DPS-PI maintained its inhibition effect on S. mutans growth after 24 h. The incisor surfaces of rabbits treated with DPS-PI developed significantly less dental plaque biofilm than that on PI treated surfaces. The DPS-PI had good biocompatibility with the cells. We successfully constructed a novel tooth-binding antimicrobial peptide against S. mutans in vitro and inhibited dental plaque biofilm development in vivo. DPS-PI may provide a feasible alternative to conventional antibiotics for the prevention and treatment of dental caries. Dental caries is primarily caused by pathogenic bacteria infection, and Streptococcus mutans is considered a major cariogenic pathogen. A tooth-binding antimicrobial peptide was designed by grafted diphosphoserine (-Ser(p)-Ser(p)-) to the structure of polyphemusin I. This novel tooth-binding antimicrobial peptide can inhibit dental plaque biofilm development and thus provide a feasible alternative to conventional antibiotics for the prevention and treatment of dental caries.


Assuntos
Anti-Infecciosos/metabolismo , Biofilmes/efeitos dos fármacos , Placa Dentária/prevenção & controle , Fragmentos de Peptídeos/metabolismo , Dente/metabolismo , Animais , Antibacterianos/metabolismo , Antibacterianos/farmacologia , Anti-Infecciosos/farmacocinética , Bovinos , Cárie Dentária/microbiologia , Cárie Dentária/prevenção & controle , Placa Dentária/microbiologia , Testes de Sensibilidade Microbiana , Microscopia Eletrônica de Varredura , Fragmentos de Peptídeos/farmacocinética , Ligação Proteica , Streptococcus mutans/efeitos dos fármacos , Propriedades de Superfície
13.
Am J Orthod Dentofacial Orthop ; 155(4): 462-472, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30935601

RESUMO

INTRODUCTION: The objective of this 2-arm parallel trial was to determine the plaque removal efficacy (main outcome) and the motivation assessment (secondary outcome) comparing a manual versus an interactive power toothbrush in orthodontic patients. METHODS: Sixty adolescents with fixed orthodontic appliances in both arches were randomized in a 1:1 ratio in this parallel, randomized, examiner-blind controlled clinical trial. Eligibility criteria included at least 16 natural teeth, 1-6 "focus care areas," plaque score of ≥1.75, no severe caries, gingivitis and periodontitis, no dental prophylaxis, no smoking, no antibiotics, and no chlorhexidine mouth rinse. Subjects were to brush unsupervised with either an interactive power toothbrush (Oral-B Professional Care 6000, D36/EB20) with Bluetooth technology or a regular manual toothbrush (Oral-B Indicator 35 soft). Focus care areas were each brushed for 10 additional seconds. Plaque removal was assessed with the use of the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) to determine change from baseline at 2 and 6 weeks. Supervised brushing at screening and post-treatment visits recorded actual brushing times. Subject-reported motivational aspects were recorded at screening and week 6. RESULTS: Fifty-nine subjects aged 13-17 years completed the study. The interactive power toothbrush provided significantly (P <0.001) greater plaque reduction versus the manual toothbrush at 2 and 6 weeks according to the whole-mouth TMQHPI. The treatment difference in adjusted mean plaque change from baseline was 0.777 (95% CI 0.614-0.940) at week 2 and 0.834 (0.686-0.981) at week 6. Mean reductions in the number of focus care areas were also significantly greater (P <0.001) in the power brush group at weeks 2 and 6. Brushing times increased significantly at weeks 2 and 6 (P ≤0.013) versus baseline in the interactive power brush group only. Subject-reported motivation was significantly increased in the interactive power brush group at week 6 versus screening (P ≤0.005). CONCLUSIONS: An interactive power toothbrush generated increased brushing times and significantly greater plaque removal versus a manual brush.


Assuntos
Placa Dentária/prevenção & controle , Motivação , Aparelhos Ortodônticos Fixos , Escovação Dentária/instrumentação , Adolescente , Índice de Placa Dentária , Feminino , Humanos , Masculino , Método Simples-Cego , Escovação Dentária/psicologia , Escovação Dentária/estatística & dados numéricos
14.
Oral Dis ; 25(5): 1335-1343, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30947385

RESUMO

OBJECTIVES: The role of dental plaque in gingival lesions caused by oral lichen planus has not been fully defined. The aim of this clinical trial was to evaluate the effects of oral healthcare motivation on clinical variables in patients with gingival oral lichen planus. MATERIAL AND METHODS: Oral lichen planus patients with symptomatic gingival lesions were randomized in control and intervention groups. The intervention group was instructed to effectively remove bacterial biofilm from dental surfaces, while controls did not receive any advice. The outcome variables were as follows: quality of life (OHIP-14), pain, plaque index and clinical severity of the disease (Escudier index). Outcome variables were assessed at 0, 4 and 20 weeks and analysed using an ANOVA model for factorial design. RESULTS: Data from 60 patients were collected. Regression analysis showed a significant positive trend of OHIP-14, plaque index and Escudier index in the intervention group compared to controls (p < 0.05). Pain did not prove significantly different (p = 0.408). CONCLUSIONS: Plaque control improved both OHIP-14 and gingival lesion clinical severity. Oral hygienists should be involved in the multidisciplinary management of patients affected by oral lichen planus with gingival lesions.


Assuntos
Placa Dentária/prevenção & controle , Doenças da Gengiva/complicações , Líquen Plano Bucal/complicações , Motivação , Higiene Bucal , Qualidade de Vida/psicologia , Índice de Placa Dentária , Humanos , Saúde Bucal , Estudos Prospectivos
15.
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
16.
J Clin Dent ; 30(Spec No A): A1-8, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30964968

RESUMO

OBJECTIVES: The objective of this study was to compare the effect of two home use oral hygiene regimens on plaque, gingivitis, and gingival bleeding on subjects undergoing orthodontic treatment with fixed appliances. METHODS: This was a randomized, parallel, single-center clinical trial. Eligible study subjects fit the following profile: age 12-65 years; nonsmoker; plaque score of = 2.0 per Bonded Bracket Index (BBI) on dentition with fixed orthodontic hardware; minimum of 10 orthodontic brackets in each arch or on all teeth from first molar to first molar; presenting with mild to moderate gingivitis, defined as a score of = 1 on at least 20 sites per Gingival Bleeding Index (GBI). Subjects with advanced periodontal disease or gingival recession were not eligible. Eligible subjects were randomized to one of two home use oral hygiene regimens: manual toothbrush plus string floss (used with a threading device) for interdental cleaning (MTF regimen); or Philips Sonicare EasyClean power toothbrush with InterCare brush head and AirFloss Pro powered device, used with BreathRx mouthrinse for interdental cleaning (Sonicare Orthodontic Regimen or SOR). All subjects brushed twice daily with standard fluoridated dentifrice and performed interdental cleaning once daily. Efficacy and safety examinations were performed at Baseline and following three and six weeks of home use of the study products, and included assessments of BBI, GBI, Modified Gingival Index (MGI), and Modified Plaque Index (MPI). RESULTS: Of 228 enrolled subjects, 223 were included in the primary analysis. For the primary endpoint, reduction in BBI score following three weeks of product use, the overall least squares (LS) mean (95% CI) reduction was 0.89 (0.84, 0.95) for SOR and 0.06 (0.01, 0.12) for MTF. Expressed as percent reduction (95% CI) from Baseline, this was 33.1% (31.1%, 35.2%) for SOR and 2.01% (-0.06%, 4.07%) for MTF. The differences between regimens were statistically significant, p < 0.0001. Statistically significant differences between regimens were observed in BBI following six weeks of product use, and also for all other efficacy variables (GBI, MGI, MPI) at Week 3 and Week 6. CONCLUSIONS: The powered oral hygiene regimen was significantly more effective than a manual regimen in reducing plaque on bracketed and non-bracketed teeth, and in reducing gingival bleeding and gingival inflammation in orthodontic subjects following three weeks of use and persisting following six weeks of use. All products were safe on oral tissues and fixed orthodontic appliances.


Assuntos
Placa Dentária , Gengivite , Higiene Bucal , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Humanos , Índice Periodontal , Método Simples-Cego , Escovação Dentária
17.
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(1): 82-92, abr. 2019. ilus
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1008052

RESUMO

Las estrategias tradicionales para abordar la salud bucal en México han carecido de un enfoque integrado a la promoción de la salud y a los factores de riesgo en común con otras patologías, principalmente crónicas. De unir esfuerzos se aprovecharían mejor los limitados recursos sanitarios. Esta investigación tuvo como objetivo implementar un modelo operativo de promoción de la salud y prevención de las enfermedades bucales, usando un ciclo de mejora continua en el preescolar de la comunidad Peña-Flores, Cuautla, Morelos. Se realizó un estudio cuasi-experimental con 120 niños de ambos sexos. La implementación contempló: diagnóstico epidemiológico bucal y social, capacitación de actores clave, ejecución del programa de salud bucal, monitoreo, análisis y evaluación de resultados. Se levantaron datos mediante una guía de observación participante, de reuniones con madres de familia y maestras bajo la perspectiva participativa del triple diagnóstico de educación popular. Se determinó el índice de dientes cariados, a extraer y obturados. Se realizó la medición de la placa dento-bacteriana utilizando el índice de sedimento dental (DIS). Como resultado del control y sistematización del proceso de cepillado dental y del monitoreo de la placa dento-bacteriana, se identificó una disminución del DIS de 1,04 a 0,47. Con la implementación de un menú escolar, se mejoró la alimentación infantil. El modelo implementado constituye una posible solución a la problemática de salud bucal del preescolar de la comunidad Peña-Flores, situado en un contexto de desventaja social por factores como pobreza, migración y déficit de servicios públicos(AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Saúde Bucal , Promoção da Saúde , Doenças da Boca/prevenção & controle , Escovação Dentária , Consumo de Alimentos , Prevalência , Fatores de Risco , Cárie Dentária/prevenção & controle , Cárie Dentária/epidemiologia , Placa Dentária/prevenção & controle , Placa Dentária/epidemiologia , México/epidemiologia , Doenças da Boca/epidemiologia
18.
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
19.
Pediatr Dent ; 41(1): 20-24, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30803472

RESUMO

Purpose: This study's purposes were to: (1) correlate toothbrushing effectiveness measured by plaque removal with children's parent- reported ability to perform life tasks and their executive function; and (2) compare plaque removal by children using a manual versus electric toothbrush. Methods: A convenience sample of 120 healthy five- to 11-year-olds was randomly and evenly assigned to manual or electric tooth- brush groups. A questionnaire was developed from items selected from previously validated social science instruments and completed by caregivers. Plaque was measured by calibrated scorers using the Oral Hygiene Index-Simplified before and after children brushed with respective toothbrushes. Statistical significance was established at P<0.05. Results: The type of toothbrush had no effect on brushing effectiveness. Ability to write a complete address, tie shoes independently, cut meat with a knife, and cut out complex shapes were associated with better toothbrushing effectiveness. Increasing ability to play a musical instrument and wash dishes independently were associated with increased plaque removal. Parents were good predictors of a child's readiness to brush, based on plaque removal scores. Conclusions: Certain life skills and quality of performance of tasks were associated with toothbrushing effectiveness in five- to 11-year-olds and may be used to determine a child's readiness to brush independently.


Assuntos
Escovação Dentária , Criança , Placa Dentária/prevenção & controle , Humanos , Índice de Higiene Oral , Desempenho Psicomotor , Escovação Dentária/instrumentação
20.
J Appl Res Intellect Disabil ; 32(3): 522-532, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30734986

RESUMO

BACKGROUND: People with intellectual disabilities (ID) typically have poorer oral health. Oral diseases have a microbiological origin, and thus, dental plaque control (DPC) is key to safeguard their oral health. METHODS: A structured search strategy was applied to screen oral health promotion initiatives for DPC among children and adolescents with ID following PRISMA statements. Qualitative and quantitative analyses were performed. RESULTS: From 1,455 citations, 22 studies informed this review. Seven studies related to mechanical interventions and 13 to chemical interventions. Qualitative analyses found conventional toothbrushes were less effective than modified toothbrushes but quantitative analyses were conflicting. Of the nine studies that compared chlorhexidine to placebos, seven reported chlorhexidine was more effective than placebos. Meta-analysis favoured chlorhexidine to placebos (p < 0.0001, 95% CI 0.34-0.63). CONCLUSIONS: Both mechanical and chemical interventions are effective for DPC. It is unclear whether they are alternative means for DPC or whether they are best employed together.


Assuntos
Clorexidina/uso terapêutico , Placa Dentária/prevenção & controle , Deficiência Intelectual , Higiene Bucal/métodos , Adolescente , Criança , Humanos
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