A simple point of care test can indicate the need for periodontal therapy to reduce the risk for adverse pregnancy outcomes in mothers attending antenatal clinics.

INTRODUCTION: Although the association between periodontal disease (PD) and adverse pregnancy outcomes has gained recognition amongst antenatal healthcare workers, not much has changed in practice to address it. This prospective study tested the hypothesis that BANA (N-benzoyl-DL-arginine-2-naphthylamide), a diagnostic test for PD, may inform obstetricians and other antenatal healthcare practitioners, of the risk of adverse pregnancy outcomes in mothers attending antenatal clinics. METHODS: At first visit, the presence of suspected periodontopathogens was assessed by BANA testing of dental plaque from 443 mothers attending antenatal clinics in KwaZulu-Natal, South Africa and an association later sought with pregnancy outcomes. The accuracy of BANA to predict adverse pregnancy outcomes was evaluated by the calculation of likelihood ratios. The study complied with the Declaration of Helsinki. RESULTS: Significant differences were found between pregnancy outcomes of BANA-negative and BANA-positive mothers (p < 0.0001). BANA showed sensitivity and negative predictive values of 87% and 91%; 75% and 78%; 87% and 94% in detecting low birth weight, preterm delivery, and preterm low birth weight delivery respectively. CONCLUSION: This study confirms that BANA may indicate the need for periodontal therapy to reduce the risk of adverse pregnancy outcomes and could form part of the routine antenatal examination.

Relationship of psychological and oral health statuses with self-perceived halitosis in a Jordanian population: a cross-sectional study.

BACKGROUND: Self-perceived halitosis could be a symptom of a psychosomatic or psychogenic disorder. The aim of this cross-sectional study was to clarify the relationship of self-perceived halitosis with psychological and oral health statuses. METHODS: One hundred participants with a history of halitosis were enrolled from a teaching hospital. They were divided into the self-perceived and suggested groups if they sensed and did not sense the malodor, respectively. Demographic and socioeconomic information, smoking status, and oral hygiene practices were noted. Complete nasal, oral, and periodontal examinations with organoleptic tests (OLTs) and N-benzoyl-DL-arginine-2-naphthylamide (BANA) tests were conducted. The participants also completed the validated Arabic version of the 90-item revised symptom checklist (SCL-90R). Data were compared by analysis of variance, chi-square test, Student's t-test, and multivariate logistic regression. RESULTS: The self-perceived group had higher OLT scores (p = 0.005) and were significantly younger (p = 0.001) than the suggested group. A significantly higher number of its participants were smokers (p = 0.004). No significant differences were observed in socioeconomic information, oral hygiene practices, oral conditions, and BANA test results. Further, no significant association was noted between self-perceived halitosis and the nine psychological dimensions of SCL-90R. CONCLUSIONS: Halitosis is a multifactorial symptom that requires multidisciplinary management. Self-reporting of the condition is unique entity and trust worthy symptom. It tends to be related to nonoral pathologies and extrinsic causes such as smoking.

Assessment and management of halitosis.

Halitosis is an unpleasant condition that may be the origin of concern not only for a possible health condition but also for frequent psychological alterations which may lead to social and personal isolation. The most frequent sources of halitosis that exist in the oral cavity include bacterial reservoirs such as the dorsum of the tongue, saliva and periodontal pockets. Volatile sulphur compounds (VSCs) are the prominent elements of oral malodour. Genuine halitosis and pseudo-halitosis should be in the treatment realm of dental practitioners. Clinical Relevance: Halitosis can be a symptom of underlying systemic disease, therefore the exact diagnosis and its source (oral or non-oral) is important in the proper approach to its management.

Relationship of a turbidity of an oral rinse with oral health and malodor in Vietnamese patients.

AIM: In the present study, the relationship between the turbidity of mouth-rinse water and oral health conditions, including oral malodor, in patients with (n = 148) and without (n = 231) periodontitis was examined. METHODS: The turbidity of 20 mL distilled water that the patients rinsed in their mouths 10 times was measured using a turbidimeter. Oral malodor was evaluated using an organoleptic test and Oral Chroma. Oral health conditions, including decayed teeth, periodontal status, oral hygiene status, proteolytic activity of the N-benzoyl-dl-arginine-2-napthilamide (BANA) test on the tongue coating, and salivary flow rate, were assessed. RESULTS: Turbidity showed significant correlations with oral malodor and all oral health parameters in the periodontitis group. In the non-periodontitis group, turbidity showed significant correlations with oral malodor and oral health parameters, including dental plaque, tongue coating, BANA test, and salivary flow rate. The regression analysis indicated that turbidity was significantly associated with methyl mercaptan and the BANA test in the periodontitis group, and with hydrogen sulfide, dental plaque, tongue coating, and salivary flow rate in the non-periodontitis group. CONCLUSION: The findings of the present study indicate that the turbidity of mouth-rinse water could be used as an indicator of oral health conditions, including oral malodor.

Comparison between self-estimated and clinical oral malodor.

OBJECTIVES: The aims were to evaluate the validity of patients' self-estimation and clinical diagnosis of oral malodor and to examine the relationship of oral malodor with oral health status. METHODS: The subjects were 252 patients (mean age 43.7 ± 10.7 years) who complained of oral malodor. Oral malodor was assessed by patients' self-estimation, organoleptic test and Oral Chroma. Oral health status, including dental and periodontal conditions, oral hygiene status and flow rate of saliva, was examined. The N-benzoyl-DL-arginine-2-napthilamide (BANA) positive bacteria in tongue coating were evaluated by BANA test. A Spearman's correlation coefficient was used to test correlation between self-perceived and clinical oral malodor. The stepwise multiple regression analysis was used to assess predictors of patients' self-estimated and clinical oral malodor. RESULTS: The percentage of patients who were diagnosed with pseudo-halitosis was 38.5%. Patients' self-estimated oral malodor was significantly correlated with organoleptic test (r = 0.61), H(2)S (r = 0.50) and CH(3)SH (r = 0.46). There were 47.1% of patients who estimated correctly their oral malodor's scores with those by examiner. The highest correspondence was found in patients without oral malodor (52.6%), followed by in those with moderate or strong oral malodor (46.7%) and in those with slight oral malodor (33.3%). The significant predictors of patients' self-estimated and clinical oral malodor were bleeding on probing, tongue coating, BANA test and flow rate of saliva. CONCLUSION: Patients' self-estimated oral malodor was found to correspond significantly with clinical oral malodor and be associated with oral health status. Current findings suggest that self-estimation can be used to judge one's own oral malodor.

Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy.

OBJECTIVE: To compare the periodontal status of adults treated with fixed buccal orthodontic appliances vs removable orthodontic aligners over 1 year of active therapy. MATERIALS AND METHODS: The study population consisted of 42 subjects; 22 treated with fixed buccal orthodontic appliances and 20 treated with removable aligners. Clinical indices recorded included: plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing pocket depth (PPD). Plaque samples were assessed for hydrolysis of N-benzoyl-DL-arginine-naphthylamide (BANA test). Indices and BANA scores were recorded before treatment and at 6 weeks, 6 months, and 12 months after initiation of orthodontic therapy. RESULTS: After 6 weeks, only mean PPD was greater in the fixed buccal orthodontic appliance group. However, after 6 months, the fixed buccal orthodontic appliance group had significantly greater mean PI, PPD, and GI scores and was 5.739 times more likely to have a higher BANA score. After 12 months, the fixed buccal orthodontic appliance group continued to have greater mean PI, GI, and PPD, while a trend was noted for higher BANA scores and BOP. CONCLUSIONS: These results suggest treatment with fixed buccal orthodontic appliances is associated with decreased periodontal status and increased levels of periodontopathic bacteria when compared to treatment with removable aligners over the 12-month study duration.

The effect of menstrual cycle on periodontal health - a clinical and microbiological study.

PURPOSE: Fluctuations in female sex hormones result in changes in the gingival and periodontal tissues. The purpose of this study was to compare the periodontal status of premenopausal women at different time points during their menstrual cycle and to find the associated subgingival microbiota. MATERIALS AND METHODS: One hundred premenopausal women participated in the study and were divided into two groups: group I consisted of 50 subjects with clinically healthy gingival, and group II consisted of 50 subjects with chronic gingivitis. Group II was further divided into group IIa and group IIb. Group IIa consisted of 25 subjects who did not receive any periodontal therapy during the study period. All the examinations were performed at three points during the menstrual cycle: ovulation (OV), pre-menstruation (PM) and menstruation (M). Plaque Index (PI), Gingival Index (GI), Papillary Bleeding Index (PBI), probing depth (PD), subgingival temperature (ST) recording, gingival crevicular fluid (GCF) collection, and estimation and microbiological examination using the benzoyl-DL-arginine-naphthylamide (BANA) test was carried out. For group IIb subjects, all the examinations were performed again during the next menstrual cycle, which followed 4 weeks after periodontal therapy. RESULTS: Women with clinically healthy gingiva exhibited negligible changes throughout the menstrual cycle, whereas women with gingivitis showed aggravated inflammation during ovulation and pre-menstruation as compared to menstruation. However, there was no alteration in subgingival microbiota. After treating gingivitis, the next menstrual cycle following 4 weeks after periodontal therapy was monitored, and no periodontal changes were detected. CONCLUSION: Ovarian hormones have a negligible effect on clinically healthy periodontium. However, these hormones may exaggerate pre-existing inflammation in gingival tissues, but the clinical significance of these changes remains uncertain.

Comparison between self-perceived and clinical oral malodor.

OBJECTIVES: The aims were to compare self-perceived with clinical oral malodor and to examine risk factors of oral malodor. STUDY DESIGN: The study was performed on 565 dental patients. Information on sociodemographics, dental health behavior, and self-perceived oral malodor was collected. Clinical oral malodor, oral health status, and the proteolytic activity of the N-benzoyl-DL-arginine-2-napthilamide (BANA) test in tongue coating were assessed. RESULTS: The sensitivity and specificity of self-perceived oral malodor were 47.2% and 59.2%, respectively. Risk factors for self-perceived oral malodor were smoking habit and alcohol consumption, whereas those for clinical oral malodor were level of education, dental visit frequency, tongue-brushing frequency, mouth rinse use, deep periodontal pockets, gingivitis, tongue coating, and a high BANA test score. CONCLUSIONS: Self-perception was considered an invalid method of judging one's own oral malodor. Factors related to self-perceived oral malodor were different from those found in clinical oral malodor.

[Association between atherosclerosis and periodontitis]. / Aterosclerosis en sujetos con periodontitis.

BACKGROUND: Chronic inflammation and infections are involved in the development and progression of atherosclerotic vascular disease. AIM: To evaluate the association between periodontitis and early atherosclerosis. MATERIAL AND METHODS: Fifty-three subjects who received periodontal treatment and regular maintenance for at least 10 years, and 55 subjects with periodontitis but without a history of periodontal treatment were studied. Carotid artery intima-media wall thickness (CIMT) was measured with high-resolution B-mode ultrasonography. A blood sample was obtained to measure high sensitivity C-reactive protein, fibrinogen, lipoprotein cholesterol, leukocyte count and erythrocyte sedimentation rate. Covariates included age, gender, smoking, level of education, body mass index and physical activity. The benzoyl-DL-arginine-naphthylamide (BANA) test was used to determine the number of periodontal sites with periodontal pathogens. RESULTS: CIMT value was significantly higher in subjects with periodontitis than those without it (0.775 ± 0.268 and 0.683 ± 0.131 mm respectively, p = 0.027). C-reactive protein, leukocyte count and percentage of sites with periodontal pathogens were also significantly higher in subjects with periodontitis. Regression analysis identified age, periodontitis, and smoking as independent predictors of CIMT. CONCLUSIONS: These results suggest that untreated periodontitis is associated with early atherosclerotic carotid lesions and higher levels of inflammatory markers.

Effect of oil pulling on halitosis and microorganisms causing halitosis: a randomized controlled pilot trial.

BACKGROUND: Oil pulling therapy has been used extensively as a traditional Indian folk remedy for many years for strengthening teeth, gums, and jaws and to prevent decay, oral malodor, bleeding gums and dryness of throat, and cracked lips. AIMS: The aims of this study were to evaluate the effect of oil pulling with sesame oil on halitosis and the microorganisms that could be responsible for it and to compare its efficacy with chlorhexidine mouthwash. MATERIALS AND METHODS: Group I (oil pulling) and group II (chlorhexidine) included 10 adolescents each. The following parameters were assessed: marginal gingival index, plaque index, organoleptic breath assessment (ORG 1), self-assessment of breath (ORG 2), and BANA test from tongue coating samples on days 0 and 14 of the experimental period. RESULTS: The comparisons of the pre and post therapy values of plaque and modified gingival index score showed a statistically significant difference (P = 0.005 and 0.007, respectively) in group I and II. There was a definite reduction in the ORG 1, ORG 2, scores and BANA test score in both groups I and II. CONCLUSIONS: Oil pulling therapy has been equally effective like chlorhexidine on halitosis and organisms, associated with halitosis.

Periodontal disease and related factors among Vietnamese dental patients.

PURPOSE: Periodontal diseases have a multifactorial etiology and their risk factors are influenced by modifiable and nonmodifiable factors. The information on periodontal disease and associated risk factors in the Vietnamese population is sparse. Vietnamese dental patients are specific groups with high dental needs and often have greater overall oral health problems. Thus, the purpose of this study was to examine the relationships of periodontal disease to sociodemographic, health-behavioural, and biological characteristics in Vietnamese dental patients. MATERIALS AND METHODS: A sample of 243 subjects was selected from the National Hospital of Odonto-Stomatology in Hochiminh City. The sociodemographic and health-behavioural characteristics were investigated by a questionnaire. Oral examination including dental and periodontal conditions was conducted. Bacterial load in tongue coating and hemoglobin in saliva were assessed using the BANA test and Perioscreen test. RESULTS: The Perioscreen test showed moderate sensitivity (0.752) and specificity (0.746) to periodontal disease. The binary logistic regression analyses indicated that older subjects (OR = 2.5), or those who did not frequently visit a dentist (OR = 4.1), brushed their teeth only once a day (OR = 2.5), did not use dental floss (OR = 2.9), were past smokers (OR = 3.1), current smokers (OR = 4.1), or had positive BANA test results (OR = 12.0) were more likely to have periodontal disease. CONCLUSION: The results revealed the periodontal disease was related to age, dental visit behaviour, smoking behaviour, frequency of tooth brushing, use of dental floss, bacterial load in the tongue coating, and hemoglobin in saliva.

Clinical trial of oral malodor treatment in patients with periodontal diseases.

BACKGROUND AND OBJECTIVE: Only a few clinical research studies have assessed different therapeutic approaches to oral malodor in subjects affected by periodontal diseases. The aim of this study was to evaluate the effects of periodontal treatment and tongue cleaning on oral malodor parameters in periodontitis and gingivitis patients. MATERIAL AND METHODS: The subjects were 102 periodontitis and 116 gingivitis patients with oral malodor. Oral malodor was measured by organoleptic test and Oral Chroma™. Oral health status, including tooth conditions, periodontal health, tongue coating and proteolytic activity of the BANA test in tongue coating were assessed. Subjects in each periodontal disease group were randomly assigned into two subgroups depending on the sequence of treatment: periodontal treatment and tongue cleaning. Oral malodor and oral health parameters were compared by groups and sequence of treatment. RESULTS: For subjects in the periodontitis group, there were statistically significant reductions in oral malodor after periodontitis treatment or tongue cleaning; however, major reductions were found after periodontitis treatment. For those in the gingivitis group, there were also statistically significant reductions in oral malodor after gingivitis treatment or tongue cleaning, but the most marked reductions were observed after tongue cleaning. At the completion of treatment, all oral malodor parameters fell below the threshold levels in all subgroups. CONCLUSION: The present study indicated that periodontal treatment played an important role and tongue cleaning contributed to a lesser extent to reduction in oral malodor in periodontitis patients. In contrast, tongue cleaning alone can be the primary approach to reduce oral malodor in gingivitis patients.

Periodontal parameters and BANA test in patients with chronic renal failure undergoing hemodialysis.

OBJECTIVES: The aim of this study was to analyze the periodontal parameters of patients with chronic renal failure. MATERIAL AND METHODS: The periodontal status of 16 Brazilian patients aged 29 to 53 (41.7 ± 7.2) years with chronic renal failure (CRF) and another matched group of 14 healthy controls with periodontitis was assessed clinically and microbiologically. Probing pocket depth (PPD), gingival recession (GR), dental plaque index (PLI), gingival index (GI), and dental calculus index (CI) were the clinical parameters recorded for the entire dentition (at least 19 teeth), while the anaerobic periodontopathogen colonization in four sites with the highest PPD was evaluated using the BANA test ("PerioScan"; Oral B). RESULTS: The results for the CRF group and control group, respectively were: PPD: 1.77 ± 0.32 and 2.65 ± 0.53; GR: 0.58 ± 0.56 and 0.51 ± 0.36; PLI: 1.64 ± 0.56 and 1.24 ± 0.67; GI: 0.64 ± 0.42 and 0.93 ± 0.50; CI: 1.17 ± 0.54 and 0.87 ± 0.52. Comparison between groups using the "t" test revealed a significantly increased PPD (p<0.001) in the control group. Comparison of the other clinicial parameters by the Mann-Whitney test showed differences only for PLI, which was significantly higher (p<0.05) in the CRF group. Spearman's test applied to each group showed a positive correlation among all clinical parameters, except for GR (p<0.05). None of the groups showed any correlation between GR and GI, while a significant negative correlation between GR and PPD was observed for the CRF group. The percentage of BANA-positive sites was 35.9% for the CRF group and 35.7% for the control group. The BANA test correlated positively with PPD only in the control group and with GR only in the CRF group. CONCLUSIONS: In spite of a higher PLI and dense anaerobic microbial population even in shallow PPD, patients with CRF exhibited better periodontal conditions than periodontitis patients, which is an evidence of altered response to local irritants.

The ability of the BANA Test to detect different levels of P. gingivalis, T. denticola and T. forsythia.

The aim of this study was to evaluate the ability of the BANA Test to detect different levels of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia or their combinations in subgingival samples at the initial diagnosis and after periodontal therapy. Periodontal sites with probing depths between 5-7 mm and clinical attachment level between 5-10 mm, from 53 subjects with chronic periodontitis, were sampled in four periods: initial diagnosis (T0), immediately (T1), 45 (T2) and 60 days (T3) after scaling and root planing. BANA Test and Checkerboard DNA-DNA hybridization identified red complex species in the subgingival biofilm. In all experimental periods, the highest frequencies of score 2 (Checkerboard DNA-DNA hybridization) for P. gingivalis, T. denticola and T. forsythia were observed when strong enzymatic activity (BANA) was present (p < 0.01). The best agreement was observed at initial diagnosis. The BANA Test sensitivity was 95.54% (T0), 65.18% (T1), 65.22% (T2) and 50.26% (T3). The specificity values were 12.24% (T0), 57.38% (T1), 46.27% (T2) and 53.48% (T3). The BANA Test is more effective for the detection of red complex pathogens when the bacterial levels are high, i.e. in the initial diagnosis of chronic periodontitis.

Effects of hyperbaric oxygen therapy on the treatment of severe cases of periodontitis.

OBJECTIVES: To evaluate the effect of hyperbaric oxygen therapy (HBO2) as an adjunct to scaling and root planing (SRP) in the treatment of severe cases of chronic periodontitis. MATERIALS AND METHODS: In 20 patients diagnosed with severe generalized chronic periodontitis (pockets>7mm) with bleeding on probing, SRP was rendered in all pockets. Additionally, five consecutive hyperbaric sessions were administered in 10 patients after random allocation (SRP + HBO2). Clinical parameters were assessed at baseline up to six months: plaque index, bleeding on probing, probing depth, clinical attachment level and benzoyl-DL-arginine-naphthylamide (BANA) test. RESULTS: SRP + HBO2 resulted in greater probing reduction and attachment gain than SRP alone three months after treatment (p<0.001). The BANA test was negative after one week only for sites in the SRP + HBO2 group (p<0.05). However, SRP + HBO2 failed to show a significant difference from SRP group after 3 months, where all BANA sites became negative (p>0.05). CONCLUSION: Our data suggest that hyperbaric oxygen therapy had a short-term beneficial effect on pocket reduction and bacterial elimination, and may be considered a potential adjunct therapeutic option to improve the clinical outcomes of scaling in severe cases of chronic periodontitis.

Periodontal disease activity measured by the benzoyl-DL-arginine-naphthylamide test is associated with preterm births.

BACKGROUND: Infection is a risk factor for preterm birth. This study was conducted in the field and addressed the link between periodontal pathogens measured with the benzoyl-DL-arginine-naphthylamide (BANA) test and preterm birth. METHODS: This prospective study was performed in Changhua, Taiwan. Periodontal examinations included the plaque index, papillary bleeding scores, and measurement of the BANA enzyme in plaque samples at the second and third trimesters. Independent variables included maternal demographic characteristics, previous pregnancy histories, risk factors, plaque and gingivitis scores, and current pregnancy outcomes. RESULTS: There were 19 (7%) preterm deliveries among the 268 subjects. A history of a previous preterm birth and low birth weight, frequency of prenatal visits, preterm uterine contractions, antepartum hemorrhages, placenta previae, and preterm premature rupture of membranes were significantly related to preterm birth (P = 0.035, 0.027, <0.001, 0.025, 0.006, 0.014, and <0.001, respectively). Maternal weight gain was higher with a normal term delivery (P = 0.003). Multivariable logistic regression analyses showed that the number of BANA-infected sites in the third trimester (odds ratio [OR]: 5.89; 95% confidence interval [CI]: 1.5 to 31.6), maternal weight gain (OR: 0.78; 95% CI: 0.65 to 0.91), antepartum hemorrhages (OR: 10.0; 95% CI: 2.2 to 46.9), and preterm premature rupture of membranes (OR: 12.6; 95% CI: 3.97 to 42.71) had significant influences on preterm-birth outcomes. CONCLUSIONS: BANA-positive plaque in the third trimester was associated with preterm births after controlling for other risk factors. The BANA test can be used to screen pregnant women at chairside and/or bedside to apply suitable intervention tactics.

The use of Perioscan as a potential screening test for mothers at risk for delivery of pre-term and low birth-weight infants.

Increased levels of oestrogen and progesterone during pregnancy may lead to periodontal disease. The anaerobic Gram-negative bacteria classified as the "red complex" (Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola) are frequently associated with periodontal disease. Periodontopathogens produce toxins and enzymes that can enter the bloodstream and cross the placenta to harm the foetus. The response of the mother's immune system to infection by these periodontopathogens brings about the release of inflammatory mediators which may trigger preterm labour or result in low birth-weight infants. The purpose of this study was to examine the use of Perioscan as a potential screening test for mothers at risk for pre-term delivery of low birth weight infants due to periodontal disease. Subgingival plaque samples were obtained from pregnant women between the ages of 17 to 45 years attending an ante-natal clinic in the Western Cape in South Africa. Plaque samples were analyzed by the enzymatic Perioscan test for detection of the red complex in 372 sites from 66 women. Results were confirmed by polymerase chain reaction (PCR) detection of the three species of the red complex. Seventeen (25.75%) of the population group tested positive with Perioscan but only 27 (7.25%) of the 372 sites were positive. Of the 66 mothers examined, we managed to retrieve 29 records post-delivery. In all the mothers examined, Perioscan results showed an association with the indices used to diagnose periodontal disease, and could also be associated with preterm delivery of low birth-weight infants in two of the 29 maternal records recovered.

Chlorhexidine Inhibits the Proteolytic Activity of Root and Coronal Carious Dentin in vitro.

The purpose of this study was to evaluate the effect of chlorhexidine on the proteolytic activity of carious coronal and root dentin collected from patients. Sound dentin from freshly extracted human teeth was used as a control. Dentin fragments were mixed with a synthetic substrate for proteolytic enzymes (N-benzoyl-DL-arginine-naphthylamide--BANA) and the suspensions mixed with either 0.12% chlorhexidine digluconate or distilled water. These mixtures were incubated for 18 h at 37 degrees C, color was developed by the addition of 0.1% Fast Garnet and their optical density was recorded spectrophotometrically. BANA hydrolysis measured by the optical density of incubated specimens was detected in all tested groups, but was significantly higher for carious than for sound dentin (p < 0.05). The proteolytic activity was reduced for carious coronal and root dentin by chlorhexidine (p < 0.05; 50 and 30%, respectively). Chlorhexidine also reduced the proteolytic activity in sound root dentin (p < 0.05; 20%). Conversely, changes in the proteolytic activity of sound coronal dentin were not observed in the presence of chlorhexidine. The reduction in proteolytic activity by chlorhexidine was significantly higher in carious coronal dentin than in carious root dentin (p < 0.05). In conclusion, part of the effect of chlorhexidine in controlling caries progression in humans may be due to a decrease in the proteolytic activity of carious coronal and root dentin. Because of the prolonged incubation time in the present study, similar results may be obtained clinically with prolonged dentin exposure to chlorhexidine, e.g. chlorhexidine-containing varnishes.

Community periodontal index of treatment needs index: an indicator of anaerobic periodontal infection.

BACKGROUND: Community periodontal index of treatment needs (CPITN) index is commonly used to measure periodontal disease. It's uniqueness, apart from assessing the periodontal status, also gives the treatment needs for the underlying condition. Benzoyl-DL-arginine napthylamide (BANA) test is a chair side diagnostic test used to detect the presence of putative periodontal pathogens. We correlated the CPITN scores of patients with BANA test results to assess the validity of CPITN as an indicator of anaerobic periodontal infection. OBJECTIVES: The present study was aimed to correlate the CPITN scores with the BANA activity of subgingival plaque. The objective was to assess the validity of CPITN index as indicator of anaerobic periodontal infection. PATIENTS AND METHODS: A total of 80 sites were selected from 20 patients with generalized chronic periodontitis. After measuring the probing depth with CPITN C probe, the highest score from each sextant was selected according to the CPITN criteria and subgingival plaque samples were collected using a sterile curette and the BANA test was performed. RESULTS: Kendall's tau-b and Chi-square test were used to assess the correlation between the BANA test results and CPITN scores. Results indicated sensitivity (92.86%), specificity (80%) and agreement (91.25%); indicating the validity of CPITN in assessing anaerobic infection. CONCLUSION: There was a significant correlation between BANA test results and scores 3 and score 4 of CPITN index (P < 0.001) clearly indicating the presence of anaerobic periodontal infection.

Effects of sodium lauryl sulphate (SLS), present in dentifrice, on volatile sulphur compound (VSC) formation in morning bad breath.

The purpose of the present investigation was to evaluate the effects of sodium lauryl sulphate (SLS), present in a commercial dentifrice, on the formation of volatile sulphur compounds (VSC) and tongue coating in a panel of periodontally healthy subjects. A two-step blinded, crossover, randomized study was carried out in 25 dental students with healthy periodontium; these were divided into two experimental groups: SLS (dentifrice with SLS) and WSLS (dentifrice without SLS). The volunteers received the designated dentifrice and a new toothbrush for a 3x/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath (ORG), VSC levels by portable sulphide monitor before (H1) and after (H2) cleaning of the tongue, tongue coating wet weight (TC) and benzoyl-DL-arginine-naphthylamide (BANA) test from tongue coating samples. The intra-group analysis showed a decrease in the median of organoleptic scores from 3 to 2 after 30 days for the SLS group (p < 0.05). The inter-group analysis showed lower values in ORG and H1 for the SLS group (p < 0.05). There was no difference between the amount of TC in SLS and WSLS groups. In the BANA test, the presence of SLS did not affect the BANA number of +/- results (p > 0.05). These findings suggest that sodium lauryl sulphate (SLS), present in dentifrice, appears to prevent VSC formation in morning bad breath regardless of the amount of tongue coating in periodontally healthy subjects.