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1.
Int J Dent Hyg ; 16(4): 476-483, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29651816

RESUMEN

OBJECTIVES: Oral health in nursing homes for elderly is often unsatisfactory, and oral health education to nursing staff has not shown sufficient results why there is need for novel approaches. The aim of the study was to trial a new oral healthcare educational programme and to evaluate the effects on residents' oral health. In addition, attitudes among the nursing staff in the intervention nursing home were explored. METHODS: In a controlled clinical trial, two comparable nursing homes were randomly assigned for intervention or control. Interventions included weekly theoretical and hands-on guidance from dental hygienists on oral hygiene procedures and discussions on oral care routines. The residents' oral health, measured by the Revised Oral Assessment Guide (ROAG), dental plaque and gingival bleeding were evaluated at baseline and after 3 months. Attitudes among the staff to oral health care were measured at the intervention nursing home. RESULTS: Revised Oral Assessment Guide gums and lips scores showed a tendency to decrease in the intervention group, but remained high in the control group. Plaque levels improved significantly after intervention, and a trend towards less gingival bleeding was observed. The intervention nursing staff seemed to be more aware of their own limitations concerning oral health care after intervention and valued more frequent contact with dental services to a greater extent. CONCLUSIONS: The oral healthcare situation for elderly people today is so complex that theoretical education at the group level regarding different aspects of oral health is not sufficient. Individual hands-on guidance by dental hygienists on a regular basis in everyday care may be a new approach.


Asunto(s)
Higienistas Dentales , Placa Dental/prevención & control , Enfermedades de las Encías/prevención & control , Promoción de la Salud/métodos , Hemorragia/prevención & control , Casas de Salud , Personal de Enfermería/educación , Personal de Enfermería/psicología , Salud Bucal/educación , Higiene Bucal/educación , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Índice Periodontal , Proyectos Piloto
2.
Eur J Orthod ; 39(4): 446-452, 2017 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-27629261

RESUMEN

BACKGROUND: The maintenance of gingival health around orthodontic fixed retainers (FRs) is difficult and different designs have been proposed. OBJECTIVE: The goal of this systematic review was to analyse whether FR designs that allow unobstructed interproximal flossing, compared with the ones that do not, improve gingival parameters. SEARCH METHODS: Detailed individual database search strategies for Cochrane Library, 'Latin' American and 'Caribbean' Health Sciences Literature, PubMed, Scopus, and Web of Science were developed. Grey literature was also considered. SELECTION CRITERIA: Clinical trials and cross-sectional studies that compared two types of FRs (plain and waved) were included and evaluated. DATA COLLECTION AND ANALYSIS: Study selection, data extraction, and risk of bias (RoB) assessment were performed individually and in duplicate. The methodology quality was assessed using the MAStARI RoB tool. RESULTS: Four studies met the inclusion criteria, and all presented moderate RoB. While two of those studies found a statistically significant difference in gingival parameters, the other two did not report differences. A meta-analysis was conducted based on two of the selected studies, which performed evaluations of plaque index (PI) and calculus index (CI). The results revealed no differences on PI between wave FR and plain FR of 0.46 (0.24 to 0.69) and no differences on CI of 0.12 (-0.10 to 0.33). Regarding comfort, no clear differences were identified. CONCLUSIONS: There is not enough scientific evidence to support or not an association between FR design and gingival health, flossing frequency, or patient comfort. REGISTRATION: PROSPERO - CRD42016030059.


Asunto(s)
Enfermedades de las Encías/etiología , Retenedores Ortodóncicos/efectos adversos , Estudios Transversales , Dispositivos para el Autocuidado Bucal , Índice de Placa Dental , Enfermedades de las Encías/prevención & control , Humanos , Higiene Bucal , Diseño de Aparato Ortodóncico
3.
Rural Remote Health ; 17(3): 4164, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28918642

RESUMEN

INTRODUCTION: The purpose of this study was to analyze the effects of an oral health care program administered at rural public health subcenters on oral hygiene status and bleeding on probing (BOP) scores among Korean rural residents older than 40 years. METHODS: Residents older than 40 years living in two rural areas were allocated randomly by order of visit into an intervention group (n=23) and control group (n=23). Changes in plaque and BOP score were analyzed between the groups using repeated-measures ANOVA. Hierarchical multiple regression analysis was conducted to identify factors affecting changes in BOP score. RESULTS: The BoP score decreased by 22.87 in the intervention group and 0.27 in the control group between baseline and the eighth week (p<0.001). Multiple regression analysis showed that the change in BoP score (ΔBoP score) increased significantly with an increase in the reduction of the plaque (PHP) index (ΔPHP index) (t=-2.174, p<0.05) and increased significantly more in the intervention group than in the control group (t=2.143, p<0.05). CONCLUSIONS: Professional care and continuous oral health education for 8 weeks prior to scaling among adults older than 40 years living in rural environments resulted in a change in oral health behaviors and a substantial reduction in gingival bleeding.


Asunto(s)
Atención Odontológica/organización & administración , Enfermedades de las Encías/prevención & control , Educación en Salud/organización & administración , Higiene Bucal/métodos , Población Rural , Anciano , Femenino , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Índice Periodontal , República de Corea , Factores Socioeconómicos
5.
Cochrane Database Syst Rev ; (6): CD002281, 2014 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-24934383

RESUMEN

BACKGROUND: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005. OBJECTIVES: To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months). MAIN RESULTS: Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias.There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual toothbrushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I(2) = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups.With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I(2) = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups.The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points. AUTHORS' CONCLUSIONS: Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.


Asunto(s)
Dispositivos para el Autocuidado Bucal/efectos adversos , Dispositivos para el Autocuidado Bucal/economía , Placa Dental/prevención & control , Gingivitis/prevención & control , Cepillado Dental/instrumentación , Placa Dental/complicaciones , Enfermedades de las Encías/prevención & control , Humanos , Salud Bucal , Enfermedades Periodontales/prevención & control , Ensayos Clínicos Controlados Aleatorios como Asunto , Cepillado Dental/métodos
6.
J Prosthet Dent ; 112(6): 1315-8, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25156092

RESUMEN

Ceramic veneers of minimum thickness provide satisfactory esthetic outcomes while preserving the dental structure. Dental ceramics can both improve the esthetic appearance and reestablish the strength and function of teeth. In worn anterior teeth, functional surfaces, for example, anterior and lateral guidance, can be restored effectively. The characteristics of dental ceramics, such as color stability and mechanical and optical properties, make this material a good choice for indirect restorations, especially when optimum function and esthetics are required. This clinical report presents an occlusal, periodontal, and restorative solution with minimum thickness glass ceramic veneers for worn anterior teeth with multiple diastemas.


Asunto(s)
Oclusión Dental , Porcelana Dental , Coronas con Frente Estético , Estética Dental , Enfermedades de las Encías/prevención & control , Incisivo/patología , Grabado Ácido Dental/métodos , Adulto , Cerámica/química , Diente Canino/patología , Porcelana Dental/química , Diseño de Prótesis Dental , Diastema/terapia , Femenino , Gingivitis/prevención & control , Humanos , Coloración de Prótesis , Cementos de Resina/química , Desgaste de los Dientes/rehabilitación
7.
Odontostomatol Trop ; 37(148): 25-31, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25980094

RESUMEN

OBJECTIVE: To evaluate the self-reported oral health attitudes and behaviour among the clinical dental students and to compare the influence of clinical experience on oral health attitudes and behaviour among dental students at the different clinical years in the University of Benin using the modified Hiroshima University Dental Behavior Inventory (HU-DBI). METHODS: The study involved 156 clinical dental students from the University of Benin, Benin City, Nigeria. Demographic data were obtained for age and gender from 4th, 5th and 6th year clinical students. A modified English version of HU-DBI survey consisted of 22 items with dichotomous responses (yes-no) was used in this study. Descriptive statistics was performed for age and clinical level of education. Chi-square text was applied to the percentages of responses. Tamhane's T2 post-hoc multiple comparison for pairwise comparison of the three clinical levels of students was done to determine the differences. Test significance was set at P < 0.05. RESULTS: The response rate was 87.2%. The mean age of the respondents was 26.2 + 2.4 years. A total of 62 (39.7%) respondents were females and 94 (60.3%) males. Statistically significant differences were found among the various clinical levels of dental students for previous visit to the dentist office, visiting the dentist unless there is toothache, brushing the teeth twice daily and the prevention of gum disease with tooth brushing alone. CONCLUSION: There was improvement in the dental students' oral health behaviour and attitudes with increasing level of dental education.


Asunto(s)
Actitud Frente a la Salud , Educación en Odontología , Conductas Relacionadas con la Salud , Salud Bucal , Estudiantes de Odontología/psicología , Adulto , Atención Odontológica/psicología , Femenino , Enfermedades de las Encías/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Antisépticos Bucales/uso terapéutico , Nigeria , Autoinforme , Fumar/psicología , Odontalgia/psicología , Cepillado Dental/psicología , Adulto Joven
8.
Am J Dent ; 26(3): 156-60, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23986963

RESUMEN

PURPOSE: To investigate the plaque inhibiting effects of two commercially available mouthrinses containing essential oils (EO). Both products contained the same concentration of EO, but one of them did not contain ethanol. METHODS: The study was an observer-masked, randomized, 4 x 4 Latin square cross-over design, balanced for carryover effects, involving 12 participants in a 4-day plaque regrowth model. A 0.12% chlorhexidine (CHX) rinse and a saline solution served as positive and negative controls, respectively. On Day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced rinsing with their allocated rinses. On Day 5, subjects were scored for disclosed plaque. RESULTS: Differences among treatments were highly significant (P < 0.0001), with greater plaque inhibition by CHX compared to EO rinse containing ethanol (P = 0.012), which, in turn, was significantly more effective than the rinse without ethanol and the saline (P < 0.001). The reduction in plaque regrowth seen with the EO rinse without ethanol was quite similar to that elicited by saline (P > 0.05).


Asunto(s)
Placa Dental/patología , Enfermedades de las Encías/prevención & control , Antisépticos Bucales , Aceites Volátiles , Estudios Cruzados , Humanos
9.
Int J Comput Dent ; 16(1): 23-36, 2013.
Artículo en Inglés, Alemán | MEDLINE | ID: mdl-23641662

RESUMEN

The quality of intraoral scanning systems is steadily improving, and they are becoming easier and more reliable to operate. This opens up possibilities for routine clinical applications. A special aspect is that overlaying (superimposing) situations recorded at different times facilitates an accurate three-dimensional difference analysis. Such difference analyses can also be used to advantage in other areas of dentistry where target/actual comparisons are required. This article presents potential indications using a newly developed software, explaining the functionality of the evaluation process and the prerequisites and limitations of 3D monitoring.


Asunto(s)
Diseño Asistido por Computadora , Técnica de Impresión Dental/normas , Imagenología Tridimensional/métodos , Dispositivos Ópticos , Control de Calidad , Algoritmos , Calibración , Técnica de Impresión Dental/instrumentación , Profilaxis Dental , Progresión de la Enfermedad , Enfermedades de las Encías/prevención & control , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Programas Informáticos , Técnicas de Movimiento Dental , Desgaste de los Dientes/fisiopatología , Interfaz Usuario-Computador
10.
Int Dent J ; 62(4): 208-12, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23017003

RESUMEN

OBJECTIVES: This study aimed to evaluate the clinical effects of 0.05% sodium hypochlorite mouth rinse on supragingival biofilm and gingival inflammation. METHODS: The study was performed as a controlled, randomised, investigator-blinded, parallel group trial in 40 prison inmates. Following a preparatory period to obtain a plaque- and gingivitis-free dentition, tooth-brushing was substituted for 21 days by supervised twice daily rinsing with either 15 ml of fresh solution 0.05% sodium hypochlorite or 15 ml of distilled water. Clinical outcomes were assessed using the Quigley-Hein Plaque Index (QHPI), the Löe and Silness Gingival Index (L&SGI) and bleeding on probing. Adverse events were evaluated by questionnaire, visual examination and clinical photographs. RESULTS: At day 21, the average QHPI score had increased to 3.82 in the water rinse group and 1.98 in the sodium hypochlorite rinse group. The average L&SGI score had increased to 2.1 in the water rinse group and 1.0 in the sodium hypochlorite rinse group, and the average percentage of sites that bled on probing had increased to 93.1% in the water rinse group and 56.7% in the sodium hypochlorite rinse group. Differences were statistically significant (P = 0.001). A brown extrinsic tooth stain along the gingival margin appeared in 100% of participants in the sodium hypochlorite rinse group and in 35.0% of participants in the water rinse group (P < 0.05). CONCLUSIONS: An oral rinse with 0.05% sodium hypochlorite resulted in significant reductions in supragingival biofilm accumulation and gingival inflammation. Dilute sodium hypochlorite may represent an efficacious, safe and affordable antimicrobial agent in the prevention and treatment of periodontal disease.


Asunto(s)
Antiinfecciosos/administración & dosificación , Placa Dental/prevención & control , Enfermedades de las Encías/prevención & control , Antisépticos Bucales/administración & dosificación , Hipoclorito de Sodio/administración & dosificación , Adulto , Biopelículas/efectos de los fármacos , Índice de Placa Dental , Enfermedades de las Encías/tratamiento farmacológico , Humanos , Masculino , Índice Periodontal , Prisioneros , Método Simple Ciego , Resultado del Tratamiento
11.
Dent Update ; 39(1): 51-4, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22720381

RESUMEN

UNLABELLED: Pregnancy is a period of both joy and anxiety in a woman's life and is characterized by various physiological changes in her body brought about by the circulating female sex hormones. The oral cavity is also the seat of changes and these physiologic changes of pregnancy need to be addressed while managing the pregnant woman in the dental clinic. The main goal is to minimize the occurrence of any complications that might harm the mother-to-be and/or the unborn child. Preventive, emergency, and routine dental procedures are all deemed suitable during various phases of pregnancy, with some treatment modifications and initial planning. CLINICAL RELEVANCE: The dentist should be in a position to manage pregnant women in clinical practice effectively.


Asunto(s)
Atención Odontológica , Salud Bucal , Embarazo/fisiología , Prescripciones de Medicamentos , Femenino , Enfermedades de las Encías/prevención & control , Granuloma/prevención & control , Hemodinámica/fisiología , Humanos , Náuseas Matinales/fisiopatología , Boca/fisiología , Guías de Práctica Clínica como Asunto , Complicaciones del Embarazo/prevención & control , Trimestres del Embarazo , Radiografía Dental
12.
Int J Dent Hyg ; 10(2): 142-6, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22040165

RESUMEN

AIM: The aim of this study was to describe self-reported oral health, oral hygiene habits and frequency of visits to a dentist among pregnant women visiting maternity hospitals in the United Arab Emirates. MATERIAL AND METHODS: A cross-sectional study was conducted, with anonymous structured questionnaires distributed to 800 pregnant women who were chosen at random from attendants of three maternity and child health centres from various geographical areas of UAE, during January-March 2010. RESULTS: The response rate was 93.7% (n = 750). Less than quarter of the participated pregnant women were in their first trimester. Almost a quarter (23.5%) of the women believed that they had periodontal problem currently, while 46.3% reported having carious teeth. More than 44% reported having dental pain, and about 40% women felt that her oral health was poor. About 60% reported having heard about the possible connection between pregnancy and the oral health. About 94% of the women were brushing their teeth at least once a day. More than half of the women (58.3%) visited the dentist during their most recent pregnancy, mostly for dental pain. CONCLUSIONS: A large proportion of the pregnant women in this study had oral health problems; however, more than 40% of those women had not visited a dentist during their pregnancy, and the majority of those utilized dental services when they had dental pain only. To provide better oral health care, more knowledge needs to be made available to the pregnant women and the medical community.


Asunto(s)
Atención Odontológica/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Higiene Bucal/estadística & datos numéricos , Enfermedades Periodontales/prevención & control , Complicaciones del Embarazo/prevención & control , Adolescente , Adulto , Estudios Transversales , Autoevaluación Diagnóstica , Femenino , Enfermedades de las Encías/prevención & control , Humanos , Salud Bucal , Embarazo , Autoinforme , Emiratos Árabes Unidos , Adulto Joven
13.
J Clin Dent ; 22(6): 179-82, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-22403972

RESUMEN

This article briefly discusses the antibacterial action ofcetylpyridinium chloride (CPC) and its efficacy in the removal of bacterial plaque as an adjunct to the mechanical cleaning of tooth surfaces. It reviews new studies on the effectiveness of mouthwash formulations containing CPC against two common oral bacteria species and in disrupting plaque biofilms. Finally, this article reviews three clinical studies which support that the daily use of mouthwashes containing 0.075% CPC, with and without alcohol, represents a valuable complement to daily mechanical plaque control.


Asunto(s)
Antibacterianos/uso terapéutico , Antiinfecciosos Locales/uso terapéutico , Cetilpiridinio/uso terapéutico , Placa Dental/prevención & control , Enfermedades de las Encías/prevención & control , Antisépticos Bucales/uso terapéutico , Antiinfecciosos Locales/química , Biopelículas/efectos de los fármacos , Cetilpiridinio/química , Química Farmacéutica , Placa Dental/microbiología , Etanol , Humanos , Antisépticos Bucales/química , Vehículos Farmacéuticos
14.
Northwest Dent ; 90(3): 17-22, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21736189

RESUMEN

What does polishing oral hard tissues and restorations accomplish? The two parts of this review will describe the effect of polishing on various restorative materials and teeth; the development of biofilm and adherence of plaque to teeth and restorations; the effects of unpolished versus polished surfaces on gingival health and longevity of restoration; and techniques for polishing various restorative materials. A listing of available polishing materials is included in Part Two, which will appear in the July-August Northwest Dentistry.


Asunto(s)
Profilaxis Dental , Adhesión Bacteriana/fisiología , Biopelículas , Película Dental/microbiología , Placa Dental/microbiología , Restauración Dental Permanente , Enfermedades de las Encías/prevención & control , Humanos , Diente/microbiología
15.
Fogorv Sz ; 104(3): 75-9, 2011 Sep.
Artículo en Húngaro | MEDLINE | ID: mdl-22039712

RESUMEN

Among the predisposing agents for inflammatory periodontal lesion dental plaque is the most important, but different local and systemic factors may influence the seriousness or progression of periodontitis. Hormonal changes during pregnancy belong to the systemic aggravating factors. The aim of the present study was to assess pregnant women's oral hygiene knowledge and habits, and if these have a relationship with age, residence, educational level and profession/occupation. Questionnaires were used for the data collection. 275 pregnant women, who underwent prenatal care at the Department of Obstetrics and Gynecology in Szeged, volunteered to answer the questions. The results showed that almost all the women brushed their teeth daily, but only about one third of them used special oral hygiene tools, like dental floss. Many of the women claimed to have gingival bleeding when brushing their teeth. More then 70% visited a dentist during pregnancy. There was a significant relationship between educational level and the use of dental floss (p=0.004) and gingival bleeding (p=0.023) Oral hygiene education, dental and periodontal treatment of pregnant women need more emphasis during prenatal care.


Asunto(s)
Enfermedades de las Encías/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Higiene Bucal/estadística & datos numéricos , Complicaciones del Embarazo/epidemiología , Mujeres Embarazadas , Adolescente , Adulto , Factores de Edad , Dispositivos para el Autocuidado Bucal , Edema/epidemiología , Escolaridad , Femenino , Enfermedades de las Encías/prevención & control , Hemorragia/epidemiología , Hemorragia/etiología , Vivienda , Humanos , Hungría/epidemiología , Ocupaciones , Embarazo , Complicaciones del Embarazo/prevención & control , Encuestas y Cuestionarios , Cepillado Dental/efectos adversos
16.
Support Care Cancer ; 18(8): 1007-21, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20449756

RESUMEN

INTRODUCTION: This purpose of this systematic review was to evaluate the literature and update our current understanding of the impact of present cancer therapies on the dental apparatus (teeth and periodontium) since the 1989 NIH Development Consensus Conference on the Oral Complications of Cancer Therapies. REVIEW METHOD: A systematic literature search was conducted with assistance from a research librarian in the databases MEDLINE/PubMed and EMBASE for articles published between 1 January 1990 and 31 December 2008. Each study was independently assessed by two reviewers. Taking into account predetermined quality measures, a weighted prevalence was calculated for the prevalence of dental caries, severe gingival disease, and dental infection. Data on DMFT/dmft, DMFS/dmfs, plaque, and gingival indexes were also gathered. The level of evidence, recommendation, and guideline (if possible) were given for published preventive and management strategies. RESULTS: Sixty-four published papers between 1990 and 2008 were reviewed. The weighted overall prevalence of dental caries was 28.1%. The overall DMFT for patients who were post-antineoplastic therapy was 9.19 (SD, 7.98; n = 457). The overall plaque index for patients who were post-antineoplastic therapy was 1.38 (SD, 0.25; n = 189). The GI for patients who were post-chemotherapy was 1.02 (SD, 0.15; n = 162). The weighted prevalence of dental infections/abscess during chemotherapy was reported in three studies and was 5.8%. CONCLUSIONS: Patients who were post-radiotherapy had the highest DMFT. The use of fluoride products and chlorhexidine rinses are beneficial in patients who are post-radiotherapy. There continues to be lack of clinical studies on the extent and severity of dental disease that are associated with infectious complications during cancer therapy.


Asunto(s)
Neoplasias/terapia , Enfermedades Periodontales/etiología , Enfermedades Dentales/etiología , Caries Dental/etiología , Caries Dental/prevención & control , Fluoruros/uso terapéutico , Enfermedades de las Encías/etiología , Enfermedades de las Encías/prevención & control , Humanos , Enfermedades Periodontales/prevención & control , Índice de Severidad de la Enfermedad , Enfermedades Dentales/prevención & control
17.
Cochrane Database Syst Rev ; (8): CD003069, 2010 Aug 04.
Artículo en Inglés | MEDLINE | ID: mdl-20687072

RESUMEN

BACKGROUND: It is important to institute an effective supportive therapy to maintain or recover soft tissue health around dental implants. Different maintenance regimens have been suggested, however it is unclear which are the most effective. OBJECTIVES: To assess the effects of different interventions for 1) maintaining and 2) recovering soft tissue health around osseointegrated dental implants. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Handsearching included several dental journals. We checked the bibliographies of the identified randomised controlled trials (RCTs) and relevant review articles for studies outside the handsearched journals. We wrote to authors of all identified RCTs, to more than 55 oral implant manufacturers and to an Internet discussion group to find unpublished or ongoing RCTs. No language restrictions were applied. The last electronic search was conducted on 2 June 2010. SELECTION CRITERIA: All randomised controlled trials comparing agents or interventions for maintaining or recovering healthy tissues around dental implants. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. Results were expressed as random-effects models using standardised mean differences for continuous data and risk ratios for dichotomous data with 95% confidence intervals. MAIN RESULTS: Five trials compared interventions for maintaining soft tissue health around implants and a further six trials compared interventions to recover soft tissue health where there was evidence of peri-implant mucositis. No statistically significant differences were found between the effectiveness of powered versus manual toothbrushes for either maintaining or recovering soft tissue health. There was no statistically significant difference found between different types of self administered antimicrobials for maintaining soft tissue health (hyaluronic acid gel compared to chlorhexidine gel, amine fluoride/stannous fluoride mouthwash compared to chlorhexidine mouthwash) and triclosan dentifrice compared to sodium fluoride dentifrice showed no statistically significant difference in recovering soft tissue health. However chlorhexidine irrigation was more effective in reducing plaque and marginal bleeding scores compared to chlorhexidine mouthwash and Listerine mouthwash was found to be statistically significantly better than placebo with regard to reducing mean plaque scores and marginal bleeding scores. When interventions administered by dental professional were compared there was no statistically significant difference found between chlorhexidine and physiologic solutions as irrigants at second stage surgery to maintain health of soft tissues. In patients with peri-implant mucositis two trials evaluated interventions performed by dental professionals. There was no statistically significant difference between mechanical debridement followed by either minocycline or chlorhexidine gel, or between debridement with a titanium curette compared to an ultrasonic debridement tool. AUTHORS' CONCLUSIONS: There was only low quality evidence for which are the most effective interventions for maintaining or recovering health of peri-implant soft tissues. The included RCTs had short follow-up periods and few subjects and although overall the risk of bias of the studies was either low or unclear, only single trials were available for each outcome. There was no reliable evidence as to which regimens are most effective for long term maintenance. This should not be interpreted as meaning that current maintenance regimens are ineffective. There was weak evidence that antibacterial mouthrinses are effective in reducing plaque and marginal bleeding around implants. More RCTs should be conducted in this area. In particular, there is a definite need for trials powered to find possible differences, using primary outcome measures and with much longer follow up. Such trials should be reported according to the CONSORT guidelines (www.consort-statement.org/).


Asunto(s)
Implantes Dentales , Enfermedades de las Encías/terapia , Higiene Bucal/métodos , Pérdida de Diente/rehabilitación , Adulto , Enfermedades de las Encías/prevención & control , Humanos , Higiene Bucal/instrumentación , Ensayos Clínicos Controlados Aleatorios como Asunto
18.
J Periodontol ; 80(7): 1103-13, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19563290

RESUMEN

BACKGROUND: The present study was planned to investigate the therapeutic actions of 1-tetradecanol complex (1-TDC), a novel monounsaturated fatty acid mixture, in established periodontitis in rabbits. METHODS: Periodontitis was initiated in 18 New Zealand White rabbits using ligatures around mandibular second premolars, followed by topical Porphyromonas gingivalis application (10(9) colony forming units). After 6 weeks of disease induction (phase 1), three animals were sacrificed to assess the established periodontitis level. P. gingivalis application was discontinued, and the remaining 15 animals continued with topical treatment of 1-TDC (100 mg/ml; n = 5) or placebo (n = 5) or no treatment (n = 5) for an additional 6 weeks (phase 2). Mandibular block sections obtained after euthanasia were decalcified and embedded in paraffin. In addition to the macroscopic analyses, hematoxylin and eosin-stained sections were used to study cellular inflammatory infiltrate and quantitative histomorphometry. Tartrate-resistant acid phosphatase and osteocalcin were used to identify osteoclastic and osteoblastic activity, respectively. RESULTS: P. gingivalis application resulted in periodontal disease with gingival inflammation and bone loss (30% compared to baseline) at 6 weeks. Treatment with 1-TDC stopped the progression of the disease and resulted in a significant reduction in the macroscopic periodontal inflammation, attachment, and bone loss (10.1% +/- 1.8%), whereas periodontal disease progressed in the untreated and placebo groups (P <0.05). Histologic assessment and histomorphometric measurements demonstrated that 1-TDC inhibited inflammatory cell infiltration and osteoclastic activity (P <0.05). CONCLUSION: The findings suggest that topical application of cetylated monounsaturated fatty acid complex (1-TDC) is a potential therapeutic approach in controlling the progression of chronic periodontal disease.


Asunto(s)
Pérdida de Hueso Alveolar/prevención & control , Ácidos Grasos Monoinsaturados/administración & dosificación , Alcoholes Grasos/uso terapéutico , Enfermedades de las Encías/prevención & control , Periodontitis/prevención & control , Administración Tópica , Pérdida de Hueso Alveolar/microbiología , Pérdida de Hueso Alveolar/patología , Análisis de Varianza , Animales , Diente Premolar , Modelos Animales de Enfermedad , Enfermedades de las Encías/microbiología , Enfermedades de las Encías/patología , Masculino , Mandíbula , Periodontitis/microbiología , Periodontitis/patología , Porphyromonas gingivalis/efectos de los fármacos , Porphyromonas gingivalis/patogenicidad , Conejos , Distribución Aleatoria
19.
Biochem J ; 409(2): 601-9, 2008 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-17919120

RESUMEN

New molecules were designed for efficient intra-oral delivery of antimicrobials to prevent and treat oral infection. The salivary statherin fragment, which has high affinity for the tooth enamel, was used as a carrier peptide. This was linked through the side chain of the N-terminal residue to the C-terminus of a defensin-like 12-residue peptide to generate two bifunctional hybrid molecules, one with an ester linkage and the other with an anhydride bond between the carrier and the antimicrobial components. They were examined for their affinity to a HAP (hydroxyapatite) surface. The extent of the antimicrobial release in human whole saliva was determined using 13C-NMR spectroscopy. The candidacidal activity of the molecules was determined as a function of the antimicrobial release from the carrier peptide in human saliva. The hybrid-adsorbed HAP surface was examined against Candida albicans and Aggregatibacter actinomycetemcomitans using the fluorescence technique. The bifunctional molecules were tested on human erythrocytes, GECs (gingival epithelial cells) and GFCs (gingival fibroblast cells) for cytotoxicity. They were found to possess high affinity for the HAP mineral. In human whole saliva, a sustained antimicrobial release over a period of more than 40-60 h, and candidacidal activity consistent with the extent of hybrid dissociation were observed. Moreover, the bifunctional peptide-bound HAP surface was found to exhibit antimicrobial activity when suspended in clarified human saliva. The hybrid peptides did not show any toxic influence on human erythrocytes, GECs and GFCs. These novel hybrids could be safely used to deliver therapeutic agents intra-orally for the treatment and prevention of oral infectious diseases.


Asunto(s)
Antiinfecciosos/administración & dosificación , Defensinas/administración & dosificación , Portadores de Fármacos/química , Péptidos/química , Enfermedades Periodontales/tratamiento farmacológico , Proteínas y Péptidos Salivales/química , Administración Oral , Secuencia de Aminoácidos , Antiinfecciosos/química , Antiinfecciosos/farmacología , Candida albicans/efectos de los fármacos , Dicroismo Circular , Defensinas/química , Defensinas/farmacología , Portadores de Fármacos/síntesis química , Enfermedades de las Encías/tratamiento farmacológico , Enfermedades de las Encías/prevención & control , Humanos , Control de Infecciones , Infecciones/tratamiento farmacológico , Cinética , Datos de Secuencia Molecular , Pasteurellaceae/efectos de los fármacos , Péptidos/síntesis química , Péptidos/farmacología , Enfermedades Periodontales/microbiología , Enfermedades Periodontales/prevención & control , Saliva/microbiología
20.
Int Dent J ; 59(2): 78-82; quiz 62, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19489286

RESUMEN

AIM/OBJECTIVE: To define the basic oral health goals for Spain 2015 (children)/2020 (adults). METHODS: The Spanish Society of Epidemiology and Oral Public Health commissioned a six-member Expert Panel, which worked over the period 2006-2007 and reached consensus according to the EuropeAid Evaluation Guidelines. The Panel's work included three meetings and a presentation at the Society's annual conference in 2007. Since each autonomous region/city in Spain has control over its health policy, only basic goals for the country as a whole were defined. The variables used to set goals were caries history and gingival health according to the World Health Organisation criteria, and tooth brushing frequency and health perception according to the European Global Oral Health Indicators Development Project. RESULTS AND CONCLUSIONS: A total of 16 targets were defined, 8 for children and 8 for adults. For example, the number of permanent decayed, missing and filled teeth should be < 1.0 at 12 years of age by 2015, or the percentage of edentulous persons should be < 15% at 65-74-years by 2020. In order to achieve the proposed goals, the Expert Panel recommends involving all health system personnel in the maintenance and/or development of new oral health programmes and strategies.


Asunto(s)
Salud Bucal/normas , Adulto , Anciano , Niño , Índice CPO , Caries Dental/prevención & control , Enfermedades de las Encías/prevención & control , Objetivos , Planificación en Salud , Indicadores de Salud , Humanos , Investigación Cualitativa , España , Cepillado Dental/estadística & datos numéricos
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