Supportive periodontal care with or without subgingival instrumentation: Microbiological results of a 2-year randomized clinical trial.

AIM: To compare the subgingival microbiota of patients receiving supportive periodontal care (SPC) with and without subgingival instrumentation, over 2 years. MATERIALS AND METHODS: This study was a randomized clinical trial that included 62 participants (50.97 ± 9.26 years old; 40 females) who completed non-surgical periodontal therapy. Participants were randomly assigned to receive oral prophylaxis with oral hygiene instructions alone (test) or in combination with subgingival instrumentation (control) during SPC. Pooled subgingival biofilm samples were obtained from four sites per patient at SPC baseline and at 3, 6, 12, 18, and 24 months. Real-time polymerase chain reaction was used for absolute quantification of Eubacteria and the target bacteria Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. Data were analysed using generalized estimating equations, taking into consideration the clustering of observations within individuals. RESULTS: No significant differences were found between the experimental groups regarding the mean counts of Eubacteria and target bacteria, as well as the periodontal parameters at the sampled sites. Although significant variability in bacterial counts was present during SPC, all counts after 2 years were not statistically different from those at baseline. Bacterial counts were associated with the presence of plaque, bleeding on probing, mean probing depth ≥3 mm, and follow-up period. CONCLUSIONS: SPC with or without subgingival instrumentation can result in comparable subgingival microbiological outcomes. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov: NCT01598155 (https://clinicaltrials.gov/study/NCT01598155?intr=supragingival%20control&rank=4#study-record-dates).

Comparative Evaluation of 0.25% Lemongrass Oil Mouthwash and 0.2% Chlorhexidine Mouthwash in Fixed Orthodontic Patients Suffering from Gingivitis.

AIM: The aim of this study is to compare the antiplaque and antigingivitis efficacy of 0.25% lemongrass oil mouthwash and 0.2% chlorhexidine mouthwash in patients undergoing fixed orthodontic treatment, who are suffering from gingivitis. MATERIALS AND METHODS: A total of 60 patients undergoing fixed orthodontic treatment with mild-to-moderate gingivitis were selected for the study. The patients were randomly divided into three groups of twenty each, that is, group I: 0.25% lemongrass oil mouthwash (n = 20); group II: 0.2% chlorhexidine mouthwash (n = 20); and group III: oral prophylaxis (n = 20). Baseline gingival index (GI) and plaque index (PI) were accessed followed by oral prophylaxis was done and the PI score was set to zero for all the patients. Patients were asked to swish their mouth with their respective mouthwashes and brushing (twice daily), that is, morning and before bedtime for 21 days. The PI and GI scores were recorded for all three groups on the 14th and the 21st days. The post hoc Bonferroni test was used for multiple comparisons of mean differences among variables after the application of the analysis of variance (ANOVA) test for comparison within the groups. RESULTS: A lower PI and the GI were found in the lemongrass oil mouthwash group by the 14th and the 21st days, respectively, a statistically significant difference (p < 0.001) compared to the chlorhexidine mouthwash group. CONCLUSION: The findings of the current study suggested that 0.25% lemongrass oil mouthwash has the potential to be used as a natural or herbal alternative to chlorhexidine mouthwash. CLINICAL SIGNIFICANCE: It can be suggested that 0.25% lemongrass oil mouthwash may be a good herbal alternative to mouthwash containing 0.2% chlorhexidine gluconate.

Efficacy of Adjunctive Chlorhexidine in non-surgical treatment of Peri-Implantitis/Peri-Implant Mucositis: An updated systematic review and meta-analysis.

Objective: The current review aimed to assess the efficacy of adjunctive chlorhexidine (CHX) in the non-surgical treatment of peri-implantitis/peri-implant mucositis. Methods: PubMed, Embase, Science Direct, CENTRAL, and Google Scholar databases were searched up to 10th March 2022 for relevant randomized controlled trials or controlled clinical trials. Results: Fourteen studies were included. Meta-analysis revealed significantly lower probing depths in peri-implant mucositis patients using CHX adjuncts as compared to controls (SMD: -1.49 95% CI: -2.56, -0.42 I2=95% p=0.006). However, the same effect was not noted in peri-implantitis (SMD: -1.18 95% CI: -0.04, 2.40 I2=96% p=0.06). CHX was not found to improve bleeding of probing in peri-implant mucositis while sufficient data was unavailable for peri-implantitis. Results on other outcome variables were conflicting. Conclusion: Evidence on the efficacy of adjunctive CHX for peri-implant mucositis is conflicting. Similarly, strong conclusions on the effect of CHX for peri-implantitis cannot be drawn due to limited number of studies. Overall, there seems to be a trend of non-significant impact of CHX on outcomes of peri-implant mucositis as well as peri-implantitis.

Research on dental plaque removal methods for efficient oral prophylaxis: With a focus on air polishing and rubber cup polishing.

OBJECTIVES: This study was conducted to compare the plaque control effectiveness of rubber cup polishing with that of air polishing during oral prophylaxis procedures and to investigate the effect of the order of air-polishing application on the efficiency of oral prophylaxis. METHODS: The study included adult patients (≥20 years of age) who had visited the dental clinic for oral prophylaxis. A total of 173 subjects were divided into three groups (scaling followed by rubber cup polishing, SR; scaling followed by air polishing, SA; and air polishing followed by scaling, AS) based on sex, age, oral health status, oral hygiene status, and indications and contraindications according to the oral prophylaxis method. The analysis of variance (ANOVA) was used to determine the difference in oral prophylaxis time, residual deposits rate, subjects and dental hygienist satisfaction. RESULTS: The total scaling time was shorter in the AS group (15.4 ± 6.9 minutes) than in the SA (18.7 ± 5.5 minutes) and SR groups (19.9 ± 6.2 minutes) (p < 0.05). The rate of residual deposits was significantly higher in the SR group than in the AS or SA groups (p < 0.05). The satisfaction level of dental hygienists was higher in the AS group (8.8 ± 1.0 points) and the SA group (8.4 ± 1.0 points) than in the SR group (6.2 ± 1.3 points). CONCLUSION: During oral prophylaxis, dental plaque removal using air polishing requires a relatively longer time when compared to rubber cup polishing, but it can better eliminate dental plaque. In addition, we found that dental plaque removal using air polishing prior to scaling reduced the total scaling time.

Supportive periodontal therapy in moderate-to-severe periodontitis patients: A two-year randomized clinical trial.

AIM: Evaluate supportive periodontal therapy (SPT) consisting of oral prophylaxis with oral hygiene instructions as sole intervention (test) or combined with subgingival instrumentation removing/disrupting the subgingival biofilm (control). MATERIAL AND METHODS: Sixty-two treated periodontitis patients (50.97 ± 9.26 years, 24 smokers) were randomly assigned to receive, every 3 months during 2 years, either test or control treatment. Examination included periodontal probing depth (PPD), bleeding on probing (BOP) and clinical attachment loss (CAL). Generalized estimating equations were used for analyses. RESULTS: Baseline demographics and smoking were similar between groups. However, at baseline, mean PPD was greater in test group than in control group (2.32 mm vs. 2.17 mm, p = .03), but similar after 2 years (2.23 mm vs. 2.15 mm, respectively). With time, significant PPD and BOP decrease and CAL increase were observed although without significant differences between groups. At sites ≥ 5 mm, PPD decrease was greater in test group than in control group irrespective of sex and smoking habit (p = .034). The distribution of sites gaining or losing attachment ±2 mm was similar between groups. CONCLUSION: Oral prophylaxis with oral hygiene instructions alone or in combination with subgingival instrumentation was able to maintain the previously obtained periodontal condition to a comparable extent during 2 years of SPT.

An assessment of oral prophylaxis in patients with myocardial infarction diagnosed by means of coronary angiography.

AIM: The aim of this study was to assess oral prophylaxis in patients with myocardial infarction diagnosed by means of coronary angiography compared with a control group. MATERIALS AND METHODS: The participants were recruited from patients who had undergone coronary angiography in the Cardiology Department. The study included 128 patients - 68 patients in a study group with acute coronary syndrome diagnosed by means of coronary angiography (ACSgroup) as well as 60 patients in a control group in whom coronarography revealed no lesions in coronary arteries (H-group). A detailed clinical dental examination was performed. The level of oral prophylaxis was assessed for both groups. The following factors were considered: the frequency of dental visits per year, the regularity of dental care, the frequency of toothbrushing per day, dental flossing, rinsing with a mouthwash, the use of an irrigator, and the use of single-tuft and interdental toothbrushes. RESULTS: Oral hygiene in the case of the study group was characterised by irregular dental care and inadequate hygiene procedures, with the exception of the use of an irrigator as well as single-tuft and interdental toothbrushes, where no statistically significant differences were noted between the groups. CONCLUSIONS: The oral hygiene of patients from the ACS-group was poorer than in the case of the H-group and the difference was statistically significant.

Effects of Ultrasonic Debridement on Oral Hygiene Status.

The aim of this randomized-controlled, single-blinded study was to compare the effects of mechanical tooth cleaning (MTC) and ultrasonic debridement (UD) on oral hygiene status in healthy young adults. Thirty-seven participants (mean age: 20.3±0.62 years) were divided into 3 groups after pre-examination: group A, receiving MTC; B, receiving MTC+UD using a universal insert (UDUI); and C, receiving MTC+UD using a probe-shaped insert (UDPI). All participants were required to abstain from oral hygiene for 24 hours after the allocated intervention, after which they were examined. A masked examiner determined the Quigley-Hein plaque index (PlI) and Silness and Löe gingival index (GI) scores before the interventions and after 24 hours of non-brushing. A significant increase in the PlI score was observed in group A (p<0.001) in comparison with that in group B (A: 0.311±0.26; B: -0.01±0.33; C: 0.13±0.27; p<0.05). A significant decrease in the GI score was observed in groups B and C (p<0.05), and the change in this score in group C significantly differed from that in group A or B (A: -0.04±0.25; B: -0.13±0.17; C: -0.33±0.2; p<0.05). Only MTC was insufficient to prevent plaque formation over a 24-hour period of non-brushing and decrease the GI score. Ultrasonic debridement was more effective in preventing plaque formation and decreasing the GI score, regardless of the type of insert used. The present results suggest that UD should be included as an important procedure in the provision of professional oral prophylaxis and that UDPI is as efficient for cleaning as UDUI.

Efficacy of interdental calibrated brushes on bleeding reduction in adults: a 3-month randomized controlled clinical trial.

This study investigated the effect of interdental brushes on the reduction of interproximal bleeding in adults without periodontal disease. Forty-six adults were enrolled in a 3-month, observer-blinded, parallel-group randomized control trial. The test group used a standard manual toothbrush twice daily and an interdental brush daily. The control group used a standard manual toothbrush. At each visit, a calibrated colorimetric probe was used in all interdental spaces to determine the appropriate size of the interdental brush required, the brush of the corresponding size was introduced into the interproximal space, and the presence of bleeding was recorded. The outcome was the frequency of bleeding after application of the appropriate interdental brush. All participants were evaluated 1 wk, 1 month, and 3 months after the baseline visit. The overall preventive fraction with respect to bleeding frequency was 46% at 1 wk and 72% at 3 months. More bleeding reduction was observed in anterior sites than in posterior sites (80% vs. 69%, respectively). Participants with low baseline bleeding frequency presented with less bleeding (OR = 2.3). This study shows that daily use of calibrated interdental brushes reduces interdental bleeding. These findings may support interdental cleaning as an effective means to help individuals maintain and/or achieve optimal oral health.

Nonsurgical Management of Phenytoin-induced Gingival Hyperplasia.

INTRODUCTION: The aim of this report is to present a severe case of phenytoin (PHT)-induced gingival hyperplasia in a Saudi patient. MATERIALS AND METHODS: A 12-year-old male epileptic patient, undergoing PHT therapy, was diagnosed clinically with severe gingival hyperplasia. His treatment consisted meticulous oral care and weekly professional prophylaxis. The patient was advised oral folic acid supplementation (0.5 mg/day) and was also recommended 0.2% chlorhexidine gluconate mouthwash twice daily. RESULTS: There was significant reduction in the hyperplastic tissue within 4 weeks of treatment. CONCLUSION: It is possible to treat PHT-induced gingival hyperplasia non-surgically with intensive dental care, correct oral hygiene and oral folic acid supplements.

Oral prophylaxis and its effects on halitosis-associated and inflammatory parameters in patients with chronic periodontitis.

OBJECTIVE: A controlled clinical trial was conducted to evaluate the effects of oral prophylaxis on halitosis-associated, immunological and microbiological parameters. METHODS: Thirty subjects were included in this controlled clinical trial (patients with generalized chronic periodontitis and controls without clinical attachment loss; each n = 15). Before oral prophylaxis and 14 days after (including tongue cleaning) volatile sulphur compounds (VSC), organoleptic scores and a tongue coating index were evaluated. The levels of IL-1ß, IL-8, IL-10 and MMP-8 were measured in GCF, and also major periodontal pathogens were detected. Data were statistically analysed using anova and paired t-test. RESULTS: Supragingival plaque and calculus removal with combined tongue cleaning was able to reduce significantly (P < 0.05) the VSC values in both groups (no significant differences between both groups). Two weeks after periodontal debridement, the VSC values were observed in the periodontitis group, but not in the control group, similar to the baseline values. The difference between the groups was statistically significant (P < 0.05). Only a repeated prophylaxis session in the periodontitis group was able to reduce VSC values significantly in comparison with baseline (P < 0.05). Organoleptic scores (10 and 30 cm) were significantly different (P < 0.05) between both groups before and after the treatment. Periodontal pathogens and host-derived markers were not significantly affected by a single prophylaxis session. CONCLUSIONS: Oral prophylaxis may result in a significant decrease in VSC values. However, in periodontal diseases, a more complex treatment seems to be necessary.

The Influence of Epilepsy on Oral Health Outcomes: A Retrospective Study in South Indian Adults.

Introduction Epilepsy, a chronic neurological disorder marked by recurrent seizures, affects approximately 50 million people worldwide with a higher prevalence in developing countries. This condition challenges motor skills and coordination, leading to poor oral health maintenance. The study aimed to evaluate the effect of epilepsy on oral health outcomes in adults by contrasting South Indian epileptics with healthy controls. The primary objective was to assess the prevalence of oral health issues in patients with epilepsy compared to healthy individuals and to analyze the types and frequency of dental procedures required in epileptic patients compared to healthy controls in the South Indian population. Materials and methods A retrospective study was conducted in the Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Chennai, India. Approved by the Institutional Human Ethical Committee (Registration ID: IHEC/SDC/OMED-2202/23/106), the study involved 105 epileptic patients and 105 healthy controls from records between January 2021 and December 2023. Both male and female patients within the age limit of 18-55 years were included. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 29.0 (Released 2022; IBM Corp., Armonk, New York, United States). Results The study involved 210 participants with an equal gender distribution. Valproate was the most common medication used by 39% of epileptic patients. Gingival hyperplasia was significantly more prevalent in the epileptic group (24%). The epileptic group also required more dental procedures, with 32% of teeth needing restoration, 20% root canal treatment, and 20% extraction, compared to 12%, 11%, and 5%, respectively, in the control group. Conclusion Epileptic patients exhibit poorer oral health outcomes, including higher rates of gingival hyperplasia and a greater need for dental procedures compared to healthy controls. These findings highlight the necessity for targeted dental care and regular monitoring for individuals with epilepsy to improve their oral health and overall quality of life.

3-Position Biaryl Endochin-like Quinolones with Enhanced Antimalarial Performance.

ELQ-300 is a potent antimalarial drug with activity against blood, liver, and vector stages of the disease. A prodrug, ELQ-331, exhibits reduced crystallinity and improved in vivo efficacy in preclinical testing, and currently, it is in the developmental pipeline for once-a-week dosing for oral prophylaxis against malaria. Because of the high cost of developing a new drug for human use and the high risk of drug failure, it is prudent to have a back-up plan in place. Here we describe ELQ-596, a member of a new subseries of 3-biaryl-ELQs, with enhanced potency in vitro against multidrug-resistant Plasmodium falciparum parasites. ELQ-598, a prodrug of ELQ-596 with diminished crystallinity, is more effective vs murine malaria than its progenitor ELQ-331 by 4- to 10-fold, suggesting that correspondingly lower doses could be used to protect and cure humans of malaria. With a longer bloodstream half-life in mice compared to its progenitor, ELQ-596 highlights a novel series of next-generation ELQs with the potential for once-monthly dosing for protection against malaria infection. Advances in the preparation of 3-biaryl-ELQs are presented along with preliminary results from experiments to explore key structure-activity relationships for drug potency, selectivity, pharmacokinetics, and safety.

Effectiveness of mouthrinses and oral prophylaxis on reduction of microorganisms count in irreversible hydrocolloid impression: an in vivo study.

Dental impressions, contaminated with saliva, blood, plaque, are potential source of infection. All impressions should be disinfected after their removal from mouth to prevent cross contamination. Different methods have been tried to disinfect the commonly used irreversible hydrocolloid impression material, but they have been shown to influence the dimensional stability and surface detail of the impression which ultimately affects the precision of the final prosthesis. The aim of this study was to evaluate the efficacy of pre-procedural oral prophylaxis and mouthrinses in reducing the overall microbial load intraorally as well as on alginate impression surface. A total of 60 positive cases selected from 100 subjects who were partially edentulous and above 18 years of age and without medical or pharmacotherapy histories were studied over a period of 18 months, from outpatient clinic of Department of Prosthodontics, GNIDSR. Alginate impressions, before and after prophylaxis were examined microbiologically for the persistence of test microorganisms on the untreated (control group) and the impressions made after treatment. The data were statistically analyzed by the Student t test to assess the effectiveness of the procedure and also the comparative effectiveness of oral prophylaxis and commonly used mouthrinses. The results showed that the impressions were safer when made after oral prophylaxis and/or mouthrinses.

Assessment of Patients' Experience and Perception Toward Dentinal Hypersensitivity for Its Diagnosis and Management: A Cross-Sectional Study.

Background Dentinal hypersensitivity (DH) is a common clinical finding that varies greatly in prevalence. An appropriate impulse that detonates noxious stimuli in the pulp/dentin boundary causes the typical DH pain, which is sudden, short, sharp, and of rapid onset. The objective of this research was to ascertain the incidence of DH in Keralites and evaluate some contributory factors, along with other initiating stimuli. Methodology Over three months, from June 2022 to August 2022, a cluster sampling technique was employed to conduct the study in 14 districts of Kerala. Patients from five clinics from each district who reported having DH and were aged 25 to 65 years were chosen at random. Using Google Survey forms, a 20-question, closed-ended survey was mailed to patients. The data were collected, evaluated, and analyzed using SPSS Version 23.0 (IBM Corp., Armonk, NY, USA). The statistical difference in the distribution of DH and the patient's age was determined using analysis of variance (ANOVA). A chi-square test was carried out to test the association between dentinal hypersensitivity, gender, and other parameters; P < 0.05 was considered to be statistically significant. Results Among the 2,520 persons to whom questionnaires were mailed, 2,321 responded, with an unresponsive rate of 7.89%. The study revealed a sensitivity predilection among females (54%), although statistically insignificant. Respondents aged 25 to 35 years (41.01%) were commonly reported to have DH, the age distribution of which was found to be highly significant statistically (P < 0.01). Teeth whitening resulted in 82.98% of the sensitivity, whereas 47.99% accepted poor oral hygiene as an additional contributory factor. DH was reported in 52.01% of the patients with gastritis and 63.03% of the patients with gingival recession. Further, blame for poor dental treatment (88.88%) and climate change (82.92%) were also found relevant. The quality of life was claimed to be afflicted in 90.99% of the patients. Desensitizing agents were used by 68.97% of the patients, with which 68.03% reported satisfaction. Of the subjects who underwent professional treatment, 87.03% reported being satisfied. Oral prophylaxis-induced sensitivity was reported in 57.99%, indicating enhanced oral health awareness among Kerala residents. There was a statistically highly significant difference in the patient distribution based on the exposure to DH, and their perception of the causes and factors affecting DH (P < 0.01). Conclusions DH is a frequently and widely prevalent dental malady. Respondents demonstrated that they were conversant with DH. The quality of life and enjoyment of daily activities are both impacted by dentin hypersensitivity, and many patients are unaware that it is a treatable illness. Various desensitizing substances are also available and can be applied quickly to sensitive areas. Patients prefer this procedure as it is simpler to apply these agents and the effects are pleasant and beneficial.

A review of berotralstat for the treatment of hereditary angioedema.

INTRODUCTION: Hereditary angioedema due to C1-inhibitor deficiency (C1-INH-HAE) imposes a significant disease burden on patients and their families. Unpredictable episodes of angioedema, which can lead to life-threatening conditions, have a significant impact on the quality of life of the patient. The fundamental aim of the treatment of C1-INH-HAE is to ensure that patients can lead a normal life. The most effective way to do this is to prevent the onset of angioedema attacks. AREAS COVERED: This review gives a brief overview of the safety and efficacy of the oral kallikrein inhibitor berotralstat in C1-INH-HAE disease. It provides a comprehensive synopsis of the results of the first clinical trials with a targeted oral kallikrein inhibitor (APeX-1 [NCT02870972]; ZENITH-1 [NCT03240133]; APeX-2 [NCT03485911]; APeX-S [NCT03472040]; APeX-J [NCT03873116]), reviewing evidence on the efficacy and safety of the drug, and placing berotralstat on the spectrum of long-term prophylactic therapeutic options. EXPERT OPINION: The availability of the first targeted oral prophylactic drug, the kallikrein inhibitor berotralstat, in 2021, is a milestone in the treatment of patients with hereditary angioedema.

A randomized, double-blind, split-mouth controlled clinical trial of systemically administered Lycopene on periodontal health.

BACKGROUND/PURPOSE: This research aimed to compare the effects of systemically prescribed Lycopene as a monotherapy and as an alternative to scaling and root planing in patients with chronic gingivitis. MATERIALS AND METHODS: The participants were randomly assigned to one of two treatment groups: the experimental group (n = 50), which received 10 mg of Lycopene a day for two weeks, or the control group (n = 50) received a placebo for two weeks. For each category, quadrant distribution was randomized, with two quadrants receiving oral prophylaxis (OP) and two quadrants receiving no care (non-OP). At baseline, 1st, and 2nd weeks, the sulcus bleeding index, plaque index, gingival index, and salivary uric acid level were measured. RESULTS: All clinical criteria, including SBI, PI, GI, and salivary uric acid levels, showed a statistically significant decline in all patient types. Both clinical parameters were significantly reduced (p < 0.001) in the OP-lycopene group relative to the non-OP-placebo group and non-OP lycopene group (p < 0.05). The PI value in the OP-lycopene group was statistically significantly lower (p < 0.001) than in the non-OP-placebo group; there was no statistically significant difference in the other groups. Salivary uric acid levels in the OP- and non-OP- lycopene groups were significantly lower (p < 0.001) than in the non-OP-placebo population. CONCLUSION: Based on the findings of this study, Lycopene seems to have a bright future as a treatment option for plaque-induced generalized chronic marginal gingivitis. More research with a broad sample size and multicentre trials is required. CLINICAL RELEVANCE: The article reveals the positive relationship between Lycopene and gingivitis. The analysis shows that a combination of systemically administered Lycopene with oral prophylaxis can be a valuable tool in treating chronic gingivitis and controlling respiratory oxidative stress.

The Influence of Coordinative Skills on the Oral Health of Children and Adolescents in Permanent Dentition.

Removing dental plaque by using a toothbrush is the most important measure for oral hygiene. The aim of the present study was to estimate the impact of the coordination skills of children and adolescents on their oral health (plaque level, DMF/T: decayed, missing, filled teeth). Within a prospective cohort study, 996 children (10 to 18 years) were examined. The results of three coordination tests from the Motorik Modul (MoMo) were included to evaluate the coordination skills. Other parameters taken into account were age, sex, orthodontic treatment and socioeconomic status (SES). Univariate and various multivariate analyses were performed to evaluate relationships. Better results in precision coordination tests were significantly related to a better oral hygiene (backward balancing: logistic regression OR 0.86, 95%CI: 0.73−0.99, p = 0.051, proportional odds model OR 0.86, 95%CI: 0.75−0.99, p = 0.037; one-leg-stand: logistic regression OR 0.78, 95%CI: 0.63−0.96, p = 0.018, proportional odds model OR 0.77, 95%CI: 0.64−0.92, p = 0.003). Higher scores on one-leg-stand were significantly related to a lower caries prevalence (logistic regression OR 0.81, 95%CI: 0.66−0.99, p = 0.037; Poisson regression exp(ß) 0.82, 95%CI: 0.74−0.91, p < 0.001). Coordination test under a time constraint (jumping side-to-side) showed no significant relation. Oral hygiene was poorer in younger children, boys and low SES. Caries prevalence increased with low SES and increasing age. The present results suggest that oral health is influenced by coordinative skills.

Prevention and Treatment of Oral Complications in Hematologic Childhood Cancer Patients: An Update.

Cancers have a highly negative impact on the quality of life of paediatric patients and require an individualised oral treatment program for the phases of the disease. The aim of this study was to update existing research on oral care in children diagnosed with cancer. We carried out a literature search (in English, Spanish and Portuguese) in the Pubmed, Cochrane Library, EBSCO, WOS, SciELO, Lilacs, ProQuest, and SCOPUS databases and the websites of hospitals that treat childhood cancers. We found 114 articles and two hospital protocols. After review, we describe the interventions necessary to maintain oral health in children with cancer, divided into: phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30-45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies.

Effect of Monthly and Bi-Monthly 50,000 International Units (IU) Maintenance Therapy With Vitamin D3 on Serum Level of 25-Hydroxyvitamin D in Adults: A Randomized Controlled Trial.

Background Vitamin D deficiency is a prevalent condition worldwide. Identification of optimal supplementation approaches for maintaining normal vitamin D level in healthy adults is still required. It has been clearly established that sun exposure and diet do not provide the recommended daily amount of vitamin D, and that vitamin D supplementation is needed to maintain normal levels in the Saudi population. The aim of this study was to compare the efficacy of two regimens, monthly and bimonthly doses of 50,000 International Units (IU) cholecalciferol (vitamin D3), in maintaining normal serum levels of 25-hydroxyvitamin D in Saudi adults. Methods This study was a randomized controlled trial conducted to compare the efficacy of three regimens in maintaining a normal level of vitamin D in adult individuals. The study took place at three primary healthcare centers in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia. A total of 65 participants were enrolled and randomly divided into two intervention groups and one control group. All participants were contacted by researchers and followed up at their corresponding primary health care center for two successive visits. Results All 65 participants completed the study. The participants were mostly females (49; 75.4%); the mean age was 42.1 years (±13.5). The difference in vitamin D levels after three months of the trial was statistically significant among the three groups. A decrease in vitamin D level was recorded in the control group and in the once monthly intake of 50,000 IU group. The bimonthly intake of 50,000 IU group maintained statistically significant vitamin D levels > 75. Conclusion Bimonthly vitamin D3 supplementation appears to be an efficient regimen for maintaining a normal level of 25(OH)D, regardless of the amount of vitamin D obtained from diet and sun exposure.

A clinical investigation of dental evacuation systems in reducing aerosols.

BACKGROUND: The route of transmission of severe acute respiratory syndrome coronavirus 2 has challenged dentistry to improve the safety for patients and the dental team during various treatment procedures. The purpose of this study was to evaluate and compare the effectiveness of dental evacuation systems in reducing aerosols during oral prophylactic procedures in a large clinical setting. METHODS: This was a single-center, controlled clinical trial using a split-mouth design. A total of 93 student participants were recruited according to the inclusion and exclusion criteria. Aerosol samples were collected on blood agar plates that were placed around the clinic at 4 treatment periods: baseline, high-volume evacuation (HVE), combination (HVE and intraoral suction device), and posttreatment. Student operators were randomized to perform oral prophylaxis using ultrasonic scalers on 1 side of the mouth, using only HVE suction for the HVE treatment period and then with the addition of an intraoral suction device for the combination treatment period. Agar plates were collected after each period and incubated at 37 °C for 48 hours. Colony-forming unit (CFU) counts were determined using an automatic colony counter. RESULTS: The use of a combination of devices resulted in significant reductions in CFUs compared with the use of the intraoral suction device alone (P < .001). The highest amounts of CFUs were found in the operating zone and on patients during both HVE and combination treatment periods. CONCLUSIONS: Within limitations of this study, the authors found significant reductions in the amount of microbial aerosols when both HVE and an intraoral suction device were used. PRACTICAL IMPLICATIONS: The combination of HVE and intraoral suction devices significantly decreases microbial aerosols during oral prophylaxis procedures.