Periodontal health in mothers of preterm and term infants.

Taiwan J Obstet Gynecol. 2007 Jun;46(2):157-61

Authors: Zadeh-Modarres S, Amooian B, Bayat-Movahed S, Mohamadi M

OBJECTIVE: Recent studies have suggested that chronic periodontitis may induce an inflammatory response which can cause premature delivery. This study was designed to assess the association between periodontal health and preterm labor in Iranian female population. MATERIALS AND METHODS: In this case-control study, 201 pregnant women without systemic disease or other risk factors for preterm labor were chosen. The control group (n = 99) had term labor (infants > or =37 weeks) and the case group (n = 102) had preterm labor (infants < 37 weeks). Bleeding index, pocket depth and debris index were measured. RESULTS: The data of bleeding index (cases, 0.64 +/- 0.38; controls, 0.57 +/- 0.35), probing depth (cases, 2.80 +/- 0.30; controls, 1.63 +/- 0.23) and debris index (cases, 1.38 +/- 0.67; controls, 0.81 +/- 0.38) revealed a statistically significant difference between the two groups (p < 0.05). CONCLUSION: According to the findings of this study, there is a noticeable relationship between periodontal health and duration of pregnancy; periodontal disease could be a risk factor for preterm labor. Oral hygiene is strongly recommended to be included in prenatal care.

PMID: 17638624 [PubMed - indexed for MEDLINE]

Periodontal findings and blood analysis of blood donors: a pilot study.

J Contemp Dent Pract. 2007;8(5):43-50

Authors: Ziebolz D, J&#xE4;ger GC, Hornecker E, Mausberg RF

AIM: Before blood donation a medical check-up is mandatory to ascertain the health of the donor and to detect infections clinically. Although gingivitis and periodontitis are also bacterial infections, the oral cavity is only inspected superficially. The purpose of this study was to investigate the periodontal condition of blood donors and whether this affects the results of their blood tests. METHODS AND MATERIALS: A total of 192 blood donors were examined. The investigation included a periodontal examination to determine the Community Periodontal Index (CPI), an analysis of blood chemistry, as well as the determination of hematologic, coagulation, and immune parameters C-reactive protein (CRP), Neopterin, Procalcitonin (PCT), and tumor necrosis factor (TNF-a). Groups were formed according to periodontal status: "healthy" (n=47, mean age 24+/-4 years), "gingivitis" (n=65, mean age 24+/-4 years), and "periodontitis" (n=80, mean age 29+/-8 years). Most parameters of the routine blood test as well as the immune parameters were unremarkable with regard to the periodontal status. The values for SGPT, GGTP, uric acid, triglycerides, total protein (TP), RBC, hemoglobin (Hb) and hematocrit (HC), Eos, and Baso were also within the normal range. Nevertheless, statistical analysis showed some significant differences in these parameters between the "healthy" group and the "periodontitis" group (p=0.05). RESULTS: The results of this study show some blood donors have infections of the gingiva and/or of other periodontal tissues. Whether this is a sufficient reason to exclude them from blood donation, or in which case potential donors should be excluded, is not yet known. Nevertheless, it seems reasonable to integrate a screening method for revealing at least severe periodontitis in the medical check-up of blood donors.

PMID: 17618329 [PubMed - indexed for MEDLINE]

Assessment of periodontal status in dental fluorosis subjects using community periodontal index of treatment needs.

Indian J Dent Res. 2007 Apr-Jun;18(2):67-71

Authors: Vandana KL, Reddy MS

BACKGROUND: Periodontitis is multifactorial in nature. The various determinants of periodontal disease are age, sex, race, socioeconomic status and risk factors including tobacco usage and oral hygiene status. However, there is inconsistent epidemiological data on the periodontal status of subjects living in high-fluoride areas. The aim of the study was to investigate the effect of dental fluorosis on the periodontal status using community periodontal index of treatment needs (CPITN), as a clinical study. The purpose of this study is to determine the periodontal status using CPITN index in a population aged between 15 and 74 years residing in the high fluoride areas of Davangere district. The possible reasons for the susceptibility of this population to periodontal disease are discussed. MATERIALS AND METHODS: 1029 subjects, aged between 15 and 74 years suffering from dental fluorosis were assessed for their periodontal status. Clinical parameters recorded were OHI-S to assess the oral hygiene status, Jackson's fluorosis index to assess the degree of fluorosis and CPITN index to assess the periodontal status where treatment need was excluded. RESULTS: Gingivitis and periodontitis were more common in females (65.9% and 32.8%,respectively) than in males (75.1% and 24.2%, respectively). Periodontitis was significantly more common in females. As the age advanced from 15 to 55 years and above, gingivitis reduced from 81.0 to 42.9% and periodontitis increased steadily from 18.0 to 57.1%, which was significant. Periodontitis was high in subjects with poor oral hygiene (81.3%), compared to those with good oral hygiene (14.5%), which was significant. As the degree of fluorosis increased, severity of gingivitis reduced and periodontitis increased, i.e, with A degree fluorosis, gingivitis was 89.4% and periodontitis 8.5%, but with F degree fluorosis the former was 64% and the latter 35.8%, which was statistically significant. CONCLUSION: The results suggest that there is a strong association of occurrence of periodontal disease in high-fluoride areas. The role of plaque is well understood in contrast to the effect of fluorides on periodontal tissues. It goes a long way to reason out fluoride as an important etiological agent in periodontal disease.

PMID: 17502711 [PubMed - indexed for MEDLINE]

Greater severity and extent of periodontal breakdown in 136 south Indian human immunodeficiency virus seropositive patients than in normal controls: a comparative study using community periodontal index of treatment needs.

Indian J Dent Res. 2007 Apr-Jun;18(2):55-9

Authors: Ranganathan K, Magesh KT, Kumarasamy N, Solomon S, Viswanathan R, Johnson NW

Apart from the more or less distinctive forms of periodontal disease associated with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome there remains considerable uncertainty as to whether or not conventional destructive periodontitis is exacerbated in HIV positive individuals. This is especially so in developing countries, from which few studies have been reported. The present study compared the severity and extent of periodontal break down in 136 HIV positive individuals from Chennai, South India, with 136 age-matched controls from the same low socio-economic and ethnic group. All surfaces of all teeth were scored for the community periodontal index of treatment needs (CPITN). Statistical analysis was performed using SPSS package. The results of the present study show that CPITN is a simple, useful technique to assess periodontal status in immunosuppressed patients and that periodontitis is associated with immunosuppression and oral candidiasis. The assessment of periodontal statuscould thus be a useful tool in minimally invasive screening of populations for HIV disease, especially in those parts of the world, like India and Africa, with high prevalence and rising incidence.

PMID: 17502708 [PubMed - indexed for MEDLINE]

Association between periodontal disease and acute coronary syndrome.

Arq Bras Cardiol. 2007 Feb;88(2):185-90

Authors: Rech RL, Nurkin N, da Cruz I, Sostizzo F, Bai&#xE3;o C, Perrone JA, Wainstein R, Pretto D, Manenti ER, Bodanese LC

OBJECTIVE: To evaluate the relationship between PD and ACS and the association of PD and periodontitis in ACS patients. METHODS: Fifty-eight ACS patients and 57 controls with no history of coronary artery disease (CAD) were included in the study. Variables: arterial hypertension, diabetes, dyslipidemia, obesity, history of CAD, cigarette smoking, and interleukin-1beta gene polymorphism. RESULTS: One hundred and fifteen subjects were enrolled in the study. In the ACS group, 58 patients were evaluated, 32 of whom (55.2%) were male and 26 (44.8%), female. In the control group, 57 subjects were evaluated, 32 (56.1%) of whom were male and 25 (43.9%), female. Periodontal disease was diagnosed in 26 (44.8%) ACS patients and 15 (26.6%) control patients (beta2 = 4.43, p = 0.04). In a logistic regression analysis, the odds ratio for association between PD and ACS was 1.8 (95% CI: 1.0-5.0); p = 0.24. The odds ratio for association of periodontitis with ACS was 4.5 (95% CI: 1.3-15.6); p = 0.019. CONCLUSION: No independent association was found between PD and ACS. There was an independent association between periodontitis and ACS.

PMID: 17384836 [PubMed - indexed for MEDLINE]

The detection of eight putative periodontal pathogens in adult and rapidly progressive periodontitis patients: an institutional study.

Indian J Dent Res. 2007 Jan-Mar;18(1):6-10

Authors: Joshi VM, Vandana KL

PURPOSE: Periodontal disease is a commonly prevalent problem faced alike by both the developed and third world countries but showing wide variations in prevalence and severity across different geographical areas. The purpose was to identify Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Ekinella corrodens (Ec), Campylobacter rectus (Cr), Bacteroides forsythus (Bf), Treponema denticola (Td) and Fusobacterium nucleatum (Fn) in Indian adult periodontitis and rapidly progressive periodontitis patients. MATERIALS AND METHODS: Paper points were used to collect the sample from 28 sites in both adult periodontitis and rapidly progressive periodontitis (8 healthy/20 diseased sites) patients and DNA analysis done. The categorical data was analysed by Fishers exact test and difference in the clinical parameters was tested by Mann-Whitney test. RESULTS: In healthy sites of adult and rapidly progressive periodontitis patients, Aa, Ec, Bf and Aa, Pg, Pi, Td, Fn were detected respectively. However, when diseased and healthy sites were compared in both adult periodontitis and rapidly progressive periodontitis patients respectively, only Pg( P =0.004), Cr( P =0.04), Fn( P =0.014) and Pg( P =0.002), Cr( P =0.02), Fn( P =0.008) were statistically significant. CONCLUSION: The prevalence of the microorganisms correlate with the clinical parameters like probing depth and bleeding on probing as seen in the Japanese and Western periodontitis patients' population.

PMID: 17347537 [PubMed - indexed for MEDLINE]

Evaluation of the marginal gingival health using laser Doppler flowmetry.

Braz Dent J. 2006;17(3):219-22

Authors: Develioglu H, Kesim B, Tuncel A

The purposes of this study were to compare the gingival blood flow (GBF) in test sites (teeth retaining fixed partial dentures) and control sites (contralateral natural teeth) and investigate whether there is any relationship between clinical indices and GBF values. Twelve healthy subjects (6 females and 6 males) aged 20 to 54 years were enrolled this study. The GBF was measured from the middle point of the marginal gingiva in the test and control sites using laser Doppler flowmetry (LDF). Additionally, plaque index, gingival index and probing depth measurements were recorded. Statistically significant difference (p<0.05) was found between the test and control sites for marginal GBF. In contrast, no significant difference (p>0.05) was found between test and control sites with respect to the clinical indices, except for plaque index. The findings of this study suggest that there is a significant relation between resin-bonded fixed partial dentures with margins located subgingivally and marginal GBF. Clinical indices are helpful to collect information about the clinical health status of gingival tissues, but GBF is a good tool to measure gingival tissue blood flow and assess periodontal health. In conclusion, laser Doppler flowmetry can be used together with clinical indices to evaluate the marginal gingival health.

PMID: 17262128 [PubMed - indexed for MEDLINE]

Periodontal disease in patients with ischemic coronary atherosclerosis at a University Hospital.

Arq Bras Cardiol. 2006 Dec;87(6):695-700

Authors: Barilli AL, Passos AD, Marin-Neto JA, Franco LJ

OBJECTIVE: To verify the prevalence of periodontal disease (PD) in patients with ischemic heart disease. PD is a serious public dental health care problem with a differentiated distribution in regards to severity, age group, type of infection, co-morbidities and risk factors. METHODS: Four hundred and eighty patients were examined at the Ischemic Cardiopathy Outpatient Clinic of the Hospital das Cl&#xED;nicas of the Ribeirão Preto Medical School, São Paulo University, as well as 154 patients without heart disease from the same institution. Fifty-eight patients with heart disease and 62 patients without heart disease between the ages of 30 and 79 met the criteria to be included in the investigation. In accordance with recommendations of WHO (1999) the Community Periodontal Index (CPI) and the Periodontal Attachment Loss Index (PALI) were used. RESULTS: Patients with heart disease had a prevalence of sextants with moderate to advanced PD (76.3% versus 20.2%; p < 0.00001). In these patients, 1.1% of the sextants were found to be healthy versus 32.0% of those without heart disease (p < 0.00001). In regards to the progression of PD, 6.0% of the sextants of the patients with heart disease did not exhibit attachment loss versus 68.0% of those without heart disease (p < 0.00001). Dental biofilm was observed in 100.0% of the patients with heart disease and in 82.3% of those without heart disease (p < 0.001). Treatment of periodontal pockets > 6 mm was required in 79.3% of the patients with heart disease versus 9.7% of those without heart disease (p < 0.0001). CONCLUSION: PD was very prevalent in the groups studied with a higher degree of severity in those with ischemic heart diseases. The elevated prevalence of risk factors found, indicates that intervention strategies are required.

PMID: 17262105 [PubMed - indexed for MEDLINE]

Relationship between maternal periodontal disease and birth of preterm low weight babies.

Braz Oral Res. 2006 Oct-Dec;20(4):318-23

Authors: Alves RT, Ribeiro RA

It has been recently suggested that periodontal disease is an associated factor for prematurity and low birth weight. The aim of this work was to assess the periodontal status of puerperae and determine its possible relationship with preterm low birth weight (PLBW) delivery. The sample included 59 women seen at two maternity hospitals in Juiz de Fora, MG, Brazil. Nineteen mothers had premature and low birth weight babies (gestational age below 37 weeks and birth weight below 2,500 g--group I), and 40 had mature, normal weight babies (gestational age over 37 weeks and birth weight over 2,500 g--group II). The mothers' data were obtained from medical files, interview, and periodontal clinical examination carried out up to 48 hours after delivery. The Periodontal Screening and Recording (PSR) was used for periodontal assessment. The association between periodontal disease and PLBW was expressed as odds ratio (OR). There was a higher rate of periodontal disease in group I (84.21% - 16/19) as compared with group II (37.5% - 15/40). The data also showed a significant association between periodontal disease and PLBW (OR = 8.9 - 95% CI: 2.22-35.65--p = 0.001). It was concluded that maternal periodontal disease was an associated factor for prematurity and low birth weight in this sample.

PMID: 17242792 [PubMed - indexed for MEDLINE]

Periodontal disease as a potential risk factor for acute coronary syndromes.

Arq Bras Cardiol. 2006 Nov;87(5):592-6

Authors: Accarini R, de Godoy MF

OBJECTIVE: To investigate whether there is a relationship between active periodontal disease (PD) and acute coronary syndromes (ACS). METHODS: Three hundred and sixty-one patients (57,3% male), ages ranging from 27 to 89 (mean +/- DP = 60.5 +/- 12.2), were admitted to the Intensive Care Unit of a Teaching Hospital with symptoms and complementary examinations consistent with acute coronary syndrome. All the patients had a complete periodontal examination in the ICU setting, and 325 (90.9%) underwent coronary angiography for diagnostic confirmation and/or treatment planning. Periodontal examination included evaluation of all the teeth in the oral cavity and the following parameters: probing depth, clinical attachment level, plaque index, and gingival index. RESULTS: Of the 325 patients, 91 (28%) had coronary arteries free of obstruction or with mild obstructions (< 50% diameter stenosis), and the remaining 72% had severe obstructions. Fisher's exact text yielded a p value of 0.0245 with an odds ratio of 2.571 (95% CI 1.192 to 5.547), meaning that the group with ACS and significant obstructive coronary artery disease was 2.5-fold more likely to have active PD. CONCLUSION: A significant association was found between active periodontal disease and severe obstructive coronary artery in patients with acute coronary syndrome, underscoring the importance of prevention and adequate treatment of periodontal disease, which should be considered as a potential risk factor in the etiology and instability of the atherosclerotic plaque.

PMID: 17221034 [PubMed - indexed for MEDLINE]

Screening of periodontitis with salivary enzyme tests.

J Oral Sci. 2006 Dec;48(4):177-83

Authors: Nomura Y, Tamaki Y, Tanaka T, Arakawa H, Tsurumoto A, Kirimura K, Sato T, Hanada N, Kamoi K

The purpose of this study was to determine the usefulness of salivary biochemical markers for the screening of periodontal disease and examine the agreement between the results of saliva enzyme tests and those of probing depth. The present study included a total of 187 subjects who underwent annual medical check-ups at the Comprehensive Health Care Center, Honjo, Saitama Prefecture, Japan. Periodontal pocket probing was performed with a WHO probe, and various enzymes and biochemical parameters in saliva were measured. For lactate dehydrogenase (LDH), the proportions of the five isoenzymes were calculated. To decide the cut-off point for each enzymatic activity, receiver operating characteristic curves (ROC curves) were constructed and the points of minimum difference between sensitivity and specificity were decided. Among the biochemical markers tested, salivary LDH level had the highest sensitivity and specificity (sensitivity 0.66, specificity 0.67), while salivary levels of aspartate aminotransferase (AST) and blood urea nitrogen (BUN) also had sensitivity and specificity above 0.60. Among the LDH isoenzymes, LDH4 and LDH5 dominated in whole saliva samples. Salivary LDH may be a feasible and useful parameter for the screening of periodontal disease, while salivary AST and BUN also appear to be potentially useful for this purpose.

PMID: 17220614 [PubMed - indexed for MEDLINE]

Dentinal hypersensitivity?--Can this agent be the solution?

Indian J Dent Res. 2006 Oct-Dec;17(4):178-84

Authors: Madhu PS, Setty S, Ravindra S

AIM: To test the efficacy of desensitizing tooth paste containing EMS salts in alleviating dentinal hypersensitivity, reducing plaque accumulation, and reducing gingivitis. METHODS: A randomised, single blind, parallel placebo controlled study was conducted in 40 cases. The cases were randomly assigned to test and control groups. The test group was instructed to use the test tooth paste (containing EMS salts) and control group a placebo tooth paste (without any therapeutic agents) for a period of 6 weeks. The hypersensitivity levels were measured with scratchometer and verbal rating scale. Student t test and wilcoxon's Mann-Whitney test were used to compare the test and control groups. RESULTS AND CONCLUSION: The results indicated that both the test as well as the control toothpastes were effective in alleviating dentinal hypersensitivity as well as reducing gingivitis. However, the test toothpaste was superior in alleviation of dentinal hypersensitivity.

PMID: 17217214 [PubMed - indexed for MEDLINE]

Oral health status and treatment needs in institutionalized psychiatric patients: one year descriptive cross sectional study.

Indian J Dent Res. 2006 Oct-Dec;17(4):171-7

Authors: Kumar M, Chandu GN, Shafiulla MD

BACKGROUND AND OBJECTIVES: Psychiatric patients are one of the special groups requiring attention as they are often neglected. Oral health is an major determinant of general health for psychiatric patients and may have a low priority in the context of mental illness. The present study was conducted to assess the oral health status and treatment needs of institutionalized psychiatric patients of Davangere. METHODS: 220 psychiatric patients admitted in two general hospitals of Davangere during the period of one year were included in the study. The oral health status was evaluated with respect to caries, oral hygiene, and periodontal status. RESULTS: Of the 180 examined with the response rate of 81.8%. 58.3% were males, mean age was 36.7 years, 57.8% had < 1 year of mental illness with a mean of 2.2 years, and 90% were self-sufficient. The multiple logistic regression analysis showed that the mean DMFT (0.92) increased with age, duration of mental illness, and irregularity of oral hygiene habits (P<0.001). Mean OHI-S score was 3.3 and multiple logistic regression analysis showed that the mean OHI-S score increased with age (P<0.001). The multiple logistic regression analysis showed that the CPI score increased with age, duration of mental illness, and degree of helplessness (P<0.001). INTERPRETATION AND CONCLUSION: The findings of this study demonstrates low caries prevalence, poor oral hygiene, and extensive unmet needs for dental treatment.

PMID: 17217213 [PubMed - indexed for MEDLINE]

Partial recording protocols for periodontal disease assessment in epidemiological surveys.

Cad Saude Publica. 2007 Jan;23(1):33-42

Authors: Vettore MV, Lamarca Gde A, Le&#xE3;o AT, Sheiham A, Leal Mdo C

The objective of the present study was to compare the reliability of four partial-mouth protocols for assessing shallow, moderate, and deep sites for periodontal pocket depth and clinical attachment levels. Periodontal pocket depth and clinical attachment level measurements were recorded for 156 subjects (age > or = 30). The four models of partial-mouth protocols compared were: Model I: all sites per tooth in the random half-mouth protocol randomly selecting one maxillary and mandibular quadrant, Model II: buccal sites in a full-mouth protocol, Model III: buccal sites in the random half-mouth protocol randomly selecting one maxillary and mandibular quadrant, Model IV: all sites per tooth using Community Periodontal Index teeth. In comparison with full mouth examination, Model I did not show significant differences for periodontal pocket depth and clinical attachment level parameters. Models II and III were different for some periodontal pocket depth means, and Model IV significantly overestimated all clinical parameters related to periodontal disease. Model I appears to be adequate to substitute for the full-mouth examination to assess the prevalence and severity of chronic periodontal disease in adults.

PMID: 17187102 [PubMed - indexed for MEDLINE]

Association of psychological well-being with oral conditions in Japanese workers.

J Occup Health. 2006 Nov;48(6):487-93

Authors: Ide R, Hoshuyama T, Wilson D, Takahashi K, Higashi T

Although the effect of disorders on psychological well-being is well-known, there are few studies focusing on oral conditions at the worksite. The present study examined the association between psychological well-being and oral conditions of Japanese workers. A cross-sectional study was performed using data from 1381 Japanese civil service officers aged 20-59 yr old. Psychological well-being was measured with the 12-item version of the General Health Questionnaire (GHQ-12) in a comprehensive health questionnaire, while measures for oral condition included self-rated oral health, oral symptoms and clinical indicators: dental caries, periodontal status and number of missing teeth. The mean GHQ scores according to the levels of each oral condition were estimated by analysis of variance, separately for males and females. Higher scores corresponded to poorer psychological well-being. Age, gender, smoking and type of occupation were adjusted in a multivariate analysis. Psychological well-being was not associated significantly with dental caries, periodontal status or number of missing teeth. The adjusted means of the GHQ scores for ;conscious of appearance of mouth' were significantly different among the categories for both genders (male: p<0.001, female: p=0.018). For five of six oral symptoms, the adjusted means of GHQ scores were lowest for those respondents who rated their oral symptoms as ;never or hardly ever.' Our results did not show that psychological well-being was associated with oral conditions measured by clinical indicators. However, an association was found between some oral symptoms and psychological well-being. Absence of oral symptoms seems to be related to better psychological well-being.

PMID: 17179642 [PubMed - indexed for MEDLINE]

Oral condition and health status of elderly 8020 achievers in Aichi Prefecture.

Bull Tokyo Dent Coll. 2006 May;47(2):37-43

Authors: Hashimoto M, Yamanaka K, Shimosato T, Ozawa A, Takigawa T, Hidaka S, Sakai T, Noguchi T

The purpose of this study was to investigate differences in oral condition and health status between persons with 20 or more teeth at the age of 80 (8020 elderly) and persons of the same age with less than 20 teeth (non-8020 elderly). This study was conducted by a team belonging to the Aichi Dental Association. Number of remaining teeth, Community Periodontal Index of Treatment Needs (CPITN), salivary blood test, masticatory ability, bone mineral density (BMD), grip strength, balance test (length of time one can stand on one leg with eyes open), height, weight and body mass index (BMI) were all examined. The percentages of CPITN code 0, 1 and 2 were 68% in the 8020 male elderly and 72% in the 8020 female elderly. The positive percentage in the salivary blood test in the 8020 elderly was lower than that in the non-8020 elderly. Masticatory ability was 1.55 g in the 8020 male elderly, and 1.53 g in the 8020 female elderly. Relative masticatory ability in the 8020 female elderly was 20% higher than that in the non-8020 female elderly. BMD in the 8020 female elderly was significantly higher than that in the non-8020 female elderly. Grip strength in the 8020 elderly was also significantly higher than that in the non-8020 elderly. The duration of balance test in the 8020 male elderly was 2.2 times longer than that in the non-8020 male elderly. The 8020 elderly showed good oral condition and health status was found to be better in the 8020 elderly than in the non-8020 elderly.

PMID: 17167218 [PubMed - indexed for MEDLINE]

Clinical evaluation of an ionic tooth brush on oral hygiene status, gingival status, and microbial parameter.

Indian J Dent Res. 2006 Apr-Jun;17(2):74-7

Authors: Deshmukh J, Vandana KL, Chandrashekar KT, Savitha B

It has long been recognised that the presence of dental plaque leads to gingivitis and periodontal disease, as well as dental caries. Today tooth brushing is the most widely accepted method of removing plaque. Hence this present clinical study was undertaken to evaluate the effectiveness of an ionic toothbrush on oral hygiene status. For this study, 20 dental students in the age group of 18-20 years were included. All the subjects after undergoing dental prophylaxis were then provided with ionic toothbrushes, either active (equipped with lithium battery) or inactive (without lithium battery). Plaque index and gingival bleeding index were examined at 7th, 14th, and 21st day. Microbial assessment was done for detection of colony forming units (CFU) from the plaque samples which were collected on 0 day and 21st day, both before brushing and after brushing. Results shown a significant reduction in all the parameters and the reduction was more significant in active and inactive ionic toothbrush users. It was concluded that both active and inactive ionic toothbrushes reduced the plaque index and gingival bleeding index scores significantly and active ionic tooth brushes were more effective as compared to inactive ionic toothbrushes. There was no soft tissue trauma following the use of both type of toothbrushes, which showed that ionic toothbrushes were equally safe for regular long-term use.

PMID: 17051872 [PubMed - indexed for MEDLINE]

Detection and measurement of oral malodour in periodontitis patients.

Indian J Dent Res. 2006 Jan-Mar;17(1):2-6

Authors: John M, Vandana KL

BACKGROUND & OBJECTIVES: Malodour has been correlated with the concentration of volatile sulphur compounds produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal sites and the dorsum of the tongue. The aim of this study was to detect malodour in mouth air organoleptically and using a portable sulphide monitor and to correlate it with the clinical parameters, halitosis linked toxins and BANA, using tongue and subgingival plaque samples. The halitosis grading is also correlated with the microbial colonies of the subgingival plaque sample. METHODS: 20 patients with chronic periodontitis with 5-7 mm pocket depth, radiographic evidence of bone loss and presence of oral malodour participated in this study. Assessment of mouth air was done organoleptically and by using a portable sulphide monitor. The clinical parameter, plaque index (PI), gingival index (GI), gingival bleeding index (BI), were obtained from all the areas. Samples for BANA and to detect halitosis linked toxins were taken from the dorsal surface of the tongue and periodontal pockets ranging 5-7 mm. Halitosis related microbial colonies were identified using anaerobic culturing from the subgingival plaque. RESULTS: The scores of PI, GI, BI and sample that tested positive for halitosis linked toxins and with the halitosis grading were not significant. The presence of tongue coating and the halitosis grading and toxin levels were significant. BANA has shown to be non contributory due to technical problems. Anaerobic culture has shown to identify Streptococcus, Bacteroides, Fusobacterium, Porphyromonas and Prevotella colonies. INTERPRETATION & CONCLUSION: The results confirmed that there was no correlation between the clinical parameters, halitosis linked toxins and halitosis grading. The microbial colonies have shown to correlate with the presence of oral malodour.

PMID: 16900888 [PubMed - indexed for MEDLINE]

Dental and periodontal status and risk for progression of carotid atherosclerosis: the inflammation and carotid artery risk for atherosclerosis study dental substudy.

Stroke. 2006 Sep;37(9):2271-6

Authors: Schillinger T, Kluger W, Exner M, Mlekusch W, Sabeti S, Amighi J, Wagner O, Minar E, Schillinger M

BACKGROUND AND PURPOSE: Dental and periodontal disease are potentially involved in the pathogenesis of atherosclerosis. We investigated whether dental and periodontal status is associated with the presence and future progression of carotid stenosis. METHODS: We randomly selected 411 of 1268 participants from the prospective Inflammation and Carotid Artery Risk for Atherosclerosis Study and evaluated dental and periodontal status and oral hygiene at baseline measuring three World Health Organization-validated indices: DMFT (decayed, missing, filled teeth), SLI (Silness-L&#xF6;e Index), and CPITN (community periodontal index for treatment needs), respectively. The degree of carotid stenosis was measured by duplex ultrasound at baseline and after median 7.5 months (range=6 to 9 months) to identify patients with progressive carotid stenosis. RESULTS: DMFT (P<0.01), SLI (P=0.048), CPITN (P=0.007), and edentulousness (P=0.007) were associated with the baseline degree of carotid stenosis. Atherosclerosis progression was observed in 48 of 411 patients (11.7%). DMFT (adjusted odds ratio [OR]=1.11, 95% CI=1.01 to 1.22, P=0.032) and SLI (adjusted OR=1.77, 95% CI=1.09 to 2.79, P=0.021), but not CPITN (adjusted OR=1.51, 95% CI=0.89 to 2.45, P=0.16) were significant predictors of disease progression, irrespective of traditional cardiovascular risk factors and the baseline degree of stenosis. Edentulous patients had a significantly increased risk for disease progression as compared with patients with teeth (adjusted OR=2.10, 95% CI=1.06 to 4.16, P=0.33). CONCLUSIONS: Dental status, oral hygiene, and particularly tooth loss are associated with the degree of carotid stenosis and predict future progression of the disease.

PMID: 16888276 [PubMed - indexed for MEDLINE]

Efficacy of a herbal toothpaste on patients with established gingivitis--a randomized controlled trial.

Braz Oral Res. 2006 Apr-Jun;20(2):172-7

Authors: Ozaki F, Pannuti CM, Imbronito AV, Pessotti W, Saraiva L, de Freitas NM, Ferrari G, Cabral VN

The aim of this randomised, double blind controlled trial was to verify the efficacy of a herbal dentifrice on the reduction of plaque and gingivitis. Forty eight volunteers with established gingivitis were randomly assigned to either a test group (herbal dentifrice) or positive control group (dentifrice with triclosan and fluoride). The dentifrices were distributed in plain white tubes by an independent pharmacy, which revealed the contents of each tube only after the experimental period. Plaque and gingivitis assessments were carried out on baseline and after 28 days of product use. All examinations were conducted by the same calibrated investigator. Subjects were instructed to brush their teeth three times daily using their assigned dentifrice for 28 days. There was a significant reduction in plaque levels in both the test and control groups. However, there was no significant difference between the groups. A significant reduction in gingivitis was observed in both groups, although there was no significant difference between them. No adverse reactions were reported. The authors concluded that both dentifrices were effective in reducing plaque and gingivitis in subjects with established gingivitis.

PMID: 16878213 [PubMed - indexed for MEDLINE]

Stress and inflammation as a detrimental combination for peri-implant bone loss.

J Dent Res. 2006 Aug;85(8):711-6

Authors: Heckmann SM, Linke JJ, Graef F, Foitzik Ch, Wichmann MG, Weber HP

The causes of peri-implant bone loss continue to be controversial. To determine the impact of biomechanical stress and inflammation, we investigated a total of 80 interforaminal implants in situ for more than 10 years. Two stress groups, with 14 patients each, were established: a low-stress situation with single-standing implants, and an increased-stress situation with splinted implants. To categorize inflammation, we introduced a Composite Inflammation Score using 4 inflammatory parameters. Peri-implant bone loss was calculated from digital panoramic radiographs. To differentiate between the effects of stress and inflammation, we compared bone loss in both stress groups at equivalent levels of inflammation. With greater Composite Inflammation Score values, a clear discrepancy between single-standing and splinted implants was evident (p = 0.117/0.000, regression analysis; p = 0.135/0.000, analysis of variance; p = 0.002, t tests). While stress and inflammation alone may not necessarily be detrimental factors, the presence of stress heightens peri-implant bone loss significantly as inflammation increases.

PMID: 16861287 [PubMed - indexed for MEDLINE]

Factors associated with periodontal diseases in Jordan: principal component and factor analysis approach.

J Oral Sci. 2006 Jun;48(2):77-84

Authors: Khader YS

This study was conducted to identify factors associated with periodontal disease in a Jordanian population using principal component and factor analysis techniques. Subjects were 603 dentate patients aged 15-65 years attending dental teaching clinics at the Jordan University of Science and Technology. Their oral hygiene and periodontal status were assessed using plaque index, gingival index, probing pocket depth, clinical attachment level, gingival recession, and number of missing teeth. Factor and principal component analysis and binary logistic regression were conducted to identify factors related to periodontal disease. Probing pocket depth, clinical attachment level, gingival recession, and number of missing teeth were sorted as the same factor and could be combined in one scale to measure the severity of periodontal disease. On the other hand, plaque index and gingival index were sorted as another factor and could be combined in another scale to correlate between oral hygiene and gingival status. The results demonstrated that increased age, low level of education, increased plaque index score, not brushing teeth, smoking more than 15 pack-years, and having diabetes were significantly associated with increased severity of periodontal disease. In conclusion, it was possible to form a standard scale, based on linear combinations of periodontal indices and parameters, to measure the severity of periodontal disease and determine its risk indicators.

PMID: 16858136 [PubMed - indexed for MEDLINE]

Hepatocyte growth factor in saliva is a potential marker of symptomatic periodontal disease.

J Oral Sci. 2006 Jun;48(2):47-50

Authors: Wilczynska-Borawska M, Borawski J, Kovalchuk O, Chyczewski L, Stokowska W

Evidence has been emerging that hepatocyte growth factor (HGF) - a pluripotential regenerative cytokine - is a key factor in the pathogenesis and progression of periodontal disease, mostly through its over-stimulation of gingival epithelial cell growth and impairment of the regeneration of collagenous structures. We measured the levels of immunoreactive HGF in unstimulated whole mixed saliva from 26 patients referred for treatment of periodontal disease, and from 20 healthy subjects. HGF was detected in all saliva samples from the patients, the concentration ranging from 0.06 to 5.38 ng/ml, with a mean concentration of 1.87 +/- 1.32 ng/ml. In healthy individuals, the median salivary HGF level was 0.68 ng/ml (range: 0 - 7.33 ng/ml), being almost 3-fold lower (P < 0.0001) than that in the patients. Periodontal parameters in the patients were: gingival index (GI) 2.0 (0 - 2.8), papillary bleeding index (PBI) 2.2 (0 - 3.2), plaque index (PI) 2.0 (0 - 3.0), probing depth (PD) 3.0 (1.8 - 5.9) mm, and loss of clinical attachment level (CAL) 4.7 (1.1 - 10.6) mm. We found that the salivary HGF level was positively correlated with GI (P = 0.004), PBI (P = 0.046) and PI (P = 0.001), but not with PD (P = 0.351), CAL loss (P = 0.172), number of teeth (P = 0.279) or patient age (P = 0.362). Our findings suggest that salivary HGF concentration may be a novel marker of symptomatic periodontal disease, and that it warrants further validation.

PMID: 16858131 [PubMed - indexed for MEDLINE]

Periodontal disease and atherosclerosis from the viewpoint of the relationship between community periodontal index of treatment needs and brachial-ankle pulse wave velocity.

BMC Public Health. 2006;6:131

Authors: Miyaki K, Masaki K, Naito M, Naito T, Hoshi K, Hara A, Tohyama S, Nakayama T

BACKGROUND: It has been suggested that periodontal disease may be an independent risk factor for the development of atherosclerosis. However, the relationship between periodontal disease and atherosclerosis has not been fully elucidated. This study aimed to assess the effects of periodontal disease on atherosclerosis. METHODS: The study design was a cross-sectional study. Subjects were 291 healthy male workers in Japan. We used the Community Periodontal Index of Treatment Needs (CPITN) score, average probing depth and gingival bleeding index (rate of bleeding gums) to assess the severity of periodontal disease. We also used the Brachial-Ankle Pulse Wave Velocity (baPWV) as the index for the development of atherosclerosis. RESULTS: The unadjusted odds ratio (OR) of atherosclerosis in relation to the CPITN score was 1.41 [95% CI: 1.16-1.73]. However, after adjustment for age, systolic blood pressure and smoking, the CPITN score had no relationship with atherosclerosis (adjusted OR: 0.91 [0.68-1.20]). CONCLUSION: Our results show no relationship between mild periodontal disease and atherosclerosis after appropriate adjustments.

PMID: 16696868 [PubMed - indexed for MEDLINE]

Subgingival and tongue microbiota during early periodontitis.

J Dent Res. 2006 Apr;85(4):318-23

Authors: Tanner AC, Paster BJ, Lu SC, Kanasi E, Kent R, Van Dyke T, Sonis ST

Periodontal infections have a microbial etiology. Association of species with early disease would be useful in determining which microbes initiate periodontitis. We hypothesized that the microbiota of subgingival and tongue samples would differ between early periodontitis and health. A cross-sectional evaluation of 141 healthy and early periodontitis adults was performed with the use of oligonucleotide probes and PCR. Most species differed in associations with sample sites; most subgingival species were associated with subgingival samples. Few species were detected more frequently in early periodontitis by DNA probes. Porphyromonas gingivalis and Tannerella forsythia (Tannerella forsythensis) were associated with early periodontitis by direct PCR. In conclusion, the microbiota of tongue samples was less sensitive than that of subgingival samples in detecting periodontal species, and there was overlap in species detected in health and early periodontitis. Detection of periodontal pathogens in early periodontitis suggests an etiology similar to that of more advanced disease.

PMID: 16567551 [PubMed - indexed for MEDLINE]

Cigarette smoking increases the risk of root canal treatment.

J Dent Res. 2006 Apr;85(4):313-7

Authors: Krall EA, Abreu Sosa C, Garcia C, Nunn ME, Caplan DJ, Garcia RI

Few studies have investigated smoking as a risk factor for root canal treatment. We studied the effect of smoking on the incidence of root canal treatment, controlling for recognized risk factors, in 811 dentate male participants in the VA Dental Longitudinal Study. Participants were not VA patients. Follow-up ranged from 2 to 28 years. Root canal treatment was verified on radiographs and evaluated with proportional hazards regression models. Compared with never-smokers, current cigarette smokers were 1.7 times as likely to have root canal treatment (p < 0.001), but cigar and/or pipe use was not significantly associated with root canal treatment. The risk among cigarette smokers increased with more years of exposure and decreased with length of abstinence. These findings suggest that there is a dose-response relationship between cigarette smoking and the risk of root canal treatment.

PMID: 16567550 [PubMed - indexed for MEDLINE]

Periodontal infections and coronary heart disease: role of periodontal bacteria and importance of total pathogen burden in the Coronary Event and Periodontal Disease (CORODONT) study.

Arch Intern Med. 2006 Mar 13;166(5):554-9

Authors: Spahr A, Klein E, Khuseyinova N, Boeckh C, Muche R, Kunze M, Rothenbacher D, Pezeshki G, Hoffmeister A, Koenig W

BACKGROUND: Chronic inflammation from any source is associated with increased cardiovascular risk. Periodontitis is a possible trigger of chronic inflammation. We investigated the possible association between periodontitis and coronary heart disease (CHD), focusing on microbiological aspects. METHODS: A total of 789 subjects (263 patients with angiographically confirmed, stable CHD and 526 population-based, age- and sex-matched controls without a history of CHD) were included in the Coronary Event and Periodontal Disease (CORODONT) study. Subgingival biofilm samples were analyzed for periodontal pathogens Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Porphyromonas gingivalis, Prevotella intermedia, and Treponema denticola using DNA-DNA hybridization. The need for periodontal treatment in each subject was assessed using the Community Periodontal Index of Treatment Needs (CPITN). The main outcome measures included total periodontal pathogen burden, number of the various periodontal pathogens in the subgingival biofilm, and periodontal treatment needs (according to the CPITN). RESULTS: In multivariable analyses, we found a statistically significant association between the periodontal pathogen burden (log10 of the sum of all pathogens) (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.34-2.74; P<.001) or the number of A actinomycetemcomitans in periodontal pockets (log10) (OR, 2.70; 95% CI, 1.79-4.07; P<.001) and the presence of CHD. In addition, a statistically significant association between an increase in mean CPITN score by 1 and the presence of CHD (OR, 1.67; 95% CI, 1.08-2.58; P = .02) was observed. CONCLUSIONS: Our findings suggest an association between periodontitis and presence of CHD. Periodontal pathogen burden, and particularly infection with A actinomycetemcomitans, may be of special importance.

PMID: 16534043 [PubMed - indexed for MEDLINE]

Validity of the "Community Periodontal Index of Treatment Needs" (CPITN) for population periodontitis screening.

Cad Saude Publica. 2006 Feb;22(2):277-83

Authors: Bassani DG, da Silva CM, Oppermann RV

The aim of the present study was to validate two versions of CPITN for periodontitis diagnosis. A sample of 400 individuals underwent full mouth periodontal examination including Clinical Attachment Loss, Periodontal Pocket Depth, and Sub-gingival Calculus. Full and partial CPITN versions were derived from this exam (gold standard). Contingency tables were constructed and operational characteristics obtained, as well as ROC curves. The results show 58% sensitivity for full CPITN and 80.6% specificity. Positive and negative predictive values were 87% and 46.3%, respectively. According to the test, estimated periodontitis prevalence was 46%, while the figure obtained with the gold standard was 69%. The partial version of the CPITN showed 50% sensitivity and 87.1% specificity. Positive and negative predictive values were 89.6% and 43.9%, respectively. Estimated periodontitis prevalence, through partial CPITN, was 30.5%. Adjusted global agreement (kappa) for partial and full CPITN was 0.32 and 0.29, respectively. Both CPITN versions disagreed significantly with gold standard results (chi-square p < 0.001). As a conclusion, both total and partial CPITN failed to reflect the real periodontal status of the sample.

PMID: 16501740 [PubMed - indexed for MEDLINE]

The transmission of anaerobic periodontopathic organisms.

J Dent Res. 2006 Feb;85(2):182-6

Authors: Lee Y, Straffon LH, Welch KB, Loesche WJ

The oral microbial flora is unique, and available evidence indicates that it is passed vertically from parents to children. In this investigation, we used a chairside assay for the N-benzoyl-DL-arginine-2-naphthylamide (BANA)-sensitive enzyme found in Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythensis, to determine the prevalence of these BANA-positive species in young children and their caregivers. We predicted that if the BANA enzyme was found in plaque samples of children, it would also be present in the plaque samples of the caregivers. Forty-four percent of 150 children had at least one plaque sample positive for the BANA enzyme. If the caregiver was BANA-positive, the odds of the child also being BANA-positive was 35 times more than for a child with a BANA-negative caregiver, after adjustment for the child's age and papillary bleeding score (PBS). Other significant predictors were the PBS of children (p < 0.001), a history of periodontal disease, and the ages of the caregivers (p < 0.001).

PMID: 16434739 [PubMed - indexed for MEDLINE]

Clinical evaluation of dental and periodontal status in a group of oncological patients before chemotherapy.

Med Oral Patol Oral Cir Bucal. 2006 Jan;11(1):E17-21

Authors: L&#xF3;pez-Galindo MP, Bagán JV, Jiménez-Soriano Y, Alpiste F, Camps C

OBJECTIVE: To evaluate the dental status of 88 cancer patients before chemotherapy. MATERIAL AND METHODS: Eighty-eight patients with cancer in different body locations were studied and compared with a control group. Dental plaque was assessed by means of the Silness and Löe index, dental status with the DMFT index, and periodontal status with the modified CPI index. RESULTS: In the oncological patients the mean Silness and Löe index was 1.28-/+0.11. Patients showed multiple missing teeth (mean number 7.55-/+0.80); the mean number of decayed teeth was 2.10-/+0.36; and the mean number of filled teeth was 2.27-/+0.37. As to periodontal status, the mean modified CPI index was 1.45-/+0.11. In the control group, the mean Silness and Löe index was 0.94-/+0.00. The mean number of decayed teeth was 1.21-/+0.25; the mean number of missing teeth was 4.97-/+0.67; and the mean number of filled teeth was 4.82-/+0.44. The mean modified CPI index was 1.29-/+0.10. CONCLUSIONS: Oncological patients in our study showed more dental plaque versus healthy patients and more decayed and missing teeth. However, patients in the control group showed more filled teeth than cancer patients. Periodontal status as determined by the modified CPI index was similar in both patient groups.

PMID: 16388287 [PubMed - indexed for MEDLINE]

Periodic exacerbation of gingival inflammation during the menstrual cycle.

J Oral Sci. 2005 Sep;47(3):159-64

Authors: Koreeda N, Iwano Y, Kishida M, Otsuka A, Kawamoto A, Sugano N, Ito K

Sex hormones are believed to be a risk factor for periodontitis because of their ability to proliferate specific periodontal microorganisms and affect host immunologic response. In this case report, gingival redness and swelling occurred during the menstrual cycle, although the patient maintained good oral hygiene during periodontal treatment. Medical history revealed that exacerbation of gingival inflammation corresponded to the menstrual cycle and occurred during the ovulation period, when estrogen levels are high. Mean bleeding index of the ovulation period (18.9%) showed higher levels than that during the menstrual phase (5.3%). This case indicates that frequent and effective maintenance should be provided while considering the influence of the menstrual cycle, as sex hormones may be involved in exacerbating gingival inflammation.

PMID: 16313095 [PubMed - indexed for MEDLINE]

Oral health status in a population of Nigerian diabetics.

J Contemp Dent Pract. 2005 Nov 15;6(4):75-84

Authors: Ogunbodede EO, Fatusi OA, Akintomide A, Kolawole K, Ajayi A

Oral manifestations of diabetes mellitus have been documented, but the effect of glycemic control on the oral tissues has been scantily reported. The oral health status of 65 metabolically controlled adult diabetic patients attending the Diabetes Clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, was prospectively assessed over six months and compared with that of 54 non-diabetic acting as controls. The mean duration of diabetes was 100.5+/-85.1 months. The difference in periodontal status of the patients and control, assessed using the Community Periodontal Index of Treatment Needs (CPITN), was not statistically significant (p=0.07). The degree of hyposalivation between the two groups was, however, statiscally significant (p<0.05). No significant difference was observed in the altered taste, burning mouth sensation, angular cheilitis, glossitis, and stomatitis status of the two groups. We conclude, with adequate metabolic control, the oral health status of a diabetic may not be significantly different from that of a non-diabetic except for xerostomia. A good understanding of the interactions between systemic diseases and oral health is imperative for physicians and dental practitioners. The need for early detection and closer linkages between the dental and medical professions in managing diabetic patients is emphasized.

PMID: 16299609 [PubMed - indexed for MEDLINE]

Obesity and periodontal disease in diabetic pregnant women.

Braz Oral Res. 2005 Apr-Jun;19(2):83-7

Authors: Chapper A, Munch A, Schermann C, Piacentini CC, Fasolo MT

This cross-sectional study investigated the impact of pregestational overweight and obesity on periodontal status of patients with gestational diabetes mellitus (GDM). Sixty pregnant women with gestational diabetes mellitus (GDM) were recruited for the study. According to the pregestational body mass index (BMI), patients were classified into 3 groups: normal, overweight or obese. The periodontal assessment parameters were the presence of gingival bleeding (GB) and bleeding on probing (BOP) per tooth. Clinical attachment loss (CAL) was assessed per tooth and classified according to following values: 1) absence of attachment loss; 2) between 1 and 2 mm, 3) between 3 and 5 mm; and 4) CAL > or = 6 mm. The means of individual percentage of teeth with GB and BOP and the means of the individual classified values of CAL were compared through ANOVA. Differences between the groups were established through post hoc Bonferroni test for multiple comparisons (p < 0.05). The analysis revealed significant differences between the normal group and the obese group considering GB (52.76% +/- 27.99% and 78.85% +/- 27.44%, respectively) and CAL (2.21 +/- 0.41 and 2.61 +/- 0.54, respectively). Although an increase was found in BOP as the BMI increased (ranging from 55.65% to 75.31%), no statistically significant differences were found among the groups. Patients with GDM and pregestational obesity had significantly more gingivitis and periodontal attachment loss that those with normal pregestational BMI. Periodontal treatment should be considered in the establishment of future recommendations for metabolic control for this special group of patients.

PMID: 16292438 [PubMed - indexed for MEDLINE]

[Assessment of periodontal condition of kidney patients in hemodialysis]

Rev Assoc Med Bras. 2005 Sep-Oct;51(5):285-9

Authors: Souza CR, Lib&#xE9;rio SA, Guerra RN, Monteiro S, Silveira EJ, Pereira AL

OBJECTIVES AND METHODS: Thirty patients undergoing hemodialysis were evaluated for their periodontal condition through plaque, calculus and gingival indexes; PSR and IgA present in the saliva were also appraised in order to determine the periodontal condition of patients presenting chronic kidney disease. RESULTS: Results obtained demonstrated that in the studied group the plaque, calculus and gingival indexes were high. With regard to these patients' requirement to undergo periodontal treatment, most patients submitted to hemodialysis needed better oral hygiene, in addition to supra and sub gingival scraping and topic application of fluor (code 2). As to the IgA amount present in the saliva, only three patients showed a low density. CONCLUSIONS: Patients presenting chronic kidney disease disclosed a tendency for greater bacterial plaque concentration, high formation of dental calculus suggesting the need for periodontal treatment comprising supra and sub gingival scraping.

PMID: 16270147 [PubMed - indexed for MEDLINE]

A prospective, randomized clinical study on the effects of an amine fluoride/stannous fluoride toothpaste/mouthrinse on plaque, gingivitis and initial caries lesion development in orthodontic patients.

Eur J Orthod. 2006 Feb;28(1):8-12

Authors: Øgaard B, Alm AA, Larsson E, Adolfsson U

The aim of this study was to examine the effect of combined use of a toothpaste/mouthrinse containing amine fluoride/stannous fluoride (AmF/SnF2; meridol) on the development of white spot lesions, plaque, and gingivitis on maxillary anterior teeth in orthodontic patients. A prospective, randomized, double-blind study with 115 orthodontic patients (42 males and 73 females, average age 14.4 years, drop outs 18) was designed. Group A (50) brushed twice daily with an AmF/SnF2 toothpaste (1400 ppm F) and rinsed every evening with an AmF/SnF2 solution (250 ppm F). Group B (47) brushed twice daily with a sodium fluoride (NaF) toothpaste (1400 ppm F) and rinsed every evening with a NaF solution (250 ppm F). Visible plaque index (VPI), gingival bleeding index (GBI) and white spot lesion index (WSL) were recorded on the six maxillary anterior teeth at bonding and after debonding, and evaluated with t tests. In group A no significant differences between bonding and debonding were recorded for WSL (1.02 +/- 0.08 versus 1.05 +/- 0.13, P = 0.14), VPI (0.10 +/- 0.21 versus 0.12 +/- 0.21, P = 0.66) or GBI (0.13 +/- 0.21 versus 0.16 +/- 0.22, P = 0.47), whereas statistically significant differences were found in group B between bonding and debonding for WSL (1.00 +/- 0.02 versus 1.08 +/- 0.17, P = 0.01), VPI (0.06 +/- 0.13 versus 0.17 +/- 0.25, P = 0.01) and GBI (0.06 +/- 0.12 versus 0.16 +/- 0.21, P = 0.01). The increase in lesions on the upper anterior teeth was 4.3 per cent in group A and 7.2 per cent in group B. It was concluded that the combined use of an AmF/SnF2 toothpaste/mouthrinse had a slightly more inhibitory effect on white spot lesion development, plaque and gingivitis on maxillary anterior teeth during fixed orthodontic treatment compared with NaF.

PMID: 16230329 [PubMed - indexed for MEDLINE]

Estimation of salivary bacteria capable of inhibiting and stimulating Streptococcus mutans and its correlation to dental caries and untreated carious teeth.

J Indian Soc Pedod Prev Dent. 2005 Sep;23(3):126-30

Authors: Hegde SK, Kumar KB, Sudha P, Bhat SS

Bacteriocins are bacteriocidal proteinaceous molecules produced by the Gram-positive bacteria not active against the produced strain. Many investigations have revealed that certain bacteria using antibacterial or the inhibitory substance inhibit some other bacteria. A study was conducted in a group of 60 children to ascertain whether any correlation exists between the proportion of salivary bacteria inhibiting and stimulating Streptococcus mutans and the oral health indices (DMFT, deft and Community Periodontal Index of Treatment Needs). A definite inverse correlation was observed between the percentage of salivary inhibiting S. mutans and untreated carious teeth (UCT).

PMID: 16224131 [PubMed - in process]

Association between serum concentrations of 25-hydroxyvitamin D and gingival inflammation.

Am J Clin Nutr. 2005 Sep;82(3):575-80

Authors: Dietrich T, Nunn M, Dawson-Hughes B, Bischoff-Ferrari HA

BACKGROUND: Vitamin D has been shown to have immunomodulatory effects in in vitro and in animal studies. However, data from clinical studies of inflammatory diseases are scarce. OBJECTIVE: The purpose of this study was to evaluate the association between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and gingival inflammation. DESIGN: We analyzed data from 77,503 gingival units (teeth) in 6700 never smokers aged 13 to >90 y from the third National Health and Nutrition Examination Survey. Multiple logistic regression models adjusted for subject- and site-specific covariates included age, sex, race-ethnicity, income, body mass index, diabetes, use of oral contraceptives and hormone replacement therapy among women, intake of vitamin C, missing teeth, full crown coverage, presence of calculus, frequency of dental visits, and dental examiner and survey phase. Generalized estimating equations were used to account for correlated observations within subjects. RESULTS: Compared with sites in subjects in the lowest 25(OH)D quintile, sites in subjects in the highest 25(OH)D quintile were 20% (95% CI: 8%, 31%) less likely to bleed on gingival probing (P for trend < 0.001). The association appeared to be linear over the entire 25(OH)D range, was consistent across racial or ethnic groups, and was similar among men and women as well as among users and nonusers of vitamin and mineral supplements. CONCLUSIONS: Vitamin D may reduce susceptibility to gingival inflammation through its antiinflammatory effects. Gingivitis may be a useful clinical model to evaluate the antiinflammatory effects of vitamin D.

PMID: 16155270 [PubMed - indexed for MEDLINE]

Alterations in gingival dimensions following rapid canine retraction using dentoalveolar distraction osteogenesis.

Eur J Orthod. 2005 Aug;27(4):324-32

Authors: G&#xFC;rgan CA, Işeri H, Kişnişci R

The aim of this clinical prospective study was to evaluate the alterations that occurred in the gingival dimensions of canine teeth following dentoalveolar distraction (DAD) during a 12 month follow-up period.The study sample comprised 36 maxillary canines of 18 growing or adult subjects with a mean age of 16.94 years (13.08-25.58 years) at the start of treatment. Full retraction of the canines was achieved in 10.36 +/- 1.93 days (range 8-14 days) at a rate of 0.8 mm/day using a custom-made intraoral rigid tooth-borne distraction device. Before surgery (pre-DAD), immediately after removal of the device (post-DAD), and at 1, 6, and 12 months post-DAD, the plaque index (PI), gingival index (GI), pocket depth (PD) and width of keratinized gingiva were recorded and the width of attached gingiva was calculated. The alterations in clinical measurements among different evaluation periods were analysed by Friedman and repeated measure ANOVA tests.There were significant differences between pre- and post-DAD for PD measurements for all sites, with the highest at the distal site. The palatal sites likewise showed significant differences at the 1, 6, and 12 month follow-up periods compared with the post-DAD period. The buccal sites showed no significant changes at any time point. The width of keratinized gingiva also showed no significant change during the follow-up period, while the width of attached gingiva was significant only between the pre- and post-DAD periods (P < 0.01). On the basis of the above findings, it could be concluded that DAD is an innovative technique with no unfavourable long-term effects on the gingival tissues of rapidly retracted canine teeth.

PMID: 16043471 [PubMed - indexed for MEDLINE]

Dental death rate prevalence in smokers and non smokers adults with periodontal disease.

Med Oral Patol Oral Cir Bucal. 2005;10 Suppl 2:E109-16

Authors: Feser G, Funosas E, Marí G, Escovich L

The current study target was to evaluate the dental loss pattern in an adult population with periodontal disease who was treated at the Periodontal Chair, Dentistry Faculty, National University of Rosario, Argentina. The sample was of 203 patients, 130 women and 73 men; 75 of them were blond cigarette smokers and 128 of them were not in that habit. Inclusion criteria as follows: good systemic condition given by the absence of illnesses that may be risky for the development of a periodontal disease, and the presence of at least one teeth with insertion loss of 2 mm. minimum in its proximal faces. The age average of the group was 37,83 years (IC 95% 34,46-41,19) for smokers, and 40,98 (IC 95% 38,27- 43,69) years for non smokers. Regarding females, 85 of them were non smokers and 45 had that habit; concerning men 43 were non smokers and 30 were indeed. The independence test made under smoking and sex variables showed no significant relation between them. Regarding smoker group the smoked cigarette average per day (daily doses) was 13,27 cigarettes (IC 95% 10,96-15,57) and the time since habit started in measure of months was 193,57 (IC 95% 160,43-226,81). The death rate for tooth loss in each group was 4,71 teeth (CI 95 % 3,43-5,98) for smokers and 5,05 teeth (CI 95% 4,07-6,03) for non-smokers. Setting the probability of error of type I equal to 0.05, this study demonstrated that in this group of patients with periodontal disease, the tooth loss in smoker individuals was similar to the tooth loss in non-smoker individuals.

PMID: 15995569 [PubMed - indexed for MEDLINE]

[The influence of smoking on oral health]

Medicina (Kaunas). 2005;41(5):418-26

Authors: Kelbauskas E, Kelbauskiene S, Nedzelskiene I

Smoking is a serious risk factor for many diseases. The determining of smoking as a harmful habit among young people is very important. We examined 618 (mean age 21+/-2.9 years) young Lithuanian men. The findings of our research showed that 70% of young men smoked. The analysis of the research findings showed that smoking had a negative effect on oral hygiene. Young men who smoke daily had significantly higher oral hygiene index than those who do not smoke (Simplified Oral Hygiene Index (OHI-S)=2.9(1.0) and OHI-S=2.2(1.2), respectively; p<0.001). Smoking is especially harmful to the periodontal tissues. The periodontal lesions were more prevalent and severe among young men who smoke. It is confirmed by the fact that smokers had significantly higher Community Periodontal Index of Treatment Needs (CPITN) than nonsmokers (CPITN=1.5(0.7) and CPITN=1.2(0.8), respectively; p<0.001). Our findings show that smoking increased the possibility of having decayed untreated teeth and this shows young men's careless attitude to their oral health. There was no difference in the prevalence of smoking among men who live in the countryside and those who live in the city. However, the men with poorer education smoked more frequently.

PMID: 15947526 [PubMed - indexed for MEDLINE]

The effect of menopause, hormone replacement therapy (HRT), alendronate (ALN), and calcium supplements on saliva.

J Contemp Dent Pract. 2005 May 15;6(2):10-7

Authors: Yal&#xE7;in F, Gurgan S, Gurgan T

PURPOSE: In menopausal women many physiological changes take place, most of which are due to decreased estrogen production. It is known estrogen influences oral health in a number of ways and saliva undergoes variations depending upon the levels of this hormone. MATERIALS AND METHODS: The study was designed to evaluate the relationship of menopause, hormone replacement therapy (HRT), alendronate (ALN), and calcium supplements on salivary flow rate, saliva pH, and electrolytes. A group of a group of 14 osteoporotic women in menopause with an age average of 50.7 and 14 non-menopausal women with an age average of 42.4 and were selected as subjects. The oral status of the subjects was determined using the Community Periodontal Index of Treatment Needs (CPITN), the Decayed, Missing and Filled Teeth (DMFT) and the Decayed, Missing and Filled Surfaces (DMFS) indices. The non-stimulated whole saliva samples were subsequently collected from the women in both the control and experimental groups and then analyzed biochemically. The women comprising the experimental group received HRT supplemented with ALN and calcium; saliva collecting and analyzing procedures were repeated at the third and sixth months of the treatment. RESULTS: The most significant oral discomfort in women in the menopausal period was oral dryness, and this symptom was relieved after HRT with ALN and calcium supplements. The oral status of the non-menopausal women was better than the women in menopause. The salivary flow rate was decreased in the menopausal period and increased after HRT, ALN, and calcium supplementation. The saliva pH values were not affected by menopause and HRT with ALN and calcium supplementation. The level of Na+ was increased with menopause and did not change with HRT supplemented with ALN and calcium, whereas the K+ level decreased in the menopausal period and remained constant after HRT with ALN and calcium. The Cl- level was not affected by menopause and the HRT supplemented with ALN and calcium. The Ca++ level was not different in the two groups of women and did not change after HRT supplemented with ALN and calcium. CONCLUSION: HRT with ALN and calcium supplementation affected some factors in saliva positively.

PMID: 15915200 [PubMed - indexed for MEDLINE]

Correlation study on oral health and electrocardiogram abnormalities.

J Oral Sci. 2004 Dec;46(4):241-6

Authors: Tamaki Y, Nomura Y, Inoue K, Inosita E, Tsurumoto A, Hanada N

The purpose of this study was to investigate the association between periodontal conditions and electrocardiogram test results that were obtained to screen for coronary heart disease risk factors. The present study included a total of 578 subjects who underwent annual medical check-ups at the Total Health Care Center in Otsu, Shiga Prefecture, Japan. To calculate the odds ratios for the electromyography abnormalities, we performed a logistic regression analysis for the oral examination, electrocardiogram, and blood analysis data. The crude odds ratio was obtained by a logistic regression analysis of age, sex, number of missing teeth, number of filled teeth, simplified oral hygiene index, community periodontal index, and blood analysis factors and results indicated there was a statistically significant correlation with the prevalence of electrocardiogram abnormalities. However, electrocardiogram abnormalities have a strong correlation with demographic factors such as sex and age. Therefore the experimental factors representing oral status were reexamined after the odds ratios were adjusted for age and sex. As a result of this adjustment, the new odds ratios that were determined indicated that there were no correlations between the oral factors and the prevalence of electrocardiogram abnormalities.

PMID: 15901069 [PubMed - indexed for MEDLINE]

[The effect of regular scaling on periodontal health in fixed orthodontic treatment]

Shanghai Kou Qiang Yi Xue. 2005 Apr;14(2):140-2

Authors: Wei J

PURPOSE: The purpose of this study was to investigate the effect of scaling and teeth brushing with YAHAO toothpaste (eugenol and borax cream) on periodontal health in fixed orthodontic treatment. METHODS: 48 patients who needed fixed orthodontics were chosen to enroll a single-blind randomized study. The patients were randomly divided into two groups: the control group and the treatment group. Patients in the treatment group were treated with scaling and teeth brushing with YAHAO toothpaste. The changes of GI, PLI and SBI were recorded at the beginning of the treatment and after 3 months. SPSS 10.0 software package was used for Student's t test and Chi-square test. RESULTS: There was no significant difference in the periodontal indexes between the two groups before treatment. But there was a statistically significant difference in the incidence of gingivitis (P<0.01) between the two groups after treatment. CONCLUSION: The increase in the periodontal index and the rate of gingivitis in the treatment group were statistically significantly lower than that in the control group, which means that using scaling and teeth brushing with YAHAO toothpaste can effectively reduce the rate of gingivitis.

PMID: 15886837 [PubMed - in process]

Clinical and other risk indicators for early periodontitis in adults.

J Periodontol. 2005 Apr;76(4):573-81

Authors: Tanner AC, Kent R, Van Dyke T, Sonis ST, Murray LA

BACKGROUND: Periodontal diseases affect over half the adults in the U.S., disproportionately affecting minority populations. Periodontitis can be treated in early stages, but it is not clear what features indicate, or could be risk factors for, early stages of periodontal attachment loss. This study aimed to evaluate associations between clinical and other risk indicators of early periodontitis. METHODS: A cross-sectional evaluation of 225 healthy and early periodontitis adults aged 20 to 40 years was performed. Clinical measurements, demographic information, and smoking histories were recorded. Analyses evaluated demographic and clinical associations with health and early periodontitis disease categories and periodontal attachment loss. Patterns of attachment loss at interproximal and buccal/lingual sites were evaluated. RESULTS: Subject age, plaque, and measures of gingivitis exhibited associations with attachment loss and probing depth. More periodontal attachment loss was detected in African-American and Hispanic subjects compared to Asian and Caucasian subjects. Smoking history was associated with attachment loss. At interproximal sites, lower molars most frequently had attachment loss, whereas at buccal/lingual sites, higher proportions of lower bicuspid teeth demonstrated attachment loss compared with other sites. CONCLUSIONS: In this study of subjects with minimal attachment loss, gingival inflammation was associated with early periodontitis. Lower molar interproximal sites were frequently associated with interproximal attachment loss, whereas lower bicuspid teeth were at risk for gingival recession on buccal surfaces.

PMID: 15857098 [PubMed - indexed for MEDLINE]

Presence of Actinobacillus actinomycetemcomitans on the Community Periodontal Index (CPI) teeth in periodontally healthy individuals.

J Contemp Dent Pract. 2005 Feb 15;6(1):85-93

Authors: Cortelli SC, Feres M, Shibli JA, Figueiredo LC, Padilha de Oliveira V, Cortelli JR

The aim of this study was to compare the prevalence of Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans) located at Community Periodontal Index (CPI) teeth versus randomly selected teeth to determine if the CPI teeth are representative of this bacteria subgingival colonization in periodontally healthy young individuals. Forty-four individuals between 18 and 27 years of age were included in the study (mean age 23.11 +/- 2.91 years). Pooled subgingival plaque samples were collected with paper points from the mesio-buccal aspect of the CPI teeth (10 teeth for adults and 6 teeth for persons under 20 years of age) and transported in reduced Ringer's solution to the culture medium. Sixty days following the first microbial analysis, new pooled microbial samples were obtained from the mesio-buccal aspect of 10 or 6 randomly selected teeth. The presence of A. actinomycetemcomitans was determined using a selective culture medium. Microbiological data were assessed by the Wilcoxon test (p < 0.05). A border line significance (p=0.51) was observed between CPI teeth and randomly selected teeth in terms of detecting the subgingival occurrence of A. actinomycetemcomitans. CPI teeth showed to be representative of A. actinomycetemcomitans subgingival colonization. Therefore, these results suggest that in periodontally healthy young individuals, CPI teeth could be an appropriate source of samples for the subginginval detection of this pathogen.

PMID: 15719080 [PubMed - indexed for MEDLINE]

Detection of Tannerella forsythia and/or Prevotella intermedia might be useful for microbial predictive markers for the outcome of initial periodontal treatment in Koreans.

Microbiol Immunol. 2005;49(1):9-16

Authors: Kook JK, Sakamoto T, Nishi K, Kim MK, Seong JH, Son YN, Kim DK

A proportion of diseased sites in periodontal disease do not respond to the initial treatment, which might be due in part to the presence of specific microbial pathogens. The aim of this study was to clarify the value of microbial screening for predicting the outcome of periodontal treatment in Koreans using a polymerase chain reaction (PCR). This study enrolled 32 adults with periodontal disease. Microbial and clinical examinations were performed at the baseline and after the initial treatment (professional toothbrushing, scaling, and root planing). Subgingival plaque samples were taken from four sites in each subject (total 128 samples). PCR was used to detect the four putative pathogenic bacteria. There was an improvement in the average of each clinical measurement after the initial treatment. However, approximately half of the sites exhibiting bleeding upon probing (BOP) at the baseline still exhibited bleeding after treatment. There was a close association between the presence of BOP and the presence of Tannerella forsythia (formerly Bacteroides forsythus) and/or Prevotella intermedia. Furthermore, the sites harboring both T. forsythia and P. intermedia at the baseline had a poorer response to treatment than the sites where these two species were not detected. Therefore, microbial screening for T. forsythia and P. intermedia might be useful for predicting the treatment outcome in Koreans.

PMID: 15665448 [PubMed - indexed for MEDLINE]

Lesions of the oral mucosa and periodontal disease behavior in pregnant patients.

Med Oral Patol Oral Cir Bucal. 2004 Nov-Dec;9(5):434-7; 430-3

Authors: D&#xED;az-Guzmán LM, Castellanos-Suárez JL

AIMS: A study is made to contrast the prevalence and severity of periodontal disease, the needs for periodontal treatment, and the prevalence of lesions of the oral mucosa in pregnant (study group) and non-pregnant women. STUDY DESIGN: During the period 1991-1999, a prospective observational study was made of 7952 women seen in the Dental School of De La Salle Bajío University (Leon, Gto. Mexico). The following variables were documented: age, disease antecedents, simplified periodontal index, and lesions of the oral mucosa. Two patient groups were defined: pregnant and non-pregnant women exhibiting a similar age distribution. The data were presented as percentages, and comparisons were made based on the chi-square test. RESULTS: Pregnancy was not found to be a decisive factor for the development of periodontal disease, no differences in the prevalence of gingivitis (54.54 and 50.50%) and periodontitis (31.82 and 31.75%) being observed between the two groups. However, the severity of periodontitis was significantly greater among the pregnant women (18.18% versus 9.88%; p< 0.01). The prevalence of oral mucosal lesions was similar in both groups (30%), 13 lesions being identified in the study group, with a predominance of leukoedema, traumatic ulceration, red traumatic lesions, benign migratory glossitis (geographic tongue), irritative keratosis and pyogenic granuloma. The non-pregnant women in turn exhibited 57 lesions. Pyogenic granuloma and benign migratory glossitis exhibited significant differences between the two groups (p< 0.005). CONCLUSIONS: Gingivitis and periodontitis showed similar prevalences in pregnant and non-pregnant women, though severe periodontitis was more frequent among the former. Pyogenic granuloma and benign migratory glossitis were the lesions with the greatest prevalences during pregnancy.

PMID: 15580121 [PubMed - indexed for MEDLINE]

The comparison of various oral hygiene strategies in neuromuscularly disabled individuals.

J Contemp Dent Pract. 2004 Nov 15;5(4):23-31

Authors: Bozkurt FY, Fentoglu O, Yetkin Z

BACKGROUND: This study aims to investigate the effect of various oral hygiene strategies on the symptoms of inflammation in neuromuscularly disabled patients and to define the optimum hygiene method. METHODS: Fifty-nine neuromuscularly disabled participants, suffering from cerebral palsy, were randomly divided into five groups as follows: Group M: manual toothbrush (n=14), Group E: electrically powered toothbrush (n=9), Group MC: manual toothbrush and chlorhexidine gluconate (CHX) spray (n=13), Group EC: electrically powered toothbrush and CHX spray (n=9), and Group C: CHX spray (n=14). The oral hygiene applications were provided by the parents and staff. At baseline and after 21 days the plaque index (PI), the gingival index (GI), and bleeding on probing (BOP) were recorded. RESULTS: In intra-group comparisons of the pre- and post-application scores, in all groups the PI and GI scores and BOP percentages, except in Group C, were found significantly different (p<0.05). There were significant differences among the post-application scores, between Group M and Group E and between Group C and Group E in PI scores; between Group C and Group E the difference in GI scores were found statistically significant (p<0.05). CONCLUSIONS: Although all oral hygiene strategies reduced plaque and gingival inflammation, the results of our study suggested the electrically powered toothbrush could be more recommendable to neuromuscularly disabled people in these strategies, while the combined procedures appeared to be neither beneficial nor favorable.

PMID: 15558087 [PubMed - indexed for MEDLINE]

Macleya cordata and Prunella vulgaris in oral hygiene products - their efficacy in the control of gingivitis.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2004 Jul;148(1):103-5

Authors: Ad&#xE1;mková H, Vicar J, Palasová J, Ulrichová J, Simánek V

A double-blind, placebo-controlled clinical trial was performed to investigate the effectiveness of a herbal-based dentifrice in the control of gingivitis. Forty volunteers completed the 84-day study. All subjects were balanced for parameters measured - plaque index (PI), community periodontal index of treatment needs (CPITN) and papillary bleeding index (PBI). The dentifrice was effective in reducing symptoms of gingivitis as evaluated by the CPITN and PBI indexes.

PMID: 15523557 [PubMed - indexed for MEDLINE]

The prevalence of bacteraemia on removal of fixed orthodontic appliances.

Eur J Orthod. 2004 Aug;26(4):443-7

Authors: Burden DJ, Coulter WA, Johnston CD, Mullally B, Stevenson M

This study investigated the prevalence of bacteraemia on removal of fixed appliances. Venous blood samples were taken before and after debonding and debanding for 30 patients (mean age 17 years 8 months) who had worn fixed appliances for an average of 19 months. Before removal of the fixed appliances, bacteraemia was detected in one of the 30 subjects (3%) and in four subjects (13%) following removal of their fixed appliances. The 95 per cent confidence intervals for the prevalence of post-debanding bacteraemia were 3.8 and 30.7 per cent. No significant relationship was detected between the mean plaque scores (t = -0.65, P = 0.52) or the mean gingival scores (t = 0.75, P = 0.46) and the occurrence of bacteraemia. The prevalence of bacteraemia detected following debanding in this study is considerably lower than reported for dental procedures traditionally covered by antibiotic prophylaxis guidelines.

PMID: 15366390 [PubMed - indexed for MEDLINE]