Search Results (18)

Background: This study aimed to assess the effectiveness of a modified entire papilla preservation technique (MEPPT) for treating isolated intrabony defects in patients with stage III periodontitis. Material and Methods: Fifteen patients with 15 interdental intrabony defects were treated with a MEPPT using enamel matrix derivative and allogenic bone. Their probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), keratinized tissue width (KTW), defect depth (DD), full-mouth plaque score (FMPS), full mouth bleeding score (FMBS), radiographic images (radiographic angles, BF and LDF) and intrasurgical parameters were assessed at baseline and 3 years postsurgery. Standardized measurements were taken to evaluate the defect characteristics and treatment outcomes. Results: At 3 years, significant improvements from baseline were maintained. Probing pocket depth (PPD) decreased from 7.03 ± 1.61 mm to 3.33 ± 0.89 mm (p < 0.0001), clinical attachment level (CAL) improved to 3.08 ± 1.16 mm (p < 0.001) and defect depth (DD) decreased from 4.59 ± 1.24 mm to 0.38 ± 0.31 mm (p < 0.001). The changes in gingival recession and keratinized tissue were not statistically significant. The results demonstrate sustained clinical stability over a 3-year period. Conclusions: Within the limitations of this study, the findings suggest that the modified entire papilla preservation technique (MEPPT) in conjunction with enamel matrix proteins and allogenic bone grafting is an effective approach for the treatment of intrabony defects, leading to statistically significant and sustained clinical improvements over a 3-year period. The study protocol was registered in ClinicalTrials.gov ID NCT05029089. Full article

Background: Drug-induced gingival enlargement is a commonly documented adverse effect in patients administered with calcium antagonist medications. Nifedipine is the medicine most frequently linked to instances of gingival enlargement; nevertheless, amlodipine, likewise a calcium antagonist, can elicit this adverse effect. This case report aims to detail a case of amlodipine-induced gingival hyperplasia, emphasizing the significance of a multidisciplinary approach and outlining its therapy across various surgical phases. Methods: A 48-year-old hypertensive patient using amlodipine therapy presents with aberrant gingival tissue growth in the upper arch. Intraoral examination reveals localized inflammation and tissue enlargement in the papillae areas of the upper arch gingiva, leading to partial covering of the dental crowns. The patient experienced painful sensations and episodes of spontaneous bleeding in the enlarged gingival tissue. Following an initial professional dental hygiene treatment, which included root planning in the upper quadrants, and in consultation with the referring cardiologist, it was determined to discontinue amlodipine and initiate a replacement therapy with olmesartan medoxomil. Fifteen days following the cessation of amlodipine, surgical excision of the thickened interdental gingival tissues in the anterior region was conducted to obtain biopsies for histological confirmation of the observed pathological condition. Results: Histopathological examination validated the diagnosis of drug-induced gingival enlargement, characterized by chorion fibrosis and significant lymphoplasmacytic infiltration. Specifically, parakeratotic and acanthotic characteristics were seen in the gingival epithelium. Adjacent to the inflammatory regions, fibrosis was noted, along with the presence of cytoid bodies, which are typically linked to pathological diseases driven by inflammatory processes. These histological characteristics were consistent with the diagnosis of drug-induced gingival enlargement. Conclusions: A multidisciplinary approach involving the treating physician, dentist, and hygienist, incorporating drug replacement and targeted oral hygiene sessions, is crucial for the management and resolution of calcium channel blocker-induced gingival enlargement. Full article

Background/Objectives: Oral hygiene is a key factor for dental and periodontal diseases and the prognosis of any treatment to restore their consequences. The present survey aimed to evaluate how well informed patients in Albania are on oral hygiene, given the scarce evidence on this topic. Methods: This survey was performed using a Google Forms questionnaire on oral hygiene habits, type and technique of instruments used, and frequency of dental recall visits. Results: A total of 1006 questionnaires were filled in a one-month time period (January 2020) from a population of 75.2% females and 24.8% males, 32.7 ± 11.3 years of age, from whom 94.6% reported a lack of systemic diseases and 80% were non-smokers. All of the population brushed their teeth at least once daily. The most used type of toothbrush was a manual one (91.1%) with medium-bristle hardness in 71% of cases. The most prevalent way of using the toothbrush was through circular movements (36.7%) with a duration of 2–3 min in 72% of the population. Only 77.1% of the population used interdental instruments, mainly interdental floss. Conclusions: Within the limits of this study, it could be concluded that the present population seemed to be mostly appropriately informed, but the information needs further revision and promotion by dentists. Full article

Background and Objectives: This study aimed to evaluate the effects of advanced platelet-rich fibrin (A-PRF+) tissue regeneration therapy on clinical periodontal parameters in non-smokers and smoker patients. The anticipated biological mechanisms of A-PRF+ include stimulating angiogenesis, thereby promoting the formation of new blood vessels, which is essential for tissue healing. Additionally, A-PRF+ harnesses the regenerative properties of platelet-rich fibrin, contributing to the repair and regeneration of periodontal tissues. Materials and Methods: The study was conducted on 55 patients, divided into two groups: non-smoker patients (n = 29) and smoker patients (n = 26). A single operator conducted the surgical procedure. Following the administration of local anesthesia with articaine 4% with adrenaline 1:100,000 precise intracrevicular incisions were made, extending towards the adjacent teeth, until the interproximal spaces, with meticulous attention to conserving the interdental gingival tissue to the greatest extent possible. Extended, full-thickness vestibular and oral flaps were carefully lifted, and all granulation tissue was meticulously removed from the defect without altering the bone contour. After debridement of the defects, A-PRF+ was applied. BOP (bleeding on probing), PI (plaque index), CAL (clinical attachment loss), and probing depth (PD) were determined at baseline and six months post-surgery. Results: Significant reductions were observed in PD and CAL after six months. In the non-smokers group, PD decreased from 7.0 ± 1.0 mm to 3.1 ± 0.1 mm (p < 0.001), while in the smokers group, PD decreased from 6.9 ± 1.1 mm to 3.9 ± 0.3 mm (p < 0.001). CAL decreased in the non-smokers group from 5.8 ± 0.7 mm to 2.6 ± 0.2 mm and from 5.7 ± 0.9 mm to 3.2 ± 0.2 mm (p < 0.001) in smokers. Notably, the reductions in CAL and PD were statistically more significant in the non-smokers group. Conclusions: Even though the clinical periodontal improvements were considerable in smoker patients, they did not reach the level observed in non-smoker patients. Full article

Background: Without mechanical cleaning, gingivitis can develop within three weeks. The first clinical sign is bleeding on positive probing. The accumulation of dental biofilm triggers an inflammatory gingival response. In the past decade, attention has focused mainly on interproximal areas and the use of customized interproximal toothbrushes. The aim of this study was to evaluate the effectiveness of individualized oral hygiene education and its role in dental disease prevention among patients with dental problems. Methods: Altogether, 102 patients, 38 males and 64 females, were included in the study. All patients were aged over 18 years. Before treatment, patients were clinically and radiologically examined, their full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and bleeding on brushing (BOB) were recorded, and matrix-metalloproteinase-8 (MMP-8) was measured by using a chair-side MMP-8 measuring system. Patients in group A had gingivitis but no periodontal damage, and group B had periodontal damage. Patients in both groups were divided into four subgroups based on their toothbrushing habits and the oral health education they received. Three months after the initial examination, each patient was examined three more times (2, 4, and 12 weeks later). Results: It was concluded that subjects in groups A1 and B1 showed a significant reduction in BOB, MMP-8, FMBS, and FMPS levels after two weeks. Solo Prophylaxis (A1 and B1) remained a well-constructed protocol and caused the complete resolution of interdental inflammation after two weeks. Other subgroups achieved significant reductions only after 12 weeks. Conclusions: BOB and MMP-8 tests are valuable complements in preventive dentistry, and are able to detect potential pathological processes. The clinical relevance of BOB testing, in addition to FMBS, FMPS and gingival inflammation testing, can be demonstrated to patients, which may increase compliance. Full article

Background: This study aimed to subjectively assess the changes in the oral health status of pregnant women, to find out their attitudes and knowledge about possible changes in the oral cavity that occurred during pregnancy, and their influence on the outcomes of pregnancy. Methods: 112 pregnant women who visited the Republican Siauliai Hospital during their pregnancy participated in the study. An anonymous self-administered questionnaire was used to conduct the research, surveying their demographic characteristics, oral health changes and habits during pregnancy, and awareness of possible negative pregnancy outcomes. Results: The study involved 112 pregnant women, with 35 in the first trimester, 28 in the second, and 48 in the third trimester. The findings revealed that pregnant women do not take sufficient care of their oral health: more than half of the respondents did not visit an oral care specialist during pregnancy; 22.3% of women reported brushing their teeth only once a day or less; and 35.7% did not clean interdental surfaces at all. Statistically, significantly more urban women believed there is a relationship between maternal oral health and adverse pregnancy outcomes than women living in rural areas (p = 0.013). While significant oral health changes were not observed in the first trimester, more women in the second and third trimesters reported issues such as bleeding gums, swelling, plaque accumulation, tartar, and caries (p < 0.001). Conclusions: The attitude of women towards oral health during pregnancy and their understanding of the possible risks for unfavorable pregnancy outcomes are insufficient. Notably, oral health issues become more prominent in the second and third trimesters, necessitating appropriate oral care to reduce the incidence of oral and dental diseases during pregnancy. This underscores the importance of educational and preventive public health policies focused on oral care for pregnant women, aimed at increasing awareness and promoting practices that safeguard both maternal and fetal health. Full article

Objectives: Emphasizing the significance of optimal oral health for enhancing overall well-being, this study aimed to investigate oral health knowledge, self-assessed oral health behaviors, and oral hygiene practices within the Croatian general population. Materials and Methods: A cross-sectional observational study was conducted online, utilizing a questionnaire collecting sociodemographic characteristics and inquiring about respondents’ oral health knowledge, self-assessed oral health status, oral hygiene habits, and use of oral hygiene products. Collected data underwent both descriptive and regression analyses to unveil patterns and relationships within the dataset. Results: The respondents showed a high level of knowledge about oral health (median score 9, IQR 7.00–10.00, maximum possible score 10), with significant factors for higher knowledge being engaged in dental professions; above-average socioeconomic status; and the use of an electric brush, dental floss, and interdental brushes (p ˂ 0.05). Insufficient knowledge, on the other hand, was associated with bleeding gums and daily smoking (p ˂ 0.05). Although 69.4% of respondents considered their oral health to be very good, 32.5% reported tooth decay, and 38.2% reported tooth sensitivity. The majority (62.0%) cited regular check-ups as the reason for their last visit to the dentist, with 74.1% feeling no anxiety or discomfort during these visits. Daily toothbrush use was widespread (97.8%), but only 34.1% and 19.1% of respondents reported using floss and/or interdental brushes daily. A remarkable 69.0% of respondents indicated that low oral health literacy and low prioritization contribute to suboptimal oral health. Conclusions: While respondents demonstrated commendable oral health knowledge, the prevalence of reported issues suggests a potential gap between perception and actual oral health status. To address this, targeted educational interventions focusing on comprehensive oral hygiene practices and debunking misconceptions should be prioritized in Croatia. Full article

The aim of this cross-sectional study was the evaluation of the oral health-related quality of life (OHRQoL) in patients with depression or attention-deficit/hyperactivity disorder (ADHD) in comparison with a group of mentally healthy individuals. Patients from the Department of Psychiatry and Psychotherapy, University of Leipzig, Germany, were recruited. A healthy comparison group (HC) was recruited from the Department of Cariology, Endodontology and Periodontology. The OHRQoL was assessed using the Oral Health Impact Profile G14 (OHIP G14). Furthermore, a questionnaire regarding oral hygiene behaviour was applied. A total of 141 patients with depression or ADHD (depression n = 94, ADHD n = 47) and 145 HC individuals with a balanced age and gender distribution were surveyed. OHIP G14 median scores were significantly higher in the overall psychiatric patient group compared to HC (5.00 vs. 0.00, p < 0.001). This was also found for the four dimensions of OHIP G14 (p < 0.001). The OHIP G14 sum score of patients with depression and ADHD was comparable (5.00 vs. 6.50, p = 0.302). A significant association among psychiatric patients between smoking, gum bleeding, professional tooth cleaning, oral health education, interdental cleaning, and elevated OHIP scores was found (p < 0.001). In conclusion, patients with depression and adults with ADHD show a reduced OHRQoL. A contradictory association between oral hygiene/oral health behaviour and OHRQoL supports the hypothesis of a changed perception of oral conditions in patients with mental diseases. Interdisciplinary collaboration between psychiatric specialists and dentists should be fostered. Full article

The study aimed to assess self-reported symptoms of periodontal disease (gingival bleeding, tooth mobility and halitosis) among diabetic and non-diabetic patients from Transylvania, Romania. Using statistical analysis methods, correlation between the aforementioned symptoms and diet, oral hygiene habits, stress, physical activity, and BMI (body mass index) were researched. Another secondary objective was to assess the impact of self-reported oral health, aesthetics, and halitosis on their life. Patients’ willingness to use a mobile app for generating awareness of oro-dental complications, improving their knowledge of oro-dental health, and reminding them to visit the dentist based on an awareness-raising function, was also assessed. Methods: The study was based on an original self-administered questionnaire, applied to 182 subjects, in an unselected, randomized manner. A total of 110 questionnaires were applied in two dental offices and 72 questionnaires were applied in a public clinic for diabetic patients from Cluj-Napoca, Romania. Results: Warning signs and symptoms relevant to periodontal disease were identified by respondents, having statistically significant associations with the declared oral health-care habits, including interdental aids, vicious habits (nail biting, bruxism), etc. Some of these periodontal signs could be correlated with a certain lifestyle, such as the perceived stress, smoking status, practicing maintenance sports, and alcohol consumption. A total of 66% of the non-diabetics and 68% of the diabetics of the surveyed subjects consider a software application for generating awareness of oro-dental complications useful, and are willing to pay around EUR 6 for it. Conclusions: Having a medical condition such as diabetes makes patients pay more attention to dental health compared with non-diabetic patients. Patients expressed their desire to use a software application to help them to be aware of their condition and for improving their self-report capabilities, including their oral-health-related status. Full article

The scope of this study was to assess the prevalence, severity of extension, and risk factors of gingivitis among pregnant women. In this cross-sectional study, 220 nulliparous women at 3 months of pregnancy were recruited in 2022 at the first obstetrical visit in Dakar, Senegal. Demographic characteristics, lifestyle habits, prenatal clinical status, and oral clinical parameters were recorded. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. Eighty-eight percent of women had gingivitis, 15% were classified as moderate and 73% as severe. A total of 66.7% (95% CI [28.8–92.1]) of the sites had bleeding on interdental brushing. The odds for gingivitis decreased significantly for women consuming more than five portions of fruits and vegetables per day (OR = 0.15; 95% CI [0.03–0.66]) and increased in women who had a professional activity (OR = 6.75; 95% CI [1.27–35.87]) and high education. Concomitantly, the percentage of dental plaque (OR = 131.6; 95% CI [10.80–1619.71] and the severity of clinical attachment loss (OR = 7.70; 95% CI [3.16–18.92]) were important risk factors. Inverse associations were observed with increasing body mass index (OR = 0.76; 95% CI [0.63–0.93]). Our results underline that gingivitis cases and bleeding were particularly high among 3-month pregnant women. Literacy and adequate oral hygiene actions to modify behaviors and to achieve meticulous biofilm disorganization could make a favorable change in the gingival health outcome. Additionally, further research is necessary to precisely determine the role of biofilm-induced gingivitis and systemic-induced gingivitis in improving gingival conditions. Full article

An 8-year-old girl diagnosed with cardiofaciocutaneous syndrome presented to our department with gingival pain, inflammation, and bleeding. Her medical history included hypoplasia of the corpus callosum, intellectual disability, trichothiodystrophy, global developmental delay, myopia, laryngomalacia, hypothyroidism, and osteoporosis. A diagnosis was reached of “periodontitis as a direct manifestation of systemic diseases”. During 9 years of follow-up, there were exacerbation episodes with spontaneous gum bleeding, ulcers in the interdental papilla, tooth mobility, and progressive tooth loss. Some of these exacerbation episodes resolved clinically with the administration of amoxicillin and metronidazole. We therefore proposed an oral microbiome study (subgingival and saliva samples) before and after antibiotic therapy. The most abundant genera at the subgingival level before administering antibiotics were Prevotella, Streptococcus, Fusobacterium, Leptotrichia, and Aggregatibacter. Of the 94 genera sequenced, 57 were less abundant in the post-treatment state than at baseline, particularly certain Gram-negative periodontal pathogens such as Porphyromonas, Treponema, Aggregatibacter, Fusobacterium, and Campylobacter. In contrast, other genera related to oral health, such as Haemophilus, Granulicatella, and Abiotrophia, showed an increase after administering the antibiotic. In conclusion, periodontitis exacerbations as a direct manifestation of systemic disease can occasionally be controlled exclusively with systemic antibiotics, without the need for performing mechanical periodontal therapy. This clinical recovery is correlated to substantial changes in the oral microbiome, which lead to the recovery of eubiosis of the microbiota. Full article

Gingivitis and periodontitis are highly prevalent in Hong Kong, where the provision of oral health services is predominantly private. This cross-sectional study aimed to investigate the association between the oral symptoms of gum bleeding and self-reported behavioral factors, beliefs, and knowledge among Hong Kong Chinese. The research team commissioned the Public Opinion Programme of The University of Hong Kong to conduct a structured, population-based, computer-assisted telephone interview (CATI), which covered questions related to the demography, perception, and knowledge (including traditional Cantonese beliefs) of gum health, dental attendance, oral health behavior, and dental anxiety. A total of 1,265 individuals aged 25–60 years old were successfully contacted, and 704 (55.7%) reported prior gum bleeding experience. A total of 516 individuals (64.9% females, median 55–60 years) completed the CATI satisfactorily, and 321 (62.2%) experienced gum bleeding in the past 12 months. The factors that were significantly associated with reports of gum bleeding in the past 12 months include having periodontitis, sensitive teeth, having tertiary or higher education, flossing/interdental cleaning, not cleaning teeth well enough, lack of sleep, consuming too much ‘heaty’ food, avoiding going to the dentist when gums are bleeding, and waiting for gum bleeding to subside (p < 0.05, r² =0.198; forward stepwise logistic regression). Within the limitations of this study, approximately half of the Hong Kong working-age adults surveyed reported experiencing gum bleeding, and 62.2% of the participants experienced it within the past 12 months. Members of Hong Kong’s working-age population who reported having higher levels of education appeared more readily aware of their gum problems. Those with bleeding gums, especially those who have discernable periodontitis, poor dental awareness/behaviors, and/or a poor lifestyle should be targeted to receive education and encouragement, which will allow them to take action and improve their own gum health. Full article

Background: Necrotizing periodontitis (NP) is a reactive and destructive inflammatory process that occurs in response to bacterial infection. Predisposing factors such as compromised host immune responses contribute significantly to NP pathogenesis. NP occasionally progresses to a more advanced and life-threatening state. Case presentation: A 73-year-old man in need of nursing care visited our dental clinic with severe gingival pain and intraoral bleeding. He had a disability and was immunocompromised because his medical history included cerebral infarction and type 2 diabetes mellitus. He was diagnosed with NP based on his typical symptoms, such as prominent bleeding and suppurative discharge from the gingiva, in addition to crater-shaped ulcerations of the interdental papillae. To improve daily oral hygiene, periodontists, dentists, and dental hygienists educated care workers and other staff at the nursing home on appropriate oral cleansing, including brushing three times a day using the Bass technique. Basic periodontal therapy, including whole-mouth scaling and debridement of the root surfaces using hand and ultrasonic instruments, was also performed. After this basic treatment of NP, we extracted the hopeless teeth. Currently, dentists visit the patient fortnightly to manage his oral hygiene. To date, good oral health has been maintained. Full article

This study assessed the effect of triweekly interdental brushing for a period of 6 months using the bleeding on full-mouth interdental brushing (BOFIB) index. All participants answered questionnaires and were instructed to clean all interdental areas using an interdental brush at least every second day. A dentist assessed the BOFIB index of 28 participants at baseline and at 3- and 6-month follow-up visits. We stratified the participants into three groups: IB-NN, those who used the interdental brush less than three times per week both before and after this program; IB-NY, those who used the interdental brush less than three times per week before the program but at least three times per week after the program; and IB-YY, those who used it at least three times per week both before and after the program. Owing to the weekly number of interdental brushings, the IB-YY and the other two groups showed a significant difference at baseline. At the 6-month follow-up, the weekly number of interdental brushings led to a significant difference between the IB-NN and the other two groups. The BOFIB index was lower among the compliant participants than among the noncompliant participants after 3 and 6 months of triweekly interdental brushing. Full article

(1) Background: To analyze the association between periodontal health status and daily oral health activities including lingual and palatal site toothbrushing. (2) Methods: One hundred and fifty Korean elderly people aged >65 years participated in the study. Clinical examination regarding oral health status, including periodontal health status, was evaluated, and data on the oral health activities, socio-demographic factors, and systemic health-related factors were obtained using a questionnaire. Statistical analyses assessed the differences of periodontal health status according to daily oral health activities, including lingual and palatal site toothbrushing. (3) Results: Oral health activities including lingual and palatal site toothbrushing, frequency of toothbrushing, use of an interdental toothbrush, dietary patterns, and activity dependence correlated with bleeding on probing (BOP) and periodontitis. After adjusting for covariates, the prevalence of periodontitis was lower in the group where the inner surfaces of the teeth were partially or wholly cleaned than in the group without such cleaning. High BOP was significantly associated with the brushing of the inner surfaces of teeth. (4) Conclusions: Lingual and palatal site toothbrushing was associated with good periodontal health status in the elderly; the importance of brushing the inner surfaces of teeth should be emphasized for them and their caregivers. Full article