Detection of demineralization in occlusal fissures using the electronic caries detector: clinical and histological study

Ideally, sealant is placed over caries-free pits and fissures, although evidence supports the view that sealing will lead to the arrest of early lesion. However, clinical examination of a pit or a fissure will often leave doubt as to its caries status. The present study compared the validity of three in-vivo methods of caries detection with the histological appearance of the sectioned teeth. A total of 48 sound teeth, planned to be extracted as part of arthodonctic treatment were included in the study. Teeth examined to score stains in the fissures, bitewing radiographs were taken, fissures were also examined by vanguard machine. Following extraction, teeth were examined histologically and photographed using polarized light. The results found no consistent pattern to correlate stain in the fissures with vanguard readings or with histological examinations. Radiographs were of limited value in diagnosis of occlusal caries and would not be indicated for clinical diagnosis. A sensitivity of 76% of the teeth showing histological signs of dimineralization gave positive vanguard readings. As for specificity, 90% of teeth on which no demineralization was found histologically gave zero vanguard reading

Effect of metronidazole [Flagly] on advanced periodontitis

The present study was performed to evaluate the effect of one week metronidazole treatment on patients with advanced periodontal disease. Thirteen patients [three males and ten females] were selected in the study. Clinical and microbiological evaluations were carried out initially at the pretreatment visit, then repeated at 2 and 15 weeks after metronidazole treatment. Clinical measurements of pocket depth and attachement level was done using Ramfjord procedures [1967] [12]. In addition, microbiological samples were obtained from the most severely involved sites as shown by X-ray picture to detect the effect of metronidazole on anaerobic and facultative organisms. The results of this study revealed an improvement in clinical parameters as indicated by reduction in pocket depth associated with an apparent gain of attachement. This suggested that metronidazole permitted a type of disease resolution at the base of deep pockets. In addition, the presentinvestigation revealed that metronidazole eliminated anaerobic organisms from subgingival microbiota and reduced some of the facultative organisms such as streptococcus mutans, streptococcus sangius and streptococcus salivarius. These findings emphasize that the elimination of anaerobic organisms was responsible for the improved periodontal health; whereas the suppression but not the elimination of facultative species in the plaque were not primarily responsible for signs of disease observed. In addition, it may suppress the pathogenic flora so that when the antimicrobial therapy stops, a non pathogenic flora may reestablish in the subgingiral area. The metronidazole unique spectrum of activity against anaerobes involved in periodontal disease coupled with favorable clinical response to the short term treatment inelicate that this agent will have valuable usage in dentistry. However, long-term studies are needed to disclose if discontinuation of metronidazole therapy will lead to reestablishment of a subgingival microbiota inductive to progressive periodontal disease

comparative study of two different rural Egyptian communities. gingival conditions and oral lygiene statuts

The present study was carried out to assess the gingival conditions and oral hygiene status among residents of North Sinai Desert and the Red-Sea Governorate. A total of 1142 subjects were examined, of whom 689 were from North Sinai Desert and 453 from the Red-Sea Governorate. Three age groups were selected; 10-19, 20-39, and 40 years and over. The study has shown the following 1. The gingival status and oral hygiene level among North Sinai and Red-Sea residents were found to be in a poor situation. 2. Severity of gingival disease increased by age and was accompanied by deterioration of oral hygiene in both areas examined. 3. Both gingival condition and oral hygiene level among the North Sinai group were better than that of the Red-Sea residents. This picture might be related to the degree of urbanization, as the Red-Sea community can be considered less urban in terms of the educational levels, availablity and ease of transportation to other parts of the country. 4. Lack of good oral hygiene and the existence of poor gingival conditions indicates that, the existing dental services are not coping with the actual treatment needs of these communities, as well as, lack of basic dental health knowledge and behavior