ABSTRACT
The aim of this study was to carry out a short term evaluation of the effect of supragingival plaque control on the subgingival microflora and gingivoperiodontal tissues in patients with moderate and severe periodontitis. A total of 92 sites from 23 patients were studied; patients ranged between 35 and 60 years of age (x 46.4 +/- 1.71). Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BP), Probing Depth (PD), and Attachment Level (AL) were measured. Subgingival microflora of the same sites was studied by dark field microscopy, and cultures in non-selective and selective media for Actinobacillus actinomycetemcomitans (Aa), Prevotella intermedia/nigrescens (Pi/n), Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn). The patients were included in a supragingival plaque control program which included oral hygiene training and assessment, and professional control of supragingival plaque and calculus. After 28 days, measurement of clinical parameters and the microbiological study were repeated. The sites were divided according to baseline PD values into: Group 1 (5 mm), Group 2 (6 mm) and Group 3 (> or = 7 mm). Results revealed a significant reduction in PI scores, GI scores, PB and PD in groups 2 and 3. No significant difference in AL was observed in any of the three groups. PI scores were found to decrease significantly in group 1, and GI scores, BP and PD tended to decrease. A significant increase in coccoid cells and a significant decrease in motile rods and spirochetes, both small and total, was observed in groups 2 and 3. Group 1 showed a significant decrease in medium and total spirochetes. At the end of the study, a significant decrease in Pi/n was found in all three groups. Significant decreases were found in Pg and Fn in Groups 3 and 2 respectively. Although it holds true that supragingival plaque control reduced a potentially pathogenic subgingival microbiota, this effect was not sufficient to be compatible with healthy gingivoperiodontal tissues.
ABSTRACT
The aim of this work was to study the effect of a preventive program on the dental plaque and on the caries incidence in school children. The program comprised weekly supervised self brushing with acidulated phosphate fluoride (APF) gel (pH 5.6; concentration: 4520 ppm of ion F-). The program involved 240 children of 1st., 3rd and 5th grade of a primary school in the City of Buenos Aires (Argentina). The population was divided in 2 groups: A (experimental) and B (control). Ninety children from both groups (45 experimental and 45 control) were submitted to baseline clinical examination (DMFT and plaque index) and microbiological analysis (total streptococci, St mutans and St. mutans and St. mutans percentage). Group A was then submitted to a preventive program which included self brushing with APF gel (4520 ppm of ion F-). The 90-children sample was monitored after 1 and 2 years of program. Results were statistically processed and they revealed the following: a--DMFT was significantly greater in the control group than in the experimental group after 1 and 2 years of program; b--an 81.43
reduction in caries increment rate at the end of the 2-years program in the experimental group as compared to the control group; c--a rise in the number of colonies of total streptococci and of St. Mutans; d--a reduction in the
of St. mutans in the total streptococci flora in the plaque of children in the experimental group; e--the presence of St. mutans colonies featuring a rough surface; f--the effectiveness of the program in the modifying the profile of the diagnosed dental pathology.