Association between traditional oral hygiene methods with tooth wear, gingival bleeding, and recession: A descriptive cross-sectional study

Oral hygiene maintenance is crucial for prevention of various oral diseases. Oral hygiene practices across the country vary largely and people in peri-urban and rural areas use traditional methods of oral hygiene like powders, bark, oil and salt etc. Their effect on oral soft and hard tissues need to be studied to understand their beneficial and/ or harmful effects on maintenance of oral hygiene and prevention or causation of oral diseases. Objectives: This study aimed to assess the plaque-cleaning efficacy, gingival bleeding, recession and tooth wear with different traditional oral hygiene methods as compared to use of toothpaste-toothbrush, the most accepted method of oral hygiene practice. Study Design: Hospital based cross sectional analytical study. Results: Total 1062 traditional oral hygiene method users were compared with same number of toothpaste-brush users. The maximum number in the former group used tooth powder (76%) as compared to other indigenous methods, such as use of bark of trees etc and out of tooth powder users; almost 75% reported using red toothpowder. The plaque scores and gingival bleeding & recession were found to be more in traditional oral hygiene method users. The toothwear was also more severe among the toothpowder users. Conclusions: Traditional methods were found to be inferior in plaque control as was documented by increased bleeding and gingival recession. Its effect on hard tissues of teeth was very damaging with higher tooth wear scores on all surfaces.

Comparative evaluation of tooth substance loss and its correlation with the abrasivity and chemical composition of different dentifrices.

Context: In India, teeth cleaning with tooth powder is common in rural and semi‑urban areas. These dentifrices may contain low‑quality abrasives, which may have a deleterious effect on dental hard tissues. Aims: This study aims to evaluate the tooth substance loss caused by different dentifrices and to correlate it with chemical composition, size, and shape of abrasives used. Settings and Design: An indigenously made automated machine was used for brushing the specimens. Materials and Methods: Sixty‑four freshly extracted premolars were allocated to eight groups (n = 8). Colgate toothpaste was used as the control group. Each specimen was brushed in a vertical motion for 2½ h at 200 strokes/min with a constant applied load of 200 g corresponding to 6‑month brushing. The difference in weight (pre‑ and post‑brushing) was determined by an analytical weighing machine. Chemical analysis was done to determine the presence of iron oxide by Inductively Coupled Plasma Mass Spectrometry method. Shape and size of the abrasive particles was evaluated under scanning electron microscopy (SEM). Statistical Analysis Used: One‑way analysis of variance and Paired t‑test were used to analyze the data. Results: Tooth substance loss was maximum in the group brushed with red tooth powder, which was shown to contain the highest amount of iron oxide and also exhibited large, irregularly shaped abrasive particles under SEM. Conclusions: Tooth substance loss was documented to be correlated with chemical composition (iron oxide) and the size and shape of abrasive particles used in dentifrices.

Effect of prepolymerized composite megafiller on the marginal adaptation of composite restorations in cavities with different C-factors: An SEM study.

Aim: To evaluate the effect of prepolymerized custom-made composite megafiller and configuration factors (C-factor) on marginal adaptation of resin composite restorations. Materials and Methods: Forty extracted human mandibular molars were divided into four experimental groups consisting of 10 samples each. In groups I and III, class V (configuration factor 5) and in groups II and IV, class II box-shaped cavities (configuration factor 2) were prepared. Groups I and II were restored with a nanofilled composite (Filtek™ Z350 3M ESPE, St Paul, MN, USA) placed in horizontal increments. In groups III and IV, preformed composite megafiller was placed and cavities were restored with nanofilled composite Z-350. After curing, the samples were finished and prepared for examination under low vacuum scanning electron microscope. The data were analyzed with one-way analysis of variance. The significance between the individual groups was calculated by Post hoc test using the Holm-Sidak method ( P≤0.05). Results: The marginal gap values in groups III and IV were significantly lower than in groups I and II, respectively ( P≤0.05). Minimum gap values were seen in group IV. Conclusion: Use of prepolymerized composite megafiller and a lower C-factor decreased the marginal gaps between the tooth and composite restorations.

Apically extruded debris with three contemporary Ni-Ti instrumentation systems: an ex vivo comparative study.

AIM: To comparatively evaluate the amount of apically extruded debris when ProTaper hand, ProTaper rotary and ProFile systems were used for the instrumentation of root canals. MATERIALS AND METHODS: Thirty minimally curved, mature, human mandibular premolars with single canals were randomly divided into three groups of ten teeth each. Each group was instrumented using one of the three instrumentation systems: ProTaper hand, ProTaper rotary and ProFile. Five milliliters of sterile water were used as an irrigant. Debris extruded was collected in preweighed polyethylene vials and the extruded irrigant was evaporated. The weight of the dry extruded debris was established by comparing the pre- and postinstrumentation weight of polyethylene vials for each group. STATISTICAL ANALYSIS: The Kruskal-Wallis nonparametric test and Mann-Whitney U test were applied to determine if significant differences existed among the groups ( P< 0.05). RESULTS: All instruments tested produced a measurable amount of debris. No statistically significant difference was observed between ProTaper hand and ProFile system ( P > 0.05). Although ProTaper rotary extruded a relatively higher amount of debris, no statistically significant difference was observed between this type and the ProTaper hand instruments ( P > 0.05). The ProTaper rotary extruded significantly more amount of debris compared to the ProFile system ( P< 0.05). CONCLUSION: Within the limitations of this study, it can be concluded that all instruments tested produced apical extrusion of debris. The ProTaper rotary extruded a significantly higher amount of debris than the ProFile.

Association of common chronic infections with coronary artery disease in patients without any conventional risk factors.

BACKGROUND & OBJECTIVES: Report from the west suggest an association of infections and inflammation with atherosclerotic coronary artery disease (CAD). Entire microbial burden from several simultaneous chronic infections could be more important than a single infection in promoting atherosclerosis. No study has been done in Indian population, investigating the association of various chronic infections with CAD. We therefore evaluated the presence of markers of chronic infections in CAD patients having no conventional risk factors and healthy individuals in a tertiary care hospital in north India. METHODS: Seropositivity to IgG antibodies was investigated for Chlamydia pneumoniae, Mycoplasma pneumoniae, and Helicobacter pylori in 30 CAD patients with no conventional risk factors scheduled for coronary artery bypass surgery and in healthy blood donors. Periodontal pathogens were isolated by aerobic and anaerobic culture. RESULTS: All patients except one were < 55 yr of age and six were younger than 40 yr. Seropositivity to C. pneumoniae was significantly higher in CAD patients than healthy controls (63.3 vs. 23.3%, P<0.01). Combined seropositivity to both C. pneumoniae and M. pneumoniae was significantly higher in CAD patients with myocardial infarction (MI) than those without MI (61.5 vs. 11.8%, P<0.05). Aerobic and anaerobic cultures for the isolation of periodontal pathogens were positive in seven patients and five healthy blood donors. INTERPRETATION & CONCLUSION: C. pneumoniae seropositivity was significantly higher (P<0.001) in CAD patients without any of the conventional risk factors for CAD. Combined seropositivity to C. pneumoniae and M. pneumoniae was significantly higher (P<0.05) in CAD patients with MI than in those without MI. Possibly CAD in young is not (or less) governed by conventional risk factors, and infectious agents can be potential risk factors for the development of atherosclerosis and CAD in this subset of patients.