Effectiveness of chlorhexidine oral rinse in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment- a systematic review and meta analysis / Eficacia del enjuague oral de clorhexidina en la prevención de la acumulación de placa y la gingivitis en pacientes en tratamiento de ortodoncia: una revisión sistemática y metaanálisis

Aim: The aim of this review was to systematically assess and report the effectiveness of chlorhexidine (CHX) mouthwash in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment. Material and Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and registered under PROSPERO database (CRD42020170776). Four electronic databases were systematically searched along with a complimentary manual search of orthodontic journals until June 2022. Only Randomized Control Trials (RCTs) reporting on antiplaque and antigingivitis efficacy of Chlorhexidine mouthwash compared with placebo or control in orthodontic patients were included. Risk of bias assessment was done using Cochrane ROB-2. Quantitative analysis (Random-Effects Model and Standard Mean Difference (SMD)) with 95 % confidence interval was used. Results: Six RCTs were included for qualitative analysis and four were included for quantitative analysis with a total of 211 participants. Out of six studies, 3 were judged to have a low risk of bias, two had some concerns and one of them had high risk of bias. Random effects meta-analysis performed for anti-plaque effect reported a significant reduction of -1.2 SMD for CHX at 4 to 6 weeks with low heterogeneity (I2-35%). The anti-gingivitis effect at 4 to 6 weeks was significant for CHX with a SMD of -1.03 and a moderate heterogeneity (I2-65%). Conclusion: On analyzing the available evidence a moderate level of certainty supports a short-term reduction in plaque accumulation and gingivitis in orthodontic patients subjected to rinsing with chlorhexidine oral rinse.

Objetivo: El objetivo de esta revisión fue evaluar e informar sistemáticamente la efectividad del enjuague bucal con clorhexidina (CHX) para prevenir la acumulación de placa y la gingivitis en pacientes que reciben tratamiento de ortodoncia. Material y Métodos: La revisión se preparó de acuerdo con las pautas de Preferred Reporting Items for Systematic Reviews (PRISMA) y se registró en la base de datos PROSPERO (CRD42020170776). Se realizaron búsquedas sistemáticas en cuatro bases de datos electrónicas junto con una búsqueda manual gratuita de revistas de ortodoncia hasta junio de 2022. Solo se incluyeron ensayos controlados aleatorios (ECA) que informaron sobre la eficacia antiplaca y antigingivitis del enjuague bucal con clorhexidina en comparación con placebo o control en pacientes de ortodoncia. La evaluación del riesgo de sesgo se realizó mediante Cochrane ROB-2. Se utilizó un análisis cuantitativo (modelo de efectos aleatorios y diferencia de medias estándar (SMD)) con un intervalo de confianza del 95 %. Resultados: Se incluyeron seis ECA para el análisis cualitativo y cuatro para el análisis cuantitativo con un total de 211 participantes. De los seis estudios, se consideró que tres tenían un bajo riesgo de sesgo, dos tenían algunas preocupaciones y uno de ellos tenía un alto riesgo de sesgo. El metanálisis de efectos aleatorios realizado para el efecto antiplaca informó una reducción significativa de -1,2 SMD para CHX a las 4 a 6 semanas con baja heterogeneidad (I2-35%). El efecto antigingivitis a las 4 a 6 semanas fue significativo para CHX con una SMD de -1,03 y una heterogeneidad moderada (I2-65%). Conclusión: Al analizar la evidencia disponible, un nivel de certeza moderado apoya una reducción a corto plazo en la acumulación de placa y gingivitis en pacientes ortodóncicos sometidos a enjuague con enjuague bucal con clorhexidina.

Intervención educativa para la gingivitis crónica en adolescentes del Consultorio Médico de la Familia 10. Área Norte. Sancti Spíritus / Educational intervention on chronic gingivitis in adolescents at the North Area doctor´s office 10 in Sancti Spíritus

RESUMEN Fundamento: La gingivitis crónica constituye un problema de salud bucal en los adolescentes, relacionado con los escasos conocimientos y factores de riesgo presentes. Objetivo: Aplicar la intervención educativa para modificar el nivel de conocimientos de los adolescentes sobre gingivitis crónica del CMF 10 de Sancti Spíritus. Metodología: Se realizó un estudio cuasi-experimental, con diseño de antes y después en el período de septiembre 2018 a febrero del 2019, la población fueron 196 adolescentes y la muestra 61 que presentaron gingivitis crónica. Las variables utilizadas: conocimientos sobre prevención de gingivitis, higiene bucal y presencia de gravedad de la gingivitis, los métodos: del nivel teórico, empírico (encuesta, entrevista, determinación de la IHBS, Índice Gingival de Löe y Silness y de la estadística descriptiva. Resultados: Los conocimientos antes de la intervención eran insuficientes (40.8 %), la gravedad de la enfermedad el 50.8 % presentaba gingivitis moderada y el 47.5 % mala higiene bucal; después de la intervención el 90.1 % tenía conocimientos suficientes, el 73.7 % sin alteración en las encías y 83.6 % buena higiene. Conclusiones: La intervención educativa logró elevar los conocimientos, disminuir la gravedad de la gingivitis y mejorar la higiene bucal de los adolescentes.

ABSTRACT Background: Chronic gingivitis is an oral health problem in adolescents, related to poor knowledge and risk factors. Objective: To apply educational intervention to modify the adolescents' level of knowledge about chronic gingivitis at the CMF 10 in Sancti Spíritus. Methodology: A quasi-experimental study was conducted, with a before and after design from September 2018 to February 2019, the population consisted of 196, and the sample of 61 adolescents who presented chronic gingivitis. The variables used: knowledge about gingivitis prevention, oral hygiene and presence of gingivitis´ severity, methods: theoretical and empirical level (survey, interview, determination of the IHBS, Silness y Löe Gingival Index and descriptive statistics. Results: The knowledge before the intervention was insufficient (40.8 %), severity of the disease 50.8 % presented moderate gingivitis and 47.5 % bad oral hygiene; after the intervention 90.1 % had sufficient knowledge, 73.7 % without any alteration in the gums and 83.6 % good hygiene. Conclusions: The educational intervention managed to increase knowledge, decrease severity of gingivitis and improve oral hygiene of adolescents.

Systematic review of the effect of probiotics on experimental gingivitis in humans

Abstract: Probiotic therapy is a viable alternative to chlorhexidine, a widely used antiseptic in dentistry that produces significant adverse effects. This systematic review aimed to analyze the effects of probiotics on experimental gingivitis in humans. Two independent reviewers conducted a comprehensive literature search until March 2019. Randomized clinical trials and controlled clinical trials were selected. Outcome data were extracted and critically analyzed. A total of five articles were included in the qualitative synthesis. No meta-analysis could be conducted due to the heterogeneity of the selected studies. The use of probiotics showed a slight improvement in clinical parameters. Changes in gingival crevicular fluid volume were lower in the presence of the probiotic than in the placebo group. All the studies showed that the immediate, positive effects of probiotics during the period of discontinued mechanical oral hygiene were due to the modulation of the host response, not the anti-plaque effect. Investigators should conduct randomized clinical trials to elucidate the mechanisms of probiotic action and develop improved delivery systems.

Utilización del Colutorio de Aloe Vera en el Control de la Gingivitis en Pacientes Adultos: Un Estudio Preliminar / Use of Aloe Vera Mouthwash in the Control of Gingivitis in Adult Patients: A Preliminary Study

RESUMEN: La gingivitis implica una inflamación de las encías debido a la acumulación de placa, factores anatómicos, por la microbiota subgingival entre otros factores de riesgos, infectando los tejidos que rodean el diente. La utilización de colutorios colabora al cepillado en la prevención, control y reducción de esta condición, por lo que la generación de nuevos productos resulta primordial en el tratamiento de patologías periodontales. El objetivo de este estudio fue establecer la eficacia del colutorio de Aloe Vera comparado con colutorios de clorhexidina en pacientes adultos que presenten gingivitis, en la comuna de Concepción, Chile. El diseño fue una serie de casos. Se evaluó la eficacia del colutorio de aloe vera sobre la gingivitis comparado con colutorio de clorhexidina pacientes entre 18 y 25 años a los diez días de uso en dos grupos con una relación 1:1. Las variables analizadas fueron el índice gingival e índice de placa. El universo fue de 87 sujetos. La muestra se calculó mediante análisis de varianzas arrojando 18 sujetos. Se aprobó por un comité de bioética. Se utilizó estadística descriptiva, además de la t de Student para las asociaciones. Los resultados mostraron una significativa reducción del índice de placa para clorhexidina (IPI de 57,8 a IPF de 27,7), Aloe vera (IPI de 64,3 a IPF de 42,1) y en el índice gingival para clorhexidina (IGI de 0,26 a IGF de 0,11), aloe vera (IGI de 0,95 a IGF de 0,42). El colutorio de aloe vera disminuye significativamente la concentración de placa y la inflamación gingival.

ABSTRACT: Gingivitis correspond to inflammation of the gums as a result of plaque deposits, a material composed of bacteria attached to the tooth, infecting surrounding tissues, in addition to microorganisms of the subgingival microbiota. The use of mouthwash in addition to brushing, helps in the prevention, control and reduction of this condition, so that the generation of new products is paramount in the treatment of periodontal diseases. The aim of this study was to establish the efficacy of Aloe Vera Mouthwash compared with Chlorhexidine mouthwash in adults and patients with gingivitis, in the municipality of Concepción, Chile. The design was a clinical pilot study. The effectiveness of Aloe Vera mouthwash on Gingivitis mouthwash versus chlorhexidine between 18 and 25 on the tenth day of use was evaluated. The variables analyzed were the plaque index and gingival index. A total of 87 subjects were analyzed. The sample was calculated by analysis of variance yielding 18 subjects. It was approved by a committee of bioethics. Descriptive statistics were used in addition to the Student t test for associations. Results showed a significant reduction in the rate of Plaque for chlorhexidine (ICI IPF 57.8 to 27.7), Aloe Vera (IPI IPF 64.3 to 42.1) and Gingival Index for chlorhexidine (IGI 0.26 0.11 IGF), aloe Vera (IGI 0.95 0.42 IGF). Aloe Vera mouthwash significantly decreases the concentration of plaque and gingival inflammation.

Clinical efficacy of nanosilver and chlorhexidine in the treatment of plaque-induced gingivitis: a randomized controlled clinical trial

Aim: the present study aimed to assess the clinical efficacy of nanosilver (NS) mouthwash and compared with chlorhexidine (CHX) mouthwash for the treatment of plaque-induced gingivitis. materials and methods: sixty-two (28 males and 34 females) plaque-induced gingivitis patients were allocated into two groups and asked to rinse with 10ml of NS or CHX, immediately after brushing, for 1 min, in the morning and evening. the plaque, gingival, and papilla bleeding indices were taken at baseline, two weeks, and finally at four weeks for each patient. the statistical analysis between and within groups were performed using Mann-Whitney U-test and Wilcoxon signed rank test respectively. result: Intergroup comparison by Mann-Whitney U-test showed no statistically significant differences in the investigated groups at the baseline for all studied parameters. at 2 and 4 weeks follow up, the CHX group showed statistically significant lower plaque scores than the NS group (p<0.05). however, there is no statistically significant difference between NS and CHX groups for gingival and papilla bleeding scores (p>0.05). both groups showed statistically significant reductions in plaque, gingival and papilla bleeding scores after 2 weeks and 4 weeks of product use when compared to baseline (p<0.001). conclusion: both mouthwashes decreased plaque, gingival and papilla bleeding scores, however the reduction in plaque scores was higher for the CHX group compared to the NS group.

Evaluation of the clinical effect of a probiotic mouthwash in the treatment of generalized marginal chronic gingivitis: randomized pilot study

Objective. to evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. methodology. four-week study conducted in San Luis Potosí, Mexico, from january to march 2017. participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. subjects were randomized and divided into three groups: group A: mouthwash based on 0.05 percent cetylpyridinium chloride (CPC) (positive control); group B: mouthwash based on probiotics (experimental); group C: placebo mouthwash (negative control). no oral hygiene practices or routines were modified; subjects were followed for 4 weeks. the primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. results. of the 45 patients included, 19 (42.2 percent) were men and 26 (57.7 percent) women, mean age was 22.8±2.07. each group consisted of 15 subjects; all subjects completed the study. there was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). however, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). conclusions. the use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. there were no statistically significant differences between the study groups.

O uso do fio dental reduz a ocorrência de sangramento gengival? / Does dental flossing reduce the occurrence of gingival bleeding?

Objetivos: tendo em vista a relevância da prevenção à gengivite, e consequentemente à periodontite, e a falta de consenso na literatura sobre a efetividade do fio dental como medida protetora ao sangramento gengival, este artigo buscou revisar a literatura objetivando responder a seguinte pergunta: "O uso do fio dental é efetivo para prevenir o sangramento gengival?". Material e métodos: revisões sistemáticas foram buscadas na base de dados Pubmed, sem limite de data e de linguagem. Resultados: duas revisões foram encontradas, e seus resultados foram sumarizados. Conclusão: a literatura científica sugere que o uso do fio dental associado à escovação é adequado para o controle do biofilme, e consequentemente, do sangramento gengival. Entretanto, essa evidência apresenta inúmeras limitações, e seus resultados precisam ser confirmados. Assim, são necessários mais estudos que demonstrem claramente o efeito do fio dental sobre o sangramento gengival.

Objectives: given the relevance of gingivitis prevention, and consequently periodontitis, and the lack of consensus in the literature on the effectiveness of dental floss as a protective measure of gingival bleeding, this article aimed to revise the literature in order to answer the following question: Is flossing effective in preventing gum bleeding? Material and methods: systematic reviews were searched on Pubmed database, with no limits for date and language. Results: two reviews were found, and their results were summarized. Conclusion: the scientific literature suggests that flossing associated with brushing is adequate for biofilm control, and consequently, for preventing gingival bleeding. However, this evidence has relevant limitations, therefore, these results need to be carefully considered. Thus, further studies are needed to clearly demonstrate the effect of dental floss on prevention of gingival bleeding.

Principais manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapia antirretroviral altamente ativa / Most common oral manifestations in pediatric patients HIV positive and the effect of highly active antiretroviral therapy

Resumo Esta revisão integrativa da literatura tem por objetivo identificar as principais lesões bucais que afetam pacientes pediátricos com HIV, bem como descrever o efeito da terapia antirretroviral altamente ativa (HAART) sobre essas lesões, comparando-a com a terapia antirretroviral (ART). Foi feita uma busca nas bases de dados PubMed e Scielo, seguindo critérios de inclusão e exclusão pré-determinados. Foram selecionados dezenove artigos científicos e extraídas as informações principais sobre prevalência e a frequência das manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapêutica aplicada. As lesões mais frequentes foram candidíase oral, gengivite, aumento das parótidas e eritema gengival linear. O uso da HAART mostrou diminuir a prevalência das manifestações bucais nos pacientes pediátricos com HIV e ser mais eficaz que a ART. Os achados deste estudo sugerem que a manifestação bucal mais frequente em pacientes pediátricos com HIV é a candidíase oral, seguida de alterações como gengivite e aumento das glândulas parótidas. O uso de HAART parece reduzir a prevalência dessas lesões orais, apresentando resultados mais eficazes que os da ART.

Abstract This integrative literature review aims to identify the main oral lesions affecting pediatric patients with HIV, and describe the effect of highly active antiretroviral therapy (HAART) on these injuries, comparing it to antiretroviral therapy (ART). A search was conducted in PubMed and Scielo databases, following predetermined inclusion and exclusion criteria. 19 papers were selected and the main information on the prevalence and frequency of oral manifestations in HIV-positive pediatric patients and effect of therapy applied were extracted. The most frequent injuries were oral candidiasis, gingivitis, parotid gland enlargement and linear gingival erythema. The use of HAART shown to reduce the prevalence of oral manifestations in pediatric patients with HIV and be more effective than ART. The findings of this study suggest that the most frequent oral manifestation in HIV-infected children is oral candidiasis, followed by changes such as gingivitis and enlargement parotid glands. The use of HAART appears to reduce the prevalence of these oral lesions, showing more effective results than ART.

Enfermedad periodontal en adolescentes / Periodontal disease in teenagers

Introducción: durante mucho tiempo se creyó que la enfermedad periodontal era una afección de la adultez, sin embargo la falta de motivación en la práctica de la higiene oral en la etapa de la adolescencia condiciona su aparición. Objetivo: identificar el estado periodontal en adolescentes de la escuela Secundaria Básica Urbana ¨Raúl Pujols¨, en la ciudad de Santiago de Cuba, en el periodo de septiembre 2014 hasta marzo 2015. Materiales y Métodos: se realizó un estudio observacional, descriptivo transversal. El universo estuvo constituido por los 75 adolescentes, entre 11 a 14 años de edad de ambos sexos. Se utilizó el índice periodontal de Russell revisado por la Organización Mundial de la Salud y el índice de Love. Se confeccionó una planilla de recolección de datos para los resultados del examen físico y como medidas de resumen se usó el porcentaje. Resultados: prevaleció la gingivitis leve en el 66,7 % de los adolescentes, relacionado a la existencia de una higiene bucal deficiente. Predominó el sexo femenino y los factores de riesgo más encontrados fueron el apiñamiento dentario y los hábitos deletéreos. Conclusiones: la mayoría de los adolescentes del estudio presentaron gingivitis leve con una higiene bucal deficiente (AU).

Introduction: during many time it was believed that periodontal disease was adulthood affection, but lack of motivation in the practice of oral hygiene in the adolescence induces its beginning. Aim: to identify the periodontal status in teenagers from the Urban Secondary School “Raul Pujols”, in the city of Santiago de Cuba, in the period September 2014-March 2015. Materials and Methods: A cross-sectional, descriptive, observational study was carried out. The universe was formed by 75 both-sexes teenagers, aged 11-14 years. Russell’s periodontal index, up-dated by the Word Health Organization, and Love’s index were used. A form of data collection for the results of the physical examination was elaborated, and percentage was used as a summarizing measure. Results: mild gingivitis prevailed in 66.7 % of the teenagers, related with the deficient oral health. Female sex prevailed and the most commonly found risk factors were dental crowding and deleterious habits. Conclusions: most of the teenagers participating in the study had mild gingivitis and deficient oral health (AU).

Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial

Abstract This study aimed to evaluate the anti-plaque and anti-gingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Löe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival indices, by ANOVA, paired t-test and ANCOVA (α < 0.05). After 4 and 6 weeks, all mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For GI, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes.

Enfermedades gingivales en niños y adolescentes: primera parte / Gingival diseases in children and adolescents: first part

Las características de los tejidos gingivales y periodontales son diferentes en niños y adolescentes. La clasificación actual de enfermedades gingivales incluye a las gingivitis producidas por el biofilm y a las no producidas por el biofilm de placa. Las gingivitis son reversibles. Las condiciones de riesgo individuales, de origen externo o de origen sistémico, influyen en el agravamiento. La prevención de la gingivitis está enfocada en el control de los factores de riesgo.

Suplementos dietarios en periodoncia: revisión bibliográfica narrativa / Additives in periodontics: a narrative review of the literature

Se realizó la revisión de los trabajos de investigación relacionados con la utilización de resolvinas y probióticos como complementos dietarios en la terapia periodontal, tanto en animales de experimentación como en humanos, describiendo el origen, la composición y los posibles mecanismos de acción. A partir de los trabajos revisados, se concluyó que las aludidas sustencias son, en la actualidad, un tema de investigación no traspolable a la clínica y que en el mediano plano, podrían potenciar las terapias actuales para patologías periodontales específicas.

Comparison of amine fluoride and chlorhexidine mouth rinses in the control of plaque and gingivitis – A randomized controlled clinical trial.

Objectives: The objective of this triple blind randomized controlled clinical trial was to compare the efficacy of a mouth rinse containing amine fluoride (AmF) and chlorhexidine in controlling the supragingival plaque accumulation and gingival inflammation during a 4‑week period in patients with chronic gingivitis. Subjects and Methods: A total of 30 patients were participated in this study. Fifteen patients were prescribed an AmF‑containing mouth rinse and 15 were prescribed a chlorhexidine mouth rinse. Plaque index, gingival index, bleeding index, tooth stain, and tongue stain (TS) were recorded at baseline, 15 days and 1‑month. Patients’ perception of odor, taste and any discomfort were recorded. Results: The comparisons between the groups were done using Mann–Whitney U‑test. The comparison within the group at different time visits were done using Wilcoxon signed rank test. Both the mouth rinses resulted in a significant decrease in plaque index, gingival index, bleeding index. However, AmF mouth rinse resulted in a statistically significant decrease in bleeding index and gingival index compared to chlorhexidine group. There was no significant difference in tooth stain and TS in both the groups. Conclusions: The 4 weeks use of AmF containing mouth rinse is effective in reducing the gingival inflammation and plaque.

Salud bucal en el embarazo / Oral care in pregnancy

La salud oral durante el embarazo es extremadamente importante para lograr que esta etapa se desarrolle de manera equilibrada, contribuyen- do así a la salud general de la madre y el futuro bebé. Durante esta etapa la madre puede estar expuesta a la aparición de procesos infecciosos, lesiones en la cavidad oral o sintomatología dolorosa, que en ocasiones son de difícil manejo debido a las precauciones que la condición de embarazo demanda, además de que alteran el normal desenvolvimiento del mismo; por ello la prevención es primordial durante este periodo. El objetivo de esta revisión fue reunir información que nos permita revalorar los conceptos y parámetros que tenemos sobre el cuidado oral durante la gestación y de esta manera poder brindar una mejor atención y guía en el embarazo...

Oral health during pregnancy is extremely important to ensure that this stage develops in a balanced manner, thus contributing to the health of the mother and the baby. During this stage the mother may be exposed to the emergence of infectious processes, lesions in the oral cavity or pain symptoms, which are sometimes difficult to manage, because of the care that pregnancy demands, besides this alters the normal development of it, therefore prevention is essential during this period. The objective of this review was to gather information that allows us to reassess the concepts and parameters we have about oral care during pregnancy and thereby, be able to provide better care and guidance in pregnancy...

Efeitos nos níveis clínicos e de s. mutans de um protocolo de controle de biofilme dental em adolescentes portadores de aparelho ortodôntico fixo / Effect on the clinical levels of s. mutans of a dental biofilm control protocol in adolescents with fixed orthodontic appliances

A utilização de acessórios durante o tratamento ortodôntico fixo aumenta o risco à ocorrência de manchas brancas, cárie e gengivite devido aos sítios retentores de biofilme dental. O objetivo deste estudo foi observar o efeito de um protocolo de controle de biofilme dental nos níveis de gengivite e risco à cárie em adolescentes portadores de aparelho ortodôntico fixo. Foram selecionados 21 pacientes de ambos os gêneros, entre 12 e 18 anos, que usavam aparelho fixo. Os critérios de exclusão foram: doenças sistêmicas, uso de antibiótico, gravidez e fumo. Os pacientes receberam instrução de higiene oral individualmente, reforçada mensalmente, e tiveram a saliva coletada no início e no final do estudo para avaliar o número de streptococcus mutans (SM) em unidades formadoras de colônias (UFC) e o risco à cárie. Nos tempos 1, 30, 60 e 90 dias, foram analisados os níveis clínicos de placa bacteriana corada (IPC) e gengivite (IG). Os pacientes receberam profilaxia com jato de bicarbonato de sódio a cada exame. Para comparação da contagem de SM nos dois tempos analisados, foi utilizado o teste t de Student; para os tempos do IPC e IG, utilizou-se a análise de variância (Anova), com post-hoc Tukey, ambos com significância de 5%. Ocorreu redução entre as avaliações iniciais e finais do IPC (72,72% ± 11,93% para 54,18% ± 16,87%), do IG (1,10 ± 0,47 para 0,44 ± 0,27) e da contagem de SM (1,16 ± 1,345 UFC para 0,536 ± 0,56 UFC), todos com p < 0,05. A implementação do protocolo melhorou as condições de gengivite e risco à cárie na população durante o período de estudo.

The use of appliances during fixed orthodontic treatment increases the risk of occurrence of white spot, caries and gingivitis due to presence of dental biofilm at the retentive sites. The objective of this study was to observe the effect of a dental biofilm control protocol on the levels of gingivitis and caries risk in adolescents with fixed orthodontic appliances. Twenty-one patients of both genders, between 12 and 18 years, participated in the study. The exclusion criteria were: systemic diseases, use of antibiotics, pregnancy and smokers. Patients received individual monthly oral hygiene instructions, and had their saliva collected at the beginning and the end of the study to assess the number of streptococcus mutans (SM) in colony forming units (CFU) and caries risk. At 1, 30, 60 and 90 days, clinical levels of bacterial plaque (CPI) and gingivitis (GI) were analyzed. Patients received prophylaxis with sodium bicarbonate jets at each exam. Student t test was used to compare SM counts at the two analyzed moments, while analysis of variance (Anova) was used for CPI and GI times, followed by Tukeyposthoc test, at a significance of 5%. Reductions in CPI levels (72.72% ± 11.93% to 54.18% ± 16.87%), GI levels (1.10 ± 0.47 to 0.44 ± 0.27) and SM counts (1.16 ± 1.345 UFC para 0.536 ± 0.56 UFC) were observed between the initial and the final assessments, all with p < 0.05. The implementation of the biofilm control protocol improved gingivitis conditions and caries risk in the population studied during the experimental period.

Periodontopatías en jóvenes y adolescentes adictos a drogas psicoactivas, atendidos en el Centro de Deshabituación de Adolescentes, del municipio Playa / Periodontal diseases in young people and adolescents addicted to psychoactive drugs and attended in the Center for Treatment of Drug Dependency in Adolescents, Playa Municipality

Introducción: En las últimas décadas se ha incrementado el uso y abuso de drogas como el alcohol, el cannabis, la cocaína y el crack, en particular en determinados grupos sociales de especial vulnerabilidad. Por otra parte, no se han estudiado o se han estudiado muy poco las enfermedades de la cavidad bucal, con excepción del cáncer bucal, que pudieran ser consecuencia del uso y abuso del consumo de drogas tanto legales como ilegales, y en Cuba no se han realizado estudios sistemáticos sobre este tema. Objetivo: Determinar la relación entre el consumo de drogas psicoactivas y la existencia de periodontopatías en jóvenes y adolescentes tratados en el CDA. Métodos: Se realizó un estudio observacional, descriptivo, de corte transversal con el objetivo de determinar la incidencia de periodontopatías en adolescentes y jóvenes adictos tratados en el Centro de Deshabituación de Adolescentes (CDA) del Municipio Playa y que se encontraban en rehabilitación. Se analizaron las historias clínicas de los pacientes para determinar el o los tipos de drogas que consumían y el tiempo de consumo. Como método empírico se utilizó la encuesta EMTAJOVEN para determinar fumadores. Resultados: A pesar de que la mayoría de los adictos presentaban un índice de higiene bucal calificado de excelente, se encontró que 28 de los 43 adictos presentaban alguna modalidad de enfermedad periodontal como gingivitis leve, gingivitis moderada y gingivitis con bolsa; ninguno presentó periodontitis. Se comprobó que 35 de los 43 pacientes eran fumadores y 20 de los 28 portadores de gingivitis. Conclusiones: Se concluye que la causa de las diferentes formas de gingivitis presente en estos pacientes no siempre es imputable a la mala higiene bucal y que pudiera deberse a la drogodependencia, en particular el tabaquismo

Background: The use and abuse of drugs such as alcohol, cannabis, cocaine, and crack has increased in the last decades, particularly in determined social groups of special vulnerability. On the other hand, the diseases of the oral cavity, except mouth cancer, have not been studied or have been little studied and these diseases could be a consequence of both legal or illegal use and abuse of drug consumption. Also, systematic studies have not been conducted in Cuba about this topic. Objective: To determine the relation between the consumption of psychoactive drugs and the existence of periodontal diseases in young people and adolescents treated in the Center for Treatment of Drug Dependency in Adolescents (CDA). Methods: An observational descriptive cross-sectional study was conducted in order to determine the incidence of periodontal diseases in adolescents and young addicts treated in the Center for Treatment of Drug Dependency in Adolescents (CDA) in Playa Municipality who were under rehabilitation. The clinical histories of patients were analyzed to determine the types of drugs they used to consume and the time of consumption. As an empirical method, The EMTAJOVEN survey was used to determine smokers. Results: Despite the majority of addicts presented an oral hygiene index which was considered excellent, it was found that 28 of the 43 addicts presented some type of periodontal disease such as mild gingivitis, moderate gingivitis, and periodontal pockets associated with gingivitis; none of them had periodontitis. It was confirmed that 35 of the 43 patients were smokers and 20 of the 28 ones had gingivitis. Conclusions: It is concluded that the cause of the different forms of gingivitis present in these patients is not always attributable to a bad oral hygiene, but it could be a consequence of drug dependence, particularly, smoking

Efecto del tratamiento periodontal sobre la microbiota subgingival en pacientes con preeclampsia / Effect of periodontal therapy on the subgingival microbiota in preeclamptic patients

Introducción. Pocos estudios han descrito la microbiota subgingival en mujeres embarazadas con preeclampsia leve. Objetivo. Identificar cambios periodontales y de la microbiota subgingival en mujeres embarazadas con preeclampsia, después del tratamiento periodontal. Materiales y métodos. En un análisis secundario de un ensayo clínico de asignación aleatoria, se estudiaron 57 pacientes con preeclampsia en el Hospital Universitario del Valle de Cali. Se asignaron al azar 31 al grupo de intervención periodontal (detartraje y alisado subgingival ultrasónico y manual) durante su embarazo y otras 26 al grupo control (profilaxis supragingival). Se determinaron los parámetros clínicos periodontales y la microbiota subgingival a la inclusión al estudio y en el posparto. Se evaluaron 8 bacterias periodontopáticas y 2 virus herpes por reacción en cadena de la polimerasa. Se usaron las pruebas de ji al cuadrado, test de McNemar o t de Student, con un nivel de significancia de p≤ Resultados. Los grupos fueron comparables en las variables clínicas y microbiológicas al inicio del estudio. El tratamiento periodontal redujo el promedio de la profundidad de bolsa en el grupo de intervención de 2,44±0,31 a 2,31±0,24 mm (p=0,000) y en el grupo control de 2,58±0,37 a 2,44±0,39 mm (p=0,000),y el índice de sangrado, de 16,4±1,5 a 7,9±0,7 % en el primero (p=0,000), y de 17,1±1,8 a 10±0,9 %, en el segundo (p=0,002). La frecuencia de detección de microorganismos no varió de manera significativa entre los grupos. Conclusión. El raspaje y alisado radicular, así como la profilaxis supragingival, redujeron de manera significativa la profundidad a la sonda y el índice de sangrado gingival. El tratamiento periodontal no fue más efectivo que la profilaxis para reducir los organismos periodontopáticos o los virus herpes.

Introduction. Few studies have described subgingival microbiota in pregnant women with mild preeclampsia. Objective. Clinical periodontal and subgingival microbiota changes were identified in pregnant women with mild preeclampsia after periodontal treatment. Materials and methods. In a secondary analysis of a randomized clinical trial, 57 preeclamptic women were studied at Hospital Universitario del Valle in Cali, Colombia. Thirty one women were randomized to the periodontal intervention group (subgingival scaling and planing ultrasonic and manual) during pregnancy and 26 to the control group (supragingival prophylaxis). Periodontal clinical parameters and subgingival microbiota were characterized at the time of acceptance into the study and again at postpartum. Eight periodontopathic bacteria and 2 herpesviruses were assessed by polymerase chain reaction. Chi-square, McNemar or Student´s t tests were used, with a significance level of p≤0.05. Results. Both groups were comparable in the clinical and microbiological variables at baseline. Periodontal treatment reduced the average pocket depth in the intervention group from 2.4±0.3 to 2.3±0.2 mm (p<0.001) and in control group 2.6±0.4 to 2.44±0.4 mm, (p<0.001) and bleeding index 16.4±1.5% to 7.9±0.7% in the intervention group(p<0.001) and 17.1±1.8% to 10±0.9% in the control group (p=0.002). The frequency of detection of microorganisms did not differ significantly between groups. Conclusion. Scaling/root planning and supragingival prophylaxis significantly reduced the probing depth and gingival bleeding index. Periodontal treatment was not more effective than prophylaxis in reducing periodontopathic organisms or herpesvirus.

Daily biofilm control and oral health: consensus on the epidemiological challenge - Latin American Advisory Panel

Our understanding of dental plaque biofilm has evolved since the nonspecific plaque hypothesis that considered plaque as a nonspecific mass of native microorganisms that, because of lack of oral hygiene, builds up in proportions great enough to overcome the host resistance threshold and affect the tooth structure and tooth supporting tissues. A great diversity of microorganisms-over 700 species-was detected in the oral cavity, and evidence shows that the investigation of specific microorganisms or associations of microorganisms as etiological agents for periodontal diseases and caries is not a simplistic approach. Although clinical evidence shows that oral mechanical hygiene is fundamental to prevent and control caries and periodontal disease, it is important to highlight that optimal control is not achieved by most individuals. Thus the complementary use of chemotherapeutic agents has been investigated as a way to overcome the deficiencies of mechanical oral hygiene habits, insofar as they reduce both plaque formation and gingival inflammation, and represent a valid strategy to change the biofilm and maintain dental and periodontal health. The role of the dental professional is to monitor patients and offer them the best recommendations to preserve oral health throughout their life. With this in mind, chemical control should be indicated as part of daily oral hygiene, together with mechanical procedures, for all individuals who present supragingival and/or subgingival biofilm, taking into account age, physical and/or psychological limitations, allergies, and other factors.

Interproximal space recovery using an orthodontic elastic separator before prosthetic restoration: a case report

The presence of a dental contact point is essential to maintain normal occlusion and to preserve the health of periodontal structures. Occasionally dental caries could compromise the interproximal contact point, leading to migration of the adjacent teeth with consequent retention of food, gingival inflammation, pocket formation, bone loss and dental mobility. In order to achieve an adequate restorative treatment, reestablishment of interproximal space is necessary. This report describes the interproximal space recovery between the maxillary first and second molars of a 45-year-old female patient before tooth reconstruction. In this case, an orthodontic elastic separator was indicated as an alternative to fixed orthodontic appliances in order to recover the necessary space. The technique was proven efficient, effective, economical, easy to perform and, above all, less invasive than other methods. The interproximal space was regained and a ceramic onlay was cemented for restoring the maxillary second molar. Periodical clinical and radiographic follow-up should be maintained to ensure long-term success.

A presença dos pontos de contato dentais é essencial para a manutenção da oclusão habitual e da saúde das estruturas periodontais. Ocasionalmente as cáries dentárias podem comprometer o ponto de contato interproximal, induzindo a migração de dentes adjacentes com conseqüente retenção de alimento, inflamação gengival, formação de bolsa periodontal, perda óssea e mobilidade dental. A fim de realizar um tratamento restaurador adequado, o restabelecimento do espaço interproximal é necessário. O presente relato descreve a recuperação do espaço interproximal entre molares de uma paciente de 45 anos de idade antes da reconstrução dentária. Neste caso, um elástico ortodôntico separador foi indicado como alternativa aos dispositivos ortodônticos fixos no restabelecimento do espaço necessário. A técnica utilizada provou ser eficiente, efetiva e econômica, e principalmente menos invasiva e fácil de ser realizada. Contudo para que o sucesso clínico se estabeleça ao longo do tempo, faz-se necessário um controle clínico e radiográfico.