Gingivitis crónica y otros campos de interferencia en pacientes con artritis del hombro

Introducción: La odontología holística es parte de la medicina biológica o neurofocal, dirigida a la prevención, el diagnóstico y el tratamiento relacionados con las enfermedades del sistema estomatognático en correlación con otras estructuras anatómicas, a fin de tratar al paciente de manera integral, en cuerpo, mente y alma. Objetivo: Identificar la presencia de gingivitis crónica y de otros campos de interferencia en pacientes con artritis del hombro. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 24 pacientes con artritis del hombro, pertenecientes al área de salud del Policlínico Docente Carlos Juan Finlay en Santiago de Cuba, quienes fueron atendidos en la Clínica Estomatológica Provincial Docente Mártires del Moncada, desde noviembre del 2021 hasta mayo del 2022. Resultados: En la serie predominaron el sexo femenino (62,5 %) y el grupo etario de 35-59 años (75,0 %). De igual modo, la mayoría de los pacientes padecía gingivitis crónica (87,5 %), en tanto, los otros campos de interferencia mayormente hallados fueron la placa dentobacteriana (100 %) y la caries dental (58,3 %), que figuraron en todos los molares según el holograma del microsistema de dientes alemán. Conclusiones: Los campos de interferencia identificados con más frecuencia en la casuística fueron la gingivitis crónica grave, la placa dentobacteriana y la caries dental, los cuales estuvieron asociados a la artritis del hombro que aquejaba a los pacientes.

Introduction: Holistic dentistry is part of the biological or neurofocal medicine, directed to the prevention, diagnosis and treatment related to the diseases of the stomatognatic system in correlation with other anatomical structures, in order to treat the patient in an integral way, in body, mind and soul. Objective: To identify the presence of chronic gingivitis and other interference fields in patients with shoulder arthritis. Methods: An observational, descriptive and cross-sectional study of 24 patients with shoulder arthritis was carried out, who belonged to the health area of Carlos Juan Finlay Teaching Polyclinic in Santiago de Cuba. They were assisted in Mártires del Moncada Teaching Provincial Stomatological Clinic, from November, 2021 to May, 2022. Results: In the series there was a prevalence of the female sex (62.5%) and the 35-59 age group (75.0%). In a same way, most of the patients suffered from chronic gingivitis (87.5%), as long as the other mostly found interference fields were the dentobacterial plaque (100%) and dental cavity (58.3%) that were in all the molars according to the hologram of the German teeth microsystem. Conclusions: Severe chronic gingivitis, dentobacterial plaque and dental cavity were the most frequently identified interference fields in the case material, which were associated to the shoulder arthritis in patients.

Efecto de talleres de técnica de cepillado monitoreados y supervisados con la técnica "ver-repetir" sobre higiene oral en niños con discapacidad auditiva

Introducción. La salud bucodental de poblaciones vulnerables como aquellas con discapacidad auditiva se enfrenta a barreras de salud por la falta de habilidad para la comunicación resultando en una alta prevalencia de caries, enfermedad periodontal y pérdida dentaria. Objetivo. Disminuir el Índice de O´Leary posterior a talleres de técnica de cepillado monitoreados y supervisados con la técnica "ver-repetir". Materiales y Métodos. Estudio de intervención en estudiantes de una escuela para personas con discapacidad auditiva de Asunción-Paraguay, durante el 2022-2023. Los participantes recibieron entrenamiento de cepillado con la técnica de Bass en modelos y maquetas previo a cada sesión de cepillado. En cada sesión se proveyó a cada participante de cepillo y pasta dental. Se instruyó a padres y maestros para fomentar la técnica en el hogar y en la escuela. Se estableció el Índice de O´Leary previa aplicación de una sustancia reveladora de placa bacteriana. Resultados. Participaron del estudio, 46 niñas y 25 varones entre 4 a 13 años; 12 con dentición temporaria, 41 mixta y 18 permanente. Se realizaron 11 sesiones, siendo 8 la mediana de participación. El índice de O´leary fue al inicio 81,86% ± 26,09% que se redujo significativamente a 11,69% ± 3,94%; en el 100% se redujo a menos de 25%. Los primeros molares permanentes inicialmente cariados fueron restaurados y permanecieron sin recidivas hasta el final. Conclusión. La cantidad de placa bacteriana oral en niños con discapacidad auditiva se puede mantener bajo control siguiendo estrategias de higiene que sean supervisadas y monitoreadas.

Introduction. The oral health of vulnerable populations such as the hearing-impaired face barriers due to lack of communication skills resulting in a high prevalence of caries, periodontal disease and tooth loss. Objective. To decrease O'Leary index after monitored and supervised brushing technique workshops with the "see-repeat" technique. Materials and Methods. Intervention study in students of a school for people with hearing disabilities in Asunción-Paraguay, during 2022-2023. The participants received brushing training with the Bass technique on models and mock-ups prior to each brushing session. In each session, each participant was provided with a toothbrush and toothpaste. Parents and teachers were instructed to promote the technique at home and at school. The O'Leary Index was established after applying a substance that reveals bacterial plaque. Results. 46 girls and 25 boys between 4 and 13 years old participated in the study; 12 with temporary teeth, 41 mixed and 18 permanent. 11 sessions were held, with a median participation of 8. The O'leary index was 81.86% ± 26.09% at the beginning, which was significantly reduced to 11.69% ± 3.94%; in 100% it was reduced to less than 25%. The initially decayed first permanent molars were restored and remained recurrence-free until the end. Conclusion. The amount of oral bacterial plaque in hearing impaired children can be kept under control by following hygiene strategies that are supervised and monitored.

Salivary immunoglobulin levels and periodontal indices in Brazilian children with and without type 1 diabetes

Abstract This cross-sectional study evaluated the association between salivary immunoglobulins, plaque index, and gingival index in Brazilian children with and without type 1 diabetes mellitus (DM1). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for the reporting of observational studies was followed. The DM1 group had 38 children, and an equal number of volunteers matched by sex and age were recruited as controls. Clinical examination was performed for plaque index and gingival index determination. Non-stimulated whole saliva was collected. Concentrations of IgA, IgG, and IgM were determined by ELISA test. Data were tested by the Kolmogorov-Smirnov, Mann-Whitney, and Spearman tests and a multiple linear regression model (p<0.05) was performed. Gingival index was higher in the Control (DM1: 0.16±0.17; Control: 0.24±0.23, p=0.040). In DM1, there was a correlation between IgA and age (rho=0.371, p=0.024), IgM and IgG (rho=0.459, p=0.007), and IgM and gingival index (rho=0.394, p=0.014). In DM1, multiple linear regression showed that age (p=0.041; β=0.363), gingival index (p=0.041; β=0.398), and plaque index (p=0.008; β=-0.506) were good predictors of IgA levels in saliva. Thus, IgA was the only researched immunoglobulin that was directly associated with plaque and gingival indices in Brazilian children with DM1, but not in control subjects.

Research progress on oxidative stress regulatory mechanisms in Streptococcus mutans / 口腔疾病防治

@#The oral microecological balance is closely associated with the development of dental caries. Oxidative stress is one of the important factors regulating the composition and structure of the oral microbial community. Streptococcus mutans is closely related to the occurrence and development of dental caries. The ability of S. mutans to withstand oxidative stress affects its survival competitiveness in biofilms. The oxidative stress regulatory mechanisms of S. mutans include the synthesis of reductase, the regulation of iron and manganese uptake by metalloregulatory proteins, transcription regulator Spx, extracellular uptake of glutathione and other related signal transduction systems. The current research focuses on how S. mutans adapts to a complex external environment through an oxidative stress response and its influence on oral microecology. We can design targeted small molecular compounds for key signaling pathways to inhibit oxidative stress and weaken the virulence of S. mutans, which is important for oral microecological modulation and dental caries prevention and treatment.

Research progress on the relationship between free sugars and caries / 口腔疾病防治

@#Caries is a chronic infectious disease that occurs in the hard tissues of teeth. The interaction of oral microorganisms, host, food and time leads to the occurrence and progression of caries. Free sugar is an important food factor in the occurrence of dental caries. This paper reviews the research progress on the relationship between free sugar and caries in recent years, providing a reference for further clarifying the mechanism of the occurrence and progression of caries caused by free sugar and exploring the methods of caries prevention. The cariogenic mechanism of free sugar is multifaceted. Free sugar can not only be used by oral microorganisms in dental plaque biofilms to produce acid and synthesize intracellular and extracellular polysaccharides but also cause an imbalance in oral microecology and enhance gene expression related to the cariogenic toxicity of oral microorganisms. Based on the correlation between free sugar and caries, it is important to limit the intake amount and frequency of free sugar to prevent caries. This can be achieved mainly by formulating public health policies for reducing sugar, creating a low-sugar family environment with good eating habits, using sugar substitutes and using fluoride. There are few studies on the relationship between free sugar and oral microecology. More research is needed to better understand the effect of free sugar on oral microecology and its mechanism and to validate the caries-preventing effect of various sugar reduction measures. We believe such studies would open up new avenues for the effective prevention of caries.

Periodontal disease severity is associated to pathogenic consortia comprising putative and candidate periodontal pathogens

Abstract Based on a holistic concept of polymicrobial etiology, we have hypothesized that putative and candidate periodontal pathogens are more frequently detected in consortia than alone in advanced forms of periodontal diseases (PD). Objective To correlate specific consortia of periodontal pathogens with clinical periodontal status and severity of periodontitis. Methodology Subgingival biofilm was obtained from individuals with periodontal health (113, PH), gingivitis (91, G), and periodontitis (209, P). Genomic DNA was purified and the species Aggregatibacter actinomycetemcomitans (Aa), Aa JP2-like strain, Porphyromonas gingivalis (Pg), Dialister pneumosintes (Dp), and Filifactor alocis (Fa) were detected by PCR. Configural frequency and logistic regression analyses were performed to correlate microbial consortia and PD. Results Aa + Pg in the presence of Dp (phi=0.240; χ2=11.9, p<0.01), as well as Aa JP2 + Dp + Fa (phi=0.186, χ2=4.6, p<0.05) were significantly more associated in advanced stages of P. The consortium Aa + Fa + Dp was strongly associated with deep pocketing and inflammation (p<0.001). The best predictors of disease severity (80% accuracy) included older age (OR 1.11 [95% CI 1.07 - 1.15], p<0.001), Black/African-American ancestry (OR 1.89 [95% CI 1.19 - 2.99], p=0.007), and high frequency of Aa + Pg + Dp (OR 3.04 [95% CI 1.49 - 6.22], p=0.002). Conclusion Specific microbial consortia of putative and novel periodontal pathogens, associated with demographic parameters, correlate with severe periodontitis, supporting the multifactorial nature of PD.

Periodontal indexes of two types of 3 x 3 retainers: 0.032-in SS V-loop versus 0.0215-in SS coaxial - a randomized crossover trial

ABSTRACT Objective: This randomized crossover trial evaluated periodontal indexes of two types of 3 x 3 retainers (a modified 0.032-in SS V-loop retainer and a conventional 0.0215-in SS coaxial wire retainer) after bonded for six months. Also, bonded failure rate, and a questionnaire about comfort, ease of cleaning and overall preference were recorded. Material and Methods: 15 patients were enrolled in this study who used both retainers for six months each, having a 15-day wash-out interval between each bonded retainer usage. The following periodontal index were recorded: Plaque Index (PI), Calculus Index (CI) and Gingival Index (GI). Patients answered a questionnaire to assess comfort, ease of cleaning and overall retainer-type preference. Rate of bonding failure was also evaluated. Results: V-Loop retainer showed higher PI (P<0.05) as compared to conventional 0.0215-in coaxial wire retainer. However, CI and GI presented no statistically significant differences between both types of retainers. The conventional 0.0215-in coaxial wire retainer was chosen as the most comfortable (p<0.05), although no statistically significant differences were found for all other questionnaire answers. Bonding failure events were more observed in the 3x3 V-Loop retainer (p<0.002), as compared to the conventional 0.0215-in coaxial retainer. Conclusion: V-Loop retainer showed higher PI (p<0.05), higher bonding failure rate and less comfortable, as compared to conventional 0.0215-in coaxial wire.

RESUMO Objetivo: Este estudo cruzado e randomizado avaliou os índices periodontais de dois tipos de contenções 3x3 (uma contenção aço V-Loop de 0,032" modificada e uma contenção convencional de fio coaxial aço de 0,0215") após colagem, por seis meses. Além disso, foram registradas a taxa de falha na colagem e um questionário sobre conforto, facilidade de limpeza e preferência geral. Material e Métodos: Foram incluídos nesse estudo 15 pacientes que usaram ambas as contenções por seis meses cada, com intervalo de quinze dias entre cada contenção fixa. Foram registrados os seguintes índices periodontais: Índice de Placa (IP), Índice de Cálculo (IC) e Índice Gengival (IG). Os pacientes responderam a um questionário para avaliar o conforto, a facilidade de limpeza e a preferência geral pelo tipo de contenção. A taxa de falha de colagem também foi avaliada. Resultados: A contenção V-Loop apresentou maior IP (p<0,05) em comparação ao fio coaxial convencional. Entretanto, IC e IG não apresentaram diferenças estatisticamente significativas entre as contenções testadas. A contenção convencional de fio coaxial 0,0215" foi escolhida como a mais confortável (p<0,05), embora não tenham sido encontradas diferenças estatisticamente significativas para todas as outras respostas do questionário. Eventos de falha de colagem foram mais observados na contenção V-Loop 3 x 3 (p<0,002) em comparação com a contenção coaxial convencional de 0,0215". Conclusão: A contenção V-Loop apresentou maior IP (p<0,05), maior taxa de falha de colagem e foi menos confortável em comparação ao fio coaxial convencional 0,0215".

Chitosan microparticles loaded with essential oils inhibit duo-biofilms of Candida albicans and Streptococcus mutans

Abstract Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. Objective This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. Methodology Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. Results CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. Conclusion This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries.

Effectiveness of Chewable Toothbrushes Compared to ManualToothbrushes in Removing Dental Plaque - A Systematic Review andMeta?Analysis

Objective: Chewable toothbrushes (CT) are considered an effective tool for dental plaque removal; however, their effectiveness is still uncertain compared to Manual toothbrushes (MT). Aim: To evaluate the effectiveness of CT compared to MT in dental plaque removal. Methods: Studies comparing the efficiency of CT and MT in dental plaque removal measured by Turesky Modification of Quigley-Hein Plaque Index (TMQHI), Quigley-Hein Plaque Index (QHI), or Silness Loe Plaque Index (SLPI) were identified in PubMed, Medline Web of Science, Google Scholar, and the CENTRAL. Results and effect sizes estimate are presented as mean difference, and subgroup analysis is presented separately for non?randomised interventional studies and randomised intervention studies. Risk of bias was assessed using the Cochrane risk of bias tool (ROBINS?I and ROB2 tool). Results: A total of 10 studies were included in the systematic review, whereas six out of 10 studies were included in the meta?analysis. Both CT and MT were effective in plaque reduction over time when compared individually using the TMQHI and SLPI scores. The overall pooled summary showed no difference in CT and MT’s dental plaque removal ability when measured using the TMQHI score. Similarly, there was no difference in CT and MT’s dental plaque removal ability when measured using the SLPI score. Conclusion: There is no significant difference in CT and MT’s plaque removal ability. Therefore, CT should only be recommended for children and individuals with a disability or manual dexterity.

Microbial profile of the oral cavity of patients under mechanical ventilation is not influenced by the edentamento: an observational study / Perfil microbiano da cavidade oral em pacientes sob ventilação mecânica não é influenciado pelo edentameto: um estudo observacional

Objective: Understand whether the collection site (toothless or toothless) influences the frequency of bacteria in the oral cavity. It was performed as an observational, prospective, and cross-sectional study. Methods: Clinical samples of the oral surfaces of the teeth and/or cheek mucosa were collected in the oral cavity of 37 patients who underwent elective cardiac surgery in the preoperative period from May to July 2019. The clinical samples collected were subjected to identification of colonies and antimicrobial sensitivity tests. Results: It was observed that regardless of whether the collection site is toothless or toothless, the microbial profile, socio-demographic variables, comorbidities, and risk factors do not statistically influence the choice of the collection site. Conclusions: there wasn't statistical difference between the strains found at the collection sites. Practical Implications: the result found is relevant for other researchers that will work with oral cavity collections since the chosen collection site will not influence the frequency of strains found.

Objetivo: Compreender se o local de coleta (com dentes ou desdentado) influencia na frequência de bactérias na cavidade oral. Foi realizado como um estudo observacional, prospectivo e transversal. Métodos: Amostras clínicas das superfícies orais dos dentes e/ou mucosa jugal foram coletadas na cavidade oral de 37 pacientes submetidos à cirurgia cardíaca eletiva no período pré-operatório de maio a julho de 2019. As amostras clínicas coletadas foram submetidas à identificação de colônias e testes antimicrobianos de sensibilidade. Resultados: Observou-se que independente do local de coleta ser dentado ou desdentado, o perfil microbiano, variáveis sociodemográficas, comorbidades e fatores de risco não influenciam estatisticamente na escolha do local de coleta. Conclusões: Não houve diferença estatística entre as cepas encontradas nos locais de coleta. O resultado encontrado é relevante para outros pesquisadores que trabalharão com coletas de cavidade oral, pois o local de coleta escolhido não influenciará na frequência de cepas encontradas.

Use of Chlorhexidine Bioadhesive Gel to Reduce Infection and Discomfort in Alveolar Bone Graft Wound: A Randomized Pilot Study

ABSTRACT: The objective of this study was to analyze the inflammation index, edema, bacterial plaque presence and postoperative discomfort, with the use of chlorhexidine gel. This is a randomized double-blinded pilot study, with 21 unilateral cleft lip and palate individuals, randomized into 2 groups: Test Group (TG), with 7 individuals who used 0.2 % chlorhexidine bioadhesive gel in the surgical wound after the bone graft; and Control Group (CG) with 14 individuals who used a placebo gel as the same way. The gel was applied on the surgical wound suture after alveolar bone graft. The evaluation criteria of the gel application effectiveness were the visual analogue scale (VAS) for pain control and/or discomfor t and clinical evaluation of inflammatory condition and/or wound infection. The study showed promising results for postoperativel y use of the chlorhexidine gel, although there was no statistically significant difference between the groups.

RESUMEN: El objetivo de este estudio fue analizar el índice de inflamación, edema, presencia de placa bacteriana y molestias postoperatorias, con el uso del gel de clorhexidina. Se trata de un estudio piloto aleatorizado, doble ciego, con 21 individuos con fisura labial y palatina unilateral, aleatorizados en 2 grupos: Grupo Test (GT), con 7 individuos que utilizaron gel bioadhesivo de clorhexidina al 0,2 % en la herida quirúrgica posterior al injerto óseo; y Grupo Control (GC) con 14 individuos que usaron un gel placebo de la misma forma. El gel se aplicó sobre la sutura de la herida quirúrgica después del injerto óseo alveolar. Los criterios de evaluación de la efectividad de la aplicación del gel fueron la escala analógica visual (EVA) para el control del dolor y/o malestar y la evaluación clínica del estado inflamatorio y/o infección de la herida. El estudio mostró resultados positivos para el uso posoperatorio del gel de clorhexidina, aunque no hubo diferencias estadísticamente significativas entre los grupos.

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.

Effect of oral health intervention program on the self oral care of children attending childcare facilities: a quasi-experimental study

This study aimed to conduct a quasi-experimental study for assessing the effects of an oral health intervention program (OHIP), on the self-management of oral health in children attending childcare centers. The participants recruited were 83 children from two childcare centers, who were allocated to the intervention and control groups. The intervention group received the OHIP. At baseline, a self-reported survey of parents was conducted. In addition, the oral status of the children at baseline and at 5 weeks was evaluated. Their brushing behavior was assessed once a week and every day during the OHIP intervention period and at home, respectively. After the follow-up at 12 weeks, dental plaque index (PI) was measured and two-way repeated measures analysis of variance was performed. The PI of the intervention group significantly decreased at week 5, compared to the baseline (1.90 ± 0.53, p < 0.001). Despite a substantial increase in week 12 (2.67 ± 0.08, p < 0.001), the PI was significantly lower than that of the control group (3.37 ± 0.60). The OHIP was effective in reducing the PI and modifying the brushing behavior among children. It is necessary to develop and expand a systematic oral health education program to promote self-management of oral health in children.

Modificaciones del ambiente oral en el tratamiento con ortodoncia fija / Modifications of the oral environment due fixed orthodontic treatment

Objetivo. Evaluar las condiciones del ambiente oral de distintos sectores de la boca de pacientes previo y durante el tratamiento ortodóntico. Métodos. Estudio prospectivo en 46 pacientes con tratamiento de ortodoncia fija. Los parámetros clínicos, microbiológicos de saliva y placa bacteriana fueron registrados antes del tratamiento (t0) y a los 45 (t1), 90 (t2) y 135 días (t3) del inicio. Resultados. Antes del tratamiento se registraron valores elevados del componente "cariados" del índice CPO-D y niveles regulares del IHOs. El 57% de los pacientes mostró apiñamiento dental inferior. Durante el tratamiento, el índice de placa ortodóntica IPO disminuyó respecto al IHOs a t0, aunque mantuvo valores no deseables para la salud bucal (p=0,001). La capacidad amortiguadora disminuyó en t1 y t2 pero recuperó los valores iniciales en t3 (p=0,001). Se aislaron Streptococcus mutans, Candida albicans y Lactobacillus en todas las muestras de placa bacteriana, con un aumento significativo en el sector posterior (p<0,0001). Los niveles de S. mutans, Lactobacillus y α-amilasa salival en la placa bacteriana de la zona posterior aumentaron durante el tratamiento (p =0,0002; p=0,002 y p=0,0059, respectivamente). Conclusiones. La conjunción de factores de riesgo cariogénico, tales como apiñamiento dental, baja capacidad amortiguadora salival, altos niveles de α-amilasa y S. mutans en la placa bacteriana, altos valores de IPO y el bajo flujo salival a tiempos cortos, demuestra la importancia del monitoreo individualizado de los pacientes al inicio el tratamiento ortodóntico, en especial en los sectores bucales de difícil acceso para la higiene bucal.

Objective. To evaluate the conditions of the oral environment of different sectors of the mouth in patients before and during orthodontic treatment. Methods. A prospective study in 46 patients with fixed orthodontic treatment. Clinical and microbiological parameters of saliva and bacterial plaque were collected before treatment (t0) and at 45 (t1), 90 (t2), and 135 days (t3) after the start of treatment. Results. Before treatment, high values of 'decayed' component of the DMF-T and regular levels of the OHIs were registered. Fifty-seven percent of patients showed lower dental crowding. During treatment, the orthodontic plaque index OPI decreased with respect to OHIs at t0, although it maintained undesirable values for oral health (p=0.001). The buffering capacity decreased at t1 and t2 but recovered to initial values at t3 (p=0.001). Streptococcus mutans, Candida albicans, and Lactobacillus were isolated in all the bacterial plaque samples, with a significant increase in the posterior sector (p<0.0001). Levels of S. mutans, Lactobacillus, and α-salivary amylase in the bacterial plaque of the posterior area were increased during treatment (p=0.0002; p=0.002; p=0.0059, respectively). Conclusions. The conjunction of cariogenic risk factors, such as dental crowding, low salivary buffering capacity, high levels of α-amylase and S. mutans in bacterial plaque, high values of OPI, and low salivary flow at short times, demonstrates the importance of individualized monitoring of patients at the beginning of orthodontic treatment, especially in oral sectors where oral hygiene is more difficult.

Research progress on electrode technology for dental plaque pH detection / 口腔疾病防治

@#Plaque pH detection technology can detect the risk of caries and assist in the prevention of caries, with a mature theory and a relatively simple operation. With the increasing demand for clinical caries risk detection technology and the rapid development of microelectrode techniques, there is an increasing variety of types of microelectrodes that can detect the pH of dental plaque, including glass microelectrodes, metal oxide microelectrodes and ion-sensitive field effect transistors. The glass microelectrode was the first microelectrode to be applied in this field, but its structure is weak. Among the various options, the iridium oxide microelectrode has become the most promising caries risk detection electrode in recent years because of its high strength and excellent response. Metal oxide microelectrodes can also effectively compensate for the insufficient strength of glass microelectrodes. With advances in electrode technology, miniaturized, sensitive ion-sensitive field effect transistors have attracted the attention of researchers. Scientists have also recently developed a way to detect the pH of dental plaque with an optical no-contact technique. Optical contactless detection technology will not damage the dental plaque structure, so it has great research and clinical prospects. Future research will further improve the strength and performance of these electrodes on the premise of ensuring miniaturization and achieving noncontact detection.

Correlation between vitamin D level and caries risk in early childhood caries / 口腔疾病防治

Objective @#To investigate the correlation between vitamin D levels and the risk of early childhood caries (ECC), and to provide a reference for the primary prevention of ECC in children.@*Methods @# A total of 389 children aged 6 months to 48 months were enrolled in this study. Data of feeding patterns and oral health behaviors were collected, and decayed-missing-filled teeth (dmft) were recorded. The children were divided into an ECC group (dmft > 0, n= 146) and a caries-free group (dmft=0, n=243). Peripheral blood of fingertips was collected to detect the active form of vitamin D--25(OH)D in vivo, and the cariogenic activity of dental plaque was analyzed with the Cariostat test. Logistic regression analysis was carried out to analyze the correlation among caries related factors such as 25(OH)D levels and caries risk in patients with ECC.@*Results@#There was no significant difference in the prevalence of dental caries among 25(OH)D deficiency, insufficiency and normal children (χ2=2.320, P=0.313). There was no correlation between dmft and 25(OH)D levels (dmft=1-3, r < 0.001, P > 0.05; dmft > 3, r= 0.009, P > 0.05). The risk factors for ECC were age (OR=1.082, 95% CI: 1.045-1.121, P < 0.001), breastfeeding within 6 months after birth (OR=2.789, 95% CI: 1.581-4.921, P < 0.001), nighttime milk consumption or sleeping with a nipple (OR=4.187, 95% CI: 1.938-9.048, P < 0.001), and a high Cariostat value of 1.5-3.0 (OR=4.173, 95% CI: 2.014-8.646, P < 0.001). @*Conclusion@#There was no correlation between 25(OH)D level and caries in children aged 6-48 months. The risk factors for ECC are age, breastfeeding before 6 months old, nighttime milk consumption or sleeping with a nipple and high cariogenic activity (Cariostat value of 1.5-3.0). It is necessary to establish good feeding habits and oral hygiene habits for children while promoting breastfeeding.

Association between Oral Health Knowledge, Attitude and Practice with Dental Plaque Maturity Status among Adolescents in Kota Bharu, Kelantan

@#Introduction: School students are young adolescents who are in a period of acquiring good oral hygiene habits that are practised as they grow up. This study aimed to determine the association between oral health knowledge, attitude and practices (KAP) of the adolescents and their dental plaque maturity status. Methods: A cross-sectional study was conducted among 174 school students aged 13 to 14 years in Kota Bharu, Kelantan. The oral health knowledge, attitude and practices were assessed by self-administered questionnaires, while the dental plaque maturity status was assessed using GC Tri Plaque ID gel TM (TPID). The data were analysed using IBM SPSS version 24.0. Results: The mean (SD) for knowledge and attitude score of the students were 4.69 (1.44) and 3.63 (0.63), respectively. The mean (SD) dental plaque maturity score (DPMS) of the students was 1.02 (0.55). Students who had answered correctly on sugar and practised tooth brushing twice daily had significantly lower mean DPMS as compared to those who had answered incorrectly and practised tooth brushing less than twice daily (p<0.05). Conclusion: Adolescents participated in this study had moderate oral health knowledge and good oral health attitude. Correct knowledge regarding sugar and toothbrushing routines of at least twice a day significantly associated with the dental plaque maturity status.

Biopelícula cariogénica de Streptococcus mutans y efecto hemostático de ácido tánico en la hemorragia post-exodoncia / Streptococcus mutans cariogenic biofilm and hemostatic effect of tannic acid in post-extraction hemorrhage

La caries dental y la placa dental se encuentran entre las enfermedades más comunes en todo el mundo y son causadas por una mezcla de microorganismos y restos de alimentos. Tipos específicos de bacterias productoras de ácido, especialmente Streptococcus mutans, colonizan la superficie dental y causan daño a la estructura dental dura en presencia de carbohidratos fermentables, por ejemplo, sacarosa y fructosa. Por otro lado, el sangrado posterior a la extracción es una complicación reconocida y frecuente en la práctica dental, que se define como la pérdida de sangre que continúa más allá de las 8 a 12 horas después de la exodoncia. Existe una amplia gama de técnicas sugeridas y sustancias para el tratamiento del sangrado post-extracción, que incluyen intervenciones dirigidas tanto a causas locales como sistémicas. El ácido tánico es una de las sustancias astringente que precipitan proteínas, pero no penetran en las células, por lo que inciden solo en la capa superficial. Su objetivo se enfoca a robustecer la superficie para acrecentar su resistencia mecánica y reducir la exudación. El objetivo de este estudio fue determinar la presencia de S. mutans en las biopelículas dentales y al mismo tiempo evaluar la actividad del ácido tánico como inhibidor del sangrado profuso en las extracciones dentales. S. mutans se aisló en el 92,5% de los pacientes evaluados. Los tiempos de hemostasia post-exodoncia fue significativamente menor en el grupo de pacientes a los que se les aplicó el ácido tánico en comparación a los que no se les aplicó(AU)

Tooth decay and dental plaque are among the most common diseases worldwide and are caused by a mix of microorganisms and food debris. Specific types of acid-producing bacteria, especially Streptococcus mutans, colonize the tooth surface and cause damage to hard tooth structure in the presence of fermentable carbohydrates, for example, sucrose and fructose. On the other hand, post-extraction bleeding is a recognized and frequent complication in dental practice, defined as blood loss that continues beyond 8 to 12 hours after extraction. There is a wide range of suggested techniques and substances for the treatment of post-extraction bleeding, including interventions targeting both local and systemic causes. Tannic acid is one of the astringent substances that precipitate proteins, but does not penetrate the cells, so it affects only the superficial layer. Its objective is focused on strengthening the surface to increase its mechanical resistance and reduce exudation. The objective of this study was to determine the presence of S. mutans in dental biofilms and at the same time to evaluate the activity of tannic acid as an inhibitor of profuse bleeding in dental extractions. S. mutans was isolated in 92.5% of the patients evaluated. Post-extraction hemostasis times were significantly shorter in the group of patients who received tannic acid compared to those who did not(AU)

Protocol of dental biofilm control employed by the discipline of primary healthcare at the Federal University of Ceara, Brazil / Protocolo de controle de biofilme dental utilizado na disciplina de Atenção Primária a Saúde da Universidade Federal do Ceará

ABSTRACT Objective: The objective of the study was to investigate the effectiveness of a protocol of dental biofilm control designed based on an active learning strategy. Methods: A cross-sectional study was carried out with secondary data. The sample consisted of 42 patient records. Information about the patient´s knowledge, perception of oral health, and motor coordination was collected before and after the implementation of the protocol. The plaque index was used to evaluate the oral hygiene level of the patients. Results: At the first evaluation, the results of knowledge and perception were better than the ones of motor coordination. It was also observed a significant increase in the satisfactory percentages for the use of toothbrush and dental floss when comparing the first to the final evaluation. Moreover, there was a significant decrease in the plaque index through the appointments. There were no significant differences in the decrease of plaque index when comparing different genders and ages. However, there was a greater increase of satisfactory scores regarding oral health habits among men and younger age group. Conclusions: There was a significant reduction in the plaque index and an increase in the adoption of satisfactory health habits through the appointments. Although the decrease in plaque index was significant, it was still high, suggesting the need for a higher number of follow-up appointments to reinforce oral health habits.

RESUMO Objetivo: o objetivo do estudo foi avaliar a avaliar a efetividade de um protocolo de controle de biofilme dental embasado em uma metodologia ativa de educação em saúde. Methods: Foi realizado um estudo transversal com dados secundários. A amostra foi composta por 42 fichas clínicas de pacientes. Coletaram-se informações sobre conhecimento e percepção de saúde bucal, assim como habilidade motora do paciente no início e ao final da aplicação do protocolo. Utilizou-se o índice de placa dental para avaliar a saúde bucal. Results: Observou-se que, na avaliação inicial, os construtos de percepção apresentaram melhores resultados quando comparado aos construtos que avaliavam habilidade motora. Ao comparar os resultados obtidos na avaliação inicial e na final foi verificado aumento significativo de porcentagens satisfatórias no uso da escova e do fio dental. Além disso, houve redução significativa da média percentual do índice de placa ao longo das visitas registradas no protocolo. Não houve diferença significativa na redução do biofilme de acordo com gênero e idade, no entanto, observou-se maior evolução de porcentagens satisfatórias referentes a hábitos de saúde bucal entre homens e no grupo de menor faixa etária. Conclusions: Conclui-se que houve redução significativa dos índices de biofilme e maior incorporação de hábitos satisfatórios ao longo das consultas do protocolo. Apesar da redução significativa da média percentual do índice de placa, essa ainda se apresentou alta, sugerindo a necessidade de se incorporar um maior número de visitas e reforçar as ações de educação em saúde, para se obter resultados mais efetivos.

Acción antibacteriana de colutorios de uso ortodóntico sobre Streptococcus Mutans / Antibacterial action of mouthwashes for orthodontic use on Streptococcus Mutans / Ação antibacteriana de bochechos para uso ortodôntico sobre Streptococcus Mutans

El tratamiento con ortodoncia fija produce en los pacientes una mayor acumulación de biofilm dental, siendo necesario una adecuada higiene bucal complementada con colutorios bucales. OBJETIVO: el propósito de este estudio fue evaluar la acción antibacteriana de colutorios de uso ortodóntico sobre el Streptococcus Mutans en pacientes con aparatología ortodóncica fija. MATERIALES Y MÉTODO: se realizó un estudio de diseño cuasiexperimental, comparativo, de corte longitudinal, de abordaje cuantitativo ciego simple, con un tamaño de muestra de 20 pacientes distribuidos en dos grupos de estudio para el recuento de UFC, además un control positivo y otro negativo para determinar el halo inhibitorio. RESULTADOS: los colutorios bucales Vitis® Orthodontic y Ortolacer tuvieron una disminución en el recuento de las UFC de Streptococcus Mutans hasta un 48,3% (p=0,00) y 53,2% (p=0,00) respectivamente; asimismo, hay una mayor acción antibacteriana sobre el Streptococcus Mutans del colutorio Vitis® Orthodontic que el colutorio Ortolacer (p-valor=0,009); así mismo, con un p valor = 0,000 < 0,05 a las 24 y 48 horas existe una diferencia estadística significativa en anaerobiosis que indica que el colutorio Vitis® Orthodontic genera un mayor halo inhibitorio sobre el Streptococcus Mutans. CONCLUSIONES: los colutorios bucales Vitis® Orthodontic y Ortolacer disminuyen el recuento de las UFC de Streptococcus Mutans en pacientes. Además, ambos colutorios en anaerobiosis tienen acción inhibitoria sobre el Streptococcus Mutans. Sin embargo, hay una mayor acción antibacteriana del colutorio Vitis® Orthodontic sobre el Streptococcus Mutans.

Fixed orthodontic treatment produces a greater accumulation of dental biofilm in patients, and adequate oral hygiene complemented with mouthwashes is necessary. OBJECTIVE: the purpose of this study was to evaluate the antibacterial action of mouthwashes for orthodontic use on Streptococcus Mutans in patients with fixed orthodontic appliances. MATERIALS AND METHODS: A quasi-experimental, comparative, longitudinal, single-blind, quantitative approach study was carried out with a sample size of 20 patients distributed in two study groups for the CFU count, as well as a positive and a negative control to determine the inhibitory halo. RESULTS: vitis Orthodontic and Ortolacer mouthwashes had a decrease in the CFU count of Streptococcus Mutans up to 48.3% (p=0.00) and 53.2% (p=0.00) respectively; likewise, there is a greater antibacterial action on Streptococcus Mutans of Vitis® Orthodontic mouthwash than Ortolacer mouthwash (p-value=0.009); Likewise, with a p-value = 0.000 < 0.05 at 24 and 48 hours there is a significant statistical difference in anaerobiosis indicating that Vitis® Orthodontic mouthwash generates a greater inhibitory halo on Streptococcus Mutans. CONCLUSIONS: Vitis® Orthodontic and Ortholacer mouthrinses decrease the CFU count of Streptococcus Mutans in patients. In addition, both mouthwashes in anaerobiosis have inhibitory action on Streptococcus Mutans. However, there is a greater antibacterial action of Vitis® Orthodontic mouthwash on Streptococcus Mutans.

O tratamento ortodôntico fixo leva a um aumento do acúmulo de biofilme dentário nos pacientes, e é necessária uma higiene bucal adequada complementada com lavagens bucais. OBJETIVO: o objetivo deste estudo foi avaliar a ação antibacteriana de lava bucais para uso ortodôntico em Streptococcus Mutans em pacientes com aparelhos ortodônticos fixos. MATERIAIS E MÉTODOS: um estudo quase-experimental, comparativo, longitudinal, monobloco e quantitativo foi realizado com uma amostra de 20 pacientes distribuídos em dois grupos de estudo para a contagem da UFC, assim como um controle positivo e um negativo para determinar a auréola inibitória. RESULTADOS: os enxaguatórios bucais Vitis® Orthodontic e Ortolacer tiveram uma redução na contagem de Streptococcus Mutans na UFC de até 48,3% (p=0,00) e 53,2% (p=0,00) respectivamente; também, há uma maior ação antibacteriana no Streptococcus Mutans de Vitis® Orthodontic de que os enxaguatórios bucais Ortolacer (p=0,009); Da mesma forma, com um valor p = 0,000 < 0,05 às 24 e 48 horas há uma diferença estatística significativa na anaerobiose indicando que Vitis® Orthodontic mouthwash gera uma maior auréola inibitória no Streptococcus Mutans. CONCLUSÕES: Vitis® Orthodontic e Ortolacer mouthrinses diminuem a contagem de CFU de Streptococcus Mutans em pacientes. Além disso, ambos os bochechos em anaerobiose têm ação inibitória sobre Streptococcus Mutans. Entretanto, há uma maior ação antibacteriana do Vitis® Orthodontic mouthwash em Streptococcus Mutans.