Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients with oral malodor using polymerase chain reaction.

BACKGROUND: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSCs) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal pockets and the dorsum of the tongue. It has been assumed that there is a relationship between periodontal disease and diabetes mellitus. OBJECTIVES: The aim of the study was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms of subgingival plaque and tongue coating, such as P. gingivalis (Pg), T. forsythia (Tf), and F. nucleatum (Fn) using polymerase chain reaction (PCR) in nondiabetic and diabetic chronic periodontitis patients. PATIENTS AND METHODS: Thirty chronic periodontitis patients (with and without diabetes) with 5-7 mm pocket depth, radiographic evidence of bone loss, and presence of oral malodor participated in this study. Subjective assessment of mouth air was done organoleptically and by using a portable sulfide monitor. Tongue coating was also assessed. RESULTS: The scores of plaque index, gingival index, gingival bleeding index, VSC levels, and tongue coating between the nondiabetic and diabetic patients were not significant (P>0.5). In nondiabetic patients, Fn was found to be significantly (P<0.5) more in tongue samples, whereas Pg and Tf have not shown significant values (P>0.5). In diabetic patients, Fn and Tf have shown significant (P<0.5) an increase in subgingival and tongue samples, respectively, whereas Pg has not shown significant difference between subgingival and tongue samples. INTERPRETATION AND CONCLUSION: The results confirm that there is no difference in clinical parameters between nondiabetic and diabetic periodontitis patients, but the odoriferous microbial profiles in tongue samples of diabetic patients were found to be high. However, there is a weak positive correlation between VSC levels, clinical parameters, and odoriferous microbial profiles.

The use of ozonated water and 0.2% chlorhexidine in the treatment of periodontitis patients: a clinical and microbiologic study.

BACKGROUND: The development of periodontal disease has been thought to be associated with several restricted members of the oral anaerobic species, such as black-pigmented Porphyromonas species and Actinobacillus actinomycetemcomitans (Aa), in the subgingival environment. Apart from bacteria, certain viruses and fungi that are associated with periodontal disease are also present in the subgingival plaque . MATERIALS AND METHODS: A randomized, double-blind, crossover split-mouth design was performed. A total of 16 patients suffering from generalized chronic periodontitis were selected for the study. The study period of 18 days was divided into two time-intervals, i.e. baseline (0 days) to 7 th day, with a washout period of 4 days followed by a second time interval of 7 days. The use of ozone and chlorhexidine gluconate (CHX) irrigation was randomized. Both the patient and the clinician evaluating the clinical parameters were blinded regarding the type of irrigation used. RESULTS: The interpretation of clinical and microbial data is from baseline to 7 th day. A higher percentage of plaque index (12%), gingival index (29%) and bleeding index (26%) reduction was observed using ozone irrigation as compared to chlorhexidine. The percentile reduction of Aa (25%) using ozone was appreciable as compared to no change in Aa occurrence using chlorhexidine. By using O 3 and chlorhexidine, there was no antibacterial effect on Porphyromonas gingivalis (Pg) and Tannerella forsythensis. The antifungal effect of ozone from baseline (37%) to 7 th day (12.5%) was pronounced during the study period, unlike CHX, which did not demonstrate any antifungal effect. CONCLUSION: Ozone may be considered as an alternative management strategy due to its powerful ability to inactivate microorganisms. Also, there is growing evidence that ozone can be employed as a useful therapeutic agent in both dentistry and medicine.

Evaluation of a new furcation stent as a fixed reference point for class II furcation measurements.

AIM: To date probing of the furcation using sounding has been one of the reliable methods to assess horizontal component of furcation in multirooted teeth. A more precise and reliable measurement of this horizontal component of furcation involves using a fixed reference point providing stability and reproducibility of measurements. A custom stent is used to provide a fixed reference point and can be used pre- and post-surgically without re-entry. Therefore, the purposes of this study were to (1) assess the reliability of furcation measurements by direct probing (without stent) and with the use of a newly designed furcation stent and (2) to assess the furcation measurements in relation to gingival margin position pre- and post-operatively. METHODS AND MATERIALS: Forty-three chronic periodontitis patients with buccal grade II furcation involvement in maxillary or mandibular molars were included. The furcation involvement was measured by direct probing using a UNC-15 calibrated probe with and without using a custom stent. The furcation involvement and gingival margin position were measured pre- and post-surgically. RESULTS: There was a significant reduction in plaque (PI) and gingival inflammation (GI) during the study period. The reduction in plaque index and gingival index was observed from 1.75 +/- 0.35 to 0.92 +/- 0.30, 1.88 +/- 0.35 to 0.98 +/- 0.29, respectively. Complete agreement was found between the first and the second measurement for about 74% of sites without the custom stent, whereas 86% of the sites measured using the stent had complete agreement. The differences never exceeded 1 mm for any of the sites. There was significant (t = 2.49; p<0.05) difference observed at complete agreement level ('0' difference). CONCLUSION: It may be concluded the clinical attachment level-H of the furcation involvement using a PCP UNC-15 probe and a custom designed stent provides reproducible information about the furcation depth in multirooted teeth. CLINICAL SIGNIFICANCE: Use of a simple modified furcation stent has shown greater reproducibility of furcal depth measurements than direct probing without the stent. The furcation stent definitely addresses the problems of existing methods of horizontal furcal depth measurements reported in the literature. The major advantages of the newly designed stent are the simple construction and non-invasive application which translates to wide practical applications.

Tobacco use and its effects on the periodontium and periodontal therapy.

AIM: The purpose of this article is to present a review of the potential biological mechanisms underlying the effects of tobacco smoking on periodontal health and periodontal therapy. BACKGROUND: Periodontitis is the result of complex interrelationships between infectious agents and host factors. Environmental, acquired, and genetic risk factors modify the expression of disease and may, therefore, affect the onset or progression of periodontitis. REVIEW RESULTS: The study of the relationship between periodontal disease and smoking has received increased attention during the last few years. Tobacco smoking has wide spread systemic effects, many of which may provide mechanisms for the increased susceptibility to periodontitis and the poorer response to treatment. CONCLUSION: Tobacco smoking is a significant risk factor for periodontal disease. CLINICAL SIGNIFICANCE: The role smoking plays in periodontal disease should be considered by clinicians and patients during active periodontal therapy and the oral health maintenance phases of care.