The Comparative Evaluation of the Antimicrobial Effect of Propolis with Chlorhexidine against Oral Pathogens: An In Vitro Study.

This study aimed to compare the antimicrobial effectiveness of ethanolic extract of propolis (EEP) to chlorhexidine gluconate (CHX) on planktonic Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilus, Lactobacillus salivarius subsp. salivarius, Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Staphylococcus aureus, Enterococcus faecalis, Actinomyces israelii, Candida albicans, and their single-species biofilms by agar dilution and broth microdilution test methods. Both agents inhibited the growth of all planktonic species. On the other hand, CHX exhibited lower minimum bactericidal concentrations than EEP against biofilms of A. actinomycetemcomitans, S. aureus, and E. faecalis whereas EEP yielded a better result against Lactobacilli and P. intermedia. The bactericidal and fungicidal concentrations of both agents were found to be equal against biofilms of Streptecocci, P. gingivalis, A. israelii, and C. albicans. The results of this study revealed that propolis was more effective in inhibiting Gram-positive bacteria than the Gram-negative bacteria in their planktonic state and it was suggested that EEP could be as effective as CHX on oral microorganisms in their biofilm state.

Clinical evaluation of autologous platelet-rich fibrin in the treatment of multiple adjacent gingival recession defects: a 12-month study.

Leukocyte- and platelet-rich fibrin (L-PRF) belongs to a new generation of platelet concentrates. There are limited numbers of studies focused on the use of L-PRF in gingival recession defects. This study evaluated the safety and effectiveness of using L-PRF membranes as a substitute for free connective tissue grafts (CTGs) as a treatment method for gingival recession defects. A total of 44 Miller Class I/II gingival recessions that were bilateral, adjacent, and greater than 3 mm in size were selected. Each recession site was randomly assigned to the test group (L-PRF) or the control group (CTG). After 12 months, root coverage was 76.63% and 77.36% in the L-PRF and CTG groups, respectively. It is suggested that L-PRF membrane may be an alternative graft material for treating multiple adjacent recessions greater than 3 mm in size without a requirement for additional surgery.

Scintigraphic, histologic, and histomorphometric analyses of bovine bone mineral and autogenous bone mixture in sinus floor augmentation: a randomized controlled trial--results after 4 months of healing.

PURPOSE: To test our null hypothesis stating that the mixture of autogenous cortical bone scrapings and bovine bone mineral (BBM) in a ratio of 1:4, compared with BBM alone, would have no significant effect on new bone formation 4 months after maxillary sinus floor augmentation. PATIENTS AND METHODS: Twenty-four patients presenting with alveolar bone height of less than 5 mm in the narrowest zone between the sinus floor and alveolar crest were randomly assigned to 2 treatment groups in this randomized controlled trial. We augmented 12 maxillary sinuses with a mixture of BBM and cortical autogenous bone graft, which was collected from the lateral wall of the maxillary sinus by a bone scraper, and 12 maxillary sinuses with BBM alone. Four months postoperatively, new bone formation in the augmented sinus sites was evaluated through bone scintigraphy, as well as histologic and histomorphometric analyses of the biopsy specimens obtained during implant placement. Data were statistically analyzed by independent-samples t test. RESULTS: Scintigraphically detectable new bone formation did not differ significantly between the groups (P > .05). Histologic findings showed that the new bone bridged between BBM particles and BBM underwent resorption by osteoclasts with or without the addition of autogenous bone graft. According to histomorphometric findings, the difference between the percentages of newly formed bone in the sinuses augmented with graft mixture (25.73%) and BBM alone (24.19%) was statistically nonsignificant (P > .05). CONCLUSIONS: The addition of autogenous cortical bone scrapings to BBM in a ratio of 1:4, compared with BBM alone, does not markedly increase new bone formation 4 months after maxillary sinus lifting.

Determinants of serum IgG responses to periodontal bacteria in a nationally representative sample of US adults.

AIM: To assess the distribution of elevated antibody titres to multiple periodontal bacteria, including established/putative pathogens and health-related species, by selected demographic, behavioural, and oral- and general health-related characteristics. METHODS: Data from 8153 >or=40-year-old participants from the third National Health and Nutrition Examination Survey were used, including 1588 edentulous individuals. We used checkerboard immunoblotting to assess serum IgG levels to 19 periodontal species. Thresholds for elevated antibody responses were defined for each species using the 90th percentile titre in periodontal healthy participants, using two alternative definitions of periodontitis. RESULTS: Edentulous individuals showed lower antibody responses than dentate participants, notably for titres to "red complex" species and Actinobacillus actinomycetemcomitans. Elevated titres to Porphyromonas gingivalis were twice as prevalent in participants with periodontitis than in periodontal healthy individuals. Non-Hispanic blacks and Mexican-Americans were more likely to display elevated titres for P. gingivalis compared with non-Hispanic whites (22.9%versus 19.4%versus 9.5%). Current smokers were significantly less likely to exhibit high titres to multiple bacteria than never smokers. CONCLUSION: Demographic, behavioural, and oral- and general health-related characteristics were strong determinants of systemic antibody responses to periodontal bacteria in a nationally representative sample of US adults.

Scintigraphic evaluation of osteoblastic activity in extraction sockets treated with platelet-rich fibrin.

PURPOSE: To evaluate the effect of platelet-rich fibrin (PRF) on the early bone healing process with bone scintigraphy based on technetium-99m methylene diphosphonate uptake in third molar extraction sockets. PATIENTS AND METHODS: Fourteen patients with bilaterally soft tissue impacted third mandibular molars were included in the study. The right and left impacted third molars were surgically extracted in the same session. PRF was randomly administered into one of the extraction sockets, whereas the contralateral sockets were left without treatment. Four weeks after surgery, scintigrams were obtained to evaluate scintigraphic differences between PRF-treated and non-PRF-treated sockets. After completion of the clinical study, PRF samples were evaluated by light and scanning electron microscopy. RESULTS: The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 4 weeks postoperatively (P > .05). Abundant fibrin and inflammatory cells were observed by light microscopic examination of PRF samples. Scanning electron microscopic analysis of PRF revealed the existence of platelet aggregates in a fibrin network and crystalline particles on the outer surface of PRF. CONCLUSIONS: PRF might not lead to enhanced bone healing in soft tissue impacted mandibular third molar extraction sockets 4 weeks after surgery. PRF exhibits the potential characteristics of an autologous fibrin matrix. However, whether the presence of crystal-like particles on the outer surface of PRF alters bone healing should be investigated further.

Serum antibodies to periodontal bacteria as diagnostic markers of periodontitis.

BACKGROUND: Assessment of periodontal conditions in epidemiologic studies usually requires a clinical examination, which is resource-intensive. We investigated the ability of serum immunoglobulin G (IgG) antibodies to periodontal bacteria to reflect clinical periodontal status. METHODS: We used checkerboard immunoblotting to assess serum IgG levels to 19 species, including established/putative periodontal pathogens and non-pathogenic bacteria, in 5,747 dentate adults aged > or = 40 years who participated in the third National Health and Nutrition Examination Survey between 1988 and 1994. Three earlier described alternative definitions of periodontitis were used, based on specific combinations of probing depth and attachment level values. Optimized elevated titer thresholds and corresponding sensitivities and specificities were calculated for each definition. Titers significantly associated with periodontitis were identified in univariable and multivariable logistic regression models. Parsimonious models were subsequently developed using age, gender, race/ethnicity, education, smoking, and diagnosed diabetes. RESULTS: In unadjusted models, high titers to Porphyromonas gingivalis were most strongly associated with periodontitis across all definitions (odds ratio, 2.07 to 2.74; P <0.05). In parsimonious models including demographic data, smoking, and diagnosed diabetes, high P. gingivalis titers were consistently associated with periodontitis, whereas high Eubacterium nodatum titers were associated with periodontal health in two of three definitions. Receiver operating characteristic curves for the parsimonious multivariable models showed that the area under the curve ranged between 0.72 and 0.78. CONCLUSIONS: Serum IgG titers to selected periodontal species, combined with demographic and behavioral characteristics, resulted in a moderately accurate classification of periodontal status in epidemiologic studies. The external validity of these findings must be examined further.

Gingival response to mandibular incisor extrusion.

INTRODUCTION: The aims of the study were to evaluate the rate of accompanying gingival movement and changes in the widths of the attached gingiva (AG) and the keratinized gingiva (KG) after orthodontic extrusion of the mandibular incisors. METHODS: The study was carried out with 10 subjects whose mandibular incisors were orthodontically extruded to correct a dental open bite. Periodontal indices and the widths of the AG and the KG were recorded before and after treatment. The gingival movement in relation to orthodontic extrusion was determined by radiopacity with a specially designed metal device indicating the position of the gingival margin (GM) and the mucogingival junction (MGJ) on the cephalograms before and after extrusion. RESULTS: The widths of the AG and the KG, and the clinical crown length increased significantly after treatment (P <0.05). The GM and the MGJ moved in the same direction as the teeth by 80% and 52.5%, respectively. The sulcus depth decreased significantly (P <0.05). CONCLUSIONS: Orthodontic extrusion leads to increases in the widths of the AG and the KG. The gingiva moves in the same direction as the tooth, but less. Clinically, increased gingival width can lead to a gummy smile in patients with a low lip line. Gingival corrective procedures cannot be performed in such cases due to risk for root exposure. Nevertheless, long-term follow-up is suggested to determine the final sulcus depth and the position of the GM and the MGJ.

Scintigraphic evaluation of early osteoblastic activity in extraction sockets treated with platelet-rich plasma.

PURPOSE: The aim of this study was to investigate the early effect of platelet-rich plasma (PRP) on osteoblastic activity during the healing process of soft tissue impacted mandibular third molar extraction sockets by means of bone scintigraphy. PATIENTS AND METHODS: Twelve patients with bilaterally soft tissue impacted mandibular third molars were included in the study. The impacted right and left mandibular third molars were surgically extracted in the same session. PRP was administered randomly into the extraction sockets in the study (S) group whereas the extraction sockets in the control (C) group were left without PRP treatment. Scintigrams were obtained in the first and fourth weeks after surgery to evaluate the osteoblastic activity within extraction sockets in both groups. RESULTS: Scintigraphic findings of postoperative first and fourth weeks did not show significantly increased osteoblastic activity between S group and C group (P > .05). However, the osteoblastic activity in both groups significantly increased in postoperative week 4 in comparison to week 1 (P < .05). CONCLUSION: The application of PRP alone into soft tissue impacted mandibular third molar extraction sockets failed to increase the osteoblastic activity in postsurgical weeks 1 and 4 in comparison to non-PRP-treated sockets.

Gingival response to mandibular incisor intrusion.

INTRODUCTION: The aims of the study were to evaluate the rate of accompanying gingival movement and the changes in attached and keratinized gingivae after orthodontic intrusion of mandibular incisors. METHODS: The study was carried out with 16 subjects whose mandibular incisors were orthodontically intruded for the correction of overbite. The orthodontic intrusion was performed with the segmented utility arch technique. Periodontal indexes and the widths of attached and keratinized gingivae were recorded before and after treatment. The gingival movement in relation to orthodontic intrusion was determined by means of radioopacity with a specially designed metal device indicating the position of the gingival margin and the mucogingival junction on the cephalograms taken before treatment and after intrusion. RESULTS: There were no statistically significant changes in the width of attached and keratinized gingivae after treatment (P >.05). The gingival margin and the mucogingival junction moved in the same direction as the teeth by 79% and 62%, respectively. A statistically significant decrease of the clinical crown length was also observed (P <.05). CONCLUSIONS: These results suggest that orthodontic intrusion does not lead to significant changes in the width of attached and keratinized gingivae when adequate plaque control is maintained. The gingiva moves in the same direction with the tooth, yet considerably less. This might indicate the need for follow-up or gingival correction after intrusion therapy.

Histopathological evaluation of five unusual gingival enlargement cases.

Gingival fibromatosis represents the fibrous hyperplasia of the gingival tissue. Clinical examination reveals enlargement of buccal and palatal gingival tissue. Many forms of gingival fibromatosis are of unknown etiology and termed as idiopathic gingival fibromatosis. However, several authors use various terms such as gingivomatosis and elephantiasis to describe these lesions. Our aim in this case report is to present five patients (one female, four males) with unusual clinical forms of gingival hyperplasia and to discuss the histopathological and clinical features in comparison to similar enlargements. Clinical examinations did not reveal increased periodontal pocket depths, besides plaque and gingival index scores were found to be in normal range. All of the patients were systemically healthy and were not subject to medications, which could lead to gingival hyperplasia. Additionally, clinical appearance of the lesions did not show any signs of trauma. Excisional biopsies were performed in all cases. The pathological examinations of the specimens demonstrated fibroconnective tissue characteristics, which were in accordance with the clinical appearance of all patients. Lesions healed successfully without sequelae or infection, and no recurrence was observed after 1-year follow-up.