Assessment of plaque control efficacy using two types of toothbrushes in young adults: An interventional crossover study.

OBJECTIVE: Evaluation of plaque removal efficacy of short-headed toothbrush as compared to conventional/traditional toothbrush. METHOD: A total of 20 subjects meeting the inclusion criteria were considered. Selected subjects were divided into test and control groups. Initially, subjects were advised to refrain from brushing teeth for 24 h, to determine the plaque index (PI) and gingival index (GI) at the baseline. Further, crossover observation between the groups was recorded based on short-headed toothbrush (Curaprox CS 5460) and traditional brushes (ultrasoft). Finally, a questionnaire survey was conducted to gather preferences and experiences of each subject. RESULTS: In terms of plaque removal, the short-headed toothbrush and the conventional toothbrush demonstrated comparable results. In terms of PI and GI, the intergroup comparison revealed no significant differences (p = 0.878). Individual acceptability of the short-headed toothbrush was shown to be higher in the questionnaire survey. CONCLUSION: It was observed that both toothbrushes showed similar efficacy. However, the subjects preferred short-headed toothbrush. CLINICAL RELEVANCE: Short-headed toothbrushes comprising a higher number of bristles can be recommended in terms of better oral hygiene.

Efficacy of platelet rich fibrin in the treatment of human intrabony defects with or without bone graft: A randomized controlled trial.

AIM: To evaluate the efficacy of platelet rich fibrin (PRF) with or without bone graft [demineralized bone matrix (DBM) graft] in the treatment of intrabony defects based on clinical and radiographic parameters. MATERIALS AND METHODS: Thirty six intrabony defects in 36 patients were randomly divided into three different groups and were treated with group A (PRF with DBM) or group B (PRF alone) or group C [open flap debridement (OFD)]. Clinical parameters such as plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively; radiographic parameters such as linear bone growth (LBG) and percentage in bone fill (%BF) were calculated by using the image analysis software. Comparisons of groups were analyzed using Kruskal-Wallis analysis of variance test. Pair-wise comparison of groups was done by Mann-Whitney U test. RESULTS: Mean PD reduction and RAL gain were greater in group A (4.25 ± 1.48, 3.92 ± 0.90) and group B (3.82 ± 0.75, 3.27 ± 0.65) than control (3.00 ± 1.21, 2.25 ± 0.62). Furthermore, statistically significant improvement in LBG and %BF was found in group A (3.47 ± 0.53, 61.53 ± 4.54) compared to group B (2.55 ± 0.61, 49.60 ± 14.08) and group C (1.21 ± 0.80, 24.69 ± 15.59). CONCLUSIONS: The study demonstrated that PRF improves clinical and radiological parameters compared to OFD alone in intrabony defects. Addition of DBM enhances the effects of PRF in RAL gain and radiographic defect fill.

Serum interleukin-1ß in subjects with abdominal obesity and periodontitis.

BACKGROUND & OBJECTIVE: Abdominal obesity and periodontal diseases are believed to share close relation through commonality of chronic inflammation. Both inflammatory periodontal disease and excess abdominal fat modulate their systemic influences through several inflammatory mediators. The present study was carried out to evaluate and compare serum interleukin-1ß levels in subjects with abdominal obesity and periodontal disease. METHODS: Sixty non-diabetic and non-smoking subjects (aged 25-49 years; 28 females and 32 males) were assessed for abdominal obesity by waist to hip ratio. Full-mouth clinical periodontal measurements were recorded for determination of periodontal status. Serum samples were obtained and interleukin-1ß was assessed using commercially available ELISA kit. Obtained data were analyzed statistically. RESULTS: Measures of abdominal obesity and periodontal disease were found to significantly influence the serum interleukin-1ß. Abdominally obese subjects had significantly higher serum interleukin-1ß in healthy (p=0.006), gingivitis (p<0.001) and periodontitis (p<0.001) groups. There was a significant difference in serum interleukin-1ß levels among subjects with different periodontal status in both non obese (F(2,27)=18.17, p<0.0001) and obese groups (F(2,27)=15.70, p<0.0001). Serum interleukin-1ß was significantly correlated with PI, GI, BOP%, PD and CAL non obese and obese groups. A significant correlation was also seen with WC, HC and WHR only in obese group. CONCLUSION: Significant changes in serum interleukin-1ß are influenced by abdominal obesity and periodontal status independently even in the absence of diabetes mellitus and smoking. Serum interleukin-1ß was significantly higher in patients with abdominal obesity and periodontitis.

Antibiotics in periodontal surgeries: A prospective randomised cross over clinical trial.

AIMS AND OBJECTIVES: (1) To evaluate the need of antibiotics in periodontal surgeries in reducing postsurgical infections and explore if antibiotics have any key role in reducing or eliminating inflammatory complications. (2) To establish the incidence of postoperative infections in relation to type of surgery and determine those factors, which may affect infection rates. MATERIALS AND METHODS: A prospective randomized double-blind cross over clinical study was carried out for a period of 1-year with predefined inclusion and exclusion criteria. All the patients included in the study for any periodontal surgery were randomly divided into three categories: Group A (prophylactic), Group B (therapeutic), and Group C (no antibiotics). Patients were followed up for 1-week after surgery on the day of suture removal and were evaluated for pain, swelling, fever, infection, delayed wound healing and any other significant findings. Appropriate statistical analysis was carried out to evaluate the objectives and P < 0.05 was considered as statistically significant. RESULTS: No infection was reported in any of 90 sites. Patients reported less pain and postoperative discomfort when prophylactic antibiotics were given. However, there were no statistical significant differences between the three groups. SUMMARY AND CONCLUSION: There was no postoperative infection reported in all the 90 sites operated in this study. The prevalence of postoperative infections following periodontal surgery is <1% and this low risk does not justify the routine use of systemic antimicrobials just to prevent infections. Use of prophylactic antibiotics may have role in prevention of inflammatory complication, but again not infection.

Dental manifestation of primary idiopathic hypoparathyroidism.

Idiopathic hypoparathyroidism (IHP) is a rare endocrinopathic disorder, of idiopathic nature, characterized by a deficiency of parathyroid hormone causing low serum calcium (Ca) and high serum phosphorus concentrations. We present a case report ofa 40-year-old woman with complaint of bleeding gums and tingling sensation in fingers and toes reported to our department in March 2005 with no tangible diagnosis from previous medical examinations. Oral findings included abnormally short roots, cemental hyperplasia, widening of the periodontal ligament space and root resorption. Laboratory investigations revealed a low serum Ca level and along with the clinical findings, a diagnosis of IHP was reached. Oral prophylaxis was performed and Ca supplements were prescribed. We believe that this case report is a first of its kind reporting cemental hyperplasia, altered alveolar bone patterns and periodontal ligament widening in a patient with IHP.

Peripheral ossifying fibroma.

Peripheral ossifying fibroma (POF) is one of the inflammatory reactive hyperplasia of gingiva. It represents a separate clinical entity rather than a transitional form of pyogenic granuloma and shares unique clinical characteristics and diverse histopathological features. We present a case of POF in a 65-year-old male patient in the posterior maxillary gingiva, the clinical presentation of which differs from the usual presentation. Differential diagnosis and some interesting facts of POF are discussed.

Effect of alcohol consumption status and alcohol concentration on oral pain induced by alcohol-containing mouthwash.

Alcohol exposure alters oral mucosa. Patient compliance with mouthwash use may be reduced by oral pain resulting from rinsing with alcohol-containing mouthwash. However, information regarding the effects of alcohol consumption and mouthwash alcohol concentration on oral pain is limited. In this double-blind, randomized, controlled cross-over study, we investigated the effects of alcohol consumption status and mouthwash alcohol concentration on response to and perception of oral pain induced by alcohol-containing mouthwash. Fifty healthy men aged 33 to 56 years were enrolled and classified as drinkers and nondrinkers according to self-reported alcohol consumption. All subjects rinsed with two commercially available mouthwash products (which contained high and low concentrations of alcohol) and a negative control, in randomized order. Time of onset of oral pain, time of cessation of oral pain (after mouthwash expectoration), and pain duration were recorded, and oral pain intensity was recorded on a verbal rating scale. Drinkers had later oral pain onset and lower pain intensity. High-alcohol mouthwash was associated with earlier pain onset and greater pain intensity. In addition, oral pain cessation was later and pain duration was longer in nondrinkers rinsing with high-alcohol mouthwash. In conclusion, alcohol consumption status and mouthwash alcohol concentration were associated with onset and intensity of oral pain.

Single use of tetracycline with and without diclofenac sodium as local drug delivery in pocket therapy: a clinico-microbiological study.

AIM: Local drug delivery is a non-surgical method in the treatment of periodontitis. Different chemotherapeutic agents are used for local drug delivery; one such agent is tetracycline, a broad-spectrum antibiotic. Recent studies have also shown that the use of non-steroidal anti-inflammatory drugs reduces pro-inflammatory cytokines and acts as host modulator. Thus, an attempt was made to compare and evaluate the efficacy of tetracycline alone and in combination with diclofenac sodium as a local drug delivery. METHODS: A total of 36 sites with chronic periodontitis were divided into three groups with 12 sites each (i.e. group A, antibiotics alone; group B, antibiotics in combination with non-steroidal anti-inflammatory drugs; and group C, control group). For all the groups, the following parameters (plaque index, papillary bleeding index, probing pocket depth, and microbial analysis) were assessed and statistically analyzed. RESULTS: The antibiotic and non-steroidal anti-inflammatory drug combination group showed a statistically-significant improvement in clinical parameters and a shift in microbial flora when compared to the group with antibiotics alone. However, the control group failed to show any statistically-significant improvement. CONCLUSION: Antibiotics in combination with non-steroidal anti-inflammatory drugs are more efficient than using antibiotics alone as local drug delivery for the treatment of periodontal pockets.