Antimicrobial photocatalysis using bio-hydrothermally synthesized Zinc oxide nanoparticles in the management of periodontitis: a prospective split-mouth, double-blind, randomized, controlled clinical trial.

BACKGROUND: The antimicrobial activity of metallic nanoparticles (NPs) has been confirmed to fight a broad spectrum of microorganisms, through antimicrobial effects that are amplified when these particles are irradiated with light of the proper wavelength. This is the first study to use phytoconjugated Zinc oxide (ZnO) NPs containing traces of active biomolecules derived from Emblica officinalis (E. officinalis) plant extract in antimicrobial photocatalysis (PCT) during non-surgical periodontal therapy. OBJECTIVES: This study aimed to evaluate the effects of repeated PCT application in the treatment of periodontitis, using a gel containing bio-hydrothermally synthesized ZnO NPs and visible light as an adjunct to scaling and root planing (SRP). METHODOLOGY: In total, 16 systemically healthy volunteers with stage 3 grade B generalized periodontitis were recruited for this prospective double blind, randomized placebo-controlled trial. After receiving SRP, the subjects received the following interventions in a split-mouth design at baseline, 1 week and 1 month: Group 1 - Placebo gel + Sham PCT; Group 2 - Nano ZnO gel + Sham PCT; Group 3 - Placebo gel + PCT; and Group 4 - Nano ZnO gel + PCT. The site-specific profile of Porphyromonas gingivalis in the subgingival plaque and clinical parameters (Plaque Index, Gingival Index, Gingival Bleeding Index, Probing pocket Depth and Clinical Attachment Level) were assessed at baseline, 1 month and 3 months. RESULTS: All interventions tested caused participants' clinical and microbiological parameters to generally improve after 3 months. Subjects who received the Nano ZnO gel + PCT combination showed a sustained and progressive improvement in their treatment outcomes, a result that presented statistically significant differences from the outcomes obtained through the remaining interventions, at all time points during the study period. CONCLUSIONS: The repeated application of PCT using bio-hydrothermally synthesized ZnO NPs can effectively complement SRP in the non-surgical treatment of Periodontitis.

Antimicrobial photocatalysis using bio-hydrothermally synthesized Zinc oxide nanoparticles in the management of periodontitis: a prospective split-mouth, double-blind, randomized, controlled clinical trial

Abstract The antimicrobial activity of metallic nanoparticles (NPs) has been confirmed to fight a broad spectrum of microorganisms, through antimicrobial effects that are amplified when these particles are irradiated with light of the proper wavelength. This is the first study to use phytoconjugated Zinc oxide (ZnO) NPs containing traces of active biomolecules derived from Emblica officinalis (E. officinalis) plant extract in antimicrobial photocatalysis (PCT) during non-surgical periodontal therapy. Objectives This study aimed to evaluate the effects of repeated PCT application in the treatment of periodontitis, using a gel containing bio-hydrothermally synthesized ZnO NPs and visible light as an adjunct to scaling and root planing (SRP). Methodology In total, 16 systemically healthy volunteers with stage 3 grade B generalized periodontitis were recruited for this prospective double blind, randomized placebo-controlled trial. After receiving SRP, the subjects received the following interventions in a split-mouth design at baseline, 1 week and 1 month: Group 1 - Placebo gel + Sham PCT; Group 2 - Nano ZnO gel + Sham PCT; Group 3 - Placebo gel + PCT; and Group 4 - Nano ZnO gel + PCT. The site-specific profile of Porphyromonas gingivalis in the subgingival plaque and clinical parameters (Plaque Index, Gingival Index, Gingival Bleeding Index, Probing pocket Depth and Clinical Attachment Level) were assessed at baseline, 1 month and 3 months. Results All interventions tested caused participants' clinical and microbiological parameters to generally improve after 3 months. Subjects who received the Nano ZnO gel + PCT combination showed a sustained and progressive improvement in their treatment outcomes, a result that presented statistically significant differences from the outcomes obtained through the remaining interventions, at all time points during the study period. Conclusions The repeated application of PCT using bio-hydrothermally synthesized ZnO NPs can effectively complement SRP in the non-surgical treatment of Periodontitis.

An in vitro analysis of the effect of adjunctive use of ozonated oil with a desensitizing agent on dentinal tubule occlusion.

INTRODUCTION: Dentinal hypersensitivity (DH), is a commonly encountered clinical problem, the management of which is by two main approaches that involve blockage of nerve activity and tubular occlusion. Desensitizing agents containing arginine and calcium carbonate have emerged effective in occluding tubules. Ozone removes the smear layer and opens up the dentinal tubules for easy penetration of these desensitizing agents. OBJECTIVE: To comparatively evaluate the effect of ozonated oil on the patency and occlusion of dentinal tubules with and without adjunctive application of a desensitizing agent containing arginine. MATERIALS AND METHODS: 80 dentin specimens that were distributed into 4 groups as Group 1 (control), Group 2 (ozonated oil), Group 3 (desensitizing agent) and Group 4 (desensitizing agent following the application of ozonated oil), underwent an acid challenge. Scanning electron microscopic (SEM) images of the dentin specimens were obtained prior to any treatment, after the application of the therapeutic agents and after acid challenge and mean tubule occlusion scores were recorded in each case employing a suitable scoring system. The statistical analysis employed One-way ANOVA test followed by Tukey's Post hoc test and Student Paired t-test for intergroup and intragroup comparisons of the mean tubule occlusion scores respectively. RESULTS: Group 2, treated with ozonated oil alone showed a statistically significant increase in the number of open dentinal tubules. Group 4 showed more compact deposits of desensitizing agent and more densely occluded tubules as compared to Group 3 which was more retained in the former even after acid challenge. CONCLUSION: Adjunctive application of the desensitizing agent containing arginine, with ozonated oil has a synergistic effect, where the latter causes opening of dentinal tubules allowing more compact penetration of the former and thus may be a potentially more effective treatment approach in the management of DH.

Comparison of the antimicrobial properties of charcoal-infused and non-charcoal-infused toothbrushes: an in vitro study.

Toothbrushes act as a reservoir for a variety of microorganisms, possibly leading to oral infection. Some manufacturers are marketing toothbrushes that incorporate materials such as charcoal in their bristles and claiming that they reduce bacterial contamination. The present study aimed to explore the antimicrobial nature of charcoal-infused and non-charcoal-infused bristles and to characterize both bristle types physically and morphologically to ascertain any differences that might influence their antimicrobial activity. The antimicrobial property was analyzed using separate standard microbial solutions of Streptococcus mutans and Candida albicans to contaminate 40 commercially available toothbrushes of each bristle type, charcoal-infused and non-charcoal-infused (80 toothbrushes total), and microbial colonies were established. Each toothbrush head was rinsed 4 times in sterile tap water to simulate the brushing cycle, and the microbial counts of the rinsing solutions were recorded after the second and fourth rinses. After the fourth rinse, the toothbrush heads were left to dry for 20 hours, and the final microbial retention counts were recorded. The physical and morphologic characteristics of both bristle types were analyzed using Laser Raman spectroscopy, energy-dispersive X-ray spectroscopy, and scanning electron microscopy. The microbiologic analysis showed a statistically significant decrease in colony counts from initial exposure to final retention of both microbes for both types of toothbrush (P < 0.05; Wilcoxon signed rank test). However, intergroup comparisons showed no significant differences between the brush types in final retention of either microbe. Raman spectroscopy showed similar carbon compositions for both types of bristle. No significant difference was found between the 2 types of toothbrushes regarding their characterization or antimicrobial activity. Therefore, before charcoal-infused toothbrushes are marketed as a means to reduce contamination, there is a need to identify an appropriate concentration, ascertain the mechanism of action, and identify the pathogen-specific action of charcoal.

Diode laser therapy in the management of chronic periodontitis - A clinico-microbiological study.

INTRODUCTION: Chronic periodontitis (CP) is an infectious disease resulting in inflammation of the supporting tissues of the teeth with progressive attachment loss and bone loss. This study aimed to evaluate the effect of 980-nm diode laser, as an adjunct to scaling and root planing (SRP) in the management of CP. METHODOLOGY: A total of 40 systemically healthy subjects diagnosed with CP were randomly assigned into two groups G1 (SRP and sham application of laser) and G2 (SRP and laser irradiation) with equal numbers in each. The levels of Porphyromonas gingivalis (Pg) were estimated from plaque samples using real-time polymerase chain reaction. Clinical and microbiological parameters were assessed at baseline, 4-6, and 12-14 weeks posttreatment in both groups. RESULTS: A gradual reduction in the levels of Pg and improvement in clinical parameters were observed from baseline to 4-6 and 12-14 weeks in both groups. However, the comparison between groups, although clinically relevant, was not found to be statistically significant. CONCLUSION: Although a 980-nm diode laser may not have any added benefit compared with SRP, it may emerge as an effective non-surgical treatment option in advanced periodontitis with complex inaccessible subgingival niches where comprehensive periodontal care may not be feasible.

Dissemination of aerosol and splatter during ultrasonic scaling: a pilot study.

CONTEXT: Routine dental procedures produce aerosol and splatter, which pose a potential risk to the clinician and dental personnel, as well as the immunocompromised patient. Reports indicate that the ultrasonic scaler is the greatest producer of aerosol and splatter. AIMS: The study aimed to evaluate the contamination distance, contamination amount and contamination duration of aerosol produced during ultrasonic scaling. METHODS AND MATERIALS: The study was performed on a mannequin fitted with phantom jaws on a dental chair. Mock scaling was done for 15 min using an auto-tuned magnetostrictive ultrasonic scaler with the simultaneous use of a low volume saliva ejector. An ultrafiltrate-containing fluorescent dye was used in the reservoir supplying the scaler unit. Filter paper discs were placed in different positions and distances in the operatory. Immediately following scaling, the filter paper discs were replaced with new ones. This was done every 30 min for a total duration of 90 min. RESULTS: Maximum contamination was found on the right arm of the operator and left arm of the assistant. Contamination was also found on the head, chest and inner surface of the face mask of the operator and of the assistant. The aerosol was found to remain in the air up to 30 min after scaling. CONCLUSIONS: The occupational health hazards of dental aerosols can be minimized by following simple, inexpensive precautions.

Evaluation of an aminobisphosphonate (alendronate) in the management of periodontal osseous defects.

BACKGROUND AND OBJECTIVES: Alendronate, an aminobisphosphonate, is capable of inhibiting periodontitis associated osteoclastic activity and hence is effective in protecting the alveolar bone in periodontitis. In the present study, we explored the efficacy of local delivery of alendronate on the alveolar bone following mucoperiosteal flap surgery. This is the first study to use polymer impregnated gel based delivery of alendronate. MATERIALS AND METHODS: A total of 15 patients with chronic periodontitis in the age group of 35 - 55 years, of both sexes, with pocket depth of ≥ 5mm and radiographic evidence of identical osseous defects in the mandibular molar region bilaterally were included in this prospective study. A gel based drug delivery system of Alendronate was formulated. Following surgical flap debridement, 0.1 ml alendronate gel and 0.1 ml placebo gel was placed at the experimental and control sites respectively. Clinical and radiographic parameters were recorded at baseline, three months and six months post surgery. RESULTS: Alendronate was more effective in improving clinical and radiographic parameters compared to placebo. INTERPRETATION AND CONCLUSION: Alendronate is effective in the management of periodontitis associated bone loss. Gel based local delivery of the drug addresses the critical concern of exposing the patient to adverse effects of systemic administration.