Comparison of the clinical effects of subgingival application of metronidazole 25% gel and scaling in the treatment of adult periodontitis.

OBJECTIVE: Control of subgingival plaque is of paramount importance in the treatment of periodontal diseases. The role of subgingival sustained-release antibiotic therapy needs elucidation. A single-blind clinical trial was carried out in 13 patients with adult periodontitis to compare the effects of subgingival application of metronidazole dental gel with those of subgingival scaling. METHOD AND MATERIALS: A split-mouth design was used so that each patient received all treatments simultaneously. Randomly selected quadrants were treated with application of 25% metronidazole gel, subgingival scaling, or a combination of scaling and gel application. The remaining quadrant in each patient was left untreated as a control. RESULTS: All three treatments were effective in significantly reducing Plaque Index, Gingival Index, and bleeding on probing over the 14-week observation period. No statistically significant differences were found between scaling alone and combined treatment. Scaling and combined treatment were better than metronidazole. Metronidazole produced transient effects, best noted during the first 4 weeks after treatment. No additive effect of metronidazole was noted in the combined treatment. At week 14, only combined treatment sites and scaled sites showed statistically greater probing depth reduction than control sites. CONCLUSION: For the treatment of mild-to-moderate adult periodontitis, subgingival scaling alone is as effective as the combination of scaling and antibiotic therapy.

Self-reported symptoms of temporomandibular dysfunction in a female university student population in Saudi Arabia.

The symptoms of temporomandibular dysfunction (TMD), reported by 705 female university students of Riyadh, Saudi Arabia, are analysed. The population is representative of the educated class of Saudi Arabia. The most frequently reported symptoms were jaw feeling tired (34.5%), awareness of uncomfortable bite (31.3%), pain in front of the ear (22.4%) and discomfort upon wide opening (22.4%). The frequency of subjective reactions was, pain interferes with activity (42%), disturbed sleep (40.6%), taking of medication (27.8%) and pain being frustrating or depressing (26.8%). Some interesting relationships were found between the reported symptoms and marital status, residence and college of education. These findings are similar to those reported in a Bedouin community in Egypt, but lower than that in a Saudi Arabian population attending dental clinics, Saudi male dental students and high school students.

Effect of X-ray beam vertical angulation on radiographic assessment of alveolar crest level.

Periodontal diseases are diagnosed and monitored by various methods. Probing pocket depth measurements and dental radiographs are two of the most commonly used methods. The aim of this study was to assess the effect of x-ray beam vertical angulation on radiographic assessment of alveolar crest level in five human mandibles. A standardized technique was used to take bitewing radiographs with -10 degrees, 0 degree and +10 degrees angulation of X-Ray beam. The range of the mean differences at individual sites was from 1.84 mm (0.58 +/- SD) to 3.70 mm (1.01 +/- SD). It was found that there was a wide range of over or underestimation of the alveolar crest level due to a change in beam angulation. It was concluded that, to monitor patients with periodontal disease or treatment outcomes, it is important to have reproducible images and bitewing film holders should be used to minimize the X-Ray beam angulation error in general dental practice.

The silent period in the masseter and the anterior temporalis muscles in adult patients with mild or moderate mandibular dysfunction symptoms.

The electromyographical silent period in the masseter and the anterior temporalis muscles during tooth tapping and jaw jerk were studied in patients with fairly mild temporomandibular joint dysfunction symptoms. The length of the silent periods in the patient group did not differ generally from that in a control group. During tooth tapping, however, patients with distinct muscular disorders had shorter silent period duration (7.7 ms) than patients with other symptoms or when compared with control subjects (10.5 and 11.3 ms, respectively). The duration returned to normal after correction of the muscular disorders. This finding suggests that the duration of the silent period is affected by the muscle condition. Patients with obvious muscular disorders of mild to moderate magnitude, thus, may show a shorter silent period duration during tooth tapping.

The silent period in the masseter and anterior temporalis muscles in young adult subjects unaware of mandibular dysfunction symptoms.

In fourteen individuals unaware of mandibular dysfunction symptoms, latency and duration of the silent period in the masseter and anterior temporalis muscles at tooth tapping and jaw jerk were reasonably reproducible after 5 weeks and 5 months. Although the subjects felt no discomfort in the stomatognathic system, in some of them mild to moderate muscle tenderness, TMJ sound and occlusal disharmony were found at clinical examination. The relationship between these symptoms and the silent period was analysed. Muscle tenderness was the only factor to affect the silent period. The subjects with muscle soreness had a shorter duration of the silent period than the subjects without such symptoms.