The influence of the utilization time of brush heads from different types of power toothbrushes on oral hygiene assessed over a 6-month observation period: A randomized clinical trial.

PURPOSE: This randomized clinical trial investigated the influence of the utilization time of brush heads from different types of power toothbrushes [oscillating rotating (OR) and sonic action (SA)93; on oral hygiene (plaque accumulation and gingival inflammation) over a 6-month observation period. METHODS: 49 participants were randomly allocated into two groups: use of the same brush head over 6 months (NR: non-replacement) or replacement of brush head every 4 weeks over 6 months (R: replacement). Each group was subdivided into two subgroups according to kind of toothbrush (TB) used (OR and SA). Modified Quigley-Hein plaque index (QHI), papilla bleeding index (PBI), and gingival index (GI) were recorded at baseline and 2, 8, 12, 16, and 24 weeks after baseline. After 24 weeks, participants of both groups (R and NR) received a new brush head. At week 26, final QHI, PBI, and GI were recorded. RESULTS: QHI decreased between baseline and follow-up visits in R groups (P< 0.05), with the exception of week 12 (P= 0.26). In NR groups, no significant decrease was detected (P> 0.05). There was no significant effect of time on PBI or GI in any of R subgroups (P> 0.05). In NR oscillating/rotating TB: significant increase in PBI and GI was detected 24 weeks after baseline (PBI: P= 0.02, GI: P= 0.03); sonic action TBs showed significant decrease in PBI at every follow-up visit (P< 0.05), except at 24 weeks after baseline (P= 0.73). GI was significantly decreased at 2 weeks after baseline only (P< 0.01). CLINICAL SIGNIFICANCE: Six-month use of the same brush head reduced effectiveness in removing plaque, and gingival inflammation appeared to increase after a utilization time of over 4 months. Replacing brush heads is advised after 4 months.

Influence of the utilization time of different manual toothbrushes on oral hygiene assessed during a 6-month observation period: a randomized clinical trial.

BACKGROUND: The aim of this randomized clinical trial (RCT) was to investigate whether 6-month continuous use of different manual toothbrushes (TBs) influences plaque removal and the degree of gingival inflammation compared to short utilization periods of 4 weeks each. METHODS: In total, 96 participants were randomly allocated into two groups: continuous use during 6 months (non-renewal group) or a change in TB every 4 weeks during 6 months (renewal group). Each group was subdivided into four subgroups (groups A to H; n = 12 each) according to the head size (normal or short) and bristle hardness (medium or soft) of the TB used. The modified Quigley-Hein plaque index (QHI), papilla bleeding index (PBI), and gingival index (GI) were recorded at baseline and 2, 8, 12, 16, and 24 weeks after baseline. After 24 weeks, each participant received a new TB, and at week 26, the final QHI, PBI, and GI were determined. The statistical evaluation consisted of analysis of covariance (P <0.05). RESULTS: With time, QHI, PBI, and GI were significantly different between the renewal and the non-renewal groups (QHI: P = 0.02; PBI: P = 0.04; GI: P <0.01), independent of subgroup. In the renewal group, QHI showed a significant decrease between baseline and each follow-up visit (P <0.01). In the non-renewal group, there was a significant decrease compared to baseline up to and including week 16 (P <0.01). PBI in the renewal group showed no significant differences between baseline and each follow-up visit (P >0.05). In the non-renewal group, only the normal head/soft subgroup exhibited a significant increase at week 24 (P = 0.02). The GI in the renewal group showed no difference between baseline and all follow-up visits, whereas in the non-renewal group, there was a significant decrease up to and including week 12 (P <0.05). CONCLUSIONS: Six-month continuous use reduced the effectiveness of the TB with respect to plaque removal, and gingival inflammation appeared to increase.

Effects of easy-to-perform procedures to reduce bacterial colonization with Streptococcus mutans and Staphylococcus aureus on toothbrushes.

It is well known that dental caries and periodontitis are the consequence of bacterial colonization and biofilm formation on the enamel surface. The continuous presence of bacterial biofilms on the tooth surface results in demineralization of the tooth enamel and induces an inflammatory reaction of the surrounding gums (gingivitis). The retention and survival of microorganisms on toothbrushes pose a threat of recontamination especially for certain patients at risk for systemic infections originating from the oral cavity, e.g., after T-cell depleted bone marrow transplantation. Thus, the effects of different decolonization schemes on bacterial colonization of toothbrushes were analyzed, in order to demonstrate their applicability to reduce the likelihood of (auto-)reinfections. Toothbrushes were intentionally contaminated with standardized suspensions of Streptococcus mutans or Staphylococcus aureus. Afterwards, the toothbrushes were exposed to rinsing under distilled water, rinsing and drying for 24 h, 0.2% chlorhexidine-based decolonization, or ultraviolet (UV) radiation. The remaining colony forming units were compared with freshly contaminated positive controls. Each experiment was nine-fold repeated. Bi-factorial variance analysis was performed; significance was accepted at P < 0.05. All tested procedures led to a significant reduction of bacteral colonization irrespective of the toothbrush model, the brush head type, or the acitivity state. Chlorhexidine-based decolonization was shown to be superior to rinsing and slightly superior to rinsing and drying for 24 h, while UV radiation was similarly effective as chlorhexidine. UV radiation was slightly less prone to species-dependent limitations of its decolonizing effects by bristle thickness of toothbrushes than chlorhexidin. Reduction of bacterial colonization of toothbrushes might reduce the risk of maintaining bacterial infections of the upper respiratory tract. Accordingly, respective procedures are advisable, particularly as they are cheap and easy to perform.

Comparison of clinical and dental panoramic findings: a practice-based crossover study.

BACKGROUND: Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR). In addition, type and frequency of secondary findings in x-rays were investigated. METHODS: Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic measures were permitted between the DPR and the clinical findings. The clinical findings were carried out by several investigators who had no knowledge of the purpose of the study. A calibrated investigator established the x-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for each tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and frequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes. RESULTS: Findings of 275 patients were available. Comparison showed a correspondence between clinical and radiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding carious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences between the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth with periapical changes. CONCLUSIONS: With reference to the assessment of teeth, there was no difference between the two methods. However, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there was a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with x-rays. Nevertheless, additional x-ray findings were found.

Oral health status of patients with acute coronary syndrome--a case control study.

BACKGROUND: The aim of this investigation was to assess the state of oral health of patients with acute coronary syndrome (ACS) and to compare this with that of a provably healthy control group (H). METHODS: 33 patients who were receiving treatment as inpatients following acute myocardial infarction or unstable angina pectoris took part in the study (ACS-group). A healthy control group (H-group) made up of blood donors, was formed following matching for age, gender, and smoking habit with the study patient group.The dental investigation consisted of the dental status (DMF-T), a plaque-Index (PI), an assessment of gingival inflammation (GI) and periodontal situation (Periodontal Screening Index: PSR(®)/PSI), and attachment loss (AL). Statistical evaluation: t-test, Mann-Whitney-test and chi- squared test (level of significance p < 0.05). RESULTS: The mean DMF-T of the ACS-group (18.7 ± 6.8) and the H-group (19.4 ± 5.1) showed no difference (p = 0.7). Although, in the ACS-group the average loss of teeth (M-T: 8.4 ± 5.2) was higher than in the H-group (M-T: 5.8 ± 6.6) the difference was not significant (p = 0.2). Whereas with the PI no difference between the two groups was found (p = 0.9), the ACS-group showed significantly more signs of inflammation (GI) than the H-group (p = 0.045). In the case of PSR(®)/PSI, there was no difference between the two groups (p = 0.7). With regard to AL, no difference was revealed between ACS- and H-group (p = 0.2). CONCLUSION: Although, the state of oral health of the ACS-group differed only insignificantly from that of control, patients with ACS showed more signs of gingival inflammation and a higher loss of teeth.

The Orthodontic Plaque Index: an oral hygiene index for patients with multibracket appliances.

Adhesively bonded, fixed orthodontic appliances--so-called multibracket appliances--on buccal or lingual tooth surfaces can make oral hygiene difficult. This increases the risk of caries and gingivitis, and patients require closely monitored prophylactic care. Oral hygiene indices serve to assess the oral hygiene situation and evaluate oral health status. The currently available indices do not adequately meet the special requirements of patients with multibracket appliances, since they evaluate only the smooth surfaces and/or approximal spaces of the teeth in terms of plaque accumulation and signs of inflammation of the marginal gingiva. The Orthodontic Plaque Index (OPI) is a special index for patients with fixed orthdontic appliances. The OPI focuses on the tooth area in the immediate vicinity of the bracket, since additional and relatively inaccessible plaque niches arise at these sites. To record the OPI, the dentition is divided into sextants. Plaque scores (0 to 4) are assigned. The plaque accumulation on each tooth surface adjacent to the bracket base is evaluated (mesial, distal, occlusal/incisal, and cervical). In addition, signs of gingival inflammation are recorded. The highest score per sextant is entered into a sextant table. Increased risk of caries and gingivitis is assumed as of score 3. The OPI can be used for both buccal and lingual multibracket appliances. In patients with fixed orthodontic apppliances, the OPI assesses oral hygiene in the bracket vicinity and thus provides differential findings. As a result, the OPI is recommended for clinical use.

Oral health of hemodialysis patients: a cross-sectional study at two German dialysis centers.

The aim of the study was to investigate the oral hygiene behavior and state of oral health of hemodialysis (HD) patients in Germany. HD patients attending two dialysis centers were asked to participate in the study. Anamneses and oral hygiene behavior were recorded in a questionnaire. Dental examination included the dental status (DMF-T) and the degree of gingival inflammation (PDI: Periodontol Disease Index). Of 129 patients contacted, 54 (42%), aged 63.9 ± 13.0 years (23 women and 31 men), took part in the study. At an average, dialysis was required for 4.1 years. The cause of terminal renal failure was glomerulonephritis in 30% of patients and diabetic nephropathy in 22% of patients. Since dialysis therapy, 63% of the patients (n = 34) only visited a dentist when they had complaints. In 46 cases (85%), the dentist had been informed about the patient's requirement for dialysis, and in most cases (70%), the dental treatment took place on the day after dialysis. The mean DMF-T of the HD patients was 22.1 ± 6.5. The proportion of carious teeth was low (D-T: 0.7 ± 1.2), of missing teeth (M-T) high (16.2 ± 9.3). The median degree of gingival inflammation (PDI) was 1. Availing themselves of dental treatment after patients needed to have dialysis was mostly "complaint oriented." In addition to a high proportion of missing teeth, a good level of restoration of caries was found. The gingiva showed only a low level of inflammatory changes.

Long-term effects of tongue piercing--a case control study.

The aim of this study was to evaluate tooth and periodontal damage in subjects wearing a tongue piercing (TP) in comparison to matched control subjects without tongue piercing. Members of the German Federal Armed Forces who had TP (group TP) and a matched control group (group C) volunteered to take part in the study. The time in situ, localization and material of TP were documented. Dental examinations included DMF-T, oral hygiene, enamel fissures (EF), enamel cracks (EC) and recessions. Statistical analysis was determined by χ (2) test and the t test. Both groups had 46 male subjects (mean age 22.1 years). The piercings had been in situ for 3.8 ± 3.1 years. Subjects in the TP group had a total of 1,260 teeth. Twenty-nine subjects had 115 teeth (9.1%) with EF (67% lingual). In group C (1,243 teeth), 30 subjects had 60 teeth with EF (4.8%, 78% vestibular) (p < 0.01). Thirty-eight subjects belonging to group TP had EC in 186 teeth (15%). In group C, 26 subjects with 56 teeth (4.5%) were affected by EC (p < 0.001). Twenty-seven subjects in group TP had 97 teeth (7.7%) with recessions. Lingual surfaces of anterior teeth in the lower jaw were affected most frequently (74%). In group C, 8 subjects had 19 teeth (1.5%) with recessions (65% vestibular). Differences between the two groups were statistically significant (p < 0.001). Tongue piercing is correlated with an increased occurrence of enamel fissures, enamel cracks and lingual recessions. Patients need better information on the potential complications associated with tongue piercing.

Dental care and oral health in solid organ transplant recipients: a single center cross-sectional study and survey of German transplant centers.

Aim of this study was to collect information about oral health of patients before and after SOT as well as information about center-based recommendations for dental care. In a single center cross-sectional study, the oral situation of 20 patients before and 20 after SOT were examined including dental (DMF-T), periodontal (PSR(®)/PSI), and oral hygiene findings (modified QHI). In a second project, a survey among 50 transplant centers in Germany was questioned regarding their recommendations for dental care of SOT recipients. Patients before and after SOT showed similar quality of dental findings (DMF-T), but worse compared to the general population. In addition, most patients in both groups showed pronounced periodontal treatment need (PSR(®)/PSI score 3 or 4). Oral hygiene findings (modified QHI) after SOT were significantly worse than in patients on the waiting list (P = 0.032). In a second project, the questionnaire was returned by 28 of 50 centers. Interpretation of data showed that 89% carry out a dental examination before SOT and 67% contacted the patients' dentists. After SOT, 83% of the transplant centers recommend antibiotic cover before dental measures. The results of our study revealed lacks in the dental care of SOT recipients. Consistent recommendations regarding the dental care of patients before and after SOT should be determined.

[Dental care of patients with organ transplants or prosthetic joints--a survey of specialty hospitals]. / Organtransplantierte und Endoprothesenträger in der zahnärztlichen Praxis. Zur zahnärztlichen Betreuung vor bzw. nach Organtransplantation oder Endoprotheseninsertion--eine Befragung von spezifischen Fachzentren.

The aim of the investigation was to collect information from specialized hospitals regarding dental care before and after organ transplantation or replacement of prosthetic joints. 50 transplantation centres and 100 orthopaedic hospitals in Germany were chosen. A questionnaire was used to elucidate the following aspects: Is a dental examination carried out preoperatively? When the patient is discharged, is he or she recommended to have antibiotic prophylaxis before dental treatment? If so, which antibiotic is recommended? The response rate was 56% (n = 28) for transplantation centres. 89% arranged a dental examination before the transplantation. 83% of those questioned recommend antibiotic prophylaxis before dental treatment: Amoxicillin was mentioned most frequently (36%). The response rate of the orthopaedic hospitals was 31% (n = 31). 3% of those questioned arranged a dental examination before insertion of an endoprothesis. 55% recommend antibiotic prophylaxis when dental treatment is to be carried out following the insertion of the endoprosthesis. Cephalosporine was most frequently mentioned (33%). It was not possible to identify a uniform recommendation regarding dental care before and after organ transplantation or replacement of prosthetic joints either for patients with an organ transplant or those having a prosthetic joint.

Clinical periodontal and microbiologic parameters in patients with rheumatoid arthritis.

BACKGROUND: A limited number of studies suggest a prevalence of periodontal pathogens in patients with rheumatoid arthritis (RA); however, results are inconsistent. The aim of this study is to investigate clinical periodontal and microbiologic parameters in patients with RA. METHODS: Sixty-six patients with RA, aged 49.5 ± 8.4 years, participated in the study. The periodontal classification was assessed with the periodontal screening index (PSR/PSI) allocated to the following parameters: 1) healthy; 2) gingivitis (PSR/PSI score 0 to 2, maximum one sextant score; 3) moderate periodontitis (>1 sextant PSR/PSI score 3, maximum one sextant score; or, 4) severe periodontitis (>1 sextant PSR/PSI score 4). Pool samples were taken for microbiologic (polymerase chain reaction) analysis for the presence of 11 periodontal pathogens. Statistical analysis was by non-parametric analysis of covariance. RESULTS: No patients were periodontally healthy: 24 patients were classified as having gingivitis; 18 patients had moderate periodontitis; 23 patients had severe periodontitis; and one patient was toothless. For most patients, Fusobacterium nucleatum (98%), Eikenella corrodens (91%), and Parvimonas micra (previously Peptostreptococcus micros; 88%) were above the detection threshold. Strong periodontal pathogens were less frequently detected: Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans, 16%); Porphyromonas gingivalis (58%); and Tannerella forsythia (previously T. forsythensis, 78%). Statistical analysis showed no significant influence of rheumatic factor (P = 0.33) on periodontal classification and on microbiologic parameters (P >0.05). Only smoking showed a significant influence (P = 0.0004) on the periodontal classification and in the case of E. corrodens (P = 0.02). CONCLUSIONS: Most patients with RA in this study showed moderate-to-severe periodontitis and the presence of periodontal pathogens. No association was found between rheumatic factor on periodontal classification and microbiologic parameters.

Initial periodontal screening and radiographic findings--a comparison of two methods to evaluate the periodontal situation.

BACKGROUND: The periodontal screening index (PSI) is an element of the initial dental examination. The PSI provides information on the periodontal situation and allows a first estimation of the treatment required. The dental panoramic tomography (DPT) indicates the proximal bone loss, thus also allowing conclusions on the periodontal situation. In this study, the results of both methods in determining the periodontal situation are compared. METHODS: The clinical examination covered DMF-T, QHI, and PSI scores at four proximal sites per tooth; the examining dentist was unaware of the radiographic finding. Based on the PSI scores, the findings were diagnosed as follows: score 0 - 2 "no periodontitis", score 3 and 4 "periodontitis". Independent of the locality and time of the clinical evaluation, two dentists examined the DPTs of the subjects. The results were classified as follows: no bone loss = "no periodontitis", and bone loss = "periodontitis". RESULTS: 112 male subjects (age 18 to 58, Ø 37.7 ± 8 years) were examined. Regarding the PSI, 17 subjects were diagnosed "no periodontitis" and 95 subjects "periodontitis". According to the evaluation of the DPTs, 70 subjects were diagnosed "no periodontitis" and 42 "periodontitis". A comparison of both methods revealed that the diagnosis "no periodontitis" corresponded in 17 cases and "periodontitis" in 42 cases (53%). In 47% (53 cases) the results were not congruent. The difference between both methods was statistically significant (p < 0.001; kappa = 0.194). CONCLUSION: The present study shows that the initial assessment of the periodontal situation significantly depends on the method of evaluation.

Investigation of wear in manual toothbrushes from different price categories.

This clinical study examined differences in wear in manual toothbrushes from different price categories. 140 volunteers (14 groups of 10) brushed twice daily for 2-3 minutes over a period of three or six months using the modified Bass technique and seven different toothbrushes (TB) from three price categories. A: 2 TB for under 1 Euro; B: 2 TB priced between 1 and 2 Euro; C: 3 TB priced at over 2 Euro. After a period of three or six months the increase in the bristle surface field was determined and the brush heads were rated macroscopically, by light microscopy and scanning electron microscopy (SEM) (grades 1-4: new, small, clear or very clear signs of use). The statistical analysis was performed with the Mann-Whitney U-test and Error Rates method (p < or = 0.05). All bristle fields showed an increase in surface area over the period of use. When examined macroscopically and under light microscopy, very little difference was found between three and six months of use, or between brushes from the same price category. The clearest distinction was found between categories B and C, whereby C was rated worse. In SEM it was difficult to separate the findings according to price categories. Here, the scores most often awarded were 3 and 4. The results of the three test methods differed markedly from one another. Thus no conclusions on the state of the bristles can be drawn from a marked increase in bristle field surface area. The category B TB tended to perform best.

Complications of tongue piercing: a review of the literature and three case reports.

AIM: The aims of this review of the literature are to offer further insights into possible problems related to tongue piercing and present three case reports showing undesired effects of tongue piercing. BACKGROUND: From a dental perspective, oral piercings and especially tongue piercings are not a harmless fashion trend since they can be associated with local and systemic risks and complications. A search of the literature was conducted to investigate the documentation of health risks associated with tongue piercing using the MEDLINE database as well as the German literature. REVIEW RESULTS: The literature contains numerous case reports, a limited number of studies, and a review describing a wide variety of complications, especially in patients who have undergone tongue piercing. In the majority of cases, the piercing of the tongue is performed in the midline. Piercings are made of different materials, usually metal or synthetic materials. Complications during piercing, immediately following piercing, as well as long term were found. CONCLUSION: The three cases presented here demonstrate some of those adverse effects. The most commonly described oral complication is the damage of teeth and the periodontium caused by tongue piercings. Tongue piercing is a personal decision, but it is important that patients are fully aware of possible oral health hazards. CLINICAL SIGNIFICANCE: Patients need better information on the potential complications associated with tongue piercing. Dental practitioners should educate patients about potential side effects and possible oral, dental, and systemic complications.

Individual versus group oral hygiene instruction for adults.

PURPOSE: The objective of this study was to assess the practicability and effectiveness of group oral hygiene instruction for adults in comparison with individual oral hygiene instruction. MATERIALS AND METHODS: A total of 104 male subjects aged 18 to 54 (mean age: 29.7) years were randomly assigned to one of four groups: group A was given individual oral hygiene instruction; group B was given group oral hygiene instruction; group C was given a combination of individual and group oral hygiene instructions; and group D received no oral hygiene instruction (the control group). The success of each form of instruction was evaluated on the basis of four parameters: (1) the Quigley-Hein plaque index (QHI), (2) the approximal plaque index (API), (3) a modified sulcus bleeding index (SBI) and (4) the community periodontal index of treatment needs (CPITN). All participants had professional tooth cleaning at the end of the baseline examination. The final examinations were conducted 13 weeks later. RESULTS: All subjects showed a poor oral health status at the beginning of the study, and the mean QHI score was 2.2. In addition, 92% of all subjects had an API score of more than 70%. Moderate-to-severe gingival inflammation (modified SBI) was observed in 67.3% of the subjects. CPITN scores of 2 or 3 were calculated for 82% of all sextants. At the end of the study, all groups showed a significant improvement in their oral health status and periodontal parameters (P < 0.0001). The majority of the subjects achieved an API score between 25% and 70%, and they had a mean QHI score of 1.2. A CPITN score of 0 or 1 was recorded for most sextants (62%). There was no significant difference between the various groups. CONCLUSIONS: This study demonstrated that group oral hygiene instruction and conventional individual instruction have similar beneficial effects in adults.

[Oral health in young adults in Germany--a comparison between women and men of the German army]. / Mundgesundheit von jungen Frauen und Männern in Deutschland. Ein Vergleich von Angehörigen der Bundeswehr.

The objective of this cross-sectional study was to compare oral health in young German women and men. We paired female and male soldiers of the German armed force (Bundeswehr) on the basis of age, school qualification and origin. All participants underwent a clinical examination. Oral health was assessed using the decayed, missing and filled surfaces index (DMF-S), an oral hygiene index (QHI), and a periodontal index (CPITN). In addition, we collected data on the subjects' smoking habits. The study included 90 women (mean age: 21.7 years) and 90 men (mean age: 21.4 years). The mean DMF-S was 20.7 +/- 13.7 for women and 21.0 +/- 19.8 for men (p>0.05). In the female group, dental restorations were present in 71% of the teeth affected by caries. In the male group, restorations were present in 61.2% (p=0.04). The female group showed a less marked polarisation of caries than the male group (p=0.03). Oral hygiene (QHI) was poor in the entire study population. Women (QHI: 2.16 +/- 0.6), however, exhibited significantly better oral hygiene than men (QHI: 2.53 +/- 0.5) (p= 0.01). Deeper probing depths (CPITN scores of 3 and 4) were less frequently seen in females than in males (p= 0.04). In both groups more than half of the participants were smokers (56.7%) since at least four years with more than ten cigarettes per day. Smoking had a significant influence on periodontal health (p=0.02). Men showed poorer oral health than women. The study emphasizes that the proportion of young adults requiring curative dental treatment remains high in Germany. It also underlines the need for intensive preventive care including cessation of smoking.

Periodontal findings and blood analysis of blood donors: a pilot study.

AIM: Before blood donation a medical check-up is mandatory to ascertain the health of the donor and to detect infections clinically. Although gingivitis and periodontitis are also bacterial infections, the oral cavity is only inspected superficially. The purpose of this study was to investigate the periodontal condition of blood donors and whether this affects the results of their blood tests. METHODS AND MATERIALS: A total of 192 blood donors were examined. The investigation included a periodontal examination to determine the Community Periodontal Index (CPI), an analysis of blood chemistry, as well as the determination of hematologic, coagulation, and immune parameters C-reactive protein (CRP), Neopterin, Procalcitonin (PCT), and tumor necrosis factor (TNF-a). Groups were formed according to periodontal status: "healthy" (n=47, mean age 24+/-4 years), "gingivitis" (n=65, mean age 24+/-4 years), and "periodontitis" (n=80, mean age 29+/-8 years). Most parameters of the routine blood test as well as the immune parameters were unremarkable with regard to the periodontal status. The values for SGPT, GGTP, uric acid, triglycerides, total protein (TP), RBC, hemoglobin (Hb) and hematocrit (HC), Eos, and Baso were also within the normal range. Nevertheless, statistical analysis showed some significant differences in these parameters between the "healthy" group and the "periodontitis" group (p=0.05). RESULTS: The results of this study show some blood donors have infections of the gingiva and/or of other periodontal tissues. Whether this is a sufficient reason to exclude them from blood donation, or in which case potential donors should be excluded, is not yet known. Nevertheless, it seems reasonable to integrate a screening method for revealing at least severe periodontitis in the medical check-up of blood donors.

A pilot study on the oral conditions of severely alcohol addicted persons.

The aim of this study was to investigate the oral status, drinking, smoking, and oral hygiene habits of alcoholics. One hundred severely addicted alcoholics were examined during the in-patient treatment for detoxification (mean age: 44 years; 68 males/32 females) The study included a questionnaire and an oral examination that measured DMF-T, QHI, PBI, and CPI. The majority of alcoholics were heavy smokers (>30 cigarettes/day). Fifty-two percent of the alcoholics stated they frequently forgot to brush their teeth and 43% observed bleeding of their gums. The mean DMF-T was 20 (2 D-T, 9 M-T, 9 F-T), the mean QHI was 2.4, and the mean PBI was 1.8. Forty-nine percent of the sextants were scored CPI 3 or 4; about 25% were edentulous (CPI X). Our results indicate severe alcoholics have a high risk of periodontal break down and tooth loss. To what extent these findings were caused by general/oral neglect alone (in combination with nicotine abuse) is at present unknown.

[Oral condition of abstaining alcoholics. A case-control study]. / Gebisszustand von Alkoholkranken in der Abstinenz. Eine Fall-Kontroll-Studie.

The aim of this study was to investigate the oral situation of long-term severely alcohol-addicted persons in a case-control-study. 28 controlled abstinent alcoholics and 30 control persons without any drinking history but who were smokers participated in the study. The mean age of the patients was 46 years, the alcohol addiction had existed for 17 years on average; the majority were heavy smokers with an average of two packs of cigarettes per day. The mean age of the control persons was 43 years, each of them smoked about one pack of cigarettes per day. The oral examination included the DMF-T and the different components, the QHI, the PBI and the CPI. Significant differences between the two groups were found for the following parameters: M-T (p < 0.0002), DMF-T and D-T (p < 0.002), PBI (p = 0.05). F-T and QHI revealed no differences. The periodontal examination showed that in 69% of the alcoholics and in 40% of the controls severe pocketing could be found (CPI 4). 4% of the patients and 20% of the controls had no periodontal pockets (CPI 0, 1 or 2). These results indicate that long-term severely alcohol-addicted persons have a high risk of periodontal breakdown and tooth loss. They also support the assumption that excessive consumption of alcohol may promote the progression of chronic periodontal disease.