Comparative Evaluation of the Inhibitory Effect of Lactobacillus rhamnosus on Halitosis-Causing Bacteria: An Invitro Microbiological Study.

AIM:  To determine the effectiveness of Lactobacillus rhamnosus in inhibiting halitosis-causing bacteria relative to other possible inhibitors, such as mouthwashes. MATERIALS AND METHODS:  This in vitro study was done using a diffusion test with three groups with 11 samples in each group: group A, Porphyromonas gingivalis; group B, Tannerella forsythia; and group C, Prevotella intermedia. At 24, 48, and 72 hours, the inhibitory effect of L. rhamnosus was tested. RESULTS: A statistically significant difference was seen for halo formation in group A, where all 11 samples showed an inhibitory effect after 72 hours. After 48 hours, seven of the 11 samples in group B and nine of the 11 samples in group C showed inhibitory effects. CONCLUSION:  The study found that L. rhamnosus had an inhibitory effect on halitosis-causing bacteria like P. gingivalis after 72 hours, which was statistically significant. The same was true for T. forsythia and P. intermedia after 48 hours. This means that L. rhamnosus has an inhibitory effect on halitosis-causing bacteria like P. gingivalis.

An Overview of Systematic Reviews and Meta-analyses Evaluating Different Impression Techniques for Implant-Supported Prostheses in Partially and Completely Edentulous Arches.

PURPOSE: To summarize the evidence and determine the most effective impression technique for implant-supported prostheses in terms of accuracy, time efficiency, and patient preference in partially and completely edentulous arches. MATERIALS AND METHODS: The searches were performed independently up to April 30, 2021 by two review authors through the Cochrane Oral Health Review, MEDLINE/PubMed, LILACS, and Science Direct databases. Moreover, manual and gray literature searches were performed to identify further potential reviews. Only English language-based systematic reviews with and without meta-analyses evaluating the different dental implant impression techniques were included. The outcomes assessed were accuracy, time efficiency, and patient preference. The methodologic quality of the included reviews was investigated by using the R-AMSTAR tool, and the degree of overlap of primary studies was assessed by calculating the percentage of corrected covered area (CCA) as proposed by Pieper et al.64 Results: The qualitative analysis included a total of 28 reviews, 8 of which included meta-analyses, published between 2008 and 2021, involving a total of 42 clinical trials and 203 laboratory studies. Digital vs conventional implant impression techniques were compared in 17 reviews, different digital impressions in 3 reviews, and different conventional impression techniques in the remaining reviews. Overall, the methodologic quality assessed by using the R-AMSTAR tool was moderate (mean: 26.7 ± 5.5) with slight overlap of primary studies (CCA; 5.23%). CONCLUSION: Within an overall moderate methodologic quality, the digital implant impressions showed favorable outcomes in terms of accuracy, time efficiency, and patient preference in partially edentulous arches involving three or fewer implants. However, the accuracy of full-arch digital impressions involving multiple implants is not satisfactory and needs significant improvements. Hence, future studies following stringent guidelines and robust methodology are recommended to substantiate the findings of this overview and provide a high level of evidence.

Overview of Systematic Reviews and Meta-analyses Investigating the Efficacy of Different Nonsurgical Therapies for the Treatment of Peri-implant Diseases.

PURPOSE: To summarize the methodologic quality and outcome measures from systematic reviews and meta-analyses evaluating the efficacy of different nonsurgical therapies for the treatment of peri-implant diseases. MATERIALS AND METHODS: Two review authors independently searched for systematic reviews and meta-analyses evaluating the efficacy of different nonsurgical therapies for treatment of peri-implant diseases in three different databases: MEDLINE, Embase, and the Cochrane Library. In addition, journals with a high impact factor in the fields of periodontics, prosthodontics, oral maxillofacial surgery, and implant dentistry were analyzed for potential reviews. The search was implemented from January 2010 through August 2020. Eligible reviews were screened and assessed to determine the characteristics and outcome measures. Furthermore, two review authors independently evaluated the methodologic quality by using the AMSTAR tool and the checklist proposed by Glenny et al. The interrater agreement was assessed by using the Cohen kappa coefficient. The assessment of correlation between the findings of the AMSTAR tool and Glenny et al checklist was performed by using the Spearman correlation. RESULTS: Fifteen systematic reviews and 12 meta-analyses were evaluated based on the inclusion criteria. One review investigated the efficacy of growth factors and another investigated glycine powder air polishing, 5 evaluated the role of antimicrobial photodynamic therapy, 8 assessed the effect of laser therapy, and 13 compared the different nonsurgical therapies with the surgical therapies for the treatment of peri-implant diseases. The quality assessment score evaluated by the AMSTAR checklist ranged from 5 to 11 with a mean of 7.5 ± 1.8, whereas the score evaluated by the Glenny et al checklist ranged from 3 to 14 with a mean of 9.7 ± 2.8. Spearman correlation analysis between these two tools reported a high correlation (r = 0.91) that was statistically significant (P < .001). CONCLUSION: The summarized evidence of this overview shows that the different nonsurgical therapies are effective for the treatment of peri-implant mucositis. The lack of sufficient long-term data involving large datasets results in their inconclusive efficacy in the treatment of peri-implantitis. However, the summary is determined from the moderate quality of evidence. Hence, future well-designed high-quality trials are encouraged to reassess the findings.

Autogenous bone ring for vertical bone augmentation procedure with simultaneous implant placement: A systematic review of histologic and histomorphometric outcomes in animal studies.

STATEMENT OF PROBLEM: The performance of the autogenous bone ring (ABR) technique used for the vertical bone augmentation procedure has not yet been determined. PURPOSE: The purpose of this systematic review was to investigate whether the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement enhances the histologic and histomorphometric outcomes in surgically created bone defects in animal models. MATERIAL AND METHODS: An electronic search of 3 databases, Medline/PubMed, Science Direct, Lilacs, and a manual search of a reference list of relevant studies were performed. Only animal studies regarding vertical bone augmentation by using the ABR technique with simultaneous implant placement in surgically created bone defects were included in the review. The SYstematic Review Center for Laboratory Animal Experimentation tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using the Animal Research: Reporting in Vivo Experiments guidelines. RESULTS: Five studies were included in the qualitative analysis based on the inclusion and exclusion criteria. One study comparing the ABR technique with the bovine and biphasic ring reported a high percentage of bone area and bone implant contact of the ABR at 5 weeks of osseointegration. Similar histologic findings were reported in another study at 4 months of healing, but contrasting data were reported at 8 months. Another study reported an increase in the percentage of bone area and bone implant contact of the ABR technique from 3 months to 6 months of osseointegration. Two studies reported an increase in the percentage of bone area, and 1 study reported a decrease in the mean of bone implant contact, both with simultaneous and staged implant procedures. CONCLUSION: Based on the limited available studies, the use of the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement presented optimal histologic and histomorphometric outcomes in surgically created bone defects in animal models. However, the results of the current review are not sufficiently robust to support the use of the ABR technique for vertical bone augmentation in humans.

Comparative Evaluation of Two Different One-stage Full-mouth Disinfection Protocols using BANA Assay: A Randomized Clinical Study.

AIM: The aim of this study was to evaluate and compare two different one-stage full-mouth disinfection protocols in the treatment of chronic periodontitis by assessing dental plaque and tongue coat using BANA assay. MATERIALS AND METHODS: The present study was a prospective randomized clinical parallel arm study design including 40 healthy subjects randomly allocated into two groups, i.e., group A (Quirynen's protocol of one-stage full-mouth disinfection) and group B (Bollen's protocol of one-stage full-mouth disinfection). Subjects were assessed at baseline and six weeks using plaque index, gingival index, and sulcus bleeding index. Probing depth and relative clinical attachment level were also recorded at six weeks. Winkel tongue coat index and BANA were recorded at 8 weeks using subgingival plaque and tongue coat sample. RESULTS: Both group A and group B demonstrated statistically significant reduction in plaque index, gingival index, sulcus bleeding index, Winkel tongue coat index, reduction in probing depth, and gain in relative clinical attachment level on intragroup comparison. There was no significant difference in BANA assay score of subgingival plaque and tongue coat samples in between group A and group B. CONCLUSION: From the findings of this study, both Quirynen's protocol and Bollen's protocol of one-stage full-mouth disinfection are effective in plaque reduction and tongue coat reduction and achieve comparable clinical healing outcomes. CLINICAL SIGNIFICANCE: The difference in duration and mode of use of chlorhexidine as a chemical plaque control agent in the two treatment interventions of Quirynen's and Bollen's protocol of one-stage full-mouth disinfection did not demonstrate statistical significance in reducing sulcus bleeding index scores, reducing probing depths, and gain in relative clinical attachment levels.

Platelet derived growth factor-BB levels in gingival crevicular fluid of localized intrabony defect sites treated with platelet rich fibrin membrane or collagen membrane containing recombinant human platelet derived growth factor-BB: A randomized clinical and biochemical study.

BACKGROUND: Development of autologous and recombinant growth factor/matrix combination products represent a new emerging trend in regenerative therapeutics and have gained increasing attention as a strategy to optimize tissue regeneration. The aim of the present study was to evaluate the levels of platelet derived growth factor-BB (PDGF-BB) in gingival crevicular fluid (GCF) during early healing period after the regenerative treatment of intrabony defects using beta tricalcium phosphate (ß-TCP) as a bone regeneration material with either platelet rich fibrin (PRF) membrane or collagen membrane (CM) treated with recombinant human PDGF-BB (rhPDGF-BB). METHODS: Twenty patients (13 males and 7 females) with chronic periodontitis participated in this prospective, randomized clinical and biochemical study. Each patient was randomly assigned to PRF membrane (group A) or CM incorporated with rhPDGF-BB (group B). GCF samples were obtained on days 3, 7, 14, and 30 for evaluation of PDGF-BB levels and alkaline phosphatase (ALP) levels. RESULTS: On days 3 and 7 following surgery, mean levels of PDGF-BB at sites treated with PRF membrane or CM incorporated with rhPDGF-BB as a barrier membrane were not significantly different. PDGF-BB levels decreased significantly in samples collected on days 14 and 30 with significant differences between both the groups. ALP levels significantly increased from day 3 to day 30 but there was no difference between two groups. CONCLUSION: Within the limitations of the study, both PRF membrane and CM incorporated with rhPDGF-BB showed comparable GCF levels of PDGF-BB initially with PRF showing more sustained levels throughout the study period.

Effects of two desensitizing dentifrices on dentinal tubule occlusion with citric acid challenge: Confocal laser scanning microscopy study.

BACKGROUND: Dentin hypersensitivity results when patent tubules are exposed to pain-inducing external stimuli. AIM: This study aims to compare the effects of two desensitizing dentifrices containing NovaMin and arginine on dentinal tubule occlusion with and without citric acid challenge in vitro using confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS: Forty dentin discs were randomly divided into Groups I and II containing twenty specimens each, treated with NovaMin and arginine-containing dentifrices, respectively. Groups I and II were divided into subgroups A and B where IA and IIA underwent CLSM analysis to determine the percentage of tubule occlusion while IB and IIB underwent 0.3% citric acid challenge and CLSM analysis. A novel grading system was devised to categorize tubule occlusion. RESULTS: In Group II, the percentage of occluded tubules was highest for IIA (72.25% ± 10.57%) and least for IIB (42.55% ± 8.65%) having statistical significance (P < 0.0005). In Group I, the difference between IA (49.9% ± 12.96%) and IB (43.15% ± 12.43%) was statistically insignificant (P = 0.249). On the comparison between IB and IIB statistically indifferent result was obtained (P = 0.901), whereas the difference between IA and IIA was statistically significant (P < 0.001). The results of grading system were for IA 50% of samples belonged to Grade 2, for IIA 60% - Grade 3, and for IB 70% and for IIB 90% - Grade 2. CONCLUSION: Dentinal tubule occlusion with arginine-containing dentifrice was significantly higher than NovaMin. However, it could not resist citric acid challenge as effectively as NovaMin. The effects of NovaMin were more sustainable as compared to arginine-containing dentifrice, thus proving to be a better desensitizing agent.

A comparative evaluation of the efficacy of diode laser as an adjunct to mechanical debridement versus conventional mechanical debridement in periodontal flap surgery: a clinical and microbiological study.

BACKGROUND AND OBJECTIVES: Research has shown that mechanical methods of periodontal therapy alone may fail to eliminate the tissue-invasive pathogenic flora; therefore, considerable attention has been given to adjunctive antimicrobial measures. The purpose of this study is to evaluate the efficacy of diode laser as an adjunct to mechanical debridement in periodontal flap surgery, on the basis of clinical parameters and microbiological analysis. MATERIALS AND METHODS: A total of 30 patients with generalized chronic periodontitis with probing depth >5 mm after phase I therapy were included in the study. Diode laser was used as an adjunct to open flap debridement (test) as compared with conventional flap surgery (control) in a split-mouth study design. Clinical parameters (plaque and gingival index, probing depth and relative clinical attachment level) and subgingival plaque samples of test and control groups were analyzed at baseline and 3 months post-therapy. Visual analogue scale (VAS) was used to determine patient discomfort intraoperatively and after 1 week. RESULTS: The difference between the clinical parameters in the test and control groups did not reach a statistical significance. However, there was a statistically significant reduction in colony forming units (CFU) of obligate anaerobes in the test group as compared with the control group. The diode laser was well tolerated by the patients, as determined by the VAS. CONCLUSIONS: The bactericidal effect of the diode laser was clearly evident by greater reduction of CFU of obligate anaerobes in the test group than in the control group.

Evaluation of blood parameters in patients with chronic periodontitis for signs of anemia.

BACKGROUND: Anemia of chronic disease is defined as anemia occurring in chronic infections and inflammatory conditions that is not caused by marrow deficiencies or other diseases and in the presence of adequate iron stores and vitamins. Periodontitis is a chronic infectious condition of the supporting tissues of the teeth caused by subgingival microbial colonization in susceptible hosts. This study determines the correlation between signs of anemia and chronic periodontitis. METHODS: A total of 60 systemically healthy male patients, mean age 38 years, were included in the study. Of these, 30 patients were healthy controls and 30 patients had severe periodontitis. Red blood cell parameters were evaluated from peripheral blood samples. RESULTS: Data analysis shows that patients with chronic periodontitis had lower values of hematocrit, number of erythrocytes, and hemoglobin compared to healthy controls. CONCLUSIONS: Results of the present study show that patients suffering from chronic periodontitis have a lower number of erythrocytes and hemoglobin compared to healthy controls. Thus, based on these results it can be concluded that, like any other chronic condition, chronic periodontitis can lead to anemia.