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Effects of Adjunctive Daily Blue Light Toothbrushing on Dental Plaque and Gingival Inflammation—A Randomized Controlled Study

Effects of Adjunctive Daily Blue Light Toothbrushing on Dental Plaque and Gingival Inflammation—A Randomized Controlled Study

Phototherapy with blue light emitting diodes (LEDs) is gaining interest be- cause of the efficient antimicrobial benefits reported in several studies in the last decade. The aim in this study was to investigate if a toothbrush with incor- porated blue light used in daily oral care can reduce dental plaque and gingival inflammation. An 8-week single-blinded randomized controlled clinical study including 48 subjects compared effects of toothbrushes with/without 450 nm blue LED light emission, on clinical parameters (plaque index, gingival index, bleeding on probing), and on inflammatory markers in saliva and gingival crevicular fluid. Significant reductions in dental plaque and gingival inflam- mation (p < 0.001), and in some inflammatory markers (p ≤ 0.05), matrix metalloproteinase (MMP)-8, tissue inhibitor metalloproteinase inhibitor (TIMP)-1, interleukin (IL)-1 β and interleukin (IL)-8, were detected within both groups from baseline to follow-up. For all subjects dental plaque was reduced with 57%, and a reduction in gingival inflammation was demon- strated by a decrease in gingival index (GI) with 46% and in bleeding on probing (BOP) with a decrease of 15%. No significant differences were found between the groups at a level of p = 0.05. However, the amount of plaque was reduced by 62% in the blue light group and 51% in the control group, a dif- ference established at a level of p = 0.058. A toothbrush with a 450 nm LED did not show any statistical significant adjunctive effect of toothbrushing re- garding reduction in measurements of dental plaque and gingival inflamma- tion.

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Comparative evaluation of clinical and microbiological efficacy of Chlorhexidine and a herbal (hiora) mouth rinse in patients with gingival Inflammation - a clinical & microbiologic study

Comparative evaluation of clinical and microbiological efficacy of Chlorhexidine and a herbal (hiora) mouth rinse in patients with gingival Inflammation - a clinical & microbiologic study

In the crossover group, statistically there was no significant difference in mean plaque index when HiOra mouthwash was compared with Chlorhexidine mouthwash. The results of the present study are in accordance with Neeti Bajaj and Shobha Tandon (2011) 7 . They conducted a study to assess the effects of a mouthwash prepared with Triphala on dental plaque, gingival inflammation, and microbial growth and compared it with Chlorhexidine mouthwash where Triphala & Chlorhexidine group showed progressive decrease in plaque scores from baseline to 9 months, whereas distilled water group showed increase in plaque scores.

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Gingival inflammation assessment by image analysis: measurement and validation

Gingival inflammation assessment by image analysis: measurement and validation

There was no evidence of a statistically significant difference at the 95% level between first and second visits (Table 4). A few of the cases in this study when seen after a year, showed slight gingival redness level changes and reduced coverage of tooth surfaces from the measurement of the tooth area. However, most cases showed little change in short term assessments. The lack of change in the gingival colour and area of a patient may be accounted for by failure to achieve effective professional root surface cleaning, poor patient compliance, medical conditions affecting the host response or medication having an adverse effect on gingival inflammation and encroachment. However, in the group of patients examined, whilst good improvements were seen for some patients, the overall results within the group may have been adversely affected by a number of patients having a poor response to treatment.

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Gingival inflammation assessment by image analysis: measurement and validation

Gingival inflammation assessment by image analysis: measurement and validation

There was no evidence of a statistically significant difference at the 95% level between first and second visits (Table 4). A few of the cases in this study when seen after a year, showed slight gingival redness level changes and reduced coverage of tooth surfaces from the measurement of the tooth area. However, most cases showed little change in short term assessments. The lack of change in the gingival colour and area of a patient may be accounted for by failure to achieve effective professional root surface cleaning, poor patient compliance, medical conditions affecting the host response or medication having an adverse effect on gingival inflammation and encroachment. However, in the group of patients examined, whilst good improvements were seen for some patients, the overall results within the group may have been adversely affected by a number of patients having a poor response to treatment.

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Objective. To evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. Methodology. Four-week study conducted in San Luis Potosí, Mexico, from January to March 2017. Participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. Subjects were randomized and divided into three groups: Group A: mouthwash based on 0.05% cetylpyridinium chloride (CPC) (positive control); Group B: mouthwash based on probiotics (experimental); Group C: placebo mouthwash (negative control). No oral hygiene practices or routines were modified; subjects were followed for 4 weeks. The primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. Results. Of the 45 patients included, 19 (42.2%) were men and 26 (57.7%) women, mean age was 22.8±2.07. Each group consisted of 15 subjects; all subjects completed the study. There was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. Plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). However, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). Conclusions. The use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. There were no statistically significant differences between the study groups.

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Amongst the patients, who manifested gingival overgrowth, the gingiva of the buccal side was found to be affected to a greater extent and with greater severity than the gingiva of lingual side. Gingival overgrowth also manifested with greater extent and severity in the anterior region especially the lower anterior sextant. These findings are despite the known fact that oral hygiene is generally always better in the anterior region. A plausible explanation for such site specificity has till date evaded various workers all over the world. The role of plaque and gingival inflammation has been controversial in literature. Dental plaque as a cofactor in the etiology of gingival overgrowth has been mentioned in the periodontal diseases classification system wherein drug induced gingival diseases are categorized into the major group ‘dental plaque induced gingival diseases [30]. Whereby, not only the severity but also development was pointed as being influenced by accumulation of dental plaque. It has been postulated that presence of dental plaque may provide a reservoir for the accumulation of the drug thus posing a risk factor for gingival overgrowth [31]. Dental plaque affecting gingival overgrowth has been shown in a number of studies [11,32]. On the contrary, some other writers have reported no correlation between gingival overgrowth and poor oral hygiene [33,34]. A genetic link has also been previously given as an explanation as to why some people even with poor oral hygiene do not develop gingival overgrowth [35,36 ]. A recent publication describes that there exists a complex interplay of various factors viz. fibroblast biology, connective tissue turnover, growth and inflammatory processes in a larger backdrop of genetic susceptibility [37].

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After the initial report on significance of attached gingiva by Lang NP et al., many studies have focused on this concept and some reported their findings in favour while others contradicted. An association between lack of attached gingiva and recession has often been implied in the literature [27]. Tenenbaum H observed a negative correlation between width of attached gingiva and the number of gingival recessions and also reported no significant correlation between oral hygiene and width of attached gingiva [28]. Ericsson I et al., suggested that an adequate band of attached gingiva could be defined as that amount which is sufficient to prevent gingival recession in opinion of individual practitioners [29]. Further, studies on the width of keratinised gingiva related to gingival recessions are limited. Almost for the past two decades, much of the attention shifted on volume of the keratinised gingiva around implants and subgingival restorations and the earlier concept remained unclear. In the literature review done by Mehta P et al., from 1972-2009, it was concluded that the width of attached gingiva is not significant to maintain periodontal health in the presence of adequate oral hygiene [30]. Previous studies have reported on several contributing factors that can predispose gingival recession like tooth malposition, traumatic brushing, frenum pull, gingival biotype and still considering width of the attached gingiva one among them [31-33]. The gingival features vary based on race and genetics. Hence, in the present study, the role of width of the attached gingiva in causing gingival inflammation, recession and in oral hygiene maintenance in Malaysian subjects was evaluated. In addition the influence of depth of the vestibule on the above parameters has been studied as well. Earlier studies reported 29%-76% subjects of 15-32 years age group were associated with at least one root-surface exposure >1 mm [34]. The prevalence of gingival recession of the subjects in the present study was 28.6%. This prevalence as compared with the studies mentioned in the review paper is lower than Vietnamese (72.5%), France (84%), brazil (64%) or Sweden (44%)

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Risks Factors of Caries and Periodontal Diseases in the Patients, after 5 Years Use a Partial Removable Denture

Risks Factors of Caries and Periodontal Diseases in the Patients, after 5 Years Use a Partial Removable Denture

Gingival inflammation, probing depths and gingival recession have all been reported to be greater in patients wearing RPDs [21]. Another study has also reported that wearing RPDs resulted in higher plaque scores, gin- gival inflammation and loss of attachment at abutment teeth compared with non-abutment teeth, and that there is an increased frequency of higher plaque levels, gingivitis and attachment loss with increased denture age [22]. Tooth mobility has also been reported to increase a greater extent at RPD abutment teeth compared with non- abutment teeth when assessed objectively with the Periotest [20].

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Volume: 3. 3Research Article The Effect of Inter-Radicular Brushing on Class II Furcation of Lower Molars: A Randomized, Single- Blinded, Prospective Trial

Volume: 3. 3Research Article The Effect of Inter-Radicular Brushing on Class II Furcation of Lower Molars: A Randomized, Single- Blinded, Prospective Trial

The major reason for poor prognosis in the treatment of furcation defect is the incomplete removal of subgingival plaque and calculus in the inter-radicular area [6]. The variable morphology such as cervical enamel projections, bifurcation ridges, convexities, concavities and furcation entrance dimensions can limit the complete debridement of sub-gingival plaque and calculus by the practitioner [6-8]. Moreover, the deep cavernous furcation space makes adequate plaque control difficult for the patients. Thus, accumulation of plaque bacteria by limited access and the resultant inflammatory reaction can provide the ideal environmental niche for accelerating growth of periodontitis-associated microflora. The primary etiological factor for the development of gingival inflammation

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An Insight into the Periodontal Restorative Interrelationship

An Insight into the Periodontal Restorative Interrelationship

have a pleasing visual tooth contour in esthetic areas. There seems to be an association between over contouring and gingival inflammation according to evidence from human and animal studies, although no periodontal effect is noticed with under contouring. Inadequate tooth preparation by the dentist is the most common reason for the production of over contoured restorations, resulting from the fabrication of bulky restoration to provide space for the restorative material. [13,14]

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The effect of fixed appliances on oral malodor from beginning of treatment till 1 year

The effect of fixed appliances on oral malodor from beginning of treatment till 1 year

After the application of the brackets, the oral malodor scores began to increase over the next seven months. It was interesting that oral malodor scores at the beginning of the treatment without brackets in the study group were also higher than in the control group. Buckley [17] and Bollen [18] demonstrated that there is a significant relationship between irregular dentition and periodontal disease. Subjects with malocclusions have a higher ten- dency for increased dental plaque accumulation, gingival inflammation, and PPDs than those with normal occlu- sions. In the present study, the increase in oral malodor may correlate with the increased pocket depths, which may stem from the inflammation in the gingival and other periodontal tissues, poor salivary flow, excessive dental plaque accumulation, or unclean dental appliances.

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An oral health optimized diet can reduce gingival and periodontal inflammation in humans - a randomized controlled pilot study

An oral health optimized diet can reduce gingival and periodontal inflammation in humans - a randomized controlled pilot study

that individuals reacted differently regarding their inflammatory response to plaque accumulation, with some individuals showing only a mild expression of gingival inflammation. A study by Baumgartner et al. [6] looking at participants during a stone-age experi- ment showed pronounced reductions of gingival and periodontal inflammation, even though oral hygiene was not performed at all. The authors concluded that the experimental gingivitis protocol is not applicable if the diet does not include refined carbohydrates. Thus, diet seems to have a profound impact on the gingival and periodontal inflammatory reaction. Examining the litera- ture, several dietary recommendations for benefiting the health of periodontal tissues can be found, such as a reduction in carbohydrates, and an additional intake of

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Clinical and Radiographic Evaluation of Marginal Bone Loss and Periodontal Parameters after Various Dental Reconstruction Procedures

Clinical and Radiographic Evaluation of Marginal Bone Loss and Periodontal Parameters after Various Dental Reconstruction Procedures

The present study results showed an increase in the plaque and gingival in- dices in majority of the study subjects. In addition, the mean and ±SD of plaque and gingival indices in restoring teeth scored significantly higher than the mean and ±SD scores of plaque and gingival indices of non-restored teeth. These findings are in agreement with different other studies deciding increased plaque formation and gingival inflammation on teeth with dental restorations and there is a public agreement of the closely related between the dental plaque and pres- ence of gingivitis [25] [26]. In another study on FPDs (Fixed Partial denture) and crowns that was carried out by Kent Kent et al. , in 2002, there was increased in progressive of gingival inflammation neighboring to dental restorations par- ticularly when the margins extend subgingivally, rough surface and poor adapta- tion, these findings agree with the results of our study. Moreover the periodontal pocket depth, loss of attachment and the radiographic evidence of bone loss were utilized as adjective information to supply data of the periodontal tissue changes in teeth with restorations and not as manifestations of disease activity [25].

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

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

Considering the results for PI the differences between the groups were not significant, but oral hygiene in the ACS- group tended to be worse. This finding has been obtained by two other studies [24,44]. In the case of ACS patients, however, gingival inflammation was increased significantly versus H subjects. It should be taken into account that 18 % of the ACS patients in the studies mentioned above had diabetes mellitus[44], and in addition, there were differ- ences in smoking behavior between the ACS patients and the control subjects [24,44]. This could possibly have influ- enced (confounder) the results. In the present study these factors were taken into account by matching procedure and exclusion criteria, and can be excluded as a possible confounder.

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Efficacy of an aluminium triformate mouthrinse during the maintenance phase in periodontal patients: a pilot double blind randomized placebo-controlled clinical trial

Efficacy of an aluminium triformate mouthrinse during the maintenance phase in periodontal patients: a pilot double blind randomized placebo-controlled clinical trial

Methods: Forty non-smoking periodontal patients with modified sulcus bleeding index (MSBI) ≥ 40 % were randomly divided into two groups. The participants received a masked mouthrinse (ATF or placebo) and were instructed with the rinsing protocol of 3 daily rinses during 30 s for 7 days. One blinded investigator (CE) performed all clinical examinations. The primary outcome was reduction in gingival inflammation as measured by MSBI. The secondary outcomes were reduction of the amount of plaque as measured by plaque index (PI) and approximal plaque index (API) and the occurrence of side effects. The patients were evaluated at the start and the end of the rinsing period, including the compliance of the patients.

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Biologic width violation – a wake up call literature review

Biologic width violation – a wake up call literature review

Restorative considerations will frequently dictate the placement of restoration margins beneath the gingival tissue crest because of caries or tooth deficiencies, and/ or to mask the tooth/restoration interface. Invasion of biologic periodontal space for additional retention will cause iatrogenic periodontal disease with a premature loss of restoration. Restorative margin placement within the biologic width is detrimental to periodontal health and acts as a plaque retentive factor. When the restoration margin is placed too far below the gingival tissue crest, it will impinge on the gingival attachment apparatus and a constant inflammation is created and made worse by the patient’s inability to clean this area. Body attempts to recreate room between the alveolar bone and the margin to allow space for tissue reattachment. This is more likely to occur in areas where the alveolar bone surrounding the tooth is very thin in width. Highly scalloped, thin gingiva is more prone to recession than a flat periodontium with thick fibrous tissue. The more common finding with deep margin placement is that bone level appears to remain unchanged; however, gingival inflammation develops and persists on the tooth restored. (Waerhaug, 1978) Add on to above disadvantage is, that this type of margin is not accessible for finishing and polishing which act as a niche for bacterial growth and cause gingival inflammation. (Frank et al., 2002) If the margin must be placed subgingivally,

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Gingival prosthesis: an efficient solution to severe gingival recessions in aggresssive periodontitis

Gingival prosthesis: an efficient solution to severe gingival recessions in aggresssive periodontitis

The management of these esthetic problems can be a big challenge for periodontist. It includes both non-surgical and surgical approaches. Non-surgical approaches advocate orthodontic, restorative or prosthetic interventions. Surgical techniques aim to preserve, re- contour or reconstruct the interdental papilla. Surgical techniques that have been used include coronally advanced flap, laterally displaced flap, the pedicle graft procedure and an envelope type flap prepared for coverage of a connective tissue graft (Sharma 2017). However, the results of these techniques have largely been unpredictable and are documented as case studies. In moderate to severe periodontitis, where class III and even more class IV gingival recessions can be general and extended, surgical root coverage procedures have a

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Autophagy in periodontitis patients and gingival fibroblasts: unraveling the link between chronic diseases and inflammation

Autophagy in periodontitis patients and gingival fibroblasts: unraveling the link between chronic diseases and inflammation

Inflammation needs the proper functioning of cells. The degradation of damaged and excess organelles as well as the elimination of invading pathogens is essential to main- tain cell homeostasis. Autophagy is the principal catabolic pathway allowing the cell to survive the stress of these and other intrinsic and extrinsic insults [6]. The autophagy machinery interfaces with most cellular stress-response pathways, including those involved in controlling immune responses and inflammation [7]. Impaired autophagy is correlated with various severe pathologies, including cardi- ovascular and autoimmune diseases [8]. More specifically, constitutive autophagy in the heart under baseline condi- tions is a homeostatic mechanism for maintaining cardio- myocyte size and global cardiac structure and function [9]. The molecular mechanism underlying autophagy has been extensively researched in the past decade, and the genes participating in this process, usually named autophagy- related genes (ATGs) [10], were found to be conserved in yeast and humans [11,12]. Oxidative stress has been shown to induce autophagy under starvation and ische- mia/reperfusion conditions [13,14]. Within most cells, the mitochondrion is the main source of reactive species which are by-products of cell energy production. All con- ditions able to alter mitochondria efficiency can enhance the production of reactive oxygen species (ROS), having a direct and critical effect on oxidative stress [15].

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Gingival Unit Graft versus Free Gingival Graft for Treatment of Gingival Recession: A Randomized Controlled Clinical Trial

Gingival Unit Graft versus Free Gingival Graft for Treatment of Gingival Recession: A Randomized Controlled Clinical Trial

Gingival unit graft should be harvested from an area, which is not esthetically important [26]. There are only a few case studies and just one clinical trial in this respect [22,26]. Kuru and Yildirim [16] compared the gingival unit graft and the conventional free gingival graft in patients with Miller class I/II gingival recession. Reduction in vertical recession and attachment and keratinized tissue gain were significantly higher in gingival unit group. Other human studies have shown that in clinically healthy gingiva, there are significantly different vascular distributions in marginal, attached and inter- dental gingiva [16]. The involvement of marginal

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E-cigarettes and flavorings induce inflammatory and pro- senescence responses in oral epithelial cells and periodontal fibroblasts

E-cigarettes and flavorings induce inflammatory and pro- senescence responses in oral epithelial cells and periodontal fibroblasts

contribution of smoking tobacco to the progression of periodontal disease and other adverse oral health outcomes is well described [10, 19], no information is available regarding the impact of e-cig aerosols vaping on periodontal/gingival oral health effects, especially in response to e-cig flavoring agents. We determined the effect of flavoring on oxidative and pro-inflammatory responses, and upon exposure of periodontal ligament fibroblasts, Human Gingival Epithelium Progenitors pooled (HGEPp), and epigingival 3D epithelium to menthol flavoring agent resulted in increased oxidative/ carbonyl stress, and IL-8 release. Menthol acts on transient receptor potential ankyrin 1 (TRPA1) receptors to activate inflammatory responses [20, 21]. It may be conceived that activation of TRPA receptors by e-cig aerosols will drive COX-PGE 2 mediated responses in periodontal tissues, leading to augmentation of inflammatory and pro-fibrotic and pro-carcinogenic responses. However, further studies are required to understand the augmented response by BLU ® menthol

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