Effect of self‐performed mechanical plaque control frequency on gingival health in subjects with a history of periodontitis: A Randomized Clinical Trial

The Potential of a Novel Cold Atmospheric Plasma Jet as a Feasible Therapeutic Strategy for Gingivitis-A Cell-Based Study

Due to its antimicrobial, anti-inflammatory and pro-healing properties, the application of cold atmospheric plasma (CAP) has emerged as a new and promising therapeutic strategy in various fields of medicine, including general medicine and dentistry. In this light, the aim of the present study was to investigate the effects of a homemade plasma jet on the cellular behaviour of two important cell types involved in gingivitis, namely gingival fibroblasts (HGF-1 cell line) and macrophages (RAW 264.7 cell line), by the direct application of CAP in different experimental conditions. The cellular behaviour of the HGF-1 cells was investigated in terms of viability/proliferation (LIVE/DEAD and CCK-8 assays), morphological features (immunofluorescent staining of the actin cytoskeleton) and fibronectin expression (immunocytochemical staining of the fibronectin network), while the macrophages' response was evaluated through the assessment of the cellular survival/proliferation rate (LIVE/DEAD and CCK-8 assays), morphological behaviour (immunofluorescent staining of the actin cytoskeleton) and inflammatory activity (pro-inflammatory cytokine secretion profile (ELISA assay) and foreign body giant cells (FBGCs) formation (immunofluorescent staining of the actin cytoskeleton and multinuclearity index determination)). The in vitro biological assessment revealed an upward trend dependent on treatment time and number of CAP applications, in terms of fibroblasts proliferation (p < 0.0001) and fibronectin expression (p < 0.0001). On the other hand, the macrophages exposed to five consecutive CAP applications for longer treatment times (over 120 s) exhibited a strong pro-inflammatory activity, as evinced by their altered morphology, pro-inflammatory cytokine profile (p < 0.0001) and FBGCs formation. Overall, our results demonstrate that CAP exposure, when used with appropriate operating parameters, has a beneficial effect on the cellular response of HGF-1 and RAW 264.7 cells, thus paving the way for further in vitro and in vivo investigations that will allow the translation of CAP treatment from research to clinic as an alternative therapy for gingivitis.

Oral hygiene and infective endocarditis: a case control study

OBJECTIVE

To determine if oral hygiene is associated with infective endocarditis (IE) among those at moderate risk for IE.

STUDY DESIGN

This is a case control study of oral hygiene among hospitalized patients with IE (cases) and outpatients with heart valve disease but without IE (controls). The primary outcome was the mean dental calculus index. Secondary outcomes included other measures of oral hygiene and periodontal disease (e.g., dental plaque, gingivitis) and categorization of blood culture bacterial species in case participants.

RESULTS

The 62 case participants had 53% greater mean dental calculus index than the 119 control participants (0.84, 0.55, respectively; difference = 0.29, 95% CI: 0.11, 0.48; P = .002) and 26% greater mean dental plaque index (0.88, 0.70, respectively; difference = 0.18, 95% CI: 0.01.0.36; P = .043). Overall, cases reported fewer dentist and dental hygiene visits (P = .013) and fewer dental visits in the 12 weeks before enrollment than controls (P = .007). Common oral bacteria were identified from blood cultures in 27 of 62 cases (44%).

CONCLUSIONS

These data provide evidence to support and strengthen current American Heart Association guidance that those at risk for IE can reduce potential sources of IE-related bacteremia by maintaining optimal oral health through regular professional dental care and oral hygiene procedures.

Powered tooth brushes are beneficial for long-term oral health: Results from the Study of Health in Pomerania (SHIP-TREND)

AIM

To determine the long-term effects of the use of powered tooth brush (PTB) in comparison to manual tooth brush (MTB) on periodontitis severity, coronal caries experience, and the number of missing teeth using in a population-based cohort study.

MATERIALS AND METHODS

Using 7-year follow-up data of 2214 participants of the Study of Health in Pomerania (SHIP-TREND), comprehensively adjusted linear models using generalized least squares and ordinal regression models estimated the effects of PTB usage on dental outcomes in complete case and imputed data.

RESULTS

At follow-up, PTB users had lower medians for mean probing depth (PD; 2.21 mm) and mean clinical attachment levels (1.73 mm) than MTB users (2.30 and 1.96 mm, respectively). Adjusted models revealed the beneficial effects of PTB usage on follow-up levels of plaque, bleeding on probing, mean PD, percentage of sites with PDs ≥4 mm, mean clinical attachment levels (all, interdental, and non-interdental sites, respectively), and the number of missing teeth. For the number of missing teeth, the effects were more pronounced in participants aged ≥50 years. No significant effects of PTB usage on the number of decayed or filled surfaces (all and interdental sites) were found.

CONCLUSIONS

A recommendation of PTB usage in dental practice could contribute to the long-term promotion of oral health.

Correlation between dental plaque accumulation and gingival health in periodontal maintenance patients using short or extended personal oral hygiene intervals

AIMS

To evaluate the correlation between bacterial dental plaque accumulation and gingival health in subjects with history of periodontitis attending a maintenance programme including personal oral hygiene measures (pOH) at short and extended intervals. This study is a secondary analysis of a randomized clinical trial.

MATERIALS AND METHODS

Forty-two subjects were randomized into groups performing pOH at 12-, 24- or 48-h intervals. The Plaque Index (PlI), Gingival Index (GI) and bleeding on probing (BoP) were recorded at baseline, 30 and 90 days. For the analysis, pOH groups were collapsed into subjects performing pOH at daily (G12/24) or extended (G48) intervals. Summary statistics and Spearman correlations between plaque accumulation and gingival inflammation are presented.

RESULTS

G12/24 and G48 subjects showed significant increases in plaque scores and percentage sites with gingival inflammation over the course of study. At 90 days, G48 subjects showed significantly greater GI and BoP scores than G12/24 subjects. While PlI/GI correlations were not affected by pOH interval, PlI/BoP correlations remained unchanged with short to increase with extended pOH intervals.

CONCLUSION

pOH interval influences the correlation between bacterial dental plaque accumulation and gingival inflammation. Subjects using extended pOH intervals exhibit an increased correlation allowing accumulation of bacterial dental plaque to the detriment of gingival health. (ClinicalTrials.gov: 50208115.9.0000.5346). Clinical Trials: ClinicalTrials.gov: NCT02684682.