Evaluation of chemokines in gingival crevicular fluid in children with band and loop space maintainers: A clinico-biochemical study

Effects of Prefabricated Versus Conventional Band and Loop Space Maintainers on Wound Healing, Plaque Accumulation, and Gingival Health of the Abutment Tooth: A Split-Mouth Randomized Controlled Trial

BACKGROUND

Conventional band and loop space maintainers are widely used for space maintenance but have drawbacks, such as soldering failures and multiple appointments. Prefabricated space maintainers address this by requiring less time and only one appointment. However, space maintainers may affect postextraction wound healing and plaque accumulation, leading to gingivitis.

OBJECTIVE

This study compares the effects of prefabricated and conventional band and loop space maintainers on postextraction wound healing, plaque accumulation, and gingival health of the abutment tooth.

METHODOLOGY

The split-mouth study included 10 healthy children aged five to eight years with bilateral mandibular primary first molars indicated for extraction. Each patient's experimental side was randomly selected, dividing quadrants into two groups: conventional and prefabricated band and loop space maintainers. Follow-up appointments were scheduled on the third and seventh day after extraction to assess wound healing using the Landry index, and at first, second, and third months to assess plaque using the Plaque index and gingival health of abutment using the Gingival index. Statistical analysis was performed using Statistical Package for Social Sciences, version 21, for Windows (SPSS Inc., Chicago, IL). Overall intergroup comparison among two groups was done using unpaired t-test.

RESULTS

Both prefabricated and conventional designs increased plaque accumulation and gingivitis. Conventional space maintainers resulted in more plaque accumulation and a higher incidence of gingivitis than the prefabricated ones. However, no statistically significant difference was observed in postextraction wound healing.

CONCLUSION

Prefabricated band and loop space maintainers offer a practical and efficient solution for space maintenance and represent a promising alternative to conventional designs.

Comparative Evaluation of Gingival Health Among Children With Stainless Steel Crowns and Stainless Steel Bands: A Split-Mouth Randomized Controlled Trial

Introduction Putting in stainless steel crowns as a post-endodontic restoration and space maintainers as a post-extraction appliance to maintain the space for the eruption of underlying teeth in case of early loss in children are some of the most commonly practised procedures that pediatric dentists undertake in their day-to-day lives. Maintaining good oral hygiene for better gingival health is important. If it is not taken care of, gradual destruction of supporting soft and hard tissues of the teeth occurs. There were numerous studies conducted over the past few years, but no split-mouth study compares the crowns and bands. Hence, this study compares the gingival health between stainless steel crowns and band and loop space maintainers. Materials and methods This split-mouth randomised controlled trial included 31 children aged between four and nine years who had stainless steel crowns on one side and a band and loop space maintainer on the other side of the mandibular arch. The split-mouth study was carried out to minimise the outcome bias as oral hygiene practices differ from one individual to another. Presence/absence of bleeding on probing (BOP) and the Gingival Index (GI) using the Loe and Silness GI were assessed at baseline and at six months. Data was entered in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and analysed in IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). The significance level was fixed as 5% (α = 0.05). The Shapiro-Wilk test was used to assess the normality of parameters of gingival health. The parameters are described in terms of mean, standard deviation, frequency and percentages. Intragroup analysis was done using Friedman tests across the timelines. Intergroup analysis using Mann-Whitney U tests was done between the groups at different timelines.  Results At the beginning of the study, 46 children (22 girls and 24 boys) were enrolled considering the dropout. However, 15 children did not attend the follow-up review, resulting in a loss to follow-up. Consequently, only 31 children, each with a band and loop space maintainer and a stainless steel crown, were included for the final interpretation of the results in this study. At one month, both BOP and GI were significantly different (p<0.05) between the stainless steel crown and stainless steel band where the crown showed better gingival health and absence of bleeding than the band and loop. At three months and six months, gingival health improved in both groups, but there was no significant difference between the groups. The Friedman test revealed that both the stainless steel crown and stainless steel band groups had a significant difference at six months from baseline. Mann-Whitney tests were done to analyse the difference in parameters at baseline and at six months between both groups. There was no significant difference in the baseline in the parameters between the groups. Conclusion Within the limitations of the study, this study concludes that the gingival health based on BOP and GI shows a significant difference across the timeline within the groups, namely, stainless steel crown and stainless steel band, but no significant difference between the groups at various timelines.

Evaluation of Levels of Proinflammatory Chemokines MIP-1α and MIP-1β in Gingival Crevicular Fluid of Primary, Mixed and Permanent Dentition

Aim:

This study aims to find out the proinflammatory chemokines macrophage inflammatory protein (MIP)-1α and MIP-1β levels in gingival crevicular fluid (GCF) of primary, mixed, and permanent dentitions.

Materials and Methods:

GCF of 160 individuals (4–15 years of age) was collected by the extracrevicular method. They were categorized into four groups (40 per each group). Group I: subjects with primary dentition (4–5 years of age), Group II: 40 subjects in early transition period (6–8 years), Group III: 40 individuals in the late transition period (9–11 years), and Group IV: 40 individuals with permanent dentition (12–15 years). MIP-lα and MIP-1β levels were determined in the samples of GCF by ELISA method. Data were analyzed by software SPSS Version 20 (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY: USA).

Results:

MIP-1α and MIP-1β were detected in all samples. The highest mean MIP-1α and MIP-1β concentrations in GCF were detected in the early transition period, while the lowest concentrations were seen in primary dentition group. The chemokine levels were higher in girls than in boys in Group III. There was a substantial rise of MIP-1α and MIP-1β levels during eruption.

Conclusions:

Since levels of MIP-1α and MIP-1β in GCF are positively associated with tooth eruption, they may perhaps be deemed as novel biomarkers in the eruption process.