Efficacy of 0.12% Chlorhexidine and Salvadora persica-based Mouthwash in Reducing Oral Candida Carriage and Periodontal Inflammation in Cigarette Smokers and Non-smokers after Non-surgical Periodontal Therapy

PURPOSE

The present study assessed the efficacy of 0.12% chlorhexidine (CHX) and Salvadora persica-based mouthwashes (SPM) in reducing oral Candida carriage (OCC) and periodontal inflammation in cigarette smokers and non-smokers after non-surgical periodontal treatment (NSPT).

MATERIALS AND METHODS

Self-reported cigarette smokers and non-smokers with periodontal inflammation as well as non-smokers with a healthy periodontal status were included. NSPT was performed in all participants. Based on the type of mouthwash, participants were randomly divided into three groups as follows: group 1: CHX; group 2: SPM; and group 3: distilled water (ddH2O) with mint flavour (control group). Clinical attachment loss (CAL), plaque index (PI), gingival index (GI), probing depth (PD), and marginal bone loss (MBL) were measured. Clinical periodontal parameters were re-assessed at a 6-week follow-up. Oral yeast samples were collected and identified using a concentrated oral-rinse culture technique and PCR, respectively. Clinical and laboratory-based investigations were done at baseline and after six weeks. Statistical significance was set at p < 0.05.

RESULTS

At baseline, PI, MBL, PD and CAL were comparable in all participants. None of the patients had periodontitis at baseline. Post-operatively, CHX and SPM were more effective in reducing PI (p < 0.01), GI (p < 0.01) and PD (p < 0.01) in non-smokers than in the control group. The OCC was statistically significantly higher among smokers compared with non-smokers at baseline. At the 6-month follow-up, CHX was more effective than SPM in reducing OCC in non-smokers (p < 0.01). At the 6-week follow-up, there was no difference in OCC among cigarette smokers regardless of the type of mouthwash prescribed postoperatively.

CONCLUSION

In cigarette smokers and non-smokers, CHX and SPM are effective in reducing periodontal soft-tissue inflammation after NSPT. Post-operative use of CHX is more effective than SPM in reducing OCC.

Role of Chlorhexidine and Herbal Oral Rinses in Managing Periodontitis

OBJECTIVE

The aim of this research was to assess the effect of 0.12% chlorhexidine (CHX) and a Salvadora persica-based mouthwash on whole salivary tumour necrosis factor-alpha (TNF-α) levels and periodontal inflammation in patients with type 2 diabetes mellitus (T2DM).

METHODS

Patients with and without medically diagnosed T2DM were included. Patients' medical records were evaluated to confirm the diagnosis of T2DM. All patients underwent nonsurgical periodontal therapy (NSPT). Patients were divided into 2 subgroups. In the test and control group, patients were advised to rinse with an S persica-based mouthwash and a non-alcoholic 0.12% CHX after NSPT twice daily for 2 weeks, respectively. Demographic data were collected. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were measured, and whole salivary TNF-α levels were gauged at baseline and at 3-month follow-up. Haemoglobin A1c (HbA1c) levels were measured in all patients at baseline and at 3-month follow-up. Sample size estimation was done, and group comparison was performed. Level of significance was set at P < .01.

RESULTS

Twenty-one nondiabetic individuals and 21 patients with T2DM were included. At baseline, there was no significant difference in clinical and radiographic periodontal parameters amongst in patients with and without T2DM. At 3-month follow-up, HbA1c, TNF-α, PI, PD, and clinical AL were comparable with their respective baseline values in the test and control groups amongst patients with T2DM. In nondiabetic individuals, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01), and TNF-α (P < .01) at 3-month follow-up in the test and control groups compared with their respective baseline scores.

CONCLUSIONS

In the short term, NSPT with 0.12% CHX or S persica-based mouthwashes is more effective in reducing periodontal inflammation and whole salivary TNF-α levels in nondiabetic individuals than in patients with T2DM with periodontal inflammation.

Effect of non-surgical periodontal therapy with adjunct photodynamic therapy on periodontal and glycemic statuses in prediabetic patients with periodontal disease

OBJECTIVE

Studies have shown that non-surgical periodontal therapy (NSPT) helps reduce periodontal inflammation and glycemic levels in patients with type-2 diabetes mellitus; however, the role of NSPT with adjunct photodynamic therapy on glycemic status and periodontal parameters in prediabetic patients remains unclear. The aim of the present study was to assess the effect of NSPT with and without adjunct PDT on periodontal and glycemic statuses in prediabetic patients with periodontal disease.

METHODS

Prediabetic (Group-1) and non-diabetic (Group-2) patients diagnosed with periodontal inflammation were included. In both groups, patients were randomly assigned to test and control-groups. In the test- and control groups, patients underwent NSPT with and without adjunct PDT, respectively. The following parameters were assessed at baseline and at four weeks' follow-up: plaque index (PI); gingival index (GI), probing depth (PD), clinical attachment loss (CAL) and hemoglobin A1c (HbA1c). Collection of demographic data and assessment of full mouth marginal bone loss was performed at baseline. Level of significance was set at P < 0.05.

RESULTS

At baseline, there was no difference in PI, GI and PD among patients with and without prediabetes. At 3-weeks' follow up there was no difference in PI, GI and PD among patients without prediabetes. PI (P < 0.01), GI (P < 0.01) and PD (P < 0.01) were significantly higher in the control-group compared with the test-group at 3-weeks' follow-up in patients without prediabetes. The HbA1c levels were significantly higher in patients with prediabetes throughout the study duration compared with individuals without prediabetes.

CONCLUSION

One session of NSPT with or without PDT reduce periodontal inflammation but do not influence glycemic levels in prediabetic patients.

Levels of peri-implant sulcular fluid levels of soluble urokinase plasminogen activator receptor and TNF-α among cigarette smokers and non-smokers with peri-implantitis

BACKGROUND

Soluble urokinase plasminogen activator receptor (suPAR) and tumor necrosis factor-alpha (TNF-α) are inflammatory biomarkers. No studies have yet assessed the suPAR levels in relation with TNF-α in the peri-implant sulcular fluid (PISF) among cigarette smokers and non-smokers with peri-implantitis.

OBJECTIVE

The aim was to evaluate PISF levels of suPAR, and TNF-α among cigarette smokers and non-smokers with and without peri-implantitis.

METHODS

Sixty male patients with peri-implantitis were included. There were 20 cigarette smokers and 20 and non-smokers with peri-implantitis (Groups 1 and 2), and 20 non-smokers without peri-implantitis (Group 3). Demographic data and information related to cigarette smoking was recorded. Peri-implant clinicoradiographic parameters (plaque index [PI], gingival index [GI], probing depth [PD] and crestal bone loss [CBL]) were assessed. The PISF samples were collected and levels of suPAR and TNF-α were measured. Sample-size estimation was performed and all parameters were statistically assessed. Level of significance was set at P< 0.05.

RESULTS

Sixty individuals were included in Groups 1, 2 and 3 (20 in each). Peri-implant PI (P< 0.01), PD (P< 0.01) and mesial (P< 0.01) and distal (P< 0.01) CBL were significantly higher in Group 1 than in Groups 2 and 3. The PISF volume (P< 0.01) and suPAR (P< 0.01) and TNF-α levels (P< 0.01) were significantly higher in Groups 1 and 2 than in Group 3. There was no difference in PISF volume and suPAR and TNF-α levels between patients in Groups 1 and 2. In Group 2, there was a statistically significant correlation between peri-implant PD and PISF suPAR and TNF-α levels (P< 0.01). The suPAR and TNF-α levels are expressed in high concentrations in the PISF of smokers and non-smokers with peri-implantitis compared with non-smokers without peri-implantitis.

CONCLUSION

In non-smokers, PISF suPAR and TNF-α levels are correlated with peri-implant PD.

Association of Peri-Implant Health Status With COVID-19

OBJECTIVE

The aim of this research was to evaluate peri-implant health status in patients infected with COVID-19 and control patients (individuals without COVID-19).

METHODS

This observational investigation was performed in adults with (test group) and without (control group) COVID-19 infection having at least 1 functional dental implant. Self-reported education status and daily frequency of toothbrushing and flossing was determined. A questionnaire was administered to record demographic data, brushing/flossing frequency, and education status. Periodontal examination comprised full-mouth assessment of clinical attachment loss (CAL), plaque index (PI), probing depth (PD), and gingival index (GI). Peri-implant PD, modified PI, and modified gingival index were recorded. Loss of marginal and crestal bone around teeth and implants was also measured. Significance level was established for P < .05.

RESULTS

Seventy-three (41 males) and 71 (44 males) individuals were included in the test and control groups, respectively. Average ages of patients and controls were 44.6 ± 5.2 and 40.1 ± 3.1 years, respectively. University-level education was attained by 52 (75.3%) and 50 (70.4%) individuals in the test and control groups, respectively. Seventy (95.9%) and 68 (95.7%) patients and controls were brushing twice a day. Once-daily interproximal flossing was reported by 44 (60.3%) and 48 (67.6%) individuals in test and control groups. All participants had healthy periodontal and peri-implant tissues.

CONCLUSIONS

The study indicated that there are no short-term adverse effects on the peri-implant tissues due to acute COVID-19 infection, and further well-controlled longitudinal studies are needed to evaluate the long-term effect of the infection on these tissues.

Levels of whole salivary advanced glycation end products and interleukin-17 and peri-implant clinical and radiographic status in patients with osteoporosis at 6-years' follow-up

BACKGROUND

There are no studies that have assessed advanced glycation end products (AGEs) and interleukin 17A (IL-17A) levels in whole saliva (WS) of patients with dental implants. The aim was to compare levels of AGEs and IL-17A in WS and peri-implant clinical and radiographic status of patients with and without osteoporosis at 6-years' follow-up.

METHODS

Osteoporotic (Group-1) and systemically healthy controls (Group-2) having undergone dental implant therapy at least 5 years ago were included. A questionnaire was used to collect information about age, gender, duration and treatment of osteoporosis, number and duration of implants in function, and frequencies of toothbrushing, flossing and hygiene visits. Modified bleeding and plaque indies (mBI and mPI), peri-implant probing depth (PD) and crestal bone loss (CBL) were recorded. WS was collected and levels of AGEs and IL-17A were determined using enzyme linked immunosorbent assay. Sample-size estimation was done and statistical analyses were doing using the independent t- and Wilcoxon rank-sum tests. Statistical significance was marked for P-values that were below 0.01.

RESULTS

In patients with (n = 24) and without (n = 27) osteoporosis, implants were in function for 6.3 ± 0.27 and 6.6 ± 0.5 years, respectively. There was no significant difference in peri-implant mBI, PD, mPI and CBL in both groups. Levels of AGE in patients with (119.6 ± 26.5 μg/ml) and without (91.5 ± 14.6 μg/ml) osteoporosis were comparable. Levels of whole salivary IL-17A in patients without and with osteoporosis were 4.6 ± 0.3 and 5.1 ± 0.8 pg/ml, respectively. Flossing of full mouth interproximal spaces once and twice daily toothbrushing daily was reported by 100% patients with osteoporosis. Among patients with osteoporosis 75% and 25% individuals were receiving professional dental prophylaxis every 4 and 6 months, respectively.

CONCLUSION

Within the limitations of the present study osteoporotic patients are not at an increased risk of peri-implant diseases and can demonstrate salivary AGE and IL-17A levels comparable to non-osteoporotic individuals as long as oral hygiene is stringently maintained.

Effectiveness of 0.12% chlorhexidine and a Salvadora persica-based mouthwash in reducing periodontal inflammation and whole salivary IL-1β levels after non-surgical periodontal therapy in young light cigarette-smokers

OBJECTIVE

The aim was to assess the effectiveness of 0.12% chlorhexidine (CHX) and a Salvadora persica (SP)-based mouthwash in reducing periodontal inflammation and whole salivary interleukin (IL)-1β levels after non-surgical periodontal therapy in young light cigarette-smokers.

PATIENTS AND METHODS

Self-reported current cigarette-smokers and never-smokers with periodontal inflammation were included. All patients underwent non-surgical periodontal therapy. Patients were divided into 2 subgroups. In the test- and control-group, patients were advised to rinse with a Salvadora persica-based mouthwash and a non-alcoholic 0.12% CHX twice daily for 2-weeks, respectively. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment loss (AL) and whole salivary IL-1β were measured at baseline and at 3-months' follow-up. Significance was set at p<0.01.

RESULTS

34 cigarette-smokers and 34 never-smokers were included. At 3-months of follow-up, PI, PD, and clinical AL were comparable with their respective baseline values among cigarette-smokers. In never-smokers, there was a significant reduction in scores of PI (p<0.01), GI (p<0.01) and PD (p<0.01) at 3-months of follow-up compared with baseline. At 3-months of follow-up, there was no significant difference in PI, GI, PD, and clinical AL among never-smokers in the test- and control-groups. Among never-smokers, there was a significant reduction in whole salivary IL-1β levels at 3-months' follow-up (p<0.01).

CONCLUSIONS

Usage of 0.12% CHX or a S. persica-based mouthwash following NSPT is ineffective in controlling periodontal inflammation and reducing whole salivary IL-1β in young light cigarette-smokers compared with never-smokers.

Assessment of salivary alpha amylase and mucin-4 before and after non-surgical treatment of peri-implant mucositis

BACKGROUND

The present study was based on the null hypothesis that there is no difference in clinicoradiographic parameters and whole salivary alpha amylase (AA) and mucin-4 levels before and after non-surgical mechanical debridement (NSMD) of patients with peri-implant mucositis (PM). The aim was to assess whole salivary AA and mucin-4 levels before and after treatment of PM.

METHODS

Patients with PM (Group-1) and individuals without peri-implant diseases (Group-2) were included. Demographic data was collected and peri-implant modified plaque and bleeding indices (mPI and mBI, respectively), probing depth (PD) and crestal bone loss were measured at baseline. Levels of AA and mucin-4 were assessed in unstimulated whole saliva samples. All patients underwent full-mouth non-surgical periodontal therapy (NSPT) and NSMD; and clinical parameters and salivary biomarkers were re-assessed after 3 months. Level of significance was set at P < 0.01.

RESULTS

Twenty-six and 32 individuals were included in groups 1 and 2, respectively. None of the participants had periodontitis. At baseline clinical periodontal parameters (PI [P < 0.001], GI [P < 0.001], clinical AL [P < 0.001] and PD [P < 0.001]) were significantly high in Group-1 than Group-2. At 3-month follow-up, there was a statistically significant reduction in clinical periodontal and peri-implant parameters (PI [P < 0.01], GI [P < 0.01], and PD [P < 0.01]) in Group-1 compared with their baseline values. At baseline, salivary AA levels were significantly high in Group-1 than Group-2 (P < 0.01). At 3-month follow-up, there was no significant difference in whole salivary AA levels among patients in groups 1 and 2.

CONCLUSIONS

The AA and mucin-4 levels are potential biomarkers for evaluation of peri-implant diseases including PM. Mechanical instrumentation continues to be the most predictable treatment option for the management of peri-implant diseases.

Efficacy of antimicrobial photodynamic therapy in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems

OBJECTIVE

The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems (ENDS).

METHODS

Self-reported ENDS users and non-users (individuals that reported to have never used any nicotinic product) were included. Demographic data was collected using a questionnaire. Patients were divided into 2 subgroups: (a) aPDT group; and (b) sham aPDT group. aPDT was performed using a curcumin-based photosensitizer that was exposed to a central wavelength of 660 nm and an estimated average fluency of 200 J/cm2. The system delivered light by uniform diffusion for 5 minutes. Sham aPDT was performed using a non-activated laser tip. Oral yeasts colony forming units were determined using standard techniques. Oral yeasts were assessed at baseline and at 3-months of follow-up. Level of significance was set at P<0.05.

RESULTS

Twenty-three ENDS-users (19 males and 4 females) and 23 controls (17 males and 6 females) were included. ENDS-users were vaping for 8.3 ± 0.6 years and were using their ENDS devices 13.6 ± 2.7 times daily. Toothbrushing twice daily was reported by 8.7% and 21.7% of ENDS-users and controls, respectively. Tongue brushing was reported by none of the individuals. At baseline, oral yeasts CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls (Table 2; Figure 1). At 3-months of follow-up, CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls CONCLUSION: : A single session of aPDT is ineffective in reducing the oral yeasts CFU/ml in ENDS-users. Further studies are needed to assess the impact of multiple sessions of aPDT in reducing the oral yeasts CFU/ml in ENDS-users.

Knowledge and attitude of dental professionals toward COVID-19 in Riyadh, Saudi Arabia: a cross-sectional survey

Background

Coronavirus disease-2019 (COVID-19) is a life-threatening global pandemic. The dental profession is considered a high-risk group in the transmission of the responsible virus.

Objective

To assess the knowledge and attitude among dental professionals in response to the COVID-19 pandemic.

Methods

We conducted a cross-sectional study of dental graduates, interns, postgraduates, and dental faculty from May to July 2020. A standardized questionnaire was developed to assess knowledge and attitude of 650 participants. The questionnaire comprised 14 questions to assess general knowledge about COVID-19, 11 questions regarding knowledge about prevention of COVID-19 in dental practice, and 10 questions regarding the attitude toward preventing COVID-19.

Results

Among the study population, only 376 (57.8%) knew the causative virus for COVID-19. Only 425 (65.3%) knew about rinsing the mouth with an antimicrobial solution or 1% hydrogen peroxide before the dental procedure. Regarding the hand hygiene guidelines, 357 (54.9%) had knowledge of the Centers for Disease Control and Prevention (CDC) and 377 (58.0%) about World Health Organization (WHO) guidelines. At the time of our survey, 72% of the participants showed sufficient knowledge, while 28% had low or insufficient knowledge about COVID-19.

Conclusion

While there was a lack of knowledge among dental professionals in Riyadh, Saudi Arabia about COVID-19, there was an excellent positive attitude toward preventing disease. Greater awareness is needed to control the spread of this disease.

Role of Chitosan in Remineralization of Enamel and Dentin: A Systematic Review

Aim and objective

The purpose of this research was to analyze the role of chitosan in the remineralization of enamel and dentin.

Materials and methods

An electronic search was done for articles published from January 2009 to January 2020. A manual search was done from bibliographies of selected articles for relevant articles that were unexplored. Only in vitro studies conducted on the application of chitosan for remineralization of enamel and dentin were included in the study.

Results

Of the 162 articles that were searched, only 15 in vitro studies were selected for the study. These studies met the inclusion criteria and were published from January 2009 to January 2020.

Conclusion

The review provides insight into the mechanism of remineralization of enamel and dentin. The properties of chitosan make it an ideal biomaterial that can be employed in the formulation of a novel remineralizing gel. However, more in vivo studies, clinical trials, and research are essential to transform chitosan-based remineralizing gels from research to clinical use.

Clinical significance

This review article opens a new window of opportunities for remineralizing enamel and dentin which have been long considered a challenging job.

How to cite this article

Nimbeni SB, Nimbeni BS, Divakar DD. Role of Chitosan in Remineralization of Enamel and Dentin: A Systematic Review. Int J Clin Pediatr Dent 2021;14(4):562–568.

A Plausible Proposition of CCL20-Related Mechanism in Fusobacterium nucleatum-Associated Oral Carcinogenesis

Objective: The objective of this prospective observational case–control study is to evaluate the prevalence of Fusobacterium nucleatum in the tissues of oral squamous cell carcinoma (OSCC). Reconnoitering the CCL20-related mechanism of carcinogenesis in Fusobacterium nucleatum-positive OSCC is another objective. Methodology: Tissues from 50 OSCC patients and 30 healthy oral tissues were collected. The prevalence of Fusobacterium nucleatum was evaluated in both tumour and healthy tissue by polymerase chain reaction. The immunohistochemistry of OSCC tissues was conducted to evaluate the difference in the expression of CCL20 between Fusobacterium nucleatum-positive and -negative OSCC tissues. Results: Fusobacterium nucleatum was significantly (p < 0.001) prevalent in OSCC tissues (74%), compared to healthy tissues (26%). No association of Fusobacterium nucleatum or CCL20 immuno-expression with any clinical or histopathological features of OSCC was observed. While the intensity of CCL20 immuno-expression did not differ (p = 0.053), the CCL20-positive cell population was significantly different (p = 0.034) between Fusobacterium nucleatum-positive and -negative OSCC. Conclusion: Fusobacterium nucleatum is possibly prevalent in oral cancer tissues in the Indian population. By using immunohistochemistry, this is the first study to propose that the carcinogenesis in Fusobacterium nucleatum-positive OSCC may be CCL20-related. The findings enrich the knowledge of mechanisms involved in Fusobacterium nucleatum-mediated oral carcinogenesis.

Effectiveness of antimicrobial photodynamic therapy as an adjunct to mechanical instrumentation in reducing counts of Enterococcus faecalis and Candida albicans from C-shaped root canals

BACKGROUND/PURPOSE

The aim was to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct to mechanical instrumentation (MI) in reducing Enterococcus faecalis (E faecalis) and Candida albicans (C albicans) counts from C-shaped root-canals.

METHODS

Teeth with C-shaped canals as identified on cone beam computed tomographic images were included. Following incubation with E faecalis and C albicans, samples were divided into 4 groups a four follows: Group-1: MI with adjunct aPDT; Group-2: aPDT alone; Group-3: MI alone; and Group-4: no treatment. The pulp chambers of these teeth were exposed and coronal pulp was mechanically derided using sterile endodontic excavators. Using flexible files, all canals were debrided up to size #30 K-files with intermittent irrigation with 2.5% sodium hypochlorite irrigation. In Groups 1 and 3, methylene-blue was injected in all canals and aPDT was performed using a 600 nm diode laser. Sample-size estimation was done on data from a pilot investigation and group-comparisons were done using one way analysis of variance and Bonferroni post-hoc adjustment tests. P < .05 was considered statistically significant.

RESULTS

Sixty periodontally hopeless mandibular second molars with C-shaped canals were included. There was a statistically significant reduction CFU/mL of E faecalis (P < .001) and C albicans (P < .001). At post-operative microbial assessments in Group-1. There was no difference CFU/mL of E faecalis and C albicans at post-operative microbial assessments in Groups 2-4.

CONCLUSION

MI with adjunct aPDT is more effective in reducing count of E faecalis and C albicans from C-shaped root canals.

Pediatric maxillofacial and dental trauma: A retrospective review of pediatric emergency management in Riyadh, Kingdom of Saudi Arabia

BACKGROUND

Due to the high prevalence of oral and maxillofacial (OMF) trauma in city of Riyadh, a special focus on pediatric trauma is needed. The purpose of this audit was to assess the protocol followed by the OMF unit at King Khalid University Hospital (KKUH) on pediatric trauma patients. The trauma incidence, mechanism of injury, volume, the type of pediatric trauma operated and dental management were analyzed.

MATERIALS AND METHODS

A quantitative retrospective review of 223 patients, at pediatric emergency unit of KKUH, Riyadh, KSA from January 2017 to July 2018, was done. The data retrieved included variables such as, age, gender, and cause of injury, site of injury, type of injury, and assessment of jaws, and teeth. Data regarding the type of investigations, treatment protocol, follow up visit, and dental management, were extracted from the medical records.

RESULTS

Of the 223 pediatric patients presenting to the emergency unit, 116 (52%) were under the age of 5 years. A total of 64.4% of patients reported "self-fall" as the cause of injury. Soft-tissue injuries were common in 63 (56.8%) of patients in the form of lacerations 87 (41.2%). Involvement of the teeth in the injury was observed in 57 patients, in which 33 (57.9%) patients were reported to have tooth/teeth avulsions, 15 (26.3%) patients had luxation and 9 (15.8%) patients had crown fractures. 27 (47%) patients were referred to the pedodontist for a follow-up visit.

CONCLUSIONS

It can concluded that clinicians facing maxillofacial trauma in an emergency department need to have access to useful and practice guidelines. The study also showed the need for more manpower-oriented training such as a pedodontist and a general dentist to join the OMFS team to manage pediatric patients. The regional referral hospitals should be equipped to decentralize the management of these patients to the Dental University Hospital.

Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis

BACKGROUND AND OBJECTIVE

The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis.

METHODS

Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant.

RESULTS

At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up.

CONCLUSION

PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.

The One-Year In Vivo Comparison of Lithium Disilicate and Zirconium Dioxide Inlays

The objective of the present study was to evaluate the one-year clinical performance of lithium disilicate (LD) and zirconium dioxide (ZrO₂) class II inlay restorations. Thirty healthy individuals who met the inclusion criteria were enrolled for the study. The patients were randomly divided into two study groups (n = 15): LD (IPS e.max press) and ZrO₂ (Dentcare Zirconia). In the ZrO₂ group, the internal surfaces of the inlays were sandblasted and silanized with Monobond N (Ivoclar, Leichsteistein, Germany). In the LD group, the internal surfaces of the inlays were etched with 5% hydrofluoric acid. The ceramic inlays were cemented with self-cure resin cement (Multilink N). Clinical examinations were performed using modified United State Public Health Codes and Criteria (USPHS) after 2 weeks, 4 weeks, 6 months and 1 year. The one-year survival rate was evaluated. In total, one failure was observed in the ZrO₂ group. The survival probability after 1 year for the ZrO₂ inlays was 93%, and for the LD inlays was 100%, which was statistically insignificant. The differences between both groups for most USPHS criteria (except for colour match) were statistically insignificant. Within the imitations of the present study, the lithium disilicate- and zirconia dioxide-based inlays exhibited comparable clinical performances. However, the colour and translucency match was superior for the lithium disilicate restorations.

Comparison of knowledge, attitude and concern about HIV/AIDS patients among dental students: A cross sectional survey

HIV/AIDS has taken a pandemic form affecting 40 million people around the world. The present study aimed to determine the knowledge, attitude, and concerns of dental students towards HIV/AIDS infected individuals. A cross sectional study was conducted among 224 subjects, among them 112 final year (FY) students and 112 interns. Subjects were selected from 10 dental colleges in Bangalore city, India. Data was collected through a self-administered questionnaire. The mean knowledge score of FY students and interns was 73.66+5.9 and 80.4+7.2 respectively; the mean attitude score was 71.25+1.707 and 87.75+1.8 and the mean concern score was 92+2.645 and 97.75+3.171 respectively. Differences in the mean score were significant. Dental interns had slightly higher knowledge, attitude, and concern than the FY students. There is a need to add HIV/AIDS patient's infection control measures in the dental curriculum.

Effect of tongue piercing on periodontal and peri-implant health: A cross-sectional case-control study in adults

OBJECTIVES

The authors hypothesize that periodontal and peri-implant inflammatory parameters are poorer in adult patients with tongue piercing compared with controls. The aim was to assess the influence of tongue piercing on periodontal and peri-implant health status in adults.

METHODS

Test and control groups comprised of individuals with and without tongue piercing, respectively. A questionnaire was used to collect information about gender, age, duration of tongue piercing and implants in function, jaw location of the implant, reasoning for wearing the tongue ornament, and oral hygiene and ornament cleaning habits. Full-mouth and peri-implant plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and marginal/crestal bone loss (MBL and CBL, respectively) on mesial and distal surfaces of teeth/implants were recorded. The material (plastic or metal) from which, the bar and ball-ends of the ornament were fabricated was also recorded. A p < 0.01 was considered statistically significant.

RESULTS

Forty-eight and 49 individuals were included in the test and control groups, respectively. There was no difference in PI, GI, PD, CAL and MBL (mesial and distal) among individuals in the test and control groups. In the test group, peri-implant PI (p < 0.01), GI (p < 0.01), PD (p < 0.01) and mesial (p < 0.01) and distal (p < 0.01) CBL were significantly higher in the anterior mandible compared with implants in other jaw locations. In the control group, there was no difference in peri-implant PI, GI, PD and CBL around implants placed in both jaws.

CONCLUSION

Wearing tongue piercings could increase the risks of periodontal and peri-implant diseases particularly in the mandibular anterior segment.

Biosorption of oxybenzene using biosorbent prepared by raw wastes of Zea mays and comparative study by using commercially available activated carbon

Organic pollutants present in waste water have undesirable effect on the environment. Industry activities are the key sources of organic pollutants. Prime pollutants released from various sources react instantly with the environment and become derived (secondary) pollutants, which stay for an elongated time. The present research work has been carried out using biosorbent prepared from various Zea mays wastes for elimination of oxybenzene. Different parameters viz contact time, initial concentration; adsorbent dose, temperature and pH were optimized for the biosorption of oxybenzene on to the biosorbent samples. BCS (Baby corn silk) showed higher percentage of biosorption at optimum contact time of 3 h, pH between 5 and 6 and temperature at 25 °C. Analysis of equilibrium biosorption data in terms of several isotherm models revealed that Langmuir isotherm and Freundlich isotherm indicates better agreement with the experimental data. The kinetics of oxybenzene biosorption on to the biosorbents was described with the pseudo-first-order model. Thermodynamic parameters indicated that biosorption onto biosorbent was feasible in nature, spontaneous, and endothermic for some biosorbents, but on contrary not feasible, exothermic and non spontaneous for other biosorbents. The result of this study showed that the biosorbent derived from Zea mays can be used as a prospective biosorbent for oxybenzene in wastewater and also can be an alternative for the commercially activated carbon.

Efficacy of root canal treatment in c-shaped canals with adjunctive photodynamic therapy using micro-CT

AIM

To investigate the efficacy of conventional root canal treatment (cRCT) with adjunctive photodynamic therapy (aPDT) against microbial biofilms within infected c-shaped root canals.

METHODS

In this in vitro report, the inoculation of 20 freshly extracted human mandibular molar teeth having c-shaped root canal configuration was performed with E. faecalis and P. aeruginosa to produce three-day biofilms in prepared canal system. PDT used a combination of chlorin (ce6) and polyethylenimine (PEI) as the photosensitizer (PS). A 200 μ-fiber was employed to deliver a 660 nm diode laser light into the root canal, and this was compared and conjugated with conventional endodontic treatment utilizing antiseptic irrigation and mechanical debridement.

RESULTS

The utilization of aPDT (group-2) resulted in a considerable decrease in the count of E. faecalis and P. aeruginosa from 12.84 ± 2.18 CFU/mL to 5.13 ± 0.67 CFU/mL, and from 14.06 ± 3.98 CFU/mL to 4.82 ± 1.05 CFU/mL pre-and post-treatment, respectively. A statistically significant reduction in the bacterial counts of both microbes was observed after treatment among the samples of the both study groups (p < 0.05). Specimens in group-2 (8.42 ± 1.14 MPa) demonstrated the highest mean push-out bond strength, whereas the lowest was shown by samples in group-1 (7.08 ± 1.09 MPa). ANOVA showed no statistical difference between the research groups (p = 0.676). The independent t-test revealed that the mean push-out bond strength scores of the cervical segments were higher than the apical and middle segments of roots in research groups (p < 0.05).

CONCLUSION

In c-shaped root canals, the application of photodynamic therapy as an adjuvant to conventional root canal treatment contributes to a statistically significant decrease in the microbial count of E. faecalis and P. aeruginosa along with an improved push-out bond strength of the root canal filling material with root.

Autosomal dominant mutation of MSX1 gene causing tooth and nail syndrome

Tooth and Nail Syndrome or Nail Dysplasias with Hypodontiaor Witkop´s Syndrome is an autosomal dominant condition present at birth and improves by age. An early diagnosis is essential to avoid future functional, aesthetic, and psychological problems. Here we report two classic cases with brief clinical, radiological and genetic investigation along with a brief review of literature.

Fascial space odontogenic infections: Ultrasonography as an alternative to magnetic resonance imaging

BACKGROUND

The introduction of modern diagnostic tools has transformed the field of maxillofacial radiology. Odontogenic infection and fascial space involvement have been evaluated with many diagnostic tools, including ultrasonography (USG) and magnetic resonance imaging (MRI).

AIM

To explore USG as an alternative model to MRI in the detection of fascial space spread of odontogenic infections.

METHODS

Among 20 patients, 50 fascial spaces were clinically diagnosed with odontogenic infection and included in this prospective study. Fascial space infection involvement was examined by USG and MRI. Results were compared for both and confirmed by microbiological testing.

RESULTS

Ultrasonography identified 42 (84%) of 50 involved fascial spaces. Whereas MRI identified all 50 (100%). USG could stage the infections from edematous change to cellulitis to complete abscess formation.

CONCLUSION

MRI was superior in recognizing deep fascial space infections compared to USG. However, USG is a significant addition and has a definite role in prognosticating the stage of infection and exact anatomic location in superficial space infections.

Application and performance of artificial intelligence technology in forensic odontology - A systematic review

Forensic odontology (FO) mainly deals with the identification of the individual through the remains, which mainly includes teeth and jawbones. Artificial intelligence (AI) technology has proven to be a breakthrough in providing reliable information in decision making in forensic sciences. This systematic review aimed to report on the application and performance of AI technology in FO. The data was gathered through searching for the articles in the renowned search engines, which have been published between January 2000 - June 2020. QUADAS-2 was adopted for the risk of bias analysis of the included studies. AI technology has been widely applied in FO for identifying bite-marks, predicting mandibular morphology, gender determination, and age estimation. Most of these AI models are based on either artificial neural networks (ANNs) or convolutional neural networks (CNNs). The results of the studies are promising. Studies have reported that these models display accuracy and precision equivalent to that of the trained examiners. These models can be promising tools when identifying victims of mass disasters and as an additive aid in medico-legal situations.

Periodontal Conditions and Whole Salivary IL-17A and -23 Levels among Young Adult Cannabis sativa (Marijuana)-Smokers, Heavy Cigarette-Smokers and Non-Smokers

In the United States, prevalence of marijuana-use has doubled in the past 2 decades. The aim was to compare the periodontal conditions and whole-salivary IL-17A and IL-23 levels among young adult marijuana-smokers, heavy cigarette-smokers and non-smokers. Self-reported marijuana-smokers, heavy-cigarette-smokers, non-smokers with periodontitis and periodontally-healthy non-smokers were included. Demographic data was recorded and full-mouth plaque index (PI), bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (AL), marginal bone loss (MBL) and missing teeth were recorded. Levels of IL-17A and IL-23 levels were measured in the whole saliva. p < 0.01 was considered statistically significant. Fifteen-marijuana-smokers, 15 heavy-cigarette-smokers, 16 non-smokers-with-periodontitis and 15 periodontally-healthy-non-smokers) were included. The clinicoradiographic parameters were worse among marijuana-smokers (p < 0.01), cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01) than periodontally-healthy-non-smokers. Marijuana- and cigarette-smokers had Stage-IV/Grade C and non-smokers with periodontitis had Stage-III/Grade-C. Salivary IL-17A and IL-23 levels were higher in marijuana-smokers than cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01). Whole salivary IL-17A and IL-23 levels were higher among cigarette-smokers than non-smokers with periodontitis (p < 0.01) and periodontally-healthy-individuals (p < 0.01). Marijuana- and heavy cigarette-smokers have comparable clinicoradiographic periodontal statuses. This rejects hypothesis-1. However, whole salivary immunoinflammatory response may be moderately worse in marijuana-smokers compared with heavy cigarette-smokers and non-smoker with periodontitis thereby supporting hypothesis-2.

Efficacy of Nonsurgical Mechanical Debridement With and Without Adjunct Low-Level Laser Therapy in the Treatment of Peri-Implantitis: A Randomized Controlled Trial

We hypothesized that in the long term (6-month follow-up), nonsurgical mechanical debridement (NSMD) with adjunct low-level laser therapy (LLLT) is more effective for the treatment of peri-implantitis than NSMD alone. The aim of the present 6-month follow-up convenience-sample cohort study was to assess the efficacy of LLLT as an adjunct to NSMD in the treatment of peri-implantitis. A questionnaire was used to collect demographic information. Patients with peri-implantitis in the test and control groups underwent NSMD with and without adjunct LLLT, respectively. Randomization was done by tossing a coin. In the test group, the laser was applied perpendicular to the periodontal pocket for 20 seconds at a constant distance of 15 mm and with a continuous wavelength (3.41 J/cm2 delivery with a 1.76 cm2 spot and average output of 0.3 W). In both groups, peri-implant probing depth, bleeding upon probing, and crestal bone resorption were assessed at baseline and at the 3-month and 6-month follow-up. Group comparisons were performed, and P < .05 was considered statistically significant. Sixty-seven individuals with peri-implantitis were included. The mean age of participants who underwent NSMD with adjunct LLLT and NSMD alone was 46.5 ± 3.4 and 45.3 ± 1.1 years, respectively. At the 3- and 6-month follow-up, peri-implant (P < .05), bleeding upon probing (P < .05), and probing depth (P < .05) were significantly higher among patients who underwent NSMD alone compared with patients who underwent NSMD with adjunct LLLT. There was no significant difference in crestal bone resorption in all patients up to the 6-month follow-up. In the short term, NSMD with adjunct LLLT was a useful treatment protocol for the treatment of peri-implant soft-tissue inflammation.

Twelve-month evaluation of the atraumatic restorative treatment approach for class III restorations: An interventional study

BACKGROUND

Atraumatic restorative treatment (ART) may be appropriate for populations without accessibility and affordability. More data are required regarding the success rate of ART in anterior teeth.

AIM

To evaluate the clinical performance of restoring class III cavities in anterior teeth of permanent dentition using the ART approach.

METHODS

A longitudinal interventional field study was carried out at two rural primary health centers, Tumkur district, India. A total of 54 teeth in 39 patients were evaluated for the survival rate of class III restorations in permanent anterior teeth using the ART approach in children and adult populations. Evaluation of ART restoration was carried out using Frencken J criteria, the mean procedure time, patient acceptance and reported pain severity during the ART approach were evaluated using a visual analog scale. Calculation of the cost of ART was also performed.

RESULTS

The mean time taken to perform the ART procedure was 14.79 ± 5.8 min with the majority of patients reporting only mild pain. At 6 mo follow-up, 72.2% remained in a good state, but this reduced to 27% at 12 mo. The cumulative survival rate of the restorations was 94.4% at 6 mo and 80.9% at 12 mo follow-up. Estimation of the direct cost for a single class III restoration was 186.50 INR (2.64 USD).

CONCLUSION

ART may be a good comprehensive option for basic oral health care for underserved or inaccessible populations, and preventive care for patients.

Comparison of an Herbal- and a 0.12% Chlorhexidine-based Oral Rinse as Adjuncts to Nonsurgical Mechanical Debridement in the Management of Peri-implant Mucositis: A Randomised Controlled Trial

PURPOSE

In the present randomised controlled trial (RCT), the authors hypothesise that herbal-based oral rinses are as effective as 0.12% chlorhexidine when used as adjuncts to non-surgical mechanical debridement (MD) in the management of peri-implant mucositis. The aim of the present RCT was to compare the efficacy of an herbal oral rinse with a 0.12% chlorhexidine-based oral rinse when used as adjuncts to non-surgical MD in the treatment of peri-implant mucositis.

MATERIALS AND METHODS

Adult patients with peri-implant mucositis were included. Participants were randomly allocated into 3 groups. In group 1, patients only underwent non-surgical MD. In groups 2 and 3, patients underwent non-surgical MD with adjunct rinsing with an herbal- and 0.12% CHX-based oral rinse, respectively. Peri-implant plaque index (PI) and bleeding-on-probing (BOP) and probing-depth (PD) were assessed at baseline and at 3, 6, and 12 weeks. Group comparisons were done and p < 0.01 was considered statistically significant.

RESULTS

Forty-eight patients with peri-implant mucositis (16, 16, and 16 in groups 1, 2 and 3, respectively) were included. At baseline, there was no difference in PI, PD, BOP in all groups. In group 1, there was no statistically significant difference in PI and BOP at 6, and 12 weeks of follow-up compared with baseline. In groups 2 and 3, PI (p < 0.01) and BOP (p < 0.01) were statistically significantly higher at baseline than 3, 6, and 12 weeks of follow-up. In group 1, there was no statistically significant difference in PD at all time intervals. In groups 2 and 3, PD was statistically significantly higher at baseline than 3, 6, and 12 weeks of follow-up. In groups 2 and 3, there was no statistically significant difference in PI, BOP and PD at all intervals.

CONCLUSION

Herbal- and 0.12% CHX-based oral rinses are useful adjuncts to MD for the treatment of peri-implant mucositis.

A Digital Cephalometric Study on The Morphometric Evaluation of Soft Palate in Oral Submucous Fibrosis

OBJECTIVE

Oral submucous fibrosis (OSMF) is a chronic precancerous condition affecting the oral cavity, which is progressive and characterised by burning sensation and fibrotic change leading to restriction of mouth opening. This study evaluated the morphology of soft palate in different stages of OSMF patients using digital lateral cephalogram and compare it with healthy individuals.

METHODS

The study included 60 subjects, who were grouped as 30 OSMF and 30 healthy subjects from the same geographic population. Digital lateral cephalograms were taken with Planmeca Proline XC (Oy, Helsinki, Finland). Soft palate morphology was evaluated using Lateral Cephalogram, and the results were analysed statistically.

RESULTS

Leaf-shaped (Type 1) soft palate was commonly seen in the control group and stage I and II OSMF. Stage III OSMF patients presented with a butt-shaped (Type 3) soft palate. As the disease progressed, there was a conversion of Type 1 variety of soft palate to Type 3 variety. There was a gradual reduction in the length of the soft palate in the anteroposterior direction in OSMF patients compared to the control group.

CONCLUSION

Early cephalometric diagnosis of soft palate changes may play a pivotal role in the overall management of OSMF.<br />.

Quantification of pathogenic bacteria in the subgingival oral biofilm samples collected from cigarette-smokers, individuals using electronic nicotine delivery systems and non-smokers with and without periodontitis

OBJECTIVE

The aim of the present study was to quantify pathogenic bacteria isolated from the subgingival oral-biofilm samples collected from cigarette-smokers and ENDS-users with periodontitis, when compared to non-smokers with and without periodontitis.

METHODS

Demographic data was collected using a questionnaire. Periodontal parameters (plaque [PI] and gingival [GI] indices, clinical attachment loss [CAL], probing depth [PD] and marginal bone loss [MBL]) were measured. Subgingival oral bio-film samples were collected and assessed for periodontopathogenic bacteria (Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Tannerella forsythia [T. forsythia] and Treponema denticola [T. denticola]). Group-comparisons were performed; and P < 0.01 were considered statistically significant.

RESULTS

All cigarette-smokers, ENDS-users and non-smokers with periodontitis had Grade-B periodontitis. The CFU/mL of A. actinomycetemcomitans (P < 0.001) and P. gingivalis (P < 0.001) were significantly higher among cigarette-smokers (P < 0.01) and ENDS-users (P < 0.01) than non-smokers with periodontitis. The CFU/mL of T. denticola were significantly higher among cigarette-smokers (P < 0.001), ENDS-users (P < 0.001) and non-smokers with periodontitis (P < 0.001) compared with non-smokers without periodontitis. There was no statistically significant difference in the CFU/mL of P. intermedia and T. denticola among cigarette-smokers, ENDS-users and non-smokers with periodontitis.

CONCLUSION

Counts of periodontopathogenic bacteria in the subgingival oral-biofilm are comparable among cigarette-smokers and individuals using ENDS.

Dental management of patients with congestive heart failure before and after implantation of ventricular assist devices: linking the missing protocol

Objectives: There are no studies that have reviewed the pre- and post-operative dental protocols for the management of congestive heart failure (CHF) patients before and after implantation of the left ventricular assist device (LVAD). The aim of the present study was to review the pre- and post-operative dental protocols reported in indexed literature related to the management of CHF patients before and after implantation of ventricular assist devices (VAD). Design: The addressed focused question was "Is there a protocol for the dental management of end-stage CHF patients before and after VAD implantation?" Indexed databases were searched using various keywords. Letters to the Editor, review articles, and commentaries/expert opinions were excluded. Results: Seven studies were included and processed for data extraction. The number of participants ranged between 1 and 32 individuals, with age ranging between 14 and 66 years. Dental extractions were performed in 5 studies, and in 2 studies scaling and root planing was done for the treatment of periodontal diseases. One study assessed odontogenic infective foci and other lesions of the oral soft and hard tissues as a preoperative protocol. Six of the 7 studies did not report a dental therapeutic protocol, which was followed for the pre and/or post-LVAD implantation. Conclusions: It is recommended that standardized protocols should be adopted that allow the delivery of safe and effective pre- and postoperative dental care to VAD patients. Such protocols may help influence the morbidity and mortality rates and simultaneously improve the overall quality of life in vulnerable patients.

Antimicrobial resistance, mechanisms and its clinical significance

Antimicrobial agents play a key role in controlling and curing infectious disease. Soon after the discovery of the first antibiotic, the challenge of antibiotic resistance commenced. Antimicrobial agents use different mechanisms against bacteria to prevent their pathogenesis and they can be classified as bactericidal or bacteriostatic. Antibiotics are one of the antimicrobial agents which has several classes, each with different targets. Consequently, bacteria are endlessly using methods to overcome the effectivity of the antibiotics by using distinct types of mechanisms. Comprehending the mechanisms of resistance is vital for better understanding and to continue use of current antibiotics. Which also helps to formulate synthetic antimicrobials to overcome the current mechanism of resistance. Also, encourage in prudent use and misuse of antimicrobial agents. Thus, decline in treatment costs and in the rate of morbidity and mortality. This review will be concentrating on the mechanism of actions of several antibiotics and how bacteria develop resistance to them, as well as the method of acquiring the resistance in several bacteria and how can a strain be resistant to several types of antibiotics. This review also analyzes the prevalence, major clinical implications, clinical causes of antibiotic resistance. Further, it evaluates the global burden of antimicrobial resistance, identifies various challenges and strategies in addressing the issue. Finally, put forward certain recommendations to prevent the spread and reduce the rate of resistance growth.

Clinicoradiographic markers of peri-implantitis in cigarette-smokers and never-smokers with type 2 diabetes mellitus at 7-years follow-up

BACKGROUND

It is hypothesized that in the long-term, (a) peri-implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette-smokers (CS) and patients with type-2 diabetes mellitus (T2DM) than never-smokers (NS) without T2DM. The aim of the present 7-year follow-up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM.

METHODS

Study participants were divided into four groups based on glycemic status and self-reported cigarette-smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri-implant PI, BOP, PD, and CBL were measured. Sample-size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant.

RESULTS

In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri-implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri-implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01).

CONCLUSIONS

Peri-implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.

Correlation Between Sex and Facial Soft Tissue Characteristics Among Young Saudi Patients with Various Orthodontic Skeletal Malocclusions

BACKGROUND There is a debate over the influence of sex on facial soft tissue physiognomies. Therefore, the present study used teleradiographs to assess and compare the soft tissue physiognomies between males and females in a sample from Saudi Arabia who have various orthodontic malocclusions. MATERIAL AND METHODS We obtained 221 lateral cephalometric radiographs taken from orthodontic clinics of patients ages 16-26 years (114 males and 107 females) living in the central and eastern regions of Saudi Arabia. OnyxCeph3TM digital software was used to analyze the dentoskeletal classification of the sample as class I (n=84), class II division 1 (n=42), class II division 2 (n=33), and class III (n=62). Burstone analysis of 6 linear measurements for facial soft tissue thickness (FSTT) was used. We used descriptive analysis and the independent-samples t test using SPSS version 25 for Windows (Chicago, IL) with p<0.05 set as the level of statistical significance. RESULTS Male patients with a class I dento-skeletal relationship showed thicker FSTT; the most significant thickness was seen near the glabella, followed by the upper/lower lip and sub-labiomental sulcus areas. Male patients with class II division 1 showed a substantial difference in FSTT at subnasal, lower lip, and sub-labiomental sulcus areas. No significant difference in FSTT was found between males and females among class II division 2 and class III patients. CONCLUSIONS These observations of significant changes in facial structures of Saudis between males and females should be of great help for diagnosis of orthodontic cases in Saudi adults.

Impact of electronic cigarette smoking on the Saudi population through the analysis of literature: A systematic review

Tobacco usage is harming the health, the treasury and the spirit of Saudi Arabia. Every year, more than 7000 of its people are killed by tobacco-caused diseases. Still, more than 20,000 children and 3,352,000 adults continue to use tobacco each day. Likewise, the usage of electronic (e)-cigarette is also increasing; this could be because of the publicity and marketing strategies adopted by the manufacturers of these products which are attracting the younger population. This review was taken up to determine the usage and attitude toward e-cigarette smoking among the Saudi population through the analysis of literature. This review identified peer-reviewed articles using several search terms and databases from 2010 to 2018. PubMed, ISI-Web of Science, Medline and Google Scholar were searched using the following alternate terms for e-cigarettes: electronic cigarettes, electronic nicotine delivery systems following which hand search was conducted through the reference list of articles. The search results only found descriptive data on these e-cigarettes among the Saudi population. This literature review reported that the usage of these e-cigarettes was high among this population and recorded a wide variety of reasons for using e-cigarettes. Reducing tobacco use, considering e-cigarette as less harmful, less addictive, for pleasure and peer influence, lower cost and curiosity were the most commonly reported reasons. Recognizing the dangerous impact of smoking and usage of other type of tobacco, the aggressive marketing of these e-cigarettes needs to be controlled.

Repeated application of photodynamic and antibiotic therapy as an adjunct to root surface debridement in patients with grade C and stage III or IV aggressive periodontitis

PURPOSE

To evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) and antimicrobial therapy on clinical and immunological outcomes of periodontal treatment in patients with periodontitis grade C and stage III or IV.

MATERIAL AND METHOD

The patients recruited in the current research fulfil the clinical case definition of periodontitis 'grade C' in terms of onset of the infection and stage III or IV that defines degree and severity of the disease. One-stage full-mouth ultrasonic debridement (UD) was performed and randomly divided in two groups: Group-I - four applications of aPDT, and Group-II - combination of metronidazole (MTZ) and amoxicillin (AMX) 3 tablets each for 7 days. Whole-mouth periodontal parameters were recorded at baseline, 3-, 6-months after completion of treatment. Gingival crevicular fluid samples were obtained for assessment of inflammatory interleukin (IL)-10 and IL-17 at the same time points.

RESULTS

Seventeen healthy patients completed the study protocol and revealed similar clinical findings at baseline. Bleeding scores significantly reduced in group-I at 3 months post treatment (p < 0.05). It could be seen that group-I showed statistically significant reduction of deep periodontal pockets and gain in CAL in patients with GAP at 3 months (p < 0.05). This difference was maintained at 6 months of follow-up (p < 0.001). Group-II was capable of increasing the levels of IL-10 and reducing IL-17 in GCF at both time periods compared to Group-I (p < 0.05). Group-I did not have significant effect on either cytokine levels in GCF (p > 0.05).

CONCLUSION

Antimicrobial photodynamic therapy improved severe deep periodontal pockets. However, the combination of antimicrobial therapy helped in reducing proinflammation in grade C and stage III or IV periodontitis.

Modulation of host immune status by cryptococcus co-infection during HIV-1 pathogenesis and its impact on CD+4 cell and cytokines environment

BACKGROUND

Cryptococcus infection is the second most common opportunistic infection in HIV patients with an increased rate of morbidity and mortality. Altered immune system during HIV- Cryptococcus co-infection is yet to be explored by laboratory. This study evaluates pro- and the anti-inflammatory cytokines in HIV patients with Cryptococcus co-infection and correlate them with CD4+T cell counts as well as viral loads before the initiation of drug therapy. This information would enable to understand host immune modulation and cellular environment during co-infection and understand its impact on HIV pathogenesis.

METHODOLOGY

The study comprised four categories of patients with cryptococcosis, HIV, HIV-cryptococcosis co-infected and asymptomatic Healthy volunteers. All the patients and healthy individuals were subjected to CD4+T cells count by FACS using monoclonal antibody cocktail CD4+T cell count (counts per mm3) which was counted using multiSET software on FACS caliber. The viral loads were counted in terms of viral RNA copy numbers which was estimated by real-time PCR using by Artus HIV-1 RG. The sensitivity of kit was >70 IU/ml. ELISA was performed for IL-12 p70, IL-12, IL-4, IL-10, IL-6, TNF-α and IFN-Y using commercially kits (BD Biosciences, USA). Significant variations were assayed by Student's t-test and P values ≤ 0.05 were considered statistically significant.

RESULTS

Reduction in CD+4 cell counts was highly significant in HIV patients with or without cryptococcosis. CD4+T cell counts were inversely proportional to viral load. TNF-α levels were raised in cryptococcosis patients significantly higher than healthy individuals. TNF-α was more or less not dependent on viral load but it was more related to the cryptococcosis IL-12 levels were increased in patients with infection and was highest in the HIV infected group. Level of IL-4 was similar in healthy and patients with cryptococcosis but it was elevated in HIV-Crypto co-infected patients. HIV infected patients showed a significant increase in IL-4 level and it was elevated higher in co-infected patients. IL-10 and IL-6 were significantly higher in HIV patients. The fungal infection did not influence the levels of IL-10 in HIV group but IL-6 was low in fungal infected patients.

CONCLUSION

There are very limited studies related to the immune modulation status of HIV co-infected with Cryptococcus before the initiation of any drug therapy. Such information might through in-depth light to understand the initial state of the immune environment which certainly would play a pivotal role in the outcome of the immune modulation.

Effect of Non-Surgical Periodontal Therapy on the Serum Sialic Acid Levels in Diabetic Patients with Periodontitis

Sialic acid (SA), a family of acetylated derivatives of neuraminic acid, an acute phase reactant by itself. It usually occurs as a terminal component at the non-reducing end of carbohydrate chains of glycoproteins and glycolipids. SA participates in multiple physiological functions, such as cell-to-cell interactions, cell migration and proliferation. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by rise in blood glucose level. Periodontitis is a chronic inflammatory disease of the periodontal tissue, leading to destruction of bone surrounding the tooth and ultimately tooth loss. There is a two way relationship between diabetes mellitus and periodontitis. Periodontitis is the sixth complication of diabetes along with retinopathy, nephropathy, neuropathy, macrovascular disease, and altered wound healing. Inflammatory mediators like interleukin-6 and tumor necrosis factor-alpha produced during periodontal inflammation can interfere with the actions of insulin receptors and worsen the glycemic control of diabetic patients. Periodontitis is a major cause of tooth loss, affecting over 300 million people and bacteria associated with periodontitis are also linked with systemic problems like endocarditis, atherosclerosis. Recent work has highlighted a major role for the host sugar sialic acid in the biofilm physiology and host-pathogen interactions of T. forsithya, a key periodontal pathogen. There exists a need for a biomarker, for early detection of disease evolution and more robust therapy efficacy measurements. Serum sialic acids were estimated in Indian population by diphenylamine method and Thiobarbituric acid method. The average values were 68 ± 2.6 mg percent by DPA method and 56 ± 5 mg percent by TBA (thiobarbituric acid assay) method. Age and sex showed no influence on serum sialic acid level. Objectives of the present study was to compare (TSSA) level in healthy subjects, subjects with (CMP) with and without (NIDDM) and its effect on non-surgical periodontal therapy. In the present study, the participants were divided into three groups: Group A, B and C. Group A consists of systemically healthy subjects, Group B consists of subjects with (CMP) while Group C consists of subjects with (CMP) with (NIDDM) and results of this study indicated that, at baseline, there were significant differences between Group A, B and Group C with respect to all the clinical parameters, including (GI), (OHI-S), (PPD), (CAL), (TSSA) and (HbA1c) levels. Thus (TSSA) level could be considered as novel biomarker in the progression of periodontal disease and diabetic status. Periodontitis could be considered as a potential, modifiable, and independent risk factor for the development of diabetes. Early detection of elevated (TSSA) level may help in interpreting the progression of periodontitis, risk of development of diabetes mellitus in future and also to prevent complications.

Experimental and theoretical insights on the effect of solvent polarity on the photophysical properties of a benzanthrone dye

Benzanthrone derivatives show interesting solvent dependent photophysical properties. Understanding of their photophysical properties is essential for developing the fluorescence probes based on benzanthrone derivatives. The photophysical properties of 3-(N'-chlorophenyl)piperazino-7H-benzo[de]anthracen-7-one [ClPh-PBA] molecule are reported in different solvents and solvent mixtures. The change in Stokes shift, quantum yield, fluorescence life time and radiative rate constants as a function of solvent polarity shows that the Intermolecular Charge Transfer (ICT) is affected by solvent polarity and hydrogen bonding. The quantum yield and fluorescence life time values decrease and the nonradiative decay rate constant (k_nr) values are observed to be higher in polar solvents. The weak emission of ClPh-PBA in polar solvents is primarily due to the non-radiative torsional motion of the chlorophenyl group around benzanthrone moiety. The torsional motion of chlorophenyl group at the remote nitrogen around benzanthrone moiety is also evident from TDDFT calculations performed using B3LYP/6-311+ G (d, p) basis set. The ground state and excited state dipole moments, absorption and emission maxima (nm) along with other quantum chemical parameters are obtained using B3LYP/6-311+ G (d, p) basis set. The experimental and theoretical results follow the similar trends.

Understanding the interaction of carbon quantum dots with CuO and Cu2O by fluorescence quenching

In spite copper oxide being one of the essential micronutrient, copper oxide in its nano size is found to be toxic in nature; this instigates for the detection of copper oxides in trace levels. In the present study, we demonstrate simple cost effective detection method for CuO/Cu₂O using carbon quantum dots (CQD) by fluorescence quenching technique. CuO/Cu₂O nanoparticles are synthesised by mere variation of fuel ratio by solution combustion technique. The resulting oxides are characterized by various analytical and spectroscopic techniques. Powder X- ray diffraction (PXRD) results reveals that samples prepared with oxidizer to fuel (O/F) ratios 1:1, 1:1.5 and 1:2 showed pure nano CuO, major CuO phase (minor Cu₂O) and major Cu₂O phase (minor CuO) respectively. Further, the samples prepared using 1:1 O/F ratio and calcinated at 700 °C showed highly crystalline CuO phase. In order to study the interaction of CuO/ Cu₂O with CQDs the fluorescence quenching method has been employed. The bimolecular quenching rate constants for the samples prepared with different O/F ratios have been measured. The interaction between CQDs and copper oxides, indicates fluorescence quenching greatly depends on the oxidation state of the copper oxide and can be a promising method for detecting CuO/Cu₂O through CQDs.

An immunohistochemical study of p53 expressions in oral submucous fibrosis

BACKGROUND

The objective of this histopathological study was to identify the expression of tumor suppressor gene p53 and to detect the correlation between p53 expression and the degree of dysplasia in oral submucous fibrosis (OSMF).

METHODS

A sample size of 30 OSMF patients irrespective of sex was taken up for the study. The tissue samples obtained were subjected to immunohistochemical method to detect p53 protein. The technique used was indirect super sensitive Polymer-HRP IHC detection system. The p53 positive samples were evaluated on a 4-point scale, which ranged from 3+ to negative.

RESULTS

Out of 30 cases 3(10%) cases were negative for p53 expression and 13(43.3%) showed + expression, and 14(46.6%) showed ++ expression. On application of Mantel-Haenszel Chi-Square test a statistically significant P <=0.05 i.e. (P=0.012) was obtained and there was Linear-by-Linear association between p53 expressions and dysplasia that showed the point probability of 0.006.

CONCLUSION

Immunohistochemistry is a powerful tool to identify distinct patterns of gene expression in premalignant disorders and also Oral Squamous Cell Carcinomas (OSCC) from different populations. In the present study, a significant number of samples of OSMF were positive for p53 protein.

Insight on the relationship of ABO blood grouping associated with oral premalignant lesions, conditions and inherited oral cancer syndromes

BACKGROUND

Risk factors such as chronic use of tobacco, smoking and alcohol consumption of individual's lifestyle may possibly influence the significant role in the etiopathogenesis of precancerous lesions (PL) and Conditions (PC) and lead to oral cancer. Previous studies have revealed that genetic factors have contributed to a remarkable extent in the development of this chronic disease. Limited studies have confirmed that ABO blood groups remain reportedly possible genetic factor to the specific disease such as oral malignant. In this context, we have reported that individuals in a particular blood group are more prone to develop lesions and certain types of cancer. This has thrown a light to take up an effort to conduct this present study.

MATERIALS AND METHODS

The present study covering 105 patients and grouped into three subjects with 35 participants in each. a) oral squamous cell carcinoma b) oral leukoplakia and c) submucous fibrosis. Gender and age group impact was also made to understand the interaction between the focused sample groups. A separate control was gathered from a same geographical population composed of gender-matched healthy volunteers. Slide agglutination was employed for blood grouping and results were tabulated for statistical analysis.

RESULTS

Blood group "A" exhibited a significant relationship between oral squamous cell carcinoma patient and odd ratio shown 1.74 times higher risk of developing oral cancer. Gender different and habit stimulation have increased the risk. A significant relationship was observed between ABO blood group and oral leukoplakia and oral submucous fibrosis.

CONCLUSION

Study inferred that blood group "A" is found to be at the high risk in developing oral malignant syndrome due to its susceptibility, whereas oral pre-cancer is hypothesized that individual habits are the host risk factor and transformed to carcinoma by interacting genetic factors to act upon ABO blood group.

Evaluating the possible association between systemic osteoporosis and periodontal disease progression in postmenopausal women

To evaluate the association between systemic osteoporosis and periodontal diseases in postmenopausal women. A total of 300 women aged (50-70 years) were divided into an osteoporotic (OP) group (n = 150) and non-osteoporotic (NOP) group (n = 150) depending on BMD measured using (DXA) at the femoral neck and lumbar spine. Periodontal examination including PI, GI, PPD, and CAL was measured. A standard digital dental panoramic radiograph was taken for each patient and analyzed using specially developed software graphic program to assess the alveolar bone level and BMD. Elemental analysis of root surfaces of extracted teeth was done for detecting Ca, P, F, Mg, and K using (LIBS). Results showed the differences between both groups were not statistically significant in PI, GI, and PPD. A statistically significant difference was found between both groups in CAL, the distance between CEJ-AC and alveolar bone density. Elemental analysis of the root surfaces revealed that Ca was statistically significantly less in the OP group while the differences between both groups regarding F and P were not statistically significant. Mg and K found to be significantly more in the OP group than in the NOP group. To conclude osteoporosis is certainly a risk factor for periodontal disease and seems to plays a vital role in disease progression.

Characterization of oral mucosa lesions and prevalence of yeasts in diabetic patients: A comparative study

BACKGROUND

There is no data available on the prevalence of oral mucosal lesion and candida infection among DM patients which necessitate conducting a local or nation-wide study to assess the oral mucosa lesions and candida prevalent in diabetic patients in Riyadh, Saudi Arabia.

OBJECTIVES

The objective of the present study was to characterize oral mucosa lesions, and the prevalence of yeasts in diabetic patients and their association with the risk factors in comparison with a group of non-diabetic controls.

METHODS

Study design: A cross-sectional comparative study was conducted assuming 50% of the diabetic patients have oral lesions compared to nondiabetic patients and a power of 80% with 5% level of significance, the minimum required sample size was estimated to be 115 in each group. The buccal swabs were collected to isolate Candida species from the individual patient with a current and former history of diabetes. The laboratory findings were collected and the clinical examination of the oral mucosa was processed at the department of microbiology.

RESULTS

The results inferred a significant presence of oral mucosa alterations in the diabetic group. A majority of the patients were suffering from type 2 diabetes for the past 10 years. C. albicans was the predominant yeast, followed by. C. tropicalis and C. krusei nonalbicans species that were most frequently isolated. Diabetes and smoking habit were the two risk factors for oral mucosa alterations.

CONCLUSIONS

The study found a significant presence of oral mucosa alterations in the diabetic group and the fungal infection tended to be more in the diabetic group with a high incidence of C. albicans. The presence of diabetes and smoking habit were two risk factors identified as significant for oral mucosa alterations. The significant variation in education level in groups indicates that education would help to enhance the prognosis in diabetic patients and healthcare behavior.

Photophysical properties of benzanthrone derivatives: effect of substituent, solvent polarity and hydrogen bonding

Benzanthrone derivatives are potential fluorescent probes for various chemical and biological environments. A mechanistic understanding of their photophysical properties is pivotal for designing an efficient fluorescence sensor based on the benzanthrone framework. In this study, we report on the effect of chemical substitution on the photophysical properties of two benzanthrone derivatives, namely, 3-(N'-methyl)-piperazino-7H-benzo[de]anthracen-7-one [Me-PBA] and 3-(N'-phenyl)-piperazino-7H-benzo[de]anthracen-7-one [Ph-PBA] in different solvents and solvent mixtures of varying polarities and proticities. Both benzanthrone derivatives show interesting solvent-dependent photophysical properties. Although both derivatives exhibit strong intramolecular charge transfer (ICT) characteristics in the excited state, the extent of the charge transfer is significantly influenced by the nature of the chemical substitution. Modulation of photophysical parameters as a function of solvent properties led us to propose that ICT is affected by solvent polarity and hydrogen bonding. From the viscosity effect, it is revealed that the weaker emission of Ph-PBA compared to Me-PBA in polar solvents is primarily due to the non-radiative torsional motion of the phenyl group in the former derivative. In protic solvents, intermolecular hydrogen bonding imparts strong non-radiative deactivation to both derivatives, thus rendering a weak fluorescence yield.

GC/MS analysis and characterization of 2-Hexadecen-1-ol and beta sitosterol from Schimpera arabica extract for its bioactive potential as antioxidant and antimicrobial

AIMS

We evaluated the in vitro antioxidant and antimicrobial potential of Schimpera arabica extract and fractions (2-Hexadecen-1-ol and beta sitosterol).

METHODS AND RESULTS

Free radical scavenging activity was estimated by using ABTS and DPPH methods, reducing power and iron chelation was studied to investigate antioxidant potential of the extracts. Well-diffusion method was utilized to evaluate the antimicrobial activity of the extracts. Gas chromatography-mass spectroscopy analysis of the extract revealed the presence of 27 compounds. Phenolic and flavonoid contents were found in high amount (7·6-18 mg GAE, mg g^-1 ; 3·2-10·8 mg catechin, mg g^-1 ) in dry plant material.

CONCLUSIONS

Among all the extracts, 2-Hexadecen-1-ol and beta sitosterol were the major constituents of crude extract and exhibited significant antioxidant potential as well antimicrobial activity; however, all other fractions also exhibited fare degree of antioxidant potential. 93% DPPH was scavenged by 100 μg ml^-1 of the ethyl acetate fraction; in ABTS assay chelation was 86·2 and 88% in ferric chloride reducing power assay.

SIGNIFICANCE AND IMPACT OF THE STUDY

Schimpera arabica is naturally present and used in food preparation in most Arabian nations. The characterization of S. arabica would provide an insight into its medicinal use as home remedial for bacterial infection and as antioxidant. Significant and comparable antimicrobial activity was demonstrated by both 2-Hexadecen-1-ol and beta sitosterol fractions. The results suggest that S. arabica contain a good amount of natural antioxidants of medicinal importance. However, further investigations are needed to characterize the further activity of 2-Hexadecen-1-ol and beta sitosterol in vivo.

Pathogenic features of Streptococcus mutans isolated from dental prosthesis patients and diagnosed cancer patients with dental prosthesis

Though S. mutans, virulence, and pathogenesis are characterized, reports are limited to the status of its carriage and virulence in patients with oral cancer and prosthesis. In this present study, we investigated the pathogenic characteristics of twenty strains of S. mutans of healthy subjects, fifteen of prosthesis patients, and eleven from oral cancer. The putative virulence gene and other factors, such as the ability to adhere to the oral epithelial cells, production of glycan and lactic acid of these strains were examined. Few of representative isolates of each group were used to see their activity on oral cancer cell line using cell cytotoxicity assay. The isolation rate of S. mutans was significantly more in carcinoma than prosthesis patients and control health group. The production of glycan and latic acid was together high in those isolates derived from prosthesis patients and patients with cancer. Adherence ability of strains isolated from prosthesis patients and cancer patients with oral prosthesis were significantly higher, compared to one isolated from a healthy individual. From our study results, we conclude that prosthesis patients and cancer patients with prosthesis carried a high number of S. mutans in their oral cavities.

SIGNIFICANCE AND IMPACT OF STUDY

This study report that prosthesis patients and cancer patients with prosthesis carried a high number of S. mutans in their oral cavities. However, the S mutans are commensals still they have the capability to raise the severity of disease condition due to their ability to produce glycan and lactic acid. In our study, we proved that the adherence to buccal epithelial cells was significantly increased in S. mutans isolates of prosthesis patients and cancer patients. These indicate that in prosthesis patients as well as in cancerous patient's microbes had more potential to cause infection and increase the severity.

Association between ENAM polymorphisms and dental caries in children

Aim

Dental enamel, the most rigid biological tissue of the tooth known to mankind, is the most integral and fundamental part of the tooth. Enamel matrixes compile 5% of Enamelin peptides and at the time of tooth development, they are considered to effect the formation and elongation of enamel crystallites. ENAM plays critical role in enamel formation. Any changes in ENAM may affect the thickness of enamel and may lead to dental caries. The present study is aimed to evaluate the association of ENAM gene polymorphisms and susceptibility of dental caries development risk.

Material and methods

The present study was carried out on 168 South Indian children, children’s with dental caries were included in study. Written consent was taken from their parents/guardians. Additionally 193 healthy individuals were enrolled as controls. Sampling was done after dental examination of the individuals. Three ENAM gene single nucleotide polymorphisms (SNPs) were rs7671281, rs3796704 and rs12640848 was genotyped to check their role in susceptibility of dental caries development risk.

Results

Out of three SNPs rs7671281 showed statistically significant risk association with dental caries susceptibility in this ethnic population at heterozygous allele CT (OR: 1.939, p = .01865) and with minor allele T (OR: 1.451, p = .001292). SNP rs3796704 showed significant protective association with dental caries in Indian population at heterozygous allele GA (OR: 0.409, p = .0192) and with minor allele A (OR: 0.645, p = .00875). SNP rs12640848 showed significant protective association with dental caries in Indian population at heterozygous allele AG (OR: 3.041, p = .00642) and with minor allele G (OR: 1.478, p = .02184). Preliminary insilico analysis also showed that rs7671281 (Ile648Thr) amino acid change will cause the structural and functional changes in ENAM protein.

Conclusions

In the present study significant association was observed between ENAM gene SNP rs7671281 and dental caries susceptibility in South Indian children. These results suggested that ENAM gene variants may contribute to dental caries in children.