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Thomassen TMJA, Van der Weijden FA, Sälzer S, Slot DE. Cross-angled versus flat-trim bristle tuft configurations in manual toothbrushes: A systematic review. Int J Dent Hyg 2024. [PMID: 38590292 DOI: 10.1111/idh.12799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/14/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Abstract
AIM This systematic review synthesizes and evaluates the literature regarding the effect of manual toothbrushes (MTBs) with cross-angled bristle tufts (CA-TB) compared to flat-trim (FT-TB) configurations on plaque scores and parameters of gingival health in adult patients. MATERIALS AND METHODS PubMed-MEDLINE and Cochrane-CENTRAL databases were searched, from their insertion up to August 1st, 2023, to detect appropriate papers. Clinical trials involving adult patients without periodontitis who performed self-brushing were eligible for inclusion. Primary outcome parameters included plaque, bleeding, and gingival scores. Secondary outcomes encompassed signs of soft and hard tissue abnormalities. A descriptive analysis was conducted. When feasible, a meta-analysis was performed using either the 'fixed' or 'random effects' model, as appropriate. RESULTS Nine eligible papers were retrieved, presenting 20 comparisons. There was considerable heterogeneity in the clinical and methodological design aspects of the included studies. In the descriptive analysis, eight out of 12 comparisons demonstrated a difference in plaque removal performance in favour of the CA-TB. However, data regarding bleeding and gingival index scores were inconclusive. A meta-analysis was performed on plaque, bleeding, and gingival index scores, including different indices used for scoring. The meta-analysis of short-term studies showed a medium effect statistically significant difference in the reduction of plaque scores in favour of the CA-TB (SMD = 0.75; 95% CI (0.51; 0.99)), but this was not substantiated in longer-term studies (SMD = -0.06; 95% CI(-0.44; 0.31)). No adverse events were described in any group. CONCLUSION Within the limitations of the present study design, short-term evaluations, as assessed with various plaque indices, show a weak certainty in favour of the cross-angled toothbrush over the flat-trim toothbrush. However, based on longer-term evaluations, there is insufficient support due to the inconsistent outcomes of the analysis.
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Affiliation(s)
- Tim M J A Thomassen
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fridus A Van der Weijden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dagmar E Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Härdter AK, Nordloh A, Cyris M, Straßburger M, Rinder T, Dörfer CE, Sälzer S, Graetz C. New design of interdental rubber picks - does the archimedean screw design bring an improvement for experimental cleaning efficacy and force? BMC Oral Health 2024; 24:404. [PMID: 38553668 PMCID: PMC10981285 DOI: 10.1186/s12903-024-04162-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Up to date, interdental brushes (IDB) are the first choice for interdental cleaning because of their cleaning efficacy. Cylindrical ones must be selected individually according to the size/morphology of the interdental area (IDR), whereas conical ones cover a larger variability of IDR. However, there is a trend on the part of patients towards interdental rubber picks (IRP) which are in general conically shaped, and which seem to be linked with lower cleaning efficacy. A new IRP with an Archimedes´ screw design was developed to overcome this limitation. Therefore, the in vitro study aimed to measure the experimental cleaning efficacy (ECE) and force (ECF) during interdental use of IDBs versus the new IRP type. METHODS Three IRPs with different tapers (PHB angled: 0.039, PHB straight S: 0.027, Vitis straight M: 0.045; all Flexipicks, Dentaid, Cerdanyola del Vallès, Spain) were compared to one IDB (Interprox micro PHD 0.9, Dentaid, Cerdanyola del Vallès, Spain). IDR were reproduced by a 3D-printer (Form2, Formlabs Sommerville, MA, USA) according to human teeth and matched to equivalent pairs (isosceles triangle, concave, convex) in three different diameters (1.0 mm,1.1 mm,1.3 mm). Covered with simulated biofilm, pre-/ post-brushing situations of IDR (standardized, computer-aided ten cycles) were photographed and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. Statistically significant differences were detected using the Mann-Whitney-U-test and the Kruskal-Wallis-test with Bonferroni correction for multiple testing. RESULTS Overall, the ECE (mean ± SD) was higher for IDB micro 0.9 (45.95 ± 11.34%, p < 0.001) compared to all IRPs (PHB angled: 25.37 ± 15.29%; PHB straight: 22.28 ± 16.75%; Vitis straight: 25.24 ± 12.21%; p ≤ 0.001), whereat best ECE was achieved in isosceles triangle IDR of 1.0-1.1 mm (IDB micro 0.9: 70.7 ± 7.7%; PHB angled S: 57.30 ± 4.43%; p < 0.001). The highest ECF occurred for Vitis straight M with 2.11 ± 0.46 N, while IDB micro 0.9 showed lowest ECF values (0.64 ± 0.14 N; p < 0.001). CONCLUSIONS IRP with an Archimedes´ screw design and a higher taper were associated with advanced ECE but also higher ECF, nevertheless, ECE didn't reach the cleaning efficacy of conventional IDBs.
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Affiliation(s)
- Ann-Kristin Härdter
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anna Nordloh
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Cyris
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Martin Straßburger
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
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Graetz C, Härdter AK, Schorr S, Cyris M, Geiken A, Rinder T, Dörfer CE, Sälzer S. The influence of artificial saliva on the cleaning force of interdental rubber picks: an in-vitro comparison. BMC Oral Health 2022; 22:459. [PMID: 36320016 PMCID: PMC9624009 DOI: 10.1186/s12903-022-02479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The familiar aids for interdental cleaning such as dental floss or interdental brushes (IDB) are often associated with difficult handling or an increased potential for trauma. Interdental picks (IRP), which have no metal core and silicone flaps instead of nylon brushes, offer the alternative. However, in-vitro studies found a lower cleaning effectiveness combined with higher forces for cleaning compared with conventional IDBs. The aim of this in-vitro study was to measure the experimental cleaning forces (ECF) using IRP with versus without an artificial saliva (AS; GUM Hydral, Sunstar Suisse SA, Etoy, Switzerland). METHODS The test set-up was developed to investigate the cleaning of 3D-printed interdental area (IDR) mimicking human teeth (Form 2, Formlabs Sommerville, MA, USA) under standardized conditions. Three different morphologies (isosceles triangle, convex, concave) and three different sizes (1.0 mm,1.1 mm,1.3 mm) were used. Two different IRPs (GUM Soft-picks Advanced: SPA versus GUM Soft-picks Advanced Plus: SPA+, Sunstar Suisse SA, Etoy, Switzerland) in three sizes (small, regular, large), were used with versus without AS. ECF during ten cleaning cycles were recorded by a load cell [N]. RESULTS Using AS leaded to significant lower values for ECF than without (1.04 ± 0.66 N versus 1.97 ± 1.01 N, p < 0.001). In general, a lower ECF was recorded for convex IDR compared to isosceles triangle and concave morphologies (p < 0.001) as well as for gap sizes of 1.3 mm compared to the smaller sizes (p < 0.001). For SPA+ we found significantly higher force values than for SPA (1.67 ± 0.93 N versus 1.31 ± 0.97 N, p < 0.001) independent of the use of AS. CONCLUSION Within the study´s in-vitro limitations, we found AS reduced ECF of IRPs by half and allowed using larger diameters interdentally, which could be associated with (1) a higher cleaning effectiveness and (2) a higher acceptance e.g. of patients with dry mouth. This has to be confirmed by further clinical investigations.
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Affiliation(s)
- Christian Graetz
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Ann-Kristin Härdter
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Susanne Schorr
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Miriam Cyris
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Antje Geiken
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Thomas Rinder
- grid.440947.a0000 0001 0671 1995Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E. Dörfer
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
| | - Sonja Sälzer
- grid.9764.c0000 0001 2153 9986Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105 Kiel, Germany
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Graetz C, Schoepke K, Rabe J, Schorr S, Geiken A, Christofzik D, Rinder T, Dörfer CE, Sälzer S. In vitro comparison of cleaning efficacy and force of cylindric interdental brush versus an interdental rubber pick. BMC Oral Health 2021; 21:194. [PMID: 33853594 PMCID: PMC8048228 DOI: 10.1186/s12903-021-01558-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Interdental brushes (IDB) are according to the actual evidence the first choice for cleaning interdental areas (IDR). Their size should be chosen individually according to the IDR morphology. However, interdental rubber picks (IRP) are appreciated better by the patients and are hence becoming more and more popular but the evidence regarding their efficacy is still limited. The aim of this in vitro study was to measure the experimental cleaning efficacy (ECE) and force (ECF) during the use of interdental brushes versus newer wireless types with rubber filaments (IRP), both fitted and non-fitted for different IDR. METHODS The medium size of a conical IRP (regular, ISO 2) with elastomeric fingers versus four sizes (ISO 1, 2, 3, 4) of cylindric IDB with nylon filaments (all Sunstar Suisse SA, Etoy, Switzerland) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to three different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at IDR (standardized, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. RESULTS Overall, a higher ECE was recorded for IDB compared to IRP (58.3 ± 14.9% versus 18.4 ± 10.1%; p < 0.001). ECE significantly depended on the fitting of the IDB. ECE was significant higher in isosceles triangle compared to concave and convex IDR for both IDB and IRP (p ≤ 0.001). ECF was lower for IDB (0.6 ± 0.4N) compared to IRP (0.8 ± 0.5N; p ≤ 0.001). ECE in relation to ECF increases with smaller IDB. For IRP highest values of ECF were found in the smallest IDR. CONCLUSIONS Within the limitations of an in vitro study, size fitted IDB cleaned more effectively at lower forces compared to conical IRP.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Kristina Schoepke
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Johanna Rabe
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Seidel M, Sutor S, Conrad J, Engel AS, Geiken A, Sälzer S, Graetz C. Influence of motivation and a new digitized training program on undergraduate dental students during preclinical scaling training. BMC Oral Health 2020; 20:346. [PMID: 33256683 PMCID: PMC7706025 DOI: 10.1186/s12903-020-01343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current study evaluated whether a new digitized scaling training program (DTP: n = 30; supervisor-student-ratio 1:10) improves the performance of undergraduate dental student during a preclinical course in regard to two different instruments [sonic scalers (AIR) and Gracey curettes (GRA)] compared to a conventional training program (CTP: n = 19; supervisor-student-ratio 1:4). METHODS All the participants received a two-hour lecture on both instruments, followed by a 12-week period with a weekly training program lasting 45 min (10 sessions); one group was supported by DTP. At the end of the training phase, all the participants performed the subgingival scaling of six equivalent test teeth using GRA and AIR. Treatment time, proportion of removed simulated biofilm (relative cleaning efficacy, RCE-b) and hard deposits (RCE-d) were recorded. By using a pseudonymized questionnaire with a 5-point Likert scale, self-assessment of scaling effort, handling, root surface roughness/destruction and effectiveness were evaluated. In addition, personal data such as age, gender, handedness, regularity of playing computer games/consoles and previous dental/technical or medical education were elevated and correlated with cleaning efficacy. RESULTS The DTP participants showed higher effectiveness in RCE-b compared to those who used the CTP with GRA (71.54% vs. 67.23%, p = 0.004) and AIR (71.75% vs. 62.63%, p ≤ 0.001), and the DTP students were faster with both instruments (p ≤ 0.001). For RCE-d, there was no significant difference between the DTP and CTP groups (GRA p = 0.471; AIR p = 0.158), whereas DTP showed better RCE-d results with GRA versus AIR (84.68% vs. 77.85%, p < 0.001). According to the questionnaire, no significant differences were detected between the training groups in terms of self-assessment, handling, treatment time, root surface roughness/destruction or effectiveness of the instruments. The CTP group favored AIR compared to GRA regarding the fatigue effect. The CTP and playing computer games/consoles regularly was correlated with lower RCE-b, whereas previous education in medicine/dentistry was correlated with higher RCE-b values. CONCLUSIONS Within the limitations of the study, the DTP with a reduced supervision effort compared to the CTP resulted in higher effectiveness and lower instrumentation time for removing simulated biofilms.
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Affiliation(s)
- Miriam Seidel
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Simone Sutor
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Jonas Conrad
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Anne Sophie Engel
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany.
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Sälzer S, Graetz C, Dörfer CE, Slot DE, Van der Weijden FA. Contemporary practices for mechanical oral hygiene to prevent periodontal disease. Periodontol 2000 2020; 84:35-44. [PMID: 32844413 DOI: 10.1111/prd.12332] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
It is well established that dental plaque on teeth leads to gingivitis and periodontitis, and that several mechanical and chemical methods of plaque control can prevent gingivitis. The aim of the current review is to summarize and synthesize the available scientific evidence supporting practices for mechanical oral hygiene to prevent periodontal diseases. Evidence for contemporary practices of mechanical oral hygiene to prevent periodontal disease relies on studies of gingivitis patients. General recommendations concerning the ideal oral hygiene devices and procedures are still inconclusive. However, toothbrushing and interdental cleaning remain the mainstays of prevention of periodontal diseases. The primary approach requires individually tailored instruction for implementation of a systematic oral hygiene regimen.
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Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Dagmar E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fridus A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Graetz C, Fecke P, Seidel M, Engel AS, Schorr S, Sentker J, Dörfer CE, Sälzer S. Evaluation of a systematic digitized training program on the effectivity of subgingival instrumentation with curettes and sonic scalers in vitro. Clin Oral Investig 2020; 25:219-230. [PMID: 32474807 PMCID: PMC7785550 DOI: 10.1007/s00784-020-03356-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
Objectives Whereas the key role of subgingival instrumentation in periodontal therapy is well known, the influence of operators’ experience/training with different devices on treatment results is yet uncertain. Therefore, we assessed untrained undergraduate students, working on manikins, as to how effectively they learn to use curettes (GRA) and sonic scalers (AIR); hypothesizing that AIR will result in higher relative cleaning efficacy (RCE) than GRA. Material and methods Before baseline evaluation (T0), 30 operators (9 males, 21 females) received a 2-h theoretical lesson for both instruments, followed by a 12-week period with a weekly digitized training program for 45 min. During three sessions (T1–T3), the operators had to instrument six equivalent test teeth with GRA and AIR. At T0–T3, treatment time, proportion of removed simulated biofilm (RCE-b), and hard deposits (RCE-d) were measured. Results At T0, RCE-b was in mean(SD) 64.18(25.74) % for GRA, 62.25(26.69) % for AIR; (p = 0.172) and RCE-d 85.48(12.32) %/ 65.71(15.27) % (p < 0.001). At T3, operators reached highest RCE-b in both groups (GRA/AIR 71.54(23.90) %/71.75(23.05)%; p = 0.864); RCE-d GRA/AIR: 84.68(16.84) %/77.85(13.98) %; p < 0.001). Both groups achieved shorter treatment times after training. At T3, using curettes was faster (GRA/AIR 16.67(3.31) min/19.80(4.52) min; p < 0.001). Conclusions After systematic digitized training, untrained operators were able to clean 70% of the root surfaces with curettes and sonic scalers. Clinical relevance It can be concluded that a systematic digitized and interactive training program in manikin heads is helpful in the training of root surface debridement.
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Affiliation(s)
- Christian Graetz
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Paula Fecke
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Miriam Seidel
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Anne Sophie Engel
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Johanna Sentker
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Christof E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Graetz C, Rabe J, Schoepke K, Schorr S, Geiken A, Christofzik D, Rinder T, Dörfer CE, Sälzer S. New experimental setup for the measurement of cleaning efficacy and force of interdental aids in 3D-reproduced interdental areas. BMC Oral Health 2020; 20:136. [PMID: 32384897 PMCID: PMC7206737 DOI: 10.1186/s12903-020-01129-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/29/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Interdental rubber picks (IRP) have become a frequent and convenient alternative for interdental cleaning. However, only little evidence exists supporting the effectiveness of newer designs available on the market. Therefore, a new in vitro model was evaluated to measure the experimental cleaning efficacy (ECE), as well as the force needed for insertion and during the use of IRP, with high reproducibility. METHODS Five different sizes of commercially marketed IRP with elastomeric fingers (IRP-F) (GUM SOFT-PICKS® Advanced, Sunstar Deutschland GmbH, Schönau, Germany) or slats (IRP-S) (TePe EasyPick™, TePe D-A-CH GmbH, Hamburg, Germany) were tested. Interdental tooth surfaces were reproduced by a 3D-printer (Form 2, Formlabs Sommerville, MA, USA) according to human teeth and matched to morphologically equivalent pairs (isosceles triangle, concave, convex) fitting to different gap sizes (1.0 mm, 1.1 mm, 1.3 mm). The pre-/post brushing situations at interdental areas (standardized cleaning, computer aided ten cycles) were photographically recorded and quantified by digital image subtraction to calculate ECE [%]. Forces were registered with a load cell [N]. RESULTS IRP-F have to be inserted with significant higher forces of 3.2 ± 1.8 N compared to IRP-S (2.0 ± 1.6 N; p < 0.001) independent of the size and type of artificial interdental area. During cleaning process IRP-S showed significantly lower values for pushing/pulling (1.0 ± 0.8 N/0.5 ± 0.4 N) compared to IRP-F (1.6 ± 0.8 N/0.7 ± 0.3 N; p < 0.001) concomitant to significantly lower ECE (19.1 ± 9.8 vs. 21.7 ± 10.0%, p = 0.002). Highest ECE was measured with largest size of IRP-F/IRP-S independent the morphology of interdental area. CONCLUSIONS New interdental cleaning aids can be tested by the new experimental setup supported by 3D printing technology. Within the limitations of an in vitro study, IRP-F cleaned more effectively at higher forces compared to IRP-S.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany.
| | - Johanna Rabe
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Kristina Schoepke
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Antje Geiken
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Thomas Rinder
- Institute of Mechatronics, Computer Science and Electrical Engineering, Kiel University of Applied Sciences, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Arnold-Heller-Str. 3, Haus B, 24105, Kiel, Germany
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Graetz C, Mann L, Krois J, Sälzer S, Kahl M, Springer C, Schwendicke F. Comparison of periodontitis patients' classification in the 2018 versus 1999 classification. J Clin Periodontol 2019; 46:908-917. [PMID: 31152600 DOI: 10.1111/jcpe.13157] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/17/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We aimed to assess how the 2018 and 1999 classifications of periodontal diseases reflect (a) patients' characteristics, (b) disease severity/extent/progression and (c) tooth loss (TL) during observation period. METHODS A total of 251 patients were followed over 21.8 ± 6.2 years. For the 1999 classification, using clinical attachment level (CAL), patients were classified as localized/generalized, mild/moderate/severe and aggressive/chronic periodontitis. For the 2018 classification, patients were staged according to their CAL or bone loss (BL) and the number of lost teeth (stages I-IV). Further factors like probing pocket depths (PPD) or furcation involvement modified the stage. The extent was sub-classified as generalized/localized. Patients were graded according to the BL/age index, smoking and/or diabetes. RESULTS According to the 1999 classification, most patients suffered from generalized severe chronic periodontitis (203/251) or generalized aggressive periodontitis (45/251). Patients with aggressive periodontitis were younger and less often female or smokers. They showed similar TL (0.25 ± 0.22 teeth/patient*year) as generalized severe chronic periodontitis patients (0.23 ± 0.25 teeth/patient*year). According to the 2018 classification, most patients were classified as generalized III-C (140/251), III-B (31/251) or IV-C (64/251). Patients' age, smoking status, CAL, PPD and BL were well reflected. TL differed between IV-C (0.36 ± 0.47), generalized III-C (0.21 ± 0.24) and localized forms (0.10-0.15). CONCLUSIONS Patients' characteristics, disease severity/extent/progression and TL were well reflected by the 2018 classification.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Lucas Mann
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité University of Berlin, Berlin, Germany
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Graetz C, Schorr S, Christofzik D, Dörfer CE, Sälzer S. How to train periodontal endoscopy? Results of a pilot study removing simulated hard deposits in vitro. Clin Oral Investig 2019; 24:607-617. [PMID: 31111282 DOI: 10.1007/s00784-019-02913-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is uncertainty regarding the benefits of periodontal endoscopy (PE) for subgingival instrumentation. Moreover, the influence of operators' experience and training with such a device on treatment results is unclear. Therefore, we compared in an in vitro study the use of PE for scaling and root planing (SRP) with the conventional non-surgical therapy, hypothesizing that using a PE allows to remove more simulated hard deposits than without (nPE), influenced by the operators' experience and training. MATERIAL AND METHODS A sonic device and Gracey curettes were utilized by 11 operators (six dentists, five dental hygienists) in periodontitis manikins heads. The time required for treatment and the proportion of removed simulated hard deposits by SRP were measured. RESULTS Using the PE led to a significant difference in removal of simulated hard deposits (%) (mean ± SD) irrespective of operators' experience (PE 90.78 ± 12.10% (range 58.80-100%); nPE 79.98 ± 22.15% (range 38.10-100%, p < 0.001)), sub-analyses for different tooth types demonstrated a significant difference in favor of PE for front teeth (p < 0.001) and in the upper jaw independent of the tooth type (p < 0.001). Comparison of treatment times for two quadrants with and without PE showed a significantly longer treatment time with PE (∆22.27 ± 17.98 mins, p <0.001). CONCLUSIONS Within the present pilot study, the use of PE led to more removal of simulated hard deposits but was concomitantly related to more time and financial effort. Using PE was most beneficial in the front area. CLINICAL RELEVANCE PE may provide additional benefits for the removal of hard deposits compared to traditional SRP. The beneficial effect of PE seems not to be influenced by operators experience nor by pocket probing depth.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany.
| | - Susanne Schorr
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - David Christofzik
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - Christof E Dörfer
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts - University of Kiel, Arnold-Heller-Str. 3, Haus 26, 24105, Kiel, Germany
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11
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Pretzl B, Sälzer S, Ehmke B, Schlagenhauf U, Dannewitz B, Dommisch H, Eickholz P, Jockel-Schneider Y. Administration of systemic antibiotics during non-surgical periodontal therapy-a consensus report. Clin Oral Investig 2018; 23:3073-3085. [PMID: 30374830 DOI: 10.1007/s00784-018-2727-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/18/2018] [Indexed: 12/16/2022]
Abstract
AIM The aim of this meta-review was to evaluate whether there is a meaningful clinical benefit regarding the use of systemic adjunctive antibiotics in the treatment of patients with periodontitis. Additionally, a consensus regarding possible recommendations for future administration of antibiotics should be reached. METHODS A structured literature search was performed by two independent investigators focusing on systematic reviews (SR) covering adjunctive systemic antibiosis during non-surgical periodontal therapy. Additionally, recent randomized clinical trials (RCT, July 2015 to July 2017) were searched systematically to update the latest SR. Results were summarized and discussed in a plenary to reach a consensus. RESULTS Mostly, systematic reviews and RCTs showed a significant positive effect of adjunctive systematic antibiosis compared to controls. These positive effects gain clinical relevance in patients with severe periodontal disease aged 55 years and younger. CONCLUSION Systemic antibiotics as an adjunct to non-surgical periodontal therapy should be sensibly administered and restrictively used. Only certain groups of periodontitis patients show a significant and clinically relevant benefit after intake of systemic antibiosis during periodontal therapy. CLINICAL RELEVANCE Avoiding antibiotic resistance and possible side effects on the human microbiome should be a focus of dentists and physicians. Thus, a sensible administration of antibiotics is mandatory. This manuscript suggests guidelines for a reasonable use.
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Affiliation(s)
- B Pretzl
- Department of Conservative Dentistry, Section of Periodontology, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, 69120, Heidelberg, Germany.
| | - S Sälzer
- Clinic for Conservative Dentistry and Periodontology, University Hospital of Schleswig-Holstein, 24105, Kiel, Germany
| | - B Ehmke
- Department of Periodontology, University Hospital Münster, 48149, Münster, Germany
| | - U Schlagenhauf
- Divison of Periodontology, University Hospital of Julius-Maximilians-University, 97070, Würzburg, Germany
| | - B Dannewitz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, 60596, Frankfurt, Germany
| | - H Dommisch
- Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - P Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, 60596, Frankfurt, Germany
| | - Y Jockel-Schneider
- Divison of Periodontology, University Hospital of Julius-Maximilians-University, 97070, Würzburg, Germany
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Schwendicke F, Schmietendorf E, Plaumann A, Sälzer S, Dörfer CE, Graetz C. Validation of multivariable models for predicting tooth loss in periodontitis patients. J Clin Periodontol 2018; 45:701-710. [DOI: 10.1111/jcpe.12900] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
| | - Elisa Schmietendorf
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
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13
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Sälzer S, van der Weijden F, Dörfer C, Slot D. Current Evidence on Prevention of Gingivitis: Oral Hygiene Devices and Dentifrices. ACTA ACUST UNITED AC 2017. [DOI: 10.11607/ebh.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Graetz C, Sälzer S, Plaumann A, Schlattmann P, Kahl M, Springer C, Dörfer C, Schwendicke F. Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment. J Clin Periodontol 2017; 44:612-619. [DOI: 10.1111/jcpe.12725] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics; Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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15
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Sälzer S, Alkilzy M, Slot DE, Dörfer CE, Schmoeckel J, Splieth CH. Socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level. J Clin Periodontol 2017; 44 Suppl 18:S106-S115. [DOI: 10.1111/jcpe.12673] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Mohammad Alkilzy
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Julian Schmoeckel
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Christian H. Splieth
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
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16
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Graetz C, Plaumann A, Schlattmann P, Kahl M, Springer C, Sälzer S, Gomer K, Dörfer C, Schwendicke F. Long-term tooth retention in chronic periodontitis - results after 18 years of a conservative periodontal treatment regimen in a university setting. J Clin Periodontol 2017; 44:169-177. [DOI: 10.1111/jcpe.12680] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Peter Schlattmann
- Institute of Medical Statistics, Computer Sciences and Documentation; Jena University Hospital; Jena Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Konstantin Gomer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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17
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Graetz C, Plaumann A, Heinevetter N, Sälzer S, Bielfeldt J, Dörfer CE. Bristle splaying and its effect on pre-existing gingival recession—a 12-month randomized controlled trial. Clin Oral Investig 2016; 21:1989-1995. [DOI: 10.1007/s00784-016-1987-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
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18
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Sälzer S, Slot DE, Van der Weijden FA, Dörfer CE. Efficacy of inter-dental mechanical plaque control in managing gingivitis--a meta-review. J Clin Periodontol 2016; 42 Suppl 16:S92-105. [PMID: 25581718 DOI: 10.1111/jcpe.12363] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 01/08/2023]
Abstract
FOCUSED QUESTION What is the effect of mechanical inter-dental plaque removal in addition to toothbrushing, on managing gingivitis using various formats of inter-dental self-care in adults based on evidence gathered from existing systematic reviews? MATERIAL & METHODS Three Internet sources were searched by a strategy designed to include systematic reviews on inter-dental cleaning devices. Plaque and gingivitis scores were the primary parameters of interest. Characteristics of selected papers were extracted. The potential risk of bias was estimated and the acquired evidence was graded. RESULTS Screening of 395 papers resulted in six systematic reviews. Two papers evaluated the efficacy of dental floss, two of inter-dental brushes (IDB), one of woodsticks and one of the oral irrigator. Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs in combination with toothbrushing reduce both plaque and gingivitis. CONCLUSION Evidence suggests that inter-dental cleaning with IDBs is the most effective method for inter-dental plaque removal. The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal. All investigated devices for inter-dental self-care seem to support the management of gingivitis, however, to a varying extend.
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Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
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19
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Sälzer S, Graetz C, Plaumann A, Heinevetter N, Grender J, Klukowska M, Schneider CA, Springer C, Van der Weijden FA, Dörfer CE. Effect of a Multidirectional Power Toothbrush and a Manual Toothbrush in Individuals Susceptible to Gingival Recession: A 12-Month Randomized Controlled Clinical Study. J Periodontol 2016; 87:548-56. [DOI: 10.1902/jop.2016.150472] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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20
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Sälzer S, Rosema NAM, Martin ECJ, Slot DE, Timmer CJ, Dörfer CE, van der Weijden GA. The effectiveness of dentifrices without and with sodium lauryl sulfate on plaque, gingivitis and gingival abrasion--a randomized clinical trial. Clin Oral Investig 2016; 20:443-50. [PMID: 26293981 PMCID: PMC4799265 DOI: 10.1007/s00784-015-1535-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/13/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of this study was to compare the efficacy of a dentifrice without sodium lauryl sulfate (SLS) to a dentifrice with SLS in young adults aged 18-34 years on gingivitis. MATERIAL AND METHODS One hundred twenty participants (non-dental students) with a moderate gingival inflammation (bleeding on probing at 40-70 % of test sites) were included in this randomized controlled double blind clinical trial. According to randomization, participants had to brush their teeth either with dentifrice without SLS or with SLS for 8 weeks. The primary outcome was bleeding on marginal probing (BOMP). The secondary outcomes were plaque scores and gingival abrasion scores (GA) as well as a visual analogue scale (VAS) score at exit survey. Baseline and end differences were analysed by univariate analysis of covariance (ANCOVA) test, between group differences by independent t test and within groups by paired sample t test. RESULTS BOMP improved within groups from on average 0.80 at baseline to 0.60 in the group without SLS and to 0.56 in the group with SLS. No statistical difference for BOMP, plaque and gingival abrasion was found between both groups. VAS scores for taste, freshness and foaming effect were significantly in favour of the SLS-containing dentifrice. CONCLUSION The test dentifrice without SLS was as effective as a regular SLS dentifrice on gingival bleeding scores and plaque scores. There was no significant difference in the incidence of gingival abrasion. CLINICAL RELEVANCE In patients diagnosed with gingivitis, a dentifrice without SLS seems to be equally effective compared to a dentifrice with SLS and did not demonstrate any significant difference in gingival abrasion. In patient with recurrent aphthous ulcers, the absence of SLS may even be beneficial. However, participants indicate that they appreciate the foaming effect of a dentifrice with SLS more.
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Affiliation(s)
- S Sälzer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - N A M Rosema
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - E C J Martin
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - C J Timmer
- Sara Lee Corporation, Amersfoort, Netherlands
| | - C E Dörfer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - G A van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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21
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Sälzer S, Rosema N, Hennequin-Hoenderdos NL, Slot DE, Timmer C, Dörfer CE, Van der Weijden GA. The effectiveness of a dentifrice without sodium lauryl sulphate on dental plaque and gingivitis - a randomized controlled clinical trial. Int J Dent Hyg 2016; 15:203-210. [PMID: 26853798 DOI: 10.1111/idh.12201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of the study was to evaluate the effect on dental plaque and gingivitis of a dentifrice without sodium lauryl sulphate (SLS) compared to two SLS-containing dentifrices. MATERIAL AND METHODS For this double-blind, parallel study, 90 volunteers having moderate gingival inflammation (≥40%) were randomly divided among three groups: one group using non-SLS dentifrice containing enzymes, colostrum and low concentrations of zinc and two control groups each using different SLS-containing dentifrices. Dental plaque scores (Turesky modification of Quigley & Hein) and gingivitis scores (Bleeding On Marginal Probing) were assessed at baseline, after 2 and 4 weeks. RESULTS Eighty-nine participants provided evaluable data. A slight decrease in gingivitis scores was observed for all groups over 4 weeks, which was statistically significant for the non-SLS group. Mean values for dental plaque scores did not show major differences over 4 weeks. For both parameters, no significant differences between groups could be observed at any time point. Patient appreciation was in favour of the SLS groups especially regarding the foaming effect. CONCLUSION No significant differences could be observed with respect to the effect on plaque and gingivitis between SLS-containing and SLS-free dentifrice containing enzymes, colostrum and low concentration zinc. Patients enjoyed the duration of taste and the 'foaming effect' of SLS-containing dentifrices better.
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Affiliation(s)
- S Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany.,Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Nam Rosema
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - N L Hennequin-Hoenderdos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - C Timmer
- Colgate-Palmolive, Weesp, The Netherlands
| | - C E Dörfer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University Kiel, Kiel, Germany
| | - G A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
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Graetz C, Schützhold S, Plaumann A, Kahl M, Springer C, Sälzer S, Holtfreter B, Kocher T, Dörfer CE, Schwendicke F. Prognostic factors for the loss of molars - an 18-years retrospective cohort study. J Clin Periodontol 2015; 42:943-50. [DOI: 10.1111/jcpe.12460] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 02/02/2023]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Svenja Schützhold
- Unit of Periodontology; School of Dentistry; University of Greifswald; Greifswald Germany
| | - Anna Plaumann
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Birte Holtfreter
- Unit of Periodontology; School of Dentistry; University of Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology; School of Dentistry; University of Greifswald; Greifswald Germany
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité University of Berlin; Berlin Germany
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Graetz C, Plaumann A, Bielfeldt J, Tillner A, Sälzer S, Dörfer CE. Efficacy versus health risks: An in vitro evaluation of power-driven scalers. J Indian Soc Periodontol 2015; 19:18-24. [PMID: 25810588 PMCID: PMC4365149 DOI: 10.4103/0972-124x.145796] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Accepted: 05/05/2014] [Indexed: 11/26/2022] Open
Abstract
Background: Power-driven instrumentation of root surfaces during supportive periodontal therapy is an alternative to hand instrumentation. The purpose of this pilot in vitro study was to investigate the efficacy of sub- and supragingival plaque removal with a sonic (AIR: Synea, W and H, Bürmoos, Austria) and two ultrasonic devices (TIG: Tigon+, W and H, Bürmoos, Austria; VEC: Vector, Dürr, Bietigheim-Bissingen, Germany) as well as the health-risk for dental professionals during treatment. Materials and Methods: The power-driven devices were utilized to remove plaque from model teeth in dummy heads. The percentage of residual artificial plaque after 2 min of supra- or subgingival instrumentation was calculated by means of image-processing techniques at four sites (n = 576) of each tooth. The Health-Risk-Index (HRI: spatter/residual plaque quotient) with the different power-driven devices was assessed during treatment. Results: The smallest amounts of residual plaque were found for the sonic device AIR (8.89% ± 10.92%) and the ultrasonic scaler TIG (8.72% ± 12.02%) (P = 0.707). Significantly more plaque was remained after the use of the ultrasonic scaler VEC (18.76% ± 18.07%) (P < 0.001). Irrespectively of the scaler, efficacy was similar sub- (10.7% ± 11.6%) and supragingivally (13.5% ± 17.2%) (P = 0.901). AIR/TIG demonstrated equal residual amounts of plaque sub- (P = 0.831) as well as supragingivally (P = 0.510). However, AIR/VEC and TIG/VEC were significantly in favor of AIR and TIG (P < 0.001). In contrast, the lowest HRI was found after using VEC (0.0043) and differed considerably for AIR (0.2812) and TIG (0.0287). Conclusion: Sonic devices are as effective as ultrasonic devices in the removal of biofilm but bear a higher risk to the dental professional's health concerning the formation of spatter.
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Affiliation(s)
- Christian Graetz
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Anna Plaumann
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Jule Bielfeldt
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Anica Tillner
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Sonja Sälzer
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
| | - Christof Edmund Dörfer
- Department of Conservative Dentistry and Periodontology, School of Dental Medicine, University of Kiel, Kiel, Germany
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Graetz C, Schwendicke F, Plaumann A, Rauschenbach S, Springer C, Kahl M, Sälzer S, Dörfer CE. Subgingival instrumentation to remove simulated plaque in vitro: influence of operators' experience and type of instrument. Clin Oral Investig 2014; 19:987-95. [PMID: 25231069 DOI: 10.1007/s00784-014-1319-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/09/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is uncertainty regarding the benefits and risks of hand versus powered root surface instrumentation. Moreover, the influence of operators' experience on treatment results is unclear. We compared newly developed sonic, ultrasonic and hand instruments, hypothesizing that powered devices allow to remove more simulated plaque in less time than hand instruments, with significant influence of operators' experience. METHODS Sonic scaler (AIR), ultrasonic scaler (TIG) device and double Gracey curettes (GRA) were utilized by seven experienced operators (EOs) and four less experienced operators (LOs) in periodontitis manikin heads. The time required for treatment, the proportion of residual-simulated plaque and the weight loss caused by scaling as a proxy for root surface destruction were measured. RESULTS Using different instruments led to significantly different proportions of removed simulated plaque regardless of operators' experience (AIR, 80.2 ± 21.3 %, TIG, 69.9 ± 22.5 %, GRA, 73.1 ± 20.0 %) (p < 0.001). Treatment times did not significantly differ between EO and LO (p > 0.05). Weight loss was increased when using hand instead of powered instruments (p < 0.001), with significantly higher weight loss induced by LO than EO (p = 0.004). CONCLUSION Within the present study, EO did not remove more simulated plaque in less time but induced less root surface destruction. Using a sonic device was most beneficial for plaque removal. CLINICAL RELEVANCE Successful root surface debridement requires both time and training regardless of the used instrument. Hand instruments might cause more damage to root surfaces, especially in the hands of less experienced operators.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany,
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Sälzer S, Slot DE, Dörfer CE, Van der Weijden GA. Comparison of triclosan and stannous fluoride dentifrices on parameters of gingival inflammation and plaque scores:a systematic review and meta-analysis. Int J Dent Hyg 2014; 13:1-17. [DOI: 10.1111/idh.12072] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2014] [Indexed: 12/01/2022]
Affiliation(s)
- S Sälzer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - DE Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - CE Dörfer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - GA Van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
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Graetz C, Plaumann A, Wiebe JF, Springer C, Sälzer S, Dörfer CE. Periodontal probing versus radiographs for the diagnosis of furcation involvement. J Periodontol 2014; 85:1371-9. [PMID: 24605872 DOI: 10.1902/jop.2014.130612] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Decisions in periodontal therapy for multirooted teeth are essentially based on accurate diagnosis of the furcation involvement (FI). Furcation probing (FP) is still the basic diagnostic measure, although the assessment may be difficult. The aim of this study is to evaluate the validity of FP and radiographic assessment of FI compared with visual assessment during open flap surgery (OFS). METHODS In this retrospective clinical cohort study, 215 participants with periodontal disease and at least one molar treated with OFS were enrolled, and a total of 834 molars were assigned for FI by FP and in radiographs analyzed by an experienced (EE) and less experienced examiner (LE). For the investigation, 143 panoramic radiographs (OPGs) and 77 intra-oral radiographs (I-Os) were evaluated. RESULTS The Class of FI by FP was confirmed in 56%, whereas 15% were overestimated and 29% underestimated. FI Class 0 and I had been detected with high probability (74% and 54%, respectively). Of all FI Class III, 57% were detected correctly by radiographs and 32% by FP. FP and OFS revealed a weighted κ-coefficient (κw) = 0.588; radiographs and OFS had κw = 0.542 (OPG κw = 0.555 and I-O κw = 0.521). The interrater reliability for radiographs was dependent on the experience of the examiner (EE κw = 0.618; LE κw = 0.426). CONCLUSIONS Experience in analyzing conventional radiographs increases the potential of correct diagnosis of advanced FI. The reliability of FP compared with radiographic assessment depends on the anatomy and location of the tooth. Both diagnostic tools should be used in cases of suspected FI.
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Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany
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Graetz C, Schwendicke F, Kahl M, Dörfer CE, Sälzer S, Springer C, Schützhold S, Kocher T, König J, Rühling A. Prosthetic rehabilitation of patients with history of moderate to severe periodontitis: a long-term evaluation. J Clin Periodontol 2013; 40:799-806. [DOI: 10.1111/jcpe.12124] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2013] [Indexed: 12/22/2022]
Affiliation(s)
- Christian Graetz
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Falk Schwendicke
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Maren Kahl
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Christof E. Dörfer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Sonja Sälzer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Claudia Springer
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
| | - Svenja Schützhold
- Unit of Periodontology, School of Dentistry; University of Greifswald; Greifswald Germany
| | - Thomas Kocher
- Unit of Periodontology, School of Dentistry; University of Greifswald; Greifswald Germany
| | - Jörgen König
- Folktandvården Kalmar län; Parodontologi Kalmar; Kalmar Sweden
| | - Andreas Rühling
- Clinic of Conservative Dentistry and Periodontology; University of Kiel; Kiel Germany
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Graetz C, Bielfeldt J, Wolff L, Springer C, Fawzy El-Sayed KM, Sälzer S, Badri-Höher S, Dörfer CE. Toothbrushing Education via a Smart Software Visualization System. J Periodontol 2013; 84:186-95. [DOI: 10.1902/jop.2012.110675] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fawzy El-Sayed KM, Paris S, Becker ST, Neuschl M, De Buhr W, Sälzer S, Wulff A, Elrefai M, Darhous MS, El-Masry M, Wiltfang J, Dörfer CE. Periodontal regeneration employing gingival margin-derived stem/progenitor cells: an animal study. J Clin Periodontol 2012; 39:861-70. [PMID: 22694281 DOI: 10.1111/j.1600-051x.2012.01904.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2012] [Indexed: 12/11/2022]
Abstract
AIM This study investigated the periodontal regenerative potential of gingival margin-derived multipotent postnatal stem/progenitor cells. MATERIAL AND METHODS Periodontal defects were induced at six sites in eight miniature pigs in the premolar/molar area (-4 weeks). Autologous cells isolated from the gingival margin were magnetically sorted using STRO-1 antibodies and characterized flow cytometrically for the expression of CD14, CD31, CD34, CD45, CD117 and STRO-1 surface markers. Colony formation and multilineage differentiation potential were tested. The cells were expanded and loaded on deproteinized bovine cancellous bone (DBCB) and Collagen scaffolds. Within every miniature pig, six periodontal defects were randomly treated with loaded-DBCB (test group 1), unloaded-DBCB (control group 1), loaded-Collagen scaffolds (test group 2), unloaded-Collagen scaffolds (control group 1), scaling and root planing (negative control 1) or left untreated (negative control 2). Differences in clinical attachment level (ΔCAL), probing depth (ΔPD), gingival recession (ΔGR) and radiographic defect volume (ΔRDV) between baseline and 12 weeks, as well as histological attachment level (HAL), junctional epithelium length (JE) and connective tissue adhesion (CTA) after 12 weeks were evaluated. RESULTS Isolated cells showed stem/progenitor cell characteristics. Cell-loaded scaffolds showed higher ΔCAL, ΔPD, ΔGR, HAL and lower JE and CTA compared with unloaded scaffolds and negative controls. The sort of scaffold had no significant influence on the measured outcomes. CONCLUSION Gingival margin-derived stem/progenitor cells show significant periodontal regenerative potential.
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Affiliation(s)
- Karim M Fawzy El-Sayed
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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Beikler T, Abdeen G, Schnitzer S, Sälzer S, Ehmke B, Heinecke A, Flemmig TF. Microbiological shifts in intra- and extraoral habitats following mechanical periodontal therapy. J Clin Periodontol 2004; 31:777-83. [PMID: 15312101 DOI: 10.1111/j.1600-051x.2004.00557.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The aim of the present study was to analyze the intra- and extraoral colonization dynamics of periodontal pathogens following supra- and subgingival debridement. MATERIAL AND METHODS Thirty five patients with chronic periodontitis were enrolled in the study. Supra- and subgingival plaque samples, saliva, and swab samples from mucosa and extraoral sites were taken at baseline and 6 weeks, 3 months and 6 months after mechanical periodontal therapy. Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Eikenella corrodens (Ec), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Prevotella nigrescens (Pn), and Treponema denticola (Td) were identified by PCR. RESULTS Supra- and subgingival debridement decreased the number of subgingival sites infected with the analyzed pathogens only transiently, if at all. However, the detection frequencies of Tf, Td, Ec, Pi, and Pn in the supragingival region, of Pg, Td, and Pn at the oral mucosa sites (mostly the tongue), and of all pathogens except Aa in saliva increased over the 6-month observation period. Td was the only pathogen recorded in notable quantities in the extraoral habitat (external ear canal). CONCLUSION The results indicate that supra- and subgingival debridement results in a dissemination of periodontal pathogens within the oral cavity.
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Affiliation(s)
- Thomas Beikler
- Department of Periodontology, University of Münster, Germany.
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