Oral Health and Preventive Dentistry

Purpose: To assess the association of various factors including education level and oral health with type 2 diabetics’ awareness of periodontitis and periodontitis/diabetes relationship, and to evaluate the importance of integrated healthcare in this association. Materials and Methods: 288 type 2 diabetics were evaluated through a validated structured questionnaire about oral hygiene habits, access and attendance to dental treatment, the presence of periodontitis and previously received information of periodontitis and periodontitis/diabetes relationship. Descriptive data were explored and both simple and multiple logistic regressions were performed. Results: The average age of participants was 62.24 (±10.93) years, 81.6% were previously treated for periodontitis and approximately 70% have never received information on periodontitis and its relationship with diabetes. A higher chance of participants having previously received information regarding periodontitis was associated with more than 8 years of schooling, daily flossing habit, presence of periodontitis and prior treatment for periodontitis (p  Keywords: diabetes mellitus, periodontal diseases, health promotion, public health/community dentistry, primary healthcare

Purpose: The aim of the present research was to analyse the effects of two bleaching agents, on the enamel crystallography by means of X-ray diffraction. Material and Methods: Twelve human sound posterior teeth, were collected for the present study (n = 12) and from each tooth two enamel slabs were obtained and randomly assigned to one of two different bleaching protocols. The first protocol involved an in-office bleaching agent (hydrogen peroxide 37.5%/ SDI Polaoffice+), and the second an at-home whitening product (carbamide peroxide 16%/ PHILIPS Zoom! NiteWhite). X-ray diffraction readings were made before and after applying the treatments in order to analyse the peak intensity and crystal domain size. Additionally, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) were carried out to identify the composition correctly. Statistical analysis included repeated measures analysis of variance (p ≤ 0.05). Results: Peak intensity in spectra obtained by X-ray diffraction had a tendency to diminish, mostly in the at-home bleaching group. The analysed data approximate a decrease in the crystal domain size among the samples treated for longer periods of time. Statistical analysis depicted no statistically significant differences among the experimental groups (p ≥ 0.05). Conclusions: Crystal domain size had a tendency to decrease, mostly when the enamel was treated by bleaching gels that had to be applied by prolonged periods of time. Keywords: bleaching agent, enamel crystallography, X-ray diffraction

Purpose: To investigate the subgingival microbiological profiles of patients with periodontitis, to determine their stage and grade scores and to evaluate the differences in the microbiota among different stages and grades. Materials and Methods: Sixty-seven (n = 67) periodontitis patients were selected. Periodontitis staging and grading, following the 2018 classification system, were defined. Following a clinical examination, subgingival samples were taken from the deepest periodontal pocket of each quadrant for cultivation, identification and quantification. The prevalence, proportion and counts of nine selected periodontal pathogens were determined, and differences between periodontitis stages III and IV and grades B and C were assessed. Results: All nine cultivable periodontal bacteria were detected, of which the most prevalent was P. intermedia (91.0%) and the least prevalent were E. corrodens (9.0%) and C. ochracea (9.0%). The frequency of detection of the two main target pathogens, A. actinomycetemcomitans and P. gingivalis, was 41.8% and 76.1%, respectively. The prevalence (grade B: 80.6%, grade C: 55.6%, p = 0.035) and total counts (grade B: 19.8 colony forming units – CFU/ml-4 (1.9–52.8); grade C: 4.0 CFU/ml-4 (0.0–26.4); p = 0.022) of F. nucleatum were statistically significantly higher in grade B than in grade C periodontitis patients, whereas the counts of P. gingivalis and A. actinomycetemcomitans were similar between grades and stages. Conclusion: Our study suggests that relevant differences between the various grades of periodontitis exist only in the numbers of F. nucleatum. Prevalence and quantities of other cultivable species between different stages and grades of periodontitis seem to be similar. Keywords: periodontitis, stage, grade, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum

Purpose: The aim of this study was to verify how the prevalence of viridans-streptococci is changed by two appointments of professional prophylaxis and after the subgingival instrumentation via scaling and root planing (SRP). Material and Methods: Samples of the subgingival biofilm were collected from 19 individuals with periodontitis receiving two appointments of professional prophylaxis and SRP before and after the treatment procedures and the presence of viridans-streptococci was analysed by microbiological cultivation. Non-parametric statistical testing using Friedman/Wilcoxon tests and chi-square testing was used for statistical analysis. Results: No statistically significant changes over time were found for the mutans-group. The prevalence of Streptococcus mitis decreased after two appointments of professional prophylaxis (p = 0.013). The prevalence of S. mitis decreased again after SRP (p <0.001). The prevalence of Streptococcus anginosus decreased after two appointments of professional prophylaxis (p = 0.002). After SRP five positive results for S. anginosus were detected (p = 0.026). For Streptococcus oralis and Streptococcus gordonii tendencies to statistical significance were found. The number of positive results for S. oralis increased after the first appointment of professional oral prophylaxis (p = 0.055). The number of positive results for S. gordonii increased after the first appointment of professional oral prophylaxis (p = 0.055). Conclusion: The step-wise periodontal therapy influences the prevalence of viridans-streptococci, especially S. mitis and S. anginosus. No tremendous increase of streptococci especially related to the carious process occurs in the subgingival biofilm. Clinical Relevance: The study reveals knowledge on changes of the composition of the subgingival biofilm due to different steps of periodontal therapy. Keywords: periodontitis, professional dental prophylaxis, subgingival instrumentation, subgingival biofilm, viridans-streptococci

Purpose: Several studies demonstrated compromised oral health and periodontal diseases as risk factors for adverse pregnancy outcomes. However, consideration of oral health by pregnant women remains elusive. The aim of this study was to evaluate knowledge and behaviour of French pregnant women towards relationship between oral conditions and pregnancy outcomes and to evaluate influencing factors. Materials and Methods: A self-reported questionnaire was given to women between 1 and 3 days after delivery in three specialised clinics in France. The questionnaire aimed to evaluate demographic characteristics, self-perceived oral health, type of pregnancy follow-up and knowledge regarding oral conditions during pregnancy and risk of adverse pregnancy outcomes. A multivariate analysis was performed to evaluate correlation between knowledge and behaviour. Results: The questionnaire was completed by 212 women. Among them, 92% considered prevention of oral diseases during pregnancy important. Despite knowledge of potential negative influence of periodontal diseases on pregnancy outcomes, only 47% of pregnant women received dental diagnosis or treatment during pregnancy. Only 18% of the women discussed oral health consideration during pregnancy with health professional in charge of pregnancy follow-up. Interestingly, absence of dental consultation during pregnancy was associated with low rate of dental consultation prior to pregnancy (p < 0.01). Conclusions: Pregnant women were aware of the association between oral health and pregnancy and of need of prevention. However, consideration of importance of oral health was not adequate to the rate of dental consultation and seems to be influenced by individual dental follow-up habits prior to pregnancy. Clinical Relevance: Dental evaluation should be considered systematically during pregnancy follow-up. Keywords: oral health, questionnaire, prevention, risk factor

Purpose: To assess the effect of age on the mean percentage of bleeding on probing (BOP) during supportive periodontal therapy (SPT) in patients enrolled in SPT for at least 5 years. Materials and Methods: This study was performed as a retrospective analysis of data collected from SPT patients initially diagnosed with gingivitis or mild to severe periodontitis. Two groups of patients were selected: in group A, younger adults (age ≤ 35 years) were included while group B consisted of older SPT patients (age ≥ 65 years). BOP in the two groups was compared according to both disease severity and % compliance with SPT visits. Results: BOP in all patients (n = 236) was 19.2% (± 12.4). Group A (n = 110) presented mean BOP levels of 19.7% (± 11.8), while lower BOP levels of 18.7% (± 13.0) were found in group B (n = 126; p = 0.5272). Older patients demonstrating high % compliance had lower mean BOP levels (14.2% ± 9.5) than younger patients (18.0% ±  11.7; p = 0.0841). Similarly, BOP was lower in older patients with moderate (group B: 18.4% ± 12.1, group A: 19.3% ± 14.6, p = 0.0541) or severe periodontitis (group B: 22.4% ± 11.4, group A: 23.2% ±  14.0; p = 0.3440). In patients with moderate or severe periodontitis and higher % compliance with SPT, the mean BOP was statistically significantly lower in older patients than in younger patients (moderate: 14.4% ± 11.9 vs 19.4% ± 15.1, p  Keywords: bleeding on probing, elderly, compliance, supportive periodontal therapy

Purpose: A previous clinical study showed that the prevalence of erosive toothwear in vegetarians is statistically significantly higher than in nonvegetarians, due to the consumption of vinegar and other acidic foodstuffs. To adequately inform patients, this study investigated the erosive potential of bottled salad dressings available in Switzerland and compared it with that of orange juice. Materials and Methods: One hundred enamel samples of bovine teeth were divided into ten groups. Samples were placed in 1 of 9 bottled salad dressings or orange juice (Granini) for 2 min. Afterwards, they were rinsed with Zürich tap water for 30 s, followed by abrasion with a toothbrush for 20 brush strokes and a toothpaste-saliva mixture. Erosive/abrasive enamel wear was determined with contact profilometry after 40 cycles. Results: The enamel wear (median/IQR) caused by Tradition Sauce Balsamique (9.5 µm/5.3 µm), M-Classic Dressing Italiano (10.9 µm/12.3 µm), Betty Bossi Balsamico Dressing (9.4 µm/4.5 µm) and Thomy Balsamico Vinaigrette Dressing (14.2 µm/6.5 µm) was statistically significantly higher than that caused by orange juice (2.4 µm/0.8 µm). Enamel wear caused by M-Classic Dressing French Joghurt (0.2 µm/0.2 µm) and Coop Qualité & Prix French Dressing (1.2 µm/1.0 µm) was statistically significantly lower compared to that of orange juice. Conclusions: The pure balsamico vinegar-based dressings (Italian type) showed a statistically significantly higher erosive potential than orange juice, whereas dressings containing calcium-rich products (enriched with milk and/or cream) (French-type) caused lower enamel wear than orange juice. The study shows that some bottled dressings have erosive potential even higher than orange juice and patients should be informed accordingly. Keywords: erosion, tooth wear, salad dressings

Purpose: The topical fluoride treatment of teeth can lead to a formation of CaF2-like material, which is considered to play a significant role in caries prevention. Different types of fluoride sources are applied. The aim of this study was to analyse the in vitro fluoridation effect of the lesser known organic fluoride compound nicomethanol hydrofluoride (NH) regarding fluoride accumulation and morphological changes on dental enamel surfaces. Materials and Methods: The fluoridation effect was investigated by scanning electron microscopy (SEM) and energy dispersive x-ray analysis (EDX) after treatment with fluoride solutions at a concentration of 1350 ppm F - and a pH value of 5.5. NH was tested against inorganic sodium fluoride (NaF) as reference. Fluoridation was done on pellicle-free and pellicle-covered enamel. Results: Formation of globular CaF2-like material was observed for both fluoride types. However, NH led to considerably higher calcium fluoride accumulation on the enamel surface as shown by both EDX and SEM. The globule diameters varied between 0.2 and 0.8 µm. Cross-sectional analysis revealed that the globular precipitates lay directly on the enamel surface; only the very surface-near volume was affected. No statistically significant difference of the fluoridation effect was measured with vs without saliva pre-treatment. Conclusion: The experiments showed a 6 times greater F - surface uptake on dental enamel with NH compared to sodium fluoride, thus suggesting an important role of NH during remineralization phases, fostering equilibrium between de- and remineralization. Keywords: amine fluorides, calcium fluoride precipitation, enamel, energy dispersive x-ray analysis, scanning electron microscopy

Purpose: Orthodontic treatment may introduce a risk to the integrity of enamel due to plaque accumulation and colonisation by oral microbes. This prospective cohort study observed the effect of fixed, self-ligating orthodontic appliances on saliva properties and oral microbial flora. Materials and Methods: Thirty adolescent patients were recruited (13 female, 17 male, mean age 13.97 ± 2.07 years). Saliva samples were collected before placement of fixed orthodontic appliances (T0), and 4 (T1) and 12 (T2) weeks later. Salivary pH, flow rate and buffering capacity were recorded. All saliva samples were cultured on agar plates for 2 days. Salivary prevalence of Neisseria spp., streptococci, Staphylococcus aureus, coagulase-negative staphylococci and Candida albicans were assessed. Results: High buffering capacity was reported in 21 patients at T0, 22 patients at T1 and in 28 patients at T2. Saliva flow rate also increased over time (7.08 ml/5 min at T0, 7.93 ml/5 min at T1 and 8.35 ml/5min at T2). Mean pH was 7.63 at T0, 7.67 at T1 and 7.78 at T2. There was no evidence that either pH or the number of colonies of any of the microbial species changed over time. Conclusion: The increased buffering capacity of saliva as well as the salivary flow rate after initial bonding might be protective against the development of dental caries. Current microbial findings indicate that initiation of orthodontic treatment may not be associated with significant changes in oral microbial flora. Keywords: microbial flora, orthodontics, saliva

Purpose: The aim of this study was to review the literature and chart the clinical studies that have focused on periodontal diseases and adverse pregnancy outcomes since 1996. Materials and Methods: Medline, Cinahl, and Cochrane databases were searched for original studies focused on pregnancy outcomes and periodontal status in humans. The most recent search was conducted on April 30, 2020. Results: Of the 633 articles identified, 232 articles (n = 119,774 participants) were selected for analysis. The majority of studies highlighted a statistically significant association between periodontal diseases and preterm birth (71 of 111 articles; 63.96%), low birth weight (46 of 64 articles; 71.87%), preterm low birth weight (29 of 49 articles; 59.18%), preeclampsia (31 of 45 articles; 68.89%) and other pregnancy complications, such as preterm, prelabor rupture of membranes (17 of 26 articles; 65.38%). Geographical analysis revealed that clinical studies were conducted in 51 countries, primarily in the United States (42 studies, 18.10%), Brazil (33 studies, 14.22%) and India (25 studies, 10.78%). Irrespective of geographical location, analysis showed various degrees of evidence of a relationship between periodontal diseases and adverse pregnancy outcomes. Conclusion: The majority of the studies found a statistically significant link between periodontal diseases and some complications of pregnancy. The strength of such a link varies according to type of study, type of variable and outcome measure selected. Keywords: periodontal diseases, pregnancy, adverse pregnancy outcomes, mapping

Purpose: To determine how the currently available techniques of scaling and root planing, used either alone or with additional polishing techniques, affect the substance thickness and surface roughness of enamel and cementum. Materials and Methods: After extraction, impacted third molars were prepared and subjected to air polishing with a nonabrasive powder, ultrasonic scaling, or hand instrumentation. All three techniques were performed alone and in combinations for a total of 9 treatment groups. The control group consisted of untreated surfaces. Optical microcoordination measurements were conducted to separately assess substance loss, mean roughness depth (Rz), and roughness average (Ra) on enamel and cementum. The Rz results were analysed using a t-test for paired samples. Results: Air polishing alone and with additional rubber-cup polishing using a paste were the only two approaches which caused no enamel loss. Both groups also entailed less cementum loss (≤ 20 μm) than any of the other seven groups, and both yielded the most favorable Rz results on enamel. Air polishing alone was the only group to reveal no significant change in Rz from untreated cementum (p = 0.999). The other 8 approaches statistically significantly reduced the surface roughness of cementum (p ≤ 0.017). Conclusion: Air polishing with a nonabrasive powder yielded the best hard-tissue preservation. Combining any of the scaling techniques with additional polishing was not beneficial; on the contrary, they caused even more abrasion of hard tissue on both enamel and cementum. Keywords: cementum, enamel, hand instruments, substance loss, surface roughness, ultrasonic air polishing

Purpose: Preschool children with early childhood caries (ECC) frequently exhibit extreme dental anxiety and fear, posing a considerable challenge to paediatric dentists for their treatment. The aim of this study was to evaluate the influence of silver diamine fluoride (SDF) treatment on the oral health-related quality of life (OHRQoL) of uncooperative preschool children using an Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS). Materials and Methods: A pre-validated A-ECOHIS was used to assess the sensitivity and responsiveness. Fiftyone children, uncooperative with conventional dental care, underwent SDF treatment; their mothers answered the A-ECOHIS before and 4 weeks after treatment. Based on the global transition rating (GTR), the mothers rated their child’s oral health condition following SDF treatment. Results: SDF effectively arrested caries after 4 weeks in all children. There was a statistically significant reduction in mean scores of the total A-ECOHIS, child impact scale and family impact scores at follow-up (Wilcoxon signedrank test; p ˂ 0.001). There were statistically significant changes in the mean GTR of children’s oral health. Conclusions: A-ECOHIS was sensitive and responsive to SDF treatment. SDF statistically significantly improved the OHRQoL of uncooperative preschool children. Keywords: children, dental caries, mothers, silver diamine fluoride, quality of life

Purpose: Obesity and dental caries constitute an important public health problem worldwide. Special-needs children are at higher risk of developing dental caries and obesity because of their physical, neurological, or behavioural impairment or due to side effects of the medications they take. The present study was conducted to assess the association between dental caries and obesity among children with special health care needs in Taif City, Saudi Arabia. Materials and Methods: A descriptive cross-sectional study was conducted among 400 (220 girls and 180 boys) special-needs children. Body mass index (BMI) was determined by using height and weight measurements. Dental caries was recorded according to World Health Organization criteria. The association between caries and obesity was assessed using multivariable logistic regression analysis. Results: 289 (72.3%) children presented with caries with mean dmft and DMFT of 3.9 ± 2.7 and 4.8 ± 2.3, respectively. Regression analysis showed specials needs children were at a greater risk of having dental caries: 1.69 times (CI: 0.18–2.62, p < 0.05) greater with obesity; 2.01 (CI: 0.18–3.09, p < 0.05) times greater with sugar consumption; 2.21 times (CI: 1.27–4.12, p < 0.001) greater with cerebral palsy; and 2.27 (CI: 1.29–5.12, p < 0.001) times greater with intellectual disability. Conclusion: The present study showed a positive association between dental caries and obesity among children of special health care needs. Hence, a focused approach towards the common risk factors is essential to prevent both obesity and dental caries in special-needs children. Keywords: dental caries, obesity, special needs

Purpose: To identify the oral hygiene habits and denture hygiene status (e.g. sociodemographic characteristics, general health status) of complete denture wearers in Central Transylvania, Romania. Materials and Methods: This descriptive cross-sectional study was based on an original self-administered questionnaire. It included 162 patients who experienced complete tooth loss in one or both jaws and wore polymethylmethacrylate acrylic (PMMA) complete dentures. The exclusion criteria were partial dentures, dentures fabricated from materials other than PMMA, and the patient being unable to provide all the required information. The questionnaire solicited information regarding sociodemographic status, general health and oral hygiene-related habits. The dentures were clinically evaluated in order to assess denture hygiene. Results: Most respondents were completely edentulous (38.0% wore maxillary dentures, 10.6% mandibular dentures, while 51.6% had both), with an average age above 60, all wearing dentures. The clinical evaluation of the dentures revealed that 12.3% exhibited optimal hygiene status, 40.1% good, 32.7% unsatisfactory and 14.8% bad, with more women than men having well-cleaned dentures. Cleaning frequency was found to be 2–3 times per day for 54.3% of the patients, with 93.2% of the subjects using a toothbrush and 76.5% using toothpaste. Most of the participants felt at ease with the cleaning procedures. Only 30.9% of the respondents reported denture removal overnight. The results showed that the hygiene of the patients’ dentures was not correlated with their answers regarding oral hygiene habits. Conclusions: Competent oral health and denture hygiene promotion should be established, especially regarding nocturnal denture removal, denture hygiene methods, instruments and cleaning frequency. Keywords: complete dentures, denture cleaners, oral hygiene habits, nocturnal wear, stomatitis

Purpose: Psychosocial impacts on quality of life among adolescents with access to affordable dental care is not well documented. In addition, dental pain is accelerating towards a public health problem that needs immediate attention. The objective was to determine impacts on quality of life using the Oral Impacts on Daily Performances (OIDP) frequency scale and to determine prevalence of dental pain with its impact. Methods: A total of 288 students (mean age 15.72 ± 1.5) completed the survey instrument (sociodemographic variables, consumption of chocolates/candies, perceived need for dental care, history of dental pain in last 6 months and OIDP frequency scale) designed to measure subjective oral health indicators. Mean OIDP simple count scores were analysed using logistic regression and additive (ADD) scores for dental pain were compared using student’s t test. Results: The response rate was 96%. About 44.4% reported impacts affecting daily performances. About 11.4% consumed tobacco and 92.7% consumed forms of refined sugars. About 39% perceived a need for dental care and 32.3% experienced dental pain with problem in eating and cleaning teeth. Those not perceiving a need for dental care were more likely to have an impact (OR: 2.3; CI: 1.2–4.4). Males had higher OIDP ADD scores for dental pain than females (p = 0.015). Conclusion: Overall impact was less than 50%. Dental pain was reported among students with access to dental care with impacts on eating and cleaning of teeth. Oral health promotion needs to be reinforced by strengthening school community relationship. Keywords: adolescent, child, quality of life, school health services, dental care, dental pain

Purpose: To evaluate the effect of a full-mouth disinfection protocol (FMD) on periodontal parameters, glycaemic control and subgingival microbiota of periodontal patients with type 1 and type 2 diabetes, as well as those without diabetes. Materials and Methods: This study included 33 patients with periodontitis. Eleven of them were type 1 diabetes patients, 11 were type 2 diabetes patients, and 11 were non-diabetics. At baseline and 3 months after the FMD, the periodontal parameters of each patient were recorded, samples of capillary blood for the chairside assessment of HbA1c were taken, and plaque samples from the two deepest periodontal pockets were collected to test for the presence of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Tannerella forsythia (Tf) and Treponema denticola (Td). Results: Bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL) and glycated haemoglobin (HbA1c) decreased statistically significantly (p  Keywords: diabetes mellitus, full-mouth disinfection, HbA1c, periodontitis, subgingival microbiota

Purpose: To evaluate the association between orthodontic treatment with fixed appliances and periodontal health during treatment by examining gingival inflammation indices and saliva properties. Materials and Methods: Thirty consecutive orthodontic patients, aged 11–18 years old, who were eligible for fixed orthodontic appliances, were included in the study. Plaque index (PI), gingival index (GI), salivary pH and flow rate were recorded at three timepoints: immediately before placement of orthodontic fixed appliances (T0), and 1 (T1) and 3 months (T2) after bonding. Results: The hypothesis that PI would remain constant across timepoints was rejected. PI increased over time (0 to 1 scale, T1-T0: mean diff. = 0.10, 95% CI = 0.03, 0.18, p = 0.01; T2-T0: mean diff. = 0.16, 95% CI = 0.08, 0.24, p < 0.001). On the other hand, GI changed statistically significantly over time (p = 0.05). Patients’ age was not a predictor for PI change (p = 0.93), but it was for GI (p = 0.01). As anticipated, average PI was found to be higher for the mandibular dentition by 0.10 (95% CI = 0.04, 0.16) and the labial surfaces of teeth of both jaws by 0.51 (95% CI = 0.45, 0.57). Conclusions: Within the framework of the current study, orthodontic treatment appeared to affect the periodontal health of patients, but the changes were clinically negligible and not consistently statistically significant. Keywords: fixed orthodontic appliances, gingival index, periodontal health, plaque index

Purpose: To compare clinical outcomes and oral fluid biomarkers in gingivitis subjects using an electric toothbrush/irrigator combination (test) or a manual toothbrush alone (control) over 8 weeks. Materials and Methods: Subjects were randomly assigned to two groups of n = 30. In both groups, toothbrushing was performed twice daily at home and no additional interdental cleaning aids were allowed. Plaque Index (PLI), Gingival Index (GI), whole saliva (WS), and gingival crevicular fluid (GCF) samples were collected at weeks 2, 4, and 8. Results: Subjects’ mean age was 23 years and 52% were female. Overall baseline means were 1.31 for PLI, 1.07 for GI, and 34.9 for number of bleeding sites. At every follow-up visit, both groups differed statistically significantly (p < 0.001) from baseline for all clinical parameters. The test group demonstrated statistically significantly (p < 0.001) greater reductions in GI vs the control group by 18% at week 2, 17% at week 4 and 24% at week 8. The test group also demonstrated statistically significantly (p < 0.002) greater reductions in the number of bleeding sites vs the control group by 33% at week 2, 34% at week 4 and 43% at week 8. Between-group comparisons for both WS and GCF revealed numerical trends for decreased levels of interleukin (IL)-1β in GCF after 4 and 8 weeks, but these were not statistically significant. Conclusion: In subjects using the electric toothbrush/irrigator combination, increased clinical improvements may be found accompanied by similarly improved trends for oral fluid biomarkers such as IL-1β. Keywords: gingival crevicular fluid, gingivitis, prevention, toothbrushing

Purpose: To investigate the relationship between periodontal parameters and lipid profiles. Subjects and Methods: A total of 48 subjects with dyslipidemia, consisting of 33 subjects who did not receive lipid-lowering medication (NLM) and 15 subjects who did receive lipid-lowering medication (LM) were enrolled in this cross-sectional study. Sixteen systemically healthy subjects were recruited as controls. The plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured. The levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels were determined. The variables related to high cholesterol levels, including age, gender, waist circumference, and body mass index (BMI), were evaluated. Results: The LM group had a statistically significantly higher CAL in comparison with either the control or the NLM groups. TG was statistically significantly correlated with PD (ρ = 0.398, p = 0.001) and CAL (ρ = 0.349, p = 0.005). HDL-C was negatively correlated with PI (ρ = -0.371, p = 0.003), GI (ρ = -0.284, p = 0.025), and PD (ρ = -0.289, p = 0.023). The stepwise multiple regression analysis showed that BMI was statistically significantly associated with percentage of sites with BOP (β = 0.367, p = 0.003) and PD (β = 0.392, p = 0.002). CAL was statistically significantly influenced by age (β = 0.496, p  Keywords: body mass index, dyslipidemia, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, periodontal disease

Purpose: To evaluate the positive effects of a CPC-, GK2-, and TXA-based (CPC/GK2/TXA) mouthwash after implant placement. Materials and Methods: Twenty patients (n = 20) who underwent posterior implant-placement surgery were randomly and evenly allocated to the study or the placebo group. After the mouthwash was used 3x/day for 7 to 10 days postoperatively, sutures were analysed by counting the colony-forming units (CFU) for total aerobes, total G [-] anaerobes, total enterobacteria and total H. influenzae, followed by Real-Time PCR of bacterial-specific DNAs of A. actinomycetemcomitans, P. gingivalis, T. forsythia, T. denticola, P. intermedia, P. micra, F. nucleatum, C. rectus, and E. corrodens. In vitro resistance of P. gingivalis, S. aureus, and P. aeruginosa was analysed. The compatibility of the mouthwash with Straumann SLA implant surfaces was evaluated by scanning electron microscopy (SEM). Results: Sixteen patients (n = 16) completed the trial. A statistically significantly greater number of CFU was found in the placebo group for almost all species, especially for total G [-] anaerobes. No statistically significant in vitro resistance was found for P. gingivalis, S. aureus, and P. aeruginosa. SEM revealed no surface alteration after exposure to the mouthwash. Conclusion: The use of a CPC/GK2/TXA mouthwash inhibited propagation of the bacteria extracted from the post-surgical sutures after implant placement. Keywords: antibacterial agents, biofilms, implantology, microbiology, periodontology

Purpose: This study aimed to obtain the oral health-related factors of patients with intellectual and developmental disabilities (IDD) from family caregivers and to relate caregiver-perceived risk factors to dental treatment needs of patients. Materials and Methods: A total of 120 dyads of patients (mean [SD] age = 29.1 [8.4] years) and their family caregivers (mean [SD] age = 56.5 [9.5] years) were included. Data were obtained from self-administered questionnaires by caregivers and oral examinations by a dentist. Oral health conditions of patients were analysed in different age groups using paired t-tests. Caregiver-perceived oral health conditions of patients and dentist-assessed caries and periodontal disease were compared using Pearson’s chi-squared and Fisher’s exact tests. Relationships between patient factors and treatment needs were analysed using multiple logistic regression. Results: Tooth pain, chewing difficulty, and reasons for the last dental visit were associated with high numbers of decayed teeth (DT) (p  Keywords: caregiver, caries, DMFT, intellectual disability, oral health, periodontal index