OBJECTIVES: To compare the treatment effects of periodontal endoscope-assisted and traditional subgingival scaling on residual pockets. METHODS: A total of 13 patients with periodontitis from Dept. of Periodontics, West China Hospital of Stomatology, Sichuan University were recruited. After 4-6 weeks of initial treatment, the residual pockets with a probing depth (PD) of ≥4 mm and attachment loss (AL) of ≥4 mm and bleeding on probing were examined with traditional (control group) and periodontal endoscope-assisted subgingival scaling (endoscopy group) in a randomly controlled split-mouth design. At baseline and 6 weeks and 3 months after treatment, plaque index (PLI), PD, AL, and bleeding index (BI) were measured. Differences in these clinical parameters within and between groups and patient-reported outcomes were compared. RESULTS: A total of the 694 sites of 251 teeth were included in this trial. Both groups showed significant improvement in each periodontal parameters 6 weeks and 3 months after treatment ( CONCLUSIONS Periodontal endoscope-assisted subgingival scaling resulted in better effects than traditional subgingival scaling when the residual pockets were in a single-rooted tooth, with a PD of ≥5 mm but without vertical alveolar bone resorption and furcation involvement.
Dental Plaque Index ; Dental Scaling ; Endoscopes ; Humans ; Periodontitis/therapy*

OBJECTIVES: This study aimed to measure the efficacy of different tooth-brushing methods for removing plaque in Korea. METHODS: This study was conducted with the approval of the Institutional Review Board (IRB) of the Seoul National University School of Dentistry (S-D20180021). Thirty participants aged between 19 and 30 years, who did not have periodontal disease, were enrolled in this observational study. Participants were given the same type of toothbrush and toothpaste and asked to brush their teeth as they usually would. During brushing, participants were recorded with a camcorder that was attached to a mirror. Participants were aware they were being recorded. After they had finished brushing their teeth, a dental plaque staining and oral plaque index (PI) examination was performed. The PI score was measured using the Turesky modified Quigley Hein Index. Brushing methods were classified as rolling, horizontal, vertical, circling, and oblique. Skipped surfaces were recorded separately. Following this, statistical analysis was performed using SPSS software. RESULTS: Most surfaces of the mouth were skipped. The most commonly used brushing method was the circling method, followed by the vertical, horizontal, rolling, and oblique methods. The most frequently used method on the vestibular surface was circling, with 52.92% of the oral surface skipped. The oblique brushing method had the lowest mean PI score with a mean±SD of 1.73±0.82. The mean PI score of the skipped surfaces was the highest with a mean±SD of 2.52±0.81. We also analyzed the linear mixed model considering the different lengths of time spent brushing. Both the brushing method used and the time spent brushing had a significant effect on the PI score, but no interactions between these were observed. In areas where a horizontal brushing method had been used, the PI score was significantly decreased. CONCLUSIONS: This study suggests that the horizontal brushing method is an efficient tooth-brushing method compared to the other methods. Additionally, tooth-brushing for more than 10 seconds on 3 to 4 teeth area was effective in removing dental biofilm.
Biofilms ; Dental Plaque Index ; Dental Plaque ; Dentistry ; Ethics Committees, Research ; Humans ; Korea ; Methods ; Mouth ; Observational Study ; Oral Hygiene ; Periodontal Diseases ; Seoul ; Tooth ; Toothpastes ; Video Recording

OBJECTIVE: To survey the cigarette smoking status and periodontal status, and to study the correlation between cigarette smoking and periodontal status. METHODS: Questionnaires were distributed (including self-assessed periodontal status, such as bleeding while brushing teeth, oral odor, tooth loosening, gum swelling, etc.) and clinical periodontal examinations performed for parameters including probing depth (PD), bleeding index (BI), attachment loss (AL), plaque index (PLI) and amount of teeth loss, which was recorded in the population above 35 years of a community in Beijing. A total of 974 subjects were recruited in the study. The population was divided into current smokers and non-smokers, and the differences of self-assessed periodontal status and periodontal parameters between the groups analyzed. RESULTS: The smokers had significantly less bleeding during toothbrushing, and in the meantime, had significantly more self-reported tooth loosening compared with the non-smokers. The smokers brushed their teeth less than the non-smokers (P<0.05). The self-reported gum swelling and oral odor had no significant difference between the smokers and non-smokers. The smokers had 0.565 times and 1.572 times the risk of bleeding during toothbrushing, self-reported tooth loosening and from Logistic regression analyses, respectively (P<0.05). The mean PD, AL, PLI and the amount of tooth loss of the smokers were significant higher than the non-smokers (P<0.05). However, the mean BI of the smokers was slightly less than the non-smokers' (1.93±0.540 vs. 1.94±0.512, P=0.707). The smokers had 2.129 times, 1.698 times and 1.933 times the risk of the mean PD>3 mm, the mean AL>3 mm, and the amount of tooth loss above 8, respectively compared with the non-smokers (P<0.05) from Logistic regression analyses. CONCLUSION The self-assessed periodontal status is different between smokers and non-smokers in the population of a community in Beijing. Smokers have less bleeding during toothbrushing but no significant difference with BI. Smokers also have more self-reported tooth loosening. Compared with non-smokers, smokers have more severe periodontal destruction.
Adult ; Beijing ; Cigarette Smoking ; Dental Plaque Index ; Humans ; Periodontal Attachment Loss ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. METHODS: A total of 116 patients were included in this study. After evaluation of the Löe and Silness gingival index (GI), Silness and Löe plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. RESULTS: After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was 2.76±0.71 times longer than that for MPS measurement after 2 weeks of training. CONCLUSIONS: MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health.
Dental Plaque Index ; Education ; Humans ; Oral Hygiene ; Peri-Implantitis ; Periodontal Index ; Periodontitis ; Polymerase Chain Reaction ; Root Planing ; Tooth

OBJECTIVE: Cytokines produced by various cells are strong local mediators of inflammation. Interleukin-1beta (IL-1β) and C-reactive protein (CRP) play essential roles in the development and progression of diabetes mellitus (DM). Thus periodontal diseases could be related to DM via the same mediators of inflammation. To evaluate plasma and gingival crevicular fluid (GCF) levels of IL-1β and CRP in adolescents with DM to further investigate whether DM has an impact on the levels of inflammation factors at an early stage, and to analyze the risk of developing periodontal diseases in adolescents with DM. METHODS: A total of 121 adolescents aged from ten to sixteen years were enrolled, 41 adolescents diagnosed with diabetes mellitus were collected in the DM group, and 80 nondiabetic adolescents as the control group. The periodontal indices of each individual were recorded, including plaque index (PLI), modified bleeding index (mBI), probing depth (PD) and attachment loss (AL). GCF and intravenous blood samples were collected, and CRP and IL-1β levels were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: (1) PLI of DM group and control group were 1.23±0.05 and 0.95±0.04 separately, with significant difference (P=0.001). DM group and control group had mBI of 0.80±0.08 and 0.51±0.06 separately, with significant difference (P=0.003). Attachment loss was found in none of the subjects. PDs of DM group and control group were (2.37±0.51) mm and (2.31±0.05) mm separately, and there was no significant difference. (2) CRP in GCF was only detectable in partial of the individuals, with a detectable rate of 22.9% (11/48) in total. The detectable rate of CRP in GCF was significantly higher in DM group (38.5%) than that in control group (4.5%, P=0.006). The plasma level of CRP in DM group [0.23 (0.15, 1.89) mg/L] was higher than that in control group [0.19 (0.12, 4.18) mg/L], but without significance (P=0.776). (3) The plasma levels of IL-1β in DM group and control group were (14.11±0.57) ng/L and (14.71±0.50) ng/L separately, but there was no significance (P=0.456). GCF levels of IL-1β in DM group and control group were (12.91±1.95) μg/L and (17.68±3.07) μg/L, without significant difference (P=0.185). CONCLUSION Periodontitis was not observed in adolescents with DM at an early stage. However, the rising levels of periodontal indices and CRP in GCF, might indicate that adolescents with DM have a higher risk of developing periodontal diseases in the future.
Adolescent ; C-Reactive Protein/analysis* ; Dental Plaque Index ; Diabetes Mellitus, Type 2 ; Disease Progression ; Enzyme-Linked Immunosorbent Assay ; Female ; Gingival Crevicular Fluid/chemistry* ; Humans ; Interleukin-1beta/analysis* ; Male ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Plasma

PURPOSE: This study aimed to evaluate the effects of a cetylpyridinium chloride (CPC) and tranexamic acid (TXA) mouth rinse on patients with gingivitis. METHODS: This randomized, placebo-controlled, double-blind, parallel-group, clinical trial included 45 healthy adults with gingivitis, who were randomized into 2 groups. The experimental group used a 0.05% CPC and 0.05% TXA mouth rinse, and the control group used a placebo mouth rinse. The following clinical indices were assessed at baseline, at 3 weeks, and at 6 weeks: the Turesky-Quigley-Hein plaque index (QHI), the Löe-Silness gingival index (GI), and bleeding on marginal probing (BOMP). The subjects used the mouth rinse during the experimental period for 20 seconds, 4–5 times daily (10 mL each time). RESULTS: There were no significant differences in the clinical indices between the groups at baseline. In the experimental group (CPC+TXA), a statistically significant improvement was evident in the QHI, GI, and BOMP at 3 and 6 weeks. These results were similar to those observed in the control group at 3 and 6 weeks, although the change in BOMP was not statistically significant in that group. At 6 weeks, the experimental group had a significantly lower mean score for the QHI than the control group. CONCLUSIONS: This study demonstrated that a CPC and TXA mouth rinse exhibited significant antiplaque and anti-gingivitis efficacy, and had a positive effect on bleeding control when used daily for 6 weeks.
Adult ; Cetylpyridinium* ; Dental Plaque Index ; Gingivitis* ; Hemorrhage* ; Humans ; Mouth* ; Periodontal Index ; Tranexamic Acid*

OBJECTIVEThis study aimed to systematically evaluate the oral health status of patients suffering from chronic renal failure and undergoing hemodialysis (HD).

METHODSElectronic databases, namely, China National Knowledge Infrastructure, Wanfang Data base, PubMed, Web of Science, and Cochrane Library, were searched until May 2016 for cross-sectional and case-control studies that investigated the oral health status of patients suffering from chronic renal failure and undergoing HD. Two reviewers independently screened the trials, extracted the data, assessed the quality, and conducted a Meta-analysis with RevMan 5.3 in accordance with the inclusion and exclusion criteria.

RESULTSSixteen studies satisfied the eligibility criteria. Meta-analysis revealed that plaque index (MD=0.62, 95%CI: 0.51-0.72), calculus index (MD=1.09, 95%CI: 0.56-1.63), probing depth (MD=0.63, 95%CI: 0.29-0.98), and attachment loss (MD=0.63, 95%CI: 0.56-0.69) were significantly higher in the patients undergoing HD than in the healthy control group (P<0.01). No significant differences in decayed missing filled teeth (MD=1.12, 95%CI: -1.08-3.32) were observed between the patients undergoing HD and the healthy control group (P=0.32).

CONCLUSIONSThe prevalence of caries in patients undergoing HD is similar to that in the healthy control group. However, these patients are at a higher risk of acquiring periodontal diseases than the healthy control group. Thus, the oral health status of these patients should be further evaluated in clinical treatments.

Case-Control Studies ; China ; Cross-Sectional Studies ; Dental Caries ; Dental Plaque Index ; Health Status ; Humans ; Oral Health ; Periodontal Diseases ; Renal Dialysis ; Tooth Loss

PURPOSE: A novel index, the periodontal inflamed surface area (PISA), represents the sum of the periodontal pocket depth of bleeding on probing (BOP)-positive sites. In the present study, we evaluated correlations between PISA and periodontal classifications, and examined PISA as an index integrating the discrete conventional periodontal indexes. METHODS: This study was a cross-sectional subgroup analysis of data from a prospective cohort study investigating the association between chronic periodontitis and the clinical features of ankylosing spondylitis. Data from 84 patients without systemic diseases (the control group in the previous study) were analyzed in the present study. RESULTS: PISA values were positively correlated with conventional periodontal classifications (Spearman correlation coefficient=0.52; P<0.01) and with periodontal indexes, such as BOP and the plaque index (PI) (r=0.94; P<0.01 and r=0.60; P<0.01, respectively; Pearson correlation test). Porphyromonas gingivalis (P. gingivalis) expression and the presence of serum P. gingivalis antibodies were significant factors affecting PISA values in a simple linear regression analysis, together with periodontal classification, PI, bleeding index, and smoking, but not in the multivariate analysis. In the multivariate linear regression analysis, PISA values were positively correlated with the quantity of current smoking, PI, and severity of periodontal disease. CONCLUSIONS: PISA integrates multiple periodontal indexes, such as probing pocket depth, BOP, and PI into a numerical variable. PISA is advantageous for quantifying periodontal inflammation and plaque accumulation.
Antibodies ; Chronic Periodontitis ; Classification ; Cohort Studies ; Dental Plaque ; Hemorrhage ; Humans ; Inflammation ; Linear Models ; Multivariate Analysis ; Periodontal Diseases ; Periodontal Index ; Periodontal Pocket ; Porphyromonas gingivalis ; Prospective Studies ; Smoke ; Smoking ; Spondylitis, Ankylosing

This study aimed to investigate the effect of repeated oral health education on the oral health of preschool children. This study classified the control group of children of 5~6 years of age where the oral health education was conducted one time, and the experiment group where the oral health education was conducted 4 times. The oral health conditions of each group and their risk of developing dental caries were also assessed. No significant difference was observed in the participants in terms of general characteristics, oral health conditions, risk of developing dental caries, and oral health behavior after oral health education. The two groups did not show a significant difference (p<0.001) in dental plaque index before and after oral health education, and showed a significant difference (p<0.001) according to the number of education sessions. Before oral health education, the participants in both groups were brushing their teeth incorrectly. However, after the third session, 56.7% of the participants in the experimental group and 9.4% in the control group used the correct method of tooth brushing. A significant difference was observed between the two groups (p<0.05). In addition, when the tooth-brushing time was compared, the two groups showed a significant difference (p<0.001), and a significant difference was observed in terms of the number of education sessions (p<0.05). In summary, repeated oral health education had significant influences on the dental plaque index, tooth-brushing method, brushing occlusal surfaces, and tooth-brushing time. Therefore, when oral health education is carried out, repeated oral health education in children is more effective than one-time oral health education as reflected in the changes in dental plaque index and oral health behavior. Moreover, oral health education is considered effective in changing the oral health behavior of children when conducted at least 3 times.
Child ; Child, Preschool* ; Dental Caries ; Dental Caries Activity Tests ; Dental Plaque Index ; Education* ; Humans ; Methods ; Oral Health* ; Tooth ; Toothbrushing

This study aimed to compare the effectiveness of chewable toothbrush and manual toothbrush and provide basic data for recommendation of the chewable toothbrush in specific groups and situations. A total of 20 subjects participated in this study (rolling method, 10; non-rolling method, 10). After professional prophylaxis, participants used the manual toothbrush to brush their teeth for 3 minutes. After a 7-day wash-out period, participants used the chewable toothbrush according to the manufacturer's instructions. Pre- and post-plaque indexing of the teeth was performed. The dental plaque index was assessed using the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPI) for amount of plaque and Silness-Löe Plaque Index (SLPI) for plaque thickness. The difference between pre- and post-dental plaque index was analyzed using a paired t-test and the Wilcoxon signed-rank test. The Mann-Whitney U test was also used to compare the dental plaque index reduction rates. The dental plaque index differed significantly between the chewable toothbrush and the manual toothbrush. The TMQHPI reduction rate was significantly different between the rolling and non-rolling method groups for the manual toothbrush but not the chewable toothbrush. The difference in SLPI reduction rate between the rolling and non-rolling method groups was significant for the manual toothbrush but not for the chewable toothbrush. Differences in the dental plaque index reduction rates between the chewable and manual toothbrushes were not significant in the non-rolling method group. The results of this study showed higher reduction rates in dental plaque with manual toothbrush use than with chewable toothbrush use. However, the non-rolling method group did not show statistically significant differences according to toothbrush type. The present study showed that a chewable toothbrush can be an alternative to a manual toothbrush for individuals who have difficulty using the generally recommended rolling method.
Abstracting and Indexing as Topic ; Dental Plaque Index ; Dental Plaque* ; Methods ; Pilot Projects* ; Tooth