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

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: 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*

OBJECTIVES: The influence of sex steroid hormones on periodontium can be knockdown with good plaque control. The aim of the present study was to evaluate periodontal status in pre- and postmenopausal women with periodontitis following non-surgical therapy. METHODS: Total 60 female patients' periodontal status was measured by periodontal index (PRI), and oral hygiene status was measured by plaque index (PI). Both the parameters were measured at baseline i.e. before scaling and root planing and after 3 months intervals post treatment. Data were analyzed using SPSS version 21. RESULTS: The mean PRI scores in premenopausal group were 5.68 ± 0.64 and 2.53 ± 0.13, and PI scores were 1.84 ± 0.17 and 0.91 ± 0.13 respectively at baseline and 3 months. The mean PRI scores in postmenopausal group were 6.08 ± 0.46 and 2.55 ± 0.12, and PI scores were 1.86 ± 0.24 and 1.00 ± 0.24 respectively at baseline and 3 months. CONCLUSIONS: There was more desirable response to non-surgical periodontal therapy in both the groups but not significant variation in between two groups.
Dental Plaque ; Dental Scaling ; Female* ; Gonadal Steroid Hormones ; Humans ; Inflammation ; Menopause ; Oral Hygiene ; Periodontal Index ; Periodontitis* ; Periodontium ; Root Planing

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

OBJECTIVES: The aim of this study was to compare Plaque Percent Index (PPI), calculated by Patient Hygiene Performance Index (PHPI), Rustogi's modification of the Navy Plaque Index (RMNPI), and the Quigley & Hein Plaque Index (QHPI), with visual assessment. METHODS: Ninety-six subjects, aged between 30–65 years, were examined; twenty subjects were included in the final analysis. The subjects' teeth were stained and photographed. Dental coloring and intraoral camera photography were performed by a single examiner. The oral images obtained were analyzed using Image J to measure the area of dental plaque. The values of PHPI, RMNPI, and QHPI were calculated twice. Statistical analyses were performed using descriptive statistics, chi-square test, and Pearson's correlation coefficient. RESULTS: The results of the correlation analyses of PPI with PHPI, QHPI, and RMNPI were as follows: for PHPI, the correlation coefficient (r)=0.584; for QHPI, r=0.689; and for RMNPI, r=0.729. Further, the kappa indices of PHPI, QHPI, and RMNPI were 0.810, 0.677, and 0.590 respectively. CONCLUSIONS: Among RMNPI, QHPI, and PHPI dental plaque indices, RMNPI and QHPI showed a high degree of correlation with the actual stained dental plaque area; on the other hand, PHPI showed the highest kappa index.
Dental Plaque Index* ; Dental Plaque* ; Hand ; Humans ; Hygiene ; Photography ; Tooth