The effect of chlorhexidine on plaque index and mutans streptococci in orthodontic patients:A pilot study

Aim: The purpose of this study was to assess chlorhexidine effects on plaque index and salivary levels of mutans streptococci (MS) when used as the immersion solution for removable orthodontic appliances and added to their acrylic resin composition. Methods: Forty-five patients (6 to 12 years old) were randomly assigned into three groups with 15 patients each. Group I (control)—without orthodontic appliances disinfection;Group II—removable orthodontic appliances which had been immersed in 0.12% chlorhexidine digluconate overnight (8 hours), and Group III—orthodontic appliances in which 0.12% chlorhexidine digluconate solution had been incorporated into their resin composition. Saliva was collected for quantification of MS and evaluation of plaque index was performed before and after installation of orthodontic appliance at 0, 2, 4, 6, 8, and 10 weeks. Data were analyzed by using analysis of variance. Results: Number of MS colonies in saliva and plaque index showed no statistically differences among groups at the different periods (p > 0.05). Conclusions: It could be concluded that chlorhexidine incorporation into the acrylic resin of removable orthodontic appliances at 0.12% concentration and immersion of the appliance into 0.12% chlorhexidine solution were not effective in reducing plaque index and the number of MS in saliva.

Nigella sativa oil as a treatment for gingivitis: A randomized active-control trial

Objective: To assess the clinical anti-inflammatory and antimicrobial efficacy of Nigella sativa oil compared with chlorhexidine in patients with gingivitis. Methods: A double-blind, randomized clinical trial was conducted in patients having chronic generalized gingivitis. Patients were randomly assigned to receive Nigella sativa oil(n=18) or chlorhexidine(n=19). The following assessments were made on day 0 and day 15: plaque index, gingival index, gingival IL-6 and IL-18 levels were measured using ELISA, plaque colony-forming units, and alpha-hemolytic Streptococcus strains. Data were analyzed using parametric and non-parametric tests and Fisher’s exact test.Results: Both interventions reduced plaque index and gingival index scores(P<0.000 1). The Nigella sativa oil group was better at lowering IL-6(P=0.007 6) than the chlorhexidine group(P=0.145), although there was no change in IL-18 levels(P>0.05). The post-intervention plaque index and gingival index scores and inflammatory cytokine levels between the two groups were not significantly different. Both interventions caused a significant reduction in the plaque colony-forming units(P<0.000 1), reducing pathogenic bacteria: Streptococcus mitis, Streptococcus oralis, Streptococcus sanguinis, and Streptococcus parasanguinis in the chlorhexidine group(50%)(P=0.103 1), and the Nigella sativa oil group(20%)(P=0.739 5). Conclusions: Nigella sativa oil had anti-inflammatory and antibacterial activities, reducing biofilm formation and disrupting the colonization of pathogenic bacteria essential for the progression of periodontal disease. Nigella sativa oil could offer an alternative therapy for treating gingivitis and may prevent associated systemic diseases and improve overall health outcomes.

Periodontal Health among Type 2 Diabetes Patients Treated with Different Dental Restorations

Background: Diabetes increases periodontal disease risk and its complications, which are worsened with age or faulty restorations. Aim: Evaluate periodontal health among patients with diabetes treated with different dental restorations. Materials and Methods: This comparative cross-sectional study was conducted at the faculty of dentistry, Najran University, KSA, from March 2018 to February 2020. It included 260 diabetics, treated with different dental restorations, divided into four groups, each comprising 65 patients aged 45 - 60 years: Group 1 (G1), no restorations (control group);Group 2 (G2), Class II amalgam restorations;Group 3 (G3), Class II composite resin restorations;and Group 4 (G4), three-unit posterior metal ceramic prostheses. The Ages of all restorations ranged from 8 to 10 years. All groups were assessed for the Plaque Index (PI) and Gingival Index (GI), Overhangs Rate (OR), Alveolar Bone Loss (ABL) (the latter two using panoramic X-ray). HbA1c and duration of participants were also assessed and compared. Results: The mean HbA1c results of the groups ranged from 8.1% to 9.5%, and their mean diabetes durations ranged from 7.2 to 12 years. All the groups showed worse periodontal scores, ranging from 2.45 - 2.95 for PI and 2.25 - 2.8 for GI. G2 had higher scores than G1 and G3 (p < 0.001). G4 had the highest two recorded scores (p < 0.001). G2 had a higher rate of overhangs than G3 (p < 0.037). The mean ABL was 44% (SD 6.4) for G1, 56.0% (SD 6.7) for G2, 46.5% (SD 5.8) for G3, and 74.5% (SD 6.4) for G4. The lowest values were recorded in G1 and G3 (p = 0.987). The highest value was observed in G4, which was significantly higher than other groups (p < 0.001). Conclusion: The worse periodontal parameters among subjects treated with either three-unit metal ceramic or Class II amalgam restorations indicated severe periodontal destruction. Untreated subjects and subjects treated with Class II composite resin had relatively better periodontal status.

Role of salivary matrix metalloproteinase-8 （MMP-8） in chronic periodontitis diagnosis

Periodontitis is an inflammatory disease of the periodontium. Any imbalance between the matrix metalloproteinases （MMPs） secreted by neutrophils and tissue inhibitors initiates the destruction of collagen in gum tissue, leading to chronic periodontitis. This study aimed to correlate salivary levels of MMP-8 and periodontal parameters of chronic periodontitis to establish MMP-8 as a noninvasive marker for the early diagnosis of chronic periodontitis. The study involved 40 subjects visiting the periodontic OPD of Dr. Ziauddin Ahmad Dental College and Hospital, located in Aligarh, U.P., India, from 2011 to 2012. The subjects were divided into two groups： group I consisted of 20 periodontally healthy subjects （controls） while group II consisted of 20 patients with chronic periodontitis. Chronic periodontitis was assessed on the basis of several periodontal parameters, including pocket probing depth （PPD）, clinical attachment level （CAL）, gingival index （GI）, and plaque index （PI）. Around 3 ml of unstimulated and whole expectorated saliva was collected for MMP-8 estimation by ELISA using Quantikine human total MMP-8 immunoassay kits. Data were analyzed using STATISTICA （Windows version 6） software. Salivary MMP-8 levels of groups I and II were 190.91 ± 143.89 ng/ml and 348.26± 202.1 ng/ml, respectively. The MMP-8 levels and periodontal status （PPD, CAL, GI, and PI） of groups I and II showed positive and significant correlations （for PPD, r = 0.63, P 〈 0.001; for CAL, r = 0.54, P 〈 0.001; for GI, r = 0.49, P 〈 0.001; and for PI, r = 0.63, P 〈 0.001）. The results of this study demonstrate elevated concentrations of MMP-8 in individuals with chronic periodontitis.