Displaying publications 1 - 20 of 39 in total

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  1. Nasution DLI, Furuta M, Li H, Zakaria MN, Takeshita T, Peres MA, et al.
    J Clin Periodontol, 2023 Aug;50(8):1042-1050.
    PMID: 36935202 DOI: 10.1111/jcpe.13809
    AIM: To investigate the existence of a bidirectional temporal relationship between periodontal condition and glycaemic status.

    MATERIALS AND METHODS: This longitudinal study included 2198 participants with mean age 43.4 ± 7.7 years, who underwent dental examinations in Yokohama, Japan, at two time points, 2003-2004 and 2008-2009, at an interval of 5 years. Periodontal condition was assessed by the mean value of probing pocket depth (PPD) and clinical attachment level (CAL). Glycaemic status was assessed by fasting glucose and glycated haemoglobin (HbA1c).

    RESULTS: The cross-lagged panel models showed the effect of HbA1c at baseline on mean PPD at follow-up (β = 0.044, p = .039). There was a marginal effect of fasting glucose on the mean PPD (β = 0.037, p = .059). It was similar to the effect of fasting glucose or HbAlc on mean CAL. However, in the opposite direction, no effect of mean PPD or CAL at baseline on fasting glucose or HbAlc at follow-up was identified.

    CONCLUSIONS: This study demonstrated a unidirectional relationship between glycaemic status and periodontal condition. The study population, however, had mostly mild periodontitis. Future studies are needed to investigate the effect of periodontal condition on glycaemic status in patients with severe periodontitis.

    Matched MeSH terms: Gingival Diseases*
  2. Nik-Azis NM, Razali M, Goh V, Ahmad Shuhaimi NN, Mohd Nazrin NAS
    J Clin Periodontol, 2023 Jan;50(1):80-89.
    PMID: 36089895 DOI: 10.1111/jcpe.13723
    AIM: Assessment of the thickness of gingival tissues using the probe visibility test is regarded as the method of choice during routine examinations. However, the probe visibility test has not been validated for patients with gingival pigmentation and its accuracy in populations with physiological gingival pigmentation is yet unknown. This study aims to evaluate different methods for the clinical assessment of gingival thickness in participants with varying levels of gingival pigmentation.

    MATERIALS AND METHODS: Buccal mucosa of the maxillary right central incisor teeth of 171 participants was evaluated using four methods, which were direct measurements using calliper, transgingival probing method using an endodontic probe, and probe visibility method using Colorvue biotype probe (CBP) and UNC-15 probe. The pigmentation of the gingiva was assessed using the Dummett-Gupta oral pigmentation lesion index.

    RESULTS: The average gingival thickness of the selected population was 1.22 ± 0.38 mm with a distribution of 70% thick and 30% thin gingiva. Transgingival and calliper methods showed good agreement and significant correlation (r = 0.229; p = .003). Visual assessment using CBP and UNC-15 probe showed poor agreement with the direct measurement methods. Gingival pigmentation significantly affected the probe visibility assessment, reducing the visibility of both the CBP (odds ratio [OR] = 4.00; 95% confidence interval [CI], 1.83-8.74) and UNC-15 probe (OR = 1.84; 95% CI, 1.05-3.23) while controlling for thickness of the gingiva.

    CONCLUSION: The probe visibility method using either CBP or the UNC-15 probe is affected by the degree of gingival pigmentation. Direct measurements using either a calliper or transgingival probing are recommended as methods to measure the gingival thickness in populations with gingival pigmentation.

    Matched MeSH terms: Gingival Diseases*
  3. Kamar Affendi NH, Ahmad R, Vahidi F, Hassan MZ, Rahimi SN
    Case Rep Dent, 2020;2020:8883156.
    PMID: 33343944 DOI: 10.1155/2020/8883156
    Introduction: A diode laser is one of the universally compact accepted laser systems used fundamentally for soft tissue applications. Most diode laser devices have a single wavelength of either 810 nm for superior coagulation or 980 nm for tissue ablation. In these case series, the use of dual wavelengths (810 nm and 980 nm) in combination with super pulsing has provided a cleaner cut (no charring) with faster healing that eases the placement of the final restoration in the esthetic zone. Case Description. The present case series describe four cases in the esthetic zone that achieved hemostasis ablation without collateral damage to enhance gingival balance of definitive restoration. The gingivoplasty and gingivectomy modes are used to achieve efficient tissue ablation. Although there is no specific mode indicated in the FDA laser requirement for gingival depigmentation, the procedure could be safely performed with the dual-wavelength diode laser.

    Result: All four patients revealed a good esthetic outcome and reported no pain postoperatively. Healing was uneventful, and definitive restoration was delivered within two to four weeks postoperatively.

    Conclusion: Within the limitation of these case series, the dual-wavelength super pulsed diode laser has the capacity to deliver peak powers resulting in efficient cutting and less tissue charring and also as an alternative tool for removal of gingival pigmentation. Prospective clinical research with larger sample size is needed for conclusive results.

    Matched MeSH terms: Gingival Diseases
  4. Law, Leh Shii, Stephen, Jeffery
    MyJurnal
    Oral health gained attention worldwide as it exerted unfavourable and undesired influences on an individual’s daily lives and wellbeing, especially among the rural population. In order to increase the understanding on the oral health among the rural community, this study aimed to determine the oral health knowledge and practice and its association with sociodemographic characteristics among the longhouse residents in Julau, Sarawak. In this cross-sectional study, a total of 105 residents were recruited from five longhouses, namely Rumah Panjang Mengga, Rumah Panjang Ikeh, Rumah Panjang Michael, Rumah Panjang Budit, and Rumah Panjang Manju. Information related to sociodemographic characteristics, as well as oral health knowledge and practice was gathered through face-to-face interview by using a structured questionnaire. Spearman rho correlation test, Mann-Whitney U-test, and Krukal-Wallis H-test were applied during data analysis. Median (interquartile) age of the children and adults was 10.0 (5.0) and 50.0 (22.0) years old, respectively. Findings revealed that oral health knowledge and practices among participants, both children and adults were inadequate as a high proportion of the participants were unable to provide answers for oral health related questions (functions of fluoride and correlation between gum disease with heart disease) and several oral health practices (regular oral check-up, change of toothbrush, and consumption of sweetened food) were also not being engaged in the daily life among the children and adult participants. A significant correlation was found between age and knowledge score among adult participants (rs = -0.389, p < 0.001). Besides, significant higher oral health knowledge score were found among adult participants with higher education level (H = 27.466; p < 0.001) and significant higher in oral health practice score was found among unemployed adult participants when compared to self-employed and employed workers for government and private (H = 9.631, p = 0.008). In conclusion, younger and educated participants are more knowledgeable regarding oral health. Engagement of oral health practices were related to occupation of the adult participants. Provision of health education and education aid for longhouse community should be continued taking into consideration age, level of education level, and even occupation in order to improve their oral health knowledge and practice.
    Matched MeSH terms: Gingival Diseases
  5. Nazir MA, Izhar F, Akhtar K, Almas K
    J Family Community Med, 2019 10 2;26(3):206-212.
    PMID: 31572052 DOI: 10.4103/jfcm.JFCM_55_19
    BACKGROUND: Oral health is integral to systemic health. There is a growing body of evidence of an association between periodontal and systemic diseases. The aim of the study was to evaluate the awareness of dentists regarding link between oral and systemic health.

    MATERIALS AND METHODS: Data was collected using a self-administered pilot-tested questionnaire. Dentists awareness about link between oral and systemic link was assessed on five point likert scale. Data was entered and analysed using SPSS.

    RESULTS: Of the 588 dentists, 500 completed the questionnaire (response rate 85.03%). About 93% of the participants (mean age 25.82 ± 4.21 years) agreed that oral health was associated with systemic health. Most dentists were aware of a connection between periodontal disease and diabetes (84.4%) and heart disease (70.2%). Similarly, 85.6% believed in the negative impact of oral disease on the quality of life of patients. More female than male dentists were aware of the relationship between periodontal disease and adverse pregnancy outcomes, diabetes, and rheumatoid arthritis (P < 0.001). Most dentists (97%) believed that more patients would seek oral care if they were aware of the oral-systemic link. After adjustments, private dentists were 4.65 times more likely than public dentists to believe in improving access to oral care with increased patient awareness of the oral-systemic connection (P = 0.011).

    CONCLUSIONS: Most dentists were aware of the oral-systemic link. They believed that patients' access to oral care would improve if they were aware of a connection between oral and systemic health. Therefore, patients should be informed of the oral-systemic link to improve their oral health.

    Matched MeSH terms: Gingival Diseases
  6. Muniandy S
    J Indian Soc Periodontol, 2019 5 31;23(3):275-280.
    PMID: 31143010 DOI: 10.4103/jisp.jisp_479_18
    Background: The impact of smoking on oral health is directly related to the toxic tobacco fumes. The study aimed to investigate the awareness of the link between smoking and periodontal disease among the population seeking periodontal treatment.

    Materials and Methods: A self-administered questionnaire constructed in local Malay language consisting of 13 questions on sociodemographic details and 10 questions on the knowledge domain was distributed to eligible respondents while they were waiting for their consultation in the periodontal clinic waiting hall. There were 330 study participants aged 16 years old and above, who participated in this study from all 12 dental clinics in the state of Perlis, Malaysia. Data were entered into Statistical Package for the Social Sciences version 20.0 for analysis. Descriptive statistics were used to describe the sociodemographic data, whereas association between potential factor and the knowledge of awareness was found using the Pearson Chi-square test of independence or a Fisher's exact test, depending on the eligibility criteria.

    Results: Our study showed that 4.5% (n = 15) of the respondents were not aware that smoking did add risk for oral cancer, 14.5% (n = 48) were not aware that smoking could cause gum disease. Smoking status was significantly associated with the awareness of smoking effect on gum disease (P = 0.002). The proportion of the active smokers being aware that smoking could potentially cause gum disease was considerably less as compared to the nonsmokers (62.7% vs. 83.3%).

    Conclusions: Continuous dental health campaigns and awareness program are crucial to instil awareness and health-seeking behavior as well as to enforce public's knowledge.

    Matched MeSH terms: Gingival Diseases
  7. Singh VP, Gan JY, Liew WL, Kyaw Soe HH, Nettem S, Nettemu SK
    Dent Res J (Isfahan), 2019 2 13;16(1):29-35.
    PMID: 30745916
    Background: Periodontitis is a public health concern since it is a major factor in tooth loss worldwide and has association with many systemic diseases. Sleep is a complex and essentially biological process and a critical factor for maintaining mental and physical health. Since inflammation is characteristic of both chronic periodontitis and sleep deprivation, few studies in recent years present the contradictory results regarding this potential association. The objective of the present study was to investigate the association between quality of sleep and chronic periodontitis.

    Materials and Methods: A total of 200 individuals participated in this study. All participants underwent a comprehensive clinical periodontal examination. Case-control were identified using the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions for periodontal disease. The quality of sleep was assessed by Pittsburgh Sleep Quality Index. The univariate and multivariate logistic regression analysis was used to test the influence of variables (quality of sleep, age, sex, ethnicity, education, and socioeconomic status), in the occurrence of periodontitis. Odds ratio (OR) and respective confidence intervals (CIs) were calculated and reported. P =0.05 was considered statistically significant.

    Results: The prevalence of poor quality of sleep was 56.75% in cases (periodontitis group) and 43.24% in control group. There was positive association between quality of sleep and chronic periodontitis (OR = 3.04; 95% CI = 1.42-6.5; P = 0.004). In multivariate logistic regression analysis, only the age was significantly related to the periodontitis (OR = 1.11; 95% CI = 1.07-1.41; P < 0.001), other variables failed to reach the significant level.

    Conclusion: Poor quality of sleep was significantly associated with chronic periodontitis. Only the age was significantly related to periodontitis among the other covariable measured.
    Matched MeSH terms: Gingival Diseases
  8. Jeyasree RM, Theyagarajan R, Sekhar V, Navakumar M, Mani E, Santhamurthy C
    J Indian Soc Periodontol, 2019 1 12;22(6):487-491.
    PMID: 30631226 DOI: 10.4103/jisp.jisp_133_18
    Background: The traditional method of diagnosing periodontitis includes the assessment of clinical parameters and radiographic aids to evaluate the periodontal tissue destruction. Saliva has the potential to be used as the diagnostic fluid for oral disease. This study aimed at comparing the quantitative levels of alkaline phosphatase (ALP) in saliva and serum before and after scaling and root planing in patients with chronic generalized periodontitis.

    Materials and Methods: A total number of 50 participants (40 with chronic generalized periodontitis and 10 periodontally healthy volunteers) of 30-50 years were included in the study. Clinical parameters such as simplified oral hygiene index (OHI-S), gingival index, probing depth, and clinical attachment loss (CAL) were measured, and then, saliva and blood sample collection was done and analyzed for ALP levels by spectrometry. The clinical parameters along with saliva and serum ALP levels were reevaluated after 30 days following Phase I periodontal therapy. The results were statistically analyzed using paired t-test and one-way ANOVA.

    Results: The saliva and serum ALP levels were significantly increased in patients with chronic generalized periodontitis with an increase in clinical parameters such as OHI-S, gingival index, probing depth, and CAL when compared with periodontally healthy individuals. The saliva and serum ALP levels were significantly decreased following Phase I periodontal, therapy along with improvement in clinical parameters.

    Conclusion: With the limitations of the present study, it could be concluded that ALP levels in saliva can be used for the diagnosis of active phase of periodontal disease and also for evaluation of the treatment outcomes following Phase I periodontal therapy.

    Matched MeSH terms: Gingival Diseases
  9. Singh VP, Nettemu SK, Nettem S, Hosadurga R, Nayak SU
    J Hum Reprod Sci, 2017 Jul-Sep;10(3):162-166.
    PMID: 29142443 DOI: 10.4103/jhrs.JHRS_87_17
    Ample evidence strongly supports the fact that periodontal disease is a major risk factor for various systemic diseases namely cardio-vascular disease, diabetes mellitus, etc. Recently, investigators focussed on exploring the link between chronic periodontitis (CP) and erectile dysfunction (ED) by contributing to the endothelial dysfunction. Both the diseases share common risk factors. Various studies conducted in different parts of the world in recent years reported the evidence linking this relationship as well as improvement in ED with periodontal treatment. Systemic exposure to the periodontal pathogen and periodontal infection-induced systemic inflammation was thought to associate with these conditions. The objective of this review was to highlight the evidence of the link between CP and ED and the importance of oral health in preventing the systemic conditions.
    Matched MeSH terms: Gingival Diseases
  10. Naik SV, K R, Kohli S, Zohabhasan S, Bhatia S
    Open Dent J, 2016;10:196-206.
    PMID: 27386005 DOI: 10.2174/1874210601610010196
    The usage of ozone in dentistry has been proposed because of its antimicrobial, disinfectant, biocompatibility and healing properties. In the last decade a number of therapeutic protocols with ozone have been developed to address common dental infections associated with periodontal disease, RCT and caries. Despite these advantages, therapeutic ozone's application in dentistry is limited because of its possible side effects. Hence, dental practitioners need to know the proper usage of ozone therapy that can provide better patient care and considerably cut down the time and cost of the treatment.
    Matched MeSH terms: Gingival Diseases
  11. Balakumar P, Kavitha M, Nanditha S
    Pharmacol Res, 2015 Dec;102:81-9.
    PMID: 26409645 DOI: 10.1016/j.phrs.2015.09.007
    Oral health is an imperative part of overall human health. Oral disorders are often unreported, but are highly troublesome to human health in a long-standing situation. A strong association exists between cardiovascular drugs and oral adverse effects. Indeed, several cardiovascular drugs employed clinically have been reported to cause oral adverse effects such as xerostomia, oral lichen planus, angioedema, aphthae, dysgeusia, gingival enlargement, scalded mouth syndrome, cheilitis, glossitis and so forth. Oral complications might in turn worsen the cardiovascular disease condition as some reports suggest an adverse correlation between periodontal oral disease pathogenesis and cardiovascular disease. These are certainly important to be understood for a better use of cardiovascular medicines and control of associated oral adverse effects. This review sheds lights on the oral adverse effects pertaining to the clinical use of cardiovascular drugs. Above and beyond, an adverse correlation between oral disease and cardiovascular disease has been discussed.
    Matched MeSH terms: Gingival Diseases
  12. Vaithilingam RD, Safii SH, Baharuddin NA, Karen-Ng LP, Saub R, Ariffin F, et al.
    Oral Dis, 2015 Jan;21(1):e62-9.
    PMID: 24930489 DOI: 10.1111/odi.12267
    Periodontal bio-repositories, which allow banking of clinically validated human data and biological samples, provide an opportunity to derive biomarkers for periodontal diagnosis, prognosis and therapeutic activities which are expected to improve patient management. This article presents the establishing of the Malaysian Periodontal Database and Biobank System (MPDBS) which was initiated in 2011 with the aim to facilitate periodontal research. Partnerships were established with collaborating centres. Policies on specimen access, authorship and acknowledgement policies were agreed upon by all participating centres before the initiation of the periodontal biobank. Ethical approval for the collection of samples and data were obtained from institutional ethics review boards. A broad-based approach for informed consent was used, which covered areas related to quality of life impacts, genetics and molecular aspects of periodontal disease. Sample collection and processing was performed using a standardized protocol. Biobanking resources such as equipment and freezers were shared with the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). In the development of the MPDBS, challenges that were previously faced by the MOCDTBS were considered. Future challenges in terms of ethical and legal issues will be faced when international collaborations necessitate the transportation of specimens across borders.
    Matched MeSH terms: Gingival Diseases
  13. Al-Tayar B, Tin-Oo MM, Sinor MZ, Alakhali MS
    Tob Induc Dis, 2015;13:35.
    PMID: 26539068 DOI: 10.1186/s12971-015-0061-8
    BACKGROUND: The traditional type of smokeless tobacco used in the Arabian Peninsula, particularly common in Yemen, is called shammah. This study aims to determine the prevalence of shammah use and its association with the development of periodontal pockets. Other associated factors with the development of periodontal pocket were also determined.

    METHODS: This cross-sectional study included 346 adult males aged 18 years old to 68 years old. Socio-demographic characteristics, oral hygiene practices, and shammah use history were surveyed by using a structured interview questionnaire. The clinical assessment for the presence or absence of periodontal pockets was assessed on the basis of community periodontal index. The chi-square test was used to assess significant differences in study groups in terms of the presence of periodontal pockets. Multivariable logistic regression was selected to assess potential associated factors with the development of periodontal pockets.

    RESULTS: Among the 346 adult males, 248 (71.7 %), 30 (8.6 %), and 68 (19.7 %) males never used shammah, were former shammah users, and were current shammah users, respectively. The significant associated factors with the development of periodontal pocket were age group (30 years old and above) (Adjusted Odds Ratio (AOR) = 2.03, 95 % CI: 1.13, 3.65; P = 0.018), low family income category (AOR = 2.35, 95 % CI: 1.39, 3.99; P = 0.001), former shammah user (AOR = 2.66, 95 %: CI: 1.15, 6.15; P = 0.022), and current shammah user (AOR = 6.62, 95 %: CI: 3.59, 12.21; P = 0.001).

    CONCLUSIONS: The results revealed that periodontal pockets were significantly associated with age group (30 years old and above), low family income category, former shammah use, and current shammah use. The findings of the current study highlighted the need to develop comprehensive shammah prevention programs and reduce periodontal disease and other shammah-associated diseases.

    Matched MeSH terms: Gingival Diseases
  14. Siti Norsuryani Shamsuddin, Azelinda Ahmad, Haslina Taib, Wan Majdiah Wan Mohamad
    MyJurnal
    Chronic periodontitis (CP) is an inflammatory disease of the supporting tissues of the teeth caused by specific microorganism. Hypertension is one of the major causes of cardiovascular disease whereas periodontitis has recently drawn increasing attention because of its potential relationship with cardiovascular disease. The objectives of this study were to determine the prevalence of the hypertension in CP patients as well as to evaluate the association between hypertension and severity of CP. One hundred and eighty five records of CP patients treated in Dental Clinic, Universiti Sains Malaysia Hospital (USM Hospital), Kelantan from 2010 until 2013 were retrieved and reviewed. The diagnosis of periodontal disease and the presence of hypertension were recorded. The severity of chronic periodontitis was classified into mild, moderate and severe according to the clinical attachment loss. The data was obtained and analyzed using SPSS version 20.0. Majority of the subjects were from Malay ethnic group (94.4%) at the age range between 41 and 61 years (67.8%). In conclusion, the prevalence of hypertension in chronic periodontitis patients was 12.2%. There was no significant association between hypertension and severity of CP (p=0.229).
    Matched MeSH terms: Gingival Diseases
  15. Sadikin AS, Mansor H, Saub R, Vaithlingam RD
    Ann Dent, 2015;22(2):15-22.
    MyJurnal
    Objective: This study aimed to assess the awareness of periodontal disease and level of knowledge of the relationship between smoking and periodontal disease amongst subjects who were smokers verses non-smokers.
    Methods: A questionnaire looking at knowledge of respondents regarding gum disease and knowledge and awareness about oral impacts of smoking on periodontal disease was developed and pretested in Dental Faculty University of Malaya. Basic Periodontal Examination (BPE) index was used to assess periodontal status.
    Results: The questionnaire was answered by 130 subjects. Prevalence of smoking was 14.6%. A total of 58.6% non-smokers and 57.9% smokers knew about periodontal disease. However, only 26.1% non-smokers and 10.5% smokers knew that the cause for periodontal disease was plaque. More non-smokers than smokers knew that smoking affected periodontal health (80.2% and 68.4% respectively) (p>0.05) and tooth mobility was an effect of smoking on periodontal health (27.0% and 0%) (p<0.05). Regarding source of information on effect of smoking on periodontal health, 63.2% smokers and 63.1% non-smokers reported obtaining information through the mass media. However, only 31.6% smokers and 28.8% non-smokers were informed by their dentist.
    Conclusion: The awareness of periodontal disease and knowledge of the relationship between smoking and periodontal disease was low in this selected population of smokers and non-smokers.
    Keywords: Awareness, knowledge, periodontitis, smoking
    Study site: Primary Care Unit, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
    Matched MeSH terms: Gingival Diseases
  16. Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, et al.
    PMID: 24934383 DOI: 10.1002/14651858.CD002281.pub3
    BACKGROUND: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005.

    OBJECTIVES: To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.

    SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

    SELECTION CRITERIA: Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults.

    DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months).

    MAIN RESULTS: Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias.There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual toothbrushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I(2) = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups.With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I(2) = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups.The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points.

    AUTHORS' CONCLUSIONS: Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.

    Matched MeSH terms: Gingival Diseases/prevention & control
  17. Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.
    Matched MeSH terms: Gingival Diseases
  18. Tuti Ningseh Mohd-Dom, Khairiyah Abdul-Muttalib, Rasidah Ayob, Yaw, Siew Lan, Ahmad Sharifuddin Mohd-Asadi, Mohd Rizal Abdul-Manaf, et al.
    MyJurnal
    The paucity of published literature on periodontal treatment needs and services in developing countries has undermined the significance of periodontal disease burden on healthcare systems. This study analyses periodontal status and population treatment needs of Malaysians, and patterns of periodontal services provided at public sector dental clinics. A retrospective approach to secondary data analysis was employed. Data for population treatment needs were extracted from three decennial national oral health surveys for adults (1990, 2000 and 2010). Annual reports from the dental subsystem of the government Health Information Management System (HIMS) provided information on oral health care delivery for years 2006-2010. They were based on summaries of aggregated data; analyses were limited to reporting absolute numbers and frequency distributions. Periodontal disease prevalence declined between 1990 (92.8%) to 2000 (87.2%) but a sharp rise was observed in the 2010 survey (94.0%). The proportion of participants demonstrating periodontal pockets of 6 mm and more increased in 2010 survey after showing improvements in 2000. Individuals not requiring periodontal treatment (TN0) increased in proportion from 1990 to 2000, only to drop in 2010. An increase in utilisation was observed alongside a growing uptake of periodontal procedures (62.2% in 2006 to 73.6% in 2010). Only about 10% of treatment was surgeries. While the clinical burden of periodontal disease is observed to be substantial, the types of treatment provided did not reflect the increasing needs for complex periodontal treatment. Emphasis on downstream and multi-collaborative efforts of oral health care is deemed fit to contain the burden of periodontal disease.
    Matched MeSH terms: Gingival Diseases
  19. Ismail, N., Mohd Ali, S. S., Swaminathan, D.
    Ann Dent, 2013;20(1):8-12.
    MyJurnal
    A preliminary investigation to assess the relationship
    in the severity of periodontal disease in diabetics when
    compared with non-diabetic subjects. Materials and
    Methods: A retrospective, comparative study using
    periodontal case notes of 40 subjects (20 Type 2 diabetics,
    20 non-diabetics) who were selected based on the
    inclusion and exclusion criteria. Severity of periodontal
    disease was assessed through number of periodontal
    pocket ≥5mm. The results were compared between
    subjects whose age, gender and plaque scores are matched
    with the test group. Data obtained was then analyzed by
    SPSS Version 12. Results: When comparisons were made
    between test (Type 2 diabetic) and control (non-diabetic)
    groups, there were no significant difference (p>0.05) in
    the severity of periodontal disease. However, there was
    a clinically mean difference between the two groups.
    Conclusions: This preliminary investigation indicated
    that the severity of chronic periodontitis, as indicated in
    periodontal pocketing, increased in diabetic patients when
    compared to non-diabetics clinically, although it was not
    statistically significant. The finding of this investigation
    was thus not conclusive as it was only a retrospective
    study using patients’ case notes. However, the results
    are now being further investigated with a proper clinical
    trial which examines periodontal parameters and diabetic
    status (HbA1c) of the subjects to determine the association
    between periodontal disease and diabetes mellitus.
    Matched MeSH terms: Gingival Diseases
  20. Shahrul Hisham Zainal Ariffin, Nurfathiha Abu Kasim, Rohaya Megat Abdul Wahab, Abdul Aziz Jemain
    Sains Malaysiana, 2013;42:99-105.
    The aim of this study was to observe the pattern of lactate dehydrogenase (LDH) activity in GCF and the rate of tooth movement at two different orthodontic forces (1.0 N and 1.5 N). Twelve subjects participated in this study and was chosen based on the inclusion criteria. Each subject received forces of 1.0 N and 1.5 N for tooth movement either on the left or right side of the maxillary canine. GCF sample was collected at mesial and distal sites of the canines before applying the appliance (week 0) and every week for 5 weeks after tooth movement (week 1 to week 5) where baseline activity served as control. LDH activity was assayed spectrophotometically at 340 nm. The tooth movements were measured from casted study models. LDH specific activity at mesial sites in 1.0 N and 1.5 N force groups, respectively increased significantly (p<0.05) only on week four and throughout the treatment when compared with baseline. At distal sites, LDH specific activity with 1.5 N was higher than 1.0 N throughout the five weeks of tooth movement. LDH specific activity with 1.5 N force increased at both mesial (week 2) and distal sites (week 3) with significant different (p<0.05) when compared with 1.0 N force. Tooth movement with 1.5 N showed significantly faster (p<0.05) at the end of week 5 when compared with 1.0 N. LDH has the potential as a biological marker of inflammation during tooth movement.A force of 1 N was more suitable to be used although less tooth movement was produced because less inflammation caused by the force can be useful in orthodontic treatment for patients with stabilised periodontal diseases compared with 1.5 N force.
    Matched MeSH terms: Gingival Diseases
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