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  1. Mulimani P, Abas AB, Karanth L, Colombatti R, Kulkarni P
    Cochrane Database Syst Rev, 2023 Feb 02;2(2):CD012969.
    PMID: 36732291 DOI: 10.1002/14651858.CD012969.pub3
    BACKGROUND: Thalassaemia is a quantitative abnormality of haemoglobin caused by mutations in genes controlling production of alpha or beta globins. Abnormally unpaired globin chains cause membrane damage and cell death within organ systems and destruction of erythroid precursors in the bone marrow, leading to haemolytic anaemia. The life-long management of the general health effects of thalassaemia is highly challenging, and failure to deal with dental and orthodontic complications exacerbates the public health, financial and personal burden of the condition. There is a lack of evidence-based guidelines to help care seekers and providers manage such dental and orthodontic complications. This review aimed to evaluate the available evidence on methods for treating dental and orthodontic complications in people with thalassaemia to inform future recommendations. This is an update of a Cochrane Review first published in 2019.

    OBJECTIVES: To assess different methods for treating dental and orthodontic complications in people with thalassaemia.

    SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register in September 2022, and we searched nine online databases and trials registries in January 2022. We searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organisations, pharmaceutical companies and researchers working in this field.

    SELECTION CRITERIA: We searched for published or unpublished randomised controlled trials (RCTs) that evaluated treatment of dental and orthodontic complications in individuals diagnosed with thalassaemia, irrespective of phenotype, severity, age, sex and ethnic origin.

    DATA COLLECTION AND ANALYSIS: Two review authors independently screened the 37,242 titles retrieved by the search. After deduplication, we identified two potentially relevant RCTs. On assessing their eligibility against our inclusion and exclusion criteria, we excluded one and included the other.

    MAIN RESULTS: We included one parallel-design RCT conducted in Saudi Arabia and involving 29 participants (19 males, 10 females) with thalassaemia. It aimed to assess the effectiveness of photodynamic therapy as an adjuvant to conventional full-mouth ultrasonic scaling for the treatment of gingivitis. The average age of participants was around 23 years. There is very low-certainty evidence from this trial that full-mouth ultrasonic scaling plus photodynamic therapy compared to full-mouth ultrasonic scaling alone may improve gingival index score and bleeding on probing after 12 weeks in people with thalassaemia. We found no studies that assessed other interventions for the various dental or orthodontic complications of thalassaemia.

    AUTHORS' CONCLUSIONS: Although the included study showed greater reduction in gingivitis in the group treated with full-mouth ultrasonic scaling plus photodynamic therapy, the evidence is of very low certainty. The study had unclear risk of bias, a short follow-up period and no data on safety or adverse effects. We cannot make definitive recommendations for clinical practice based on the limited evidence of a single trial. Future studies will very likely affect the conclusions of this review. This review highlights the need for high-quality RCTs that investigate the effectiveness of various treatment modalities for dental and orthodontic complications in people with thalassaemia. It is crucial that future trials assess adverse effects of interventions.

    Matched MeSH terms: Gingivitis*
  2. Ramli H, Mohd-Dom TN, Mohd-Said S
    BMC Oral Health, 2021 Dec 03;21(1):618.
    PMID: 34861857 DOI: 10.1186/s12903-021-01950-0
    BACKGROUND: Siwak is a chewing stick used as an oral hygiene aid associated with Muslim communities across the globe since more than 1500 years ago. Used either exclusively or in conjunction with a regular toothbrush, there is evidence supporting its clinical effectiveness in plaque control, but adverse effects on periodontal health remains inconclusive.

    OBJECTIVE: This study aims to systematically review the wide range of data and literatures related to siwak practice and its effect on periodontal health.

    METHOD: The review was conducted based on scoping review techniques, searching literature in EBSCOHOST, PubMed, SCOPUS and Google scholar databases using the following search terms: "siwak' or 'miswak' or 'chewing stick" for intervention, and "periodontium or 'periodontal' or 'periodontal health' or 'periodontal disease" for outcome. Articles published between January 1990 to March 2021 and written in English language were included.

    RESULTS: A total of 721 articles collected from the search and 21 of them were eligible for the final analysis. Results of this study was described based on clinical and antibacterial reporting of siwak, method of siwak practice and its adverse effect on oral health. Siwak was found effective at removing dental plaque and improving periodontal health over time although its effect on subgingival microbiota was inconclusive. Presence of gingival recession and clinical attachment loss were much more commonly reported in siwak users, attributable to variations in the methods employed for tooth cleaning using the siwak.

    CONCLUSION: There is substantial evidence that the lack of standardised reporting for effective siwak use may have resulted in contradictory findings about its oral hygiene benefits and adverse effects. As such, future work on safe and effective siwak practice is to be advocated among its users.

    Matched MeSH terms: Gingivitis*
  3. Veerasingham KV, Somasundaram A
    Matched MeSH terms: Gingivitis, Necrotizing Ulcerative
  4. Trihandini, Indang, Adiwoso, Adiningrum Wiradidjaja
    MyJurnal
    Perbezaan penjagaan kesihatan di antara orang-orang kurang upaya intelektual dan penduduk umum adalah jelas. Olimpik Khusus Indonesia (SOIna) adalah organisasi NGO yang berkaitan dengan kegiatan olahraga olimpik sedunia yang berkesempatan bekerja dengan warga kurang upaya intelektual. Kajian ini dilakukan untuk mengukur prevalen pereputan karies dan gingivitis di kalangan atlet-atlet Indonesia yang kurang upaya intelek. Jumlah peserta yang terlibat adalah 1452 atlet daripada 11 wilayah (Jawa Timur, Bali, Selatan Sabah, Utara Sumatera, Nusa Tenggara Timur, Kalimantan tengah, DKI, Jawa Barat, Yogyakarta, Nusa Tenggara Barat, Banten) di Indonesia. Pengumpulan data bermula dari tahun 2004 hingga 2009. Setiap tahun pengambilan data minimum dilakukan di dua wilayah yang berbeza. Purata usia atlet adalah 15.04 ± 4,62 tahun. 77.6% atlet mengalami rasa nyeri di rongga mulut kerana karies yang tidak dirawat. Karies tertinggi dijumpai pada atlet yang tinggal di pulau Jawa (81.5% Yogyakarta; Jawa Barat 83.8%. DKI Jakarta 80.2%, dan Jawa Timur 83.5%) berbanding dengan atlet yang tinggal di luar pulau Jawa. Secara umumnya prevalens inflamasi gusi pada atlet kurang upaya intelektual adalah 29.47%. Atlet dari wilayah DKI Jakarta menunjukkan prevalen inflamasi gusi tertinggi iaitu 51.04% berbanding dengan atlet daripada wilayah Nusa Tenggara Barat dengan 14.84%. Berdasarkan hasil tersebut, prevalen karies dan gingivitis adalah tinggi. Atlet yang tinggal di pulau Jawa mengalami kerosakan gigi yang tidak dirawat dan inflamasi gusi yang lebih tinggi berbanding dengan atlet yang tinggal di luar pulau Jawa.


    Matched MeSH terms: Gingivitis
  5. Cugadasan V
    Med J Malaysia, 1977 Jun;31(4):353-4.
    PMID: 927246
    Matched MeSH terms: Gingivitis/diagnosis
  6. Chaubal T, Bapat R
    Am J Med, 2017 Nov;130(11):e493-e494.
    PMID: 28602875 DOI: 10.1016/j.amjmed.2017.05.020
    Matched MeSH terms: Gingivitis, Necrotizing Ulcerative/diagnosis*
  7. Leong XF, Ng CY, Badiah B, Das S
    ScientificWorldJournal, 2014;2014:768237.
    PMID: 24526921 DOI: 10.1155/2014/768237
    This review is to examine the current literatures on the relationship between periodontitis and hypertension as well as to explore the possible biological pathways underlying the linkage between these health conditions. Hypertension is one of the major risk factors for cardiovascular diseases. Oxidative stress and endothelial dysfunction are among the critical components in the development of hypertension. Inflammation has received much attention recently and may contribute to a pivotal role in hypertension. Periodontitis, a chronic low-grade inflammation of gingival tissue, has been linked to endothelial dysfunction, with blood pressure elevation and increased mortality risk in hypertensive patients. Inflammatory biomarkers are increased in hypertensive patients with periodontitis. Over the years, various researches have been performed to evaluate the involvement of periodontitis in the initiation and progression of hypertension. Many cross-sectional studies documented an association between hypertension and periodontitis. However, more well-designed prospective population trials need to be carried out to ascertain the role of periodontitis in hypertension.
    Matched MeSH terms: Gingivitis/diagnosis; Gingivitis/metabolism; Gingivitis/epidemiology
  8. Shilpa M, Jain J, Shahid F, Gufran K, Sam G, Khan MS
    J Pharm Bioallied Sci, 2019 May;11(Suppl 2):S246-S251.
    PMID: 31198346 DOI: 10.4103/JPBS.JPBS_1_19
    Aim: The aim of this study was to evaluate and compare the efficacy of three types of plaque control methods among 13- to 35-year-old subjects receiving fixed orthodontic treatment in Coorg Institute of Dental Sciences, Virajpet, Coorg district, Karnataka, India.

    Materials and Methods: A total of 111 subjects who fulfilled the inclusion and exclusion criteria were randomly included in the study. The subjects were recalled after 1 month of the commencement of fixed orthodontic treatment for the recording of baseline data including plaque index (PI), gingival index (GI), and modified papillary bleeding index (MPBI). After recording of the baseline data, the subjects were randomly allocated into each of the intervention groups, i.e., group A (manual tooth brush), group B (powered tooth brush), and group C (manual tooth brush combined with mouthwash) by lottery method. Further, all the subjects were recalled after 1 and 2 months for recording the data.

    Results: Regarding plaque levels, it was seen that there was a highly statistically significant difference between the three groups (P = 0.001), with the manual tooth brush combined with chlorhexidine mouthwash group recording the lowest mean PI score of 0.5 ± 0.39. A comparison of the mean GI scores among the groups at the end of 2 months shows a highly statistically significant difference (P = 0.001). The mean MPBI scores at the end of 2 months were highly statistically significant among the three groups (P = 0.001), with the group C recording the lowest mean MPBI score of 0.3 ± 0.3.

    Conclusion: The powered tooth brush group subjects exhibited significantly lesser PI, GI, and MPBI scores than the manual tooth brush group at the end of 2 months, whereas the manual tooth brush combined with chlorhexidine mouth wash group subjects showed maximum improvement, having significantly lesser PI and GI scores than the powered tooth brush group.

    Matched MeSH terms: Gingivitis
  9. Tratman EK
    Matched MeSH terms: Gingivitis, Necrotizing Ulcerative
  10. Goh, Y.C., Lau, S.L., Ramanathan, A., Swaminathan, D.
    Ann Dent, 2013;20(2):24-28.
    MyJurnal
    The purpose of this study was to assess the tissue
    response of Type 2 diabetic subjects towards non surgical
    periodontal therapy as compared with matched, nondiabetic
    subjects. This was a retrospective, comparative
    study using periodontal case notes of 40 subjects attending
    undergraduates’ periodontal clinics (20 diabetics, 20 nondiabetics),
    who were selected based on the inclusion
    and exclusion criteria. Response towards non surgical
    periodontal therapy was assessed through three clinical
    periodontal parameters, namely plaque score, gingivitis
    score and number of periodontal pocket ≥5mm at the
    baseline and after initial non surgical periodontal therapy.
    Data obtained was then analyzed by SPSS Version 12.
    Both diabetic and non-diabetic subjects showed significant
    improvements (p-value = 0.021; 0.000; 0.001 and 0.010;
    0.014; 0.001) in all three parameters after the therapy.
    However, when comparison was made between the two
    groups, there was no significant difference (p-value = 0.913;
    0.892 and 0.903) in any of the parameters. Periodontal
    conditions improved clinically in both diabetic and nondiabetic
    subjects after non-surgical periodontal therapy.
    Therefore, both groups responded similarly towards the
    therapy and thus it can be postulated that well-controlled
    diabetic status does not have a significant effect on the
    outcome of periodontal therapy.
    Matched MeSH terms: Gingivitis
  11. Abdul Majid Z, Nik Hussein NN, Meon R
    J Int Assoc Dent Child, 1987 Dec;18(2):36-40.
    PMID: 3273298
    Matched MeSH terms: Gingivitis/epidemiology*
  12. Adam FA, Mohd N, Rani H, Baharin B, Mohd Yusof MYP
    J Ethnopharmacol, 2021 Jun 28;274:113882.
    PMID: 33513418 DOI: 10.1016/j.jep.2021.113882
    ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L. chewing stick, commonly known as miswak is still being used as an oral hygiene tool for plaque control and prevention against gingivitis. Various studies have reported on the therapeutics and prophylactic effects particularly on periodontal disease. This review aimed to evaluate the effectiveness of S. persica chewing stick compared to the standard toothbrush for anti-plaque and anti-gingivitis.

    MATERIAL AND METHODS: A PRISMA-compliant systematic search of literature was done from the MEDLINE, CENTRAL, Science Direct, PubMed and Google Scholar. Literature that fulfilled eligibility criteria was identified. Data measuring plaque score and bleeding score were extracted. Qualitative and random-effects meta-analyses were conducted.

    RESULTS: From 1736 titles and abstracts screened, eight articles were utilized for qualitative analysis, while five were selected for meta-analysis. The pooled effect estimates of SMD and 95% CI were -0.07 [-0.60 to 0.45] with an χ2 statistic of 0.32 (p = 0.0001), I2 = 80% as anti-plaque function and 95% CI were -2.07 [-4.05 to -0.10] with an χ2 statistic of 1.67 (p = 0.02), I2 = 82%.

    CONCLUSION: S. persica chewing stick is a tool that could control plaque, comparable to a standard toothbrush. Further, it has a better anti-gingivitis effect and can be used as an alternative.

    Matched MeSH terms: Gingivitis/prevention & control*
  13. Kamath NP, Tandon S, Nayak R, Naidu S, Anand PS, Kamath YS
    Eur Arch Paediatr Dent, 2020 Feb;21(1):61-66.
    PMID: 31111439 DOI: 10.1007/s40368-019-00445-5
    PURPOSE: To evaluate the effect of two herbal mouthwashes containing aloe vera and tea tree oil, on the oral health of school children.

    METHODS: A double-blinded, placebo-controlled prospective interventional study was conducted in school children aged 8-14 years. The study participants were divided into four groups depending upon the mouthwash used: Group 1 (aloe vera), Group 2 (chlorhexidine), Group 3 (tea tree oil) and Group 4 (placebo). The variables studied included plaque index, gingival index and salivary Streptococcus mutans counts, which were recorded at baseline, 4 weeks after supervised mouth rinse and after 2 weeks of stopping the mouth rinse.

    RESULTS: A total of 89 boys and 63 girls were included. A statistically significant decrease in all variables was noted after the use of both the herbal preparations at the end of 4 weeks which was maintained after the 2-week washout period (p 

    Matched MeSH terms: Gingivitis*
  14. Fathilah, A.R., Othman, Y., Rahim, Z.H.A.
    Ann Dent, 1999;6(1):-.
    MyJurnal
    Chlorhexidine gluconate and hexitidine have been used in many oral health care products as antiplaque and antigingivitis agents. Based on the clinical observations and the plaque and gingivitis scores, chlorhexidine gluconate has been reported to be a better agent. In this study, the anti-adherence properties of chlorhexidine gluconate and hexitidine on individual bacteria strains isolated from a 3-hour plaque (Streptococcus sanguis, Streptococcus mitis 1 and Actinomyces sp.) and on a whole 6-hour plaque culture were determined and compared. The study showed that chlorhexidine gluconate inhibited almost 100 % the adherence of the individual bacteria strains and 87.7 % the adherence of a whole 6-hour plaque culture to the saliva-coated glass surface. Hexitidine appeared to be more selective in its effect. It was shown to inhibit the adherence of S. sanguis and Actinomyces sp. to saliva-coated glass surface by 86.5 % and 51.4 % respectively. Its effect on the S. mitis 1 strains is comparable to that of a whole 6-hour plaque culture where inhibition to adherence were less than 4 % for both.
    Matched MeSH terms: Gingivitis
  15. Shaju P Jacob, Sonia Nath
    MyJurnal
    Preclinical drug testing is an important area in new drug development where animals are used. An ideal animal model for this is one which is simple, reliable and can be extrapolated to humans. Topical drugs for inflammation are conventionally tested on the skin of animals after induction of inflammation. A gingival model would be simple as inflammation can be induced naturally by the action of plaque. Rats are a popular animal model for testing drugs as well as to study various diseases of the periodontium. Periodontal disease including gingival inflammation develops in
    rats in relation to indigenous plaque or experimentally induced bacterial products. A number of features of rats ranging from anatomy, histology and response to bacterial insult can be seen mirrored to a great extent in humans. There is a lot similarity in the development and resolution of inflammation as well as the gingival wound healing of rats and humans. This paper tries to explore the feasibility of using the rat gingival model for preclinical testing of drugs acting on or influencing inflammation and concludes by identifying potential areas of research using this model. The addition of such a simple and inexpensive model for preclinical testing of drugs will be welcomed by the drug developers.
    Matched MeSH terms: Gingivitis
  16. Bakar NA, Jayah NI, Mohamed NR, Ali SM, Nasir SH, Hashim R, et al.
    J World Fed Orthod, 2020 03;9(1):3-8.
    PMID: 32672665 DOI: 10.1016/j.ejwf.2019.11.004
    INTRODUCTION: Gingivitis is one of the commonest problems faced by patients with fixed appliances (FA) as there is close relation between the appliances to gingival sulcus. Stichopus horrens (SH) is a sea cucumber from the Indo-Pacific that has medical healing properties which have been traditionally used.

    OBJECTIVE: To assess the effects of toothpaste containing aqueous SH extract on plaque-induced gingivitis following orthodontic bond-up and to identify the optimal concentration of SH.

    METHODS: A single-centred; triple-blinded randomized controlled trial conducted in 40 patients with FA. Participants were randomly assigned to one of the four groups with toothpaste which has concentration of SH extract of 0%, 3%, 6% or 9%. The statistician, the participants and the researchers involved in data collection were kept blinded from the allocation. Gingival Index (GI) and Bleeding on Probing (BOP) for each group were taken at day 0,7,14 and 30.

    RESULTS: 9% of SH-containing toothpaste (SHCT) showed most substantial result as there were significance difference of GI (P = 0.020) from Day 7 to 14 and from Day 0 to 14 (P = 0.020). There was also significance difference of BOP from Day 0 to 14 (P = 0.022) and from Day 0 to 30 (P = 0.027). Significant difference was seen in 3% of SHCT group with the decrease of GI (P = 0.004) from Day 1 to 14. There were no significant difference noted for 0% and 6% SHCT.

    CONCLUSION: The 9% SHCT is the most effective concentration to reduce both the gingival inflammation (up to day 14) and bleeding on probing (up to day 30).

    Matched MeSH terms: Gingivitis/etiology; Gingivitis/prevention & control*
  17. Noordin, K., Kamin, S.
    Ann Dent, 2007;14(1):19-25.
    MyJurnal
    This study evaluated the effect of a Probiotic mouthrinse containing nisin, a bacteriocin extracted from Lactococcus lactis on dental plaque and gingivitis in young adult population. A group of 32 subjects were randomly assigned into two groups of 16 each. The first group started using the control mouthrinse (placebo) for 2 weeks followed by a washout period of 4 weeks. This group then used the test mouthrinse (Probiotic) for a further duration of 2 weeks. The second group followed a similar protocol as the first except that this group started with the test mouthrinse (Probiotic). Plaque Index (PI) and Gingival Index (GI) were recorded at baseline and after 2 weeks for each group. All subjects were given full mouth prophylaxis after each measurements. The results of this study showed that rinsing with Probiotic mouthrinse resulted in a statistically significant reduction of plaque accumulation and gingivitis compared to rinsing with placebo. The results indicated that Probiotic mouthrinse containing nisin had the potential of inhibiting plaque accumulation and was effective in reducing gingivitis.
    Matched MeSH terms: Gingivitis
  18. Baharuddin, N.A., Al Bayaty, F.H.
    Ann Dent, 2008;15(2):59-66.
    MyJurnal
    Objective: this study was carried out to evaluate the relationship between smoking and periodontal status in a selected Malaysian population. The sample for this cross-sectional study involved 39 subjects who were smokers. Each subject was required to answer the guided questionnaire followed by clinical examination. The questionnaires had 11 questions and were set in English and Bahasa Melayu. Basically, the questionnaire consisted of 3 sections: socio-demographic data, smoking status and subject's knowledge on periodontal health. The clinical parameters used in this study were: Community Periodontal Index, Visible Plaque score, Gingival Bleeding Index and Calculus Surface Index. Results showed that out of 39 subjects, 28 subjects (71.8%) were current smokers, followed by 6 subjects (15.4%) and 5 subjects (12.8%) who were former and who never smoked respectively. From the 216 sextants examined, 42 sextants (19.4%) were healthy gingival, 127 sextants (58.8%) suffered from gingivitis and 47 (21.8%) sextants suffered from periodontitis. There were positive relationships between smoking and periodontal status.
    Matched MeSH terms: Gingivitis
  19. Uma, S., Swaminathan, D.
    Ann Dent, 2001;8(1):-.
    MyJurnal
    CWorhexidine gluconate, a dicationic bisbiguanide agent, contains anti-plaque properties. Most chlorhexidine gluconate mouth rinses presently available contain alcohol in varying concentrations. The role of alcohol in these mouth rinses is to act as a preservative and solvent although it may have deleterious effects on the oral epithelium on long term usage. Recently, an alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse (Oradex®) has become available in Malaysia. This clinical study is aimed at determining the effects of this alcohol-free product compared to a placebo. A group of 60 meticulously screened subjects were assigned into two groups of 30 each. The first group started using the test product for 2 weeks followed by a washout period of 4 weeks. After this duration, this group used the placebo for a further 2 weeks. The 2nd group underwent similar protocol as the 1st except that this group started with the placebo. Measurements consisting of the following scores were recorded at baseline and after 2 weeks for each group: Plaque, Gingivitis: Papillary Bleeding, Stain and Calculus. Full mouth prophylaxis was carried out for all subjects after measurements at baseline as well as after the 2-week period. They were told to rinse with 15 ml of the designated mouth rinse twice daily for thirty seconds each after tooth brushing. The results of this study indicated that there was significant improvement in the plaque, gingival and papilla bleeding scores compared to the placebo. Stain and calculus scores were significantly increased for the test product when compared to the placebo. In conclusion, this study showed that alcohol-free 0.12 % w/v chlorhexidine gluconate mouth rinse is effective in reducing plaque and gingivitis but causes staining and calculus formation.
    Matched MeSH terms: Gingivitis
  20. Syarida Hasnur Safii, Lily Azura Shoaib, Halimah Awang
    Sains Malaysiana, 2013;42:107-114.
    The objectives of this study were to determine the prevalence of caries and gingivitis in a selected population of schoolchildren and to examine the relationship between prevalence of the diseases with their oral health behaviours. A total of 39 subjects, aged nine to 11 years, from 147 schoolchildren of a private school in Selangor, Malaysia were examined by two calibrated examiners trained in their own field. The subjects were interviewed using structured questionnaires. Erupted first permanent molars and permanent anterior teeth were examined. Dental caries, Plaque Score and Gingival Index were recorded. Descriptive statistics using frequency distribution were used to analyse the data. Forty-one percent of the subjects presented with more than 75% of total plaque accumulation. Prevalence of caries and gingivitis for the subject population was 18.0% and 31.0%, respectively. Caries was found on both the smooth (buccal/lingual/palatal) and occlusal surfaces. Gingivitis, diagnosed around 31.6% of teeth, was found more on the incisors (16.9%) than molars (14.7%). A relatively higher distribution of gingivitis was found on labial aspect of the incisors (5.5%) and palatal/ lingual aspect of the molars (4.7%). The prevalence of caries and gingivitis in this selected population was low. Certain dentition sites were more susceptible to dental caries and gingivitis. Good tooth brushinghabits and regular visits to the dentists do not guarantee the efficacy of plaque removal.
    Matched MeSH terms: Gingivitis
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