International journal of dental hygiene最新文献

Introduction: This randomised, single-blind, controlled study aimed to compare daily adjunctive use of an ultrasonic water irrigation device to dental floss in controlling plaque and gingival inflammation in patients with gingivitis.

Methods: Participants were randomly allocated to either daily use of an ultrasonic water irrigator or dental floss as an adjunct to manual toothbrushing for 4 weeks, with periodontal assessment repeated at 1 and 4 weeks after baseline (Rustogi Modified Navy Plaque Index [PI], Loe and Silness Gingival Index [GI] and bleeding on marginal probing [BOMP]).

Results: Sixty-two participants completed the investigation. Statistically significant reductions in total and marginal PI at Weeks 1 and 4 were noted in both groups compared to baseline (p < 0.05) with no significant differences between groups. BOMP and GI scores were likewise significantly reduced in both groups at Weeks 1 and 4 compared to baseline (p < 0.01). However, at Week 4, those using the ultrasonic water irrigator showed a significantly greater reduction in GI scores when compared to the floss group (-0.35 ± 0.26 vs. -0.16 ± 0.25, respectively, p < 0.01) and a significantly greater reduction in BOMP scores when compared to floss (-0.26 ± 0.12 vs. -0.15 ± 0.15, respectively, p < 0.01). Those using the ultrasonic water irrigator also reported easier usage scores (p < 0.05) when compared to the floss group.

Conclusion: Daily use of the ultrasonic water irrigator resulted in significantly greater reductions in gingival inflammation (gingival index and BOMP) than dental floss after 4 weeks, whereas plaque removal was similarly effective using the irrigator or floss.

Objective: The purpose of the present observational study was to evaluate the bacterial load in the air following various dental procedures.

Methods: Air contamination following seven aerosol-generating dental procedures was assessed. The air volume was sampled by a wet cyclone collector for 10 min during 10 sessions of the following procedures: air-polishing, ultrasonic instrumentation, manual instrumentation, rubber cup polishing, cavity preparation with a 1:5 red contra-angle, cavity preparation with turbine and Low Volume Evacuator (LVE), and cavity preparation with turbine and High Volume Evacuator (HVE). Contamination of the sampled solution was determined using ATP (Adenosine TriPhosphate) quantification of the viable bacterial count, and compared to baseline measurements.

Results: The baseline air contamination was 1.45 (0.85-2.04) CFUs/L of air. The highest increase in air contamination was observed after the use of a turbine with LVE, with an average of 7.38 (95% CI 3.87-10.89) CFUs/L of air (p < 0.01). The use of the turbine with HVE and the use of the red hand-piece resulted in non-significant increases in bacterial counts compared to baseline (2.98 [1.34-4.63] and 2.70 [0.18-4.22] CFUs/L of air respectively). The application of air polishing, ultrasonic instrumentation, hand instrumentation and rubber cups did not result in a higher bacterial count than the baseline.

Conclusion: Routine professional oral hygiene procedures do not increase air contamination. However, cavity excavation with LVE creates a significantly higher bacterial count in the air.

Introduction: The plasminogen activating (PA) system has a multitude of functions such as wound healing, proteolytic activity, collagen degradation and cell growth, and the role of the urokinase plasminogen activator/urokinase plasminogen activator receptor (uPA/uPAR) system has been studied in many disease states. The aim of this study was to investigate salivary concentrations of uPA, uPAR and uPA activity in patients with periodontitis to identify biomarkers and novel pathogenic relationships.

Methods: Saliva samples were obtained from 169 participants, comprising patients with periodontitis (n = 103) and periodontally healthy volunteers (n = 66) and analysed for uPA and uPAR with a multiplex protein assay using proximity extension analysis in a subset of samples, followed by validation with ELISA. The protease activity of salivary uPA was quantified using a fluorometric assay.

Results: Patients with periodontitis had a 4.0-fold higher (p < 0.001) salivary uPA and a 2.5-fold higher (p < 0.001) salivary uPAR concentration in comparison to periodontally healthy participants. The salivary uPA activity (median [IQR]) from patients with periodontitis (123.21 [188.29] U/mL) was 1.6-fold higher (p < 0.01) than the salivary uPA activity from periodontally healthy participants (76.83 [98.09] U/mL). Levels of uPA and uPAR were strongly correlated with periodontal indices, whereas only weak correlations were found with BMI and age.

Conclusion: Activation of uPA/uPAR likely plays a role in the pathogenesis of periodontal diseases. uPA/uPAR may have potential utility as candidate salivary biomarkers in periodontal pathogenesis.

Objectives: Children and young patients with chronic kidney disease (CKD) are at persistent risk of gingivitis despite usual preventive measures. This clinical study aimed to determine the efficacy of an intensive oral preventive programme (OPP) for young patients with CKD in treating plaque-induced gingivitis modified by systemic factors.

Methods: Young patients with CKD (N = 30) were recruited/randomised to a need-related OPP (n = 15) or treatment as usual (TAU) including mainly motivation and instructions (controls, n = 15) followed by a single intensive prophylactic appointment after 3 months. For the OPP group, depending on the baseline degree of inflammation (PBI) professional mechanical plaque removal, local chlorhexidine gel application and mouth rinse were applied at need-related appointments focussing on local plaque control and reduction in inflammation.

Results: After 3 months OPP, lower plaque indices were found (2.62-0.66, p < 0.05) in contrast to TAU (2.32-2.05, p > 0.05) with differences between study groups (p < 0.05). Regarding gingivitis, lower PBI values than baseline were observed in OPP (1.03-0.05, p < 0.05) than TAU (1.15-1.00; p > 0.05); OPP reductions (effect size) were higher than after a single intensive appointment (1.00-0.36; p < 0.05). Degree of immunosuppressive therapy did not differ between groups throughout the study.

Conclusions: Young patients with CKD suffer from generalised gingivitis with increased bleeding sites. This moderate degree of inflammation shows a normal distribution of high and low plaque responders, with no pattern of impact for the degree of immunosuppression. Effectiveness and duration of preventive measures follow a dose-response principle. Therefore, need-related preventive measures should be implemented and maintained in future regular care for CKD patients.

Trial registration: German Clinical Trials Register, registration number: DRKS00010580.

Objectives: Resin infiltration is a micro-invasive treatment method for non-cavitated enamel lesions that aims to arrest the progression of carious lesions and improve the aesthetic qualities of teeth. The aim of this study is to provide a description of dental hygienists' readiness to perform resin infiltration and their experiences of performing it.

Methods: The study was conducted during the years 2020 and 2021 using qualitative research methods. The data was collected through semi-structured single interviews and analysed using inductive content analysis. The informants were dental hygienists (n = 10) from Finland. The criterion for participation was experience of performing resin infiltration. The average number of procedures performed was seven. Five out of 10 informants had received training in the technique prior to their first procedure.

Results: Dental hygienists had varied experiences of resin infiltrations. The readiness required to perform resin infiltrations was seen to be equivalent to their basic professional skills. Assessing the treatability and extent of lesions caused uncertainty, though readiness was felt to improve with experience. Resin infiltration training and inclusion in the curriculum of a dental hygienist was perceived to be important. The treatment was felt to be well suited to the job description of dental hygienists.

Conclusions: The results indicate that dental hygienists in Finland have adequate readiness to perform resin infiltration. However, the results are based on 10 informants' experiences and therefore cannot be generalised. Including resin infiltration in a dental hygienist's training programme could enhance dental hygienists' readiness to perform resin infiltrations.

Objective: Individuals' Sense of Coherence (SOC) is measured with the Orientation to Life Questionnaire (OLQ-13). SOC reflects a person's orientation to life and ability to manage stress, which can impact health. The aim of the study was to test the reliability and construct validity of the OLQ-13, with self-reported general and oral health as criterion measures, in a Norwegian general adult population.

Methods: Data were collected using the OLQ-13 in addition to items measuring sociodemographic information, self-reported general health and self-reported oral health. This study was based on data from a population-based cross-sectional oral health study in Troms County, conducted from October 2013 to November 2014 (n = 1875, mean age 47.4 years, 50.5% women). Internal consistency was examined with Cronbach's alpha (α). Confirmatory factor analysis (CFA) was used to test the construct validity (one- and three-factor structure of the OLQ-13). The associations between SOC and self-reported general and oral health were tested using one-way ANOVA.

Results: The internal consistency of the OLQ-13 was good (α = 0.84). The CFA showed that while the OLQ-13 demonstrated an unacceptable fit, a shortened 11-item version with a three-factor structure revealed an acceptable fit and good internal consistency (α = 0.86). The highest mean SOC scores were found among individuals reporting good or very good general and oral health.

Conclusion: A three-factor structure with an 11-item version of the OLQ to assess SOC showed better validity than OLQ-13 in a general population in Northern Norway. Self-reported general and oral health can be considered appropriate criterion measures when validating SOC. To achieve a valid measurement scale for assessing SOC, a revision of the OLQ-13 appears necessary, and further studies are needed.

Objective: To analyse sex differences in health-related quality of life (HRQL) before, during and up to 3 months posttreatment of head and neck cancer, and to examine the importance of salivary secretion rate for HRQL posttreatment.

Methods: Patients were recruited before starting curative oncologic treatment. Clinical examinations were performed including determination of the stimulated salivary secretion rate. HRQL (EORTC C30 and HN35) was reported at baseline, weeks 2, 4 and 6 during treatment and 3 months after treatment.

Results: A total of 56 men and 19 women were included. During treatment, men reported more problems with pain and sexuality, a higher use of painkillers and need for nutritional support during oncologic treatment, while women reported more problems with weight loss and dry mouth. At 3 months posttreatment, women reported more problems and symptoms than men with the highest scores noted for dry mouth, weight loss and sticky saliva. Patients with hyposalivation (≤ 0.7 mL/min) posttreatment reported more problems and symptoms compared with those with a secretion rate of > 0.7 mL/min, especially regarding dry mouth, sticky saliva and social eating (p < 0.001 for all three).

Conclusion: Problems and symptoms during and postoncologic treatment seem to differ between women and men, which must be taken into consideration by healthcare and dental professionals. Patients with hyposalivation posttreatment have more problems and symptoms and are therefore in greater need of supportive care.

Objectives: To assess the learning and relationship-building potential of a near-peer teaching scheme that is low in faculty financial and time input.

Methods: This longitudinal study collects data via pre- and post-programme questionnaires completed by near-peer tutors and learners following a six-week scheme schedule. Qualitative data are analysed using a descriptive analysis model to assess the perceived value of the scheme.

Results: Participants find the scheme to be highly beneficial and rewarding. In the 2023 scheme, as for all previous cohorts, no near-peer tutees reported any issues of negative cognitive congruence and most found that they had experienced a greater opportunity to ask for clarification on basic knowledge without fear of reproach. Near-peer tutors valued the opportunity to develop teaching skills in the supportive confines of their own undergraduate diploma, and reflected on their own experience of learning within a prior run of the scheme as being motivational to teach others.

Conclusion: Near-peer teaching offers a sustainable and effective approach for dental hygiene and dental therapy programmes. It benefits both tutees and tutors, enhancing skills, fostering relationships and preparing students for future teaching roles. The scheme also promotes a positive learning culture and improves overall educational quality.

Aim: The aim of this systematic review was to investigate the quality of evidence for methods used to diagnose, restore and prevent dental erosions, by evaluating and summarising clinical controlled studies and in situ studies covering this field.

Material and methods: Three databases, PubMed, Embase and Cochrane database, were searched for studies published until October 2023. Studies fulfilling the selection criteria were selected, and the risk of bias of the included studies was assessed. Two authors independently reviewed the studies, evaluated their risk of bias and extracted data from the included studies. The certainty of evidence of the findings in the studies was determined using GRADE.

Results: The literature search identified 7176 records. Out of these, 19 studies were included in this review, three revolving diagnostics, three revolving treatment and 13 revolving prevention. However, due to the fact that only few studies with a small number of participants have investigated the same methods on the same outcome, the studies do not constitute any body of evidence.

Conclusion: This systematic review highlights the shortage of data on methods used for diagnostics, restorative treatment and prevention of dental erosions. More knowledge is needed to strengthen the scientific evidence regarding methods used for dental erosions.

Objectives: The aim of this network meta-analysis was to compare the anti-plaque effects and adverse effects of different concentrations of chlorhexidine (CHX).

Methods: PubMed, OVID Embase and the Cochrane Library were searched from inception to October 2023 for randomised controlled trials (RCTs) of different concentrations of CHX in healthy populations. Random-effects network meta-analyses were performed to summarise the evidence, and the Grading of Recommendations Assessment, Development and Evaluation framework was used to rate the certainty of evidence. Cohen's d standardised mean differences were calculated as the measure of effect size.

Results: Thirty-eight RCTs involving 2011 participants and six concentrations of CHX (0.2%, 0.12%, 0.1%, 0.3%, 1% and 0.06%) were included. The anti-plaque effects of CHX at all concentrations were compared with placebo. Moderate to very low certainty evidence established 0.2% CHX as the most effective on anti-plaque. 0.12% and 0.1% CHX also showed significant anti-plaque effects. However, the ranking probabilities showed that the adverse effects of 0.12% and 0.1% CHX were < 0.2% CHX.

Conclusions: Compared with placebo, 0.2%, 0.12% and 0.1% CHX had significant anti-plaque effects, with moderate to very low certainty evidence that 0.2% CHX was most effective on anti-plaque. However, 0.2% CHX had larger adverse effects than 0.12% and 0.1% CHX.

Trial registration: PROSPERO: Number CRD: 42022327083.