A Manual Bristleless Toothbrush Demonstrates Slight Improvement in Gingival Recession Compared to a Conventional Soft Manual Brush

Oral Health Prev Dent 17 (2019), No. 1  (21.02.2019)

Page 75-82, doi:10.3290/j.ohpd.a41810, PubMed:30714059

Purpose: This randomized clinical trial tested whether a novel bristleless toothbrush design is more effective in preventing gingival recession in adults receiving periodontal maintenance than is a soft toothbrush with nylon bristles.

Materials and Methods: Twenty-three subjects with gingival recession were recruited who received regular periodontal maintenance care at Western University of Health Sciences Dental Center, and who did not exhibit signs of acute dental or systemic disease, occlusal discrepancies or parafunctional habits. These subjects were randomly assigned to to two groups, one using a soft nylon-bristled toothbrush, and the other using the experimental toothbrush that contains a brush head with short, soft, rubbery cones. Both groups received regular periodontal maintenance and periodontal exams by blinded examiners every 3-4 months, measuring probing depth, bleeding on probing, and plaque indices. Gingival recession was assessed clinically and through use of a stent on diagnostic casts obtained at each visit.

Average probing depths, plaque levels, and the number of sites with bleeding on probing did not change over at least 9 months. After 9 months, there was a small but statistically significant improvement in gingival recession (0.4 mm, p < 0.01) at sites with gingival recession in the experimental toothbrush group compared to the control group.

Conclusion: In periodontal maintenance patients, the bristleless toothbrush used in this study was as effective in plaque removal and prevention of gingival inflammation than a conventional toothbrush with soft nylon bristles, while increasing the possibility of gingival tissue rebound over denuded root surfaces.

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Effect of Custom-made Probiotic Chocolates on Streptococcus mutans, Plaque pH, Salivary pH and Buffering Capacity in Children – A Randomised Controlled Trial

Oral Health Prev Dent 17 (2019), No. 1  (21.02.2019)

Page 7-15, doi:10.3290/j.ohpd.a41809, PubMed:30714058

Purpose: To compare the effect of three custom-made probiotic chocolates and conventional chocolates on plaque pH, salivary pH and buffering capacity of saliva in children. The study also evaluated its antimicrobial efficacy against S. mutans.

Materials and Methods: A parallel randomised double-blinded trial was conducted in two phases. For the phase І trial, 90 children were randomly divided into 3 groups: milk (MC), white (WC) and dark chocolate (DC). Salivary pH, plaque pH and buffering capacity were assessed at baseline, 10 min, 30 min and 60 min after consumption of the chocolates. After a washout period of 20 days, the children were assigned to their respective probiotic chocolate groups and the assessments were repeated. In the phase ІІ trial, 60 children were divided into 3 groups (n = 20): probiotic milk (PMC), white (PWC) and dark chocolate (PDC). They were given probiotic chocolates for 5 consecutive days in a week. S. mutans colony count was measured at baseline, post intervention, 15 days and 30 days.

Results: All probiotic chocolates were less acidogenic than their counterparts. PWC was found to be the least acido-genic. DC was found to be the least acidogenic among plain chocolates. All probiotic chocolates were effective in reducing the S. mutans colony count.

Conclusion: Chocolates can serve as a vehicle for delivering probiotics with the added advantage of making them tooth-friendly.

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Hospital-based Emergency Department Visits with Periapical Abscess: Updated Estimates from 7 Years

March 2019Volume 45, Issue 3, Pages 250–256 



The impact of the Affordable Care Act (ACA) on the utilization of the emergency department (ED) for periapical abscess (PA) is unknown. The objectives of this study were to provide nationwide estimates of hospital-based ED visits with PA and to examine the effect of the ACA on the use of EDs for PAs.


We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS) for 2008 to 2014. All ED visits with a diagnosis of PA were selected. The International Classification of Diseases, Ninth Revision–Clinical Modification code was used to identify PA. Patient- and hospital-level characteristics were examined. Descriptive statistics were used to summarize the data.


From 2008 to 2014, a total of 3,505,633 ED visits for PA occurred. The proportion of ED visits with PA significantly increased over the study period (from 460,260 in 2008 to 545,693 in 2014). Medicaid was the primary payer (30.3%) and more than 40% were uninsured. Mean charge per PA-related ED visit was $1080.50 and total PA-related ED charge across the United States was $3.4 billion. Among those hospitalized following PA-related ED visits, mean hospitalization charges were $34,245 and total hospitalization charges were $5.7 billion.


Oral health continues to be overlooked in health care. A large proportion of ED visits with PA were made by those covered by Medicaid and uninsured. The passing of the ACA has not reduced the number of ED visits with PA.
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Immediate Augmentation of Compromised Extraction Sockets in Chronic Periodontitis Patients: 1-Year Results of a Case Series on Volumetric and Histologic Response.

Int J Periodontics Restorative Dent. 2019 Mar/Apr;39(2):245-251. doi: 10.11607/prd.3337.


The present case series evaluated three-dimensional volumetric bone tissue changes and new bone formation in severely resorbed extraction sockets augmented with Bio-Oss collagen and a covering collagen membrane in nine chronic periodontitis patients. Healing was by secondary intention. After 12 months of healing, the augmentation procedure appeared not only to compensate for bone remodeling but also appeared to repair a significant portion of the buccal wall. The mineralized tissue filled the 91.49% ± 6.77% of the maximum volume for regeneration. Overall, a mean of 49.6% new bone, 27.1% residual graft material, and 23.3% connective tissue were detected.
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In-vitro Evaluation of Microleakage in Root Canal Obturation with Mineral Trioxide Aggregate and Calcium-enriched Mixture Cement Using Fluid Filtration

Articles in Press, Accepted Manuscript , Available Online from 25 February 2019  XML PDF (301 K)
Introduction: Endodontic treatment failure is caused by the leakage of microorganisms and endotoxins, which leads to pathological lesions. Adequate seal of the root canal is essential to preventing recontamination and ensuring the long-term clinical success rate. Mineral trioxide aggregate (MTA) and calcium-enriched mixture cement (CEM) are common types of cement with adequate sealing capability in endodontics. The present study aimed to compare the microleakage in the root canals filled with ProRoot MTA and CEM cement using fluid filtration. Methods: This experimental, in-vitro study was conducted on 46 root canals of extracted mandibular premolars. After preparation and disinfection with 3% sodium hypochlorite, the crowns were resected from the cervical region. The teeth were randomly divided into two experimental groups of 20 based on the tested materials (ProRoot MTA and CEM cement), as well as two negative and positive control groups of three. All the samples were instrumented and obturated using the step-back technique, and fluid filtration was used to evaluate sealing ability and leakage inhibition. Data analysis was performed using the Mann-Whitney U test (α=0.05). Results: Mean microleakage in the ProRoot MTA and CEM cement was 2±0.79 and 3.02±1.38 µL/8 min, respectively. In addition, a significant difference was observed between the two groups in this regard (P<0 .011="" strong="">Conclusion:

According to the results, ProRoot MTA provided significantly less microleakage compared to the CEM cement. Therefore, the sealing ability of ProRoot MTA was higher than the CEM cement, which makes MTA a better material than CEM cement for canal obturation.

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