The aim of this paper was to critically review the current role of community water fluoridation in preventing dental caries. Original articles and reviews published in English language from January 2001 to June 2006 were selected through MEDLINE database. Other sources were taken from the references of the selected papers. For the past 50 years community water fluoridation has been considered the milestone of caries prevention and as one of the major public health measures of the 20th century. However, it is now accepted that the primary cariostatic action of fluoride occurs after tooth eruption. Moreover, the caries reduction directly attributable to water fluoridation have declined in the last decades as the use of topical fluoride had become more widespread, whereas enamel fluorosis has been reported as an emerging problem in fluoridated areas. Several studies conducted in fluoridated and nonfluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has became low. Although water fluoridation may still be a relevant public health measure in poor and disadvantaged populations, the use of topical fluoride offers an optimal opportunity to prevent caries among people living in both industrialized and developing countries.
The factors associated with cyclosporin A (CsA)- and nifedipine (Nif)-induced gingival overgrowth were investigated in 113 renal transplant recipients receiving CsA alone (Group 1) [n = 61], CsA and Nif (Group 2) [n = 28], or azathioprine (Aza) (Control Group) [n = 24]. Periodontal and pharmacological parameters were assessed for each patient. The patients with a gingival overgrowth index (GOI) score >1 were considered responders (R); those with a score = 1 were non-responders (NR). Gingival overgrowth occurred in 33.7% of the patients in Groups 1 and 2; 60% of the responders were receiving CsA+Nif. In R, no relationship was found between the GOI and the periodontal and pharmacological parameters, and although there was a trend towards an increased presence of HLA-A19 antigen (chi-square=4.40; P=0.04; RR=2.86), no significant difference was found between R and NR (Pc>0.05). It is concluded that the prevalence and severity of gingival overgrowth are greater in patients receiving CsA+Nif. As overgrowth appeared to be unrelated to local irritants, gingival inflammation or pharmacological parameters, it may be related to individual susceptibility.
These findings, together with those from clinical trials, suggest that the CHX-containing sprays may represent an effective alternative to CHX rinses when mechanical oral hygiene has to be avoided in restricted areas. On the contrary, the TRN and CPC sprays showed little or no plaque inhibitory effects.
SummaryBackgroundThe risks/benefits balance of hormone replacement therapy (HRT) is controversial. The aim of this study was to assess the periodontal status of a postmenopausal women group receiving HRT and to determine the effects of HRT on clinical measures of periodontal disease.Material/MethodsNinety-one postmenopausal women, 52 taking HRT (HRT+) and 39 not taking HRT (HRT−), completed the study. Clinical parameters measured included visible supragingival plaque, probing pocket depth (PD) and clinical attachment level (CAL). Gingival status was recorded as gingival bleeding on probing (BOP). Previous oral contraceptive use and current and past smoking status were also assessed.ResultsData indicated that PD and CAL were not significantly different between HRT+ patients and HRT− patients (P=0.8067 and P=0.1627, respectively). The HRT+ group exhibited significantly lower visible plaque levels compared to the control group (P<0.0001). The percentage of gingival sites with positive BOP was significantly lower in the HRT+ group compared to the HRT− group (34.85% vs. 65.15%; P=0.0007). Plaque accumulation was also tested in ANCOVA as a possible explanatory variable for the differences observed in gingival bleeding. The ANCOVA showed no significant differences in gingival bleeding between HRT+ and HRT− women (P=0.4677). No significant differences in past smoking status and oral contraceptive use were detected between HRT+ and HRT− women (P=0.9999 and P=0.0845, respectively).ConclusionsThese findings indicated that long-term HRT was not associated with relevant effects on periodontal status and clinical measures of periodontal disease, thus suggesting that HRT may not confer protection against periodontitis in postmenopausal women.
ASF and EO mouthrinses exerted effective and similar plaque inhibition. The two dosages tested for ASF did not differ in plaque reduction. These findings, together with those from long-term trials, suggest that ASF and EO rinses may represent effective alternatives to CHX rinse as adjuncts to oral hygiene.
The aim of this study was to compare the plaque removal efficacy of a new oscillating/rotating/pulsating toothbrush [Oral-B Professional Care 8500 (PC 8500)] with two manual toothbrushes [Oral-B CrossAction Vitalizer (CAV) and Oral-B Indicator (IND), respectively]. The safety of the PC 8500 was also assessed. The study was a single-use, observer-masked, randomised 3 x 3 Latin square crossover design balanced for carryover effects. The enrolled subjects (n = 66) refrained from brushing for 23-25 h before each clinical examination. Plaque scores were recorded before and after brushing with the allocated toothbrush using the Turesky et al. modification of the Quigley and Hein plaque index. The safety was assessed evaluating the soft tissue conditions present after 30 days of the use of the PC 8500. The PC 8500 toothbrush was better in plaque removal efficacy compared with the CAV and IND brushes for full mouth and approximal surfaces (P < 0.01). When marginal surfaces were considered, the PC 8500 was significantly more effective than the IND (P < 0.01). No significant differences were found between PC 8500 and CAV (P > 0.05). The latter was shown to be significantly more effective than the IND at all tooth surfaces (P < 0.01). Safety examinations revealed the onset of only two small gingival abrasions after the 30-day use of the PC 8500. The PC 8500 toothbrush demonstrated to be more effective in plaque control than the CAV and IND in the full mouth and approximal surfaces and similar to the CAV in the marginal surfaces. The PC 8500 was safe to oral tissues in long-term use.
Detection of Epstein-Barr virus (EBV) DNA and antigens in oral mucosa of renal transplant patients without clinical evidence of oral hairy leukoplakia (OHL).The use of the polymerase chain reaction (PCR) to detect the presence of Epstein-Barr virus (EBV) DNA in oral mucosa in the absence of specific lesions gives rise to the problem of identifying the real viral replication sites. To verify whether the detection of EBV is due to salivary contamination or its true replicative capacity in oral mucosa, saliva samples and exfoliated cells from four different oral mucosa sites were taken from 40 renal transplant patients and 20 normal subjects for examination by PCR using two pairs of primers specific for the BamHI-L and BamHI-K genomic regions. EBV-specific sequences were detected in one or more of the oral mucosa samples from 29 transplant patients (72.5%) and six healthy controls (30%), and in the saliva samples of 16 transplant patients (40%) and three healthy controls (15%). A total of 89 oral mucosa smears from 29 transplant patients, and 13 from healthy subjects, were EBV-positive. The positive samples were also investigated by means of in situ hybridization in order to confirm the intracellular presence of the viral genome, and by means of immunofluo-Key words: Epstein-Barr virus; oral mucosa; rescence testing with monoclonal antibodies to assess the possible expression of polymerase chain reaction (PCR); renal viral antigens. Hybridization with the EBV-specific probe was observed in 40/ transplant patients 89 and 2/13 samples, respectively. Latent antigens (with or without lytic antigens) Pietro Ammatuna, Policlinico ''P. Giaccone'', were detected in only 23 of the 40 samples (collected from eight different Dipartimento di Igiene e Microbiologia, Via transplant patients) that were positive by in situ hybridization. Our data show del Vespro 129, 90127 Palermo, Italythat EBV is more frequently present in the oral mucosa of immunodeficient patients (where it can efficiently replicate) than in normal subjects.
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