Gingivitis
Conditions
Keywords
Oral hygiene education, Personalized three-dimensional visualization, Dental plaque, Gingival inflammation, Dental treatment motivation, Patient education
Brief summary
This study evaluated whether personalized three-dimensional images of possible future changes in the gums could improve oral hygiene and motivation in adults with gingivitis. Gingivitis is inflammation of the gums associated with dental plaque. Eighty-four adults aged 18-60 years were randomly assigned to three groups of 28 participants. The groups received conventional oral hygiene education, general three-dimensional educational animations, or personalized three-dimensional visualization using models created from their own intraoral scans. All participants received the same nonsurgical periodontal treatment and instruction in toothbrushing and cleaning between the teeth. The personalized images illustrated possible gum recession and tissue changes if periodontal care and daily plaque control were neglected. They were educational scenarios, not individual predictions of future disease. Personalized visualization was accompanied by a clinician-guided motivational discussion. Dental plaque, gum inflammation, gum bleeding, and motivation toward dental treatment were assessed before treatment and six weeks later. The study compared these outcomes among the three educational approaches.
Interventions
BEHAVIORALConventional Oral Hygiene Education
Face-to-face education delivered by a clinician using a dental model and a written information leaflet. The content covered the causes of periodontal diseases, the role of dental plaque, and daily oral hygiene practices. Participants received instruction in the modified Bass toothbrushing technique and appropriate interdental cleaning.
BEHAVIORALThree-Dimensional Animation-Based Oral Hygiene Education
Clinician-guided oral hygiene education using DentalMaster three-dimensional educational software. The content covered the causes and clinical signs of periodontal diseases, periodontal treatment, and daily oral care. General three-dimensional animations illustrated potential gingival recession, periodontal tissue loss, and tooth loss associated with inadequate plaque control. Participants received instruction in the modified Bass toothbrushing technique and appropriate interdental cleaning.
BEHAVIORALPersonalized Three-Dimensional Visualization With Motivational Discussion
Participants viewed general educational animations about periodontal disease, treatment, and daily oral care, followed by personalized three-dimensional dentogingival models generated from their own intraoral scans using the Periodontal Disease Prediction (PDP) system. The models illustrated potential gingival recession and visible periodontal tissue changes if periodontal care and daily plaque control were neglected. These images were presented as conditional educational scenarios, not individualized prognostic predictions. A clinician-guided motivational discussion addressed personal goals and barriers to oral hygiene. Participants also received instruction in the modified Bass toothbrushing technique and appropriate interdental cleaning.
Sponsors
Abant Izzet Baysal University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Adults aged 18-60 years. Systemically healthy. Diagnosis of gingivitis according to the 2017 World Workshop classification. At least 20 natural teeth, excluding third molars. At least 12 years of formal education. Turkish as the native language. Probing depths ≤3 mm. Bleeding on probing at more than 10% of sites. Visible plaque at more than 50% of sites. Provision of written informed consent.
Exclusion criteria
* Dentists or dental students. Previous periodontal treatment or structured oral hygiene education. Use of antibiotics or nonsteroidal anti-inflammatory drugs within the preceding 3 months. Generalized gingival recession or dentin hypersensitivity. Full-arch fixed or removable prostheses. Acute odontogenic infections. Overhanging or defective restorations, or root caries that could affect oral hygiene practices. Active orthodontic treatment. Communicable diseases such as hepatitis or HIV infection. Cognitive, systemic, or physical conditions that could interfere with understanding the educational content or performing oral hygiene practices.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Full-Mouth Rustogi Modified Navy Plaque Index From Baseline to Week 6 | Baseline and 6 weeks | Dental plaque was assessed using the Rustogi Modified Navy Plaque Index (RMNPI) after application of a plaque-disclosing agent. The facial and lingual/palatal surfaces of each eligible tooth were divided into nine areas, scored as 0 for absence of plaque or 1 for presence of plaque. The full-mouth score was calculated as the proportion of assessed areas with plaque, ranging from 0 to 1, with higher scores indicating more plaque. Third molars and teeth with crowns or cervical restorations were excluded. Change was calculated as the week 6 score minus the baseline score; negative values indicate improvement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Full-Mouth Gingival Index From Baseline to Week 6 | Baseline and 6 weeks | Gingival inflammation was assessed using the Löe and Silness Gingival Index at four sites around each tooth. Scores range from 0 to 3, with higher scores indicating more severe gingival inflammation. A full-mouth mean score was calculated for each participant. Change was calculated as the week 6 score minus the baseline score; negative values indicate improvement. |
| Change in Full-Mouth Papillary Bleeding Index From Baseline to Week 6 | Baseline and 6 weeks | Interdental gingival bleeding was assessed using the Papillary Bleeding Index (PBI). Interdental papillae were scored from 0 to 4 according to the severity of bleeding elicited after probing, with higher scores indicating more severe bleeding. A full-mouth mean score was calculated for each participant. Change was calculated as the week 6 score minus the baseline score; negative values indicate improvement. |
| Intrinsic Motivation Assessed by the Dental Treatment Motivation Scale | Baseline and 6 weeks | Intrinsic motivation was assessed using the seven-item intrinsic motivation subscale of the Dental Treatment Motivation Scale (DTMS). Each item was rated on a five-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The mean item score was calculated, ranging from 1 to 5, with higher scores indicating greater intrinsic motivation. Scores were assessed at baseline and week 6 and compared among the three study groups. |
| Extrinsic Motivation Assessed by the Dental Treatment Motivation Scale | Baseline and 6 weeks | Extrinsic motivation was assessed using the eight-item extrinsic motivation subscale of the Dental Treatment Motivation Scale (DTMS). Each item was rated on a five-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The mean item score was calculated, ranging from 1 to 5, with higher scores indicating greater extrinsic motivation. Scores were assessed at baseline and week 6 and compared among the three study groups. |
Countries
Turkey (Türkiye)
Outcome results
None listed