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  • 1
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To examine the effect of amine fluoride/stannous fluoride (AmF/SnF2)-containing dentifrice and mouth rinse on plaque formation and gingivitis as compared with habitual oral hygiene procedures with a regular sodium fluoride (NaF) dentifrice.Material and Methods: In total, 22 general practices participated in this research project. The participants (N=281) were randomly assigned into two groups: the test group received an AmF/SnF2 dentifrice–mouth rinse combination and the control group received a NaF-containing dentifrice. The patients were requested to brush twice daily for approximately 2 min. The subjects of the test group had to rinse additionally in the evening for 30 s with 10 ml of the mouth rinse.Results: Both groups started with comparable scores of plaque, bleeding and staining. At 6 months, the plaque scores were 0.95 for the AmF/SnF2 group and 0.99 for the NaF group (decrease of 16% and 10%, respectively). Bleeding scores, although significantly different from baseline, did not show differences between the two regimes. At the end of the experimental period, the overall staining was more pronounced in the AmF/SnF2 group (41%) than the NaF group (26%). Both plaque reduction and increase in staining seemed to be correlated to the amount of mouth rinse used in the test group.Conclusion: In instruction-resistant patients recruited from dental practices, the combined use of AmF/SnF2 did not decrease gingivitis at a significant level in comparison with the regular regime of two times daily brushing with an NaF-containing dentifrice. However, the above-mentioned combination resulted in greater plaque reduction than that observed with the use of the conventional dentifrice. When used according to the manufacturer's instructions, this effect on plaque scores was more pronounced.
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  • 2
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The papillary structure of the dorsum of the tongue forms a unique ecological site that provides a large surface area favoring the accumulation of oral debris and microorganisms. These micro-organisms of the tongue may be of influence on the flora of the entire oral cavity. The normal appearance of the dorsum of the tongue is either pinkish or has a thin white coating. For the present study a scoring method was developed to describe the appearance of the dorsum of the tongue in relation to the extent of color and thickness of tongue coating.Aim: The purpose of this study was to investigate the discoloration and coating of the tongue in healthy/gingivitis subjects and periodontitis patients. Furthermore, to determine the relationship between the appearance of the tongue and the bacterial load in salivary samples.Material and Methods: 2 groups of patients were studied, 70 healthy/gingivitis subjects and 56 periodontitis patients. After scoring of the tongue a salivary sample of each patient was taken and analyzed using a phase-contrast microscope.Results: This investigation showed that most discoloration was found on the distal part of the tongue. The mean number of bacteria per ml sample in relation to a pink, white and yellow appearance of the tongue was 948, 855 and 900 (×106) respectively. The mean number of bacteria per ml sample in relation to no, thin and thick coating was 948, 863, and 895 (×106), respectively. Analysis did not reveal a relationship between discoloration, coating thickness and total bacterial load. The mean number of bacteria per ml in healthy/gingivitis subjects was 860 and in periodontitis patients 918 (×106).Conclusion: No relationship between the appearance of the tongue and salivary bacterial load could be detected. There was no difference in bacterial load between the healthy/gingivitis and the periodontitis group within the present study population.
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  • 3
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Chlorhexidine (CHX) 0.2% solution is still “the leading oral antiseptic” for controlling gingivitis. Side effects, however, limit the acceptability to users and the long-term employment of a 0.2% CHX antiseptic in preventive dentistry. This stimulated the development of new formulations. The aim of the present study was to assess the effect on plaque inhibition and taste perception of two commercially available mouthrinses (0.12% CHX non-alcohol base with 0.05% cetyl pyridinium chloride (Cpc) versus 0.2% CHX alcohol base).Methods: The study was designed as a single-blind, randomized two group parallel experiment, to compare two different commercially available mouthrinses, during a 3-day plaque accumulation model. Forty healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of the test period. Over a 72-h experimental non-brushing period, during which subjects abstained from all forms of mechanical oral hygiene, one group (test) used a 15 ml alcohol free 0.12% CHX (=18 mg) mouthrinse on a Cpc base (Perioaid®, CHX⊕Cpc), twice daily for 30 s. The other group (control) used a 10 ml 0.2% CHX (=20 mg) mouthrinse on an 11.8% ethanol alcohol base (Corsodyl®, CHX⊕Alc), twice daily for 60 s. After 72 h of plaque formation, the amount of plaque was evaluated. By the use of visual analogue scale, the subjects were asked for their appreciation of the taste of the mouthrinse they had used.Results: The mean plaque index for the CHX⊕Cpc group was 0.97 and for the CHX⊕Alc group 0.78. After 72 h of non-brushing, there was no significant difference in plaque accumulation between the two groups. The answers to the questions (taste perception and after-taste) showed a statistically significant difference between the two groups. The mean visual analogue scale (VAS) scores for taste appreciation on a scale from very bad to very good taste (0–10) were 5.92 for the CHX⊕Cpc group and 4.10 for the CHX⊕Alc group (p=0.02). The mean visual analogue scale (VAS) scores for the after-taste on a scale from very short to very long (0–10) were 7.24 for the CHX⊕Cpc group and 5.38 for the CHX⊕Alc group.Conclusions: Within the limitations of the present study design, it can be concluded that rinsing with a 0.12% CHX mouthrinse on a non-alcohol base with 0.05% Cpc (Perio-Aid®) is not significantly different from rinsing with a 0.2% CHX mouthrinse on an alcohol base (Corsodyl®). It appears that the subjects appreciated the taste of the non-alcohol CHX solution better but the after-taste of the rinse remained longer in the mouth.
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  • 4
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: This study was designed to evaluate two factors possibly influencing incidence of gingival abrasion during toothbrushing: (1) the abrasiveness of a dentifrice and (2) the possible influence of feedback of oral sensory perception.Material and Methods: For this purpose, two separate, single blind, randomized clinical experiments were performed. The two groups of subjects were requested not to brush their teeth 48 h, prior to the experiments. After staining with disclosing solution gingival abrasion sites were recorded as small (〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE652:les" location="les.gif"/〉5 mm) and large (〉5 mm), both before and after brushing. The dentifrice experiment was a split-mouth design, including 36 subjects, brushing their teeth in two randomly selected contra-lateral quadrants, either with or without dentifrice, whereas the remaining two quadrants were brushed, using the alternative choice. The sensory perception feedback experiment was a full-mouth design, including 43 subjects and two separate brushing exercises with use of dentifrice. The first brushing-exercise was performed by a dental hygienist, excluding the feedback of oral sensory perception of the brusher. After a 4 weeks period of familiarization to the manual toothbrush, subjects brushed themselves in the same random order as the hygienist, using a fresh brush, thus including oral sensory perception.Results: In the dentifrice experiment, the increment of small abrasion sites was 5.86 for brushing with and 5.75 without dentifrice. There was no statistically significant difference between brushing with and without dentifrice. Both with and without dentifrice, more small abrasions were found vestibular, (3.78 and 4.22, respectively) as compared with lingual (2.22 and 1.42, respectively) (p=0.027, p〈0.001). In the sensory perception feedback experiment, the increment in small gingival abrasion sites was larger for the subjects brushing themselves (8.86) as compared with the professional brushing (2.94, p 〈0.0001). Subjects caused more abrasion on the vestibular surfaces (6.28) as compared with the lingual (0.60, p=0.0001), where the professional did not show this difference (vestibular: 1.88, lingual: 1.30, p=0. 1388).Conclusions: No statistically significant difference in the incidence of gingival abrasion was found between brushing with dentifrice or without dentifrice. Neither did oral sensory perception seem to affect the incidence of gingival abrasion.
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  • 5
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Does a high brushing force induce more gingival abrasion than a low (regular) brushing force? Furthermore, what is the effect of a low or high force on the efficacy?Methods: Thirty-five non-dental students were selected. All received an appointment prior to which they abstained from oral hygiene for at least 48 h. At baseline the teeth and surrounding tissues were disclosed using Mira-2-Tone® disclosing solution. Next, the examiner (PAV) evaluated the number of sites with gingival abrasion and the amount of dental plaque (Quigley & Hein) at 6 surfaces of each tooth. In the absence of this examiner, the subject's teeth were brushed by a hygienist (MP) using the Braun/Oral-B®-D17 oscillating rotating toothbrush. Brushing was performed in two randomly selected contra-lateral quadrants for 60 s with either a low force (±1.5 N) or high force (±3.5 N) and in the opposing quadrants for 60 s with the alternative force. Visual feedback was given to control force. The brush was moved from the distal tooth to the central incisor perpendicular to the tooth surface with an angle of approximately 10–15° towards the gingival margin. Next, the number of sites with abrasion and the remaining plaque were assessed again.Results: The overall baseline gingival abrasion scores were 3.1 and 3.2 sites for high and low force, respectively, and increased to 5.0 and 5.9 sites respectively after brushing. There was no significant difference with respect to incidence of abrasion. At baseline, 48 h. plaque levels were 2.2. The reduction in plaque scores with the low force was 60% and with the high force 56%. This difference was significant.Conclusion: With the oscillating rotating power toothbrush (Braun/Oral-B D17) the use of high force (±3.5 N) is less efficacious as compared to a regular low force (±1.5 N) while the incidence of gingival abrasion sites was comparable. (This study was sponsored by Gillette.)
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  • 6
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Although the efficacy of chlorhexidine (CHX) chemically can be affected by the presence of a sodium lauryl sulphate (SLS)-containing dentifrice in the oral cavity, previous data, collected without supervision, showed that the level of plaque inhibition offered by a 0.2% CHX post-brushing rinse in one jaw is not reduced under the influence of toothbrushing with a 1.5% SLS-containing dentifrice in the opposite jaw.Objectives: The aim of the present study was to investigate, during a 4-day supervised study period, the anti-plaque efficacy of a 0.2% CHX pre-brushing rinse in one jaw, under the influence of toothbrushing in the opposite jaw, either with a SLS-containing dentifrice or with a SLS-free dentifrice. Three different dentifrices were tested. Two of them contained SLS (Colgate Total® & Aquafresh Natural Whitening®), the other (Zendium®) did not.Methods: The study was an examiner blind, randomised 4-cell, crossover design. It used a 4-day plaque accumulation model to compare under supervision 4 different oral hygiene regimens with a washout period of at least one week. Thirty-five healthy volunteers were enrolled in the study and were randomly assigned to a sequence according to a 4 × 4 Latin square design. At the beginning of each 4-day test period, they received a thorough dental prophylaxis. Plaque was scored in one randomly assigned (upper or lower) jaw, called the study jaw. At the end of the 4-day period the study jaw was used to study the effect of the four regimens on the level of plaque accumulation. The opposite jaw was assigned as the dentifrice jaw and served only to introduce the effect of brushing with a dentifrice in the study model. Four oral hygiene regimens were designed. During the randomly assigned test periods, rinsing with 0.2% CHX and then brushing the dentifrice jaw was performed twice daily. In regimen 1, 2, and 3 the subjects used a dentifrice in the assigned dentifrice jaw being either a dentifrice with SLS (Colgate Total® and Aquafresh Natural Whitening®) or a SLS-free dentifrice (Zendium®). Regimen 4 served as a control during witch subjects only rinsed with 0.2% CHX. No other oral hygiene methods were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque was evaluated (Lobene et al. 1982, Quigley & Hein 1962, Turesky et al. 1970 modifications).Results: The overall plaque index for regimen 1, 2 and 3 was, respectively, 1.8, 1.8 and 1.9. For regimen 4, the overall plaque index was 1.9. There was no significant difference in plaque accumulation between the four regimens.Conclusions: Within the present study design, it can be concluded that the anti-plaque efficacy of a pre-brushing 0.2% CHX mouthrinse does not seem to be reduced under the influence of a normal toothbrushing exercise with a dentifrice after rinsing, whether the dentifrice contains SLS or not.
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  • 7
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The purpose of the present study was to evaluate the beneficial effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF2) in a group of periodontal maintenance patients. Efficacy parameters were plaque, gingival inflammation, pocket depth and attachment loss. An additional parameter was development of stain.Material and Methods: In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3–4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1) the test group used an AmF/SnF2 dentifrice and mouthrinse and (2) the control group used a sodium fluoride (NaF)-containing dentifrice and mouthrinse. Clinical assessments were performed at baseline, 3, 6, 12, 18 and 24 months.Results: The mean plaque index score after 3 months in the test group (0.24) was significantly lower than that in control group (0.34) (p〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE466:les" location="les.gif"/〉0.05), a difference that was maintained throughout the remainder of the study. In terms of bleeding on probing, at no point in time were significant differences between test and control group found. No significant differences were noted between the two groups, nor were there any significant changes in comparison with baseline values with respect to pocket depth and attachment level. At baseline, the mean percentage of sites with no staining was 98% for both the test and control groups. At all further assessments, the staining in both groups was elevated as compared with baseline. Smoking did not affect the outcome of the study.Conclusion: The combined use of an AmF/SnF2 dentifrice and mouthrinse did not affect the parameters of inflammation (bleeding upon marginal probing and probing pocket depth), but it has shown to be more effective in terms of plaque reduction when compared with the use of an NaF dentifrice and mouthrinse in a group of periodontal patients placed under regular maintenance care.
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  • 8
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The purpose of the present study was to evaluate in a group of periodontal maintenance patients, the effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF2) as compared with a dentifrice and mouthrinse both containing sodium fluoride (NaF) with regard to their root caries experience.Material: In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3–4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1) the test group used an AmF/SnF2 dentifrice and mouthrinse and (2) the control group used an NaF-containing dentifrice and mouthrinse. Root caries was recorded at four sites per tooth at baseline and 24 months.Results: An increase in number of the exposed root surfaces was noted for both groups during the experimental period (p〈0.05). The mean number of active caries lesions at baseline was 2.1 and 1.8 for the test group and control group, respectively. At 24 months, the corresponding values were 1.8 for the test and 2.2 for the control group. An increase of the mean number of restored surfaces was noted for the AmF/SnF2 group (from 7.3 to 13.4) and the control group (from 7.9 to 14.7) during the course of the study. This increase was found to be statistically significant for both groups in comparison with the baseline values (p〈inlineGraphic alt="leqslant R: less-than-or-eq, slant" extraInfo="nonStandardEntity" href="urn:x-wiley:03036979:JCPE593:les" location="les.gif"/〉0.01). No statistically significant differences were noted between groups. Further analysis of the restored surfaces revealed that the major increase in number of the restorations was associated with restorations involving three to four root surfaces in the same tooth. Molars and premolars were the teeth receiving most new restorations.Conclusion: The present study did not detect a difference in terms of root caries development between the two groups. Root caries development is a common finding associated with surfaces developing recession in patients once treated for periodontal problems.
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  • 9
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: The purpose of the present study was to investigate in periodontitis patients the relationship between the number of bacteria in the saliva and the amount of de novo plaque formation before and after treatment.Methods: At baseline, before any treatment was provided, patients rinsed with 10 ml sterile saline. After professional tooth cleaning the patients were instructed to abolish all tooth cleaning procedures for the subsequent 24 h. After this period, the rinsing procedure was repeated and the amount of de novo plaque was assessed. Three months after the initial periodontal therapy was completed the experiment was repeated. The microbiological evaluation of the rinsing samples was carried out by means of phase contrast microscopy and anaerobic culturing.Results: After treatment the amount of de novo plaque was less compared to before treatment, 0.40 and 0.65 respectively. Both before and after treatment more de novo plaque was present at sites with inflammation than at healthy sites. In order to evaluate the contribution of the numbers of salivary bacteria to the amount of de novo plaque formation an analysis was carried out for healthy sites. This analysis included only healthy sites as determined before treatment and the same sites after treatment. The results showed a significant reduction in the de novo plaque formation after treatment (0.49 before and 0.22 after treatment). Phase contrast microscopic evaluation showed that the number of bacteria in the rinsing samples after treatment was less than before treatment. After treatment also a reduction was found in the prevalence of Prevotella intermedia, Tannerella forsythensis and Peptostreptococcus micros in the rinsing samples.Conclusion: The present study confirms the observation in the literature that the periodontal condition is of major importance in the rate of de novo plaque formation. In addition, the results suggest that the number of bacteria in the saliva may play a role.
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  • 10
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: Evidence suggests functional relevance for polymorphisms in FcγR in relation to inflammatory and infectious diseases. The present aim was to investigate genetic polymorphisms in three FcγR in relation to susceptibility and severity of periodontitis.Material and Methods: The study population consisted of 68 periodontitis patients and 61 controls (Northern European Caucasian background, mean ages 44 and 42 years, respectively). Among the patients, 12 subjects were diagnosed with aggressive periodontitis (AgP) and 56 individuals were diagnosed with chronic periodontitis (CP). Radiographic bone levels were scored for all teeth in the patients. Subjects were typed for the following genes (alleles): FcγRIIa (R131 or H131), FcγRIIIa (V158 or F158) and FcγRIIIb (NA1 or NA2).Results: Hardy–Weinberg equilibrium criteria were fulfilled for the different genotypes at the three genes investigated. The frequency of the FcγRIIIa-V158 allele in the patient population (53%) was higher than in the control group (39%) (OR 1.73 [1.06–2.85], p=0.034). The V158 carriage rate in AgP was even higher (63%). The frequency of the FcγRIIa-H131 allele in the total periodontitis population was 58%; for AgP this was 79%, compared with 51% in the control population (OR 3.68 [1.29–10.5], p=0.013). Also, the frequency of the FcγRIIa-H/H131 genotype was significantly higher in AgP patients than in controls (OR 9.07 [1.29–63.56], p=0.026, adjusted for smoking status and other potential confounders). Moreover, patients with the FcγRIIa-H/H131 genotype had more severe radiographic bone loss than patients with the other FcγRIIa genotypes.Conclusion: The current study of relative small sample size suggests that the FcγRIIa-H/H131 genotype may be a putative susceptibility and severity factor, and the FcγRIIIa-V158 allele a putative susceptibility factor for periodontitis in Northern European Caucasians. These results need further verification and the biological importance of these findings needs further investigation.
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