Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases.

Periodontal diseases like gingivitis and periodontitis are primarily caused by dental plaque. Several antiplaque and anti-microbial agents have been successfully incorporated into toothpastes and mouthwashes to control plaque biofilms and to prevent and treat gingivitis and periodontitis. The aim of this article was to review recent developments in the antiplaque, anti-gingivitis, and anti-periodontitis properties of some common compounds in toothpastes and mouthwashes by evaluating basic and clinical studies, especially the ones published in the past five years. The common active ingredients in toothpastes and mouthwashes included in this review are chlorhexidine, cetylpyridinium chloride, sodium fluoride, stannous fluoride, stannous chloride, zinc oxide, zinc chloride, and two herbs-licorice and curcumin. We believe this comprehensive review will provide useful up-to-date information for dental care professionals and the general public regarding the major oral care products on the market that are in daily use.

Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial.

AIMS: The aim of this study was to assess the efficacy of mouthrinses formulations in oral malodour. MATERIAL & METHODS: This single-centre, double-blind, randomized, parallel group clinical trial compared the efficacy of Halita™ and meridol(®) with and without zinc lactate versus negative and positive control. Volunteers with confirmed oral malodour (18/group) rinsed with one mouthrinse during 7 days (15 ml, 2x/day for 1 min.). 15 min. after a first rinse (masking effect), and after 7 days (therapeutic effect) the change in organoleptic scores and level of sulphur compounds was recorded. RESULTS: All rinses showed a masking effect (OLS 1 to 2 values reduced), only the rinses with antimicrobial ingredients showed a therapeutic effect (OLS 1 to 1.5 value less). The addition of zinc resulted in a more pronounced masking effect. Halita™ and meridol(®) with zinc showed the best therapeutic effect. CONCLUSION: Although the masking effect of the rinses can be attributed partially to a dilution and the effect of aromas, the therapeutic effect should be linked to the anti-microbial action of active ingredients and counter action of zinc ions on VSC. A complete resolution of the unpleasant breath by additional mechanical intervention remains to be proven.

Effect of fluoride and 10% carbamide peroxide on the surface roughness of low-fusing and ultra low-fusing porcelain.

STATEMENT OF PROBLEM: The effect of repeated applications of fluoride solutions and 10% carbamide peroxide on the surface roughness of newer dental porcelains is not completely known. PURPOSE: The purpose of this study was to compare the surface roughness of 3 different porcelains when exposed to 2 fluoride solutions, a 10% solution of carbamide peroxide, and distilled water. MATERIAL AND METHODS: Forty discs (10-mm diameter, 2 mm thick) were made of each of the following porcelains: feldspathic porcelain (Ceramco II), low-fusing porcelain (Finesse), and an aluminous porcelain (All-Ceram). Each disc was abraded with a medium-grit diamond bur and auto-glazed. One side of each disc was abraded with a diamond bur and polished using a porcelain polishing kit to simulate a chairside adjustment and polishing. The discs (10 specimens/group) were immersed in 1.23% APF, 0.4% stannous fluoride, 10% carbamide peroxide, and distilled water for 50 seconds (control). The discs in the 10% carbamide peroxide solution were immersed for 48 hours. The surface of each disc was evaluated with surface profilometry (0.1 mm/s speed, 600-microm range). The data were analyzed by factorial analysis of variance and a Tukey multiple comparison test, (alpha=.05). RESULTS: The data showed that the acidulated phosphate fluoride etched the auto-glazed surface of all 3 porcelains. For Finesse specimens, the mean Ra values for the auto-glazed surface were significantly higher than that of the control after immersion in 1.23% APF (mean Ra 0.3 +/- 0.06 microm, P<.031). All-Ceram auto-glazed surface specimens had a significantly higher mean Ra value when immersed in the 3 solutions than the control (1.23% APF, 0.4% stannous fluoride, and 10% carbamide peroxide, 0.245 +/- 0.115 microm, 0.22 +/- 0.104 microm, 0.22 +/- 0.04 microm, respectively; P<.002). Ceramco II specimens were affected by all 3 solutions, with the auto-glazed surface having higher Ra values (1.23% APF, 0.4% stannous fluoride, and 10% carbamide peroxide, with mean Ra values of 0.35 +/- 0.1 microm, 0.26 +/- 0.08 microm, and 0.24 +/-.0.05 microm, respectively, P=.001). Immersion in the 3 solutions had no effect on the polished surfaces of all-ceramic specimens tested. CONCLUSION: Prior to the use of fluoride and 10% carbamide peroxide, dentists should ascertain the type of porcelain restoration present to prevent a roughened surface from occurring.

Sensitivity of titanium brackets to the corrosive influence of fluoride-containing toothpaste and tea.

Titanium brackets are used in orthodontic patients with an allergy to nickel and other specific substances. In recent studies, the corrosive properties of fluoride-containing toothpastes with different pH values were investigated. The present in vivo study tested how the surfaces of titanium brackets react to the corrosive influence of acidic fluoride-containing toothpaste during orthodontic treatment. Molar bands were placed on 18 orthodontic patients. In these same patients, titanium brackets were bonded on the left quadrants and stainless steel brackets on the right quadrants of the upper and lower arches. Fifteen patients used Gel Kam containing soluble tin fluoride (pH 3.2), whereas 3 used fluoride-free toothpaste. The brackets were removed for evaluation by light microscopy and scanning microscopy 5.5 to 7.0 months and 7.5 to 17 months after bonding. The quality and quantity of elements present were measured by scanning microscopy. Macroscopic evaluation showed the matte gray color of titanium brackets dominating over the silver gleam of the steel brackets. The plaque accumulation on titanium brackets is high because of the very rough surface. Pitting and crevices were observed in only 3 of the 165 brackets tested. The present in vivo investigation confirms the results of in vitro studies, but the changes are so minor that titanium brackets can safely be used for up to 18 months. Wing surfaces should be improved by modifying the manufacturing process.

Studies on stannous fluoride toothpaste and gel (1). Antimicrobial properties and staining potential in vitro.

Stannous fluoride (SF) in a toothpaste vehicle has the potential to provide anticaries and plaque inhibitory benefits through the fluoride and antimicrobial stannous moieties respectively. Dental staining, however, can occur by precipitation of dietary chromogens onto the tooth surface by stannous ions. These studies in vitro compare the antimicrobial profile and propensity to cause tea staining of a number of stannous fluoride formulations. The formulations used were 2 SF toothpaste products (SF1, SF2), 2 experimental SF plus stannous pyrophosphate toothpastes (SFSP1, SFSP2), a SF gel (G) and a NaF toothpaste (C). Maximum inhibitory dilution values against a range of oral bacteria were determined by agar dilution. Tea staining was measured spectrophotometrically on saliva coated clear acrylic blocks exposed to slurries of the paste or gel. All formulations showed antimicrobial activity with the order of greatest activity downwards being C, SF2, SF1, SFSP1, SFSP2 and G. Tea staining at 10 exposures was in the following descending order of optical density SFSP1, SFSP2, G. C, SF1, SF2, water control. The antimicrobial profile of G was similar to that of SF, whereas that of the other formulations were varied but similar to a detergent profile. The difference in staining suggested considerable variation in availability of stannous ions in the formulations. However, the propensity for stannous ions to stain must be balanced against the stain removal propensity of the contained detergents in the toothpaste formulations. In conclusion, the variation in antimicrobial activity and more particularly staining activity of the formulations suggest the products will vary in activity in vivo.

The effect of topical fluorides on ceramic brackets.

Topical fluorides are frequently prescribed to orthodontic patients to minimize development of initial carious lesions around brackets and bands. However, various topical fluorides are reported to cause surface changes and weight loss of dental materials composed of ceramic elements. Little is known of the effects of these fluorides on ceramic brackets. The purpose of this study was to determine the effects of topical fluorides (0.4% stannous fluoride, 0.5% acidulated phosphate fluoride, and 1.1% sodium fluoride) as compared with water, on the weight and on the surface of the wings and slots of aluminum oxide ceramic brackets. The brackets (n = 10 each treatment agent) were weighed before 6-minute immersions in the treatment agent, rinsed, dried, and reweighed for a total of 10 immersions. The surface appearance of the wings and the slots of the brackets (n = 5 each treatment group) were evaluated with scanning electron microscopy. No statistically significant changes in weight were found among the groups. Surface changes were not observed in either the slots nor the wings of ceramic brackets. Therefore it was concluded that the commercially available topical fluorides when applied as per the regimen in this study to the aluminum oxide ceramic brackets did not cause surface damage or significant weight loss as compared with controls (water).