The stain removal performance of a new anti-hypersensitivity dentifrice.

OBJECTIVE: To investigate the stain removal potential in vitro of a new anti-hypersensitivity dentifrice. The dentifrice contains a low level of abrasive, the zwitterionic surfactant cocamidopropyl betaine, and potassium nitrate. It has been developed to be as gentle as possible to tooth surfaces and oral soft tissues, while effectively treating dentinal hypersensitivity. METHODOLOGY: The Relative Dentine Abrasivity (RDA) method was used to measure abrasivity. The Pellicle Cleaning Ratio (PCR) and the Natural Extrinsic Stain Removal (NESR) methods were used to test stain removal performance against suitable controls. RESULTS: The RDA value for the formulation was 34 +/- 2 (Mean +/- S.E.). The PCR value was 46 +/- 4, comparable with Elmex Sensitive. The NESR test, which has previously been shown to give better clinical correlation than the PCR, demonstrated that the new formulation gave superior stain removal performance compared with both Sensodyne MultiCare and a conventional nonsensitivity formulation, and similar stain removal performance to Elmex Sensitive. CONCLUSION: The new formulation has been shown, in these studies, to combine low abrasivity with an in vitro stain removal performance comparable with that of benchmark marketed pastes.

Comparison of TTS-fentanyl with sustained-release oral morphine in the treatment of patients not using opioids for mild-to-moderate pain.

OBJECTIVE: This randomised, multicentre, direct open comparative trial evaluated the efficacy, treatment convenience, tolerability and safety aspects of transdermal therapeutic system (TTS)-fentanyl and sustained-release oral morphine (SRM) in both opioid-naïve patients with moderate-to-severe cancer-related pain and in patients who had already been using opioids for mild-to-moderate pain. The two treatment groups were run in parallel. Special attention was paid to constipation, nausea/vomiting, drowsiness and respiratory depression. PATIENTS AND METHODS: The 131 enrolled patients started the 4-week treatment at low doses of opioid (25 microg/h TTS-fentanyl for 3 days or 30 mg SRM every 12 h) and were individually titrated. Tolerability, efficacy and safety were assessed throughout the study period. Frequency of constipation was the primary study variable and accordingly the study was powered for this. Both patients and investigators made a global treatment evaluation. RESULTS: TTS-fentanyl and SRM were shown to be equally effective. Pain control and sleep quality improved with both treatments. None of the patients developed respiratory depression. Statistically significantly more patients in the SRM treatment group discontinued the trial prematurely (59% vs 27%; p < 0.001), particularly due to adverse events (36% vs 4%; p < 0.001). Fewer patients in the TTS-fentanyl than in the SRM treatment group reported constipation during the trial. This finding was statistically significant after 1 week of treatment (27% vs 57%; p = 0.003). The favourable tolerability profile of TTS-fentanyl was also reflected in both the patient and the investigator global evaluation of the treatment. Patient assessment favoured TTS-fentanyl treatment in terms of a significantly lower rate of troublesome side-effects ('quite a bit' to 'very much' troublesome side-effects in 14% vs 36% of patients; p = 0.003) and less interruption of daily activities (absence of any interruption of daily activities in 88% vs 63% of patients; p = 0.012). Investigators scored TTS-fentanyl as significantly better with respect to 'side-effects' (p = 0.039) and 'overall impression' (p = 0.013). Sub-analyses of opioid-naïve users gave similar results. CONCLUSION: These data indicate that TTS-fentanyl, when used as an opioid of first choice in the treatment of cancer-related pain, is as effective as, but better tolerated than, SRM, including in opioid-naïve patients.