No benefit of an adjunctive phototherapy protocol in treatment of periodontitis: A split-mouth randomized controlled trial.

AIM: To assess the efficacy of a commercially available adjunctive phototherapy protocol ("Perio-1") in treatment of periodontitis. MATERIALS AND METHODS: In an examiner-blind, randomized, controlled, split-mouth, multicentre study, 60 periodontitis patients received root surface debridement (RSD) in sextants either alone (control sextants) or with the adjunctive phototherapy protocol (test sextants). Re-evaluation was performed at 6, 12 and 24 weeks. RESULTS: No statistically significant differences in mean (± standard deviation) clinical attachment level (CAL) change from baseline to week 24 were observed between test (-1.00 ± 1.16 mm) and control sextants (-0.87 ± 0.79 mm) at sites with probing pocket depths (PPDs) ≥5 mm ("deep sites") at baseline (p = .212). Comparisons between test and control sextants for all other parameters (CAL change at all sites, PPD change at deep sites/all sites, bleeding on probing, plaque scores), and for all change intervals, failed to identify any statistically significant differences. CONCLUSIONS: The phototherapy protocol did not provide any additional clinical benefits over those achieved by RSD alone. (German Clinical Trials Register DRKS00011229).

Effects of triclosan on host response and microbial biomarkers during experimental gingivitis.

AIM: This exploratory randomized, controlled clinical trial sought to evaluate anti-inflammatory and -microbial effects of triclosan during experimental gingivitis as assessed by host response biomarkers and biofilm microbial pathogens. MATERIALS AND METHODS: Thirty participants were randomized to triclosan or control dentifrice groups who ceased homecare for 21 days in an experimental gingivitis (EG) protocol. Plaque and gingival indices and saliva, plaque, and gingival crevicular fluid (GCF) were assessed/collected at days 0, 14, 21 and 35. Levels and proportions of 40 bacterial species from plaque samples were determined using checkerboard DNA-DNA hybridization. Ten biomarkers associated with inflammation, matrix degradation, and host protection were measured from GCF and saliva and analysed using a multiplex array. Participants were stratified as "high" or "low" responders based on gingival index and GCF biomarkers and bacterial biofilm were combined to generate receiver operating characteristic curves and predict gingivitis susceptibility. RESULTS: No differences in mean PI and GI values were observed between groups and non-significant trends of reduction of host response biomarkers with triclosan treatment. Triclosan significantly reduced levels of A. actinomycetemcomitans and P. gingivalis during induction of gingivitis. CONCLUSIONS: Triclosan reduced microbial levels during gingivitis development (ClinicalTrials.gov NCT01799226).

Control of dentin/root sensitivity during non-surgical and surgical periodontal treatment.

AIM: To determine the efficacy of a desensitizing regimen compared to a control in preventing the occurrence and/or alleviating dentin/root sensitivity (DRS) following non-surgical (NSPT) and surgical periodontal treatment (SPT). METHODS: Seventy-four chronic-periodontitis patients (CPP) were randomized into a test group (n = 38) using an in-office prophylaxis paste and a toothpaste at home both containing 8% arginine and calcium carbonate (Pro-Argin(™) Technology) or into a control group (n = 36) receiving a fluoride-free prophylaxis paste and a fluoride toothpaste. The examiner applied the assigned paste onto selected teeth for 3 s following NSPT and for 60 s before flap closure. Patients brushed with the assigned toothpaste twice daily throughout the study. DRS to air stimulus was assessed by the Schiff scale (0-3) and the Visual Analog Scale (VAS: 0-100 mm) six times over 17 weeks. RESULTS: In the test group, VAS scores significantly decreased at 8, 11 and 17 weeks from baseline (p ≤ 0.003) and Schiff scores at 8 and 11 weeks from baseline (p ≤ 0.014). The control group exhibited significant increases in VAS and Schiff during the study period (p ≤ 0.006). Marked inter-group differences were noted at all time points (p < 0.001). CONCLUSIONS: The combined use of desensitizing products (8% arginine and calcium carbonate) in-office and at-home prevented DRS development and maintained this effect for 17 weeks following NSPT and SPT.

Dental hygienists' evaluation of the usability research study of the Colgate ProClinical A1500 electric toothbrush.

OBJECTIVE: To determine the user experiences among patients of a new electric toothbrush vs. a manual toothbrush. METHODS: Five dental hygienists were selected to review videotapes demonstrating patient use of their manual toothbrush and the Colgate ProClinical A1500 electric toothbrush. A total of 14 users were videotaped during the three-week duration of this observational study. The dental hygienists were asked to review four assigned user videotapes and then complete a four-page questionnaire sheet for each of them. Each patient participant was reviewed by at least two dental hygienists. RESULTS: The results provide an understanding that there may be differences in the length of time that patients brush their teeth with their manual toothbrush vs. this electric toothbrush. The users of the electric toothbrush appeared to brush in a more concentrated and focused tooth brushing pattern vs. the manual brush. The users did become accustomed to using this electric toothbrush over time and felt an improvement in cleaning efficacy with the product. The observations from the five dental hygienists were consistent with the results of a previously published usability study. CONCLUSION: The Colgate ProClinical A1500 electric toothbrush, relative to a manual toothbrush, provided an improved brushing experience for the fourteen users whose brushing techniques were evaluated by five dental hygienists who reviewed their videotapes from the usability study.

Efficacy of a desensitizing toothpaste containing arginine and calcium carbonate on dentin surface pore structure and dentin morphology.

PURPOSE: To investigate the laboratory changes in dentin tubule occlusion morphology during short term use of desensitizing products as evaluated by electron microscopy and an image analysis. METHODS: Freshly extracted human third molar teeth were collected at random and 40 dentin discs were prepared. These dentin samples were then divided in to four groups (n=10). The test treatment consisted of undiluted Colgate Sensitive Pro-Relief Toothpaste containing 8.0% arginine and calcium carbonate that was applied on the dentin surface under a brushing cycle of 200 strokes, 2 times/day, for 10 days and then soaked in the filtrated human saliva. The two other test products were a commercial toothpaste, Sensodyne Original, containing 10% strontium chloride and a professional re-mineralizing treatment paste (GC Tooth Mousse). The negative control group was soaked in human saliva that had been sterilized by filtration. The occluding ability of the dentin tubules, using the dentin disc model, was evaluated using scanning electron microscopy (SEM). The degree of occlusion of the dentin tubules was quantified using an image analyzer and the results were analyzed by ANOVA and a Tukey's test. RESULTS: All test products created a smear layer on the dentin surface that significantly reduced the diameter of dentin tubules after treatment. Compared to the dentin tubule area on disks treated with the negative control (72.02 +/- 7.23 microm2), disks treated with Colgate Sensitive Pro-Relief, Sensodyne Original, and GC Mousse had dentin tubule areas of 2.10 +/- 0.42 microm2, 10.11 +/- 2.83 microm2, and 30.40 +/- 4.04 microm2 respectively. These differences were statistically significant.

Clinical evaluation of an in-office desensitizing paste containing 8% arginine and calcium carbonate for relief of dentin hypersensitivity prior to dental prophylaxis.

PURPOSE: To evaluate the clinical efficacy of a professional prophylaxis paste containing 8% arginine-calcium carbonate in the reduction of dentin hypersensitivity used as a pre-procedural application compared to a commercially-available prophylaxis paste. METHODS: This study was conducted at Jersey Shore University Medical Center in Neptune, New Jersey, USA. A mixed population of adult males and females between the ages of 18-70 were included in the study. Baseline air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) were mandatory for inclusion in this study. Subjects were randomly assigned to either: (1) Control paste, Nupro non-fluoridated pumice based prophylaxis paste (Dentsply Professional) or (2) Test paste, a desensitizing paste containing 8% arginine and calcium carbonate (Colgate-Palmolive Company). Either the Control or Test paste was applied to subjects prior to their receiving a routine dental prophylaxis. After completion of the dental cleaning procedure, a final post-cleaning air blast examination was performed on each subject following identical methods as at the baseline exam. Paired t-tests and ANCOVA were used. RESULTS: 66 subjects were enrolled in the study. Following the post-cleaning air blast hypersensitivity examination, there was a significant decrease of 83.94% in the hypersensitivity of subjects using the Test paste. The group using the Control paste showed a 13.43% desensitization. There was a statistically significant difference of 79.65% between the two groups. Subjects in the age groups 41-50, 51-60, and 61-70 years of age showed the most reduction in dentin hypersensitivity.

A comparative investigation to evaluate the clinical efficacy of an alcohol-free CPC-containing mouthwash as compared to a control mouthwash in controlling dental plaque and gingivitis: a six-month clinical study on adults in San Jose, Costa Rica.

OBJECTIVE: This study was designed to evaluate the clinical efficacy of an antiplaque alcohol-free mouthwash containing 0.075% cetylpyridinium chloride (CPC) and 0.05% sodium fluoride (NaF), as compared to a control mouthwash containing only 0.05% NaF, in controlling established dental plaque and gingivitis after three and six months of product use. METHODS: This was a single-center, parallel-group, two-cell, double-blind, randomized clinical study. Prospective adult male and female subjects from San Jose, Costa Rica reported to the clinical facility having refrained from all oral hygiene procedures for 12 hours, and from eating, drinking, or smoking for four hours prior to their visit. Qualifying subjects who presented with Gingival Index scores (Löe and Silness Index) of at least 1.0 and Plaque Index scores (Turesky Modified Quigley-Hein Index) of at least 1.5 were allowed to participate in this study. Subjects were randomly assigned to one of two treatment groups according to their baseline gingival and plaque scores. In the first treatment group (Test), subjects used an alcohol-free mouthwash containing 0.075% CPC and 0.05% NaF, whereas in the second treatment group (Control), subjects used a mouthwash containing only 0.05% NaF. Gingivitis and plaque assessments, and examinations of oral hard and soft tissues were conducted after three months and six months of product use. RESULTS: One-hundred and ten (110) subjects complied with the protocol and completed the six-month study. After six months of product use, the Test Mouthwash group exhibited statistically significant reductions from baseline with respect to Gingival (33.5%), Gingival Interproximal (34.5%), Gingival Severity (63.2%), Plaque (33.6%), Plaque Interproximal (30.0%), and Plaque Severity (73.6%) Index scores. After six months of product use, the Control Mouthwash group exhibited statistically significant increases from baseline with respect to Gingival (6.9%), Plaque Interproximal (7.2%), and Plaque Severity (32.7%) Index scores. Furthermore, after six months of product use, the Control Mouthwash group exhibited reductions from baseline with respect to Plaque (6.1%), Gingival Interproximal (3.6%), and Gingival Severity (1.1%) Index scores which were not statistically significant. After three months of product use, the Test Mouthwash group exhibited statistically significant reductions in Gingival (25.0%), Gingival Interproximal (22.3%), Gingival Severity (38.9%), Plaque (26.1%), Plaque Interproximal (22.4%), and Plaque Severity (75.0%) Index scores as compared to the Control Mouthwash group. After six months of product use, the Test Mouthwash group exhibited statistically significant reductions in Gingival (38.1%), Gingival Interproximal (37.1%), Gingival Severity (63.6%), Plaque (36.5%), Plaque Interproximal (33.2%), and Plaque Severity (78.5%) Index scores as compared to the Control Mouthwash group. CONCLUSION: The results of this double-blind clinical study support that 1) an alcohol-free mouthwash containing a combination of 0.075% CPC and 0.05% NaF produces statistically significant reductions in dental plaque and gingivitis after three and six months compared to baseline, and 2) the alcohol-free CPC mouthwash provides a statistically significantly greater level of efficacy in controlling established dental plaque and gingivitis after three and six months of product use as compared to the Control Mouthwash containing only NaF.

Comparative investigation of a dentifrice containing triclosan/copolymer/sodium fluoride and specially-designed silica and a dentifrice containing 0.243% sodium fluoride in a silica base for the control of established supra-gingival plaque and gingivitis: a 6-month clinical study.

PURPOSE: To investigate the efficacy of a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, 0.243% sodium fluoride, and specially-designed silica in controlling established dental plaque and gingivitis. METHODS: Qualifying adult male and female subjects from the West Palm Beach, Florida area were randomly assigned into one of two treatment groups: (1) a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, 0.243% sodium fluoride, and specially-designed silica (Test Dentifrice); and (2) a dentifrice containing 0.243% sodium fluoride in a silica base (Negative Control Dentifrice). All subjects received an oral soft and hard tissue examination, baseline plaque and gingivitis were assessed, and subjects were dispensed their assigned dentifrice product along with a soft-bristled adult toothbrush for home use. Subjects were instructed to brush their teeth for 1 minute, twice daily (morning and evening), using only the dentifrice provided. Examinations for plaque and gingivitis, and oral soft and hard tissue assessments were repeated after 3 and 6 months of product use. RESULTS: 115 subjects complied with the protocol, and completed the 6-month examination. After 6 months of product use, subjects assigned to the Test Dentifrice group exhibited statistically significant reductions from baseline with respect to Plaque Index, Plaque Severity Index, Gingival Index, and Gingivitis Severity Index scores; and subjects assigned to the Negative Control Dentifrice group exhibited statistically significant reductions from baseline with respect to Gingival Index scores only. Relative to the Negative Control Dentifrice group, the Test Dentifrice group exhibited an 18.8% reduction in Plaque Index; a 50% reduction in Plaque Severity Index; a 19.6% reduction in Gingival Index; and a 60% reduction in Gingivitis Severity Index after 6 months, all of which were statistically significant.

Assessment of hypersensitivity reduction of a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, 0.243% NaF and specially-designed silica as compared to a dentifrice containing 0.454% stannous fluoride, sodium hexametaphosphate and zinc lactate and to a dentifrice containing 0.243% NaF on dentin hypersensitivity reduction: an 8-week study.

PURPOSE: To evaluate the 8-week dentin hypersensitivity efficacy of three toothpastes: (1) a dentifrice containing 0.3% triclosan, 2.0% PVM/MA copolymer, 0.243% sodium fluoride and specially-designed silica (Test Dentifrice 1); (2) a commercially-available dentifrice containing 0.454% stannous fluoride in a silica base with sodium hexametaphosphate and zinc lactate (Test Dentifrice 2); and (3) a commercially-available non-sensitive dentifrice containing 0.243% sodium fluoride in a silica base (Negative Control Dentifrice). METHODS: For this 8-week randomized controlled clinical study, qualifying subjects had to have at least two hypersensitive teeth with a tactile hypersensitivity score (Yeaple Probe) between 10 and 50 grams of force, and air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale). Subjects brushed twice daily for 1 minute, using the assigned toothpaste and toothbrush. Dentin hypersensitivity assessments, as well as examinations of oral hard and soft tissues, were conducted at the baseline examination and after 4 and 8 weeks of brushing. RESULTS: 118 subjects complied with the protocol, and completed the 8-week study. At baseline, the mean tactile sensitivity scores for toothpastes (1), (2) and (3) were 13.6, 14.1 and 13.1; at 4 weeks 28.75, 20.13, and 20.00; and after 8 weeks 33.1, 24.0 and 20.5, respectively. The mean air blast scores for toothpastes (1), (2), and (3) at baseline were 2.5, 2.5, and 2.4; at 4 weeks 1.25, 1.50 and 1.85; and after 8 weeks 0.99, 1.36 and 1.5, respectively. At all time points after the baseline examination, for both tactile and air blast sensitivity scores, the differences between Test Dentifrice 1 and the Negative Control Dentifrice were statistically significant (P < 0.05). The differences between Test Dentifrice 1 and Test Dentifrice 2 were statistically significant (P < 0.05) at 4 and 8 weeks after baseline examination for tactile sensitivity scores and at 8 weeks after baseline examination for air blast sensitivity scores.

Triclosan inhibition of acute and chronic inflammatory gene pathways.

AIM: We sought to determine whether triclosan (2,4,4'-trichloro-2'-hydroxydiphenylether), an extensively used anti-plaque agent with broad-spectrum anti-microbial activity, with reported anti-inflammatory effects via inhibition of prostaglandin E2 and interleukin 1 (IL-1)beta, could also more broadly suppress multiple inflammatory gene pathways responsible for the pathogenesis of gingivitis and periodontitis. MATERIALS AND METHODS: As an exploratory study, the effects of triclosan on the inflammatory gene expression profile were assessed ex vivo using peripheral whole blood samples from eight periodontally healthy donors. Ten-millilitres whole blood aliquots were incubated 2 h with 0.3 microg/ml Escherichia coli lipopolysaccharide (LPS) with or without 0.5 microg/ml triclosan. Affymetrix microarray gene expression profiles from isolated leucocytes and pathway-specific quantitative polymerase chain reaction arrays were used to investigate changes in expression of target cytokines and cell signalling molecules. RESULTS: Ex vivo human whole blood assays indicated that triclosan significantly down-regulated the LPS-stimulated expression of Toll-like receptor signalling molecules and other multiple inflammatory molecules including IL-1 and IL-6 and the dampening of signals that activate the T-helper type 1 acquired immune response via suppression of CD70 with concomitant up-regulation of growth factors related to bone morphogenetic protein (BMP)2 and BMP6 synthesis. CONCLUSIONS: Anti-inflammatory effects were found in this exploratory survey, including suppression of microbial-pathogen recognition pathway molecules and the suppression of acute and chronic mediators of inflammation.

A clinical investigation of the efficacy of three commercially available dentifrices for controlling established gingivitis and supragingival plaque.

OBJECTIVE: To assess the efficacy ofa dentifrice containing 0.3% triclosan/2.0% PVM/MA copolymer/0.243% sodium fluoride for controlling established gingivitis and supragingival plaque relative to that of a dentifrice containing 0.454% stannous fluoride, sodium hexametaphosphate, and zinc lactate, and a dentifrice containing 0.243% sodium fluoride as a negative control. METHODS: Following a baseline examination for gingivitis and supragingival plaque, qualifying adult male and female subjects from the Piscataway, NJ, USA area were randomized into three dentifrice groups. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice and a soft-bristled toothbrush. Examinations for gingivitis and supragingival plaque were repeated after six weeks of product use. RESULTS: One-hundred and seventy-one (171) subjects complied with the protocol and completed the study. Relative to the group using the dentifrice with 0.243% sodium fluoride alone, the 0.3% triclosan/2.0% PVM/MA copolymer/0.243% sodium fluoride group exhibited statistically significant reductions in gingival index and supragingival plaque index scores of 25.3% and 33.0%, respectively, after six weeks of product use. Similarly, relative to the group using the 0.243% sodium fluoride dentifrice, the 0.454% stannous fluoride, sodium hexametaphosphate, and zinc lactate dentifrice group exhibited statistically significant reductions in gingival index and plaque index scores of 8.1% and 14.1% after six weeks of product use. Further, relative to the 0.454% stannous fluoride, sodium hexametaphosphate, and zinc lactate dentifrice group, the 0.3% triclosan/2.0% PVM/MA copolymer/0.243% sodium fluoride dentifrice group exhibited statistically significant reductions in gingival index and plaque index scores of 18.7% and 22%, respectively. CONCLUSION: The overall results of this double-blind clinical study support the conclusion that a dentifrice containing 0.3% triclosan/2.0% PVM/MA copolymer/0.243% sodium fluoride is efficacious for the control of established gingivitis and supragingival plaque as compared to a regular fluoride dentifrice, and that it provides a greater level of efficacy for the control of gingivitis and supragingival plaque than does a dentifrice containing 0.454% stannous fluoride, sodium hexametaphosphate, and zinc lactate.

Dentin hypersensitivity reduction of a new toothpaste containing 8.0% arginine and 1450 ppm fluoride: an 8-week clinical study on Chinese adults.

PURPOSE: To present the results of an 8-week dentin hypersensitivity clinical study in which the efficacy of a new Pro-Argin formula toothpaste, with gentle whitening benefits, containing 8.0% arginine, a high cleaning calcium carbonate system, and 1450 ppm fluoride as sodium monofluorophosphate (MFP) was compared to that of a commercial Pro-Argin formula toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride as MFP and a negative control toothpaste containing calcium carbonate and 1450 ppm fluoride as MFP. METHODS: An 8-week clinical study, with 121 subjects, was conducted in Chengdu, Sichuan, China, using a double-blind, stratified, three-treatment design. Tactile and air blast sensitivity assessments were used to compare the efficacy of the three products. RESULTS: This clinical study demonstrated that the new Pro-Argin formula toothpaste provided a significant reduction in dentin hypersensitivity when used over a period of 8 weeks. The study also showed that the new toothpaste provided significantly greater reductions (P < 0.05) in dentin hypersensitivity in response to tactile (64.4%, 71.1%, and 61.0%) and air blast (40.7%, 58.8%, and 74.4%) stimuli than the negative control toothpaste containing 1450 ppm fluoride after 2, 4, and 8 weeks of product use, respectively. The results for the new toothpaste did not differ significantly from those of the positive control toothpaste at all time points in the study.

Advanced oral antibacterial/anti-inflammatory technology: A comprehensive review of the clinical benefits of a triclosan/copolymer/fluoride dentifrice.

INTRODUCTION: Triclosan is a broad-spectrum antibacterial agent, marketed for use in oral products. It is effective against both gram-positive and gram-negative bacteria. PVM/MA is the non-proprietary designation for a polyvinylmethyl ether maleic acid copolymer. It has been demonstrated that there is a greater uptake of triclosan to enamel and buccal epithelial cells from the use of a fluoride dentifrice containing triclosan and the PVM/MA copolymer than from a dentifrice containing triclosan alone. This Supplement details the results of antibacterial, anti-inflammatory, and short- and long-term plaque and gingivitis studies with a triclosan/copolymer/ fluoride dentifrice. Additionally, the Supplement reviews studies on the effect of a triclosan/copolymer/fluoride dentifrice on periodontitis, calculus, caries, whitening and stain removal, oral malodor, and on the microflora. CONCLUSION: Clinical studies indicate that the use of a triclosan/copolymer/fluoride dentifrice (Colgate Total Toothpaste) may provide oral health benefits beyond those associated with "traditional" toothpaste use, in a manner that is safe and effective. Studies presented in this Supplement demonstrate that Colgate Total Toothpaste provides superior protection against plaque and gingivitis, caries, oral malodor, exhibits superior stain removal, and provides protection against the progression of periodontal disease.

Alumni perspectives on community-based and traditional curricula.

In 1994, the University of Medicine and Dentistry of New Jersey-New Jersey Dental School (UMDNJ-NJDS) launched the Community-Oriented Dental Education (CODE) program. The CODE program provides senior dental students the opportunity to spend four days per week providing dental care in a community-based clinic. A survey of graduates of CODE (n = 55) and randomly selected graduates of the traditional curriculum (n = 110) was conducted via mail to determine attitudes relating to community service (CS), community-based learning (CBL), reasons for participating in their clinical program, perceived levels of clinical preparedness at graduation, and practice choices. A total of 111 surveys (66.9 percent) were returned to NJDS, with 84.6 percent of CODE alumni responding and 59.0 percent of traditional alumni (TA) responding. Of the 111 surveys returned, sixty-five (58.6 percent) were completed by TA, and forty-six (41.4 percent) were completed by CODE alumni. There were no differences among CODE and TA regarding attitudes toward CS and tendency to practice in underserved areas or to accept Medicaid payments. There were, however, some differences in attitudes toward CBL, reasons for applying or not applying to the CODE program, perceived impact of clinical education on graduates' preparedness, views of the extent to which the programs encouraged students to choose public or private areas of practice, and perceptions of how the desire to help communities influenced career and practice decisions. Some of these findings may be useful to schools as they plan extramural education programs.

Tuberculosis.

Tuberculosis, a chronic bacterial infection, once thought to have been eliminated, has re-emerged as a disease threat, causing health care professionals to evaluate the treatment of those infected. This article provides information on the transmission of the disease, infection and active disease, and recommendations for evaluating patients in the dental setting.