Little Ironweed and Java Tea in Herbal Toothpaste Reduced Dentine Permeability: An In Vitro Study.

Aim: To determine the effect of an herbal toothpaste containing Little Ironweed and Java Tea, on reducing dentine permeability in vitro. Materials and Methods: Dentine discs from human mandibular third molars were divided into three groups and brushed with herbal toothpaste, nonherbal toothpaste, or deionized water. Each group was immersed in artificial saliva (AS) or 6% citric acid. The permeability of each dentine disc was evaluated before and after saliva or acid challenge using a fluid filtration system. The morphology of dentine discs after treatment was observed using scanning electron microscopy (SEM). The mean permeabilities were statistically analyzed using analysis of variance and Tukey's test. Results: The nonherbal and herbal toothpaste groups demonstrated reduced dentine permeability. AS immersion decreased dentine permeability in both toothpaste groups with values lower than the control group. Dentine permeability values increased after acid immersion in the toothpaste groups and were similar to each other. SEM revealed small granular crystal-like and round particles on the dentine surface and opening of dentinal tubules of both toothpaste groups. More dentinal tubules were opened after brushing with deionized water. Conclusions: The reduction of dentine permeability caused by the herbal toothpaste was similar to that of the nonherbal toothpaste after brushing and the simulated oral conditions. Both herbal plants have the possibility to alleviate clinical hypersensitivity by reducing dentine permeability. Little Ironweed and Java Tea in the toothpaste composition is a potential choice for treating hypersensitive dentine.

Evaluation of toothpastes for treating root carious lesions - a laboratory-based pilot study.

BACKGROUND: Root caries is preventable and can be arrested at any stage of disease development. The aim of this study was to investigate the potential mineral exchange and fluorapatite formation within artificial root carious lesions (ARCLs) using different toothpastes containing 5,000 ppm F, 1,450 ppm F or bioactive glass (BG) with 540 ppm F. MATERIALS AND METHODS: The crowns of each extracted sound tooth were removed. The remaining roots were divided into four parts (n = 12). Each sample was randomly allocated into one of four groups: Group 1 (Deionised water); Group 2 (BG with 540 ppm F); Group 3 (1,450 ppm F) and Group 4 (5,000 ppm F). ARCLs were developed using demineralisation solution (pH 4.8). The samples were then pH-cycled in 13 days using demineralisation solution (6 h) and remineralisation solution (pH 7) (16 h). Standard tooth brushing was carried out twice a day with the assigned toothpaste. X-ray Microtomography (XMT) was performed for each sample at baseline, following ARCL formation and after 13-day pH-cycling. Scanning Electron Microscope (SEM) and 19F Magic angle spinning nuclear magnetic resonance (19F-MAS-NMR) were also performed. RESULTS: XMT results showed that the highest mineral content increase (mean ± SD) was Group 4 (0.09 ± 0.05), whilst the mineral content decreased in Group 1 (-0.08 ± 0.06) after 13-day pH-cycling, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4 (p < 0.05). SEM scans showed that mineral contents within the surface of dentine tubules were high in comparison to the subsurface in all toothpaste groups. There was evidence of dentine tubules being either partially or completely occluded in toothpaste groups. 19F-MAS-NMR showed peaks between - 103 and - 104ppm corresponding to fluorapatite formation in Groups 3 and 4. CONCLUSION: Within the limitation of this laboratory-based study, all toothpastes were potentially effective to increase the mineral density of artificial root caries on the surface, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4.

The use of mouthwash containing trimetaphosphate as an adjunct therapy to fluoridated toothpaste reduces enamel demineralization.

INTRODUCTION: The decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population. MATERIALS AND METHODS: This study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001). RESULTS: The 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001). CONCLUSION: The adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F. CLINICAL SIGNIFICANCE: This combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries.

Whitening efficacy of activated charcoal-based products: A single-blind randomized controlled clinical trial.

OBJECTIVE: This randomized controlled clinical trial evaluated the whitening efficacy, tooth sensitivity (TS), and volunteers' satisfaction following the use of activated charcoal powder and toothpaste. METHODS: Fifty-six volunteers were randomly allocated into 4 groups (n = 14) according to a 14-day toothbrushing or whitening treatment with activated charcoal powder (ACPW), activated charcoal toothpaste (ACT), regular fluoridated toothpaste (RT), and 10 % carbamide peroxide (CP). Objective (ΔE00) and subjective (ΔSGU) color and whiteness index (ΔWID) changes were calculated. Patients self-reported the risk and intensity of TS using a visual analogue scale and the volunteer's satisfaction was determined by a questionnaire. Color assessments were analyzed by Kruskal-Wallis followed by Dwas-Steel-Crithlow-Fligner, and absolute TS risk and volunteer's satisfaction by Fisher exact test (p < 0.05). RESULTS: ACPW and ACT promoted similar effects in ΔE00, ΔSGU, and ΔWID to that observed for RT. No significant difference was found in terms of TS risk intensity. TS risk became high after 7 and 14 days, with higher TS prevalence in CP. Volunteers reported that ACPW exhibited the lowest ease-of-use, comfort, and whitening satisfaction among groups (p < 0.05). CONCLUSION: Activated charcoal-based products presented a minor and unsatisfactory whitening effect while CP resulted in optimal tooth whitening and the highest level of satisfaction among volunteers. Risk was higher from 7 days onwards and was more pronounced in the CP. CLINICAL RELEVANCE: Based on the whitening effect and patient satisfaction, this controlled-randomized clinical evidence supports that the use of activated charcoal-based products should be discouraged.

Remineralisation of enamel and dentine with stabilised stannous fluoride dentifrices in a randomised cross-over in situ trial.

OBJECTIVES: To compare the remineralisation efficacy and ion bioavailability of two novel SnF2-containing dentifrices in a blinded, cross-over, randomised in situ clinical study. METHODS: Six participants wore removal palatal appliances holding human enamel and dentine blocks with subsurface lesions. Appliances were worn for two treatment periods of 14 consecutive days each, with a one-week washout period in-between. Participants were randomly allocated to rinse with a 1:5 diluted coded slurry of one of two dentifrices containing either 5 % casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) +1100 ppm F as SnF2 [MIPOP], or 1100 ppm F as SnF2 [CT], for 1 min, four times a day. Saliva was collected post-treatment and analysed for tin, calcium, inorganic phosphate and fluoride ions using atomic absorption spectrophotometry and ion chromatography. Enamel and dentine lesions were analysed for percent remineralisation (%R) using transverse microradiography and percent surface microhardness recovery (%SMHR). RESULTS: MIPOP released significantly higher F (3.00 ± 0.27 mM), Ca (15.23 ± 3.23 mM) and Sn (1.18 ± 0.13 mM) into saliva whereas CT released 2.89 ± 0.32 mM F and only 0.84 ± 0.11 mM Ca and 0.28 ± 0.10 mM Sn. MIPOP produced significantly higher %R than CT: 25.6 ± 1.5 % compared to 15.2 ± 0.7 % in enamel, and 33.6 ± 3.1 % compared to 20.6 ± 1.1 % in dentine. Additionally, MIPOP produced significantly higher %SMHR (18.2 ± 7.9 %) compared to CT (4.1 ± 0.6 %). CONCLUSIONS: Both dentifrices promoted remineralisation, but the MIPOP dentifrice with added CPP-ACP and the ion-stabilising effects of CPP released higher amounts of bioavailable tin and produced significantly higher remineralisation and surface microhardness recovery. CLINICAL SIGNIFICANCE: Modern dentifrices contain SnF2 for a range of oral health benefits. Challenges associated with stability of these formulations can affect ion bioavailability, reducing efficacy. Two dentifrices with SnF2 promoted remineralisation in situ, however the dentifrice with the added saliva biomimetic CPP-ACP was superior and therefore may produce greater health benefits.

At-home bleaching versus whitening toothpastes for treatment of tooth discoloration: a cost-effectiveness analysis

Abstract Objectives This study aimed to analyze the cost-effectiveness of whitening toothpastes and at-home bleaching for the treatment of tooth discoloration. Methodology A cost-effectiveness economic analysis was conducted, and eight randomized clinical trials were selected based on the whitening agent product used: blue covarine dentifrices (BCD), hydrogen peroxide dentifrices (HPD), dentifrices without bleaching agents (CD, negative control), and 10% carbamide peroxide (CP10, positive control) for at-home bleaching. The consumer/patient perspective was adopted, macro-costing techniques were used and a decision tree model was performed considering the costs in the American and Brazilian markets. The color change evaluation (ΔE*ab) was used to calculate the effectiveness of tooth bleaching. A probabilistic analysis was performed using a Monte Carlo simulation and incremental cost-effectiveness ratios were obtained. Results CP10 resulted in the highest cost-effectiveness compared to the use of dentifrices in both markets. In Brazil, HPD was more cost-effective than BCD and CD. In the US, the increased costs of HPD and BCD did not generate any whitening benefit compared to CD. Conclusions CP10 was more cost-effective than BCD and HPD for tooth bleaching from the perspectives of the Brazilian and American markets. Decision-making should consider the use of CP10 for treating tooth discoloration.

Does the combination of whitening toothpaste and hydrogen peroxide bleaching increase the surface roughness and change the morphology of a nanofilled composite?

Aim: To evaluate changes in the surface roughness and morphology of a nanofilled composite following toothbrushing with a whitening (WT) or regular toothpaste (RT), alone or combined with 35% hydrogen peroxide bleaching (HP). Methods: Seventy disc-shaped nanofilled composite (Filtek Z350XT) specimens were randomly divided into groups (n=10): WT, RT, TB (without toothpaste ­ control) or the combinations WT/ HP, RT/HP, TB/HP and HP. All groups underwent toothbrushing simulation (60,000 cycles) and bleaching treatment (4 sessions). Mean surface roughness (Ra, µm) was measured before (T0) and after treatments (TB). Surface morphology was assessed by scanning electron microscopy (SEM) at TB. Mean Ra was analyzed using general mixed models and multiple comparisons by the Tukey-Kramer test (α=5%). Results: HP caused no surface roughness changes on the nanofilled composite after treatment (p>0.05). RT toothbrushing, combined or not with HP, increased the surface roughness (p<0.05). WT and WT/ HP protocols had no effect on the surface roughness of the composite (p>0.05). The nanofilled composite submitted to RT toothbrushing combined with HP (RT/HP) presented substantial surface alterations under SEM, showing deep depressions and round-shaped defects. Toothbrushing with RT combined with the bleaching agent increased exposure of the inorganic fillers. Conclusion: WT toothbrushing, regardless of HP combination, or the single HP protocol had no effect on the surface roughness of the nanofilled composite. However, RT combined with HP negatively affected surface roughness and presented the most noticeable surface changes among groups

Effect of Toothpaste Fluoride Concentration on Color Stability of Resin Composites: An In Vitro Study

ABSTRACT Objective: To investigate the effects of two different dentifrice fluoride concentrations on the color stability of the composite. Material and Methods: Twenty-seven specimens (2×4×5 mm) each of microfilled (Gradia, GC, Japan) and nanohybrid (Grandio, VOCO, Germany) composites were prepared. The specimens were randomly divided into six groups (control, Fluoflor caries protection toothpaste with 1450ppm Fluoride (EXW, France), and Fluoflor kids toothpaste with 500ppm Fluoride (EXW, France) (n = 9). The specimens were immersed in a mixture of artificial saliva and toothpaste in a ratio of 1:3 and applied for 60 seconds every 12 hours for 42 days. The control samples were incubated in artificial saliva at 37°C. Primary and secondary color measurements were performed using color parameters (L∗a∗b) with a spectrophotoshade (MHT Optic Research AG, Niederhasli, Switzerland). Data were analyzed using a two-way analysis of variance at a significance level of 0.05. Results: According to the two-way ANOVA analysis, there was no significant difference in color change between the composites and no difference in the level of discoloration between different fluoride concentrations(p>0.05). Also, None of the dentifrices caused clinically significant color changes(∆E˂3.3). Conclusion: No clinically unacceptable color changes were observed in the microfilled and nanofilled composites with different concentrations of fluoride toothpaste.

Efeito protetor de dentifrícios fluoretados associados ao polímero aminometacrilato no desgaste erosivo do esmalte / Protective effect of fluoride dentifrices in association with aminomethacrylate polymer against the enamel erosive wear

O desgaste dental erosivo tem se tornado uma condição cada vez mais preocupante, com taxas globais de prevalência crescentes, principalmente em indivíduos jovens. Os polímeros formadores de filme têm sido investigados como uma alternativa para o controle da progressão do desgaste dental erosivo, especialmente quando associados a compostos fluoretados, protegendo o tecido dental contra a ação dos ácidos. Dentre eles está o aminometacrilato, que mostrou resultados promissores em estudos prévios sob a forma de solução, porém seu efeito quando adicionado a formulações de dentifrícios ainda não havia sido pesquisado. Dessa forma, o presente estudo visou avaliar o potencial protetor da associação do aminometacrilato com dentifrícios fluoretados frente à erosão inicial e ao desgaste erosivo do esmalte. Para isso, 72 espécimes em esmalte bovino polido foram alocados aleatoriamente em seis níveis de tratamento: erosão (controle negativo sem desafio abrasivo- CNE), abrasão sem dentifrício (controle negativo da abrasão- CNA), dentifrício sem agente ativo (placeboPL), dentifrício com fluoreto de sódio (NaF ­ 1450 ppm F-), dentifrício experimental com aminometacrilato (AMC ­ 4%) e dentifrício fluoretado com aminometacrilato (AMC+F). O grupo CNE foi submetido apenas à ciclagem erosiva, e os demais passaram por desafios erosivos e abrasivos. A ciclagem erosiva/abrasiva consistiu em imersão dos espécimes em saliva humana (1h) para a formação da película adquirida, exposição ao ácido cítrico 0,3% por 5 minutos (4x/dia) e aplicação dos tratamentos (2x/dia), intercalados por imersão em saliva humana (1h), todos sob agitação (30 rpm). A ciclagem foi repetida por 5 dias. A microdureza superficial Knoop (KN) dos espécimes foi analisada no primeiro dia da ciclagem para avaliação da erosão inicial do esmalte. A análise foi realizada em quatro momentos: KNinicial (esmalte sadio), KNE1(após a primeira exposição ao ácido), KNT (após o tratamento), KNE2 (após a segunda exposição ao ácido). Com base nestes valores, foram calculados o potencial de reendurecimento (%Re = [(KNT-KNE1) / (KNE1)] x 100) e de proteção do esmalte (%Prot = [(KNE2-KNE1) / (KNE1)] × 100). A análise perfilométrica foi realizada antes e depois do término da ciclagem (após 5 dias) para determinação da perda de estrutura (em µm). O potencial de adsorção de flúor solúvel em KOH no esmalte foi analisado ao final do ciclo erosivo (µg/cm2). Espécimes representativos de cada grupo foram observados em microscopia eletrônica de varredura após o término da ciclagem. Foram aplicados os testes ANOVA um fator e Tukey (5%). Os valores para %Re foram: CNE (3,11±4,09)a; CNA (1,62±11,38)a; PL (1,78±3,51)a; AMC (5,59±3,08)a; F (7,53±9,17)a; AMC+F (20,23±7,10)b. Para %Prot foram: CNE (-50,68±5,27)a; CNA (-49,71±6,43)a; PL (-51,65±3,74)a AMC (-41,21±8,47)b; F (-34,10±5,99)b; AMC+F (-19,80±7,95)c. Para perda estrutural: CNE (7,46±2,26)a, CNA (10,14±2,08)ab, PL(13,11±2,69)c, AMC (7,74±2,10)a, F (11,38±2,07)bc, AMC+F (7,52±2,59)a. Para flúor adsorvido na superfície foram observados os valores de: CNE (0,160 ±0,069)a; CNA (0,179 ±0,034)a; PL (0,275 ±0,142)a; AMC (0,422 ±0,161)a; F (1,29 ±0,311)b; AMC+F (1,46 ±0,217)b. Concluiu-se que a adição do copolímero aminometacrilato em dentifrícios potencializou o efeito do fluoreto de sódio contra a erosão inicial do esmalte e o desgaste erosivo do esmalte (AU)

The erosive tooth wear (ETW) has been a cause of concern, because its prevalence rates have increased in the recent years, mainly in young individuals. Film-forming polymers have been investigated as an alternative to control erosive tooth wear (ETW) progression, notably when associated to fluoride compounds, protecting the dental tissues against acids. Among them, the aminomethacrylate polymer has shown promissing results in previous studies. Nevertheless, its performance when added to toothpaste formulations remains unknown. Therefore, this study aims to evaluate the protective potential of fluoride toothpastes associated with aminomethacrylate against the initial erosion and erosive wear in enamel. For this, 72 polished bovine enamel specimens were divided in six treatments: ultra-pure water (erosion negative control without abrasive challenge- ENC), ultra-pure water (abrasion negative control abrasion without toothpaste- ANC), toothpaste without active agent (placebo- PL), experimental toothpaste with aminomethacrylate (AMC- 4% - AMC), toothpaste with sodium fluoride (NaF- 1450 ppm F- - F), and experimental toothpaste with sodium fluoride + aminomethacrylate (NaF+AMC ­ AMC+F). The NC group was subjected to erosion only. The other groups were subjected to erosion + abrasion. Three response variables were analyzed: initial erosion with Knoop surface microhardness (KN) in the first day of the cycle; enamel loss with profilometric analysis (µm), and surface adsorbed fluoride concentration at the end of the cycle. The erosive/abrasive cycling consisted in immersion of the specimens in human saliva (1 h) to form the acquired pellicle, exposure to citric acid (0.3%) for 5 minutes (4x/day) and treatments application under abrasion (2x/day), with immersion in saliva in the intermediate periods (1 h), all the immersions were realized under constant agitation (30 rpm). This cycling was repeated for 5 days. The microhardness was assessed in four moments: KNinitial (sound enamel), KNE1 (after the first acid exposure), KNT (after the treatment), KNE2 (after the second acid exposure). With these values it was calculated rehardening potential (%Re =[(KNT-KNE1) / (KNE1)] x 100), and protective potential (%Prot = [(KNE2-KNE1) / (KNE1)]100). The profilometric analysis was performed before the first cycle and after the last cycle. Then, the difference between the initial and final profiles were calculated to the enamel loss. Representative specimens from each group were analyzed by scanning electron microscopy (SEM). The data was analyzed by One-Way ANOVA and Tukey Test (5%). The values regarding %Re were: ENC (3,11±4,09)a; ANC(1,62±11,38)a; PL (1,78±3,51)a; AMC (5,59±3,08)a; F (7,53±9,17)a; AMC+F(20,23±7,10)b. For %Prot were observed the values: ENC (-50,68±5,27)a; ANC (-49,71±6,43)a; PL (-51,65±3,74)a; AMC (-41,21±8,47)b; F (-34,10±5,99)b; AMC+F (-19,80±7,95)c. Enamel loss were reported by the following values: ENC (7,46±2,26)a,ANC (10,14±2,08)ab, PL (13,11±2,69)c, AMC (7,74±2,10)a, F (11,38±2,07)bc, AMC+F(7,52±2,59)a. Surface adsorbed fluoride concentration was assessed, and thefollowing values were found: ENC (0,160 ±0,069)a; ANC (0,179 ±0,034)a; PL (0,275±0,142)a; AMC (0,422 ±0,161)a; F (1,29 ±0,311)b; AMC+F (1,46 ±0,217)b. It wasconcluded that the addition of aminomethacrylate copolymer to toothpaste enhancesthe effect of sodium fluoride against initial enamel erosion and erosive wear(AU)

Effect of Commercial Children's Mouthrinses and Toothpastes on the Viability of Neonatal Human Melanocytes: An In Vitro Study.

In this study, we examined the cytotoxic effects of six commercial children's mouthrinses (designated as #1, #2, #3, #4, #5, and #6) and four commercial children's toothpastes (designated as #1, #2, #3, and #4) on primary human neonatal melanocytes that were used as a representative model for oral melanocytes. Mouthrinses diluted directly with culture medium (1:2, 1:5, 1:10, 1:100, and 1:1000) were added to monolayers of melanocytes for 2 min, followed by 24 h recovery, after which MTS cytotoxicity assay was conducted. The extracts of each toothpaste were prepared (50% w/v), diluted in culture medium (1:2, 1:5, 1:10, 1:50, 1:100, and 1:1000), and added to cell monolayers for 2 min (standard brushing time), followed by an analysis of cell viability after 24 h. Results showed that all mouthrinses except mouthrinse #4 showed significantly greater loss of cell viability, ascribed to cetylpyridinium chloride (CPC) that induced significant cytotoxicity to melanocytes (IC50 = 54.33 µM). In the case of toothpastes, the examination of cellular morphology showed that a 2 min exposure to all toothpaste extracts induced a concentration-dependent decline in cell viability, pronounced in toothpaste containing sodium lauryl sulfate (SLS) detergent. Further results suggested SLS to be the critical driver of cytotoxicity (IC50 = 317.73 µM). It is noteworthy that toothpaste #1 exhibited much lower levels of cytotoxicity compared to the other three toothpastes containing SLS. Taken together, these findings suggest that the melanocytotoxicity of children's mouthrinse (#4) and toothpaste (#1) is comparatively low. To the best of our knowledge, this is the first study to examine the impact of children's toothpastes and mouthrinses on neonatal primary human melanocytes. Future studies to investigate these findings in a realistic scenario replicating oral cavity conditions of the presence of microbiota, pellicle layer and saliva, and other cell types are warranted.

The effect of a multicomponent oral care regimen on gingival inflammation: A randomized controlled clinical trial.

BACKGROUND: Oral care regimens can be explored to improve oral health in patients with gingivitis. This study aimed to evaluate the efficacy of a multicomponent oral care regimen with a dual zinc plus arginine (DZA) toothpaste and cetylpyridinium chloride with zinc lactate (CPC + Zn) mouthwash in reducing gingival bleeding in patients with gingivitis. METHODS: This randomized clinical trial included 94 participants with gingivitis who were randomized into two groups: the DZA/CPC + Zn group, which used a 1450-ppm fluoride toothpaste containing 0.96% zinc plus 1.5% arginine and a fluoride-containing mouthwash with 0.075% CPC and 0.28% zinc lactate, and the control group, which used a 1450-ppm fluoride toothpaste and a placebo mouthwash for 6 months. All participants were examined by a blinded examiner who measured the gingival index, plaque index, and gingival severity index. Data were analyzed using paired t test, independent t test, and analysis of covariance (ANCOVA). RESULTS: Both groups presented statistically significant reductions in all clinical parameters compared to baseline. The DZA/CPC + Zn group exhibited significantly greater reductions in gingival index, gingival severity index, proximal gingival index, plaque index and proximal plaque index compared to the control group at 1, 3, and 6 months. Furthermore, DZA/CPC + Zn significantly decreased the percentage of patients with generalized gingivitis over a 6-month follow-up period. However, differences between the DZA/CPC + Zn and the control groups were not maintained after both groups established similar regimens with fluoride toothpaste. CONCLUSION: The multicomponent oral care regimen consisting of DZA toothpaste and CPC + Zn mouthwash is effective in reducing gingival inflammation and supragingival biofilm in patients with gingivitis.

Effects of a stabilized stannous fluoride dentifrice on clinical, immunomodulatory, and microbial outcomes in a human experimental gingivitis model.

BACKGROUND: Stannous fluoride dentifrice is well established for its beneficial clinical effects. In this study, we evaluated the effects of stannous fluoride on inflammation and oral microbiome. METHODS: In this randomized, parallel-arm, double-blind, controlled clinical trial, we compared clinical resolution of experimental gingivitis by evaluating bleeding on probing, gingival index, and plaque index between stannous fluoride stabilized with zinc phosphate (test) and sodium fluoride (control) dentifrices. Further, these groups were compared for oral neutrophil counts, systemic priming of neutrophils, gingival crevicular fluid (GCF) expression of inflammatory markers, and the oral microbiome. RESULTS: We found significant reduction in bleeding on probing in the test group compared to the control group in experimental gingivitis when participants used the test dentifrice prior to induction of experimental gingivitis. The test group also showed significant reductions in GCF levels of inflammatory markers (matrix metalloproteinase 8 [MMP8], receptor activator of nuclear factor kappa-Β ligand [RANKL]), oral polymorphonuclear neutrophil (PMN) counts, and systemic neutrophil priming (CD11b expression) during experimental gingivitis. Further, significant reductions in the gram-negative genera Porphyromonas, Tannerella, and Treponema were noted in the test group. CONCLUSION: The stannous fluoride stabilized with zinc phosphate dentifrice formulation demonstrated clinical reduction in gingival inflammation and a beneficial effect on microbiome and immune markers. This intervention should be explored as a preventive aid in the progression of plaque-induced gingivitis to periodontitis.

Description of a new laboratory evaluation method of interdental brush abrasion as a clinical hazard.

OBJECTIVES: To simulate the abrasive potential of an interdental brush when applied with toothpastes and prophylactic gels/solutions in a novel laboratory brushing simulation set-up. METHODS: A brushing device was customized to treat dentin samples mimicking a simplified interdental space with an interdental brush (ISO 2). The brushing, that is, 7200 strokes for 1 h, was performed with artificial saliva (control), a povidone-iodine solution, and slurries of chlorhexidine and fluoride gels as well as three toothpastes with different RDA values ranging from 29 to 100, respectively. The loss of dentin was profilometrically assessed and compared with ANOVA and Fishers LSD. RESULTS: While artificial saliva as control, the solution and the gel slurries showed no measurable dentin loss, toothpastes resulted in a measurable linear surface damage with respect to the actual intrinsic RDA values and ranged from 12.6 to 26.5 µm (p < 0.001). CONCLUSIONS: Any interdental cleaning product should be tailored and carefully instructed. Any over- and misuse should be avoided, which applies especially to the use of interdental brushes in combination with abrasive toothpastes.

Cytotoxicity and genotoxicity of whitening toothpastes in buccal mucosal cells: a randomized controlled trial.

OBJECTIVES: To assess genotoxic and cytotoxic effect of commercially available toothpastes with the different whitening ingredients. MATERIALS AND METHODS: In vivo assessment of cytotoxicity and genotoxicity of whitening toothpastes with different ingredients using a buccal micronucleus cytome assay (BMCyt assay) comprised 199 participants randomly divided into ten groups based on used whitening or control/conventional toothpaste. The exfoliated buccal mucosal cells were collected, stained, and microscopically evaluated at baseline (T0), 30 days (T1), and 60 days (T2) after the beginning of treatment and 30 days after completing treatment (T3). Statistical evaluation was performed by repeated-measures analysis of variance (two-way ANOVA), Tukey's test, and multiple regression analysis. RESULTS: The genotoxic parameters showed no biologically significant changes in any of the observed period for the tested toothpastes, while cytotoxic parameters (number of cells with karyorrhexis and condensed chromatin) showed statistically significant difference (P < 0.05) among evaluation periods for the three peroxide-containing toothpastes. CONCLUSIONS: Peroxide-containing whitening toothpastes exhibit an increase in certain cytotoxic parameters only during the application period, which return to control values after the cessation of application. CLINICAL SIGNIFICANCE: Whitening toothpastes show no genotoxic effect, while peroxide-containing whitening toothpastes may present significant increase of cytotoxicity (measured by the number of karyorrhexis and condensed chromatin) during the application period. However, these changes observed in clinical conditions cannot be considered significant. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04460755.

Interaction between Hexametaphosphate, Other Active Ingredients of Toothpastes, and Erosion-Abrasion in Enamel in vitro.

Sodium hexametaphosphate (HMP) as toothpaste additive is claimed to reduce erosive tooth wear and to stabilize stannous ions. However, little is known about the impact of concentration and its interactions with fluoride (F) or stannous+fluoride ions (F/Sn) on enamel erosion and erosion-abrasion. In a 10 day cyclic in vitro erosion-abrasion model, 320 flat human enamel specimens were divided into ten groups (n = 32 each) and daily subjected to six erosive challenges (0.5% citric acid, 2 min) and two toothpaste suspension applications (2 min, 1:3 F-free toothpaste:mineral-salt solution, 0.23% sodium gluconate). Half of specimens per group were additionally brushed twice/day (200 g, 15 s) during suspension immersion. Nine suspensions contained HMP (0.25%, 1.75%, 3.25%), either on its own or combined with F (373 ppm F-) or F/Sn (800 ppm Sn2+, 373 ppm F-). One suspension contained sodium gluconate only (NegContr). After 10 days, specimens' surfaces were analysed with profilometry, energy dispersive X-ray spectroscopy, and scanning electron microscopy. Tissue loss (µm, mean ± standard deviation) in NegContr was 10.9 ± 2.0 (erosion), 22.2 ± 1.6 (erosion-abrasion). Under erosive conditions, only 0.25% HMP in any combination and 1.75% HMP with F/Sn reduced loss significantly (-28% to -54%); 3.25% HMP without F and F/Sn increased loss significantly (+35%). With additional abrasion, no suspension reduced loss significantly compared to NegContr, instead, in groups without F and F/Sn or with 3.25% HMP loss was increased (+15% to +30%). Conclusively, at higher concentrations, HMP increased erosive tooth wear and seemed to reduce anti-erosive effects of fluoride and stannous ions.

Effectiveness of Herbal, Homeopathic and Conventional Dentifrices on Dental Caries - A Double-Blind Randomised Controlled Trial.

PURPOSE: To compare the effectiveness of ayurvedic, homeopathic and conventional dentifrices on plaque and saliva in terms of cariogenic bacteria, salivary pH, and plaque pH. MATERIALS AND METHODS: This double-blinded, parallel-group, randomised controlled trial was performed at Saveetha Dental College and Hospitals, Chennai, India. The participants comprised healthy adults possessing more than 20 permanent natural teeth and having a Decayed Missing and Filled Teeth (DMFT) score, plaque index score, and gingival index score less than or equal to 2. There were 3 intervention groups: 1: herbal dentifrice (Dabur Meswak); 2: homeopathic dentifrice (Gum Forte gel); 3: fluoride dentifrice (Colgate Total). The outcome measures were as follows: plaque and saliva samples were evaluated for pH; colony counts of Streptococcus mutans and Lactobacillus at baseline, 14 and 28 days of follow-up. One-way and repeated measures ANOVA, Wilcoxon signed-rank and Kruskal Wallis tests were used to compare the mean differences of plaque and salivary pH and plaque and salivary S. mutans and Lactobacillus counts at baseline, 14 and 28 days. RESULTS: The mean S. mutans and Lactobacillus counts in plaque and saliva decreased statistically significantly in all treatment groups at the 28-day follow-up. Mean plaque pH was not statistically significantly different at the 14-day follow-up (p-value = 0.16). On the 28th day, group 1 (7.64 ± 0.20) showed the highest increase in plaque pH followed by group 2 (7.39 ± 0.25) and group 3 (7.27 ± 0.19), which was found to be statistically significant. No statistically significant difference in mean salivary pH was observed between the three groups at the different time points. CONCLUSION: This study reveals that the herbal dentifrice tested here was effective in reducing cariogenic bacterial count and increasing the plaque pH, thereby warranting the usage of the same.

Qualitative Characterization of the Abrasive Component of Charcoal-Containing Toothpastes and the Effect on Dentin Roughness / Caracterización Cualitativa del Componente Abrasivo de las Pastas Dentales que Contienen Carbón Vegetal y la Rugosidad de la Dentina

This study investigated the effect of commercially available whitening toothpastes containing charcoal on dentin. Nine charcoal-containing toothpastes were compared with 3 whitening toothpastes (positive control) and distilled water (negative control). Periodontally hopeless molars were cleaned and washed and the occlusal table removed to expose dentin. The teeth were mounted in auto-polymerizing resin and exposed dentine surfaces polished with water-cooled decreasing grits of silica carbide paper up to 1500 grit. Baseline average roughness (Ra) measurements were taken. Specimens were then mounted in an automatic tooth-brushing machine and brushed for 5000 cycles. Repeat Ra measurements were taken. Specimens were brushed in 5000-cycle increments up to 25,000 cycles with Ra measurements being taken at each time point. Between abrasive challenges specimens were stored in distilled water. All toothpaste samples were sputter coated and examined under a scanning electron microscope to qualify the shape and size of the abrasive components of the formulations. Data were analyzed using a two-way analysis of variance with post hoc Bonferroni. The results demonstrated that the abrasive effect, in terms of increasing Ra, on dentin was noted as early as 5000 cycles for all the tested toothpastes (p<0.05). The effect of continued brushing showed an overall cumulative effect on dentine roughness up to 25000 cycles. When toothpastes were compared between groups at each time-point, dentin specimens brushed with Pursito were statistically similar to the control group. At 25,000 cycles all dentin samples were significantly rougher compared to Pursito and the control groups. It may be concluded that all the tested toothpastes have an abrasive effect on dentin surfaces.

Este estudio investigó el efecto sobre la dentina de las pastas dentales blanqueadoras disponibles en el mercado que contienen carbón vegetal. Se compararon nueve dentífricos que contenían carbón vegetal con 3 dentífricos blanqueadores (control positivo) y agua destilada (control negativo). Los molares sin material periodontal se limpiaron y lavaron y se retiró la tabla oclusal para exponer la dentina. Los dientes se montaron en resina autopolimerizable y las superficies expuestas de la dentina se pulieron con papel de carburo de sílice de grano decreciente enfriado con agua hasta grano 1500. Se tomaron medidas de rugosidad promedio (Ra) de referencia. Luego, las muestras se montaron en una máquina automática de cepillado de dientes y se cepillaron durante 5000 ciclos. Se tomaron medidas repetidas de Ra. Las muestras se cepillaron en incrementos de 5000 ciclos hasta 25 000 ciclos y se tomaron medidas de Ra en cada punto de tiempo. Entre periodos abrasivos, las muestras se almacenaron en agua destilada. Todas las muestras de pasta de dientes se recubrieron por pulverización catódica y se examinaron bajo un microscopio electrónico de barrido para calificar la forma y el tamaño de los componentes abrasivos de las formulaciones. Los datos se analizaron utilizando un análisis de varianza de dos vías de Bonferroni post hoc. Los resultados demostraron que el efecto abrasivo, en términos de aumento de Ra, sobre la dentina se notó ya en 5000 ciclos para todas las pastas dentales probadas (p<0,05). El efecto del cepillado continuo mostró un efecto acumulativo general sobre la rugosidad de la dentina hasta 25.000 ciclos. Cuando se compararon las pastas dentales entre los grupos en cada momento, las muestras de dentina cepilladas con Pursito fueron estadísticamente similares al grupo de control. A los 25.000 ciclos, todas las muestras de dentina eran significativamente más ásperas en comparación con Pursito y los grupos controles. Se puede concluir que todas las pastas dentales probadas tienen un efecto abrasivo sobre las superficies dentinarias.

Determination of bioavailable fluoride in toothpastes marketed in Medellín, Colombia, through capillary electrophoresis / Fluoruro biodisponible en cremas dentales comercializadas en Medellín ­ Colombia mediante electroforesis capilar

Currently, the FDI recommendation (World Dental Federation) for fluoride concen­tration in toothpastes is that the total fluoride content declared by manufacturers be between 1,000 and 1,500 ppm, and of this amount, at least 800 ppm should be bioavai­lable fluoride. The aim of this study was to describe the market of toothpastes marketed in Medellín and to measure the concentration of bioavailable fluoride by capillary elec­trophoresis to verify their compliance with the FDI recommendation for the prevention of dental caries. After sampling the toothpastes available for sale in the 16 communes of the city of Medellin, a single operator measured in triplicate the concentration of bioavailable fluoride in 36 samples of previously blinded toothpastes using the capi­llary electrophoresis (EC) technique. Most of the evaluated toothpastes that declared a content of 1,000­1,500 ppm fluoride met the recommendation of presenting at least 800 ppm bioavailable fluoride. Measurement of bioavailable fluoride in toothpastes with MFP (sodium monofluorophosphate) is recommended, as it is known that binding to the abrasive can decrease its concentration over time.

Actualmente la recomendación de la FDI (Federación Dental Internacional) sobre la concentración de fluoruro en cremas dentales es que el contenido de fluoruro total de­clarado por los fabricantes sea entre 1.000 y 1.500 ppm, y que de esta cantidad al menos 800 ppm sea fluoruro biodisponible. El objetivo de este estudio fue describir el mercado de las cremas dentales comercializadas en Medellín y medir en estas la concentración de fluoruro biodisponible por electroforesis capilar para verificar su cumplimiento de la recomendación de la FDI para la prevención de la caries dental. Luego de realizar un mues­treo en las 16 comunas de la ciudad de Medellín sobre las cremas dentales disponibles a la venta, un solo operador midió por triplicado la concentración de fluoruro biodisponible en 36 muestras de cremas dentales previamente cegadas, mediante la técnica de electroforesis capilar (EC). La mayoría de las cremas dentales evaluadas que declaraban contenido de 1.000 a 1.500 ppm de fluoruro, cumplieron la recomendación de presentar al menos 800 ppm de fluoruro biodisponible. Se recomienda realizar la medición del fluoruro biodisponible en las cremas con MFP, ya que se conoce que la unión al abrasivo puede disminuir su concentración en el tiempo.

Optimization of a Validated Protocol That Determines Bioavailable Fluoride in Toothpastes.

A validated protocol used to determine how much of total fluoride is bioavailable in toothpaste formulations was evaluated if it could be simplified regarding the following parameters: (1) concentration of the slurry (0.25-4%), (2) centrifugation speed (1,000-12,000 g) and time (1-10 min), and (3) incubation time for FPO32- ion hydrolysis and insoluble-F dissolution (15-60 min). Fresh and aged Na2FPO3/CaCO3 and fresh NaF/SiO2-based toothpastes were analyzed (n = 9). The improvements were the centrifugation at 1,000 g for 5 min is enough to separate insoluble-F and the time for FPO32- ion hydrolysis and insoluble-F dissolution can be shortened to 30 min.

The effect of whitening toothpastes on colour change and surface roughness of restorative materials

To examine the colour change and surface roughness of giomer, microhybrid composite and nanohybrid composite after brushing with whitening toothpastes. Disc-shaped samples of giomer, microhybrid composite and nanohybrid composite were divided into three subgroups(n=10), with the initial colour measured with a spectrophotometer and the surface roughness measured with a mechanical profilometer. The samples, which were immersed in coffee solution were brushed once a day with whitening toothpastes (Opalescence Cool Mint (OCM), Colgate Optic White Extra Power (COW) and Signal White Now Gold (SWN)) for 12 days. Colour change and surface roughness were measured again after the colouring-brushing cycle. All of the analyses were performed using appropriate statistical hypothesis tests. The highest increase in surface roughness was seen in the microhybrid composite group applied with SWN (p<0.05). The group with the least increase was the giomer group applied with SWN (p<0.05). While the least colour change was observed in the COW applied nanohybrid composite group (ΔE00=1,814), the most colour change occurred in the COW applied giomer group (ΔE00=5.943). After the use of whitening toothpastes, the roughness of giomer, microhybrid composite and nanohybrid composite surfaces was increased and a colour change above the clinically accepted value was observed.

El objetivo del presente estudio fue evaluar el cambio de color y la rugosidad de la superficie de giomer, resina compuesta microhíbrida y resina compuesta nanohíbrida posterior al cepillado con dentífricos blanqueadores. Las muestras en forma de disco de cada material se dividieron en tres subgrupos (n=10), con el color inicial medido con un espectrofotómetro y la rugosidad de la superficie medida con un perfilómetro mecánico. Las muestras, que se sumergieron en una solución de café, se cepillaron una vez al día con pastas dentales blanqueadoras (Opalescence Cool Mint (OCM), Colgate Optic White Extra Power (COW) y Signal White Now Gold (SWN)) durante 12 días. El cambio de color y la rugosidad de la superficie se midieron nuevamente después del ciclo de coloración-cepillado. El mayor aumento en la rugosidad de la superficie se observó en el grupo de la resina compuesta microhíbrida al que se le aplicó SWN (p<0,05). El grupo de menor incremento fue el grupo de giomer aplicado con SWN (p<0.05). Mientras que el menor cambio de color se observó en el grupo de resina compuesta nanohíbrida aplicado con COW (ΔE00=1,814), el mayor cambio de color ocurrió en el grupo de giomer con COW (ΔE00=5,943). Posterior al uso de pastas dentales blanqueadoras, la rugosidad del giomer, y de las resinas compuestas microhíbridas y nanohíbridas aumentó, siendo que se observó un cambio de color por encima del valor clínicamente aceptado.