Dental Plaque Removal and Re-Accumulation: A Clinical Randomized Pilot Study Evaluating a Gel Dentifrice Containing 2.6% Edathamil.

OBJECTIVES: The goal of this clinical study was to determine the effects of a dental gel containing 2.6% edathamil on overnight plaque re-accumulation and plaque removal. METHODS: In this double-blind, randomized crossover study, 10 subjects first brushed for one week with a washout toothpaste. On the evening of Day 7, prior to tooth brushing, Plaque Index (PI) was recorded, then plaque stained and photographed. Subsequently subjects were randomized to either brush with the test dental gel or the control. After overnight plaque accumulation, PI was recorded. Plaque was stained and photographed before and after subjects brushed with the same toothpaste as the previous night. Subsequently, the process was repeated with the second toothpaste. Image J software was used to quantify plaque presence. RESULTS: Mean increase in PI overnight after brushing (1.78 versus 0.94) and final PI after tooth brushing the next morning (2.20 versus 1.31) were significantly (p < 0.05) better after use of the test gel. Tooth surface covered by plaque overnight was significantly higher after using the control gel (22.3%) than the test gel (11.8%; p < 0.05). After morning brushing, the residual area of plaque on the teeth was significantly higher for the control gel (9.2%) than for the test gel (3.6%; (p < 0.05). CONCLUSIONS: A test dental gel more effectively reduced overnight plaque re-accumulation and achieved better plaque removal than a control dentifrice.

A Double-Blinded, Randomized Study Evaluating the In Vivo Effects of a Novel Dental Gel on Enamel Surface Microstructure and Microhardness.

OBJECTIVES: The objective of this study was to evaluate the in vivo effects of a 2.6% edathamil gel (Livionex® Dental Gel) on surface microhardness and microstructure in 180 pre-eroded enamel chips. METHODS: This was a double-blind, randomized study. Two enamel chips each were cut from 90 healthy sterilized extracted teeth. One chip from each pair underwent microhardness testing and scanning electron microscopy (SEM) to establish baselines. The remaining 90 samples were demineralized, and then mounted onto intra-oral retainers worn by nine subjects, with five chips mounted on each retainer for each of the two study arms. In one two-week study arm subjects brushed with the control toothpaste; in the other they used the test gel. Study arms were separated by a two-week washout. Sequence of toothpaste use was randomized. At the end of each study arm, samples underwent microhardness measurements (Knoop) and SEM visualization. RESULTS: After intraoral wear, enamel chips recovered fully from demineralization, with no significant difference in microhardness between the two treatments (p > 0.05). In SEM images, enamel surfaces at study's end also appeared comparable in the two groups. CONCLUSIONS: Pre-eroded enamel chips remineralized intra-orally to a similar level after using a control or a test toothpaste containing 2.6% edathamil.

Exploring Mechanisms of Biofilm Removal.

OBJECTIVE: The goal of this study was to evaluate the effects of a novel anti-plaque formulation on oral biofilm removal. Specific aim was to elucidate the role of 2 potentially complementary mechanisms on dental biofilm removal using EPIEN Dental Debriding Solution (EDDS) like desiccating action leading to denaturation and destabilization of plaque and mechanical removal of destabilized plaque through forceful rinsing action. MATERIALS AND METHODS: 25 extracted teeth, after routine debriding and cleaning, underwent standard biofilm incubation model over 4 days. Then samples were randomly divided into 5 groups of 5 teeth each, treated and stained with GUM®Red-Cote® plaque disclosing solution and imaged. Samples were subsequently treated with HYBENX® Oral Decontaminant. Group 1 samples were treated with a standardized "static" water dip exposure following biofilm incubation. Samples in Group 2 were given a standardized "dynamic" exposure to a dental high pressure air/water syringe for 20 s. Group 3 samples were exposed to a standardized "static" application of test agent (30 s dip rinse) followed by a standardized "static" water rinse (30 s dip rinse). Samples in Group 4 were given both the standardized "static" application of test formulation followed by the standardized "dynamic" exposure to a dental high pressure air/water syringe. Finally, samples in Group 5 were treated with a standardized "dynamic" application of test agent (20 s high pressure syringe at 10 ml/s) followed by the standardized "dynamic" exposure to a dental high pressure air/water syringe. RESULTS: The MPM images demonstrated that the water dip treatment resulted in the persistence of an almost continuous thick layer of biofilm coverage on the tooth surface. Similarly, test agent dip treatment followed by water dip only removed a few patches of biofilm, with the majority of the tooth surface remaining covered by an otherwise continuous layer of biofilm. Samples exposed to air/water spray alone showed some disruption of the biofilm, leaving residual patches of biofilm that varied considerably in size. Test agent dip treatment followed by air/water spray broke up the continuous layer of biofilm leaving only very small, thin scattered islands of biofilm. Finally, the dynamic test agent spray followed by air/water spray removed the biofilm almost entirely, with evidence of only very few small, thin residual biofilm islands. CONCLUSION: These studies demonstrate that test agent desiccant effect alone causes some disruption of dental biofilm. Additional dynamic rinsing is needed to achieve complete removal of dental biofilm.