PubMed Health⌕ Search

Biomedical subjects

H R Pape

Publications and source records attributed to H R Pape.

12 recordsLinked to original sources
PubMed1998

A descriptive report of the effects of a 16-month xylitol chewing-gum programme subsequent to a 40-month sucrose gum programme.

A previous caries trial (Belize studies) involved the usage of sucrose chewing-gum for a period of 40 months in one group of initially 10-year-old subjects in an environment of high sugar consumption, high caries activity, and limited access to restorative care. After the termination of the 40-month supervised sucrose gum usage, the 109 subjects of the original sucrose group retrieved at the endpoint of the original trial were invited to participate in a xylitol chewing-gum programme (involving the usage of the '100% pellet-shaped formular') for 16 months. The average daily consumption level of xylitol was up to 14 g per subject, normally used in seven daily chewing episodes. Although most subjects used chewing-gum at schools and received their gum portions from a school official, gum chewing during these 16 months was mostly unsupervised. After 16 months, 83 subjects (76%; mean age 14.9 years) were retrieved. The caries status of these subjects was examined by the same calibrated, blinded examiners as in the original trial. To mask the examiners, 141 similar non-participating subjects were recruited from the same school classes and were examined in a random order with the gum-using subjects, according to the same standard routine. The intensified xylitol gum usage for 16 months was associated with a reduction of the mean DMFS score from 10.9 (at 40 months) to 9.3 (at 56 months, p = 0.0013) and a reduction in caries rate from 20.1 caries onsets per 1,000 surface-years (40-month period average rate) to 10.2 caries onsets per 1,000 surface-years. The reduction in DMFS score resulted mostly from the change in the D component of the index and possibly reflected a stabilisation of the caries process and rehardening of some caries lesions to a non-progressive carious state.

Adolescent↗
PubMed1996

Properties of whole saliva and dental plaque in relation to 40-month consumption of chewing gums containing xylitol, sorbitol of sucrose.

Samples of whole saliva and dental plaque were collected from initially 10-year old subjects who participated in a 40-month cohort study investigating the effect of chewing gum usage on caries rates. The subjects represented nine cohorts of which one did not receive gum, while in eight cohorts the subjects received gum containing either xylitol, sorbitol, their mixtures, or sucrose as bulk sweeteners, the maximum sweetener consumption in the form of gums being up to 10.7 g/day, used in 3-5 daily chewing episodes. Gum usage had no significant effect on the levels of salivary protein, IgA, alpha-amylase, peroxidase, lysozyme, SCN and buffer capacity. At the endpoint, the group that received 100% xylitol pellet-shaped gum five times/day, had significantly lower levels of sucrase (p <0.05) and free sialic acid (p < 0.001) in whole saliva than at baseline. This group showed significantly (p <0.05) smaller plaque index scores at two cross-sectional measurements, and exhibited the lowest log(10) counts of salivary lactobacilli at endpoint than most other groups. The salivary levels of peptidase(s) (oligopeptidase B-like enzymes) hydrolyzing N-alpha-benzoyl-DL-arginyl-p-nitroaniline were significantly (p<0.05) or almost significantly lower in groups which received 100% xylitol pellet gums. All groups exhibited obviously an aging-related increase of salivary mutans streptococcus scores, except the above xylitol group in which the mean scores did not change.

Aniline Compounds↗
PubMed1996

Conclusion and review of the Michigan Xylitol Programme (1986-1995) for the prevention of dental caries.

The major results of the Michigan Xylitol Programme (1986-1995) are summarised. The Programme consisted of several clinical trials and laboratory investigations designed to study the usage of xylitol-containing saliva stimulants in the prevention of dental caries. The trials patients included young (initially 6 year olds) and adult or geriatric subjects who were given saliva stimulants (mostly chewing gum) for periods of two weeks to 56 months. A special rationale behind these studies was the need to further test the validity of the 'pentitol-hexitol theory' in the prevention of caries. This theory has maintained that pentitols (sugar alcohols with five hydroxyl groups, such as xylitol) may be cariologically more effective than hexitols (sugar alcohols with six hydroxyl groups, such as sorbitol). The accumulated clinical, sialochemical and microbiologic evidence suggests that xylitol, a natural carbohydrate sweetener of the pentitol type, is more effective in preventing dental caries than sorbitol, and cariologically safer than sorbitol, a natural carbohydrate of the hexitol type. Sorbitol was found to be significantly less cariogenic than sucrose. The Programme's results shed additional light on the cariologic and oral biologic effects of natural, dietary polyols, and suggest that the usage of xylitol chewing gum (and in some cases xylitol dragées) can be considered a valuable additional tool in caries prevention and in stabilisation of caries in all age groups.

Adolescent↗
PubMed1995

Do caries explorers transmit infections with persons? An evaluation of second molar caries onsets.

UNLABELLED: Dental caries explorers may become contaminated during routine caries examinations with pathogenic organisms and thereby potentially transmit infections from one tooth to another within a patient. The purpose of this study was to test the hypothesis that the contamination status of explorers influenced the caries risk of second molars. Two explorer contamination statuses were defined: (1) contamination status 1--explorers which had probed a carious molar just prior to examining the second molar, and (2) contamination status 2--sterile explorers versus explorers which had probed several teeth. Caries examinations were performed by 4 dentists on a cohort of 4th grade students in Belize City. The examination dates and sample sizes (n) were: September-October 1989 (n = 1,277), January 1991 (n = 1,111), and January 1992 (n = 961), and January-February 1993 (n = 861). Within this cohort, there were 221 subjects who (1) had at least one pit and fissure carious onset on a caries-free second molar, (2) had no evidence of dental treatments, and (3) were examined by the same examiner during the entire study. After adjusting for confounding variables, the examination of a second molar with a dental caries explorer in either contamination status 1 or 2 had no substantial effect on the caries risk (rate ratio 0.95, 95% confidence interval: 0.77-1.18, and rate ratio 1.18, 95% confidence interval: 0.89-1.56, respectively). If a true rate ratio of 1.7 or greater was associated with the contamination status 1 and 2, these analyses had more than 99 and 80% probability of detecting it, respectively. CONCLUSIONS: Examining a sound second molar with a contaminated dental explorer either does not affect the caries risk, or results in such a small increase in caries risk that it can only be reliably identified in studies where the exposure of sound teeth to contaminated dental explorers is randomized.

Child↗
PubMed1995

Xylitol chewing gums and caries rates: a 40-month cohort study.

Dental caries is a pandemic infectious disease which can affect the quality of life and consumes considerable health care resources. The chewing of xylitol, sorbitol, and even sugar gum has been suggested to reduce caries rates. No clinical study has simultaneously investigated the effectiveness of these gums when compared with a group receiving no chewing gum. A 40-month double-blind cohort study on the relationship between the use of chewing gum and dental caries was performed in 1989-1993 in Belize, Central America. One thousand two hundred and seventy-seven subjects (mean age, 10.2 years) were assigned to nine treatment groups: one control group (no supervised gum use), four xylitol groups (range of supervised xylitol consumption: 4.3 to 9.0 g/day), two xylitol-sorbitol groups (range of supervised consumption of total polyols: 8.0 to 9.7 g/day), one sorbitol group (supervised consumption: 9.0 g/day). The gum use during school hours was supervised. Four calibrated dentists performed the caries registrations by means of a modified WHO procedure. The primary endpoint was the development of an unequivocal caries lesion on a non-cavitated tooth surface. Compared with the no-gum group, sucrose gum usage resulted in a marginal increase in the caries rate (relative risk, 1.20; 95% confidence interval,0.96 to 1.49; p = 0.1128). Sorbitol gum significantly reduced caries rates (relative risk 0.74; 95% confidence interval, 0.6 to 0.92 ; p = 0.0074). The four xylitol gums were most effective in reducing caries rates, the most effective agent being a 100% xylitol pellet gum (relative risk, 0.27; 95% confidence interval, 0.20 to 0.36; p = 0.0001). This gum was superior to any other gum (p < 0.01). The xylitol-sorbitol mixtures were less effective than xylitol, but they reduced caries rates significantly compared with the no-gum group. DMFS analyses were consistent with these conclusions. The results suggest that systematic usage of polyol-based chewing gums reduces caries rates in young subjects, with xylitol gums being more effective than sorbitol gums.

Belize↗
PubMed1995

Stabilisation of rampant caries: polyol gums and arrest of dentine caries in two long-term cohort studies in young subjects.

The purpose of this paper is to report clinical observations on the stabilisation of dentine caries in two chewing gum studies carried out in young subjects. One study focused on the permanent dentition of 1,277 initially 10-year old subjects, while the other study was carried out on 510 initially 6-year old subjects and focused on the primary dentition. In both trials, several chewing gum formulas containing dietary polyols (xylitol and sorbitol, or their combinations) were used for up to 40 months (10-year olds) or up to 24 months (6-year olds). The daily consumption level of both polyols was up to 10.7 g per subject, used normally in 5-minute chewing episodes 3 to 5 times per day. Supervised chewing in schools lasted 5 min per episode, and for variable times during non-school days. Rehardening of dentine caries lesions was observed clinically by experienced, blinded examiners using sharp dental explorers and fibre optic light. After 40 months (permanent dentition) or after 18 months (primary dentition), rehardening (caries arrest) generally occurred more frequently in subjects who used polyol gums than in subjects who did not receive gum as part of the programmes, or who received sucrose gum. Arrest or non-progression of dentine caries was most frequently observed in subjects who used 100 per cent xylitol gums or mixtures of xylitol and sorbitol, but the differences between gums were not consistently significant. However, the usage of 100 per cent xylitol pellet-shaped gum was more frequently associated with arrest of dentine caries than other treatments. These results and previous studies suggest that high-xylitol chewing gum usage can retard or arrest even rampant dentine caries in conditions where effective restoration and prevention programmes have not been instituted, and can also provide additional protection against further caries development during full implementation of restorative procedures by holding the lesion in a non-progressive condition.

Belize↗
PubMed1992

Effect of slow-release chlorhexidine mouthguards on the levels of selected salivary bacteria.

This study evaluated the effect of an alternate delivery system for chlorhexidine on salivary levels of mutans streptococci (MS) and other selected oral bacteria. On the basis of salivary MS levels > or = 10(4) CFU/ml, 22 subjects were enrolled. All caries lesions were restored prior to treatment. Two pretreatment paraffin-stimulated saliva samples were obtained for culturing at least 1 week apart. Complete-arch vacuum-adapted mouthguards were individually fabricated and coated internally with a 3% w/v chlorhexidine varnish. Mouthguards were worn for an average of 7 h/night for 7 nights. Saliva samples were obtained immediately after treatment and 1 and 3 months later. There was no significant change in levels of any of the monitored bacteria between the two pretreatment samples. A significant and specific reduction in salivary MS levels was observed in the three after-treatment samples as compared with baseline values (p < 0.001, p < 0.001, p < 0.05, respectively). The levels of Actinomyces viscosus were also measured, and there was a significant reduction immediately after treatment (p < 0.05), a return to baseline values at 1 month, and a significant increase above baseline values at 3 months, (p < 0.001). There was no significant change in saliva volume, in total numbers of facultatively anaerobic bacteria, or in levels of lactobacilli or Streptococcus sanguis. This treatment system is capable of significant and specific suppression of MS levels for up to 3 months without retreatment.

Actinomyces viscosus↗
PubMed1989

Effect of sorbitol, xylitol, and xylitol/sorbitol chewing gums on dental plaque.

The effect of sorbitol (SOR), xylitol (XYL), and the mixture XYL/SOR in chewing gums on dental plaque was studied in three groups of 7 adults (mean age 22.5 years). A fourth group of habitual users of sucrose-containing gums was used as a control. The study involved a 2-week, no-gum period followed by the use of the polyol gums for 2 weeks (10 gums/day in 5 2-gum doses). The daily consumption of XYL and SOR in the XYL and SOR groups was 10.9 g, whereas in the XYL/SOR group, 8.5 and 2.4 g of these polyols were used per day. At the end of the gum period the acidogenic response of the 48-hour plaque was tested using a 10-ml mouthrinse containing the polyols (10% w/v) present in the experimental gums, followed by a 10-ml rinse of 10% (w/v) sucrose solution. The plaque of the subjects who used XYL and XYL/SOR gums showed a significantly better ability to resist pH drops induced by the sucrose rinse than the plaque in the SOR gum group. No changes in resting pH values were observed in the XYL and XYL/SOR groups, whereas the use of SOR gum was associated with significantly lower pH values. The amount of plaque decreased in the XYL/SOR (24.3%) and the XYL (29.4%) groups, but increased in the SOR (48.3%) group, the changes in the SOR group differing significantly from those found in the other groups. The plaque and saliva levels of Streptococcus mutans generally increased in the SOR group, but decreased in groups which used XYL.

Adult↗
PubMed1979

Intraoral transmission of Streptococcus mutans by a dental explorer.

A streptomycin-resistant strain of S. mutans was introduced into the mouth as adherent growth on an artificial fissure (AF). A second AF, which was initially sterile, was placed in a crown on the opposite side of the dentition. The labeled strain was not found in 8 initially-sterile AFs which were left in vivo for 2 to 6 days and were not examined with a dental explorer. The labeled strain was detected in 7 of 9 initially-sterile AFs which were probed with the dental explorer.

Adult↗
PubMedDate not supplied

Verification and maintenance of dental explorer sharpness.

An ongoing study of the relationship between different chewing gums, remineralization, and caries rates was started in 1989 in Belize, Central America. Initially 1277 children, age 10 years, were assigned in equal randomized groups to four dentists who had been trained to identify a standard of caries diagnosis. The same children were examined according to a modified WHO caries code by the same dentist in each of the three subsequent years. To eliminate one possible variable, all 200 dental explorers used were examined under a X20 binocular Bausch and Lomb dissecting microscope initially and at each exam period. Any explorer not comparable to an explorer that was originally marked and kept unused as a standard was sharpened by hand on an Arkansas oilstone wetted with engine oil for lubrication. Explorers that could not be restored to a condition comparable at X20 to the standard were discarded. Approximately 10% of the explorers needed correction at each exam period and about 1% were discarded. In any study related to dental caries evaluation with dental explorers or comparison of explorer use versus nonuse, verification and maintenance of sharpness of used and even new dental explorers should be addressed to remove that factor as a possible variable.

Child↗