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Biomedical subjects

L Netuschil

Publications and source records attributed to L Netuschil.

At least 19 recordsLinked to original sources

Effect of two new chlorhexidine mouthrinses on the development of dental plaque, gingivitis, and discolouration. A randomized, investigator-blind, placebo-controlled, 3-week experimental gingivitis study.

OBJECTIVE: The aim of this experimental gingivitis study was to assess the efficacy and safety of two new chlorhexidine (CHX) mouthrinses. MATERIAL AND METHODS: Ninety volunteers participated in this investigator-blind, randomized, clinical-controlled trial in parallel groups. During the treatment period, no oral hygiene measures except rinsing with non-alcoholic 0.2% CHX or 0.2% CHX/0.055% sodium fluoride mouthrinses, a positive control, or a negative control were permitted. The primary parameter was the gingival index; the secondary parameters were plaque index, discolouration index, and bleeding on probing. Clinical examinations were conducted 14 days before the start of the study, at baseline, and after 7, 14, and 21 days. The two sample t-test, anova, and ancova were used for the statistical analysis. RESULTS: No difference in efficacy was found between the two new CHX formulations and the positive control. On day 21, statistically significantly less gingival inflammation and plaque accumulation compared with placebo were observed. Besides discolouration and taste irritations, no adverse events were recorded. CONCLUSION: The two new CHX mouthrinses were able to inhibit plaque re-growth and gingivitis. Neither the omission of alcohol nor the supplementation with sodium fluoride had weakened the clinical efficacy of CHX with respect to the analysed clinical parameters.

Adolescent↗

How to select the right mouthrinses in periodontal prevention and therapy. Part I. Test systems and clinical investigations.

The use of mouthrinses is increasing, especially as adjuncts to the daily mechanical oral hygiene. Different test systems may and can be used to test their antibacterial and clinical effects: bacteriology in vitro, substantivity in vivo, 4-day plaque re-growth, experimental gingivitis and long-term use. The plaque re-growth investigations of a few days are not only of limited use but may also be dangerous because often too extensive conclusions have been drawn from their design. The 'gold standard' test is the experimental gingivitis model to reveal the antiplaque as well as the antigingivitis effects of any mouthrinse preparation during 3 weeks. The last kind of investigations are of several months' duration, where the substances are used as supplements to mechanical oral hygiene measures.

Anti-Infective Agents, Local↗

How to select the right mouthrinses in periodontal prevention and therapy. Part II. Clinical use and recommendations.

Based on scientific proof, only few mouthrinse solutions can be recommended. However, it is impossible to construct an extended table that would provide precise recommendations or advices for mouthrinse utilisation related to any possible discomfort or diseases. Only reliable information on the drugs available against periodontal disease can be offered to the therapist. By evaluation of her or his individual experiences, she or he has to judge all the armamentarium she or he possesses to react in the best possible way in each specific situation.

Anti-Infective Agents, Local↗

Effect of a toothpaste containing triclosan on dental plaque, gingivitis, and bleeding on probing--an investigation in periodontitis patients over 28 weeks.

The aim of this double-blind, 28-week study was to evaluate the plaque-inhibitory and antigingivitis efficacy of a fluoride toothpaste containing 0.3% triclosan and essential oil (Dental Kosmetik, Dresden, Germany) in comparison with a control toothpaste. One hundred twenty subjects previously treated for chronic periodontitis were included in the study. At baseline, 8, 18, and 28 weeks, plaque accumulation (PlI) and gingival status (GI) were assessed. Probing pocket depth (PD) and bleeding on probing (BOP) were measured at baseline and week 28 using a Florida probe. No professional hygiene was delivered during the study period. Mean plaque scores decreased between baseline and week 8 in both groups. At the end of the study, a significant increase of mean PlI compared to baseline could be observed in the test and in the control groups. Comparing the two groups, the PlI in the triclosan group was significantly lower than in the control group. Mean gingival scores decreased significantly during the first 8-week period in both groups. This reduction was followed by an increase of GI in the control, while the GI in the test group reached a significantly lower value than in controls after 28 weeks. Furthermore, at week 28, in both groups the PD were decreased as compared to the pre-study data. It is concluded that the triclosan/essential oil additive in a fluoride-containing dentifrice exhibited distinctive antigingivitis as well as plaque-inhibitory effects during a 28-week maintenance period in periodontitis patients.

Adult↗

Effect of an amine-fluoride-triclosan mouthrinse on plaque regrowth and biofilm vitality.

BACKGROUND: The purpose of this double-blind, prospective, latin-square crossover randomised study was to examine the efficacy of a mouthrinse solution containing a combination of triclosan, amine fluoride and sodium fluoride on supragingival plaque regrowth compared to a placebo and a chlorhexidine solution. METHODS: 12 volunteers refrained after professional oral prophylaxis from all mechanical hygiene measures for the following 96 h and rinsed instead cross-over in a randomised order with either chlorhexidine digluconate (0.2%, positive control), a verum solution (0.5% amine fluoride, 0.028% sodium fluoride, 0.03% triclosan) or a placebo solution. The plaque index was assessed after 24 and 96 h (PI 1, PI 2) and the plaque area (PA) photographed and calculated after 96 h of undisturbed plaque regrowth. Moreover plaque samples were taken after 24 and 96 h and examined with the vital fluorescence technique to assess the vitality of the biofilm microbiota (VF 1, VF 2). RESULTS: The amine-fluoride-triclosan solution reduced the clinical parameters (PI and PA) as well as the vitality of the plaque flora (VF) significantly when compared to the placebo solution. The verum reached a 36.5% (p<0.05) and a 39.8% reduction (p<0.0001) in PI 1 and PI 2, respectively, concomittant with a reduction of 23.8% and 32.2% (p<0.001) in VF 1 and VF 2 and of 46.9% (p<0.0001) in PA at day 4. This was less than the reductions found with the positive control, i.e., the 0.2% chlorhexidine solution (54.2% and 71.1% reduction in PI 1 and PI 2, 40.0% and 53.4% in VF 1 and VF 2 and 71.5% in PA). However, significant differences between both active solutions were only established for PI 2 and PA. CONCLUSION: During 4-day plaque regrowth the amine-fluoride-triclosan product displayed a significant antibacterial and plaque-reducing action in comparison to the control.

Adolescent↗

Clinical controlled study on plaque and gingivitis reduction under long-term use of low-dose chlorhexidine solutions in a population exhibiting good oral hygiene.

The aim of this randomized, parallel-group, placebo-controlled, blind clinical study was to examine the dental plaque and the gingivitis inhibitory effects of two low-dose 0.06% chlorhexidine (CHX) preparations in comparison to a commercially available 0.1% CHX solution, an amine fluoride/stannous fluoride (ASF) solution and a water control as an adjunct to the daily mechanical oral-hygiene measures. After prophylaxis, 81 medical students performed their tooth cleaning and were asked to rinse for 30 s, according to the instructions given by the manufacturers with the assigned amount of the following solutions: once daily 10 ml ASF 250 ppm or twice daily each 10 ml CHX 0.06% with fluoride, 10 ml CHX 0.06% without fluoride, 15 ml CHX 0.1% or 100 ml tap water. The plaque index (PlI), the gingival index (GI) and the discoloration index (DI) were taken at day -14 and months (M) 0, 1, 2, 3 and 6. In this study group with good oral hygiene, all test products led to a reduction of the PlI scores when used as supplements to the usual mechanical hygiene measures. At M3 subjects using both the 0.1% as well as the 0.06% CHX showed significantly less plaque accumulation than those using ASF. In the GI a significant difference between the control and 0.1 % CHX was found at M3 and at M6. If a further decrease in the GI is wanted, a minimum concentration of 0.1% CHX for long-term use in association with habitual cleaning is needed, which, however, should be limited to special patients. If maintaining clinical health is the goal, the other solutions are a good alternative to 0.1% CHX because they exhibit less staining.

Adolescent↗

Spatial distribution of vital and dead microorganisms in dental biofilms.

To examine the spatial structure of dental biofilms a vital fluorescence technique was combined with optical analysis of sections in a confocal laser scanning microscope (CLSM). Enamel slaps were worn in intraoral splints by three volunteers for five days to accumulate smooth-surface plaque. After vital staining with fluorescein diacetate and ethidium bromide the specimens were processed for CLSM examination. Optical sections 1 microm apart were analysed in the z-axis of these dental biofilms. One of the films was 15 microm high, sparse and showed low vitality, i.e. <16%, while the others were taller (25 and 31 microm) and more vital, i.e. up to 30 and 69%, respectively. In all instances the bacterial vitality increased from the enamel surface to the central part of the plaque and decreased again in the outer parts of the biofilm. The spatial arrangement of the microorganisms in the biofilm showed voids outlined by layers of vital bacteria, which themselves were packed in layers of dead material.

Biofilms↗

Alcohol-free mouthrinse solutions to reduce supragingival plaque regrowth and vitality. A controlled clinical study.

BACKGROUND: The aim of this study was to evaluate the clinical and antibacterial properties of alcohol-free mouthrinses, an amine fluoride/stannous fluoride mouthrinse (ASF) and two triclosan solutions in comparison with a chlorhexidine and a placebo rinse. MATERIAL AND METHODS: In a double-blind, randomised 5-cell cross-over 4-day plaque regrowth study, 19 volunteers rinsed 2 x a day with 15 ml of each of the distributed solutions. Each test cycle was followed by a 10 days wash-out period. On day 0 of each test week, volunteers received a dental prophylaxis. Thereafter they refrained from all mechanical oral hygiene procedures for the next four days. Plaque regrowth was assessed daily by the plaque index and on day 4 by calculating the plaque area with a computer program after disclosure and photography of the front teeth. The vitality of the plaque was examined on days 1 to 4 by the vital fluorescence technique. RESULTS: 19 participants completed the study. Compared to the placebo the ASF solution showed 15.7% (p>0.5), 30.6% (p<0.001), 40.5% (p<0.001) and 44.7% (p<0.001) reductions on the consecutive days 14 in plaque index and a reduction of 61.9% in plaque area. The decrease of vitality of supragingival plaque was highly significant compared to placebo on every test day ranging between 30.9% and 36.6%. A reduction in plaque index from 19.4% (p<0.01) on day 2, 34.9% (p<0.001) on day 3 and 40.4% (p<0.001) on day 4 concommitant with a reduction in plaque area of 48.9% (p<0.001) was noted for alcohol-free chlorhexidine. Concerning the vitality chlorhexidine reduced the percentage of vital bacteria significantly on every day (16.0% to 24.9%). The reductions in mean plaque index for the 0.15% triclosan solution during the test period were 6.3%, 22.4%, 24.6% and 36% and in plaque area 41.8%. Vitality was significantly reduced at every day compared to placebo. Plaque Index reduction with the 0.02% triclosan increased from 15.3% (day 2) to 31.0% (day 4) and a reduction of 23.6% was seen in plaque area. A significant effect concerning the vitality of the plaque was only found at the first and the last day of the test cycle. CONCLUSION: Alcohol-free mouthrinse solutions were shown to be effective in reducing both plaque accumulation and plaque biofilm vitality compared to a placebo solution.

Adult↗

The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. A randomized prospective study. Part II: Bacteriological parameters.

In a prospective plaque regrowth study focusing on oral hygiene during fixed appliance therapy 12 adolescent patients (mean age 14.1 +/- 1.5 years) were evaluated twice over 2-day test periods. In the randomized, double-blind study the influences of a 0.2% chlorhexidine mouthrinse (Corsodyl, CHX) and a commercially available dentifrice supplementing fluoride (Odol-med-3) were compared intra- and interindividually in a crossover design with regard to the bacteriological parameters. The bacteriological parameters of vital fluorescence, bacteriological counts (BC), colony forming units (CFU), plating efficiency (PE) and mutans streptococci (MS) were related to the clinically assessed indices of plaque and gingivitis. All parameters analyzed demonstrated significant differences between the control and the test (chlorhexidine) group. Where-as the values of BC, CFU, and PE progressively increased in the control group from T0 to T2, these parameters distinctly decreased in the chlorhexidine group. All values of vital flora (VF) scored around 75% in the control group compared to values of 30% in the test group. BC, CFU und PE correlated significantly. The score of mutans streptococci persisted or increased in the controls whereas mutans streptococci approached 0 in the chlorhexidine group. Until the 5th day of washout a clear-cut carry over of the chlorhexidine rinse on mutans streptococci as well as on the gingival index was evident. Since dead microorganisms remain on the tooth surface and in order to maintain oral health, chlorhexidine application might advisedly be supplemented by mechanical plaque control.

Adolescent↗

The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. A randomized prospective study. Part I: clinical parameters.

In a prospective plaque regrowth study focusing on oral hygiene during fixed appliance therapy 12 adolescent patients (mean age 14.1 +/- 1.5 years) were evaluated twice over 2-day test periods. In the randomized, double-blind study the influence of a 0.2% chlorhexidine (CHX) mouthrinse (Corsodyl) and a commercially available dentifrice supplementing fluoride (Odol-med-3) were compared intra- and interindividually in a crossover design with regard to plaque and gingivitis. Before starting the first test phase there was a 14-day preliminary phase for upgrading the oral hygiene. Between the 2 test phases was a 5-day "washout". On the last day of the second test phase the patients were asked to fill in a questionnaire concerning their experiences during the study. The 0.2% Corsodyl reduced the plaque index scores significantly (p < 0.001). The gingival index revealed a similar reduction (2nd day of test: p = 0.03). Until the 5th day of washout a clear-cut carryover effect of the chlorhexidine rinse on the gingival index was observed. Both the lower mean values of the 2 clinical parameters at the beginning of the test phases as compared with those at the beginning of the preliminary phase and the evaluation of the questionnaires indicated a possible Hawthorne effect. 0.2% Corsodyl may be employed as an adjunct to other preventive measures such as professional care and patient-oriented instruction on an intermittent basis in order to reduce the plaque-induced iatrogenic side effects and to enhance the efficacy of oral hygiene measures in connection with orthodontic therapy with fixed appliances.

Adolescent↗

Clinical and antibacterial effect of tea tree oil--a pilot study.

The aim of this clinical pilot study was to compare the effect of tea tree oil with the effect of water and chlorhexidine on supragingival plaque formation and vitality. Eight subjects were asked to refrain from any kind of mechanical oral hygiene for 4 days after professional tooth cleaning (day 0), and to rinse with water instead for 1 week, with chlorhexidine in a second and tea tree oil in a third test week. The plaque index (PI), which was evaluated daily (days 1-4), served as a clinical control parameter. On the last day of the study (day 4), the plaque covering the front teeth was stained, photographed, and therefrom the plaque area (PA; %) was estimated using a digital measuring system. Each day of the study (days 1-4), the sampled plaque was examined using a vital fluorescence technique. Tea tree oil reduced neither the clinical parameters (PI and PA) nor the vitality of the plaque flora significantly. Within the limitations of the study design, it was determined that a solution with tea tree oil--utilized as ordinary mouthwash--has no positive effect on the quantity or quality of supragingival plaque.

Adult↗

A pilot study of confocal laser scanning microscopy for the assessment of undisturbed dental plaque vitality and topography.

Confocal microscopy and vital fluorescence techniques were combined for the first time to investigate ex vivo human dental plaque. The vital fluorescence technique used discriminates vital from dead cells, while confocal laser scanning microscopy allows the optical sectioning of undisturbed biofilms leaving the samples intact during analysis. The concomitant use of both methods made an examination of the three-dimensional architecture of dental plaque possible. The topography of plaque biofilms that were allowed to accumulate in situ on glass and enamel was recorded. The distribution of plaque microflora vitality as well as its accumulation varied according to plaque age. A plaque thickness of up to 8, 35 and 45 microm was estimated ex vivo on enamel after 1, 2 and 3 days, respectively. Young and sparse plaque biofilms consisted mainly of dead material. Vital bacteria were observed on top of this dead layers.

Dental Plaque↗

An approach to differentiate between antibacterial and antiadhesive effects of mouthrinses in vivo.

An experimental set-up allowing differentiation in vivo between antibacterial and antiadhesive properties of mouthrinses is described. The percentage of vital bacteria (= microbial vitality) and the bacterial counts were microscopically evaluated in saliva and in supragingival dental plaque both collected simultaneously at various times during de novo plaque formation. In a cross-over design, 12 healthy participants refrained from all oral hygiene for four separate periods of 2 x 4 h and 2 x 72 h after having rinsed with either an amine fluoride/stannous fluoride solution (Meridol) or 0.9% NaCl (placebo). Stimulated whole saliva was collected before and after the rinse. Together with whole-saliva samples, representative 4, 24 and 72-h-old plaque samples were separately taken from defined vestibular tooth surfaces that had been either exposed to the mouthrinse (unprotected sites) or temporarily covered with inert plastic films (protected sites) during rinsing. The pooled plaque and saliva were stained with fluorescent dyes to differentiate vital from dead micro-organisms which permitted the estimation of the percentages of vital bacteria. The total bacterial counts were quantified under the darkfield microscope. The Wilcoxon test was used for selected pairwise comparisons (alpha = 0.05). The percentage of vital bacteria in saliva fell significantly from 80-95% to about 50-60% as a result of the antibacterial activity of the test solution. These baseline values and those found in the presence of 4 and 24-h-old plaque were frequently lower than those recorded after the placebo rinse. In comparison to the placebo, microbial vitality was significantly reduced in early supragingival plaque formed on unprotected sites after applying the test solution. The similar total bacterial counts in 4-h-old plaque recorded after the use of the test solution on the unprotected and the protected areas did not point to an antiadhesive effect of the agent. It is concluded that this new experimental set-up allows decoding of the mode of action of a mouthrinse.

Adult↗

Vital microorganisms in early supragingival dental plaque and in stimulated human saliva.

The aim of this study was to compare the percentage of vital microorganisms (= microbial vitality) of saliva with that of supragingival plaque both collected at various times during the early phases of de novo plaque formation. Between intervals of optimal oral hygiene, 14 healthy participants refrained from all oral hygiene measures for periods of 1, 4, 8 and 72 h. Stimulated whole saliva was collected at the beginning (= baseline) and the end of each period. Vestibular plaque was removed from teeth 13-16, and 23-26. Analysis of the pooled plaque (p) and saliva (s) samples comprised the total number of bacterial counts and colony-forming units to estimate the percentage of viable microorganisms (PEp; PEs). The microbial vitality (VFp; VFs) was determined by using a fluorescence staining to differentiate vital from dead bacterial cells. The bulk of the PEs values reached 5-30%. At baseline VFs ranged between 70% and 90%. The VFs values recorded at baseline or in the presence of 1 h and 4 h-old plaque, were significantly (alpha = 0.05) higher than the corresponding VFp values ranging from 5% to 30%. It was concluded that there is a considerable discrepancy between the microbial vitality of a very early dental plaque and that of whole surrounding saliva sampled at the same time. Unfavourable local environmental conditions prevailing at cervical tooth surfaces are suggested to restrain the survival of the majority of the first bacteria adhering to a particular tooth area during the early phases of supragingival plaque formation.

Adult↗

Antibacterial effects of amalgams on mutans streptococci in an in vitro biofilm test procedure.

Conflicting data continue to be presented in the literature regarding the antibacterial potential of various amalgam alloy compositions. The aim of the present study was to compare the antibacterial effects of 4 different amalgam samples on mutans streptococci using two in vitro test procedures. Glass and bovine enamel served as negative controls. The first test, one commonly used, consisted of immersing freshly prepared disks of the six materials in culture broth inoculated with mutans streptococci. Optical density measurements of the broth served to evaluate bacterial growth. This was followed by a biofilm technique which provided more intimate contact between the bacteria and specimen surfaces. With the exception of one high-copper lathe-cut amalgam, the first test revealed no antibacterial potential of the samples whereas the second test with the biofilm design elucidated significant differences in antibacterial potential between the amalgam alloy compositions and the controls. The biofilm technique, used in an in vitro test procedure, reflects the conditions of the oral environment more accurately than conventional test designs.

Animals↗

Vital fluorescence to assess in vitro and in vivo the antibacterial effects of amalgams.

The aim of the present study was to establish an alternative methodology for testing the antibacterial effects of different amalgams. The vitality of mutans streptococci grown in vitro on various amalgam surfaces was monitored with a vital fluorescence staining technique using fluorescein diacetate and ethidium bromide. The in vivo effect of amalgam-non-gamma 2 fillings on the vitality of dental plaque was assessed with the same method and compared with samples originating from enamel. The median in vitro vitality of mutans streptococci was estimated as 70% on glass, 50% on Amalcapnon-gamma 2 and Sybraloy, 20% on Amalcap F and 10% on Neo-Silbrin. In vivo plaque vitality on enamel varied from 60 to 70%. In contrast, plaque sampled from non-gamma 2-amalgam surfaces revealed significant reductions in vitality with a minimum value of 25% of one day old supragingival plaque. The vital fluorescence technique was shown as an easy and quick method to assess the bactericidal effect against biofilm bacteria of dental materials in vitro as well as in vivo.

Anti-Bacterial Agents↗

Microbial generation time during the early phases of supragingival dental plaque formation.

The objective of this investigation was to determine the microbial generation time during early human supragingival plaque formation. On 2 occasions, 13 participants refrained from all oral hygiene measures for periods of 1, 2, 4, 8, 24 and 72 h. Plaque was sampled from defined areas of the teeth 13, 14, 15, 23, 24 and 25. Two independent methods were used to estimate the total number of viable cells: colony-forming units BCVF, total bacterial counts (BC) as enumerated by microscopic examination, and the percentage of vital bacteria using a vital fluorescence technique (VF) were recorded. The total number of vital microorganisms was calculated by BCVF (= BC x VF). The generation time based on either colony-forming units or BCVF increased significantly with plaque age. During the first interval (1-4 h), the microbial multiplication took slightly less than 1 h. After the establishment of a more mature plaque (24-72 h), the replicating time was between 12.5 h (BCVF) and 14.8 h (colony-forming units). It was concluded that the microbial generation time recorded at the initial stages of plaque formation is considerably lower than that found in older plaque.

Adult↗

Plaque bacteria counts and vitality during chlorhexidine, meridol and listerine mouthrinses.

The aim of this double-blind study was to enumerate the total number of living and dead bacteria on defined tooth areas during the application of antibacterial mouthrinses. After prophylaxis, 40 students refrained from all oral hygiene measures for 3 d, during which they rinsed with a phenolic compound (Listerine), an amine fluoride/stannous fluoride solution (Meridol), 0.2% chlorhexidine (CHX) or a control solution (0.02% quinine-hydrochloride). The plaque index (P1I) was recorded at the start and the end of the investigation. Total bacterial counts (BC) and colony-forming units (CFU) of 1d-, 2d- and 3d-old dentogingival plaque were determined. The plating efficiency (PE) was calculated as a percentage of CFU/BC and the portion of vital microflora estimated by a vital fluorescence technique (VF). All groups started with a P1I approximating 0.1. On day 3, the P1I values were 1.21 in the control group and 0.51, 0.37 and 0.14 after Listerine, Meridol and CHX use, respectively. A tremendous variation existed between the numbers of viable bacteria found per mm2 on the enamel surface and day 3 (CHX: 0.2; Meridol: 300; Listerine; 6x10(4); control: 2x10(6)), while higher total numbers of bacteria were concomitantly present (CHX and Meridol: 1-2x10(4); Listerine: 2x10(5); control: 2x10(6)). Both vitality parameters PE and VF reached 92% in the control group at day 3, but only 7% after CHX use. With Meridol and Listerine, the corresponding PE values were 3% and 43%, respectively, while the VF values reached 48% and 54%. The PII, BC, CFU and PE values of the CHX and the Meridol groups differed significantly from those of the control group. In contrast, Listerine showed no difference as compared to the control rinse. Due to the strong antibacterial action of CHX and Meridol during their use, almost only dead or non-proliferating bacteria were found on the tooth surfaces. Thus, only a thin plaque could develop. As a clinical consequence, both substances showed retardation of plaque development as reflected by significantly reduced plaque indices.

Adolescent↗