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Biomedical subjects

P Barkvoll

Publications and source records attributed to P Barkvoll.

At least 19 recordsLinked to original sources

Combining diclofenac with acetaminophen or acetaminophen-codeine after oral surgery: a randomized, double-blind single-dose study.

In a randomized double-blind study, 120 patients with moderate to strong pain after surgical removal of wisdom teeth were given the following in single oral doses: 100-mg enteric-coated diclofenac tablets; 1 g acetaminophen (INN, paracetamol); 1 g acetaminophen plus 60 mg codeine; 100-mg enteric-coated diclofenac tablets plus 1 g acetaminophen; or 100-mg enteric-coated diclofenac tablets plus 1 g acetaminophen plus 60 mg codeine. Patients recorded pain intensity and pain relief for 8 hours. Upside assay sensitivity was confirmed because acetaminophen plus codeine was superior to acetaminophen. Diclofenac plus acetaminophen with and without codeine had superior analgesic effect compared with diclofenac, acetaminophen, or acetaminophen plus codeine. Addition of 60 mg codeine increased the degree of side effects. These results support the clinical practice of combining diclofenac with acetaminophen for acute pain. Of clinical importance are superior and prolonged analgesia and fewer side effects after enteric-coated diclofenac tablets plus acetaminophen compared with acetaminophen plus codeine.

Acetaminophen↗

Clinical implications of the dry mouth. Oral mucosal diseases.

Salivary hypofunction caused by salivary gland disease, medication, or radiation may predispose for secondary oral mucosal diseases. In these patients the protective coating of saliva is reduced or absent, leaving the oral mucosa more vulnerable. Candidiasis, burning mouth syndrome, and white lesions of the oral mucosa are increased in frequency. The aim of management is to prevent oral pathological changes. The management procedure may include proper oral hygiene, saliva-stimulating agents, or saliva substitutes, depending on the severity of the salivary dysfunction. Treatment includes antifungal therapy if candidiasis is diagnosed. In severely distressed patients, local or systemic corticosteroids may be indicated. Precautions, like refraining from smoking and avoiding toothpastes containing sodium lauryl sulfate, should also be taken. In the future, agents combining antibacterial and antiinflammatory actions, like triclosan, may show promising effects in patients with oral mucosal diseases secondary to salivary hypofunction.

Humans↗

Upside assay sensitivity in a dental pain model.

The extent of surgical trauma was related to postoperative pain intensity in a previous study. However, more extensive surgical procedures with higher baseline pain intensity did not appear to influence the ability to document the additive analgesic effect of codeine when given with paracetamol, partly due to large interindividual variation in baseline pain intensity. The aim of the present study was to attempt to improve upside assay sensitivity in this dental pain model by: (1) selecting patients with high baseline pain intensity; and (2) closer supervision of outpatients>> drug intake and compliance with protocol. Only patients with baseline pain >/=50 on a 100 mm visual analogue scale after wisdom tooth surgery were included. Twenty patients were given paracetamol 1000 mg with or without codeine 60 mg in repeated doses in a randomized and double-blind manner. Intake of the first dose of test medication and its effects were closely supervised, while the two following doses were taken at 3-h intervals after the patient had left the clinic. Pain intensity was measured with the visual analogue scale for 8 h. More pain relief was revealed when codeine 60 mg was added to paracetamol 1000 mg on the following measures of effect: change of pain intensity with time (p<0.05, Mann-Whitney), sum of pain intensities (p=0.019), pain intensity difference (p</=0.05), sum of pain intensity differences (p<0.05), pain reduction index (p<0.05) and global-evaluation score (p=0.006). The study confirms that this dental pain model, when controlled for sufficient and homogeneous baseline pain and patient compliance, does have sufficient upside assay sensitivity to discriminate between paracetamol with and without codeine. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗

Does the nature of the solvent affect the anti-inflammatory capacity of triclosan? An experimental study.

The anti-inflammatory properties of triclosan have been revealed in several recent studies, including an effect on histamine-induced inflammation. In other studies, the nature of the solvent has been shown to be of importance for the plaque inhibiting as well as the antibacterial potential of triclosan. This study was aimed at examining whether the nature of the solvent also may influence the anti-inflammatory capacity of triclosan and further to study a possible dose/ response relationship. The study was performed as 3 separate, double-blind experiments, comprising 10, 11 and 12 healthy females. In all 3 experiments, 5 sites on the lower part of the back of the volunteers were intradermally exposed to one drop of 1% histamine dihydrochloride for 15 min. The size of the resulting wheals was recorded before and after 40 min of triclosan treatment. In experiment 1, 4 different concentrations of triclosan in 2-fold dilutions in absolute alcohol (0.125%-1%) were applied on the histamine-induced wheals. In experiments 2 and 3, 4 different solutions containing 0.5% triclosan and a saline solution as negative control were used. The solvents in experiment 2 were as follows: (1) absolute alcohol (positive control), (2) propylene glycol (PG), (3) polyethylene glycol (PEG), (4) olive oil, and in experiment 3: (1) absolute alcohol (positive control), (2) Tween 80, (3) sodium carbonate, (4) soy oil. The results showed a dose/ response effect of triclosan and further that the solvent may be of importance for its anti-inflammatory potential.

Adult↗

The influence of triclosan, zinc or propylene glycol on oral mucosa exposed to sodium lauryl sulphate.

Previous studies on triclosan treatment of skin exposed to sodium lauryl sulphate (SLS) indicated a protective rôle of zinc and an irritant effect of propylene glycol (PG). The aim was hence to examine whether zinc or PG also may affect SLS-induced oral mucosal reactions, and also to test the influence of zinc in combination with triclosan. 15 healthy dental students participated in this double-blind crossover study performed in 2 experimental series. They were rinsing 2x daily with solutions containing (A) 1.5% SLS, (B) 1.5% SLS/0.5% zinc citrate and (C) 1.5% SLS/PG (1:8) in experiment 1, and (D) 1.5% SLS/0.15% triclosan/0.3% zinc citrate and (E) 1.5% SLS/0.15% triclosan in experiment 2. Clinical evaluation by 2 examiners of degree of erythema and oral mucosal desquamations was then performed. The critical micellar concentration was also determined. SLS and SLS/PG, which were not different in effect, evoked significantly more erythematous reactions than SLS/Tri/Zn. This solution was numerically but not statistically better than SLS/Tri, and the latter also did lead to significantly less erythema than SLS/PG. In conclusion, the present study revealed no irritation of the oral mucosa due to PG, whereas a protective effect of zinc as well as the anti-inflammatory effect of triclosan were confirmed.

Adult↗

Skin reactions and irritation potential of four commercial toothpastes.

Skin reactions to 4 toothpastes were tested in 19 healthy dental students in a double-blind study. The hypothesis was that common toothpaste brands with and without sodium lauryl sulfate (SLS) and triclosan and with different additives/emulgators differ in irritation potential. An occlusion test system on human skin was used. The toothpastes tested were A) Zendium (non-ionic detergent), B) Solidox F (SLS/polyethylene glycol), C) Colgate Total (triclosan/copolymer/SLS/propylene glycol), and D) Solidox G (triclosan/zinc citrate/SLS/polyethylene glycol). Toothpaste C was the greatest irritant, causing skin erythema in 16 of the 19 subjects, whereas toothpaste D gave no reactions. Toothpaste B provoked three reactions (two severe), whereas toothpaste A caused only one mild reaction. Although this study was carried out on skin and hence not directly applicable to the oral cavity, these and previous results may indicate that a toothpaste without propylene glycol and SLS may be preferred by susceptible persons.

Adult↗

Preliminary study of low-level laser for treatment of long-standing sensory aberrations in the inferior alveolar nerve.

PURPOSE: The incidence of inferior alveolar nerve (IAN) damage during removal of third molar teeth has been reported to be as high as 5.5% and up to 100% during sagittal split osteotomy. Sensory aberrations in the IAN persisting for longer than 6 months leave some degree of permanent disability. The purpose of this double-blind, clinical trial was to examine the effects of low-level laser (LLL) treatment using a GaAIAs laser (820 nm, Rønvig, Denmark) on touch and temperature sensory perception after a long-standing postsurgical IAN injury. PATIENTS AND METHODS: Thirteen patients were divided into two groups, one of which received real LLL (4 x 6 J per treatment along the distribution of the IAN to a total of 20 treatments) and the other placebo LLL. The degree of mechanoreceptor injury as assessed by Semmes Weinstein Monofilaments (North Coast Medical, San Jose, CA) were comparable in the two groups before treatment. The degree of thermal sensitivity disability as assessed using a Thermotester (Somedic AB, Stockholm, Sweden) to examine the indifferent temperature threshold was also comparable between the two groups before LLL. RESULTS: Subsequent to LLL, the real laser-treated group showed a significant improvement in mechanoreceptor sensory testing (P = .01) compared with the placebo group, as manifested by a decrease in load threshold (g) necessary to elicit a response from the most damaged area. In addition, the real LLL group reported a subjective improvement in sensory function. There was no significant improvement in thermal sensitivity post-LLL for either the real or placebo laser-treated groups. CONCLUSION: It was concluded that LLL can improve mechanoreceptor perception in long-standing sensory aberrations in the IAN.

Adolescent↗

Mouthrinses containing triclosan reduce the incidence of recurrent aphthous ulcers (RAU).

Triclosan, an antibacterial agent introduced in toothpastes and mouthrinses, has recently been shown to have anti-inflammatory and analgesic properties. The aim of the present double-blind cross-over study was to examine the effect of triclosan on the incidence of recurrent aphthous ulceration (RAU) when administered in mouthrinses. The study included 30 patients with a history of multiple recurrent aphthous ulcers. Three different triclosan-containing mouthrinses, differing only in their solubilizing agents were used and compared with a control rinse. The number of new ulcers, ulcer-free days and the severity of pain were recorded. The results showed that the patients experienced a significant decrease in the number of oral ulcers during the experimental period when the mouthrinses contained triclosan. It may thus be concluded that triclosan has the potential to reduce the number of aphthous ulcers presumably due to its anti-inflammatory properties.

Adult↗

The effect of toothpaste containing triclosan on oral mucosal desquamation. A model study.

SLS-containing toothpaste has previously been shown to cause oral mucosal desquamations when used in an experimental cap splint model. The aim of the present study was to examine the effect of toothpastes containing SLS in combination with triclosan on oral mucosal desquamation in a similar cap splint model system. It has previously been shown that the antibacterial agent triclosan also may have anti-inflammatory properties. The concentration of triclosan in the experimental toothpastes was 0.3%, while SLS varied from 1.5% to 3%. No oral mucosal desquamations were observed after use of a 1.5% SLS 0.3% triclosan containing toothpaste, contrary to the positive control toothpaste that contained 1.5% SLS without triclosan. Furthermore, a statistically significant reduction in severe desquamations was observed after use of a toothpaste containing 3% SLS-0.3% triclosan compared with the positive control. It may thus be suggested that triclosan exerts a moderating effect on desquamative reactions caused by SLS and that the effect is dependent on the relative amount of triclosan and SLS in the toothpastes.

Adult↗

Oral mucosal desquamation of pre- and post-menopausal women. A comparison of response to sodium lauryl sulphate in toothpastes.

The aim of the present study was to investigate whether a difference in susceptibility to chemically induced irritation of the oral mucosa in 14 pre- and 14 post-menopausal women exists, following local exposure to sodium lauryl sulphate (SLS) in toothpastes. 4 different pastes differing only in detergent concentration present, or not, were used. The participants applied 1 cm of the different test toothpastes to a cap splint covering the teeth and the oral mucosa of the upper jaw 2 x daily for 2 min during a period of 4 days. 42 desquamative reactions of the oral mucosa (in 20 subjects) were observed, 29 and 13 in the pre- and the post-menopausal group, respectively. Desquamation was only experienced following exposure to SLS-containing toothpastes, not succeeding SLS-free paste. The results demonstrated that oral mucosa of pre-menopausal women was significantly more sensitive to SLS than oral mucosa of post-menopausal women. The difference in mucosal irritation between the 2 groups increased with increasing concentration of SLS.

Adult↗

Oral mucosal desquamation caused by two toothpaste detergents in an experimental model.

Sodium lauryl sulfate (SLS), the most widely used detergent in toothpastes, has been reported to cause adverse effects on oral soft tissues. This double-blind cross-over study describes the oral mucosal effects of SLS-containing toothpastes and pastes containing a zwitterionic detergent, cocoamidopropyl-betaine (CAPB) in an experimental model in 28 healthy females. Seven toothpastes, differing only in detergent concentration and/or type, were used: SLS (0.5, 1.0, 1.5%), CAPB (0.64, 1.27, 1.90%) and a placebo. Each participant applied 1 cm of assigned test toothpaste via a cap splint to the teeth and the mucosa of the upper jaw. The splints were used twice daily for 2 min during a period of 4 d, after which the participants were examined for oral desquamation. No other oral hygiene was allowed during the test periods. Ten days brushing with a detergent-free toothpaste was performed between each test period. Forty-five desquamative reactions were observed in 21 of 27 subjects (one was excluded) during the trial. Forty-two reactions were recorded during the SLS periods and the remaining three during the CAPB periods. The detergent-free toothpaste did not result in oral desquamation. SLS in toothpastes significantly increased the incidence of desquamation of the oral mucosa compared with toothpastes containing the detergent CAPB. The model used is not directly relevant to normal toothbrushing with toothpaste, but indicates that sensitive patients may contract mucosal irritation through SLS in toothpastes. Less toxic detergents, e.g. CAPB, are desirable in oral hygiene products.

Adult↗

The effect of two toothpaste detergents on the frequency of recurrent aphthous ulcers.

The aim of the present clinical double-blind crossover study was to investigate the effect of two different toothpaste detergents, sodium lauryl sulfate (SLS) and cocoamidopropyl betaine (CAPB), as compared with a detergent-free paste, on 30 patients with frequent occurrences of recurrent aphthous ulcers. The study consisted of three 6-week periods during which the patients brushed twice daily with the different test toothpastes. The localization and number of new ulcers were assessed. A significantly higher frequency of aphthous ulcers was demonstrated when the patients brushed with an SLS- than with a CAPB-containing or a detergent-free placebo paste. An SLS-free toothpaste may thus be recommended for patients with recurrent aphthous ulcers.

Adolescent↗

Triclosan inhibits histamine-induced inflammation in human skin.

Previous studies indicate that triclosan reduces the pain and other symptoms after chemically-induced inflammation in the oral mucosa and skin when sodium lauryl sulfate (SLS) is used as an irritant. The aim of the present study was to examine whether triclosan has an effect on the inflammation in human skin caused by intradermal administration of histamine. 9 female volunteers participated in a double-blind study, and skin patch tests were performed in 2 series. In the 1st, the skin was pre-treated for 1 h with triclosan before the histamine was applied. In the 2nd, the histamine reaction was elicited first and triclosan applied subsequently. The effect of triclosan on the weals formed in the skin after histamine application was measured. It was found that triclosan reduced the size of the weals markedly when triclosan was applied after the weals were formed, and that pre-treatment of the skin had only a slight effect. It is assumed that triclosan has an effect on the cascade reactions of inflammation elicited by histamine. 2 other phenols tested in the same study had similar effects.

Administration, Cutaneous↗

Triclosan reduces the clinical symptoms of the allergic patch test reaction (APR) elicited with 1% nickel sulphate in sensitised patients.

It has previously been shown that triclosan reduces the clinical skin reactions caused by sodium lauryl sulphate (SLS) in an irritant patch test reaction (IPR) model. Furthermore, triclosan reduces the inflammatory reactions on skin after subcutaneous injection of histamine. The aim of the present study was to examine whether triclosan reduces the clinical symptoms on skin after exposure to nickel in an allergic patch test reaction (APR) model. 1% nickel sulphate was used for APR in 10 nickel-allergic females. The results showed that application of triclosan on skin reduced the APR symptoms from nickel in sensitised patients significantly (p < 0.05) compared to the saline and alcohol solutions. It is suggested that inflammatory mediators produced by the sensitised lymphocytes are inhibited by triclosan.

Allergens↗

Triclosan protects the skin against dermatitis caused by sodium lauryl sulphate exposure.

It has recently been suggested that the lipid-soluble, antibacterial agent triclosan possesses an anti-inflammatory effect in the oral cavity. The aim of the present study was to examine whether triclosan can protect the skin from the irritation or inflammation that may be caused by exposure to sodium lauryl sulphate (SLS). Finn Chamber patch tests on the forearms of 10 volunteers showed that a mixture of SLS and triclosan caused no inflammation, whereas SLS alone caused reactions in all the subjects. Pre-treatment with triclosan before SLS exposure had a slight effect whereas treatment after exposure showed a significant effect. It is suspected that the reported anti-gingivitis effect of triclosan may at least in part be explained by an anti-inflammatory effect.

Anti-Inflammatory Agents, Non-Steroidal↗

Sodium lauryl sulfate and recurrent aphthous ulcers. A preliminary study.

Sodium lauryl sulfate (SLS), a synthetic detergent commonly used in dentifrices, is an effective denaturant. The aim of the present study was to investigate the effect of SLS in patients with recurrent aphthous ulcers (RAU). Ten patients with multiple minor RAU participated in the study. The mean incidence of RAU was 17.8 during a 3-month period before the study. The patients used a dentifrice containing 1.2% SLS for a test period of 3 months followed by a dentifrice without SLS for the same time period. The results showed a statistically significant decrease in the number of aphthous ulcers from 14.3 after using the SLS-containing dentifrice to 5.1 ulcers after brushing with the SLS-free dentifrice (p < 0.05). It is suggested that the denaturing effect of SLS on the oral mucin layer, with exposure of the underlying epithelium, induces an increased incidence of RAU.

Adolescent↗

The effect of soft-laser application on postoperative pain and swelling. A double-blind, crossover study.

The effect of soft-laser application on postoperative pain and swelling was evaluated in a double-blind, crossover study. Twenty-five healthy adults with bilateral identically impacted lower third molars were selected for this study. The teeth were removed in two separate operations. Laser treatment was tested in comparison with placebo laser, with a 40-mW, 830-nm Biophoton laser (Roenvig Dental, Denmark). All surgical procedures and measurements were done by the same surgeon. The following features were statistically analyzed: swelling, trismus, and subjective registration of pain on a visual analog scale. No statistically significant differences were observed in comparison of the experimental side with the placebo side. It may be concluded that soft-laser treatment has no beneficial effect on swelling, trismus, and pain after third molar surgery.

Adolescent↗

Desquamative effect of sodium lauryl sulfate on oral mucosa. A preliminary study.

Sodium lauryl sulfate (SLS) is the most commonly used detergent in dentifrices. The present study was concerned with the effect of SLS content of toothpastes on oral epithelial desquamation in an experimental model. Ten dental hygiene students participated in this double-blind cross-over study. Five dentifrices with different concentrations of SLS (ranging from 0.0% to 1.5%) were used in randomized order in the study. One centimeter of each test dentifrice was applied in a cap-splint, which covered both attached and non-attached oral mucosa of the upper jaw for 2 min twice daily. The test period for each experimental dentifrice was 4 days, followed by a 10-day rest period. The dentifrice without SLS did not result in any onward reaction, whereas the dentifrice containing 1.5% SLS provoked desquamation in 60% of the subjects.

Administration, Topical↗