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PubMed2004

Fresh and cultured buccal cells as a source of mRNA and protein for molecular analysis.

We developed a method for obtaining viable buccal cells from mouthwash samples for use as a source of mRNA and protein. Immunofluorescent analysis showed that most cells were derived from nonkeratinized parabasal epithelia, with a minor proportion of proliferative cells. Gene expression was detected in buccal cells using reverse transcription PCR, Western blot analysis, and immunofluorescence. Using a keratinocyte-specific medium, buccal cells could be cultured on Matrigel-coated permeable filters for up to 2 weeks while maintaining the expression of some epithelial-specific markers, including cytokeratin 13, cytokeratin 10, transferrin receptor, and beta-integrin. The basal marker cytokeratin 14 and Ki67, an indicator of cellular proliferation, were detected in a few cells. We show that buccal cells can be obtained from a noninvasive procedure for use as a source of material for biochemical analyses. A population of the buccal cells can be maintained in culture for up to 2 weeks using keratinocyte-specific medium in combination with extracellular matrix.

Cell Culture Techniques↗

PubMed1995

Mouth-rinsing with chlorhexidine causes a delayed, temporary increase in the levels of oral viridans streptococci.

The indigenous oral flora of 27 volunteers was monitored longitudinally over a 4-week period. Bacteria attached on buccal epithelial cells were counted by microscopy. Salivary bacterial colonies and the presence of alpha-hemolysis were examined after aerobic culturing on blood agar plates. The buccal and salivary bacterial counts were stably maintained in most subjects in the two repeated base-line samplings taken at 1-week intervals. Rinsing with a chlorhexidine mouthwash 45 min before sampling dramatically reduced the amount of epithelial cell-adherent bacteria. One day after the chlorhexidine rinse, however, the numbers of the epithelial cell-adherent bacteria exceeded the base-line level, and a similar decrease-increase pattern of changes was detected for the salivary alpha-hemolytic streptococcal counts. The non-hemolytic salivary bacterial counts were not affected by chlorhexidine. Subsequent weekly samplings showed no difference from the base-line samplings. The chlorhexidine-induced, delayed increase of viridans streptococci on oral epithelial surfaces should be considered a possible risk factor in medically compromised patients.

Adult↗

PubMed2006

The effect of different solutions on the bond strength of soft lining materials to acrylic resin.

In this study, we investigated the effect of different solutions--coffee, tea, Turkish coffee, artificial saliva, mouthwash, denture cleanser, and distilled water--on the bond strength of soft lining materials (one acrylic- and three silicone-based) to acrylic resin. Acrylic specimens (40x10x10 mm) were prepared for the bond strength test. The specimens were stored in different solutions and tested after 24 hours, seven days, and 30 days. Using analysis of variance, the bond strength of soft lining materials to acrylic resin was found to be related to the type of material, storage time, and storage solution. Visco-gel had the lowest bond strength to cured acrylic resin, where its strength ranged from 0.149 MPa to 0.784 MPa. The bond strength of Visco-gel was also found to increase with time. Molloplast-B and Ufi Gel P demonstrated better bond strength than Visco-gel and Mollosil.

Acrylic Resins↗

PubMed1999

Dental drug-delivery devices: local and sustained-release applications.

Dental diseases are among the most prevalent illnesses in humans. Many pharmaceutical dosage forms are used to prevent and treat these diseases. Toothpastes and mouthwashes are two of the most popular dental medicaments. A local delivery application that prolongs the release of the drug in the mouth offers great advantages in preventing and treating caries and periodontal diseases. Sustained-release devices are a relatively new concept in dentistry. This paper describes several types of sustained-release devices that are available commercially or are in the premarketing stage.

Adhesives↗

PubMed1976

Fluorine gradients in outermost surface enamel after various forms of topical application of fluorides in vivo.

Fluorine gradients were analysed in sound facial enamel of 58 pairs of homologous contralateral premolar teeth. A macroscopic stepwise acid etching technique was used to determine the F-concentration to the depths of 40-200 microns. Usually three successive enamel layers (10, 10, and 20 microns) from enamel surface and inwards were removed. Eight pairs of teeth (control group) which had not been subjected to any form of fluoride treatment in the study, were used to assess the difference between teeth extracted at three-week-interval. The F-gradients were almost identical, with only small differences between the teeth. F-concentrations usually decreased from about 900 ppm within the first 10 microns to about 200 ppm at a depth of 40-50 microns. In ten experimental groups (5 pairs of teeth in each group) the F-uptake was studied after various forms of topical application. Contralateral teeth served as control teeth. The highest F-uptake was observed when a fluoride varnish, Duraphat (5% NaF) was applied three times at one weeks' interval. The F-concentrations were about 2000, 900 and 550 ppm, respectively, in the first, second and third enamel layer. The increase in F-concentration in the first enamel layers analysed was significant, but not in the deepest. When testing the effect of paintings procedures with 2% NaF (pH = 7 and 5); 8% SnF2; 5% Na2PO3F; 2% APF-gel (Flura-Gel) in a similar way, a moderate F-uptake was found (100-450 ppm). The uptake of F was limited to the first 10 microns of the enamel. Only 2% NaF (pH = 5) And the APF-gel gave a significant F-uptake within the first layer. Daily mouthwashing procedures during 21 days resulted in insignificant uptake of F when 0.025% and 0.05% NaF solutions were used. Not even rinsing with 0.025% NaF solution for more than 100 days and rinsing with 0.2% NaF solution once a week for three weeks resulted in any significant uptake. The results showed that the F-uptake in vivo from conventional topical application is small and limited to the first few microns of the enamel surface. However, by prolonging the exposure of the enamel surfaces to fluorides in varnishes with high F-concentrations it appears possible to highly raise the F-concentration of the enamel surface and in deeper layers.

Adolescent↗

PubMed2001

Treatment strategies for recurrent oral aphthous ulcers.

The clinical features, etiology, and treatment of recurrent aphthous ulcers (RAU) are discussed. Aphthous ulcers are among the most common oral lesions in the general population, with a frequency of up to 25% and three-month recurrence rates as high as 50%. The ulcers, which usually occur on the nonkeratinized oral mucosa, can cause considerable pain and may interfere with eating, speaking, and swallowing. RAU is classified as minor, major, and herpetiform on the basis of ulcer size and number. The cause of RAU is idiopathic in most patients. The most likely precipitating factors are local trauma and stress. Other associated factors include systemic diseases and nutritional deficiencies, food allergies, genetic predisposition, immune disorders, the use of certain medications, and HIV infection. The primary goals of therapy for RAU are relief of pain, reduction of ulcer duration, and restoration of normal oral function. Secondary goals include reduction in the frequency and severity of recurrences and maintenance of remission. Topical medications, such as antimicrobial mouthwashes and topical corticosteroids, can achieve the primary goals but have not been shown to alter recurrence or remission rates. Systemic medications can be tried if topical therapy is ineffective. Levamisole has shown variable efficacy in reducing ulcer frequency and duration in patients with minor RAU. Oral corticosteroids should be reserved for severe cases of major RAU that do not respond to topical agents. Thalidomide is effective but, because of its toxicity and cost, should be used only as an alternative to oral corticosteroids. RAU can be effectively managed with a variety of topical and systemic medications.

Adjuvants, Immunologic↗

PubMed1992

[Xerostomia-related dental caries].

The initiation and prevention of xerostomia-related dental caries were studied using an in situ model. The morphology of induced carious lesions was compared with that of natural xerostomia-related dental caries. Both natural and induced xerostomia-related dental caries showed the same patterns of decay. Using the in situ model three preventive procedures were tested: neutral F gel applied every second day or weekly, and a daily rinse with a fluoride mouthwash for a period of six weeks. Application of fluoride gel or the use of the fluoride mouthrinse resulted in significant inhibition of the demineralization process. Of the procedures evaluated fluoride gel applied every second day was the most effective in preventing the onset of xerostomia-related dental caries.

Administration, Topical↗

PubMedDate not supplied

Sanguinaria-related leukoplakia: epidemiologic and clinicopathologic features of a recently described entity.

An association between the use of Viadent toothpaste and/or mouthwash and the development of leukoplakia oral mucosal lesions has been described recently. Discontinuing the Viadent products may result in resolution of the leukoplakia, although frequently this is not the case. In order to corroborate the earlier study and to provide further insight regarding the clinical features of this process, a case-control study was conducted. A significant association was seen between the use of Viadent products and the development of oral leukoplakia. Furthermore, leukoplakias affecting sites other than the buccal vestibule also were associated with the use of these products.

Alkaloids↗

PubMedDate not supplied

Polyamine contents in rectal and buccal mucosae in humans treated with oral difluoromethylornithine.

Difluoromethylornithine (DFMO) is an investigational chemopreventive agent that inhibits ornithine decarboxylase (ODC) activity, lowers cellular polyamine concentrations, and decreases cell proliferation in vivo and in vitro. In five subjects we have compared the polyamine concentrations in rectal mucosal biopsies and in exfoliated buccal mucosal cells (EBM) before and after DFMO treatment to assess the suitability of EBM as an easily accessible marker tissue for DFMO suppression of polyamine synthesis in the rectal mucosa. One month of 3 g/m2/day of DFMO treatment caused a statistically significant decrease in putrescine and spermidine concentrations in rectal mucosa biopsy specimens but not in EBM samples. ODC activity in EBM was high (approximately 1 mumol/min/mg protein), resistant to DFMO inhibition (Ki = 4200 microM), dependent on GTP concentration (maximal at 0.1 mM), and was reduced concomitantly with bacterial concentration by antiseptic mouthwashing. Bacteria adherent to EBM were visible by electron microscopy. Forty bacterial colonies/ng protein were culturable from washed EBM samples. Oral bacteria preclude the use of EBM samples as a marker tissue of DFMO effect in the rectal mucosa, but oral DFMO therapy is effective in depleting polyamines in rectal mucosa.

Administration, Oral↗

PubMed1992

Clinical study on the effect of amine fluoride/stannous fluoride on exposed root surfaces.

The aim of this study was to assess the remineralizing effect of an amine fluoride (AmF)- and stannous fluoride (SnF2)-containing toothpaste and mouthrinse on exposed root surfaces. A total of 44 adults participated in the 20-week, double-blind study and were grouped as follows: (1) 20 participants (mean age 45.7 years) used an AmF/SnF2 experimental toothpaste plus AmF/SnF2 (Meridol) mouthwash, and (2) 24 participants (mean age 48.8 years) used an NaF-containing toothpaste and mouthrinse. Root caries index (RCI) and root surface scores were determined by a modified method of Katz (J Dent Res, 1984). RCI mean values showed decreases of approximately 47% in the AmF/SnF2 group, and 10% in the NaF group. With respect to root caries scores, the number of persons with decreased softened (non-carious) surfaces between the baseline and control examinations was statistically significant (p less than 0.05) in the AmF/SnF2 group but not significant in the NaF group. A statistically significant difference (p less than 0.05) in the results of the groups favored the AmF/SnF2 subgroup. Thus, the data point to a possible remineralizing effect of topically applied AmF/SnF2 on softened root caries surfaces.

Amines↗

PubMed1992

Effect of an experimental antiplaque preparation on salivary microbial counts in military academy cadets refraining from mechanical cleaning of the teeth.

Dental emergencies in the army are mostly due to infections of the teeth, caused by dental plaque micro-organisms. Because practicing normal oral hygiene is restricted during terrain maneuvers, for example, we developed a new antiseptic tablet preparation which can be used to make an antiplaque solution or even chewed and thus mixed with saliva to rinse the mouth. The preparation contains chlorhexidine, fluoride, and xylitol (XYLIHEX) and can be added to the soldier's kit. The efficiency of the preparation on selected oral micro-organisms was tested against mouthwash solutions containing plain chlorhexidine (CHX) and sodium fluoride (F) in 45 military cadets who volunteered to participate in this double-blind cross-over study. The results showed a significant decrease in salivary mutants streptococci after rinsing periods with XYLIHEX and CHX when compared with F (p less than 0.001). Lactobacilli and yeast counts were not affected. The new preparation appeared promising as a new means for improving soldiers' oral hygiene.

Adult↗

PubMed2005

A 6-month clinical study assessing the safety and efficacy of two cetylpyridinium chloride mouthrinses.

PURPOSE: To evaluate the effects of two experimental cetylpyridinium chloride (CPC) mouthrinses containing 0.075% and 0.10% CPC on the development of gingivitis and plaque versus a placebo control over a period of 6 months. METHODS: This was a randomized, single center, parallel group, double blind, positive and placebo controlled clinical trial. A 0.12% chlorhexidine rinse served as the positive control for validation of the methodology. At the beginning of the trial, 366 subjects were balanced and randomly assigned to treatment groups. Subjects received a dental prophylaxis and began rinsing twice a day with 15 ml of their assigned mouthwash for 30 seconds after brushing their teeth. Subjects were assessed for gingivitis and gingival bleeding by the Löe-Silness Gingival Index method and plaque by the Turesky modification of Quigley Hein Plaque Index at baseline and after 3 and 6 months of product use. Oral soft tissue health was also assessed. RESULTS: After 3 and 6 months, subjects rinsing with either 0.075% or 0.10% CPC had significantly (P< 0.0001) less gingivitis, gingival bleeding, and plaque, on average, than those on placebo. The 6-month mean reductions in gingivitis, gingival bleeding, and plaque for the 0.075% and 0.10% CPC rinses versus placebo were 23%, 30% and 17%, and 20%, 27% and 19%, respectively. There was no statistically significant difference in efficacy between the two CPC mouthrinses. Reductions at 3 months were similar to those seen at 6 months. Significant benefits were observed with chlorhexidine, thereby validating the study. CLINICAL SIGNIFICANCE: This study clearly demonstrates that CPC mouthrinses formulated to deliver therapeutic benefits when used twice daily can significantly prevent the development of gingivitis, gingival bleeding, and plaque over a 6-month period.

Adolescent↗

PubMed2005

Minor oral surgery in anticoagulated patients: local measures alone are sufficient for haemostasis.

Minor oral surgery in warfarinized patients can be performed without stopping or altering the dose of the drug. Thirty patients underwent various types of oral surgical procedures without interruption of their anticoagulant therapy and their therapeutic international normalized ratio maintained. Local measures such as pressure, packing the sockets with oxidized regenerated cellulose, and suturing were applied. In some patients, tranexamic acid mouthwashes were prescribed to further enhance haemostasis. Four patients had minimal postoperative bleeding in the form of bloodstained saliva, which lasted for 24 hours. This study highlights the importance of local measures in controlling postoperative bleeding in warfarinized patients undergoing minor oral surgical procedures.

Adult↗

PubMed2006

Systemic toxicity following ingestion of the chlorhexidine gluconate solution: a case report.

The purpose of this article is to discuss possible adverse effects and emergency treatments following the ingestion of chlorhexidine (CHX). In this case a dental student (age 25, male) accidentally swallowed one shot of 20% CHX solution, which is equal to 100 shots of the standard 0.2% CHX mouthwash. Clinical emergency treatment included: washing the oral cavity with 30 g of toothpaste, drinking 100 ml of 5% (w/v) alginate syrup and ingestion of 5 g of cork. The following adverse effects were experienced: headache, euphoria, giddiness, blurred vision (duration = 12 h), stomachache, gastric lavage with demulcents (duration = 24 h) and complete loss of taste sensation (duration = 8 h), which recurred during the next 48 h. No change in plasma aminotransferase level was seen. We used basic chemical information about the incompatibilities of CHX for clinical management of unintentional ingestion. It is known that CHX is a cation, and, therefore, first aid in case of intoxication with CHX involves using anionic materials.

Adult↗

PubMedDate not supplied

Investigation of the cleanliness of dentures in a university hospital.

PURPOSE: The purpose of this study was to determine denture cleanliness of a population sample, as well as to investigate denture cleaning habits and attitudes. MATERIALS AND METHODS: Two hundred thirty-four denture-wearing patients were surveyed via a questionnaire to identify types and frequency of use of denture cleaning methods. Patients were also clinically examined to determine denture cleanliness. Dentures were classified as clean, dirty, or extremely dirty based on the level of debris and stain present. The oral mucosa was also examined and rated. RESULTS: The most common regimen employed was brushing with toothpaste (40.59% of patients), while only 1 patient reported soaking the denture in mouthwash. Results showed that 38.9% of patients were not satisfied with their cleansing methods, and 82.9% of patients claimed their dentists did not inform them how to clean their dentures. Only 11.9% of patients had clean dentures. Older dentures tended to be dirtier than newer ones (P = .0001) and had a higher incidence rate of accompanying denture stomatitis (P= .0001). CONCLUSION: In this population sample, most denture wearers did not clean their dentures satisfactorily.

Aged↗

PubMed2006

Bone necrosis of the jaws associated with bisphosphonate treatment: a report of twenty-nine cases.

Bone necrosis of the jaws is often related to head and neck radiotherapy, to surgical procedures at maxillary or mandibular level but also to various local and systemic factors such as haematological diseases, haemoglobinopathies and systemic lupus eritematosus; its pathogenesis maybe associated with defects of vascularization. Bisphosphonate are synthetic analogues of pyrophosphate used for the treatment of hypercalcemia in patients with malignancies and bone metastasis and for the treatment of many other disorders such as metabolic bone diseases, Paget's disease, and osteoporosis; their pharmacological activity is related to the inhibition of the osteoclastic function which leads to resorption and reduction of bone vascularization. Since the end of 2003 Bisphosphonate-associated Osteonecrosis (BON) has become an increasing problem and the test of that is the increase of the relative published case report and case series. Here we report 29 cases of bone necrosis of the jaws in patients treated with pamidronate (Aredia), zoledronate (Zometa) and alendronate: 15 underwent surgical procedures and 14 occurred spontaneously. Among these patients (21 females, 8 males; mean age between 45 and 83 years); 14 were treated for bone metastasis, 12 for multiple myeloma and 3 for osteoporosis. Bone necrosis involved only maxilla in 7 patients, only mandible in 20 patients and both in 2 patients. Six patients had multiple osteonecrotic lesions, 3 contemporary lesions and 3 non contemporary. In these patients we performed 3 kinds of therapy, associated or not: medical therapy (with antibiotic drugs, antimycotics and antiseptic mouthwashes), surgical therapy with curettage or sequestrectomy and Nd:YAG laser biostimulation.

Aged↗

PubMed1990

Hydrogen peroxide, the effect on plaque and gingivitis when used in an oral irrigator.

The identification of plaque as the etiological agent in chronic gingivitis and the progression of chronic periodontitis, has intensified the search for effective chemical antiplaque agents to aid in the prevention and treatment of these diseases. To date, no ideal compound has been identified. Using the experimental gingivitis model, the effectiveness of a 1.5% hydrogen peroxide-containing oral rinse, applied as a conventional mouthrinse and in an oral irrigation device, was evaluated. The ability of the mouthrinse to inhibit the development of plaque and gingivitis in the two experimental groups, was compared with controls using a placebo rinse over two 7-day periods. At no time was there any statistical difference between either of the experimental groups and/or the placebo group in terms of gingival or plaque scores. This study concluded that a 1.5% hydrogen peroxide mouthwash was of no therapeutic value in the prevention or treatment of an experimental gingivitis, when used as a mouthrinse or in an oral irrigator.

Adolescent↗

PubMed1990

[Direct removal of dentobacterial plaque using an oral rinse before brushing].

A study was conducted to evaluate the ability of a dental rinse to remove dental plaque. The hypothesis was tested that plaque, as a complex soil comprising microorganisms, cell debris, salivary deposits and other ill-defined organic and inorganic components, would be susceptible to removal by a rinse with high detersive action. A rinse was prepared based on the principles applied to formulation of products for cleansing biologic surfaces, including anionic and nonionic surfactants, sodium benzoate, and auxiliary cleansing agents. Subjects randomly selected from a dental clinic population were scored for plaque area on the lingual and buccal surfaces of the Ramfjord teeth using the Turesky modification of the Quigley-Hein Index. The subjects then rinsed 30 seconds with 15 ml of product, and stainable plaque area was scored again. The rinsing reduced average plaque scores by an average of 13-20%, a very high level of significance. A placebo rinse and a conventional mouthwash removed 2.0% and 1.3% stainable plaque, respectively. The experimental rinse substantially Increased the number of surfaces that were totally free of plaque.

Adult↗