Corrosion rate studies: measurements of corrosion rates of some non-precious dental alloys in artificial saliva.
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This study evaluated physicochemical properties of eight commercially available mouthrinses, namely surface tension, in vivo enamel contact angle, viscosity, penetration coefficient, acidity and buffer capacity. The penetration coefficient, determined by the surface tension, contact angle and viscosity, is a measure of the ability of a liquid to penetrate into a capillary space, such as interproximal regions, gingival pockets and pores. The acidity is often determined by a compromise of the requirements for taste, enamel remineralization and stability of the solution. Among the eight mouthrinses evaluated, the physicochemical properties differed greatly, in particular, the penetration coefficient which varied by a factor of 1.8 over the products tested. Surprisingly several of the products tested were found to be extremely acidic.
Inhibition of the development of dental plaque remains one of the primary aims of periodontal care. Many patients, however, are unable to master completely the mechanical methods of plaque control and for this reason, considerable research efforts have been directed towards the development and use of chemical agents to inhibit the growth of plaque. This first of two articles, therefore, examines the pharmacological properties and efficacy of commercially available antiplaque agents. We have also summarized the findings of some of the major clinical trials that have provided the scientific basis for the introduction of these agents for the management of gingival inflammation.
OBJECTIVES: The effect of a fluoride mouth rinse with hard cheese exposure was investigated on rehardening of an etched tooth enamel surface in subjects with radiation-induced hyposalivation in situ. METHODS: Ten patients, six males and four females of mean age 48 years, irradiated with 30 Gy per week for neck and head cancer, volunteered for the present intraoral study. The unstimulated saliva flow rate varied between 0.01 and 0.15 ml min-1. Enamel slabs, approximately 2 mm x 2 mm in size, cut from human molar teeth were embedded in self-curing acrylic resin to fit a microhardness tester. Hardness measurements were carried out on the polished and subsequently etched enamel surface, rinsed for 1 min in the mouth with 10 ml Meridol (GABA INT), containing 0.025% F as amine fluoride and stannous fluoride, and exposed alternatively to mastication of 20 g cheddar cheese for 5 min. RESULTS: Surface erosion of the enamel slabs decreased the mean hardness to a similar degree in all samples. The difference between the mean increased degrees of enamel microhardness following fluoride, fluoride and hard cheese, or repeated fluoride-cheese exposures was significant compared to the etched enamel values. The rate of rehardening derived from a second fluoride-cheese treatment was found to be improved significantly. It seems that the reduced saliva flow in xerostomic patients is sufficient to release bound calcium and phosphate from cheese products. CONCLUSIONS: It is suggested that for xerostomic patients frequent exposures to low-fluoride solutions combined with hard cheese consumption may prevent and remineralize initial demineralization.
OBJECTIVES: Citric acid clearance from the oral cavity may be an important factor in the erosion of dental enamel. The aim of the present study was to investigate the clearance pattern of citric acid in normal subjects. METHODS: After determination of the unstimulated salivary flow rate and the residual volume of saliva after normal swallowing, 12 subjects rinsed with 95.2 mmol l-1 citric acid for 5 s. At 1, 2, 5, 10 and 15 min after the rinse a small saliva sample was collected and the concentration of citric acid was determined enzymatically. For each subject three separate experiments on different occasions were performed with a citric acid solution of pH 2.1 and one experiment with a solution of pH 4.5. RESULTS: The salivary citric acid concentration declined biphasically: rapidly during the first 2 min, then more slowly. The elimination rate over the first minute was on average 87.7 mmol l-1 min-1 at pH 2.1 compared with 85.0 mmol l-1 min-1 at pH 4.5. The difference between individuals estimated from the areas under the clearance curve was strongly significant (P < 0.001). No significant relation was found neither between salivary flow rate and clearance, nor between residual volume after swallowing and clearance. CONCLUSION: The clearance pattern of citric acid is an individual property.
Extrinsic staining of teeth is a side-effect of some antiseptic mouthrinses. However, few of the many rinse products available to the general public have been investigated for their propensity to cause staining. Dietary factors play an aetiological role in staining and have been used in vitro to study and compare the activity of rinses. The aim of this study was to assess rinse products for staining in vitro and, through the staining reaction, to compare the activity of products containing the same ingredients. Perspex blocks, with or without saliva pretreatment, were soaked in rinses for 2 min, washed and placed in a standard tea solution for 60 min and then the optical density (OD) read on a spectrophotometer. The cycle was repeated 10 times for saliva and 17 times for no saliva specimens or until the maximum OD was exceeded. A series of three separate experiments was performed by this method. The maximum OD was not exceeded by any product before seven passages and therefore data were compared at six passages. For most products OD increased with saliva pretreatment. Some cetylpyridinium chloride (CPC) rinses stained comparably to a chlorhexidine rinse. CPC rinses, most of which contained the same concentration of the antiseptic, varied considerably in their propensity to induce staining and one was little different to water controls. A 0.1% chlorhexidine rinse stained slightly more than a 0.2%. A phenolic/essential oil product produced some staining but zinc, triclosan and other essential oil rinses did not stain.(ABSTRACT TRUNCATED AT 250 WORDS)
PURPOSE: To evaluate the value of sucralfate mouth washings in prevention of radiation-induced mucositis. METHODS AND MATERIALS: Forty patients with head and neck cancer were randomized to use either sucralfate mouth washing 1 g six times daily during irradiation (n = 20) or to placebo washing (n = 20). Mouth washing was started at the beginning of radiation therapy and continued to the end of the therapy (7-10 weeks). Assessment of the degree of radiation mucositis and collection of stimulated saliva samples were done weekly during the therapy. Salivary lactoferrin and albumin, suggested markers for the degree of mucositis, were analyzed from stimulated whole saliva samples. RESULTS: All patients developed radiation-induced mucositis of varying degree after irradiation of about 30 Gy. No difference in the visually assessed degree of mucositis or oral pain reported by the patients was found between the study and the control groups. However, the patients treated with sucralfate used less anesthetic mouth washing and their salivary lactoferrin and albumin levels were lower. CONCLUSION: Although the trial produced no direct clinical evidence indicating that sucralfate mouth rinses prevent radiation-induced mucositis, the decrease in the salivary lactoferrin and albumin levels suggests that sucralfate has a slight protective effect on the oral mucosa.
A high-performance liquid chromatographic method is presented for the analysis of the benzophenanthridine alkaloid, sanguinarine, found in plant extracts. The method is demonstrated to be applicable to analyzing samples such as saliva and gingival crevicular fluid for sanguinarine following a simple acidified methanolic extraction step. The method utilizes an ethyl silane column with acidic and basic ion-pairing reagents in the mobile phase with a limit of detection of 3 ng of sanguinarine in a sample.
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The objective of this study was to determine the magnitude of frictional force changes between several sizes of stainless steel orthodontic wires (0.018 inch round, 0.020 inch round, and 0.018 X 0.025 inch rectangular) and an edgewise bracket (0.022 X 0.028 inch slot) when an artificial saliva medium was introduced. The wires were secured in the bracket slots with a 0.010 inch polyurethane ligatures. The force values in the saliva substitute medium were compared with those produced in a dry control and in glycerin. Clinically significant differences among the environmental conditions and among the wire sizes were found. The introduction of saliva substitute provides a significant reduction in force values.
Twenty-nine new orthodontic patients and 30 experienced orthodontic patients received either behavioral self-management of toothbrushing and mouth rinsing or an experimental regimen that consisted of prompting by the orthodontist to brush and rinse regularly plus instructions to turn in home care materials during orthodontic visits. Several sets of data showed uniformly high rates of brushing and rinsing among all four groups of subjects. Several data sets also showed significant improvements in oral health status among all four groups. Substantive and methodologic directions for future research are delineated.
The presence of clinically detectable areas of decalcification (observable as whitened areas) following the removal of orthodontic appliances is well recognized. The aim of the present study was to determine quantitatively the amount of demineralization and the ability of commercially available products to inhibit or reverse orthodontically related demineralization. Twenty orthodontic patients scheduled to have premolars extracted were randomly divided into four groups--one control and three test groups. The extracted premolars (numbering 58) were bracketed using an acid-etch composite system; each patient was given precise oral hygiene instructions and supplied with a sodium fluoride (1,100 ppm fluoride) dentifrice and an orthodontic toothbrush. The control group brushed only with the supplied dentifrice. In addition to brushing with the dentifrice, those in test group I rinsed once each night with a sodium fluoride (0.05%) mouthrinse; group II received a weekly topical APF treatment (1.2% fluoride); and Group III received a weekly topical APF treatment and rinsed once each night with the sodium fluoride mouthrinse. All premolars were extracted after 1 calendar month. Mineral profiles were determined on cross-sectioned teeth 50 to 75 micron occlusal and cervical to the brackets, directly underneath the brackets, and 500 micron away from the brackets. The control teeth (dentifrice only) demonstrated up to 15% demineralization to a depth of 50 micron. All of the test teeth produced rehardening and/or inhibition of demineralization (P less than 0.01). Those in test group III showed a particularly hard outer layer. The study demonstrated that measurable demineralization occurred around orthodontic appliances after only 1 month and this demineralization can be completely inhibited and/or reversed by the use of commercially available fluoride products.
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Clinical experiments were performed to investigate the effect of fluoride on carious lesion development and on lesions established during fixed orthodontic therapy. All presently available fluoride agents are developed from the concept of fluoridating the enamel in the form of fluorhydroxyapatite. Recent research has indicated, however, that calcium fluoride formation may be a major aspect of the mechanism of the cariostatic effect of topical fluoride. Therefore a fluoride solution with very low pH (1.9) that induced large amounts of calcium fluoride also was tested on lesion development underneath orthodontic bands. Daily fluoride mouth rinsing with a 0.2% solution sodium fluoride (NaF) retarded lesion development significantly, whereas the fluoride solution with low pH inhibited lesion formation completely. Fluoride applied as a mouth rinse to plaque-covered lesions underneath orthodontic bands retarded lesion progression. The remineralizing capacity of saliva was found to be rapid in the absence of any fluoride. Although white spot lesions may remineralize and even disappear, most of the emphasis should be directed against prevention of carious lesion development during treatment with fixed orthodontic appliances.
In the present study the prevalence of white spot lesions (initial enamel lesions) on the vestibular surfaces was recorded in 19-year-olds subjected to and not subjected to orthodontic treatment. Fifty-one orthodontic patients and 47 untreated subjects were examined. On the average, 5.7 years had elapsed since orthodontic appliances were removed. The median white spot score was significantly higher in the orthodontic group than in the untreated group. The orthodontically treated subjects also had more teeth with white spot lesions than the untreated subjects. The highest prevalence was noted on the first molars in both groups. In the orthodontic group the mandibular canines and premolars and the maxillary lateral incisors were also affected. The present study showed that white spot lesions after orthodontic treatment with fixed appliances may present an esthetic problem, even more than 5 years after treatment.
A sanguinaria-containing toothpaste and oral rinse regimen was evaluated during a 6-month period to determine its effectiveness in controlling plaque, gingival inflammation, and sulcular bleeding. Oral hygiene instructions and a 1-month prestudy brushing period failed to produce a significant improvement in health among the 24 subjects as determined by the three evaluation parameters. After the oral hygiene period, the subjects were randomly assigned to the active treatment (marketed Viadent toothpaste and oral rinse) or the placebo treatment (same base formulas without sanguinaria). Treatments were evaluated using the Löe and Silness gingival index, the Silness and Löe plaque index, and the Mühlemann and Son sulcular bleeding index at baseline and monthly through 6 months. The sanguinaria regimen reduced plaque by 57%, gingival inflammation by 60%, and sulcular bleeding by 45% from baseline compared with placebo group reductions of 27% (plaque) and 21% (gingival inflammation), and an increase of 30% in bleeding index. Repeated-measures analysis of covariance with baseline scores used as covariates showed statistically significant differences at 6 months for plaque (active 0.39; placebo 0.68, p less than 0.01), gingival inflammation (active 0.32; placebo 0.76, p less than 0.001), and sulcular bleeding (active 0.34; placebo 0.70, p less than 0.002). Results of this study demonstrated that the combined use of the sanguinaria-containing toothpaste and oral rinse controls and reduces plaque and gingival inflammation in an orthodontic population.
The purpose of this study was to assess the effectiveness of a 0.12% chlorhexidine gluconate (CH) mouthrinse, Peridex, on orthodontic patients 11 through 17 years of age with established gingivitis. Thirty-four subjects were divided into two groups (CH and placebo) of 17 subjects each on the basis of gender, and they were evaluated at baseline, at 6 weeks, and at 12 weeks in a double-blinded manner. The gingival index (GI) of Löe and Silness, the plaque index (PI) of Silness and Löe, the Eastman Interproximal Bleeding Index, and the CWRU staining index were recorded for each subject. The subjects in the CH group, as compared with the placebo group, had statistically significant reductions, expressed as percent reductions against baseline, at the conclusion of this 3-month period: PI = 64.9%, GI = 60.0%, and gingival bleeding = 77.2%. Staining was in the moderate range, and it was concentrated on the mandibular lingual surfaces. Peridex, in combination with mechanical plaque removal, proved to be an important therapeutic agent in controlling gingival inflammation, bleeding, and plaque accumulation in orthodontic patients 11 through 17 years of age with established gingivitis.
A clinical study was conducted to determine if rinsing frequency with a neutral 0.05% sodium fluoride rinse influenced white spot lesion formation associated with orthodontic brackets. Patients from two private orthodontic practices participated. Each received home-care instructions and were told to use 10 ml of sodium fluoride rinse daily before bedtime. The rinse was supplied free of charge to determine if this affected compliance with its prescribed use. Compliance was measured by recording the number of bottles used by each patient. As assessment of oral hygiene status was conducted, and at the time of debonding, white spot lesions were recorded. Only 13% of the 206 participants fully complied with the rinse protocol; 42% of the subjects used 10 ml approximately every other day; and 45% used the rinse less frequently. A significant dose response relationship was noted in which those who rinsed at least once every other day had fewer lesions (21%) than those who rinsed less frequently (49%). It was concluded that a significant reduction in enamel white spot lesions can be achieved during orthodontic therapy through the use of a 10 ml neutral sodium fluoride rinse. The more closely patients complied with the prescribed use, the more likely they could expect a decrease in the occurrence of lesions.