ascorbic-acid and Tooth-Discoloration

To investigate the efficacy of various formulations of chlorhexidine 0.2% (CHX) in terms of plaque and gingival bleeding control compared to each other and to saline rinse (CTRL) over a 35-day rinsing period.. Seventy subjects were randomly allocated to one of 4 groups rinsing twice daily for 35 days. The different groups used CHX 0.2% rinse with alcohol (CHX1) and without alcohol (CHX2), with an antidiscolouration system (CHX3) or saline rinse (CTRL). Clinical examinations to evaluate full-mouth plaque scores (FMPS) and periodontal parameters were performed at baseline, 7, 21 and 35 days. Tooth discolouration (TD) was measured at each time point using digital photographs and spectrophotometric analysis.. At 35 days, CTRL showed the highest levels of plaque. The mean changes in FMPS from baseline were 69.8% ± 6.8 for CHX1, 57.5% ± 9.8 for CHX2, 43.7% ± 9.8 for CHX3 and 25.8% ± 7.7 for CTRL. Statistically significant differences were demonstrated between CHX1 and CHX3 (p = 0.02), CHX2 vs CHX3 (p ≤ 0.05) and CHX1/CHX2 vs CHX3 (p < 0.05). In contrast, CHX3 appeared more effective in reducing inflammatory indexes. TD increased over time in 60% to 70% of participants, although lighter staining was found in the CHX3 group. Greater FMPS reduction was observed in participants with staining vs without staining (26.0% ± 12.3, p = 0.04).. Conventional CHX appeared more effective in terms of plaque reduction. Interestingly, the newest formulation showed a higher control of gingival inflammation. Staining was associated with lower plaque levels.

Topics: Adult; Anti-Infective Agents, Local; Ascorbic Acid; Chemistry, Pharmaceutical; Chlorhexidine; Coffee; Dental Plaque; Dental Plaque Index; Double-Blind Method; Female; Follow-Up Studies; Gingivitis; Humans; Male; Mouthwashes; Periodontal Index; Photography, Dental; Placebos; Spectrophotometry; Sulfites; Tea; Tooth Discoloration; Treatment Outcome; Wine; Young Adult

The use of chlorhexidine (CHX) has been recommended for a number of clinical applications including plaque control in the post-operative period. However, the use of CHX is burdened by some side effects that could affect the compliance of the patient. The aim of this clinical trial was to evaluate the side effects, the staining in particular, the patient acceptance, and the efficacy of a 0.2% CHX mouthwash containing an anti discoloration system (ADS) compared with a 0.2% CHX alone, after periodontal flap surgery.. This single-centre, cross-over, triple-blind randomized clinical trial was carried out on 48 consecutive patients. After periodontal flap surgery, the patients were prescribed to rinse two times per day for 1 min for 1 week with 10 ml of test or control CHX, contained in anonymous bottles coded K or M and assigned randomly. No brushing and interdental cleaning of the surgical area was allowed. At week 1, after suture removal, patients received full-mouth prophylaxis and were given a second anonymous bottle, reversing the products, with the same instructions as at baseline. Patients resumed tooth-brushing but not interdental cleaning. At the end of week 2, prophylaxis was repeated, mouth rinsing was discontinued and patients resumed normal oral hygiene. At weeks 1 and 2, the following variables were recorded: presence of pigmentation, gingival parameters at the surgically treated sites (gingival inflammation, tissue inflammation around the sutures, gingival swelling and presence of granulation tissue), patient perception and acceptance of the 2 mouthwashes.. Forty-seven patients completed the study. The difference between treatments related to gingival variables was not statistically significant. The test CHX caused consistently less pigmentations than the control CHX in all the evaluated areas of the dental surfaces (odds ratio (OR)=0.083 p<0.0001 in the incisal area, OR=0.036 p<0.0001 in the approximal area and OR=0.065 p<0.0001 in the gingival area). The CHX ADS was found to be more tolerated by patients than the control mouthwash and to cause less food alteration, less alterations to the perception of salt and to be less irritant for the oral tissues.. (1) CHX ADS caused less pigmentation, was burdened by less side effects and was more agreeable than the control CHX; (2) CHX ADS was as effective as CHX without ADS in reducing gingival signs of inflammation in the post-surgical early healing phase; (3) the use of CHX ADS could be of value in treatment protocols in which the patient compliance with a CHX mouthwash prescription is relevant.

Topics: Adult; Aged; Anti-Infective Agents, Local; Ascorbic Acid; Chlorhexidine; Cross-Over Studies; Dental Plaque; Double-Blind Method; Female; Gingiva; Humans; Linear Models; Male; Middle Aged; Mouthwashes; Patient Compliance; Periodontitis; Sulfites; Surgical Flaps; Taste; Tooth Discoloration; Treatment Outcome; Wound Healing

Correct oral hygiene is believed to be the basis of primary and secondary prevention. Sometimes, using a toothbrush or other mechanical instruments for oral hygiene may be difficult and it may become necessary to use an antiseptic. Chlorhexidine is an essential component in many available preparations on sale, because of its marked antiseptic qualities. One of the most frequent side-effects is the appearance of stains on the teeth and mucous membranes, which particularly disturbs the patient. A new mouthwash containing chlorhexidine has recently become available, besides maintaining its antiseptic qualities, also avoids the side-effect of staining.. The aim of this study was to check the capacity of the new mouthwash, which contains chlorhexidine and Anti Discoloration System (ADS), not only to prevent plaque formation like the other mouthwashes containing chlorhexidine but also to avoid staining that is one of the most frequent side-effects.. The comparative study was carried out on a sample of 15 patients treated with two mouthwashes both containing 0.2% chlorhexidine, but different in that the first does not contain ADS, which is instead present in the second, a new product. The results obtained show that in the 15 patients treated, there is no statistically significant difference in the ability of the mouthwash to prevent bacterial plaque, however evidence of the stain was much less with the new mouthwash.

Topics: Adult; Anti-Infective Agents, Local; Ascorbic Acid; Chemistry, Pharmaceutical; Chlorhexidine; Colorimetry; Dental Plaque; Dental Plaque Index; Female; Free Radical Scavengers; Humans; Male; Middle Aged; Mouthwashes; Periodontal Index; Pharmaceutic Aids; Single-Blind Method; Sulfites; Tooth; Tooth Cervix; Tooth Discoloration

This study reported red-purple staining of light-exposed, root-treated dentin when root canals were rinsed with 1.3% NaOCl as initial rinse followed by the use of BioPure MTAD as final rinse. This intrinsic dentin staining occurred irrespective of whether the root canals were filled, and could be observed even in crown dentin when the latter was sequentially immersed in NaOCl and MTAD. Bench-top reproductions of the phenomenon revealed that the exothermic reaction is not an acid-base reaction. Conversely, the reaction is of a redox nature that highly resembled the previously reported mechanism of tetracycline staining, in which photo-oxidation of tetracycline resulted in a red-purple tetracycline degradation product that has a high affinity for hydroxyapatite. This photo-oxidative degradation process is probably triggered by the use of NaOCl as an oxidizing agent, and may be prevented by rinsing the NaOCl-treated dentin with ascorbic acid, a reducing agent, before the application of MTAD.

Topics: Antioxidants; Ascorbic Acid; Citric Acid; Dentin; Doxycycline; Humans; Iatrogenic Disease; Oxidants; Oxidation-Reduction; Photochemistry; Polysorbates; Root Canal Irrigants; Sodium Hypochlorite; Tooth Discoloration; Tooth, Nonvital

Fluorotic stains present a variety of clinical surface alteration with the modification of the enamel colour, we have a structural modification of hard tissues resulting in their hypo-mineralisation. A knowledge of the kind of surface, nature, and deepness of the discoloration is necessary in order to make the right diagnosis and so, to adapt the specific treatment which can varies from a simple general treatment based on VIT C drugs, to aesthetic veneers and includes micro-abrasion technique, and chemical bleaching methods.

Topics: Ascorbic Acid; Crowns; Dental Bonding; Dental Veneers; Enamel Microabrasion; Fluorosis, Dental; Humans; Tooth Bleaching; Tooth Discoloration

It has been well acknowledged in recent literature that minocycline, a semisynthetic tetracycline derivative, causes discolorations in adult teeth and various other collagenous tissues. This article presents the most common patterns of minocycline staining in addition to comparing the staining patterns of other tetracycline analogs in the permanent dentition. It also reviews the literature's most prominent theories describing the process of minocycline discoloration, and evaluates their plausibility. It is a goal of this article to make dental practitioners aware of the possible effects of minocycline therapy and to highlight useful ways to treat or prevent these discolorations. Currently, conventional treatments include vital and nonvital bleaching, veneers, or crowns, depending on the severity of the discoloration. The literature shows that possible preventive efforts revolve around cessation of the drug or the use of large doses of vitamin C or other antioxidants in conjunction with minocycline therapy to prevent the formation of the pigment responsible for the staining.. Minocycline and other tetracycline analogs are well known for causing discoloration of developing teeth in children. However, practitioners must be aware of the tooth staining potential of minocycline in adult populations as well. Studies suggest that the concomitant use of vitamin C may help prevent adult-onset pigmentation caused by minocycline.

Topics: Adult; Anti-Bacterial Agents; Antioxidants; Ascorbic Acid; Female; Humans; Male; Middle Aged; Minocycline; Tooth Discoloration

Minocycline, a member of the tetracycline family of antibiotics, is widely used in the treatment of acne. Its use has been associated with intrinsic staining of adult human teeth, bones, and soft tissues. It causes blackening of the thyroid glands in both animals and humans. It has been determined that the pigment is the product of an oxidation reaction. Laboratory studies have shown that the pigment formation can be induced by exposure to ultraviolet light in the presence of air, and that an antioxidant, such as ascorbic acid (vitamin C), can block its formation. The present study was undertaken to determine whether the antioxidant vitamin C could prevent the pigmentation of tissues of laboratory rats given minocycline. Based on other studies, one group of rats was given minocycline by stomach tube at a dose of 75 mg/kg/day, 5 days per week, for 6 weeks. A second experimental group was given the same regimen of minocycline plus a supplement of ascorbic acid at a level of 0.1% of the diet. A control group received no treatment at all; all rats were maintained on laboratory rats chow and water ad libitum. The rats were euthanized by carbon dioxide inhalation. Nasomaxillary bones, including central incisors, and thyroid glands were removed and fixed with 10% buffered formalin. Bones and teeth showed no gross signs of staining and, therefore, were not processed further. Thyroid glands were visibly darker in the minocycline group; specimens from all three groups were processed histologically. Microscopic examination revealed extensive deposits of black pigment throughout the follicles of the minocycline group, whereas the group receiving both minocycline and vitamin C showed no sign of pigmentation and were indistinguishable from controls. It is suggested that patients on long-term minocycline medication be monitored for thyroid function.

Topics: Animals; Anti-Bacterial Agents; Antioxidants; Ascorbic Acid; Female; Minocycline; Oxidation-Reduction; Pigments, Biological; Rats; Rats, Sprague-Dawley; Thyroid Gland; Tooth Discoloration