pyrophosphate and Gingivitis

Topics: Anti-Infective Agents, Local; Dental Calculus; Dental Plaque; Dentifrices; Diphosphates; Drug Combinations; Gingivitis; Humans; Maleates; Periodontitis; Polyethylenes; Triclosan; Zinc Compounds

Does reduction of supragingival calculus provide only a cosmetic effect, or does it benefit oral health as well? The author discusses the causes and effects of calculus development and reviews methods of calculus control.

Topics: Adult; Aged; Dental Calculus; Dental Caries; Diphosphates; Female; Gingivitis; Humans; Male; Middle Aged; Prevalence; United States

Several dentifrices are available in the market for the control of calculus, plaque, and gingivitis. The anticalculus activity of the pyrophosphate dentifrice formulation has been convincingly demonstrated. Recently, dentifrices containing 0.3% triclosan and 2.0% Gantrez have been shown to possess some anticalculus activity, in addition to their antiplaque and antigingivitis properties. Similarly, sequential application of sanguinarine-containing dentifrice with a brush, followed by a rinse of 30 to 60 seconds, also provides sustained antiplaque and antigingivitis effects. However, other dentifrices have had much less convincing clinical results. It is therefore important for dentists to interpret the therapeutic claims of various antiplaque and antigingivitis dentifrices cautiously before recommending these products to patients.

Topics: Alkaloids; Benzophenanthridines; Chlorhexidine; Clinical Trials as Topic; Dental Calculus; Dental Plaque; Dentifrices; Diphosphates; Gingivitis; Humans; Isoquinolines; Maleates; Mouthwashes; Polyvinyls; Triclosan

A double-blind, parallel, randomized and controlled clinical trial was conducted on 186 subjects over six months to assess the effects of a 0.28% triclosan/5% pyrophosphate (with NaF/silica) dentifrice on dental plaque and gingivitis as compared to a NaF/silica negative control dentifrice. An initial examination was performed to assess the health of the oral soft and hard tissues and to measure plaque (by Turesky modified Quigley-Hein Plaque Index), gingivitis (by Löe-Silness Gingival and Ainamo and Bay Gingival Bleeding [GBI] indices). Only those subjects with a GBI score > or = 5 were accepted into the study. Each enrolled subject received an oral prophylaxis and was requested to brush and floss twice per day with the negative control NaF/silica dentifrice. After one month, the subjects were recalled and a baseline examination was performed for each of the previously described parameters. Following the baseline examination, the subjects received another oral prophylaxis. The subjects were then separated by gender and by baseline GBI scores of < or = 7 or > 7 and arrayed by the changes in GBI bleeding sites from initial to baseline. Within strata, subjects were randomly assigned to brush twice per day with either the triclosan/pyrophosphate dentifrice or the negative control dentifrice. The subjects were subsequently examined for all of the above-described parameters following use of the test dentifrices for five weeks, three and six months. The data generated in this trial were analyzed using an analysis of covariance on all indices for all subjects completing the examinations. The results from this study demonstrated that the use of the triclosan/pyrophosphate dentifrice resulted in statistically significant reductions of dental plaque compared to the control by 10% (p < 0.05), 15.4% (p < 0.01) and 13.9% (p < 0.01) at five weeks, three and six months, respectively. However, there were no statistically significant differences between the test dentifrices for any of the gingivitis or gingival bleeding evaluations throughout the study. Based on 1) the fact that subjects possessed plaque-induced gingivitis in this clinical study, 2) the similarity in the magnitude of the plaque reductions observed from the triclosan/pyrophosphate dentifrice relative to those reported for other triclosan-containing dentifrices, 3) the similarity in the dose of triclosan relative to other triclosan dentifrices, and 4) the reported magnitude of gingivitis reductions from othe

Topics: Adolescent; Adult; Aged; Analysis of Variance; Anti-Infective Agents, Local; Dental Plaque; Dental Plaque Index; Dentifrices; Diphosphates; Double-Blind Method; Drug Combinations; Female; Gingivitis; Humans; Longitudinal Studies; Male; Middle Aged; Periodontal Index; Sodium Fluoride; Statistics, Nonparametric; Triclosan

The basic design for human clinical trials which examine prevention of gingivitis recurrence is well known. However, the anti-gingivitis efficacy of triclosan-containing dentifrices has not been routinely demonstrated using this design, regardless of formulation. In an effort to better understand the subtleties of design which show triclosan efficacy, a study was undertaken to prospectively test how subjects with a range of baseline disease levels (which encompassed the range of gingivitis severity documented in the triclosan literature) benefit from a triclosan dentifrice. This trial was a randomized, double-blind, parallel group, six-month study where subjects brushed twice daily with either triclosan/pyrophosphate, triclosan/copolymer, triclosan placebo or sodium fluoride control (NaF) dentifrice following a prophylaxis. Both gingivitis and bleeding were measured using the Löe-Silness Gingival Index (GI) and plaque was measured using the Turesky Plaque Index. Comparisons between treatments were performed using an analysis of covariance. At month 3, the triclosan/pyrophosphate group had a relative mean plaque benefit of 14.4% versus the triclosan placebo group (with an associated p-value of 0.004), and subjects using triclosan/copolymer had a mean reduction in GI bleeding sites of 16.2% relative to those brushing with the NaF control (with an associated p-value of 0.031). The overall results did not demonstrate a treatment effect for gingivitis or plaque for either triclosan-containing dentifrice at month 6. There was evidence of modest anti-gingivitis efficacy in the triclosan placebo. In an effort to better understand how baseline disease severity may have impacted the trial outcome, additional analyses were performed to investigate whether the magnitude of a triclosan effect was related to baseline gingivitis levels. An analysis of covariance model incorporating a baseline group interaction effect indicated that the magnitude of the treatment differences depended on the baseline scores The effect was most pronounced for GI bleeding sites. Further analysis showed that differences between triclosan dentifrices and the NaF control dentifrice were only present for subjects with more than 33 to 63 bleeding sites, depending on the specific comparison. These findings were illustrated through a series of subset analyses on subjects with > or = 20 (entire study population), > or = 31, > or = 40 and > or = 45 baseline GI bleeding sites. The magnitude of the tr

Topics: Adult; Analysis of Variance; Anti-Infective Agents, Local; Cariostatic Agents; Complex Mixtures; Dental Plaque; Dental Plaque Index; Dentifrices; Diphosphates; Double-Blind Method; Female; Fluorides; Gingival Hemorrhage; Gingivitis; Humans; Male; Maleates; Periodontal Index; Placebos; Polyvinyls; Prospective Studies; Research Design; Sensitivity and Specificity; Silicic Acid; Silicon Dioxide; Sodium Fluoride; Toothpastes; Treatment Outcome; Triclosan

3 triclosan-containing dentifrices were compared in a 6-month, unsupervised tooth brushing study. The effects on plaque, gingival bleeding and certain salivary micro-organisms (mutans streptococci, lactobacilli, total counts of streptococci and total counts of micro-organisms) were evaluated. 123 subjects were divided into 4 groups according to severity of gingival bleeding index. 112 subjects completed the study. Following a 4-week pre-experimental period, using a sodium monofluorophosphate dentifrice (placebo), the subjects were assigned to use one of 3 triclosan-containing dentifrices, available on the Swedish market: Colgate Paradent (a triclosan/copolymer dentifrice) (n = 26); Pepsodent Gum Health (a triclosan/zinc citrate dentifrice) (n = 31); Dentosal Friskt Tandkött (a triclosan/pyrophosphate dentifrice) (n = 28); or to continue with the placebo (n = 27). The results revealed that Colgate Paradent reduced baseline plaque values by 39% (Quigley and Hein) over the 6-month experimental period. The corresponding values for the other modalities were: a reduction of 6% for Pepsodent Gum Health, an increase of 5% for Dentosal Friskt Tandkött, and an increase of 2% for placebo. A significant difference in the plaque levels (p < 0.05) was found between Colgate Paradent and Pepsodent Gum Health and between Colgate Paradent and placebo. The gingival bleeding index was improved in all 4 groups. A significant difference (p < 0.05) was found with respect to bleeding between Colgate Paradent and placebo (p < 0.05) at the 3-month registration. A statistically significant increase over time in total number of streptococci and total colony forming units were found for the Dentosal, Pepsodent and placebo groups, but not for Colgate.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Analysis of Variance; Citrates; Citric Acid; Colony Count, Microbial; Cross-Sectional Studies; Dental Plaque; Dental Plaque Index; Dentifrices; Diphosphates; Double-Blind Method; Female; Gingivitis; Humans; Lactobacillus; Male; Maleates; Periodontal Index; Polyvinyls; Saliva; Streptococcus; Streptococcus mutans; Triclosan

In order to compare the antiplaque and antigingivitis activity of three commercially-available triclosan containing dentifrices with that of a placebo dentifrice without triclosan, a double-blind clinical study was conducted on 194 subjects over six months. Following baseline supragingival plaque and gingivitis examinations and a complete oral prophylaxis, subjects were stratified by their whole mouth baseline plaque (modified Quigley-Hein) and gingivitis (modified Löe-Silness) scores and then randomly assigned to one of four dentifrice using groups. Plaque and gingivitis examinations were then performed after six weeks, three months and six months use of the dentifrices. Subjects brushed twice daily in their customary manner. The triclosan/soluble pyrophosphate and the triclosan/zinc citrate commercially available dentifrices did not provide statistically significant reductions in either supragingival plaque accumulation or gingivitis at any of the examination intervals, as compared to the placebo dentifrice. The subjects using the commercially available triclosan/copolymer dentifrice had, after six months, statistically significant reductions in supragingival plaque (11.3 per cent), plaque severity (18.8 per cent), gingivitis (19.9 per cent) and gingivitis severity (27.8 per cent), as compared to the placebo dentifrice.

Topics: Adolescent; Adult; Citrates; Citric Acid; Dental Plaque; Dental Plaque Index; Dentifrices; Diphosphates; Double-Blind Method; Female; Fluorides; Gingivitis; Humans; Male; Maleates; Middle Aged; Periodontal Index; Phosphates; Placebos; Polyvinyls; Sodium Fluoride; Triclosan

A double blind, seven month clinical study was conducted to determine the effects of three Triclosan containing test dentifrices on supragingival plaque, gingivitis and supragingival calculus formation compared to a 0.8 per cent monofluorophosphate-silica control dentifrice. Each test dentifrice contained 0.3 per cent Triclosan; additionally one contained 0.75 per cent zinc citrate, the second contained 2 per cent Gantrez and the third contained 5 per cent pyrophosphate. Subjects were assigned to one of the three test groups or to the control group according to random allocation within nine strata. Subjects were evaluated for supragingival plaque and calculus formation and for gingivitis after one, four and seven months' use of the dentifrices. After seven months, the Triclosan/Gantrez and the Triclosan/pyrophosphate dentifrices each provided a statistically significant reduction of approximately 25 per cent in gingival bleeding compared to the control. Neither dentifrice gave statistically significant reductions in supragingival plaque or calculus formation. In contrast, the Triclosan/zinc citrate dentifrice provided statistically significant reductions of 33 per cent in supragingival plaque, 51 per cent in gingival bleeding and 67 per cent in supragingival calculus formation. The reductions in gingival bleeding and calculus formation were statistically superior to those of the Triclosan/Gantrez and the Triclosan/pyrophosphate products. The results demonstrate that use of the Triclosan/zinc citrate dentifrice over a seven month period provided statistically significant and clinically relevant reductions in supragingival plaque and calculus formation, and control of gingivitis as compared to a control dentifrice.

Topics: Adult; Citrates; Citric Acid; Dental Calculus; Dental Plaque; Dental Plaque Index; Dentifrices; Diphosphates; Double-Blind Method; Drug Combinations; Female; Fluorides; Gingival Hemorrhage; Gingivitis; Humans; Male; Maleates; Oral Hygiene; Periodontal Index; Phosphates; Polyvinyls; Silicon Dioxide; Tooth; Triclosan; Zinc

This research evaluated the effect of an anticalculus mouthrinse, containing 3.3% pyrophosphate anion and 1.0% of a copolymer of vinylmethyl ether and maleic acid (Gantrez), on calculus formation, gingivitis, gingival recession, and epithelial attachment in beagle dogs over a one-year period of time, compared to a distilled water rinse. Each was applied twice a day for the one-year period. Compared to the control, the anticalculus mouthrinse resulted in significant reductions in the formation of calculus and gingivitis, as well as a prevention of loss of epithelial attachment in the beagle dogs. The results from this investigation suggest that it is possible to mitigate both probing epithelial attachment loss and increases in probing pocket depth at the calculus prone sites through the use of an anticalculus mouthrinse.

Topics: Analysis of Variance; Animals; Dental Calculus; Dental Plaque; Diphosphates; Dogs; Epithelial Attachment; Gingival Recession; Gingivitis; Male; Maleates; Mouthwashes; Polyvinyls