Control Dentifrice Research Articles

A proof of principle investigation of a novel enzyme formulation on dental calculus deposition: a 4-week randomized human clinical trial

BackgroundThe dissolution of dental calculus, safely and at home, is among the more challenging issues facing the over-the-counter healthcare industry. Pontis Biologics, Inc. has developed novel model of calculus development and structure and has formulated a dentifrice (Tartarase™) using digestive enzymes as active ingredients that is shown to dissolve dental calculus in this Proof of Principle clinical trial.MethodsThis investigation was designed to evaluate the safety and efficacy of a novel enzyme formulation to remove existing calculus deposits in 4 weeks, measured using the Volpe-Manhold Index (V-MI) on lingual surfaces of 6 lower anterior teeth. The test formulation was compared to Crest Cavity Protection, as a control dentifrice. A total of 40 randomized test subjects began the study with 20 assigned to the control dentifrice and 20 assigned to the Tartarase groups (ten each, one brushing with Tartarase twice daily and one brushed with Tartarase and wore a dental tray filled with Tartarase for 30 min then brushed again with Tartarase, once daily).ResultsThe Crest group experienced a 12% increase in calculus, in contrast to the results of both Tartarase groups that experienced a 40% reduction in calculus in 4 weeks of unsupervised at home use of the Tartarase toothpaste formulation.ConclusionsThis proof of principle study demonstrates that a dentifrice, formulated along the lines of the Tartarase material, is capable of combating calculus accumulation using the same oral hygiene habits that are common worldwide.Trial registrationThis trial was registered retrospectively at clinicaltrials.gov and has the Unique Identification Number: NCT06139835, 14/11/2023.

Natural dentifrices: how can prolonged toothbrushing influence enamel color and surface roughness?

This study evaluated the color change (ΔE00) and surface roughness (Ra) of enamel submitted to prolonged toothbrushing with natural non-fluoride dentifrices. Five groups of bovine teeth (n=10) were brushed with a control dentifrice: (C) Colgate Total 12 – Colgate; and four natural dentifrices: (R) Restore – Jeunesse; (OG) OnGuard – doTerra; (OC) OzonCare – Philozon; and (N) Natural activated charcoal – Suavetex. Mechanical toothbrushing simulated one month (T1), six months (T2), one year (T3), and two years (T4) of product use. ΔE00 and Ra were measured before and after toothbrushing. Two-way repeated measures ANOVA and Tukey's test were performed. Dentifrice (p<0.001), toothbrushing time (p=0.004), and their interaction (p=0.031) influenced color change (ΔE00). Natural dentifrices promoted similar color change and Ra to the traditional product. After six months of simulated toothbrushing, OG promoted more color changes than N and R. Only OG and R reached ΔE00 above the acceptability threshold. OC and N dentifrices generated Ra above the limit of clinical roughness from T2. Toothbrushing with natural toothpaste for up to two years causes similar enamel color changes and roughness to the traditional product.

Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study.

The aim of the present study was to assess the stain removal ability and color stability of three distinct dentifrices on artificially stained enamel surface. This study included 75 intact, healthy premolars free of dental caries that were extracted during orthodontic therapy. The samples were allowed to dry for 6 hours after being submerged in the prepared tea solution for roughly 18 hours every day. Then this procedure was repeated for seven successive days. All samples were randomly divided into three experimental groups with 25 samples in each group. Group I: control dentifrice, group II: dentifrice containing hydrogen peroxide, group III: dentifrice containing papain and bromelain. A specially designed toothbrushing simulator was used to brush every sample in the relevant group. Using a spectrophotometer and a measurement program, color measurement was evaluated after staining process after 4 weeks and 8 weeks of teeth cleaning. Using a profilometer, the surface roughness values (Ra) were assessed. After 8 weeks of brushing of stained samples, the color stability was better in dentifrice containing hydrogen peroxide (1.14 ± 0.11) followed by dentifrice containing papain and bromelain (1.22 ± 0.08) and control group (1.30 ± 0.09). And after 8 weeks of brushing of stained samples, the surface roughness was more in dentifrice containing hydrogen peroxide (0.237 ± 0.02) followed by dentifrice containing papain and bromelain (0.229 ± 0.13) and control group (0.207 ± 0.05). The present study concluded that the dentifrice containing hydrogen peroxide showed a superior whitening effect on the stained enamel surface than dentifrice containing papain and bromelain and control dentifrice. The development of various dentifrice products has been greatly aided by the increased demand for an improved esthetic appearance. Teeth's natural color and any external stains that could accumulate on the tooth surface combine to determine a tooth's color. Additionally, the use of whitening dental pastes to remove external stains has grown in favor. With the development of these whitening toothpastes, dentifrices' ability to lessen or eliminate extrinsic dental stains has increased. How to cite this article: Mishra D, Kamath DG, Alagla M, et al. Evaluation of Stain Removal Efficacy and Color Stability of Three Different Dentifrices on Artificially Stained Enamel Surface-An In Vitro Study. J Contemp Dent Pract 2024;25(1):68-71.

Anti-Oxidant Efficacy of Ginger Containing Dentifrice in the Control of Biofilm Induced Gingivitis. ( Randomized Parallel Clinical Trial )

Background: Gingivitis induced by biofilm is one of the most prevalent periodontal diseases. Due to their antimicrobial, anti-inflammatory, antioxidant, and other multipotent effects, a number of traditional medicinal plants are revered as pharmaceutical alternatives. Aim: The aim of the current study was to assess the antioxidant efficacy of ginger containing dentifrice in control patients with biofilm induced gingivitis. Materials and methods: In a double-blind, randomized, parallel clinical trial, one hundred adults suffering from gingivitis caused by dental biofilm were split into two groups and given either a ginger-containing or a control dentifrice to use for three months. Clinically, periodontal assessment and saliva collection were performed at the baseline visit and after three months of toothpaste use in order to determine the superoxide dismutase level. Results: Ginger containing dentifrices showed a significantly improved in plaque (0.216+0.069) and bleeding on probing (7.818+7.339) index scores. In addition, a significant increase (22.082+1.510) in the level of SOD antioxidant after 3months compared with control dentifrice. Conclusion: Compared to conventional dentifrices, herbal dentifrices demonstrated promising outcomes.

Relationship between 1-, 3-, and 6-Month Gingival Bleeding Outcomes.

Results from systematic reviews and meta-analyses show generally consistent antigingivitis effects between 3- and 6-mo observation time points with twice-daily use of stannous fluoride (SnF2) dentifrice. However, the relationship between 1-, 3-, and 6-mo gingivitis responses has not been investigated. This pooled analysis was conducted to understand the relationship of 1-, 3-, and 6-mo gingival bleeding outcomes. Number of bleeding sites, derived from Löe-Silness Gingival Index (LSGI) or Gingival Bleeding Index, was identified as the primary end point of the analysis for the biological and clinical relevance. Randomized, double-blinded, controlled clinical studies meeting the following predefined selection criteria were identified: 1) published and unpublished gingivitis clinical trials conducted from 1995 to 2022 comparing efficacy of 0.454% SnF2 dentifrices to negative controls (sodium fluoride or sodium monofluorophosphate dentifrice) and 2) studies with a 3-mo assessment and at least a 1- or 6-mo assessment. The search resulted in ten 6-mo and fourteen 3-mo studies meeting selection criteria. A mixed-effects model was performed on the pooled data to assess gingival bleeding outcomes across time. The bleeding efficacy significantly increased between months 1 and 3 (P < 0.0001) and plateaued between months 3 and 6 (P = 0.007), supporting the fact that bleeding reduction relative to control established by 1 mo will increase and be maintained through 3 and 6 mo (R2 = 0.857). In addition, gingival bleeding and gingivitis efficacy, as measured by LSGI, were found to be highly correlated (R2 = 0.874). A clear relationship has been demonstrated between 1-, 3-, and 6-mo gingival bleeding outcomes in gingivitis clinical studies comparing SnF2 dentifrice to negative control dentifrice. These findings have important implications to the dental practice and scientific research as antigingivitis efficacy evaluations can be observed as early as 1 mo and are consistent with those seen at 3 or 6 mo. Outcomes from this investigation indicate that the clinical evaluation of antigingivitis efficacy at 1 mo is predictive of that at 3 and 6 mo, supporting studies of 1-mo duration as a viable method of knowledge acquisition. This more efficient, expedited research design has positive implications for patient care, clinical practice guidelines, protocols, and policies.

The anti-plaque effect of high concentration sodium bicarbonate dentifrice on plaque formation and gingival inflammation, irrespective to individual polishing technique and plaque quality

AimTo assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation, and gingivitis, as compared to a control toothpaste, irrespective of individual brushing technique and plaque quality.MethodsThe experimental gingivitis model, with a split-mouth design was used to assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation. By producing individual fitted trays, the toothpaste was applied in the test quadrant and a control dentifrice in the contralateral. The participants used the individual fitted trays for 1 min every morning and evening, for 21 days. In this period, the participants was only allowed to brush the teeth in the opposite jaw, as usual. Twenty healthy individuals successfully completed the study.ResultsAt 21 days, there was no statistically significant difference between test quadrant and control quadrant with regard to plaque indices, gingival index and number of bleeding sites.ConclusionThis study demonstrated that the high concentration sodium bicarbonate dentifrice used did not produce statistically significant anti-plaque effect compared to the control dentifrice, in terms of Plaque- and Gingival Indices, number of bleeding sites or by Quigely and Hein, the Turesky modification Plaque Index, irrespective of brushing technique and individual plaque quality.Trial registrationRegional Committee for Medical Research and Ethics, South-East Norway in 2021 (REK.2021/370116).Clinical Trial Registration: NCT05441371 (First registered 09/06/2022, First posted 01/07/2022) (http://www.clinicaltrials.gov). (Retrospectively registered).

Antimicrobial efficacy of S-PRG containing toothpastes on S. mutans biofilm development

Objective: to investigate the antimicrobial effects of toothpastes containing bioactive surface pre-reacted glass particles (S-PRG) on S. mutans biofilms adherence, initial colonization and maturation. Material and Methods: a reference UA 159 and a clinical S. mutans (SM6) strain were used. Bovine enamel specimens were randomly allocated into the groups (n=5): toothpastes containing 0%; 1%; 5%; 20%; 30% S-PRG; positive control dentifrice (NaF+triclosan); and negative control (distilled water). For biofilm development, samples were placed in a 24-well plate containing artificial saliva (4h), followed by adding 1mL of artificial saliva, BHI broth and 225uL of S. mutans suspension. Treatments with toothpastes were applied previously or after 4h and 24h of biofilm formation. Samples were incubated for 48h at 37°C in 5%CO2 and biofilm was detached and seeded in Petri dishes for determining the number of viable cells. Data were analyzed by ANOVA and Tukey test (5%). Results: significantly lower microorganisms’ adherence (p&lt;0.05) was obtained for all S-PRG toothpastes, with similar results to NaF+triclosan for SM6 and 20 and 30%S-PRG groups exhibiting higher inhibition effect than the NaF+Triclosan for UA159. Antibacterial effect on the early-stage biofilm was also observed for the S-PRG groups, but was not superior to the NaF+Triclosan toothpaste. For the mature biofilm, the effective antimicrobial potential of S-PRG toothpastes was observed only for the SM6 clinical strain, but was not higher than the positive control. Conclusion: experimental S-PRG toothpastes were effective to inhibit S. mutans biofilm growth by exhibiting antimicrobial activity, being promising agents to prevent cariogenic biofilm development. KEYWORDS Biofilm; Dental enamel; Giomer; Streptococcus mutans, S-PRG.

A clinical study evaluating the effect of 0.4% stannous fluoride gel in controlling plaque and gingivitis

Background: Stannous fluoride is a broad-spectrum antimicrobial agent. It has been incorporated into dentifrice formulations and shown to be effective in the prevention and reduction of gingivitis (17, 18, 20), the aim of the study was to determine whether conventional tooth brushing and twice daily use of a brush on 0.4% stannous fluoride (SnF2) gel would be more effective for controlling plaque accumulation and gingivitis than conventional tooth brushing alone.Materials and Methods: A randomized, six month, single examiner blind. Gingivitis study conducted according to the guide lines for evaluating chemotherapeutic products for the control of gingivitis. 0.4% stannous fluoride gel was tested against a commercially available negative control dentifrice (Crest Complete, KSA). The sample of the study included two groups, the first; control group (N=30) used tooth brushing with standard fluoride tooth paste( Crest Complete ,KSA),while the second; study group (N=30) used tooth brushing with the same tooth paste, supplemented with a 0.4% stannous fluoride gel used twice daily for the entire six month-study period. Clinical assessment involved plaque index(1) gingival index(2) and bleeding on probing index(3) were performed at base line, three and six months post-treatment. Result: The stannous fluoride gel (SnF2) group had highly significant lower scores for plaque index (PL.I, p&lt; 0.01), gingival index (GI, p&lt; 0.01) and bleeding tendency at all examinations than did the control group. For the study group, mean baseline PL.I score was 1.83, at three months it was reduced to 0.84and after six months it was 0.54.For the GI. Mean baseline GI. was 1.60, at three months it was 0.82 and after six months it was reduced to 0.57. Conclusion: It is concluded that the use of 0.4% SnF2 gel is an effective adjunct to mechanical tooth cleaning in decreasing plaque and gingivitis. Key words: Stannous fluoride, plaque, gingivitis.

Mechanical Effects of Brushing with Brazilian Red Propolis Toothpaste on Artificial Teeth

<p style="text-align: justify;"><strong>Objectives: </strong>The objective of this study was to verify the effect of brushing on the mass, color and roughness of the acrylic resin artificial teeth of the RDP, using a dentifrice incorporated with 1% Brazilian Red Propolis (BRP) after 5 years of brushing. <strong>Methods:</strong> The specimens were distributed in 3 groups / 10 each: Distilled Water (DW), 1% BRP-based dentifrice (PD) and Positive Control dentifrice (CD), analyzed before and after 24, 36 and 60 months of brushing. Data were expressed as mean and standard deviation, submitted to the Kolmogorov-Smirnov normality test and compared by Friedman or Kruskal-Wallis tests followed by the Dunn post test (<em>p</em> &lt;0.05, GraphPad Prism 5.0).<strong> Results: </strong>It was found that the mass had a statistically significant reduction over time, the color was observed that all experimental groups showed a significant variation (&Delta;E) and roughness did not show significant variations between groups over time. <strong>Conclusion:</strong> It was concluded that 1% BRP-based dentifrice did not cause deleterious effects on the surface of acrylic resin artificial teeth after 5 years of brushing. However, further in vivo and in vitro studies should be performed to evaluate their long-term use and then confirm their effectiveness in sanitizing RDP. <p style="text-align: justify;"><strong>Key words: </strong>Dental Prosthesis, Propolis, Toothbrushing, Natural Products, Dentistry.

Evaluating efficacy of a novel dentifrice in reducing probing depths in Stage I and II periodontitis maintenance patients: A randomized, double-blind, positive controlled clinical trial.

Compliance to periodontal maintenance therapy (PMT) is essential for long-term periodontal health. Between PMT visits, patients must maintain good oral hygiene. A dentifrice with demonstrable clinical benefits for use between PMT visits would be highly desirable. The aim of this clinical study was to investigate the effect of a novel dental gel on probing depths (PD) and inflammation when used as a home care dentifrice in Stage I and II periodontitis patients. This double-blind clinical study randomized 65 subjects with Stage I and II periodontitis to the novel dental gel containing 2.6% EDTA, and a commercially available anti-gingivitis dentifrice with 0.454% stannous fluoride. Primary endpoint was PD at 6 months for those sites with baseline PD ≥ 4mm and secondary endpoints included whole mouth mean scores of modified gingival index (MGI), modified sulcus bleeding index (mSBI) and plaque index (PI). No SRP was performed at baseline. Subjects using the novel dentifrice showed significant PD reductions of 1.18mm (from 4.27mm at baseline to 3.09mm at 6 months) compared to 0.93mm (from 4.23mm at baseline to 3.30mm at 6 months) shown for those using the positive control dentifrice. Difference between treatments at 6 months was 0.21mm with P-value=0.0126. Significant improvements in MGI (P=0.0000), mSBI (P=0.0000), and PI (P=0.0102) were also observed in 6 months. The novel dentifrice showed significant reductions in PD and gingival inflammation over 6 months solely as a home care dentifrice without baseline SRP in Stage I and II periodontitis maintenance patients.

Zinc chloride inhibits lysine decarboxylase production from Eikenella corrodens in vitro and its therapeutic implications

ObjectivesDentifrices containing zinc reduce gingival inflammation and bleeding better than control dentifrices (no zinc). How zinc might work is not understood. We have shown that lysine decarboxylase (LdcE), an enzyme from Eikenella corrodens, converts lysine to cadaverine in dental biofilms. The lack of lysine impairs the dentally attached cell barrier to biofilm, causing biofilm products to leak into junctional epithelium and stimulate inflammation. In year-old beagle dogs, immunization with LdcE, induces antibodies that inhibit LdcE activity and retard gingivitis development. We therefore examined whether a zinc-mediated loss of LdcE activity could explain the beneficial effect of zinc dentifrices. MethodsWe grew E. corrodens in modified tryptic soy broth with or without zinc chloride, and extracted LdcE from the cell surface using a Potter Elvehjem homogenizer. ResultsUp to 0.96 mM zinc chloride in the bacterial growth medium did not change cell yield, but reduced the extracted protein content by 41% (R2 = 0.27, p < 0.05) and LdcE activity/mg extracted protein by 85% (R2 = 0.90, p < 0.001). In extracts from cells grown without zinc, 78 times this zinc chloride concentration (73 mM) was required to reduce LdcE activity by 75%. ConclusionsZinc ions inhibit the production of protein with LdcE activity at E. corrodens cell surfaces. The zinc ions may attach to cysteine residues that are unique to the N-terminal region of LdcE by interfering with the non-covalent polypeptide assembly that produces enzyme activity. Clinical significanceZinc ion-mediated inhibition of LdcE assembly may provide a rationale for the improved control of gingival inflammation by zinc dentifrices.

The effects of a novel herbal toothpaste on salivary lactate dehydrogenase as a measure of cellular integrity.

Lactate dehydrogenase (LDH) is a critical intracellular enzyme responsible for anaerobic respiration in pyruvate metabolism which becomes detectable in extracellular spaces after cellular breakdown. This clinical investigation examined the effects of brushing with a test toothpaste containing natural ingredients, i.e., clove (Syzygium aromaticum), aloe vera (Aloe barbadensis), amla (Emblica officinalis), neem (Azadirachta indica), tulsi (Ocimum basillicum), and honey (from Apis mellifera), and 0.96% zinc (zinc oxide, zinc citrate) and 0.76% SMFP (1000 ppm F) in a calcium carbonate base formulated with natural ingredients (Ved Shakti, Colgate Palmolive India) and a fluoride toothpaste containing 0.76% SMFP (1000 ppm F) in a calcium carbonate base (Colgate Cavity Protection, Colgate Palmolive; henceforth control) on salivary LDH in conjunction with the assessments of dental plaque and gingivitis representing oral hygiene parameters. This double-blind, two-cell study enrolled 70 adults (age range 20-59 years). Subjects completed a washout and provided baseline saliva samples for LDH analysis and clinical assessments of dental plaque and gingivitis using the Turesky Modification of Quigley-Hein and Loe-Silness methods respectively. Subjects were randomly assigned to brush their teeth with either the test or control. Post-treatment sample collection and clinical evaluations were conducted after 3 weeks, 6 weeks, and 12 week sof brushing with all assessments conducted 12 h after hygiene. Statistical analyses were conducted independently for each parameter by t-test for within treatment evaluation and analysis of covariance (ANCOVA) for between treatment comparisons. At baseline, treatment groups demonstrated no significant differences for LDH or dental plaque and gingival index scores. Brushing with the test demonstrated progressive reductions in salivary LDH, plaque and gingival index scores over the study duration in comparison to the control. The test demonstrated reductions in LDH of 9.5-15.4% over the study period in comparison to the control representing statistically significant effects (p < 0.05). The test also demonstrated reductions in dental plaque that ranged between 6.4 and 16.2% over the study period and gingivitis reductions that ranged between 8.2 and 23.8% representing statistically significant results (p < 0.05). Brushing with a novel herbal toothpaste demonstrated significant reductions in salivary LDH representing improvements in cellular integrity with concurrent reductions in dental plaque and gingivitis as compared to the control dentifrice. Salivary LDH measurements offer a non-invasive and objective measurement of mucosal cellular integrity complementing other evaluations and clinical assessments such as plaque and gingival index scores.

Gingivitis efficacy of a 0.454% w/w stannous fluoride dentifrice: a 24-week randomized controlled trial

BackgroundPlaque-induced gingivitis can be prevented and treated with regular effective oral hygiene, principally via mechanical cleaning with regular toothbrushing. To complement the mechanical plaque removal, antimicrobial ingredients can be incorporated into dentifrices to inhibit the growth of plaque. This study aimed to evaluate and compare gingivitis and the proportion of subjects moving between gingivitis severity (< 10, > 10 < 30, > 30% bleeding sites), and plaque reduction, following twice daily use of an experimental non-aqueous 0.454% weight/weight (w/w) stannous fluoride (SnF2) dentifrice, compared to a negative control dentifrice over 12 and 24 weeks.MethodThis was a single-center, examiner-blinded, randomized, stratified, two-treatment arm, parallel group, 24-week clinical study in healthy adult volunteers with moderate gingivitis. At baseline, after abstaining from toothbrushing overnight, subjects underwent MGI (modified gingival index), BI (bleeding index) and PI (plaque index) assessments. Eligible subjects, who met the inclusion/exclusion criteria, were stratified based on gender and baseline mean MGI score (Low ≤2.00 /High > 2.00) and randomized to treatment. Following randomization, subjects underwent a thorough dental prophylaxis and flossing. After 12 and 24 weeks of twice daily brushing with their allocated treatment, subjects returned to the site (with overnight plaque, having abstained from oral hygiene procedures for 8 h prior to visit) for MGI, BI and PI assessments. Treatment effect was evaluated by comparing the MGI, BI and PI scores.ResultsOne hundred and twenty-nine subjects were screened; 98 subjects were randomized and 90 subjects completed the study. Statistically significant differences between treatments, in favour of the 0.454% stannous fluoride dentifrice were observed, compared to the negative control dentifrice, for all outcome measures (MGI, BI, bleeding sites and PI at weeks 12 and 24 p < 0.0001). At 24 weeks, 71% of subjects in the 0.453% SnF2 treatment group demonstrated < 10% of bleeding sites.ConclusionA dentifrice containing 0.454% w/w SnF2 was shown to be superior to a standard dentifrice in controlling gingivitis and supra-gingival plaque, over a 24-week period. Over two thirds of subjects in the 0.454% SnF2 treatment group demonstrated a level of bleeding sites potentially representative of “clinical periodontal health” (< 10%) following a dental prophylaxis and 24 weeks of product use.Trial registrationThis study was retrospectively registered at ClinicalTrials.gov, on 11th Oct. 2019 (NCT04123665).

Effects of a Dental Gel Over 6 Months on Periodontal Health in Subjects with Stage II and III (Mild and Moderate) Periodontitis

Objective:Overall aim of this prospective, randomized, positive controlled, double-blind in vivo study was to identify the effects of a test dental gel containing 2.6% edathamil with an added carrier and permeability enhancer vs. a positive control dentifrice on periodontal health measures in patients with Stage II and III periodontitis.Methods:In this prospective double-blinded, randomized study, 33 subjects were randomly assigned in a 1:1 ratio to brushing their teeth with either the test gel (LivFresh®, Livionex Dental Gel, Los Gatos, CA 95030) or the positive control toothpaste (Crest ProHealth®, P&G, Cincinnati, OH 45202).Full-mouth gingival index, modified sulcus bleeding index, and periodontal pocket probing depths were recorded for all teeth at baseline, and on days 90 and 180.Subjects brushed with the study material twice a day.Results:The test dental gel reduced gingival inflammation and bleeding, as well as periodontal pocket probing depths significantly more than a control dentifrice.Conclusions:In this pilot study in subjects with Stage II and III periodontitis, a test dental gel was found to improve gingival inflammation and bleeding, as well as periodontal pocket depths significantly better than a control dentifrice.

Randomized Controlled Study to Evaluate Microbial Ecological Effects of CPP-ACP and Cranberry on Dental Plaque.

Ecological approaches to dental caries prevention play a key role in attaining long-term control over the disease and maintaining a symbiotic oral microbiome. This study aimed to investigate the microbial ecological effects of 2 interventional dentifrices: a casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) dentifrice and the same dentifrice supplemented with a polyphenol-rich cranberry extract. The interventional toothpastes were compared with each other and with an active control fluoride dentifrice in a double-blinded randomized controlled trial. Real-time quantitative polymerase chain reaction (qPCR) analysis was used to determine changes in the bacterial loads of 14 key bacterial species (8 caries associated and 6 health associated) in the dental plaque of trial participants after they used the dentifrices for 5 to 6 wk. From the baseline to the recall visit, significant differences were observed between the treatment groups in the bacterial loads of 2 caries-associated bacterial species (Streptococcus mutans [P < 0.001] and Veillonella parvula [P < 0.001]) and 3 health-associated bacterial species (Corynebacterium durum [P = 0.008], Neisseria flavescens [P = 0.005], and Streptococcus sanguinis [P < 0.001]). Compared to the fluoride control dentifrice, the CPP-ACP dentifrice demonstrated significant differences for S. mutans (P = 0.032), C. durum (P = 0.007), and S. sanguinis (P < 0.001), while combination CPP-ACP-cranberry dentifrice showed significant differences for S. mutans (P < 0.001), V. parvula (P < 0.001), N. flavescens (P = 0.003), and S. sanguinis (P < 0.001). However, no significant differences were observed in the bacterial load comparisons between the CPP-ACP and combination dentifrices for any of the targeted bacterial species (P > 0.05). Overall, the results indicate that dentifrices containing CPP-ACP and polyphenol-rich cranberry extracts can influence a species-level shift in the ecology of the oral microbiome, resulting in a microbial community less associated with dental caries (Australian New Zealand Clinical Trial Registry ANZCTR 12618000095268). The results of this randomized controlled trial indicate that dentifrices containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and polyphenol-rich cranberry extracts were able to beneficially modulate the microbial ecology of dental plaque in a group of high caries-risk patients. This could contribute toward lowering the risk of developing new caries lesions, an important goal sought by patients, clinicians, and policy makers.

Effectiveness of novel herbal dentifrice in control of plaque, gingivitis, and halitosis – Randomized controlled trial

Background and aimPlaque is a common etiological factor for common oral conditions like gingivitis, periodontitis, dental caries and halitosis. We aimed to evaluate the efficacy of a novel herbal dentifrice in control of plaque, gingivitis, and halitosis in comparison to control dentifrice. Experimental procedureWe conducted a randomized controlled, single center, double-blinded parallel arm clinical trial. Participants were randomly distributed with commercially available herbal dentifrice or control dentifrice. Assessments of plaque, gingivitis, halitosis, unstimulated saliva pH were done at baseline and at one month by a trained and calibrated periodontist. All the participants were given new toothbrushes one week before the start of the study. They were asked to brush with the designated dentifrices for 2–4 min, twice daily for one month. Results and conclusionA total of 79 participants were recruited for this study, out of which 75 participants completed the follow-up. Inter-group comparisons of all the variables at baseline showed no significant differences in the mean plaque index, gingival index, halitosis and pH between test and control groups respectively. Intra-group comparisons showed a significant decrease in mean plaque, gingival and halitosis at follow-up than at baseline in both test and control groups. No significant differences between test and control groups were seen in the mean plaque index (P = 0.792), gingival index (P = 0.292), halitosis (P = 0.266), pH (P = 0.742) at follow-up after adjusting the respective baseline scores. The novel herbal dentifrice could be a suitable alternative for the control of plaque, gingivitis, and halitosis.

High fluoride dentifrice for preventing and arresting root caries in community-dwelling older adults: A randomized controlled clinical trial

ObjectiveSelf-administered non-invasive therapies with high-fluoride dentifrices are an attractive alternative to traditional restorative management of root carious lesions (RCLs), but the available evidence is still scarce, particularly in community-dwelling elders. The aim of this randomized controlled trial (RCT) was to compare the effectiveness of toothbrushing with 5,000 ppm versus 1,450 ppm fluoridated dentifrice (F- dentifrice) on preventing and arresting RCLs, in community-dwelling elders. MethodsA two years double-blinded RCT was carried out with 345 independently-living older adults, with at least one tooth with RCL. Participants were instructed to brush twice per day with either high-fluoride (5,000 ppm F) or the control dentifrice (1,450 ppm F). Incidence of new and arrested existing RCLs was recorded at two years and compared with the baseline data. Linear mixed regression model with repeated measures were used to test differences between groups (p < 0.05). ResultsThe percentage of teeth with active lesions varied significantly at two years, but in opposite directions for both groups. While the control group significantly increased the mean percentage of RCLs activity from baseline to two years, from 24.32% to 40.52%, the intervention decreased the percentage of activity from 29.74% to 3.72%. The incidence of RCL was 93.5% and 35.2% in participants of the 1,450 ppm and 5,000 ppm in the F- dentifrice groups, respectively, with a relative risk (RR) of 0.10 [CI: 0.05 – 0.19]. ConclusionNon-invasive treatment with 5,000 ppm F dentifrice is more effective than conventional dentifrices in preventing and arresting RCLs in community dwelling elders. ClinicalTrials.gov NCT02647203. Clinical SignificanceRCLs can be effectively prevented and arrested with the use of 5,000 ppm F dentifrice. Oral health programs directed to community-dwelling older adults might benefit from the inclusion of high fluoride dentifrice in their portfolio.

Evaluation of a stabilized stannous fluoride dentifrice on dental plaque and gingivitis in a randomized controlled trial with 6-month follow-up

BackgroundThe objective of this study was to compare a stannous fluoride (SnF2) dentifrice (Colgate TotalSF) stabilized with zinc phosphate with a sodium fluoride control dentifrice for gingivitis and plaque control over a 6-month period. MethodsOne hundred adult participants were enrolled in this study conducted in Chengdu, China. After random assignment and blinding of examiners and patients, enrolled participants received instructions for use of the assigned dentifrice. At 3 visits (baseline and 3 and 6 months), the authors measured various gingival and plaque indexes to determine the clinical efficacy of the stabilized SnF2 dentifrice compared with those of the control fluoride dentifrice (2 groups). ResultsNinety-eight participants completed the study. Both groups (test and control) had statistically significant reductions in gingival inflammation and improvement in plaque control at the 3- and 6-month follow-ups. In addition, the test dentifrice showed statistically significant reductions in all indexes compared with the control dentifrice (P < .001). ConclusionsThis study’s results show statistically significantly improved clinical outcomes for reduction of gingival inflammation and improvement in biofilm control over a 6-month period through the use of a SnF2 dentifrice stabilized with zinc phosphate when compared with results with a fluoride control dentifrice. Practical ImplicationsThis newly formulated dentifrice improves gingival health and plaque control and thereby may aid patients in attaining improved oral health.

Effect of stannous fluoride and zinc phosphate dentifrice on dental plaque and gingivitis: A randomized clinical trial with 6-month follow-up

ObjectiveThe objective of this study was to compare a stabilized stannous fluoride (SnF2) dentifrice with zinc phosphate (Colgate TotalSF) with SnF2 with zinc lactate and control fluoride dentifrices for gingivitis and plaque control over a 6-month period. MethodsA total of 135 adult participants were enrolled in this study. After randomization and blinding of examiners and patients, enrolled participants were provided instructions for use of assigned dentifrice. At 3 visits (0, 3, and 6 months), various gingival and plaque indexes were collected to determine the clinical efficacy of a stabilized SnF2 dentifrice. These results were compared with a SnF2 with zinc lactate dentifrice and with a control fluoride dentifrice. ResultsA total of 135 participants completed the study. All groups reported statistically significant reductions in gingival inflammation and improvement in plaque control at 3- and 6-month follow-up. Both SnF2 dentifrices showed statistically significant reductions in all indexes compared with the control dentifrice (P < .001). However, the test dentifrice showed higher but nonsignificant improvements in plaque and gingival indexes compared with the other SnF2 dentifrice. ConclusionsThis study reports similar efficacy of a test dentifrice to a commercial SnF2-containing dentifrice for plaque control and reduction in gingival inflammation and provides supporting evidence that the test dentifrice maintains its clinical efficacy with change of formulation. Practical ImplicationsThis newly formulated SnF2 stabilized with zinc phosphate dentifrice may be of benefit to patients in controlling plaque biofilm and gingivitis.

Impact of a non-fluoridated microcrystalline hydroxyapatite dentifrice on enamel caries progression in highly caries-susceptible orthodontic patients: A randomized, controlled 6-month trial.

AimThe aim of the present randomized, controlled trial was to compare the impact of the regular use of a fluoride‐free microcrystalline hydroxyapatite (HAP) dentifrice and a 1400 ppm fluoride control dentifrice on caries progression in 150 highly caries‐active orthodontic patients.MethodsThe primary outcome was the occurrence of lesions with International Caries Detection and Assessment System (ICDAS) ≥code 1 on the vestibular surfaces of teeth 15‐25 within 168 days after fixation of orthodontic brackets. Secondary outcomes were lesion development ICDAS ≥code 2, the plaque index, and the gingival index.ResultsIn total, 147 patients were included in the intent‐to‐treat (ITT) analysis; 133 finished the study per protocol (PP). An increase in enamel caries ICDAS ≥code 1 was observed in 56.8% (ITT) and 54.7% (PP) of the HAP group participants compared with 60.9% (ITT) and 61.6% (PP) of the fluoride control group. Non‐inferiority testing (ITT and PP) demonstrated the absence of a significant difference between the groups. No significant differences in secondary outcomes were observed between the groups.ConclusionIn highly caries‐active patients, the impact of the regular use of a microcrystalline HAP dentifrice on caries progression is not significantly different from the use of a 1400 ppm fluoride toothpaste (ClinicalTrials.gov: NCT02705456).