Significant Reduction In Gingivitis Research Articles

Efficacy and Safety of Tulsi Extract Mouthwash on Periodontal Health Status of Well-Controlled Type 2 Diabetes Mellitus Patients in India: A Concurrent Parallel Pilot Trial

Background:One of the main risk factors for periodontitis is Diabetes Mellitus (DM). In patients with DM, maintaining optimal oral hygiene is crucial to managing the advancement of periodontitis. The adverse effects of chlorhexidine limit its long-term use. Tulsi is gaining more popularity due to its anti-inflammatory and antimicrobial properties. Studies related to Tulsi mouthwash in Type 2 DM patients are lacking.Objective: The aim of the study is to evaluate the efficacy of 6% Tulsi extract and 0.2% chlorhexidine mouthwashes on the periodontal health status of well-controlled type 2 DM patients.Materials and Methods: The present study is a concurrent, parallel, randomized controlled trial. A total of 38 participants aged 45–55 years were randomly allocated to two different groups. Group A and B participants were treated with 0.2% chlorhexidine and 6% Tulsi extract mouthwashes, respectively. The assessments of gingivitis (gingival Index), dental plaque (plaque Index), and periodontal pocket depth (Community Periodontal Index) were done at baseline and on the 15th day. An unpaired t-test was used to compare the clinical conditions of the two groups.Results: Both groups have individually shown a statistically significant reduction in gingivitis, dental plaque, and periodontal pocket depth. When both groups were compared on the 15th day, chlorhexidine mouthwash showed a statistically significant reduction in PI scores (Group A 0.79 vs. Group B 0.86).Conclusion: Tulsi mouthwash is as efficacious as chlorhexidine in reducing dental plaque, gingivitis, and pocket depth among well-controlled Type 2 DM patients.

Protective Effect of UP446 on Ligature-Induced Periodontitis in Beagle Dogs.

Periodontal disease is an inflammatory disease of the gum caused by a formation of a plaque that triggers immune responses and inflammation leading to the destruction of tissues surrounding and supporting the teeth. Chronic usage of synthetic chemicals and antibiotics is limited by undesired adverse events to the host. A botanical composition (UP446), which consists primarily of bioflavonoids such as baicalin from roots of Scutellaria baicalensis and catechins from heartwoods of Acacia catechu, was evaluated for its effect on ligature-induced periodontal disease in beagle dogs. Disease model was induced in 20 male and female dogs. After a 12-week induction of periodontitis, animals were assigned to a placebo, positive control (doxycycline), and two treatment groups consisting of five animals each. The placebo group was only administrated to normal dog chow (25 g/kg/day). In the doxycycline treatment group, animals were fed a normal diet (25 g/kg/day) and doxycycline (5 mg/kg) was orally administrated every day. Treatment of UP446 was done by feeding the regular diet formulated with 0.1% and 0.2% of UP446 by weight. Clinical indices such as plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing pocket depth (PPD), and bleeding on probing (BoP) were measured every two weeks for 12 weeks. UP446 administered to beagle dogs for 12 weeks at 0.1% and 0.2% resulted in statistically significant reductions in gingivitis, pocket depth, loss of attachment, and gum bleeding. UP446 could potentially be used alone or as an adjunct with other oral hygiene preparations for periodontal disease in both human and companion animals.

Moderate quality evidence finds statistical benefit in oral health for powered over manual toothbrushes.

The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. Reference lists of identified articles were also scanned for relevant papers. Identified manufacturers were contacted for additional information. Only randomised controlled trials comparing manual and powered toothbrushes were considered. Crossover trials were eligible for inclusion if the wash-out period length was more than two weeks. Study assessment and data extraction were carried out independently by at least two reviewers. The primary outcome measures were quantified levels of plaque or gingivitis. Risk of bias assessment was undertaken. Standard Cochrane methodological approaches were taken. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months). Fifty-six trials were included with 51 (4624 patients) providing data for meta-analysis. The majority (46) were at unclear risk of bias, five at high risk of bias and five at low risk. There was moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual toothbrushes with regard to the reduction of plaque in both the short and long-term. This corresponds to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and a 21% reduction in the long term. There was a high degree of heterogeneity that was not explained by the different powered toothbrush type subgroups.There was also moderate quality evidence that powered toothbrushes again provide a statistically significant reduction in gingivitis when compared with manual toothbrushes both in the short and long term. This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness indices respectively. Again there was a high degree of heterogeneity that was not explained by the different powered toothbrush type subgroups. The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points. Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses. Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.

Gum health benefits of a silica based fluoride toothpaste containing zinc citrate, potassium citrate, hydroxyapatite and vitamin E acetate

Aims: To demonstrate the effective delivery to gingival tissues of the gum health actives zinc citrate and vitamin E acetate from a new silica based fluoride toothpaste and to confirm the clinical efficacy of the full formulation in vivo. Methods: Study 1: Zinc levels were measured from plaque samples immediately before and 10 minutes after brushing with the new toothpaste and compared to a similar marketed zinc containing product; Study 2: Vitamin E acetate levels were measured from the new toothpaste by swabbing gum tissues immediately after brushing; Study 3: Vitamin E acetate delivery and penetration of porcine gingival tissue ex vivo was measured and compared to delivery of the agent from an already marketed product; Study 4: The effect of the new toothpaste on gingival condition after three months home use was investigated in comparison to a marketed 0.3% triclosan containing toothpaste. Results: The new toothpaste showed significantly higher levels of zinc delivery compared to a similar marketed toothpaste. Vitamin E acetate delivery was also shown to be effective from both the in vivo and ex vivo studies. Clinically, both the new formulation and the 0.3% Triclosan control showed significant reduction in gingivitis after 12 weeks home use. Conclusions: Zinc citrate and vitamin E acetate are delivered at effective levels to gum tissue from the new formulation. The in vivo efficacy of the formulation has been demonstrated, showing the new toothpaste to be an effective anti-gingivitis formulation.

The effect of a mouthrinse containing essential oils on dental plaque and gingivitis

PubMed and the Cochrane Central Register of Controlled Trials were searched up to December 2006 were searched. Only studies published in English were included. Randomised controlled clinical trials, controlled clinical trials and uncontrolled longitudinal clinical trials were included in the initial search. Studies with a minimum duration of 6 months, healthy subjects >/=18 and gingivitis without severe periodontal disease were included. The effects of plaque and gingivitis were considered the primary outcomes with staining of teeth a secondary outcome. Studies were screened and data extracted independently by two reviewers. It is unclear whether or not this process was duplicated. Disagreements were resolved by discussion. Heterogeneity of the studies was assessed. Data was pooled for gingivitis and plaque and a weighted means meta-analysis using a random effects model was carried out. Eleven studies (all randomised controlled trials) met the inclusion criteria. All were of six months duration except one of nine months. There was no meta-analysis between baseline and end trial as the standard deviation could not be calculated. Three studies were not included in the meta-analysis. Meta-analysis of staining was not carried out. There was significant reduction in gingivitis with EO mouthrinses compared to control groups regardless of the measurement index used (Weighted Means Difference (WMD) -0.32 95% Confidence Interval (CI) [-0.46 to -0.19], P< 0.00001; test for heterogeneity: P<0.00001 I(2) =96.7%). A significant reduction in interproximal gingivitis was also noted for EO mouthrinses compared to control (WMD -0.29 95% CI [-0.48 to -0.11] P=0.002; test for heterogeneity: p<0.0001 I(2)=95.8%) and compared to floss (WMD -0.05 95% CI [-0.20 to -0.09] P=0.48; test for heterogeneity: P=0.0001 I(2)=99.7%). Similar results were seen for the effects on plaque with a decrease in total plaque in favour of EO mouthrinse (WMD -0.83 95% CI [-1.13 to -.053] P<0.00001; test for heterogeneity: P<0.00001 I(2)= 96.1%). Significant interproximal plaque reduction, again in favour of EO mouthrinse, was also seen compared to control (WMD -1.02 [-1.44 to -0.60] P<0.00001; test for heterogeneity: P<0.00001 I(2)=96.1% 95% CI) and compared to floss (WMD -0.75 95% CI [-1.15 to -0.363] P<0.0002; test for heterogeneity: P<0.0002 I(2)= 93%). When used as an adjunct to unsupervised oral hygiene, the existing evidence supports that essential oil provides an additional benefit with regard to plaque and gingivitis reduction compared to placebo or control.

Stannous fluoride toothpastes reduce the gingival index more than sodium fluoride toothpastes

Medline and the Cochrane Central Register of Controlled Trials were used to identify sources of data. Title and abstracts were screened independently. Randomised controlled clinical trials of >6 months duration that used gingivitis or plaque levels as outcome measures were selected. The mean values and standard deviations were extracted. In studies where standard errors of the mean were reported, standard deviations were calculated by the authors based on the sample size. Weighted means of baseline and of end of trial were calculated with the software Cochrane Collaboration Review Manager (version 4.2; The Cochrane Collaboration, Oxford, England) using a random-effects model. A meta-analysis for stannous fluoride (SnF) mouth rinse and dentifrice/ mouthrinse formulations was not performed because there were insufficient data. Fifteen papers were included in the review. For SnF dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control [weighted mean difference (WMD), 0.15 (gingival index) and 0.21 (gingivitis severity index); test for heterogeneity P<0.00001, I(2)=91.1% and P 50.03, I(2)= 80.1%, respectively]. There were inconsistent results for plaque reduction. On using the plaque index, no differences were found, whereas meta-analysis of the Turesky index gave a WMD of 0.31 (P 50.01; test for heterogeneity P 0.0001, I(2)=91.7%). The use of SnF dentifrices results in greater gingivitis and plaque reduction compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes.

Effectiveness of a triclosan/copolymer dentifrice on dental plaque and gingivitis in Brazilian individuais with cerebral palsy

This randomized clinical trial investigated the effect of a dentifrice containing triclosan on the reduction of dental plaque and gingivitis in institutionalized individuals with cerebral palsy. Fifty-seven residents were randomly allocated to a test group (n=28, dentifrice with triclosan) and a control group (n=29, conventional dentifrice). A single calibrated investigator performed examinations at baseline and after three months. The amount of dental plaque was assessed, and gingivitis was measured. The caretakers performed brushing with dentifrice. After three months, there was a significant reduction in the plaque index in both groups, but there was no difference between the two groups. There was a significant reduction in gingivitis only in the test group, and the difference between groups was significant after three months. The authors concluded that the dentifrice with triclosan reduced interdental bleeding in the studied population.

Efficacy of a herbal toothpaste on patients with established gingivitis: a randomized controlled trial

The aim of this randomised, double blind controlled trial was to verify the efficacy of a herbal dentifrice on the reduction of plaque and gingivitis. Forty eight volunteers with established gingivitis were randomly assigned to either a test group (herbal dentifrice) or positive control group (dentifrice with triclosan and fluoride). The dentifrices were distributed in plain white tubes by an independent pharmacy, which revealed the contents of each tube only after the experimental period. Plaque and gingivitis assessments were carried out on baseline and after 28 days of product use. All examinations were conducted by the same calibrated investigator. Subjects were instructed to brush their teeth three times daily using their assigned dentifrice for 28 days. There was a significant reduction in plaque levels in both the test and control groups. However, there was no significant difference between the groups. A significant reduction in gingivitis was observed in both groups, although there was no significant difference between them. No adverse reactions were reported. The authors concluded that both dentifrices were effective in reducing plaque and gingivitis in subjects with established gingivitis.

先天性欠如部位に犬歯誘導を付与したインプラント症例

To investigate the clinical efficacy in controlling established gingivitis and dental plaque of a 1450 ppm fluoride as sodium monofluorophosphate (SMFP)/zinc-based dentifrice, as compared to a zinc-free dentifrice with 1450 ppm fluoride as SMFP after six months product use. A six-month clinical study, with eighty-six (86) subjects, was conducted in Chengdu, China, using a double-blind, randomized, parallel-group treatment design. After a baseline evaluation, study subjects were randomly assigned to one of the two study treatments: 1) 1450 ppm fluoride as SMFP/zinc-based dentifrice (Test) or 2) 1450 ppm fluoride as SMFP/zinc-free dentifrice (Negative Control). Subjects were provided with a soft bristle toothbrush and brushed their teeth twice daily (morning and evening) for one minute with their assigned dentifrice. After three months, and again after six months of product use, subjects returned to the testing facility for their followup gingivitis and plaque examinations. Statistical analyses were performed separately for the gingivitis assessments and dental plaque assessments using the appropriate statistical methods. All statistical tests of hypotheses were two-sided, and employed a level of significance of α = 0.05. After three and six months of product use, subjects assigned to the Test treatment exhibited statistically significant (p < 0.001) reductions in gingival index and plaque index scores as compared to subjects assigned to the Negative Control treatment. The results of this single-center, double-blind, parallel-group and randomized clinical study support the conclusion that a 1450 ppm fluoride as SMFP/zinc-based dentifrice provides clinically meaningful and statistically significant reductions in gingivitis (23.8%) and dental plaque (22.5%) as compared to a 1450 ppm fluoride as SMFP/zinc-free dentifrice over a six-month period of twice-daily product use.

A review of the effects of stannous fluoride on gingivitis

To review the literature on the effects of stannous fluoride on gingivitis. The Medline and cochrane central register of controlled trials were searched up to August 2005 to identify appropriate studies. The primary outcome measure was gingivitis. Independent screening of titles and abstracts of 542 papers resulted in 36 publications (inter-reviewer ê score of 0.76), out of which 15 papers finally fulfilled the criteria of eligibility. For SnF(2)dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control (weighted mean difference (WMD) of 0.15 (gingival index) and 0.21 (gingivitis severity index) (test for heterogeneity p<0.00001, I(2)=91.1% and p=0.03, I(2)=80.1%, respectively)). With regard to plaque reduction inconsistent results existed. On using the plaque index no differences were found, whereas meta-analysis of the Turesky index provided a WMD of 0.31 (p=0.01, test for heterogeneity p<0.0001, I(2)=91.7%). Because of insufficient data, a meta-analysis for SnF(2)mouth rinse and dentifrice/mouthrinse formulations was not performed. The use of SnF(2) dentifrices results in gingivitis and plaque reduction when compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes.

Anti‐gingivitis efficacy of a stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice

Stannous fluoride is a broad-spectrum anti-microbial agent that has been used in dentistry as a chemical adjunct to prevent dental caries and gingivitis. The objective of this study was to assess the anti-gingivitis efficacy of a stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice relative to a negative control. This was a randomized, 6-month, double-blind, parallel-group gingivitis study conducted according to the guidelines for evaluating chemotherapeutic products for the control of gingivitis outlined by the American Dental Association. A stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice was tested against a commercially available negative control dentifrice. Following baseline measurements, subjects received a dental prophylaxis. Subjects were then instructed to brush twice daily for 60 s using their assigned product. Oral soft-hard-tissue examinations and clinical examinations using the Modified Gingival Index, Gingival Bleeding Index, and the Turesky modification of the Quigley-Hein Plaque Index were performed at baseline, 3 and 6 months post-treatment. A total of 143 subjects were enrolled and 130 of them completed the 6-month study. After 6 months of product usage, the experimental group had 21.7% less gingivitis (p<0.001), 57.1% less bleeding (p<0.001), and 6.9% less plaque (p=0.01) on average compared with the negative control group. No adverse oral soft-hard-tissue effects or extrinsic tooth staining was observed in the study. The results demonstrate that use of the stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice over a 6-month period provided statistically significant reductions in gingivitis, gingival bleeding, and plaque when compared with a negative control dentifrice.

咀嚼と姿勢

The objective of this study was to compare the reduction of gingivitis by two power interdental devices combined with a manual toothbrush. Eighty-two subjects completed this randomized, four-week, single-blind, two-group parallel clinical study. Subjects were randomly assigned to one of two groups: Waterpik Water Flosser (WF) plus manual tooth brushing or Sonicare Air Floss (AF) plus manual tooth brushing. Subjects were provided written and verbal instructions for all products at the baseline visit and instructions were reviewed at the two-week (W2) visit. Data were evaluated for whole mouth, lingual, and facial areas for gingivitis and bleeding on probing. Plaque data were evaluated for whole mouth, lingual, facial, approximal, and marginal areas of the tooth. Gingivitis, bleeding on probing, and plaque were scored at baseline (BSL), two weeks, and four weeks (W4). Both groups showed significant reductions in gingivitis, bleeding on probing, and plaque from baseline for all regions and time points measured (p < 0.001). The WF group was significantly more effective than the AF group at reducing plaque and gingivitis at W2 and W4 for all areas measured (p <0.001). At W4, the WF group was 80% more effective than AF for whole mouth gingivitis reduction, and twice as effective for the lingual region. In terms of plaque removal at W4, the WF group was 70% more effective for whole mouth (50.9% vs. 30%), 60% for approximal area (76.7% vs. 48%), and 47% for facial (52.8% vs. 35.9%) surfaces. The WF was twice as effective for lingual areas and more than three times as effective for marginal areas vs. the AF group (p <0.001). Results for bleeding on probing showed the WF group was numerically better than the AF group for all areas and time points, with these improvements being statistically significance for whole mouth (p = 0.02) and facial area (p = 0.004) at W2, and for the facial area (p = 0.02) at W4. The Waterpik Water Flosser is significantly more effective than Sonicare Air Floss for reducing gingivitis and plaque.

Comparative efficacy of an antiseptic mouthrinse and an antiplaque/antigingivitis dentifrice: A six-month clinical trial

The efficacy of an essential oil-containing antiseptic mouthrinse (Listerine Antiseptic, Pfizer) and an antiplaque/antigingivitis dentifrice (Colgate Total, Colgate-Palmolive) has been demonstrated in numerous double-blind clinical studies. This study was conducted to determine their comparative efficacy. Three hundred sixteen subjects with mild-to-moderate gingival inflammation and plaque received a dental prophylaxis and began their randomly assigned brushing and rinsing regimen in an unsupervised setting. Subjects brushed for one minute and rinsed with 20 milliliters for 30 seconds twice daily for six months. The three groups were L (control toothpaste/Listerine rinse), T (Colgate Total toothpaste/control rinse) and P (control toothpaste/control rinse). Subjects in the L and T groups demonstrated statistically significantly lower (P < .001) Modified Gingival Index, or MGI; Bleeding Index, or BI; and Plaque Index, or PI, at both three and six months than subjects in the P group. The magnitude of reduction for the L group was 22.9 percent, 70 percent and 56.1 percent, respectively, and for the T group, 20.8 percent, 58 percent and 22.1 percent, respectively. Subjects in the L group were not different from subjects in the T group in regard to visual signs of gingivitis (MGI), but were more effective (P < .001) than subjects in the T group in experiencing reduced BI and PI. No product-related adverse events were reported. Although the Listerine Antiseptic and Colgate Total antiplaque/antigingivitis products produced similar, clinically significant reductions in gingivitis (as measured by MGI and BI), Listerine, when used in conjunction with a fluoride dentifrice and usual oral hygiene, provided a greater benefit in reducing plaque. When considering an antiplaque/antigingivitis product to recommend to patients, clinicians should consider Listerine Antiseptic, in conjunction with usual oral hygiene, if more rigorous plaque control is desired.

Effects of Alexidine·2HCl Mouthwash on Plaque and Gingivitis after six Months

Two-hundred and fourteen subjects ranging in age from 22 to 63 years used either a mouthwash that contained 0.035% w/v alexidine.2HCL (2-ethylhexyl bisbiguanidine dihydrochloride) or a placebo twice daily on a doubleblind basis for six months in conjunction with routine oral hygiene procedures. The results indicated that alexidine.2HCL was safe and was statistically more effective in producing a clinically significant reduction in gingivitis than was the placebo.

Effects of topical application of chlorhexidine on plaque and gingivitis in monkeys. Histologic assessment.

All teeth except the lower right canine, premolars and molars, in each of 4 adult male macaque monkeys with heavy plaque deposits and severe gingivitis, were scaled and polished daily for 5 days, followed by daily topical applications of 2% aqueous chlorhexidine gluconate. Minimal amounts of simple plaque containing epithelial cells and Gram positive cocci formed on the treated teeth whereas the untreated teeth retained heavy deposits of complex plaque. In chlorhexidine treated areras the clinical level of gingivitis appeared to subside to a minimum after 15‐20 days. Histomorphometric assessments of gingivitis after 42 or 52 days treatment were made on decalcified paraffin sections, by measuring the total area of gingival connective tissue and the area containing inflammatory cells and calculating the proportion of gingival tissue affected. A total of 21 teeth were assessed. Untreated teeth had from 16‐40% of the gingivba inflamed, treated teeth only 0‐6%. Thus daily topical application of chlorhexidine significantly inhibits plaque accumulation and maintains a significant reduction in gingivitis in these animals. No differences in the nature or degree of keratinization could be detected between treated and untreated areas, nor were there any visible side effects of the use of chlorhexidine for this period.