Stannous Fluoride Research Articles

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.

Reduction in erosive tooth wear using stannous fluoride-containing dentifrices: a meta-analysis.

Dentifrices containing different active agents may be helpful to allow rehardening and to increase the resistance of the eroded surface to further acids or mechanical impacts. This study aimed to compare the effects of conventional (sodium fluoride [NaF]) and stannous fluoride (SnF2)-containing dentifrices on reducing erosive tooth wear (ETW). The PubMed/MEDLINE, Scopus, LILACS, BBO, EMBASE, TRIP electronic databases, and grey literature were searched until January 2021 to retrieve relevant in vitro and in situ studies related to research question. There were no restrictions on publication year or language. Two authors independently selected the studies, extracted the data, and assessed the risk of bias. ETW data were pooled to calculate and compare both dentifrices (overall analysis) and in vitro and in situ studies separately (subgroup analysis). Statistical analyses were performed using RevMan5.3 with a random effects model. Of 820 potentially eligible studies, 101 were selected for full-text analysis, and 8 were included in the systematic review and meta-analysis. There was a significant difference between SnF2-containing dentifrices and NaF dentifrices only for in vitro studies (p=0.04), showing a higher effect of the SnF2-containing dentifrices against the erosion/abrasion (effect size: -6.80 95%CI: -13.42; -0.19). Most in vitro and in situ studies had high and low risk of bias, respectively. In vitro literature suggests that the ETW reduction is greater when using SnF2-containing dentifrices instead NaF-containing dentifrices. However, the evidence level is insufficient for definitive conclusions. Clinical trials are necessary for a better understanding of the effect of these compounds on ETW.

Evaluation of the Effect of Fluoride Application on Periodontal Health during Orthodontic Treatment (A Clinical Study)

Purpose: This study was carried out to evaluate the effectiveness of different fluoride applications on periodontal health (clinical and microbiological) during orthodontic treatment with fixed appliance. Patients & Methods: The study groups were designed randomly into three equal groups using the same type of (fluoride-free) toothpaste. Group I used PERIOMED contains stannous fluoride mouthwash, group II used LISTERINE® contains sodium fluoride Mouthwash and the control group used distilled water. All patients were put onto the recall schedule at zero, 7th, 14 and 28 days. Samples were collected for detection of the interleukin-1 beta level, determination of reduction in microbial count and assessment of the following clinical parameters: pocket depth, plaque index, and gingival index. They were recorded at these time intervals mentioned. Following Orthodontic treatment for all patients, Interleukin- 1 beta and Colony Forming Units (CFUs) were measured. Results: interleukin-1beta level and bacterial count were high at the onset of periodontal inflammation at the same range with no significant differences between the studied groups. At the end of the study, group I and group II showed a marked decrease in the interleukin-1beta level and bacterial count compared to the control group, and there was a statistically nonsignificant difference between group I & II. Conclusion: Stannous fluoride mouthwash showed the best results in the level of IL-1β, since in the reduction of the bacterial count also includes improving in the clinical parameters (PD, PI, GI) compared with the other samples of the study.

The Effect of Demineralization and Remineralization Cycles on the Bond Strength of Resin Composite to Enamel.

77 bovine incisors were subjected to simulated toothwear by erosion (0.3% citric acid) and abrasion (oscillating toothbrush). Samples were randomly arranged into 5 test and 2 control groups (n=11). Each test group had a remineralising agent applied. Subsequently, composite was bonded to each sample and subjected to shear bond testing. Shear bond strength, mode of failure and enamel surface changes were analysed. There was no statistically significant difference for bond strength between groups (p=0.262). Mode of failure was statistically significant between groups (p⟨0.0001). Qualitative analysis showed a surface layer on samples remineralised by calcium silicate and stannous fluoride. Both groups had more adhesive failures. Within the limitations of this study, it can be concluded that the remineralising agents tested do not affect shear bond strength though surface layers created on the enamel influence the mode of failure. These 'sacrificial' surface layers have the potential to protect the underlying enamel structure.

REVIEW ON ROLE OF METAL SALT IN THE RE-MINERALIZATION OF DENTAL CARIES

Dental caries is a most common disease that affects large number of people. It is a worldwide public health problem, affecting numerous urban and rural communities. White-spot lesions (WSL) are the earliest macroscopic evidence of enamel caries. Typically, the enamel surface layer stays intact during subsurface demineralization, but, without treatment, will eventually collapse into a full cavity. Near-neutral pH of saliva is endowed with a natural buffering capacity. Natural demineralization of tooth at an early stage is reversed by saliva, which contains calcium ions, phosphate ions, buffering agents, fluoride, and other substances. The strategy for aided remineralisation is to have ions directly delivered to where and when they are needed the most. Several mechanisms are available for aided remineralisation. The most well known is the delivery of topical and systemic fluoride, which has been proven to be a highly effective measure for prevention of caries. However limitations and risks associated with the use of fluoride as a remineralising agent fuelled the need to develop newer non-toxic techniques that deliver calcium and phosphate ions directly into subsurface lesion and/or boost remineralising properties of saliva. Encouraging microscopic changes in the demineralized enamel surface following the treatment with different concentration of metal salts, involving zinc, strontium, magnesium, in addition to stannous fluoride, many metal salts are in use for the treatment of dental caries. Microscopic examination was conducted on teeth samples before and after pH-cycling procedure and following the treatment with the selected metal salt under polarized microscope (100X). The best obvious remineralisation was found following treatment with stannous fluoride, followed by zinc chloride. The stannous fluoride was the best in the remineralisation of initial caries, results for other metals seem to be promising if used for prevention of dental caries. Mineralization of teeth is determined by major inorganic elements as calcium, phosphorous in addition to other elements that occur in traces within tooth structure (Thylstrup and Fejerskov, 1996 Murry, 1996 Peter, 2004). Fluoride now a day is widely used either systemically or topically to increase resistance of teeth surface, it has been well documented as a major contributing factor in the decline of the incidence and severity of dental caries in many countries (Murry, 1996 Curzon,1999).So far fluoride has been considered to play an almost unique role in the prevention of dental caries however there is no reason to dismiss the role of other elements as being potential cariostatic agents. Different concentrations of different metal ions as zinc and copper have been tested for better effect on remineralisation in vitro (Dedhiya, et al., 1974 Fang et al., 1980). However controversy is present in the literature concerning their effectiveness in prevention of dental caries when used topically at effective concentrations (Torredo et al., 2004 Elzbieta et al., 2008 Curzon, 1983).

In vitro activity of biofilm inhibitors in combination with antibacterial drugs against extensively drug-resistant Acinetobacter baumannii

Acinetobacter baumannii is a common pathogen of nosocomial infection, and its ability to form biofilms further contributes to its virulence and multidrug resistance, posing a great threat to global public health. In this study, we investigated the inhibitory effects of five biofilm inhibitors (BFIs) (zinc lactate, stannous fluoride, furanone, azithromycin, and rifampicin) on biofilm formation of nine extensively drug-resistant A. baumannii (XDRAB), and assessed the synergistic antibacterial effects of these BFIs when combined with one of four conventional anti-A. baumannii antibiotics (imipenem, meropenem, tigecycline, and polymyxin B). Each of the five BFIs tested was found to be able to significantly inhibit biofilm formation of all the clinical isolates tested under sub-minimal inhibitory concentrations. Then, we observed synergistic effects (in 22%, 56% and 11% of the isolates) and additive effects (56%, 44% and 44%) when zinc lactate, stannous fluoride and furanone were combined with tigecycline, respectively. When zinc lactate and stannous fluoride were each used with a carbapenem (imipenem or meropenem), in 33% and 56–67% of the isolates, they showed synergistic and additive effects, respectively. Additivity in > 50% of the isolates was detected when rifampicin was combined with imipenem, meropenem, tigecycline, or polymyxin B; and a 100% additivity was noted with azithromycin-polymyxin B combination. However, antagonism and indifference were noted for polymyxin B in its combination with zinc lactate and stannous fluoride, respectively. In conclusion, five BFIs in combination with four antibacterial drugs showed different degrees of in vitro synergistic and additive antibacterial effects against XDRAB.

Quantitative assessment of dentine mineralization and tubule occlusion by NovaMin and stannous fluoride using serial block face scanning electron microscopy

Dentine hypersensitivity (DH) is one of the most common dental conditions affecting most adults during their lifetime. Tubule occlusion is a widely accepted method for treating DH. Current in-vitro techniques such as focused ion beam, scanning electron microscopy (SEM), or hydraulic conductance that are used to determine tubule occlusion do not provide the depth of occlusion, are time-consuming, expensive and the volume of dentine tested is limited. The presented study aimed to assess the ability of serial block-face SEM (SBF-SEM) to section dentine, to quantify the number of occluded tubules including the depth of penetration by NovaMin and stannous fluoride (SnF2 ) and to compare mineral density between the control and treated dentine. Results demonstrated that NovaMin provided a better occlusion with 100% of the tubules blocked at the surface compared to 83% for SnF2 . The grayscale value (230.42) was significantly higher (p ≤ 0.05) after treatment with NovaMin compared to SnF2 (222.06) and the control (196.37), indicating increased mineral density and dentine mineralization. SBF-SEM has the potential to be used for large volume analysis of bone-like materials at high resolution with minimal sample preparation over a short period. It can be significantly useful in the development and research of new biomaterials.

CONTROLE DO BIOFILME SUPRAGENGIVAL E O USO DO FLUORETO ESTANHOSO COMO ADJUVANTE NO TRATAMENTO DA GENGIVITE: REVISÃO DE LITERATURA

Agentes químicos com capacidade de ação no biofilme dental e com propriedades anti-inflamatórias têm sido amplamente inseridos em produtos para uso caseiro na Odontologia. Esses podem representar um recurso adjuvante no tratamento da gengivite, de maneira a otimizar resultados clínicos de pacientes em tratamento. Diante da diversidade dos produtos disponíveis no mercado, faz-se necessário que o cirurgião-dentista conheça o desempenho clínico desses agentes a fim de prescrever, com propriedade, os mais adequados para cada paciente. O objetivo deste trabalho foi abordar o uso de dentifrícios contendo fluoreto estanhoso como alternativa terapêutica no tratamento da gengivite através de uma revisão de literatura. Para esse fim, foi realizada pesquisa nas bases de dados PubMed, Scielo e Google Acadêmico em busca de artigos que utilizaram os seguintes descritores: "stannous fluoride", "gingivitis control" e “antimicrobial dentifrices”, sem filtros para restringir período de tempo. De acordo com os artigos incluídos nesta revisão, pode-se afirmar que o uso de dentifrícios com fluoreto estanhoso possibilita uma redução significativa tanto nos índices de placa visível, quanto nos índices de sangramento gengival. Através da revisão de literatura realizada, pode-se afirmar que a indicação de dentifrícios contendo fluoreto estanhoso é segura e representa um bom recurso como controle coadjuvante do biofilme supragengival e no tratamento da gengivite.

HISTOLOGICAL EFFECT OF SODIUM FLUORIDE AND STANNOUS FLUORIDE GELS ON BUCCAL MUCOSA OF ALBINO RAT

ABSTRACT: Different concentrations of fluoride preparations are being used enormously in dental clinics to prevent dental caries and treat tooth sensitivity. In this study the histological effect of sodium fluoride gel and stannous fluoride gel has been compared on buccal mucosa of albino rats.
 Material and Methods: This experimental study comprised of 30 Albino rats of average weight 200-250gms which were randomly divided into 3 groups. Out of total 30 rats Control group A was assigned 10 albino rats and rest of the 20 rats were included in experimental groups B and C containing 10 rats each. Animals of group B were topically treated with 0.2% sodium fluoride gel at a dose of 0.5mg/Kg as per body weight on buccal mucosa. The rest of the 10 animals of group C were given 0.4% stannous fluoride gel topically at a dose of 1mg/kg as per bodyweight. Both fluoride gels were applied once daily for 4 minutes with the help of cotton pellet on buccal mucosa for 14 days and were sacrificed on last day under deep anesthesia. Buccal mucosa of each group was taken out for biopsy. The specimens were treated with haematoxylin and eosin stain.
 Conclusion: Histological analysis showed that sodium fluoride gel has significant toxicity as compared to stannous fluoride gel.

Stannous Fluoride Effects on Enamel: A Systematic Review.

In recent years there has been a lot of talk about toothpastes with a particular chemical compound: stannous fluoride (SnF2). Its presence is currently still highly controversial, as the latter could have negative health effects. The different companies that produce toothpastes express its dosage in ppm. The purpose of this systematic literature review is to analyze all randomized clinical trials in the literature over the last 10 years and to draw clear results on the function of stannous fluoride, for this purpose the authors performed a Mann–Whitney U Test. Materials: The first analysis of the literature produced a number greater than 800 results, subsequently applying the inclusion and exclusion criteria, and following a manual analysis of the results, 26 manuscripts have been obtained. Results: From the results analyzed in this review, it could be shown that stannous fluoride does not present important contraindications, if not those commonly reported for fluorine. A meta-analysis on enamel loss has been conducted, it shows that SnF2 products provide better results with a p < 0.05 value. Conclusion: This compound could have significant effects in favor of erosion and recalcification of the enamel, on the biofilm formation, gingival inflammation, and in addition, it could be an important aid in the removal of tooth stains and halitosis.

Stannous Fluoride Preventive Effect on Enamel Erosion: An In Vitro Study.

The aim of this in vitro study was to evaluate the effects of a single dose application of two daily toothpastes on enamel exposed to acid attack. The research was conducted on human molars enamel fragments (n = 72). The two different toothpastes active ingredients were sodium fluoride (NaF) and stannous fluoride (SnF2). They were compared in protecting the surface of the enamel exposed to three acids: citric acid, lactic acid and hydrochloric acid. A spectrophotometer was used to measure the calcium ions and phosphate released in the solutions by the enamel specimens. Afterward, ionic concentrations were analyzed through the t-Student test, in order to estimate the significance level (p < 0.05) of the solubility differences obtained between the treatment and control groups. Finally, sample surfaces were analyzed with scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDX). The two analyzed toothpastes did not reveal any statistically significant variation in the release of calcium and phosphate (p > 0.05). Nevertheless, acid-resistant deposits were detected in samples treated with stannous fluoride and exposed to lactic acid, though the presence of tin ion deposits on samples treated with stannous fluoride was not shown. A single dose of a fluoride-based toothpaste before different acids attack, in simulated oral cavity conditions, did not show a significant preventive effect.

Fluoride dentifrice containing calcium silicate and sodium phosphate salts on dental erosion: In vitro study

ObjectiveTo investigate the effect of a commercial dentifrice containing fluoride, calcium silicate, and sodium phosphate and its dual phase gel serum to prevent erosive tooth wear in enamel. MethodsForty-eight enamel specimens were selected by surface hardness and randomly allocated into 4 groups (n = 12) according to the commercial toothpastes: non-fluoridated (NF); 1100 ppm Stannous fluoride (SnF2); 1450 ppm MFP + calcium silicate + sodium phosphate (CSSP); CSSP + dual-phase gel (CSSP + Serum). Cyclic experiments were repeated 3x / day for five days, including an erosive challenge with 0.05 M citric acid (pH 3.75 for 30 s), treatment with toothpaste slurries (1 min), and remineralization with artificial saliva (pH 7.0 for 60 min). Surface alterations were determined by stylus profilometry (μm) and scanning electron microscopy (SEM). Data were analyzed by ANOVA and Tukey tests (α = 0.05). ResultsSnF2, CSSP and CSSP + Serum significantly reduce surface wear compared to NF treated group. Besides, there were no significant differences among SnF2, CSSP and CSSP + Serum. In micrographs of both groups treated with CSSP, the surface demonstrates the presence of a protective layer as a deposition of particles. ConclusionsDentifrice containing calcium silicate and sodium phosphate with or without the dual-phase gel was able to prevent the erosive tooth wear.

Efficacy of an anhydrous stannous fluoride toothpaste for relief of dentine hypersensitivity: A randomized clinical study.

AimTo compare efficacy of an anhydrous 0.454% w/w stannous fluoride/sodium fluoride toothpaste (Test) versus a sodium monofluorophosphate toothpaste (Negative control) and a stannous chloride/sodium fluoride toothpaste (Positive control) for dentine hypersensitivity relief after 8 weeks’ twice‐daily use.Materials and MethodsIn this randomized, examiner‐blind, stratified, parallel study, primary and secondary efficacy variables were mean changes in Schiff score (evaporative [air] sensitivity) and tactile threshold (Yeaple probe), respectively, from baseline to Week 8 between Test (n = 62) and Negative control (n = 62). Test and Positive control (n = 61) comparisons were exploratory objectives.ResultsAll groups significantly improved from baseline on both dentine hypersensitivity measures (p < .0001). Difference between adjusted mean changes from baseline in Schiff sensitivity scores at Week 8 for Test versus Negative control groups was 0.19 (95% CI 0.002, 0.374), in favour of the Negative control (p = .0476; 12.57% difference). Difference in tactile threshold was −7.20 g (95% CI −16.376, 1.975), and this was not statistically significant (p = .3715; −21.83% difference). Test group showed no significant difference versus Positive control for either measure. Toothpastes were generally well tolerated.ConclusionWhile twice‐daily use of Test toothpaste significantly reduced dentine hypersensitivity from baseline, there was no significant advantage over negative or positive controls. Study registration: Clinicaltrials.gov; NCT03310268.

A randomized, controlled, two-month pilot trial of stannous fluoride dentifrice versus sodium fluoride dentifrice after oxalate treatment for dentinal hypersensitivity

ObjectivesTo compare the effects of a stannous fluoride dentifrice and a sodium fluoride dentifrice on dentinal hypersensitivity when used with an oxalate-based regimen combining in-office and at-home treatment.Materials and methodsIn this single-center, randomized, controlled, double-blind, pilot clinical trial, 30 subjects were professionally treated at baseline with a 3% oxalate/potassium salt solution on up to two target teeth, then randomized 1:1 to either 0.454% stannous fluoride or 0.243% sodium fluoride overlabeled dentifrice. Both groups were given 6 sensitivity strips (3.14% potassium oxalate gel) and a soft, manual toothbrush. Subjects were permitted to apply strips on up to two teeth, up to three times per tooth, at home as desired throughout the study. Dentinal sensitivity (cold air blast challenge) was assessed at baseline, immediately after post-professional treatment, and at day 60 using the Schiff scale and a Visual Analog Scale (VAS).ResultsImmediately after professional oxalate treatment, the overall mean Schiff and VAS score decreased 25.6% and 22.4% from baseline, respectively (p ≤ 0.001 for both). At day 60, further reductions in both mean scores were seen in both groups. There were no significant differences between the groups at day 60. All treatments were well tolerated.ConclusionsIn subjects treated with oxalates for dentinal hypersensitivity, both stannous fluoride and sodium fluoride dentifrices are well tolerated, are feasible for routine use, and do not detract from the desensitizing effects of an in-office and at-home oxalate combination treatment regimen.Clinical relevanceEither stannous fluoride or sodium fluoride dentifrices can be recommended to dentinal hypersensitivity patients who undergo professional oxalate treatment.

Fennel as a cause of immediate hypersensitivity to toothpaste

Ingredients in toothpaste may cause allergic and irritant contact stomatitis (Table 1). Flavoring agents are most commonly incriminated, which are present in 95% of toothpastes.1 Less frequently, cinnamon, fluoride, and anethole (anise camphor) have been suggested to cause local irritation.2,3 Pruritis and flexural dermatitis to toothpaste has been reported in a 50-year-old woman sensitized to stannous fluoride on patch testing.4

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).

Effect of in situ aspartame mouthwash to prevent intrinsic and extrinsic erosive tooth wear.

BackgroundThe aim was to evaluate whether aspartame regular mouthwash prior to erosive challenges with citric or hydrochloric acids would be able to prevent erosive enamel wear. Material and MethodsThis randomized, single blind in situ study was conducted with 3 crossover phases of 5 days. Polished bovine enamel blocks (n=252) were randomly divided among 6 groups/ 3 phases/ 21 volunteers. The groups under study were: aspartame solution (0.024% of aspartame in deionized water - experimental group), deionized water (negative-control) and stannous-containing solution (Elmex® Erosion Protection Dental Rinse; positive-control); subjected to erosion on citric acid or hydrochloric acid. Four times per day the volunteers rinsed the intraoral appliance with the respective solutions (in situ) prior to immersion of half of the appliance in 0.05M citric acid and the other half in 0.01M hydrochloric acid for 120 seconds (extraoral). The response variable was enamel loss by profilometry. Data were analyzed by ANOVA and Tukey’s test (p<0.05). ResultsNo difference on enamel loss was found between aspartame solution and deionized water. Stannous-solution resulted in less enamel loss compared to deionized water. Hydrochloric acid resulted in higher enamel loss than citric acid. ConclusionsIn this model, aspartame was not able to prevent erosive tooth wear against citric or hydrochloric acids. Key words:Dental erosion, aspartame, stannous fluoride, citric acid, hydrochloric acid.

What is the effect of active ingredients in dentifrice on inhibiting the regrowth of overnight plaque? A systematic review.

ObjectivesThe aim of this systematic review was to establish the adjuvant clinical effect of brushing with a dentifrice containing purported active ingredients as compared to a regular sodium fluoride dentifrice with respect to the inhibition of overnight dental plaque regrowth from studies with human participants.MethodsMEDLINE‐PubMed, EMBASE and Cochrane CENTRAL were searched, up to June 2019. The inclusion criteria were controlled clinical trials with participants aged ≥ 18 years in good general health. Studies were included that evaluated the effect of toothbrushing with a dentifrice on the inhibition of overnight dental plaque regrowth when an active ingredient was added to the dentifrice as compared to a common sodium fluoride product. Data were extracted from the eligible studies, the risk of bias was assessed, and a meta‐analysis was performed where feasible.ResultIndependent screening of 213 unique papers resulted in 10 eligible publications that provided 14 comparisons. Stannous fluoride and triclosan dentifrices were found as the active ingredients. The descriptive analysis indicated that all, but two comparisons demonstrated an additional effect on the active‐ingredient dentifrice. The meta‐analysis supported and strengthened these findings. It showed that when plaque was scored digitally, a DiffM was −3.15(95% CI [−4.61:‐1.69], P < .001, prediction interval [−5.07;‐1.24]). When plaque was scored clinically, the difference of means (DiffM) was −0.33(95% CI [−0.49:‐0.16], P < .001, prediction interval [−0.87; 0.21]).ConclusionThe results of this review demonstrate moderate‐quality evidence that brushing with an active‐ingredient dentifrice with stannous fluoride or triclosan does provide an added clinically relevant effect concerning plaque inhibition capabilities that surpass the effect of a regular sodium fluoride dentifrice.

Effectiveness of antimicrobial gels on gingivitis during fixed orthodontic treatment: A systematic review and meta-analysis

The present study was aimed to assess the effectiveness of antimicrobial gels along with conventional tooth brushing to improve gingival health in patients undergoing fixed orthodontic treatment. All randomized and non-randomized clinical trials done on human subjects were explored in major health science databases (PubMed, CINAHL Plus, EBSCO Dent & Oral Sciences and Cochrane). An additional manual search was done on Google Scholar and on www.clinicaltrials.gov to identify any grey literature and unpublished data. Date of publication was not restricted during the data search. The assessment of risk of bias was done using the Cochrane Collaboration's Risk of Bias assessment tool. The meta-analysis was done using Review Manager Version 5.3.5 to analyse probing depth to be in two and four-week follow-up. This systematic review is reported according to the PRISMA statement and registered at PROSPERO (CRD42018084530). The electronic database search yielded 3733 records; hand search identified 14 articles meeting the selection criteria which were included in the qualitative data synthesis. Significant improvement in gingivitis has been reported using antioxidant-essential oil gel, cervitec gel (0.2% chlorhexidine), 2% chlorhexidine gel, amine fluoride gel, and 0.4% stannous fluoride gel with>98% availability of Sn+2 ions. Three articles with probing depth as comparable parameter were used for quantitative analysis. At the two and four-week follow-up, overall insignificant differences were observed in the antimicrobial gel group compared to the control group with regard to probing depth. The use of antioxidant-essential oil gel, amine fluoride gel, 0.4% stannous fluoride gel (98% availability of Sn+2) and 2% chlorhexidine gel resulted in significant improvement in gingivitis. However, probing depth in follow-up visits showed no significant difference between antimicrobial gel and control group.

Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment.

Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment.