Oral rinse MMP‐8 point‐of‐care immuno test identifies patients with strong periodontal inflammatory burden

Oral Diseases (2010) 17 , 115–122 Objective: To determine whether oral rinse matrix metalloproteinase (MMP)‐8 levels, measured by three different methods, tissue inhibitor of matrix metalloprotease‐1 (TIMP‐1) levels and elastase activity differentiate subjects with different periodontal condition; and second, to find out if MMP‐8 levels were comparable among the methods used. Methods: MMP‐8 levels were analysed with an immunofluorometric method (IFMA), dentoELISA and commercial ELISA. Also TIMP‐1 levels and elastase activity were measured. For statistical analysis 214 study subjects were categorized into four groups, specified by the presence and number of moderate (4–5 mm) and deep (≥6 mm) periodontal pockets, and bleeding on probing percentage. Results: MMP‐8 levels especially measured by dentoELISA and adjusted to the number of teeth per subject differentiated the study group with strong periodontal inflammatory burden from groups with lower levels. This was also verified with receiver operating characteristic ( ROC) analysis. Elastase activity associated with higher IFMA and dentoELISA MMP‐8 levels. IFMA MMP‐8/TIMP and dentoELISA MMP‐8/TIMP‐1 tended to be higher with the increasing level of periodontal inflammatory burden. TIMP‐1 levels decreased with increasing age. Conclusions: Oral rinse MMP‐8 together with TIMP‐1 analysis may have potential in complementary periodontal diagnostics. dentoELISA can be applied in quantitative oral rinse chair side biomarker diagnostics.     

Long‐term follow‐up of the effects of a school‐based caries preventive programme involving fluoride mouth rinse and targeted fissure sealant: Evaluation at 20 years old

Aims : The evaluation of long‐term effects five years after the completion of a school‐based caries prevention programme combined with fluoride mouth rinse (FMR) and targeted sealant application (TS). Participants : 46 subjects in the FMR+TS group and 55 subjects in the FMR group, who were 20–21 years old, were analysed. They had participated in each 11‐year programme, underwent a dental examination at the age of 20 years and answered a self‐administered questionnaire. Methods : The caries prevalence and mean DMFT were calculated, and differences between the two groups were analysed by the X² test and Mann‐Whitney test, respectively. Logistic and multiple regression analyses were performed using sex, group, and five questionnaire items as independent variables. Results : The caries prevalence and mean DMFT (SD) was 28.3%, 1.56 (3.00) in the FMR+TS group and 60.0%, 2.20 (2.44) in the FMR group, and the difference was significant respectively. In the logistic regression analysis the odds ratio of the FMR+TS group to the FMR group was 0.28 (p < 0.05). Conclusions : The caries‐preventive effects of a school‐based combined programme with FMR and TS continued for more than five years after the programme until the age of 20 years.     

In vitro antimicrobial effects of commercially available mouth‐wetting agents

Products have been developed to provide palliation for persons with dry mouth. In addition to mouth‐wetting agents, some products incorporate antimicrobial constituents with the goal of improving oral microbial defenses. The aim of this in vitro study was to investigate the potential antimicrobial and antifungal effects of two commercially available saliva substitutes on Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans by using the agar‐well diffusion method. Antimicrobial activity as measured by the size of the inhibition zone growth for S. mutans and L. acidophilus was observed only with Biotene Dry Mouth Oral Rinse^® and BioXtra^® gel. The zone of inhibition of Biotene Dry Mouth Oral Rinse was larger than that of BioXtra gel (p= 0.00, p < 0.01). No anticandidal effect was seen with any of the test products. The pH of the preparations, the variations between the amount of active ingredients within the products, and the potential antimicrobial effects of inactive ingredients should be investigated to determine the factors that impacted microbial inhibition.     

The effect of using a pre-brushing mouthwash (Plax®) on removal of tooth stain in vivo and in vitro

Abstract The aim of this study was to determine whether the use of a pre-brushing mouthwash Plax - reduced extrinsic tooth staining in vivo and in vitro. Firstly, in a double-blind placebo controlled cross-over study, 20 subjects with tooth staining used Plax® or a placebo for 14-day periods separated by a 1-month wash-out period. The area of stain was assessed before and after each mouthwash had been used from clinical photographs. Secondly, extracted 3rd molar teeth were stained with tea and chlorhexidine. After exposure to either Plax® or placebo, the teeth were brushed in a standardized manner. The area and intensity of stain were assessed before and after rinsing and brushing. Results of the study in vivo showed that the mean % stained area for any of the surfaces studied changed very little throughout the study. No statistically significant changes were detected (Student t-test, p > 0.05). Results of the study in vitro showed that the mean area of stain fell by 19% after exposure to Plax® and by 17% after exposure to placebo. No statistically significant changes were detected (Student t-test, p > 0.05). There were also no significant changes in intensity (Wilcoxon signed rank sum test p > 0.1).     

Oral mutans streptococci levels following use of a xylitol mouth rinse: a double‐blind,randomized, controlled clinical trial

Xylitol‐sweetened chewing gum has cariostatic properties, but is not suitable for all patients. This study evaluated the effect of xylitol rinse on mutans streptococci (MS) levels in the mouth. One hundred and five subjects with high salivary MS levels were randomly assigned to one of three groups. Subjects in the positive control group (N = 35) chewed two xylitol gum pellets for at least 5 minutes three times daily (xylitol dose: 4.3g/day). The experimental group (N = 36) rinsed with 20 mL of an aqueous solution of xylitol twice daily for 60 seconds (dose: 4.4g/day). The negative control group (N = 34) used neither product. No attempt was made to change the subjects’ diet. Mean MS levels at baseline were 5.6 (0.1) in positive control, 5.4 (0.1) in experimental, and 5.5 (0.1) in negative control groups. After 3 months, MS levels were 4.4 (0.2), 4.4 (0.2), and 4.9 (0.2), respectively. Differences between groups were not significant by ANOVA (p = .2); however, MS levels tended to be lower in the experimental and positive control groups. Xylitol rinse and chewing gum caused a similar but statistically insignificant reduction in MS levels in the mouth.     

A prospective,randomized placebo‐controlled clinical trial on the effects of a fluoride rinse on white spot lesion development and bleeding in orthodontic patients

Demineralizations around orthodontic brackets are a main disadvantage of orthodontic treatment. Several methods have been advocated to prevent their development, such as fluoride rinses or varnishes. In this randomized clinical trial, a fluoride rinse (a combination of sodium fluoride and amine fluoride) was compared with a placebo rinse, to be used every evening after toothbrushing. A total of 81 participants (mean age: 13.3 yr) completed the study (mean treatment period: 24.5 months). Demineralizations, measured using quantitative light‐induced fluorescence and the decayed, missing, and filled surfaces (DMFS) index, were assessed before treatment (baseline) and around 6 wk after debonding (post treatment). Bleeding scores were measured at baseline, and during and post treatment. The incidence rate ratio for demineralizations was 2.6 (95% CI: 1.1–6.3) in the placebo group vs. the fluoride group. In the fluoride group, 31% of participants developed at least one demineralization, compared with 47% in the placebo group. Relative to baseline, gingival bleeding increased significantly in the placebo group 1 yr after the start of treatment and onwards. For the fluoride group, bleeding scores during treatment were not different from those at baseline. In conclusion, using a fluoride rinse helps to maintain better oral health during fixed appliance treatment, resulting in fewer demineralizations.