Effects of 0.05% sodium hypochlorite oral rinse on supragingival biofilm and gingival inflammation

Objectives: This study aimed to evaluate the clinical effects of 0.05% sodium hypochlorite mouth rinse on supragingival biofilm and gingival inflammation. Methods: The study was performed as a controlled, randomised, investigator‐blinded, parallel group trial in 40 prison inmates. Following a preparatory period to obtain a plaque‐ and gingivitis‐free dentition, tooth‐brushing was substituted for 21 days by supervised twice daily rinsing with either 15 ml of fresh solution 0.05% sodium hypochlorite or 15 ml of distilled water. Clinical outcomes were assessed using the Quigley–Hein Plaque Index (QHPI), the Löe and Silness Gingival Index (L&SGI) and bleeding on probing. Adverse events were evaluated by questionnaire, visual examination and clinical photographs. Results: At day 21, the average QHPI score had increased to 3.82 in the water rinse group and 1.98 in the sodium hypochlorite rinse group. The average L&SGI score had increased to 2.1 in the water rinse group and 1.0 in the sodium hypochlorite rinse group, and the average percentage of sites that bled on probing had increased to 93.1% in the water rinse group and 56.7% in the sodium hypochlorite rinse group. Differences were statistically significant (P = 0.001). A brown extrinsic tooth stain along the gingival margin appeared in 100% of participants in the sodium hypochlorite rinse group and in 35.0% of participants in the water rinse group (P < 0.05). Conclusions: An oral rinse with 0.05% sodium hypochlorite resulted in significant reductions in supragingival biofilm accumulation and gingival inflammation. Dilute sodium hypochlorite may represent an efficacious, safe and affordable antimicrobial agent in the prevention and treatment of periodontal disease.     

Management of shortened dental arches and periodontal health: 5‐year results of a randomised trial

In a multicentre randomised trial (German Research Association, grants DFG WA 831/2‐1 to 2‐6, WO 677/2‐1.1 to 2‐2.1.; controlled‐trials.com ISRCTN97265367), patients with complete molar loss in one jaw received either a partial removable dental prosthesis (PRDP) with precision attachments or treatment according to the SDA concept aiming at pre‐molar occlusion. The objective of this current analysis was to evaluate the influence of different treatments on periodontal health. Linear mixed regression models were fitted to quantify the differences between the treatment groups. The assessment at 5 years encompassed 59 patients (PRDP group) and 46 patients (SDA group). For the distal measuring sites of the posterior‐most teeth of the study jaw, significant differences were found for the plaque index according to Silness and Löe, vertical clinical attachment loss (CAL‐V), probing pocket depth (PPD) and bleeding on probing. These differences were small and showed a slightly more unfavourable course in the PRDP group. With CAL‐V and PPD, significant differences were also found for the study jaw as a whole. For CAL‐V, the estimated group differences over 5 years amounted to 0·27 mm (95% CI 0·05; 0·48; P = 0·016) for the study jaw and 0·25 mm (95% CI 0·05; 0·45; P = 0·014) for the distal sites of the posterior‐most teeth. The respective values for PPD were 0·22 mm (95% CI 0·03; 0·41; P = 0·023) and 0·32 mm (95% CI 0·13; 0·5; P = 0·001). It can be concluded that even in a well‐maintained patient group statistically significant although minor detrimental effects of PRDPs on periodontal health are measurable.     

Self‐perceived oral symptoms and periodontal status among young intravenous heroin addicts: A cross‐sectional case‐control study

1 Background

It is hypothesized that (a) self‐perceived oral symptoms (OSs) are worse in intravenous heroin addicts (IHA) than controls; and (b) clinical periodontal inflammatory parameters (plaque index [PI], bleeding on probing [BOP], PD and clinical attachment loss [AL]), number of missing teeth (MT), and radiographic marginal bone loss (MBL) are higher in IHA compared with controls. The aim was to compare the self‐perceived OSs and periodontal parameters among young IHA and controls.

2 Methods

Sociodemographic data, self‐perceived OSs and duration and daily frequency of intravenous heroin use was gathered using a structured questionnaire. Full‐mouth PI, BOP, PD, and clinical AL were measured, and number of MT were recorded. Mesial and distal MBL on all teeth was measured on digital radiographs. Odds ratios (OR) with 95% confidence intervals (CI) were computed for self‐perceived OSs and periodontal parameters were assessed using the Mann Whitney U‐test and logistic regression analysis. Sample‐size was estimated, and level of significance was set at P < 0.05.

3 Results

OR (95% CI) for self‐perceived loose teeth (P < 0.001), pain in teeth (P < 0.001), dry mouth (P < 0.001), burning sensation in mouth (P < 0.001), bleeding gums (P < 0.001) and pain during chewing (P < 0.001) were significantly higher in the test than control group. Number of MT (P < 0.05), PI (P < 0.05), clinical AL (P < 0.05), and mesial (P < 0.05) and distal (P < 0.05) MBL were statistically significantly higher among individuals in the test group compared with the control group.

4 Conclusion

Self‐perceived OSs and periodontal inflammatory parameters were worse in IHA than controls.     

Effects of oral rinsing with triclosan and sodium lauryl sulfate on dental plaque formation: a pilot study

Mouthwashes containing 0.3% or 0.15% triclosan in combination with 1.5% sodium lauryl sulfate (SLS) produced a significant reduction in plaque formation in a test panel of 11 students who refrained from oral hygiene during the test periods, during which they rinsed twice daily with different mouthwashes. Pl.I. was evaluated after each test period. A mouthwash containing only 1.5% SLS inhibited plaque to almost the same degree. In both cases, the major effect was on the buccal/lingual surfaces, where score 2 was changed to score 0. Addition of triclosan appeared to reduce the untoward side-effects of mouthwashes containing SLS alone (i.e. desquamation and a burning sensation 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.     

A clinical follow‐up study of the periodontal conditions of RPD abutment and non‐abutment teeth

Summary The purpose of this study was to evaluate the periodontal conditions of removable partial denture (RPD) wearers, comparing direct and indirect abutment teeth, and the teeth not involved in the denture design before denture placement and 1 year later. Fifty patients (32 women and 18 men), average age 45, were assessed by the same examiner at the moment of denture insertion and 3, 6, 9 and 12 months later. The following items were verified in each assessment: probing depth (PD), plaque index (PI) and gingival index (GI). PD and PI data were evaluated by anova test for linear trend followed by Tukey–Kramer post‐test, while GI data were analysed by Friedman’s test. Results showed that the teeth not involved in the denture design were the least affected for all variables studied. It was also verified that PD and GI mean values increased from the initial assessment to 1 year of RPD wearing in every group, but that only PI showed a significant increase. This study indicated that direct and indirect retainer elements tend to undergo more damaging periodontal effects associated with RPD wearing when compared with non‐abutment elements. Plaque index values were significantly higher after 1 year of denture use.     

The use of ultrasound for the removal of the smear layer. The effect of sodium hypochlorite concentration; SEM study

This study was carried out to determine the optimum concentration of sodium hypochlorite activated by ultrasound needed to remove the smear layer from an instrumented root canal wall. The results indicated that under the conditions of this experiment a 4 per cent solution of sodium hypochlorite removed all of the smear layer from all 5 specimens; a 2 per cent solution was almost as effective; 1 per cent or 1/2 per cent solutions were less effective, and water was the least effective. A 2 per cent solution of sodium hypochlorite activated by ultrasound would appear to be the optimum concentration for the production of a smear free root canal wall under clinical conditions.