Database: EMBASE <: international biomedical and pharmaceutical literature, 1988 - May 2000. [Trial access until 3/2001. Feedback welcome to medical.library@umich.edu] Search Strategy (You Saved Citations 1-160 From Set 79): ----------------------------------------------------------------------------- 1 Chlorhexidine/ 1717 2 chlorhexidine.mp. 2404 3 sebidin.mp. 0 4 tubulicid.mp. 0 5 or/1-4 2404 6 exp Cariostatic agents/ 24 7 fluoride:.mp. 9667 8 ((sulfur or sulphur) adj3 hexafluoride:).mp. 341 9 difluoride:.mp. 435 10 tetrafluoride:.mp. 41 11 ossin.mp. 15 12 zymafluor.mp. 7 13 or/6-12 10400 14 exp Tooth demineralization/ 7492 15 demineralization.mp. 879 16 caries.mp. 1798 17 caires.mp. 0 18 craies.mp. 0 19 careis.mp. 1 20 carise.mp. 0 21 (teeth adj3 cavit:).mp. 32 22 (tooth adj3 cavit:).mp. 97 23 (dental adj3 cavit:).mp. 85 24 (dentin adj3 cavit:).mp. 19 25 (enamel adj3 cavit:).mp. 10 26 (teeth adj3 decay:).mp. 58 27 (tooth adj3 decay:).mp. 58 28 (dental adj3 decay:).mp. 47 29 (dentin adj3 decay:).mp. 0 30 (enamel adj3 decay:).mp. 1 31 (active adj decay).mp. 5 32 (rampant adj3 decay:).mp. 4 33 (recurrent adj3 decay:).mp. 5 34 (white adj spot:).mp. 231 35 carious.mp. 109 36 cariology.ti,ab. 2 37 (non-cavitated adj3 lesion:).mp. 0 38 (noncavitated adj3 lesion:).mp. 1 39 Tooth remineralization/ 788 40 (dental adj3 fissure:).mp. 14 41 (tooth adj3 fissure:).mp. 8 42 (teeth adj3 fissure:).mp. 1 43 caries-free.mp. 29 44 cariesfree.mp. 0 45 Cariogenic agents/ 3 46 precavit:.mp. 2 47 (filled adj3 teeth).mp. 45 48 (filled adj3 tooth).mp. 9 49 (oral adj fissure:).mp. 17 50 (tooth adj3 remineraliz:).mp. 1 51 (teeth adj3 remineraliz:).mp. 5 52 dft.mp. 542 53 dfs.mp. 980 54 dmf:.mp. 1235 55 cariogeni:.mp. 164 56 or/14-55 12313 57 (5 or 13) and 56 1020 58 exp Research design/ 157035 59 exp Clinical trials/ 177608 60 "comparative study"/ 23406 61 Placebos/ 23285 62 placebo$1.ti,ab. 45212 63 random:.ti,ab. 140380 64 (clinical adj trial:).ti,ab. 37896 65 Feasibility studies/ 602 66 clinical protocols/ 11706 67 (single blind: or double blind: or triple blind:).ti,ab. 38581 68 exp treatment outcome/ 68214 69 Double-blind method/ 30639 70 (multicenter adj study).mp. 18449 71 (clinical adj3 trial:).mp. 199948 72 ((control: or randomiz:) adj3 trial:).mp. 121345 73 exp Epidemiology/ 173587 74 exp Methodology/ 157035 75 exp Practice guideline/ 31385 76 or/58-75 651145 77 57 and 76 183 78 from 77 keep 1-183 183 79 limit 78 to (human and english language) 160 80 from 79 keep 1-160 160 *************************** <1> UI - 2000171493 AU - Anonymous TI - The role of controlled drug delivery for periodontitis. SO - Journal of Periodontology Vol 71(1) (pp 125-140), 2000. AB - This position paper was prepared by the Research, Science and Therapy Committee of the American Academy of Periodontology and is intended to provide the dental profession with an overview of the evidence regarding the adjunctive use of locally delivered antimicrobials in the management of patients with periodontitis. [References: 102] <2> UI - 2000160043 AU - Merrick J AU - Shapira J IN - Prof. J. Merrick, Division for the Mentally Retarded, Ministry of Labour/Social Affairs, The Hebrew Univ.-Hadassah Faculty, Box 1260, IL-91012 Jerusalem; Israel. E-Mail: jmerrick@aquanet.co.il. TI - Preventive dental health for persons with Down syndrome. SO - International Journal of Adolescent Medicine & Health Vol 12(1) (pp 81-84), 2000. AB - Persons with developmental disability, intellectual disability or mental retardation, such as Down syndrome, usually have great difficulties with oral hygiene and health. The need for preventive programs of oral health is therefore paramount in this population. This communication presents two studies from Jerusalem with pre-adolescent children (aged 8-13 years) with Down syndrome, where in the first study, a chlorhexidine coating solution was applied on their teeth to reduce bacterial plaque and in the other study a comprehensive prevention program was implemented. The integration of motivated dental hygienist, dentist, staff and parents into a oral health prevention program will lead to a high degree of prevention of dental disease. With the trends of de-institutionalization it is cautioned that planners and policymakers should take into account the need for continuous high- level medical, para-medical and dental health care to the population of persons with intellectual disability. [References: 3] <3> UI - 2000117358 AU - Vyas SP AU - Sihorkar V AU - Mishra V IN - S.P. Vyas, Drug Delivery Research Laboratory, Department Pharmaceutical Sciences, Dr. H. S. Gour University, Sagar (M.P.) 470 003; India. E-Mail: spvyas@bom6.vsnl.net.in. TI - Controlled and targeted drug delivery strategies towards intraperiodontal pocket diseases. SO - Journal of Clinical Pharmacy & Therapeutics Vol 25(1) (pp 21-42), 2000. AB - Advances in the understanding of the aetiology, epidemiology, pathogenesis and microbiology of periodontal pocket flora have revolutionized the strategies for the management of intraperiodontal pocket diseases. Intra-pocket, sustained release, drug delivery devices have been shown to be clinically effective in the treatment of periodontal infections. Several degradable and non-degradable devices are under investigation for the delivery of antimicrobial agents into the periodontal pocket including non-biodegradable fibres, films (biodegradable and non-biodegradable), bio-absorbable dental materials, biodegradable gels/ointments, injectables and microcapsules. With the realization that pocket bacteria accumulate as biofilms, studies are now being directed towards eliminating/killing biofilm concentrations rather than their planktonic (fluid phase) counterparts. Intraperiodontal pocket drug delivery has emerged as a novel paradigm for the future research. Similarly, bioadhesive delivery systems are explored that could significantly improve oral therapeutics for periodontal disease and mucosal lesions. A strategy is to target a wide range of molecular mediators of tissue destruction and hence arrest periodontal disease progression. Research into regenerating periodontal structures lost as a result of disease has also shown substantial progress in the last 25 years. [References: 129] <4> UI - 2000084090 AU - Zucchelli G AU - Pollini F AU - Clauser C AU - De Sanctis M IN - Dr. G. Zucchelli, Department of Periodontology, Faculty of Odontology, Bologna University, via S. Vitale, 59, 40100 Bologna; Italy. TI - The effect of chlorhexidine mouthrinses on early bacterial colonization of guided tissue regeneration membranes. An in vivo study. SO - Journal of Periodontology Vol 71(2) (pp 263-271), 2000. AB - Background: Different membrane materials accumulate varying amounts of bacteria when exposed in the oral cavity, due to their textural and structural surface characteristics. The aim of the study was to evaluate the effect of chlorhexidine mouthrinses on the in vivo early bacterial colonization of 3 different guided tissue regeneration membrane materials. Methods: Rectangular-shaped strips cut from 3 periodontal membrane (expanded polytetrafluoroethylene, polyglactin acid) were glued to removable devices adapted to the 2 upper quadrants in 8 dental students. In each student 1 quadrant was randomly selected as test side while the other served as control side. The experiment was divided in 2 phases: in the first phase plaque accumulation was followed for 4 hours while the second accumulation was followed for 24 hours. During the 4-hour experiment, students rinsed the test device twice (immediately following device application and after 2 hours) with 0.12% chlorhexidine solution. The control device was rinsed with saline. In the second phase, students rinsed the test device with chlorhexidine and the control devices with saline 3 times (after device application and at 8 and 16 hours). Both the 4-hour and the 24-hour specimens were processed for scanning electron microscopy analysis. Fifty-four fields (at 200 x magnification) were randomly selected and analyzed on each strip. Magnification as increased to determine the presence and morphotype of bacteria. The presence or absence of bacteria was assessed in a binomial fashion: the field was bacteria-positive when bacteria constituted the deposits covering the membrane surface. The microscopic field was negative (bacteria-negative) when no bacteria were observed. Bacteria-positive fields showing rods and filaments as prevalent morphotypes were recorded a rod- positive fields. Results: The results of data analysis suggest that bacterial contamination of membrane materials is significantly reduced by treatment with chlorhexidine. They also suggest that other variables affect plaque accumulation as well; i.e., the time allowed (4 versus 24 hours) and the different membrane materials. The interaction between these 2 variables is also highly significant, thereby indicating a different rate of plaque accumulation on different materials, irrespective of the treatment with chlorhexidine. Conclusions: It was concluded that chlorhexidine mouthrinses may be effective in reducing and delaying the early bacterial accumulation on membrane materials although they are not able to fully prevent it. Membrane surface characteristics seem to be a more critical factor than the use of chlorhexidine, in influencing bacterial adhesion and colonization of barrier materials. [References: 33] <5> UI - 2000084089 AU - Jeffcoat MK AU - Palcanis KG AU - Weatherford TW AU - Reese M AU - Geurs NC AU - Flashner M IN - Dr. M.K. Jeffcoat, UAB School of Dentistry, SDB 412, 1919 7th Ave. So., Birmingham, AL 35294-0007; United States. E-Mail: jeffcoat@uab.edu. TI - Use of a biodegradable chlorhexidine chip in the treatment of adult periodontitis: Clinical and radiographic findings. SO - Journal of Periodontology Vol 71(2) (pp 256-262), 2000. AB - Background: Previous multi-center trials demonstrated the efficacy of a biodegradable chlorhexidine-gelatin chip (CHX) in reducing probing depth in patients with periodontitis. The present study utilized a subset from the parent study to determine if the CHX chip was effective in maintaining alveolar bone over a 9-month period. Methods: Forty-five subjects with at least four 5 to 8 mm pockets, stratified by smoking status, were enrolled in this double-blind controlled, placebo-controlled trial. Control groups received either placebo chip plus scaling and root planning (SRP) or SRP alone. Test group subjects received active CHX chip or SRP alone (to maintain the blind). Standardized radiographs were taken for quantitative digital subtraction radiography at baseline and 9 months. Results: At 9 months, 15% of SRP treated subjects experienced loss of bone in 1 or more sites, no subject treated with active chip plus SRP lost bone (P <0.01). At 9 months, significant differences in the change in probing depth and clinical attachment levels favoring the active chip over SRP alone or SRP plus CHX chip were also observed (P <0.05). Conclusions: These data indicate that the CHX chip, when used as an adjunct to scaling and root planing, significantly reduces loss of alveolar bone. [References: 13] <6> UI - 2000080676 AU - Anderson JR AU - Ellis RW AU - Blankenau RJ AU - Beiraghi SM AU - Westerman GH IN - R.W. Ellis, Creighton University, School of Dentistry, 2500 California Plaza, Omaha, NE 68178; United States. E-Mail: rellis@creighton.edu. TI - Caries resistance in enamel by laser irradiation and topical fluoride treatment. SO - Journal of Clinical Laser Medicine & Surgery Vol 18(1) (pp 33-36), 2000. AB - Purpose: The purpose of this in vitro study was to compare caries resistance of sound human enamel following argon laser (AL) irradiation, as well as, combinations of topical fluoride foams and AL irradiation. Methods and Materials: Thirty extracted human teeth were sectioned into four buccal windows and assigned to one of the following treatment groups: (1) no treatment/control; (2) low fluence (11.5 J/cm2) AL irradiation for 10 seconds; (3) 1.23% APF foam for 4 minutes followed by low fluence AL irradiation; (4) 2.0% NaF foam for 4 minutes followed by low fluence AL irradiation. Caries-like lesions were created by submerging the teeth in ten Cate solution (pH 4.5). Following a 96-hour exposure period, 100 mum longitudinal sections were prepared for polarized light evaluation. Visilog 5.1.1. image analysis software was used to obtain quantitative lesion depths. The Scheffe F-test was used to compare the lesion depths for each of the four treatment groups. Results: Lesion depths were: 16.1 +/- 6 mum for control; 13.7 +/- 4 mum for AL irradiation alone; 12.1 +/- 4.3 mum for 1.23% APF foam before AL irradiation; and 11.4 +/- 5.9 mum for 2.0% NaF foam before AL irradiation. Significant difference (p < 0.05) was found between the control group and the 2.0% NaF foam before AL irradiation group. AL irradiation alone reduced lesion depth by 15% compared with the control lesion. When AL irradiation was combined with 1.23% APF foam treatment, lesion depth decreased by 25% compared with control lesions, and by 29% when combined with 2.0% NaF foam. Conclusion: Combining AL irradiation and 2.0% NaF foam treatment significantly enhances the resistance of sound enamel to an in vitro cariogenic challenge. [References: 28] <7> UI - 2000047432 AU - Frame PS AU - Sawai R AU - Bowen WH AU - Meyerowitz C IN - Dr. P.S. Frame, Tri-County Family Medicine, 23 Park Avenue, Cohocton, NY 14826; United States. TI - Preventive dentistry: Practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines. SO - American Journal of Preventive Medicine Vol 18(2) (pp 159-162), 2000. AB - Introduction: The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. Methods: Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. Results: The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. Conclusions: Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low- risk populations. (C) 2000 American Journal of Preventive Medicine. [References: 16] <8> UI - 2000003253 AU - Steinberg D AU - Friedman M IN - M. Friedman, Department of Pharmacy, School of Pharmacy, Hebrew University, PO Box 12065, Jerusalem 91120; Israel. E-Mail: dorons@cc.huji.ac.il. TI - Dental drug-delivery devices: Local and sustained-release applications. SO - Critical Reviews in Therapeutic Drug Carrier Systems Vol 16(5) (pp 425-459), 1999. AB - Dental diseases are among the most prevalent illnesses in humans. Many pharmaceutical dosage forms are used to prevent and treat these diseases. Toothpastes and mouthwashes are two of the most popular dental medicaments. A local delivery application that prolongs the release of the drug in the mouth offers great advantages in preventing and treating caries and periodontal diseases. Sustained-release devices are a relatively new concept in dentistry. This paper describes several types of sustained-release devices that are available commercially or are in the premarketing stage. [References: 133] <9> UI - 1999428793 AU - Twetman S AU - Skold-Larsson K AU - Modeer T IN - S. Twetman, Department of Pediatric Dentistry, Medical and Dental Health Center, Lanssjukhuset, SE-301 85 Halmstad; Sweden. E-Mail: svantetwetman@lthalland.se. TI - Fluoride concentration in whole saliva and separate gland secretions after topical treatment with three different fluoride varnishes. SO - Acta Odontologica Scandinavica Vol 57(5) (pp 263-266), 1999. AB - Fluoride concentration in whole saliva and in separate gland secretions was determined after a single application of each of 3 different fluoride varnishes with contrasting levels of fluoride in a randomized crossover design. The study group comprised 8 healthy school children aged 10-12 years treated with A: Bifluorid(TM) 12 (6% F); B: Duraphat(TM) (2.26% F); and C: Fluor Protector(TM) (0.1% F). Unstimulated and stimulated whole saliva, as well as stimulated parotid and submandibular-sublingual saliva, were collected at baseline and 1, 6, 12, and 24 h after the varnish treatments. The fluoride concentrations were determined with an ion-selective electrode. Time- and dose-dependent concentration curves were obtained in all the collected secretions, A> B> C. In whole saliva, the fluoride levels were significantly elevated (P<0.01) 1 h after the A and B varnish applications compared with baseline, while the increase was insignificant for varnish C. Similar patterns were unveiled in the parotid and submandibular-sublingual secretions, although the increase in fluoride concentration was modest. The elevated levels did not exceed 6 h for any of the varnish tested. The results of this study suggest a correlation between the concentration of fluoride of the varnish and fluoride levels obtained in saliva after application. [References: 25] <10> UI - 1999417147 AU - Greenstein G IN - Dr. G. Greenstein, 900 West Main Street, Freehold, NJ 07729; United States. TI - Povidone-iodine's effects and role in the management of periodontal diseases: A review. SO - Journal of Periodontology Vol 70(11) (pp 1397-1405), 1999. AB - This review article addresses the effects of povidone-iodine (PVP-1) and its utility in the treatment of periodontal diseases. There are data to support the following statements: PVP-1 is a potent antiseptic and, when used as a component in a rinse with H2O2, the rinse can decrease the level of gingivitis. With regards to patients with adult periodontitis, there is some evidence to indicate that PVP-1 delivered via an ultrasonic device achieves better results in deep pockets than ultrasonic debridement when water is the irrigant. The benefits of PVP-1 in the treatment of refractory periodontitis are unclear. Subgingival irrigation with PVP-1 may reduce the incidence of bacteremia if it is employed as a pre-procedural intrasulcular irrigant; however, this technique is not recommended for high-risk patients. PVP-1 is a safe antiseptic and does not appear to impede wound healing or induce resistant bacteria. It is an approved drug whose intraoral use is an unlabeled indication. In conclusion, the literature suggests that utilization of PVP-1 is potentially beneficial in the management of some periodontal diseases. However, additional clinical trials are needed to verify this assessment, since it is based upon a limited number of studies. [References: 59] <11> UI - 1999402929 AU - Patton LL AU - Van der Horst C IN - L.L. Patton, Department of Dental Ecology, 388 Dental Office Building, University of North Carolina, Chapel Hill, NC 27599-7450; United States. TI - Oral infections and other manifestations of HIV disease. SO - Infectious Disease Clinics of North America Vol 13(4) (pp 879-900), 1999. AB - Oral lesions are important in the clinical spectrum of HIV/AIDS, arousing suspicion of acute seroconversion illness (aphthous ulceration and candidiasis), suggesting HIV infection in the undiagnosed individual (candidiasis, hairy leukoplakia, Kaposi's sarcoma, necrotizing ulcerative gingivitis), indicating clinical disease progression and predicting development of AIDS (candidiasis, hairy leukoplakia), and marking immune suppression in HIV-infected individuals (candidiasis, hairy leukoplakia, necrotizing periodontal disease, Kaposi's sarcoma, long-standing herpes infection, major aphthous ulcers). In addition, oral lesions are included in staging systems for HIV disease progressions and as entry criteria or endpoints in clinical trials of antiretroviral drugs. Recognition and management of these oral conditions is important for the health and quality of life of the individual with HIV/AIDS. In keeping with this, the U.S. Department of Health Services Clinical Practice Guideline for Evaluation and Management of Early HIV Infection includes recommendations that an oral examination, emphasizing oral mucosal surfaces, be conducted by the primary care provider at each visit, a dental examination by a dentist should be done at least two times a year, and patients should be informed of the importance of oral care and educated about common HIV-related oral lesions and associated symptoms. [References: 138] <12> UI - 1999372544 AU - Jagtap AG AU - Karkera SG IN - A.G. Jagtap, Department of Pharmacology, Bombay College of Pharmacy, Santacruz (E), Mumbai 400098; India. E-Mail: karkera@bom5.vsnl.net.in. TI - Potential of the aqueous extract of Terminalia chebula as an anticaries agent. SO - Journal of Ethnopharmacology Vol 68(1-3) (pp 299-306), 1999. AB - The aqueous extract from Terminalia chebula was tested for its ability to inhibit the growth and some physiological functions of Streptococcus mutans. The extract strongly inhibited the growth, sucrose induced adherence and glucan induced aggregation of S. mutans. Mouthrinsing with a 10% solution of the extract inhibited the salivary bacterial count and salivary glycolysis. Mouthrinsing with the extract significantly reduced total bacterial counts and the total streptococcal counts in the saliva samples obtained up to and including 3 h after rinsing, compared with the counts obtained prerinsing or after placebo rinsing. The extract successfully inhibited glycolysis of salivary bacteria for up to 90 min postrinsing. [References: 15] <13> UI - 1999335115 AU - Loesche WJ IN - W.J. Loesche, Microbiology/Immunology Department, Univ. of Michigan School of Medicine, Ann Arbor, MI 48109; United States. TI - The antimicrobial treatment of periodontal disease: Changing the treatment paradigm. SO - Critical Reviews in Oral Biology & Medicine Vol 10(3) (pp 245-275), 1999. AB - Over the last 100 years, methods of surgical periodontal treatment have enjoyed a history of success in improving oral health. The paradigm of care is based on the 'non-specific plaque hypothesis' - that is, the overgrowth of bacterial plaques cause periodontal disease, and the suppression of this overgrowth reduces disease risk. The central feature of this approach to care is the removal of inflamed gingival tissue around the teeth to reduce periodontal pocket depth, thereby facilitating plaque removal by the dentist and by the patient at home. Over the last 30 years, with the recognition that periodontal disease(s) is caused by specific bacteria and that specific antimicrobial agents can reduce or eliminate the infection, a second paradigm has developed. This new paradigm, the 'specific plaque hypothesis', focuses on reducing the specific bacteria that cause periodontal attachment loss. The contrast between the two paradigms can be succinctly stated as follows: The antimicrobial therapy reduces the cause, while the surgical therapy reduces the result of the periodontal infection. The specific plaque hypothesis has two important implications. First, with the increasing attention to evidence- based models for prevention, treatment, outcome assessment, and reimbursement of care, increasing attention and financial effort will be channeled into effective preventive and treatment methods. Second, the recent observations that periodontal infections increase the risk of specific systemic health problems, such as cardiovascular disease, argue for the prevention and elimination of these periodontal infections. This review highlights some of the evidence for the specific plaque hypothesis, and the questions that should be addressed if antimicrobial agents are to be used responsively and effectively. [References: 184] <14> UI - 1999290080 AU - Twetman S AU - Petersson LG IN - S. Twetman, Department of Pediatric Dentistry, Lanssjukhuset, SE-301 85 Halmsted; Sweden. E-Mail: svante.twetman@lthalland.se. TI - Interdental caries incidence and progression in relation to mutans streptococci suppression after chlorhexidine-thymol varnish treatments in schoolchildren. SO - Acta Odontologica Scandinavica Vol 57(3) (pp 144-148), 1999. AB - The aim of this study was to evaluate interdental caries incidence and progression in relation to the effect of antibacterial varnish treatments in schoolchildren anticipated at caries risk. After a screening procedure, 110 healthy children (8-10 years) with moderate and high counts of salivary mutans streptococci (MS) were invited to join a 2-year longitudinal study. At baseline, MS were enumerated at all mesial interdental sites of the first permanent molars with a chair-side technique. The children were then treated 3 times within 2 weeks by interdental spot applications with a 1% chlorhexidine/thymol-containing varnish (Cervitec(TM)). Follow-up samples of saliva and plaque were collected 1, 3, 6, and 12 months after onset of treatment. Caries prevalence, incidence and progression of the selected approximal surfaces were scored from bitewing radiographs exposed at baseline and after 2 years. Sixty-three children of the same age formed a non-varnish- treated reference group. Reduction of caries incidence and progression was clearly dependent on the outcome of the antibacterial treatment. A significantly (P<0.01) higher progression score was found among children who exhibited a less marked suppression of interdental MS levels compared with those with high suppression and the children of the reference group. The results suggest that a suppression of MS in interdental plaque may be an important event to prevent and arrest approximal caries development in schoolchildren at risk. Monitoring the effect of antibacterial agents in a site-specific way could therefore be advocated. [References: 26] <15> UI - 1999268468 AU - Van der Reijden WA AU - Vissink A AU - Veerman ECI AU - Amerongen AVN IN - Dr. W.A. Van der Reijden, Section Clinical Oral Microbiology, Department of Oral Biology, Academic Ctr. for Dent. Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam; Netherlands. TI - Treatment of oral dryness related complaints (xerostomia) in Sjogren's syndrome. SO - Annals of the Rheumatic Diseases Vol 58(8) (pp 465-473), 1999. <16> UI - 1999258340 AU - Littleton J IN - J. Littleton, Department of Anthropology, University of Auckland, Private Mail Bag 92019, Auckland; New Zealand. E-Mail: J.Littleton@auckland.ac.nz. TI - Paleopathology of skeletal fluorosis. SO - American Journal of Physical Anthropology Vol 109(4) (pp 465-483), 1999. AB - Skeletal fluorosis is one of a range of conditions causing excessive ossification and joint ankylosis in skeletons. It is rarely considered, however, in differential diagnoses of palaeopathological lesions. This paper considers the identification of skeletal fluorosis in a skeletal sample from the island of Bahrain, Arabian Gulf, dating to ca. 250 BC-AD 250. Approximately 4% of 255 adult skeletons in the sample have hyperostosic lesions resulting in joint ankylosis primarily of the lumbar vertebrae, as well as the major joints. These lesions most frequently occur among males in the 50+ age group. Chemical analysis on a small series of bone and dental samples confirmed the presence of high levels of fluoride, while staining of the teeth is evidence of dental fluorosis. The level of dental fluorosis is comparable with a naturally occurring fluoride level in water of between 1-2 ppm. The prevalence of hyperostosic lesions, however, appears higher than expected, and two possible reasons are suggested: confusion between a diagnosis of diffuse idiopathic skeletal hyperostosis and skeletal fluorosis on partial or less severely affected skeletons; and the presence of predisposing factors for skeletal fluorosis on the island in the past. [References: 75] <17> UI - 1999245899 AU - Gisselsson H AU - Birkhed D AU - Emilson C-G IN - D. Birkhed, Department of Cariology, Institute of Odontology, PO Box 450, S-405 30 Goteborg; Sweden. E-Mail: birkhed@odontologi.gu.se. TI - Effect of professional flossing with NaF or SnF2 gel on approximal caries in 13-16-year-old schoolchildren. SO - Acta Odontologica Scandinavica Vol 57(2) (pp 121-125), 1999. AB - The aim of this study was to evaluate the effect of professional flossing with NaF and SnF2 gels on caries development on approximal tooth surfaces. Two-hundred-and-eighty 13-year-old schoolchildren were divided into 3 groups: (1) NaF (n = 97), (2) SnF2 (n = 85), and (3) placebo gel group (n = 98). The investigation was carried out double-blind. The children were treated 4 times a year for 3 years with 1% NaF gel, 1% SnF2 gel, or placebo gel. The treatment was carried out by dental nurses and the time required per visit was approximately 10 min. After 3 years, the mean approximal caries increment, including initial caries lesions, was 2.8 in the NaF, 2.4 in the SnF2, and 4.0 in the placebo gel group (P<0.05 for SnF2 vs placebo); a reduction compared to the placebo of 30% and 39% in the NaF and SnF2 groups, respectively. Thus, professional flossing with NaF or SnF2 gel carried out 4 times a year may be considered as an interesting caries-preventing method for large-scale application in schoolchildren. [References: 17] <18> UI - 1999244495 AU - Meunier PJ AU - Delmas PD AU - Eastell R AU - McClung MR AU - Papapoulos S AU - Rizzoli R AU - Seeman E AU - Wasnich RD IN - Dr. P.J. Meunier, Hopital Edouard Herriot, Pavillon F, Place d'Arsonval, 69437 Lyon Cedex 03; France. TI - Diagnosis and management of osteoporosis in postmenopausal women: Clinical guidelines. SO - Clinical Therapeutics Vol 21(6) (pp 1025-1044), 1999. AB - The authors, all physicians involved in clinical research on bone and practicing clinicians, propose practical guidelines for identifying persons with osteoporosis or those at high risk of developing the disease and for managing patients who may benefit from therapy. These guidelines are based on an analysis of peer-reviewed articles published before November 1998. A flowchart of women who might benefit from treatment is provided, including clinical presentation (recent fracture of the spine, hip, or other bone or no fracture; risk factors for osteoporosis); relevant investigations (bone mineral density measurement and laboratory tests required for the differential diagnosis); and therapeutic management (general measures such as calcium and vitamin D supplementation and specific pharmacologic interventions such as estrogen, bisphosphonates, intranasal calcitonin, raloxifene, fluoride salts, and other compounds that have been assessed in randomized clinical trials). The strongest evidence for antifracture efficacy (reduction of vertebral and nonvertebral fracture risk) was observed with alendronate. [References: 104] <19> UI - 1999214957 AU - Mongardini C AU - Van Steenberghe D AU - Dekeyser C AU - Quirynen M IN - Prof. M. Quirynen, School of Dentistry, Oral Pathol./Maxillo-Facial Surgery, Department of Periodontology, Kapucijnenvoer 7, B-3000 Leuven; Belgium. E-Mail: Marc.Quirynen@med.kuleuven.ac.be. TI - One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. I. Long-term clinical observations. SO - Journal of Periodontology Vol 70(6) (pp 632-645), 1999. AB - Background: A standard treatment strategy for periodontal infections often consists of 4 consecutive sessions of scaling and root planing (per quadrant, at 1- to 2-week intervals), without proper disinfection of the remaining intra-oral niches for periodontopathogens. This could theoretically lead to a reinfection of previously disinfected pockets by bacteria from an untreated region/niche. This study aimed to investigate, over an 8-month period, the clinical benefits of a one stage full-mouth disinfection in the control of severe periodorititis. Methods: Sixteen patients with early-onset periodontitis and 24 patients with severe adult periodontitis were randomly assigned to test and control groups. The control group was scaled and root planed, per quadrant, at 2-week intervals and given standard oral hygiene instructions. A one stage full-month disinfection (test group) was sought by scaling and root planing the 4 quadrants within 24 hours in combination with the application of chlorhexidine to all intra-oral niches for periodontopathogens. Besides oral hygiene, the test group also rinsed twice daily with a 0.2% chlorhexidine solution and sprayed the tonsils with a 0.2% chlorhexidine spray, for 2 months. The plague index, gingival index, probing depth, bleeding on probing, gingival recession, and clinical attachment level were recorded at baseline and at 1, 2, 4, and 8 months afterwards. Results: The one stage full-mouth disinfection resulted, in comparison to the standard therapy, in a significant (P <0.001) additional probing depth reduction and gain in attachment up to 8 months. For initial pockets >= 7 mm, the 'additional' probing depth reduction at the 8 month follow-up was 1.2 mm for single-rooted and 0.9 mm for multi-rooted teeth, with corresponding additional gains in attachment of 1.0 mm and 0.8 mm, respectively. The additional improvements were observed for all subgroups (adult periodontitis, generalized early-onset cases, smokers), with the largest differences in the non-smoking adult periodontitis patients. Conclusions: These findings suggest that a one stage full-mouth disinfection results in an improved clinical outcome for the treatment of chronic adult or early-onset periodontitis as compared to scaling and root planing per quadrant at 2-week intervals. [References: 85] <20> UI - 1999207801 AU - Faggiano F AU - Di Stanislao F AU - Lemma P AU - Renga G IN - F. Faggiano, Department of Public Health, University of Turin, Via Santena 5bis, 10126 Turin; Italy. E-Mail: faggiano@molinette.unito.it. TI - Role of social class in caries occurrence in 12 year olds in Turin, Italy. SO - EUR J PUBLIC HEALTH, Vol 9(2) (pp 109-113), 1999. AB - Background: The objective of the study was to evaluate the social distribution of dental caries and its determinants in the province of Turin, an area of 2,300,000 inhabitants in the north of Italy. Methods: A cross- sectional study was carried out among a representative school-based sample of 11-12 year olds. A total of 734 (84.0% of the starting sample) students were involved. Two questionnaires were submitted (to students and parents) and the children received a dental examination. Dietary and hygiene indicators were calculated and the DMFT index (the number of decayed, missing and filled teeth) was measured using methods recommended by the World Health Organisation (WHO). The education level of the head of family was used as a proxy of social class indicator. Univariate and multivariate analyses were applied to obtain results. Results: Students from disadvantaged families showed: i) a higher tendency to belong to the higher risk group for oral hygiene (RR primary school/university = 2.78); ii) a lower use of dental prevention (RR=0.40 for use of fluoride tablets and RR=0.43 for local applications of fluoride) and iii) a higher consumption of sucrose-sweetened foods (RR=1.17%, ns) when compared with children of graduate parents. The DMFT index was more than double among children whose parents only had a primary school education, compared with those of graduate parents (3.2 versus 1.5). In addition, the percentage of caries-free children increased from 16.4 to 59.1% from the lowest to the highest social group. Conclusions: Large social differences are found in caries experience and in determinants of dental decay. Nevertheless, determinants of caries occurrence seem to explain only a small fraction of inequalities. [References: 37] <21> UI - 1999155505 AU - Horowitz HS IN - H.S. Horowitz, 6307 Herkos Court, Bethesda, MD 20817; United States. TI - Proper use of fluoride products in fluoridated communities. SO - Lancet Vol 353(9163) (pp 1462), 1999. <22> UI - 1999137305 AU - Tenenbaum H AU - Dahan M AU - Soell M IN - Prof. H. Tenenbaum, Department of Periodontology, Dental Faculty, 1, Place de l'Hopital, 67000 Strasbourg; France. TI - Effectiveness of a sanguinarine regimen after scaling and root planing. SO - Journal of Periodontology Vol 70(3) (pp 307-311), 1999. AB - Background: A variety of chemical agents have been evaluated relative to their abilities to inhibit dental plaque and to improve gingival health. Chlorhexidine gluconate is the best known and most widely used member of these agents, but its long-term use is compromised by different side effects, especially extrinsic tooth and tongue staining. Another agent, sanguinarine, which is currently used in both a mouthrinse and toothpaste, leads in some cases only to a transient burning sensation and could be used on a long-term basis. The purpose of this 14-week controlled clinical trial was to assess the effectiveness of a toothpaste and oral rinse containing sanguinaria extract after scaling, root planing and a chlorhexidine regimen. Methods: Sixty patients diagnosed as having adult periodontitis received initial periodontal therapy including scaling and root planing, followed by a 2-week oral care regimen which included rinsing with 0.2% chlorhexidine gluconate oral rinse. Upon completion of this 2-week initial therapy phase, patients were randomly assigned to either sanguinarine toothpaste and oral rinse or to control toothpaste and oral rinse without sanguinarine. Plaque (modified Quigley-Hein index) and gingivitis (gingival index) were measured prior to periodontal therapy, at the end of the chlorhexidine phase (2 weeks), and after 8 and 14 weeks. Results: Sanguinarine-containing toothpaste and oral rinse significantly inhibited the redevelopment of gingivitis through the 12 weeks following the chlorhexidine phase compared to the control toothpaste and rinse. Patients in the test group had 26% fewer bleeding sites at 8 weeks, and 32% fewer at 14 weeks, than the control group. Conclusions: Our results support the combined use of chlorhexidine mouthrinse for a short term (2 weeks) followed by sanguinaria mouthrinse and toothpaste up to 3 months in order to optimize the effectiveness of chlorhexidine without side effects. Further studies on the long-term effect of this combination should be established. [References: 23] <23> UI - 1999113019 AU - Yucel-Lindberg T AU - Twetman S AU - Skold-Larsson K AU - Modeer T IN - T. Yucel-Lindberg, Department of Pediatric Dentistry, School of Dentistry, Karolinska Institute, SE-141 04 Huddinge; Sweden. E-Mail: Tulay.Lindberg@ofa.ki.se. TI - Effect of an antibacterial dental varnish on the levels of prostanoids, leukotriene B4, and interleukin-1beta in gingival crevicular fluid. SO - Acta Odontologica Scandinavica Vol 57(1) (pp 23-27), 1999. AB - The aim of this study was to investigate the effects of a chlorhexidine/thymol-containing dental varnish on the levels of prostaglandin E2 (PGE2), prostaglandin I2 (PGI2), leukotriene B4 (LTB4), and interleukin-1beta (IL-1beta) in gingival crevicular fluid (GCF). The material consisted of 15 adolescents undergoing treatment with fixed orthodontic appliances. Four buccal sites adjacent to bands or brackets and exhibiting a mild chronic gingival inflammation were selected in the upper quadrants of each patient. According to a split-mouth technique, the first and second quadrants were randomly treated with either a varnish (Cervitec(TM)) containing 1% chlorhexidine diacetate and thymol (CHX/thymol) or a placebo varnish without active ingredients. The varnishes were applied immediately after the baseline registration, and follow-up examinations were carried out after 3, 8, and 30 days. GCF was sampled with the aid of a paper strip and the volume was determined using a Periotron(TM) 8000. The concentrations of PGE2, PGI2, LTB4, and IL-1beta in GCF were assessed using radioimmunoassay and ELISA techniques. The results unveiled statistically significant reductions of PGE2, PGI2, and LTB4 levels in GCF following the active varnish treatment when compared to baseline values. A slight drop in IL-1beta levels was registered after both active and placebo varnish applications, but the differences were not significant. The results suggest that treatment with an antibacterial varnish decreases the levels of inflammatory mediators PGE2, PGI2, and LTB4 in gingival crevicular fluid and further support the concept that topical application of a CHX/thymol-containing varnish is beneficial in patients with chronic gingival inflammation. [References: 22] <24> UI - 1999097948 AU - Neuhaus R AU - Kubo A AU - Lohmann R AU - Rayes N AU - Hierholzer J AU - Neuhaus P IN - Dr. R. Neuhaus, Department of Surgery, Charite, Campus Virchow Clinic, Humboldt University, Augustenburger Platz 1, D-13353 Berlin; Germany. TI - Calcitriol in prevention and therapy of osteoporosis after liver transplantation. SO - Transplantation Proceedings Vol 31(1-2) (pp 472-473), 1999. <25> UI - 1999014042 AU - Kumar JV AU - Swango PA AU - Lininger LL AU - Leske GS AU - Green EL AU - Haley VB IN - J.V. Kumar, Bureau of Dental Health, New York State Department of Health, Empire State Plaza, Albany, NY 12237-0619; United States. TI - Changes in dental fluorosis and dental caries in Newburgh and Kingston, New York. SO - American Journal of Public Health Vol 88(12) (pp 1866-1870), 1998. AB - Objectives. This study sought to determine whether the prevalence of dental fluorosis and dental caries had changed in a fluoridated community and a nonfluoridated community since an earlier study conducted in 1986. Methods. Dental fluorosis and dental caries data were collected on 7- to 14-year-old lifelong residents (n = 1493) of Newburgh and Kingston, NY. Results. Estimated dental fluorosis prevalence rates were 19.6% in Newburgh and 11.7% in Kingston. The greatest disparity in caries scores was observed between poor and nonpoor children in nonfluoridated Kingston. Conclusions. The prevalence of dental fluorosis has not declined in Newburgh and Kingston, whereas the prevalence of dental caries has continued to decline. [References: 51] <26> UI - 1999008766 AU - Scheie AAa AU - Fejerskov OB IN - A.Aa. Scheie, Department of Oral Biology, Dental Faculty, University of Oslo, Pb 1052 Blindern, 0316 Oslo; Norway. TI - Xylitol in caries prevention: What is the evidence for clinical efficacy?. SO - Oral Diseases Vol 4(4) (pp 268-278), 1998. AB - Xylitol has attracted much attention as an alternative sweetener. Essentially all clinical studies concerning the effect of xylitol on caries development consent to its non-cariogenicity and to the beneficial effect of substituting sucrose with xylitol in chewing gums and sweets. However, claims of anti-caries or therapeutic effects, and superiority of xylitol over other polyols are still to be confirmed by well designed and conducted studies from independent research groups. [References: 111] <27> UI - 1998369526 AU - Jones D IN - Dr. D. Jones, Department of Pharmaceutics, Queen's University, Belfast; United Kingdom. TI - Advanced polymeric biomaterials: Clinical panacea or modern dilemma?. SO - Pharmaceutical Journal Vol 261(7017) (pp 669), 1998. AB - The British Pharmaceutical Conference science medal is awarded to a pharmaceutical scientist aged under 35 years whose published work shows outstanding promise. This year's conference science medal lecture was given by Dr David Jones, (lecturer in pharmaceutics, Queen's University, Belfast) on September 9. [References: 0] <28> UI - 1998332696 AU - Jeffcoat MK AU - Bray KS AU - Ciancio SG AU - Dentino AR AU - Fine DH AU - Gordon JM AU - Gunsolley JC AU - Killoy WJ AU - Lowenguth RA AU - Magnusson NI AU - Offenbacher S AU - Palcanis KG AU - Proskin HM AU - Finkelman RD AU - Flashner M IN - Dr. M.K. Jeffcoat, University of Alabama, School of Dentistry, University Station, Birmingham, AL 35294-0007; United States. TI - Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone. SO - Journal of Periodontology Vol 69(9) (pp 989-997), 1998. AB - THE PRESENT STUDIES EVALUATED the efficacy of a controlled-release biodegradable chlorhexidine (CHX) (2.5 mg) chip when used as an adjunct to scaling and root planing on reducing probing depth (PD) and improving clinical attachment level (CAL) in adult periodontitis. Two double-blind, randomized, placebo-controlled multicenter clinical trials (5 centers each) were conducted; pooled data are reported from all 10 centers (447 patients). At baseline, following 1 hour of scaling and root planing (SRP) in patients free of supragingival calculus, the chip was placed in target sites with PD 5 to 8 mm which bled on probing. Chip placement was repeated at 3 and/or 6 months if PD remained <= 5 mm. Study sites in active chip subjects received either CHX chip plus SRP or SRP alone (to maintain study blind). Sites in placebo chip subjects received either placebo chip plus SRP or SRP alone. Examinations were performed at baseline; 7 days; 6 weeks; and 3, 6, and 9 months. At 9 months significant reductions from baseline favoring the chlorhexidine chip compared with both control treatments were observed with respect to PD (chlorhexidine chip plus SRP, 0.95 +/- 0.05 mm; SRP alone, 0.65 +/- 0.05 mm, P < 0.001; placebo chip plus SRP, 0.69 +/- 0.05 mm; P < 0.001) and CAL (chlorhexidine chip plus SRP, 0.75 +/- 0.06 mm; SRP alone, 0.58 +/- 0.06 mm, P < 0.05; placebo chip plus SRP, 0.55 +/- 0.06 mm, P < 0.05). The proportion of patients who evidenced a PD reduction from baseline of 2 mm or more at 9 months was significantly greater in the chlorhexidine chip group (19%) compared with SRP controls (8%) (P < 0.05). Adverse effects were minor and transient toothache, including pain, tenderness, aching, throbbing, soreness, discomfort, or sensitivity was the only adverse effect that was higher in the chlorhexidine group as compared to placebo (P = 0.042). These data demonstrate that the adjunctive use of the chlorhexidine chip results in a significant reduction of PD when compared with both SRP alone or the adjunctive use of a placebo chip. These multi-center randomized control trials suggest that the chlorhexidine chip is a safe and effective adjunctive chemotherapy for the treatment of adult periodontitis. [References: 58] <29> UI - 1998314175 AU - Moritz A AU - Schoop U AU - Goharkhay K AU - Aoid M AU - Reichenbach P AU - Lothaller MA AU - Wernisch I AU - Sperr W IN - Dr. A. Moritz, Department of Conservative Dentistry, Dental School, University of Vienna, Waehringerstrasse 25a, A-1090 Vienna; Austria. TI - Long-term effects of CO2 laser irradiation on treatment of hypersensitive dental necks: Results of an in vivo study. SO - Journal of Clinical Laser Medicine & Surgery Vol 16(4) (pp 211-215), 1998. AB - Objective: The present in vivo study was performed to examine the long- term effects of combined CO2 laser treatment and fluoridation on hypersensitive dental necks. Summary Background Data: Attempts have been made to treat dental hypersensitivity by sealing exposed dentinal tubules, primarily using fluoride preparations, strontium chloride, and hydroxyapatite. However, these treatment methods have the disadvantage that the preparation is effective only for a limited period of time and must be applied repeatedly, at short intervals. The CO2 laser has been shown to have an excellent sealing effect on hypersensitive dentinal surfaces. Methods: Test subjects suffering from dentinal hypersensitivity were recruited from the patients of the Department of Conservative Dentistry, School of Dentistry of the University of Vienna, Austria and treated with combined laser irradiation and fluoridation with stannous fluoride gel. The patients were followed up for a period of 18 months. In vivo examinations were supplemented by atomic absorption spectroscopy (AAS) of tiny dentin samples obtained from the dental necks 6 weeks and 18 months after laser treatment and by scanning electron microscopy (SEM). Results: Compared to conventional fluoridation, combined laser irradiation and fluoridation was shown to be effective in the treatment of hypersensitive dental necks. When success was defined as complete freedom from pain, the success rate in the laser group was 96.5%. Furthermore, examinations of irradiated teeth under the scanning electron microscope still revealed complete closure of the dentinal tubules four and six months after laser treatment. AAS showed that tin was present in the samples, which indicates that combined laser treatment and fluoridation result in permanent integration of fluoride in the dentin surface. Conclusions: Based on these results, the CO2 laser can be recommended as an ideal tool for desensitization of dental necks. [References: 16] <30> UI - 1998305246 AU - Choubisa SL IN - S.L. Choubisa, P.G. Department of Zoology, S.B.P. Government College, M.L. Sukhadia University, Dungarpur - 314 001; India. TI - Fluorosis in some tribal villages of Udaipur district (Rajasthan). SO - Journal of Environmental Biology Vol 19(4) (pp 341-352), 1998. AB - Chronic fluoride intoxication (fluorosis) was observed in villagers and their domestic animals (cattle, buffaloes, sheep and goats) from ten villages of the Udaipur district of Rajasthan where drinking waters contained 0.3 to 7.0 mg/L fluoride. The prevalence of dental fluorosis and skeletal fluorosis in villagers was relatively higher than that observed in the animals. At 5.8 mg/L mean fluoride concentration, 88.7% of children (<18 years) and 100% of adults were found to be affected with dental fluorosis. The highest prevalence (42.2%) of skeletal fluorosis was observed at 5.8 mg F/L (mean). Males showed relatively a higher prevalence of skeletal fluorosis. In general, the prevalence and severeness of skeletal fluorosis increased with increasing of fluoride concentration and with age. None of fluorotic subjects revealed evidence of genu-valgum syndrome and goitre (hyperthyroidism). Among mature animals, buffaloes were found to have a higher prevalence and greater severity of dental and skeletal fluorosis when compared with cattle. The prevalence of dental fluorosis was higher in calves of both type of animals than in adults. Sheep and goats examined at the same time were found to be free of fluorosis. Radiological findings and deformities in fluorotic subjects as well as fluorosis in relation to fluoride concentrations, age and sex have also discussed. [References: 29] <31> UI - 1998240018 AU - Burt BA IN - B.A. Burt, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI; United States. TI - Prevention policies in the light of the changed distribution of dental caries. SO - Acta Odontologica Scandinavica Vol 56(3) (pp 179-186), 1998. AB - Changes in the distribution of caries in economically developed nations over the last 15-20 years include 1) an overall decline in prevalence and severity in child populations; 2) an increasingly skewed distribution, with most disease now found in a small number of children; and 3) concentration of caries in pit and fissure lesions. Exposure to fluoride is usually seen as the principle reason for the caries decline, with little change in intraoral levels of cariogenic organisms or the annual consumption of sugars. Prevention activities are still most often conducted under policies that were established at a time when caries was a more widespread public health problem, so these policies should be critically examined in the light of modern conditions. While prevention should remain the prime activity of public health agencies, despite the reduced severity of caries, the relative economic efficiency of various procedures should be constantly evaluated. Despite the attractions of targeting, cost-effective prevention should be aimed first at the whole population, with more expensive activities targeted to all children in a chosen geographic area rather than to individually selected children. In the Scandinavian countries the prime population strategies are the regular use of fluoride toothpaste and public education that emphasizes oral hygiene. In selected areas where caries levels are still relatively high (that is, targeted geographic areas), fluoride rinse and tablet programs, provided for a whole classroom at a time, can enhance intraoral fluoride levels where necessary. Fluoride varnish and sealants, though effective, are expensive and need careful selection of locality and teeth to be efficient. Individual children with a persistent caries problem, now relatively small in number, can receive individualized preventive treatments in the clinics of the school dental service. [References: 53] <32> UI - 1998213966 AU - Lang NP AU - Hase JC AU - Grassi M AU - Hammerle CHF AU - Weigel C AU - Kelty E AU - Frutig F IN - Dr. N.P. Lang, Department of Periodontology, Fixed Prosthodontics, School of Dental Medicine, Freiburgstrasse 7, CH-3010 Berne; Switzerland. TI - Plaque formation and gingivitis after supervised mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months. SO - Oral Diseases Vol 4(2) (pp 105-113), 1998. AB - OBJECTIVES AND METHODS: A double-blind, randomized, 6-month clinical trial with parallel group design in 162 patients with gingivitis divided into three rinsing groups was conducted in order to study the efficacy and safety of a flavoured solution of delmopinol hydrochloride 2 mg ml-1 (0.2% w/v, Decapinol Mouthwash(TM)) used for supervised mouthrinsing in one rinsing group, in comparison with chlorhexidine digluconate 2 mg ml-1 (0.2% w/v, Hibitane Dental(TM)) in a second rinsing group, and placebo in the third group. The criteria of the Plaque Index (PI) were used to assess plaque formation. Bleeding on probing (BOP) to the bottom of the pocket with a standard pressure was used as the primary gingivitis assessment. The occurrence of supragingival dental calculus and extrinsic tooth staining were also assessed. In addition, patients were asked to report adverse events at each visit. RESULTS: Delmopinol and chlorhexidine exhibited lower scores of the mean PI and the BOP percentage than placebo, both at the 3-month and 6-month examinations. Furthermore, both active solutions showed a higher extent of staining of the teeth than placebo during these two observation periods. Rinsing with chlorhexidine resulted in more dental calculus than placebo after 6 months. Chlorhexidine showed lower scores for plaque formation and gingivitis development but higher scores of supragingival dental calculus (after 6 months) and tooth staining than did delmopinol. Both active solutions were reported by the patients-approximately to the same extent but more frequently than placebo- to induce taste alterations and a transient anaesthetic sensation of the oral mucosa. However, subjective staining of the teeth and tongue was reported by 16% of the delmopinol patients, but by 86% of the patients rinsing with chlorhexidine for 6 months. Furthermore, 24% of the patients in the chlorhexidine group, 9% in the delmopinol group and 4% in the placebo group wished to withdraw from treatment. CONCLUSIONS: The results from this clinical trial indi- cate that supervised rinsing with 0.2% delmopinol hydrochloride or with 0.2% chlorhexidine digluconate twice daily for 60 s as a supplement to normal mechanical oral hygiene procedures resulted in less plaque formation and gingivitis than rinsing with placebo. Although chlorhexidine was more effective than delmopinol regarding plaque formation and gingivitis, it was considered by the patients as less tolerable. [References: 42] <33> UI - 1998213967 AU - Spets-Happonen S AU - Seppa L AU - Korhonen A AU - Alakuijala P IN - S. Spets-Happonen, Dept. of Oral and Dental Diseases, University of Kuopio, PO Box 1627, FIN-70211 Kuopio; Finland. TI - Accumulation of strontium and fluoride in approximal dental plaque and changes in plaque microflora after rinsing with chlorhexidine-fluoride- strontium solution. SO - Oral Diseases Vol 4(2) (pp 114-119), 1998. AB - OBJECTIVES: To find out if strontium is incorporated into plaque and enamel in vivo during a 2-week rinsing period with a chlorhexidine-fluoride- strontium solution and to determine the effects of the rinsing on the numbers of mutans streptococci and lactobacilli in plaque. SUBJECTS AND METHODS: A total of 18 adult participants rinsed their mouths twice a day for 2 weeks, first with a placebo solution and subsequently, separated by a 1-week interval without rinsing, with a chlorhexidine gluconate (0.05%)-sodium fluoride (0.04%)-strontium (100 ppm as SrCl2) rinsing solution (CXFSr) for another 2 weeks. RESULTS: After the CXFSr rinsing period the strontium and fluoride contents (mug g-1 plaque dry weight; mean +/- s8) of approximal plaque were 32.5 +/- 4.7 and 72.8 +/- 9.0, compared with the respective contents of 8.4 +/- 1.2 and 42.0 +/- 4.8 after placebo rinsing (P = 0.0001 for both comparisons). The strontium content remained elevated for 6 weeks. The median proportion of mutans streptococci of approximal plaque of the total viable count of bacteria was 1% after placebo rinsing but decreased to 0.2% after CXFSr rinsing. The proportion of mutans streptococci remained low at 3 weeks (P = 0.018 vs placebo) but had reached the placebo level at 6 weeks. Rinsing with CXFSr solution did not reduce lactobacilli in plaque. The strontium or fluoride contents of the enamel surfaces subjected to tooth brushing did not significantly change. CONCLUSIONS: Strontium and fluoride accumulated in dental plaque during a 2-week CXFSr rinsing period and the proportion of mutans streptococci in approximal plaque was reduced at least for 3 weeks after completion of the rinsing. [References: 39] <34> UI - 1998173045 AU - Ma JK-C AU - Hikmat BY AU - Wycoff K AU - Vine ND AU - Chargelegue D AU - Yu L AU - Hein MB AU - Lehner T IN - J.K.-C. Ma, Department of Immunology, United Medical and Dental Schools, Guy's Hospital, London Bridge, London SE1 9RT; United Kingdom. E-Mail: j.ma@umds.ac.uk. TI - Characterization of a recombinant plant monoclonal secretory antibody and preventive immunotherapy in humans. SO - Natural Medicines Vol 4(5) (pp 601-606), 1998. AB - A functional comparison was made between a monoclonal secretory antibody generated in transgenic plants and its parent murine IgG antibody. The affinity constants of both antibodies for a Streptococcus mutans adhesion protein were similar. However the secretory antibody had a higher functional affinity due to its dimeric structure. In the human oral cavity, the secretory antibody survived for up to three days, compared with one day for the IgG antibody. The plant secretory antibody afforded specific protection in humans against oral streptococcal colonization for at least four months. We demonstrate that transgenic plants can be used to produce high affinity, monoclonal secretory antibodies that can prevent specific microbial colonization in humans. These findings could be extended to the immunotherapeutic prevention of other mucosal infections in humans and animals. [References: 20] <35> UI - 1998178966 AU - Forsten L IN - L. Forsten, Institute of Dentistry, University of Turku, Lemminkaisenkatu 2, 20520 Turku; Finland. TI - Fluoride release and uptake by glass-ionomers and related materials and its clinical effect. SO - Biomaterials Vol 19(6) (pp 503-508), 1998. AB - The anticariogenic effect of silicate cement is well known and considered a result of fluoride release. In several studies a similar fluoride release from conventional glass-ionomer cement (GIC) has been established. Therefore, an anticariogenic effect may be predicted from the GICs too. In my studies the fluoride release was studied by exposing the test specimens to a continuous flow of running tap water. At certain time periods the specimens were transferred for 1 week in a small amount of deionized water (5 ml). The determination of the fluoride content of the solution showed the fluoride release of the material at that time. There was an initial 'burst' effect of fluoride release and then the release gradually decreased, settling at a constant level. The long-term release from conventional GICs was shown to remain on the same level for at least 8 years. The amount of the constant release did not differ much between different brands. Resin-modified GICs released fluoride to the same extent and in the similar way as conventional GICs whereas polyacid-modified composites ('compomers') did not show an initial fluoride 'burst' effect. To study the fluoride binding ability of GICs, specimens which had been exposed to running water for different periods of time were treated with a 50 ppm fluoride solution. After this 'recharging' GIC and resin-modified GIC specimens released more than twice the amount of fluoride released before the treatment. The fluoride treatment had no effect on polyacid-modified composites or on fluoride-containing composites or on the amalgams. To get an impression of the clinical effect of GICs a questionnaire was handed out to practitioners attending courses in the Nordic countries and in Australia during the period 1991-1992 which resulted in 954 answers. Among other questions, the dentists were asked if they had observed caries and gingival inflammation in association with GIC and composite fillings. According to the opinion of most dentists caries and gingival inflammation had never or only seldom been observed in association with GIC fillings whereas most dentists had observed these complications often in connection with composite restorations. [References: 22] <36> UI - 1998169325 AU - Quirynen M AU - Mongardini C AU - Van Steenberghe D IN - Dr. D. Van Steenberghe, Department of Periodontology, Faculty of Medicine, Catholic University of Leuven, Capucijnenvoer 7, B-3000 Leuven; Belgium. TI - The effect of a 1-stage full-mouth disinfection on oral malodor and microbial colonization of the tongue in periodontitis patients. A pilot study. SO - Journal of Periodontology Vol 69(3) (pp 374-382), 1998. AB - ORAL MALODOR AFFECTS A LARGE proportion of the population and may be the cause of a significant and psychological handicap. This pilot study aimed to examine whether a 1-stage full-mouth disinfection in periodontitis patients (scaling and root planing of all pockets within 24 hours together with the application of chlorhexidine to all intra-oral niches followed by chlorhexidine mouth rinsing for 2 months) resulted in a significant improvement in malodor when compared to a fractionated periodontal therapy (consecutive root planings per quadrant, at a 1 to 2 week interval). The baseline and outcome data concerning oral malodor were linked to the presence of tongue coating and to its roughness (fissures). Twenty-four patients with severe periodontitis were randomly allocated to test and control groups. At baseline and after 1 and 2 months, the concentration of volatile sulfur compounds (VSC) in the mouth was measured and organoleptic ratings (expired air and total mouth air) were given. Plaque samples were collected from the dorsum of the tongue to calculate the number of colony forming units (CFU) per ml (anaerobic culturing) as well as the number of pigmented CFU/ml. Both the baseline organoleptic ratings and the VSC scores correlated well with the presence of tongue coating but not with the tongue roughness. Because a correlation between tongue coating and its microbial load could not be detected, it was hypothesized that the tongue coating per se, and not the bacteria, might be responsible for the malodor. The 1-stage full-mouth disinfection resulted in a faster and additional reduction in the organoleptic ratings of the oral malodor, even after 2 months. This might be explained by the improved periodontal outcome and/or the more significant reduction in the CFU/ml of pigmented species. In contrast to the organoleptic ratings, which were significantly reduced in both treatment groups (when compared to baseline), the VSC levels remained unchanged. This pilot study indicates that a 1-stage full-mouth disinfection has, in comparison to a standard periodontal therapy, additional beneficial effects in the treatment of oral malodor. [References: 50] <37> UI - 1998165634 AU - Wade DN AU - Kerns DG IN - D.N. Wade, U.S. Army Dental Activity, Billy Johnson Dental Clinic, Fort Hood, TX 76544-5063; United States. TI - Acute necrotizing ulcerative gingivitis-periodontitis: A literature review. SO - Military Medicine Vol 163(5) (pp 337-342), 1998. AB - Acute necrotizing ulcerative gingivitis-periodontitis (ANUG/NUP) is a relatively uncommon periodontal disease characterized by gingival necrosis and ulceration, pain, and bleeding. The purpose of this paper is to provide a review of current knowledge on ANUG/NUP. Current literature on the epidemiology, pathogenesis, immunology, predisposing factors, and treatment of ANUG/NUP is reviewed. [References: 51] <38> UI - 1998109604 AU - Southard GL AU - Godowski KC IN - G.L. Southard, Atrix Laboratories Inc., 2579 Midpoint Drive, Fort Collins, CO 80525; United States. TI - Subgingival controlled release of antimicrobial agents in the treatment of periodontal disease. SO - International Journal of Antimicrobial Agents Vol 9(4) (pp 239-253), 1998. AB - Local drug delivery of antimicrobics by sustained release delivery systems can be used to treat periodontal disease. Advantages of these systems may include biodegradation of the system, maintaining high levels of antibiotic in the gingival crevicular fluid (GCF) for a sustained period of time and ease of use with high patient acceptance. This review will identify human in vivo clinical and microbiological studies. Sustained release formulations, application methods, clinical results and microbiological effects are discussed. [References: 130] <39> UI - 1998094578 AU - Marcotte H AU - Lavoie MC IN - M.C. Lavoie, Departement de Biochimie, Pavillon Alexandre-Vachon, Universite Laval, Laval, Que. G1K 7P4; Canada. E-Mail: marc.lavoie@bcm.ulaval.ca. TI - Oral microbial ecology and the role of salivary immunoglobulin A. SO - Microbiology & Molecular Biology Reviews Vol 62(1) (pp 71-109), 1998. AB - In the oral cavity, indigenous bacteria are often associated with two major oral diseases, caries and periodontal diseases. These diseases seem to appear following an inbalance in the oral resident microbiota, leading to the emergence of potentially pathogenic bacteria. To define the process involved in caries and periodontal diseases, it is necessary to understand the ecology of the oral cavity and to identify the factors responsible for the transition of the oral microbiota from a commensal to a pathogenic relationship with the host. The regulatory forces influencing the oral ecosystem can be divided into three major categories: host related, microbe related, and external factors. Among host factors, secretory immunoglobulin A (SIgA) constitutes the main specific immune defense mechanism in saliva and may play an important role in the homeostasis of the oral microbiota. Naturally occurring SIgA antibodies that are reactive against a variety of indigenous bacteria are detectable in saliva. These antibodies may control the oral microbiota by reducing the adherence of bacteria to the oral mucosa and teeth. It is thought that protection against bacterial etiologic agents of caries and periodontal diseases could be conferred by the induction of SIgA antibodies via the stimulation of the mucosal immune system. However, elucidation of the role of the SIgA immune system in controlling the oral indigenous microbiota is a prerequisite for the development of effective vaccines against these diseases. The role of SIgA antibodies in the acquisition and the regulation of the indigenous microbiota is still controversial. Our review discusses the importance of SIgA among the multiple factors that control the oral microbiota. It describes the oral ecosystems, the principal factors that may control the oral microbiota, a basic knowledge of the secretory immune system, the biological functions of SIgA, and, finally, experiments related to the role of SIgA in oral microbial ecology. [References: 539] <40> UI - 1998091883 AU - Lehmann R AU - Wapniarz M AU - Hofmann B AU - Pieper B AU - Haubitz I AU - Allolio B IN - Dr. B. Allolio, Medizinische Klinik Univ. Wurzburg, Schwerpunkt Endokrinologie, Josef-Schneider-Str. 2, 97080 Wurzburg; Germany. TI - Drinking water fluoridation: Bone mineral density and hip fracture incidence. SO - Bone Vol 22(3) (pp 273-278), 1998. AB - The role of drinking water fluoride content for prevention of osteoporosis remains controversial. Therefore, we analyzed the influence of drinking mater fluoridation on the incidence of osteoporotic hip fractures and bone mineral density (BMD) in two different communities in eastern Germany: in Chemnitz, drinking water was fluoridated (1 mg/L) over a period of 30 years; in Halle, the water was not fluoridated, BMD was measured in healthy hospital employees aged 20-60 years (Halle: 214 women, 98 men; Chemnitz: 201 women, 43 men, respectively) using dual-energy X-ray absorptiometry. Hip fractures in patients <= 35 years admitted to the local hospitals in the years 1987-1989 were collected from the clinic registers. There was no difference in age, anthropometric, hormonal, or lifestyle variables between the two groups. Mean fluoride exposure in Chemnitz was 25.2 +/- 7.3 years. No correlation was found between fluoride exposure and age-adjusted BMD. We found no significant difference in spinal or femoral BMD between subjects living in Halle and Chemnitz [lumbar spine: 0.997 +/- 0.129 (g/cm2) vs. 1.045 +/- 0.171 (g/cm2), p = 0.08, for men; 1.055 +/- 0.112 (g/cm2) vs. 1.046 +/- 0.117 (g/cm2), p = 0.47, for women]. The fracture incidence showed an exponential increase with aging in men and women with an incidence about 3.5 times higher for women. In Chemnitz, we calculated an age-adjusted annual incidence of 142.2 per 100,000 for women and 72.5 per 100,000 for men, respectively. In Halle, the incidences were 178.5 per 100,000 for women and 89.2 per 100,000 for men. There was a lower hip fracture incidence after the age of 85 in women in Chemnitz (1391 per 100,000 in Chemnitz vs. 1957 per 100,000 in Halle, p = 0.006). Using the age-adjusted incidences, significantly fewer hip fractures occurred in Chemnitz in both men and women. In conclusion, our study suggests that optimal drinking water fluoridation (1 mg/L), which is advocated for prevention of dental caries, does not influence peak bone density but may reduce the incidence of osteoporotic hip fractures in the very old. [References: 29] <41> UI - 1998091517 AU - Meurman JH AU - Pyrhonen S AU - Teerenhovi L AU - Lindqvist C IN - J.H. Meurman, Institute of Dentistry, University of Helsinki, Helsinki University Central Hospital, Helsinki; Finland. TI - Oral sources of septicaemia in patients with malignancies. SO - Oral Oncology Vol 33(6) (pp 389-397), 1997. AB - This article reviews papers dealing with oral infections of adult septicaemia patients, searched from MEDLINE, Current Contents and Core Biomedical Collection databases from January 1966 to November 1996. Case reports were excluded. The systematic review of literature revealed that our knowledge of the topic is mostly based on very small patient material. There are no multicentre studies on the effects of various oral health treatment modes on the prevention of septicaemia of oral origin. The number of controlled and comparative studies on the efficacy of the different treatment protocols of oral infections is also small. Current recommendations in this respect are mainly empirical and not evidence based. Clinical practice guidelines are therefore urgently needed. Nevertheless, close co-operation between oncological and oral health units is emphasised because many studies have shown that the oral cavity is indeed an important source of bacteraemia. Life-threatening infections may follow if maintenance of oral health is neglected during anticancer therapy and if potential oral infection foci are left untreated before immunosuppressive therapy. [References: 67] <42> UI - 1998087763 AU - Vemmer T AU - Gibson SLM AU - Gibson RG AU - Jones C AU - Taylor G AU - Evans D AU - Whittle G AU - Trotter D IN - Dr. T. Vemmer, Munsterstrasse 33, D-22529 Hamburg; Germany. TI - Water fluoridation and tooth decay in 5 year olds (multiple letters) [4]. SO - British Medical Journal Vol 316(7126) (pp 230-231), 1998. <43> UI - 97373874 AU - Lambert PM AU - Morris HF AU - Ochi S IN - Dr. H.F. Morris, Dental Research (154), Dept. of Veterans Affairs Med. Ctr., Ann Arbor, MI 48105; United States of America. TI - The influence of 0.12% chlorhexidine digluconate rinses on the incidence of infectious complications and implant success. SO - Journal of Oral & Maxillofacial Surgery Vol 55(12 SUPPL.) (pp 25-30), 1997. AB - The effect of perioperative chlorhexidine on the frequency of infectious complications through stage II was examined, Chlorhexidine was used perioperatively in 54.6% of patients (52.5% of implants) in a Dental Implant Clinical Research Group study with a database of 2,641 implants (595 patients). With chlorhexidine, there was a significant reduction in the number of infectious complications (4.1% vs 8.7%). Two percent of implants failed in the absence of an infectious complication, whereas 12% with infectious complications failed. This sixfold difference is highly significant. Chlorhexidine may reduce microbial complications when used in the immediate perioperative period. [References: 28] <44> UI - 97354231 AU - Modesto A AU - Souza I AU - Cordeiro P AU - Silva L AU - Primo L AU - Vianna R IN - A. Modesto, Pediat. Dentistry/Orthodontics Dept., Dental School, Federal University of Rio de Janeiro, Rio de Janeiro; Brazil. TI - Fluoride uptake in situ after the use of dental floss with fluoride. SO - Journal of Clinical Dentistry Vol 8(5) (pp 142-144), 1997. AB - The possibility of having a commercial product such as waxed floss with an additional agent for controlling and preventing caries is promising. The aim of this research was to determine the uptake of fluoride on tooth enamel in situ after the utilization of a dental floss with fluoride incorporated into the wax. One hundred blocks of bovine enamel were artificially demineralized and randomly separated into a Control Group (C) and a Test Group (T). The dental blocks in group T were mounted two-by-two simulating proximal contacts and were fixed into intra-oral lower arch devices. Eight volunteers with a similar salivary flow and buffer capacity wore devices with the enamel blocks for eight days. During this period of time the subjects applied a 25 cm long portion of a mint waxed floss with fluoride (0.15 mgF/m, Oral-B(TM)) between the blocks, 3 times a day for 2 minutes after each meal. At the same time, brushing was carried out with a fluoride-free toothpaste. The alkali-soluble fluoride (CaF2) formed on the enamel was extracted using the Caslavska et al. method and measured with the Orion 96-09 electrode-specific and the EA 720 ion analyzer. The results showed that the group that had the most CaF2 on the enamel (median, minimum and maximum in muF/cm2) was Group T (3.00, 2.11 and 4.00), which differed significantly (p < 0.01) from group C (0.26, 0.10 and 0.69). It was concluded that fluoride uptake on enamel was 11.54 times higher after use of dental floss with fluoride in this study. [References: 20] <45> UI - 97341154 AU - Garcia-Closas R AU - Garcia-Closas M AU - Serra-Majem L IN - R. Garcia-Closas, Unidad de Investigacion, Hospital Universitario de Canarias, Tenerife, Canary Islands; Spain. E-Mail: rclosas@huc.rcanaria.es. TI - A cross-sectional study of dental caries, intake of confectionery and foods rich in starch and sugars, and salivary counts of Streptococcus mutans in children in Spain. SO - American Journal of Clinical Nutrition Vol 66(5) (pp 1257-1263), 1997. AB - In this cross-sectional study of 236 schoolchildren living in Manresa, Spain, we evaluated the association between prevalence of dental caries and frequency of consumption of various food groups, including sweetened baked goods and similar foods (rich in starch and sugars) and confectionery (rich in sugars but not starch), using a food-frequency questionnaire. Because Streptococcus mutans is associated with the cariogenicity of carbohydrates, we also evaluated the modification of these associations by salivary counts of this microorganism. Odds ratios (ORs) were used to measure the association between caries and tertiles of consumption. Sex, age, use of fluorides, tooth-brushing frequency, frequency of dental visits, socioeconomic status, and intake of other potentially cariogenic food groups were considered as potential confounders. We did not find a significant association between any of the food groups evaluated and caries prevalence. Failure to detect an association could have been due to the low prevalence of caries in our population (decayed, missing, or filled permanent teeth = 1.3 at age 10.6 y) or to underestimation of the association due to diet misclassification. In this population, the association between consumption of sweetened baked goods and caries appeared to be modified by the numbers or S. mutans [OR = 6.1 (95% CI: 1.6, 23.0) for low compared with high intake in children with moderate- to-high S. mutans counts and OR = 0.3 (95% CI: 0.1, 1.6) for low compared with high intake in children with low S. mutans counts]. These results suggest that a high intake of sweetened baked goods may be a determinant of caries prevalence in children with moderate-to-high salivary counts of S. mutans. [References: 57] <46> UI - 97258195 AU - Grossi SG AU - Skrepcinski FB AU - DeCaro T AU - Robertson DC AU - Ho AW AU - Dunford RG AU - Genco RJ IN - Dr. S.G. Grossi, Periodontal Disease Research Center, Department of Oral Biology, School of Dental Medicine, 3435 Main Street, Buffalo, NY 14214; United States of America. TI - Treatment of periodontal disease in diabetics reduces glycated hemoglobin. SO - Journal of Periodontology Vol 68(8) (pp 713-719), 1997. AB - Periodontal disease is a common infection-induced inflammatory disease among individuals suffering from diabetes mellitus. The purpose of this study was to assess the effects of treatment of periodontal disease on the level of metabolic control of diabetes. A total of 113 Native Americans (81 females and 32 males) suffering from periodontal disease and non-insulin dependent diabetes mellitus (NIDDM) were randomized into 5 treatment groups. Periodontal treatment included ultrasonic scaling and curettage combined with one of the following antimicrobial regimens: 1) topical water and systemic doxycycline, 100 mg for 2 weeks; 2) topical 0.12% chlorhexidine (CHX) and systemic doxycycline, 100 mg for 2 weeks; 3) topical povidone-iodine and systemic doxycycline, 100 mg for 2 weeks: 4) topical 0.12% CHX and placebo: and 5) topical water and placebo (control group). Assessments were performed prior to and at 3 and 6 months after treatment and included probing depth (PD), clinical attachment level (CAL), detection of Porphyromonas gingivalis in subgingival plaque and determination of serum glucose and glycated hemoglobin (HbA(1c)). After treatment all study groups showed clinical and microbial improvement. The doxycycline-treated groups showed the greatest reduction in probing depth and subgingival Porphyromonas gingivalis compared to the control group. In addition, all 3 groups receiving systemic doxycycline showed, at 3 months, significant reductions (P <= 0.04) in mean HbA(1c) reaching nearly 10% from the pretreatment value. Effective treatment of periodontal infection and reduction of periodontaI inflammation is associated with a reduction in level of glycated hemoglobin. Control of periodontal infections should thus be an important part of the overall management of diabetes mellitus patients. [References: 23] <47> UI - 97203754 AU - Haugejorden O AU - Nord A AU - Klock KS IN - O. Haugejorden, Department of Community Dentistry, Aarstadveien 17, N-5009 Bergen; Norway. TI - Direct evidence concerning the 'major role' of fluoride dentifrices in the caries decline: A 6-year analytical cohort study. SO - Acta Odontologica Scandinavica Vol 55(3) (pp 173-180), 1997. AB - The role of fluoride (F) dentifrices in caries decline was investigated by assessing the effect of variation in their use on caries scores among teenagers. The material comprised 211 subjects aged about 11 years at base line and 18 years at the last examination. Pairs of posterior bitewing radiographs were assessed by one examiner. Information concerning dental health behavior was collected by questionnaire and about treatment received from dental records. A reversal of the traditional. DFS gender difference occurred during teenage years. Multivariate regression analyses showed an inverse relationship between variation in F dentifrice use and current decay (D1S) at age 18 years (P < 0.04) and which caries incidence per year (D1FS) during the whole observation period (P < 0.02). Total explained variance in 6-year DeltaD1FS scores was 29.8%, of which variation in toothbrushing behavior contributed 1.8 percentage points. While confirming the multifactorial nature of dental caries, these results also provided quantitative evidence for the role of variation in F dentifrice use in caries incidence and decline. [References: 37] <48> UI - 97157436 AU - Corbet EF AU - Tam JOW AU - Zee KY AU - Wong MCM AU - Lo ECM AU - Mombelli AW AU - Lang NP IN - Dr. N.P. Lang, School of Dental Medicine, University of Berne, Freiburgstrasse 7, CH-3010 Berne; Switzerland. TI - Therapeutic effects of supervised chlorhexidine mouthrinses on untreated gingivitis. SO - Oral Diseases Vol 3(1) (pp 9-18), 1997. AB - AIM: The aim of the present study was to test the presumptive therapeutic effect of chlorhexidine digluconate in a population with untreated gingivitis and presence of abundant calculus. SETTING AND STUDY DESIGN: Sixty subjects ( [similar] mean age of 23.4) were recruited from a knitting factory in the Province of Guangdong, People's Republic of China. By applying a double-blind clinical trial design the participants were divided into two groups (Test and Control) and matched according to their mean GI scores. The Test group (n = 20) was assigned to two daily mouthrinses for 6 days per week using 0.12% chlorhexidine digluconate (Peridex(TM)). The Control group (n = 40) rinsed twice daily with a placebo solution. All the rinsings were supervised and timed for 45 s. No attempt was made to influence the oral hygiene habits of the participants. Prior to and after 3 months of the supervised rinsing, plaque was scored using the Plaque Index system (PII), and gingivitis was assessed using the criteria of the Gingival Index system (GI). Calculus was scored according to the Calculus Surface Severity Index system (CSSI), and stain was also graded by the Discoloration Index system (DI). RESULTS: After 3 months, the Test group (n = 13) showed significant reduction in mean PII, GI and percentage of gingivial bleeding (GB%), while significant increases in mean DI were observed. The improvement in gingival health was observed at all regions with marked reduction in mean GI (from GI = 1.40 to 1.08) and GB% reduction by 24-52%. The proportion of GI = 2 was also reduced significantly from 50-36%. The Control group (n = 23) also showed a decrease in mean PII but significant increases in the mean GI and GB%. Intergroup comparison showed statistically significant differences between mean GI, percentage of gingival bleeding (GB%) and mean DI for the test and control groups after 3 months of supervised rinsing. However, there were no significant intergroup differences for mean PII. CONCLUSION: In conclusion, there was a significant effect of chlorhexidine on gingivitis, although the effect may be too limited to assure prognostic benefits in the prevention of future disease progression. [References: 59] <49> UI - 97130639 AU - Fairbrother KJ AU - Kowolik MJ AU - Curzon MEJ AU - Muller I AU - McKeown S AU - Hill CM AU - Hannigan C AU - Bartizek RD AU - White DJ TI - The comparative clinical efficacy of pyrophosphate/triclosan, copolymer/triclosan and zinc citrate/triclosan dentifrices for the reduction of supragingival calculus formation. SO - Journal of Clinical Dentistry Vol 8(2) (pp 62-66), 1997. AB - Three triclosan-containing 'multi-benefit' dentifrices were compared for clinical efficacy in reducing supragingival calculus formation following a dental prophylaxis. A total of 544 subjects completed a double-blind parallel-group clinical study using the Volpe-Manhold Index (VMI) to record severity and occurrence of supragingival calculus. The study design included a pre-test period where the calculus formation rate was measured in subjects brushing with a placebo dentifrice. Following a prophylaxis, subjects were stratified for age, gender and VMI scores and assigned to one of four treatments: 1) a dentifrice containing 5.0% soluble pyrophosphate/0.145% fluoride as NaF/silica abrasive/0.28% triclosan (hereafter PPi/TCS - comparable to Crest(TM) Complete dentifrice, Procter and Gamble, UK); 2) a commercial dentifrice containing 2.0% Gantrez(TM) acid copolymer/0.145% fluoride as NaF/silica abrasive/0.30% triclosan (hereafter Gan/TCS - Colgate(TM) Total dentifrice, Colgate-Palmolive Company, UK); 3) a commercial dentifrice containing 0.5% zinc citrate trihydrate/0.15% fluoride as sodium monofluorophosphate/silica abrasive/0.20% triclosan (hereafter Zn/TCS - Mentadent(TM) P dentifrice, Unilever, UK); and 4) a control dentifrice comprised of 0.145% fluoride as NaF/silica abrasive (hereafter Control). Subjects were instructed to use their assigned dentifrice at least twice per day and to brush as they do normally. Supragingival calculus formation was assessed at two and four months using site-specific and whole-mouth VMI indices for both calculus severity and occurrence. Following four months of use, the PPi/TCS dentifrice provided statistically significant reductions in calculus severity (22-23%) and occurrence (15%) as compared with the Control dentifrice. The Zn/TCS dentifrice also provided significant reductions in calculus severity (17-19%) and occurrence (12-13%) as compared with the Control. The Gan/TCS produced no statistically significant reductions in calculus formation (occurrence or severity) compared with the Control. The PPi/TCS dentifrice provided statistically significant reductions in calculus severity (15-21%) and occurrence (12-16%) as compared with the Gan/TCS dentifrice. These results support the clinical effectiveness of PPi/TCS and Zn/TCS dentifrices for the reduction of supragingival dental calculus formation following a dental prophylaxis. [References: 25] <50> UI - 97130637 AU - Beiswanger BB AU - McClanahan SF AU - Bartizek RD AU - Lanzalaco AC AU - Bacca LA AU - White DJ TI - The comparative efficacy of stabilized stannous fluoride dentifrice, peroxide/baking soda dentifrice and essential oil mouthrinse for the prevention of gingivitis. SO - Journal of Clinical Dentistry Vol 8(2) (pp 46-53), 1997. AB - This double-blind parallel-design clinical study compared the efficacy of a stabilized stannous fluoride dentifrice (Crest(TM) Plus Gum Care), baking soda and peroxide (NaF) dentifrice (Mentadent(TM)), and essential oil mouthrinse (Listerine(TM)) to a conventional NaF dentifrice (Crest(TM)) for the control of plaque, gingivitis and gingival bleeding over six months. Following an initial baseline examination and stratification, subjects received a complete oral prophylaxis and were distributed assigned test products. Following three and six months, subjects re-visited the clinic for examinations. Evaluations at baseline and at 3 and 6 months included soft tissue status, Loe-Silness gingivitis/gingival bleeding, Silness-Loe plaque and dental stain. Results subsequent to six months of product use were as follows: At six months, the stabilized stannous fluoride dentifrice was observed to produce statistically significant 17.5% reductions in gingivitis and 27.5% reductions in gingival bleeding relative to the NaF dentifrice. The combination of sodium fluoride dentifrice and essential oil mouthrinse produced statistically significant reductions of 7.4% in gingivitis and 10.8% in plaque as compared with the NaF dentifrice. The stabilized stannous fluoride dentifrice produced statistically significant reductions in both gingivitis (10.8%) and gingival bleeding (23.0%) relative to the combination of sodium fluoride dentifrice and essential oil mouthrinse. The baking soda and peroxide (NaF) dentifrice did not provide reductions in gingivitis, plaque or gingival bleeding as compared with the conventional NaF dentifrice. The stabilized stannous fluoride dentifrice provided statistically significant reductions in gingivitis as compared with the baking soda and peroxide dentifrice following six months of use, and both the essential oil mouthrinse and stabilized stannous fluoride dentifrice provided statistically significant reductions in gingivitis as compared with the baking soda and peroxide dentifrice following three months of use. These results support: 1) the efficacy of stabilized stannous fluoride dentifrice and the combination of sodium fluoride dentifrice and essential oil mouthrinse for the prevention of gingivitis; 2) the superior activity of stabilized stannous fluoride dentifrice as compared with a combination of sodium fluoride dentifrice and essential oil mouthrinse for the control of gingivitis and gingival bleeding; and 3) the lack of efficacy for baking soda and peroxide dentifrice for the control of plaque, gingivitis and gingival bleeding as compared with conventional fluoridated dentifrice. [References: 24] <51> UI - 97130636 AU - McClanahan SF AU - Beiswanger BB AU - Bartizek RD AU - Lanzalaco AC AU - Bacca L AU - White DJ TI - A comparison of stabilized stannous fluoride dentifrice and triclosan/copolymer dentifrice for efficacy in the reduction of gingivitis and gingival bleeding: Six-month clinical results. SO - Journal of Clinical Dentistry Vol 8(2) (pp 39-45), 1997. AB - This parallel-group, double-blind, placebo-controlled clinical trial directly compared the efficacy of two antimicrobial dentifrice formulations for the control of plaque, gingivitis and gingival bleeding during six months of use following a pre-test randomization period. Test antimicrobial dentifrices for the study included: a stabilized stannous fluoride formulation (Crest(TM) Plus Gum Care - currently marketed in U.S.) comprised of 0.454% SnF2 in a stabilized silica abrasive base; and a formulation containing triclosan (Colgate(TM) Total, currently marketed outside the U.S. in numerous countries) comprised of 0.30% triclosan, 2.0% Gantrez(TM) co-polymer and 0.243% NaF in a silica abrasive base. The control dentifrice was a conventional fluoride dentifrice comprised of 0.243% NaF in a silica abrasive base. Clinical evaluations included Turesky et al. plaque, Loe-Silness gingivitis and gingival bleeding, and Meckel stain. The stabilized stannous fluoride dentifrice exhibited significant efficacy in the reduction of both gingivitis (20.5%) and gingival bleeding (33.4%) after six months relative to the placebo control (p < 0.05). In direct comparison, the stabilized stannous fluoride dentifrice reduced gingivitis and gingival bleeding significantly relative to the triclosan/copolymer dentifrice (p < 0.05). These results establish: 1) the superior clinical efficacy of a stabilized stannous fluoride dentifrice relative to a triclosan/copolymer dentifrice in the chemotherapeutic control of gingivitis and gingival bleeding; 2) the important contribution of clinical test design/sensitivity in assessing the therapeutic efficacy of antimicrobial agents; and 3) the value of head-to-head comparative studies in establishing the therapeutic relevance of clinical effects of formulations for the reduction of gingivitis. [References: 42] <52> UI - 97084516 AU - Anonymous TI - Good dental hygiene may prevent drug-induced gingival enlargement. SO - Drugs & Therapy Perspectives Vol 9(4) (pp 11-13), 1997. <53> UI - 97092983 AU - Holmes SD AU - Ivey R IN - R. Ivey, Drug Information Center, College of Pharmacy, Xavier University of Louisiana, New Orleans, LA; United States of America. TI - Iontophoresis and its usefulness as a drug-delivery system. SO - P & T Vol 22(2) (pp 77-80+85+cover 3), 1997. AB - Iontophoresis is the introduction of ions of soluble salts into tissues (usually through the skin) by direct current. Dating back to the 1700s, iontophoresis has been used for the delivery of some drugs to the body, mainly medications with a high molecular weight and suitable polarity. Even though iontophoresis has been around for many years, health care professionals rarely chose to use this noninvasive method of drug delivery, because there had not been much research performed explaining the usefulness and efficacy of this procedure. Recently there has been an increased interest in using this technique for the delivery of medications, both ionic and nonionic. [References: 17] <54> UI - 97070342 AU - Soskolne WA AU - Heasman PA AU - Stabholz A AU - Smart GJ AU - Palmer M AU - Flashner M AU - Newman HN IN - Dr. W.A. Soskolne, Department of Periodontics, Hebrew University, Hadassah Faculty of Dental Medicine, P.O. Box 12272, Jerusalem; Israel. TI - Sustained local delivery of chlorhexidine in the treatment of periodontitis: A multi-center study. SO - Journal of Periodontology Vol 68(1) (pp 32-38), 1997. AB - The safety and efficacy of a degradable, subgingivally placed drug delivery system containing 2.5 mg chlorhexidine (CHX) were evaluated in a randomized, blinded, multi-center stndy of 118 patients with moderate periodontitis. A split-mouth design was used to compare the treatment outcomes of scaling and root planing (SRP) alone with the combined use of SRP and the CHX in pockets with probing depths of 5 to 8 min. The two maxillary quadrants were used for the two treatment arms of the study. Scaling and root planing was performed at baseline only, while the CHX was inserted both at baseline and at 3 months. Clinical and safety measurements including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) as well as gingivitis, plaque, and staining indices were recorded at baseline, and at 1, 3, and 6 months. The average PD reduction in the CHX-treated sites was significantly greater than in the sites receiving SRP alone at both 3 and 6 months with a mean difference of 0.42 mm (P <= 0.01) at 6 months. The reduction in CAL at the treated sites was greater than at the SRP sites, although the difference was statistically significant at the 6-month visit only. An analysis of patients with initial probing depths of 7 to 8 mm (n = 56) revealed a significantly greater reduction in PD and CAL in those pockets treated with CHX compared to SRP at both 3 and 6 months. The mean differences between test and control sites at 6 months were 0.71 mm and 0.56 mm PD and CAL respectively. [References: 33] <55> UI - 97028187 AU - Vandekerckhove BNA AU - Bollen CML AU - Dekeyser C AU - Darius P AU - Quirynen M IN - Prof. M. Quirynen, Department of Periodontology, Faculty of Medicine, Catholic University, Capucijnenvoer 7, B-3000 Leuven; Belgium. TI - Full- versus partial-mouth disinfection in the treatment of periodontal infections. Long-term clinical observations of a pilot study. SO - Journal of Periodontology Vol 67(12) (pp 1251-1259), 1996. AB - A classical treatment for chronic adult periodontitis consists of four to six consecutive sessions of scaling and root planing at a 1- to 2-week interval. Such a so-called 'quadrant or sextant therapy' might result in a reinfection of a previously disinfected area by bacteria from an untreated region. The purpose of this study was to investigate, over an 8-month period, the clinical benefits of full-month disinfection within a 24-hour period in the control of chronic periodontitis. Ten adult patients with advanced chronic periodonitis were randomly assigned to a test and control group. The control group received the standard scheme of initial periodontal therapy, consisting of scaling and root planing per quadrant at 2-week intervals. In the full-mouth disinfection group, scaling and root planing of the four quadrants was performed within 24 hours and immediately followed by a thorough supra- and subgingival chlorhexidine application to limit any transfer of bacteria. The latter involved tongue brushing with a 1% chlorhexidine gel for 60 seconds, mouthrinsing with a 0.2% chlorhexidine solution twice for 60 seconds, repeated subgingival irrigation of all pockets with a 1% chlorhexidine gel (3 times within 10 minutes), and mouthrinsing twice daily with a 0.2% chlorhexidine solution during 2 weeks. In addition, both groups received thorough oral hygiene instructions. The plaque index, gingival index, probing depth, gingival recession, and bleeding on probing were recorded prior to professional cleaning and at 1, 2, 4, and 8 months afterwards. Although the test group scored higher plaque indices than the control group, especially at months 2 and 4, the gingival index and bleeding tendency showed similar improvements with time. However, when the gingival/plaque ratio was considered, the latter was lower in the test group at all follow-up visits. For pockets <= 7 mm, full-mouth disinfection showed a significantly (P = 0.01) higher reduction in probing depth at each follow-up visit with, at month 8, a reduction of 4 mm (from 8 mm to 4 mm), in comparison to 3 mm (from 8 mm to 5 mm) for the classical therapy. The increase in gingival recession in the full-mouth disinfection group remained below 0.7 mm, while in the control group it reached 1.9 mm after 8 months. This resulted in a gain of clinical attachment level of 3.7 mm for the test group versus 1.9 mm for the control group. A radiographical examination also indicated a superior improvement for the test group when compared to the control group. This pilot study suggests that a full-mouth disinfection in one day results in an improved clinical outcome in chronic periodontitis as compared to scalings per quadrant at 2-week intervals over several weeks. [References: 52] <56> UI - 97017295 AU - Zhang C AU - Kimura Y AU - Matsumoto K IN - Prof. K. Matsumoto, Department of Endodontics, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145; Japan. TI - The effects of pulsed Nd:YAG laser irradiation with fluoride on root surface. SO - Journal of Clinical Laser Medicine & Surgery Vol 14(6) (pp 399-403), 1996. AB - This study evaluated the effects of pulsed Nd:YAG laser treatment on root surface in vitro with or without fluoride. Fifty specimens of human teeth were randomly assigned to five different treatment groups: (1) untreated group; (2) laser-treated only; (3) laser-treated after applying black ink; (4) laser-treated after applying 38% Ag(NH3)2F for 1 min; (5) laser-treated followed by applying 2% NaF for 4 min. Following their respective treatments, all specimens were prepared for evaluation by light microscopy, scanning electron microscopy, and EDX (Energy dispersive x-ray spectroscopy). Specimens from group 2 to 4 exhibited gross alterations of root surface not observed in controls such as pitting, crater formation, cracking, and porous globules. The specimens of group 5 had rough surfaces with some particles of approximately 1-mum diameter on the root surface. The fluoride uptake into the root measured by EDX was higher in groups 4 and 5. The depth of penetration of fluoride and silver was approximately 20 mum. Under light microscopy, the specimens of group 2, 3, 4, and 5 revealed some melted cementum, with no changes of underlying dentin. The results of this in vitro study suggested that the laser irradiation with or without fluoride, altered the morphology of the root surface and improved the fluoride uptake into the root surface. Whether the laser-induced surface changes with or without fluoride are beneficial to prevention of root surface caries needs to be studied further. [References: 18] <57> UI - 96336721 AU - Grossi SG AU - Skrepcinski FB AU - DeCaro T AU - Zambon JJ AU - Cummins D AU - Genco RJ IN - Periodontal Disease Research Center, Department of Oral Biology, SUNY, 3435 Main Street, Buffalo, NY 14214-3092; United States of America. TI - Response to periodontal therapy in diabetes and smokers. SO - Journal of Periodontology Vol 67(10 SUPPL.) (pp 1094-1102), 1996. AB - Diabetics and smokers are two patient groups at high risk for periodontal disease who also exhibit impaired wound healing and, therefore, constitute two different groups in whom the relationship between host-parasite interaction, outcome of periodontal therapy, and systemic factors is best represented. The results of two independent clinical trials involving treatment of periodontal disease in diabetics and smokers are presented. A new treatment regimen for the management of periodontal disease associated with diabetes mellitus is proposed. This treatment approach incorporates both antimicrobial agents and pharmacological modulation of the host response. Elimination of periodontal infection and reduction of periodontal inflammation in diabetic patients resulted in a significant short-term reduction in the concentration of glycosylated hemoglobin (HbA(1c)). Control of chronic infections and modulation of the host response offer a new therapeutic approach in the management of patients with both diabetes and periodontal disease. The effect of smoking on periodontal healing is also discussed. The clinical and microbiological response of smokers to non-surgical periodontal therapy is compared to non-smokers. In addition, possible mechanisms whereby diabetes mellitus and cigarette smoking increase the severity of periodontal disease are discussed. <58> UI - 96317112 AU - Volpe AR AU - Petrone ME AU - DeVizio W AU - Davies RM AU - Proskin HM IN - Colgate-Palmolive Technology Center, Piscataway, NJ; United States of America. TI - A review of plaque, gingivitis, calculus and caries clinical efficacy studies with a fluoride dentifrice containing triclosan and PVM/MA copolymer. SO - Journal of Clinical Dentistry Vol 7(SUPPL.) (pp S1-S14), 1996. <59> UI - 96317061 AU - Mann J AU - Karniel C AU - Triol CW AU - Sintes JL AU - Garcia L AU - Petrone ME AU - Volpe AR AU - Proskin HM IN - Hebrew University, Hadassah School of Dental Medicine, Jerusalem; Israel. TI - Comparison of the clinical anticaries efficacy of a 1500 NaF silica-based dentifrice containing triclosan and a copolymer to a 1500 NaF silica-based dentifrice without those additional agents: A study on adults in Israel. SO - Journal of Clinical Dentistry Vol 7(4) (pp 90-95), 1996. AB - Recent years have seen much work in the development of dentifrices containing the antimicrobial agent triclosan, a broad spectrum antibacterial agent manufactured for use in oral products by the Ciba-Geigy Corporation. Studies have shown that the incorporation of this agent into dental products, in combination with a PVM/MA copolymer (the non-proprietary designation for a polyvinylmethyl ether/maleic acid copolymer), can provide several important dental therapeutic benefits, including an antigingivitis effect. A considerable amount of the research on the therapeutic benefits of such dentifrices has been reported in the literature. The present study is a component of a large-scale program of clinical research to investigate the anticaries effectiveness of fluoride dentifrices containing 0.3% triclosan and 2.0% PVM/MA copolymer. The study included two treatment groups, each consisting of adults living near the Kiryat Gat area in Israel, who were assigned to the use of one of the following sodium fluoride (NaF) dentifrices: 1) a dentifrice containing 0.3% triclosan and 2.0% PVM/MA copolymer in a 0.331% NaF/silica (1500 ppm F) base; or 2) a dentifrice containing 0.331% NaF/silica (1500 ppm F). Conducted in accordance with the guidelines for caries clinical studies published by the Council on Dental Therapeutics of the American Dental Association, the study employed clinical diagnostic criteria as described in the August, 1987 National Institute of Dental Research (NIH/NIDR) publication. Dental radiographs were not employed. Principal comparisons of the dentifrices tested were implemented through the construction of 90% confidence intervals for the ratio of mean 3-year caries increments using Fieller's Theorem. Of thos subjects who met the initial inclusion/exclusion criteria for this study, 1,296 were available for the 36-month examination. DFS (resp., DFT) increments over this period were 5.21 (1.30) for the triclosan/copolymer dentifrice, and 5.23 (1.39) for the dentifrice without those additives. The confidence interval calculations for both incremental DFS and DFT support the conclusion that a dentifrice containing 0.3% triclosan and 2.0% PVM/MA copolymer in a 0.331% NaF/silica (1500 ppm F) base provides a level of anticaries efficacy which is 'at least as good as' that provided by a dentifrice containing 1500 NaF/silica, without those additive agents. As such, the results of this clinical study clearly indicate that the addition of triclosan and a copolymer to a 1500 NaF/silica dentifrice does not compromise its anticaries efficacy. <60> UI - 96317060 AU - Feller RP AU - Kiger RD AU - Triol CW AU - Sintes JL AU - Garcia L AU - Petrone ME AU - Volpe AR AU - Proskin HM IN - Dental Service, Jerry L. Pettis Mem. VA Medical Ctr., Loma Linda Univ. School of Dentistry, Loma Linda, CA; United States of America. TI - Comparison of the clinical anticaries efficacy of an 1100 NaF silica-based dentifrice containing triclosan and a copolymer to an 1100 NaF silica-based dentifrice without those additional agents: A study on adults in California. SO - Journal of Clinical Dentistry Vol 7(4) (pp 85-89), 1996. AB - Recent years have seen much work in the development of dentifrices containing the antimicrobial agent triclosan, a broad spectrum antibacterial agent manufactured for use in oral products by the Ciba-Geigy Corporation. Studies have shown that the incorporation of this agent into dental products, in combination with a PVM/MA copolymer (the non-proprietary designation for a polyvinylmethyl ether/maleic acid copolymer), can provide several important dental therapeutic benefits, including an antigingivitis effect. Much research on the therapeutic benefits of such dentifrices has been reported in the literature. The present study is a component of a large-scale program of clinical research to investigate the anticaries effectiveness of fluoride dentifrices containing 0.3% triclosan and 2.0% PVM/MA copolymer. The study included two treatment groups, each consisting of adults living within a 50 mile radius of Loma Linda, California, who were assigned to the use of one of the following sodium fluoride (NaF) dentifrices: 1) a dentifrice containing 0.3% triclosan and 2.0% PVM/MA copolymer in a 0.243% NaF/silica (1100 ppm F) base; or 2) a dentifrice containing 0.243% NaF/silica (1100 ppm F). Conducted in accordance with the guidelines for caries clinical studies published by the Council on Dental Therapeutics of the American Dental Association, the study employed clinical diagnostic criteria as described in the August, 1987 National Institute of Dental Research (NIH/NIDR) publication. Dental radiographs were not employed. Principal comparisons of the dentifrices tested were implemented through the construction of 90% confidence intervals for the ratio of mean 3-year caries increments, using Fieller's theorem. Of those subjects who met the initial inclusion/exclusion criteria for this study, 1,542 were available for the 36-month examination DFS (resp., DFT) increments over this period were 2.07 (0.63) for the triclosan/copolymer dentifrice, and 2.16 (0.68) for the dentifrice without those additives. The confidence interval calculations for both incremental DFS and DFT support the conclusion that a dentifrice containing 0.3% triclosan and 2.0% PVM/MA copolymer in a 0.243% NaF/silica (1100 ppm F) base provides a level of anticaries efficacy which is 'at least as good as' that provided by a dentifrice containing 1100 NaF/silica without those additive agents. As such, the results of this clinical study clearly indicate that the addition of triclosan and a copolymer to a 1100 NaF/silica dentifrice does not compromise its anticaries. <61> UI - 96300736 AU - Bokhout B AU - Van Loveren C AU - Hofman FXWM AU - Buijs JF AU - Van Limbeek J AU - Prahl-Andersen B IN - Department of Orthodontics, Academic Ctr for Dentistry Amsterdam, ACTA, Louwesweg 1, NL-1066 EA Amsterdam; Netherlands. TI - Prevalence of Streptococcus mutans and lactobacilli in 18-month-old children with cleft lip and/or palate. SO - Cleft Palate-Craniofacial Journal Vol 33(5) (pp 424-428), 1996. AB - The prevalence of Streptococcus mutans and lactobacilli was determined in 62 18-month-old Dutch children with a cleft lip and/or palate. Plaque and saliva samples were collected, a dental examination was performed, and the parents were interviewed with a structured questionnaire regarding general health, dietary habits, fluoride exposure, and socioeconomic class. Appropriate dilutions of the plaque and saliva samples were cultured on selective media to count all viable bacteria, S. mutans and lactobacilli. S. mutans was detected in the saliva of 45% of the children, and lactobacilli was detected in 16%. Also, S. mutans was detected in 48% of the plaque samples and lactobacilli in 8%. Of all of the variables examined, consumption of more than three snacks and beverages between main meals was significantly associated with presence of S. mutans in saliva. Preoperative infant orthopedic treatment (i.e., wearing an acrylic plate from shortly after birth) was significantly associated with presence of lactobacilli in saliva. The presence of S. mutans in the plaque samples was also significantly associated with presence of lactobacilli in saliva. These results indicate that children with oral cleft are at an increased risk of being infected by S. mutans and lactobacilli at a very early age. Such early colonization indicates a high risk for caries in the primary dentition. <62> UI - 96269261 AU - Karthikeyan G AU - Pius A AU - Apparao BV IN - Department of Chemistry, Gandhigram Rural Institute, Deemed University, Gandhigram 624 302, Tamil Nadu; India. TI - Contribution of fluoride in water and food to the prevalence of fluorosis in areas of Tamil Nadu in South India. SO - Fluoride - Quarterly Reports Vol 29(3) (pp 151-155), 1996. AB - Fluoride contents of water and food, collected from the subjects of five selected areas of Tamil Nadu in South India, were determined. Surveys were conducted to ascertain dental fluorosis prevalences among children of the areas, and dental and skeletal fluorosis prevalences in the adult populations. Dean's 'Community Fluorosis Index' (CFI) for dental fluorosis was calculated, from the children's survey, and was found to be correlated with the prevalence and severity of fluorosis in the areas. A direct correlation was also confirmed between the mean fluoride level in drinking water and the percentage incidence of dental fluorosis. The dominant role of fluoride from drinking water, when compared with that from food, was established. <63> UI - 96120758 AU - Pendrys DG AU - Katz RV AU - Morse DE IN - Behav. Sci./Community Health Dept., School of Dental Medicine, Univ. of Connecticut Health Center, Farmington, CT 06030; United States of America. TI - Risk factors for enamel fluorosis in a nonfluoridated population. SO - American Journal of Epidemiology Vol 143(8) (pp 808-815), 1996. AB - The purpose of this case-control investigation was to investigate the possible association between mild-to-moderate enamel fluorosis and exposure during early childhood to fluoride supplements, fluoride toothpaste, and/or infant formula use in nonfluoridated communities. Analysis was performed on 460 10- to 13-year-old children, born after 1979, who were residents of six nonfluoridated communities in Massachusetts and Connecticut. The fluorosis status of the subjects was determined on the basis of a clinical dental examination using the Fluorosis Risk Index (FRI). Risk factor exposure was ascertained via a mailed questionnaire with a response rate of 90% and a questionnaire reliability of 87%. Logistic regression analyses revealed a moderate association between mild-to-moderate enamel fluorosis on early forming (FRI classification I) enamel surfaces and both fluoride supplement use (odds ratio (OR) = 2.25, 95% confidence interval (CI) 1.08-4.69) and early toothbrushing habits (OR = 2.56, 95% CI 1.34-4.88). There was a strong association between mild-to-moderate fluorosis on later forming (FRI classification II) enamel surfaces and both supplement use (OR = 7.97, 95% CI 2.98-21.33) and early toothbrushing habits (OR = 4.23, 95% CI 1.72- 10.41). Infant formula was not found to be associated with fluorosis on either FRI classification I or II surfaces. <64> UI - 96109813 AU - Moritz A AU - Gutknecht N AU - Schoop U AU - Goharkhay K AU - Ebrahim D AU - Wernisch J AU - Sperr W IN - Department of Conservative Dentistry, School of Dentistry, Uni