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Alghanem S, Dziurkowska E, Ordyniec-Kwaśnica I, Sznitowska M. Intraoral medical devices for sustained drug delivery. Clin Oral Investig 2023; 27:7157-7169. [PMID: 37982874 PMCID: PMC10713785 DOI: 10.1007/s00784-023-05377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/05/2023] [Indexed: 11/21/2023]
Abstract
OBJECTIVES The oral cavity constitutes an attractive organ for the local and systemic application of drug substances. Oromucosal tablets, gels, or sprays are examples of the formulations applied. Due to the elution through the saliva, the residence time of the formulation at the application site is relatively short. Medical devices placed in the oral cavity, with a reservoir for an active substance, play an important role in solving this problem. MATERIALS AND METHODS In this review, we discuss the devices described in the literature that are designed to be used in the oral cavity, highlighting the advantages, disadvantages, and clinical applications of each of them. RESULTS Among the intraoral medical devices, special types are personalized 3D-printed devices, iontophoretic devices, and microneedle patches. CONCLUSION We anticipate that with the development of 3D printing and new polymers, the technology of flexible and comfortable devices for prolonged drug delivery in the oral cavity will develop intensively. CLINICAL RELEVANCE The presented review is therefore a useful summary of the current technological state, when in fact none of the existing devices has been widely accepted clinically.
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Affiliation(s)
- Suhail Alghanem
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland
| | - Ewelina Dziurkowska
- Department of Analytical Chemistry, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland.
| | - Iwona Ordyniec-Kwaśnica
- Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdansk, Str. E. Orzeszkowej 18, 80-208, Gdansk, Poland
| | - Małgorzata Sznitowska
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Medical University of Gdansk, Al. Gen. J. Hallera 107, 80-416, Gdansk, Poland
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Liang K, Carmone S, Brambilla D, Leroux JC. 3D printing of a wearable personalized oral delivery device: A first-in-human study. SCIENCE ADVANCES 2018; 4:eaat2544. [PMID: 29750201 PMCID: PMC5942915 DOI: 10.1126/sciadv.aat2544] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 03/26/2018] [Indexed: 05/27/2023]
Abstract
Despite the burgeoning interest in three-dimensional (3D) printing for the manufacture of customizable oral dosage formulations, a U.S. Food and Drug Administration-approved tablet notwithstanding, the full potential of 3D printing in pharmaceutical sciences has not been realized. In particular, 3D-printed drug-eluting devices offer the possibility for personalization in terms of shape, size, and architecture, but their clinical applications have remained relatively unexplored. We used 3D printing to manufacture a tailored oral drug delivery device with customizable design and tunable release rates in the form of a mouthguard and, subsequently, evaluated the performance of this system in the native setting in a first-in-human study. Our proof-of-concept work demonstrates the immense potential of 3D printing as a platform for the development and translation of next-generation drug delivery devices for personalized therapy.
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Al-Bazi SM, Abbassy MA, Bakry AS, Merdad LA, Hassan AH. Effects of chlorhexidine (gel) application on bacterial levels and orthodontic brackets during orthodontic treatment. J Oral Sci 2017; 58:35-42. [PMID: 27021538 DOI: 10.2334/josnusd.58.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The objectives of this study were to evaluate the effects of applying 0.50% chlorhexidine (CHX) gel using the dental drug delivery system (3DS) on salivary Streptococcus mutans (S. mutans) and on the surface topography of metal and ceramic orthodontic brackets. The study involved 20 orthodontic patients with high levels of salivary S. mutans. The patients were treated with professional mechanical tooth cleaning followed by application of 0.50% CHX using individual trays (3DS). Salivary S. mutans levels were repeatedly measured 1, 2, 4, and 8 weeks post-treatment. In vitro study utilized forty ceramic and metallic brackets that were immersed in 0.50% CHX gel for 10 min, whereas another untreated forty brackets served as controls. The frictional resistances of stainless steel wires to the brackets before and after CHX treatment were recorded using a universal testing machine. Scanning electron microscopy was used to compare changes in the surface topography of brackets. Statistical analyses were used to determine the effect of CHX on bacterial count and to evaluate the effect of CHX on frictional resistance. According to the results of this study, S. mutans levels were reduced significantly (P < 0.05). There were no significant changes in the frictional resistance and surface topography of brackets before or after application of CHX. (J Oral Sci 58, 35-42, 2016).
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Affiliation(s)
- Samar M Al-Bazi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University
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Steinberg D, Friedman M. Sustained-release drug delivery of antimicrobials in controlling of supragingival oral biofilms. Expert Opin Drug Deliv 2016; 14:571-581. [PMID: 27454813 DOI: 10.1080/17425247.2016.1213239] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Dental caries, a bacterial biofilm-associated disease, is a prevalent oral health problem. It is a bacterial biofilm-associated disease. Conventional means of combating this disease involves oral hygiene, mostly tooth brushing. Supplementary means of prevention and treatment is often necessary. The use of sustained-release delivery systems, locally applied to the oral cavity appears to be one of the most acceptable avenues for the delivery of antimicrobial agents. Area covered: The development and current approaches of local sustained delivery technologies applied to the oral cavity for treatment and prevention of dental caries is discussed. The use of polymeric drug delivery systems, varnishes, liposomes and nanoparticles is presented. Expert opinion: The use of local sustained-release delivery systems applied to the oral cavity has numerous clinical, pharmacological and toxicological advantages over conventional means. Various sustained-release technologies have been suggested over the course of several years. The current research on oral diseases concentrates predominantly on improving the drug delivery. With progress in pharmaceutical technology, sophisticated controlled-release platforms are being developed. The sustained release concept is innovative and there are few products available for the benefit of all populations. Harmonizing academic research with the dental industry will surely expedite the development and commercialization of more products of such pharmacological nature.
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Affiliation(s)
- Doron Steinberg
- a Biofilm Research Laboratory, Institute of Dental Sciences , Hebrew University-Hadassah , Jerusalem , Israel
| | - Michael Friedman
- b Institute for Drug Research, School of Pharmacy , Hebrew University , Jerusalem , Israel
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Long-term clinical and bacterial effects of xylitol on patients with fixed orthodontic appliances. Prog Orthod 2015; 16:35. [PMID: 26467791 PMCID: PMC4605935 DOI: 10.1186/s40510-015-0103-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/20/2015] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study was to evaluate long-term clinical and bacterial effects of using 6 g of xylitol per day for 3 months on patients with full fixed orthodontic appliances. Methods The study was a pilot clinical trial that included 41 subjects who were undergoing orthodontic treatment. The subjects were randomly divided into three groups. Group A received xylitol chewing gum, group B received xylitol dissolvable chewable tablets, and Group C served as the control group and did not receive xylitol gums or tablets. Clinical examination and the collection of plaque and saliva samples were carried out at baseline and 3, 6, and 12 months. All three groups were given oral hygiene instruction and were put on a 6-month cleaning and topical fluoride schedule. Plaque scores and bacterial counts were used to evaluate the effectiveness of the different approaches at reducing the caries risk. Results Xylitol groups did not experience any more reduction in plaque score, plaque MS counts, or salivary MS counts than the control group nor did they have lower values at any of the time points. Chewing gum did not significantly increase the incidence of debonded brackets over the other groups. Conclusions Xylitol does not have a clinical or bacterial benefit in patients with fixed orthodontic appliances. Oral hygiene instructions and 6-month topical fluoride application were effective at reducing plaque scores and bacterial counts in patients with full fixed appliances regardless of whether or not xylitol was used.
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Simons D, Brailsford S, Kidd EAM, Beighton D. The effect of chlorhexidine acetate/xylitol chewing gum on the plaque and gingival indices of elderly occupants in residential homes. J Clin Periodontol 2008. [DOI: 10.1111/j.1600-051x.2001.281104.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ribeiro LGM, Hashizume LN, Maltz M. The effect of different formulations of chlorhexidine in reducing levels of mutans streptococci in the oral cavity: A systematic review of the literature. J Dent 2007; 35:359-70. [PMID: 17391828 DOI: 10.1016/j.jdent.2007.01.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Revised: 12/27/2006] [Accepted: 01/29/2007] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES The current study undertakes a systematic review of the literature in order to assess how long different formulations (solutions, gels and varnishes) of chlorhexidine (CHX) reduce the level of mutans streptococci (MS) in the oral cavity. SOURCES A search of the PUBMED and LILACS databases was conducted through October 2005. STUDY SELECTION Clinical studies evaluating the effects of CHX solutions, gels, or varnishes on MS levels were targeted (n=52). CONCLUSIONS The studies varied greatly in quantity of mouthwash solution used in rinsing, length of rinsing, and treatment frequency and period. CHX mouthwash solution had short-term effect on salivary MS. Most of studies evaluating CHX gel and varnish used a concentration of 1%. The 1% CHX gel showed a significant reduction through intensive treatment (3-4 daily applications over 2 days) or through daily application for 10 and 14 days. It cannot be asserted that 1% CHX varnish provides better results when applied intensively as compared to applications conducted at intervals of 1 or more months. Treatment using 1% CHX varnish displays large variations in the level and length of decreased MS levels. Despite variability in results, 40% CHX varnish has a greater effect on the period of decreased MS levels than does 1% CHX varnish. Studies did not show a statistically significant difference between the gel and the varnish. The effects of CHX treatment must be monitored, given sharp individual variability in response to this treatment.
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Affiliation(s)
- Luciana Gazaniga Maia Ribeiro
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Tamaki Y, Nomura Y, Takeuchi H, Ida H, Arakawa H, Tsurumoto A, Kumagai T, Hanada N. Study of the clinical usefulness of a dental drug system for selective reduction of mutans streptococci using a case series. J Oral Sci 2006; 48:111-6. [PMID: 17023742 DOI: 10.2334/josnusd.48.111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was to evaluate the clinical efficacy and safety of a dental drug delivery system (3DS) for the selective reduction of mutans streptococci. Twenty patients with high levels of mutans streptococci in saliva participated. The efficacy of 0.2% chlorhexidine (CHX) delivered by 3DS in reducing the salivary levels of mutans streptococci compared with total streptococci and lactobacilli was investigated. Each subject was treated by professional mechanical tooth cleaning (PMTC) and subsequently individual trays with CHX for 5 min. Salivary bacterial samples were taken at the baseline and weeks 1-12. A significant reduction in the colony count of mutans streptococci was observed during the first 4 weeks compared with the baseline count, while no significant decrease in the count of total streptococci or lactobacilli was found during 12 weeks. In particular, the proportion of mutans streptococci in total streptococci remained low after 12 weeks. Our results indicate that the new 3DS used in combination with PMTC appears to be a promising intraoral drug delivery system which, when used with a low CHX concentration selectively, effectively reduces mutans streptococci in the oral cavity with no adverse effects.
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Affiliation(s)
- Yoh Tamaki
- Department of Preventive Dentistry and Public Health, Tsurumi University School of Dental Medicine, Kanagawa, Japan.
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Decker EM, von Ohle C, Weiger R, Wiech I, Brecx M. A synergistic chlorhexidine/chitosan combination for improved antiplaque strategies. J Periodontal Res 2005; 40:373-7. [PMID: 16105089 DOI: 10.1111/j.1600-0765.2005.00817.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The minor efficacy of chlorhexidine (CHX) on other cariogenic bacteria than mutans streptococci such as Streptococcus sanguinis may contribute to uneffective antiplaque strategies. METHODS AND RESULTS In addition to CHX (0.1%) as positive control and saline as negative control, two chitosan derivatives (0.2%) and their CHX combinations were applied to planktonic and attached sanguinis streptococci for 2 min. In a preclinical biofilm model, the bacteria suspended in human sterile saliva were allowed to attach to human enamel slides for 60 min under flow conditions mimicking human salivation. The efficacy of the test agents on streptococci was screened by the following parameters: vitality status, colony-forming units (CFU)/ml and cell density on enamel. The first combination reduced the bacterial vitality to approximately 0% and yielded a strong CFU reduction of 2-3 log(10) units, much stronger than CHX alone. Furthermore, the first chitosan derivative showed a significant decrease of the surface coverage with these treated streptococci after attachment to enamel. CONCLUSIONS Based on these results, a new CHX formulation would be beneficial unifying the bioadhesive properties of chitosan with the antibacterial activity of CHX synergistically resulting in a superior antiplaque effect than CHX alone.
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Affiliation(s)
- E-M Decker
- Department of Conservative Dentistry, School of Dental Medicine, University of Tuebingen, Germany.
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Beyth N, Redlich M, Harari D, Friedman M, Steinberg D. Effect of sustained-release chlorhexidine varnish on Streptococcus mutans and Actinomyces viscosus in orthodontic patients. Am J Orthod Dentofacial Orthop 2003; 123:345-8. [PMID: 12637907 DOI: 10.1067/mod.2003.19] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study evaluated the effect of sustained-release chlorhexidine varnish on orthodontic patients. Ten children, ages 10 to 16 years, participated. Bacterial levels of Streptococcus mutans and Actinomyces viscosus and total counts were evaluated in sputum samples. These counts were evaluated at 4 stages: before orthodontic treatment, at least 2 weeks after bonding of the brackets, 1 week after application of chlorhexidine varnish, and 3 weeks after application of chlorhexidine varnish. Increases in bacterial levels of S mutans and in the total bacterial count were detected after the brackets were bonded. One week after the sustained-release chlorhexidine varnish was applied, a significant decrease of total bacterial levels and S mutans was observed. This decrease persisted for 3 weeks after the first application. No significant change in A viscosus levels occurred during that period. The results provide additional evidence that sustained-release chlorhexidine varnish decreases S mutans levels in orthodontic patients with fixed appliances and therefore might be useful in preventing caries lesions.
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Affiliation(s)
- Nurit Beyth
- Department of Prosthodontics, Institute of Dental Sciences, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
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Costalonga M, Hodges JS, Herzberg MC. Streptococcus sanguis modulates type II collagen-induced arthritis in DBA/1J mice. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2002; 169:2189-95. [PMID: 12165549 DOI: 10.4049/jimmunol.169.4.2189] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Native type II collagen is tolerogenic when given orally or i.p. to DBA/1J mice and induces autoimmune arthritis when given s.c. in CFA. The tolerogenic epitope is contained in cyanogen bromide fragment 11 (CB11) and is structurally mimicked by PGEQGPK within the platelet aggregation-associated protein (PAAP) on Streptococcus sanguis. To learn whether S. sanguis modulates transmucosally the Ag-specific development of autoimmune arthritis, DBA/1J pups were given live S. sanguis, CB11, or type II collagen intragastrically. Feeding S. sanguis at 6 days postpartum delayed the onset of arthritis, and reduced the rate, final severity, and percentage of affected limbs. Next, PAAP(+) S. sanguis and type II collagen were tested for T cell cross-reactivity. T cells primed with the tolerogenic epitope of type II collagen proliferated more when incubated with PAAP(+) S. sanguis than with PAAP(-) Streptococcus gordonii or type II collagen, suggesting an Ag-specific transmucosal tolerogenic effect. In neonatal mice, therefore, bacterial surface Ags that mimic self can transmucosally stimulate Ag-specific inhibitory T cells. In adult mice immunized with type II collagen, these Ag-specific inhibitory T cells manifest later as attenuated arthritis. The PAAP(+) S. sanguis appear to activate adult memory, rather than naive, type II collagen-specific T cells, suggesting that systemic challenge with commensal self-mimicking microorganisms may perpetuate existing autoimmunity, but not initiate autorecognition.
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Affiliation(s)
- Massimo Costalonga
- Department of Preventive Sciences and Minnesota Oral Health Clinical Research Center, University of Minnesota, Minneapolis, MN 55455, USA.
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Simons D, Brailsford S, Kidd EA, Beighton D. The effect of chlorhexidine acetate/xylitol chewing gum on the plaque and gingival indices of elderly occupants in residential homes. J Clin Periodontol 2001; 28:1010-5. [PMID: 11686821 DOI: 10.1034/j.1600-051x.2001.281104.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM A randomised, controlled, double-blind, clinical trial was conducted to investigate the effect of a chlorhexidine acetate/xylitol gum (ACHX) on the plaque and gingival indices of 111 elderly occupants in residential homes. A gum containing xylitol alone (X) and a no gum (N) group was included. Participants' opinions about chewing gum were also investigated. METHODS Subjects chewed 2 pellets, for 15 min, 2x daily for 12 months. RESULTS In the ACHX group, the plaque and gingival indices significantly decreased (p<0.001) over the 12 months. In the X group, only the plaque score significantly decreased (p<0.05) and in the N control group, both indices remained high and did not change significantly. The acceptance of both chewing gums was high but more participants in the ACHX group felt that the gum kept their mouth healthy (p<0.05). The effect of the ACHX gum on plaque and gingival indices was significantly greater than for the X gum. CONCLUSION The long-term use of a chlorhexidine acetate/xylitol chewing gum may therefore support oral hygiene routines for an elderly dependent population.
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Affiliation(s)
- D Simons
- Dental Caries Research Group, Guy's, King's and St Thomas's Dental Institute, London, UK
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Abstract
BACKGROUND One strategy for treating dental caries is to suppress oral mutans streptococci, or MS, with chlorhexidine, or CHX, mouthrinse. Oral MS levels, however, tend to quickly return to baseline values without further intervention. In this clinical study, the authors evaluated the effect of xylitol chewing gum on MS regrowth. METHODS The authors selected 151 subjects with elevated oral MS levels (> or = 105 colony-forming units per milliliter, or CFU/mL, of paraffin-stimulated saliva). Subjects rinsed with 0.12 percent CHX gluconate mouthrinse twice daily for 14 days. The authors then randomly assigned the subjects to one of three groups. Those in the test group (n = 51) chewed a commercial xylitol gum three times daily for a minimum of five minutes each time for three months. The placebo group subjects (n = 50) used a commercial sorbitol gum, and the control group subjects (n = 50) did not chew gum. The authors estimated MS load on the dentition using paraffin-stimulated saliva samples. The authors serially diluted the samples, plated them on selective media and incubated them anaerobically; they then enumerated the colonies under a stereomicroscope. RESULTS MS levels were not significantly different between the three groups at baseline (mean log CFU/mL +/- standard deviation: 5.4 +/- 0.7, 5.4 +/- 0.8, 5.2 +/- 0.7, respectively) nor after CHX therapy (2.7 +/- 0.8, 3.1 +/- 1.1, 3.0 +/- 1.1, respectively). After three months of gum chewing, the test group subjects had significantly lower salivary MS levels (3.6 +/- 1.2) than did the placebo (4.7 +/- 1.2) or control (4.4 +/- 1.3) group subjects. CONCLUSIONS Xylitol chewing gum appears to have the ability to prolong the effect of CHX therapy on oral MS. CLINICAL IMPLICATIONS Maintaining long-term caries-pathogen suppression is feasible with currently available commercial products and can be expected to result in significant caries inhibition.
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Affiliation(s)
- G H Hildebrandt
- School of Dentistry, University of Minnesota, Minneapolis 55455-0348, USA.
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Steinberg D, Friedman M. Development of sustained-release devices for modulation of dental plaque biofilm and treatment of oral infectious diseases. Drug Dev Res 2000. [DOI: 10.1002/1098-2299(200007/08)50:3/4<555::aid-ddr39>3.0.co;2-p] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Steinberg D, Hirschfeld Z, Tayeb I, Ben-Yosef S, David A, Friedman M. The effect of parabens in a mouthwash and incorporated into a sustained release varnish on salivary bacteria. J Dent 1999; 27:101-6. [PMID: 10071466 DOI: 10.1016/s0300-5712(98)00040-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the antimicrobial efficacy of parabens, in a mouthwash and in a slow release device, against cariogenic bacteria in the oral cavity. METHODS Parabens were formulated in a mouthwash or in a topical slow release varnish preparation. In two separate studies, volunteers were asked to use the mouthwash or the slow release varnish applied in a personal night guard device. The levels of mutans streptococci (MS), Lactobacilli (LB) and total cultivated bacteria were measured before and after using the mouthwash or the slow release varnish. RESULTS The mouthwash containing parabens had a minor and a short-term effect on MS and LB counts in human saliva. The use of slow release varnish containing parabens, applied in a night guard, had a prolonged antibacterial effect on both MS and LB counts. CONCLUSIONS Parabens in a mouthwash had little effect on oral bacteria counts; however, paraben in the slow release device had a significant and an extended effect in reducing oral bacteria. Although substantial reductions in oral bacterial counts were recorded after the use of parabens in a slow release device, this effect could probably be enhanced by an improved pharmaceutical formulation.
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Affiliation(s)
- D Steinberg
- Department of Oral Biology, Faculty of Dentistry, Hebrew University-Hadassah, Jerusalem, Israel.
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Affiliation(s)
- E Lynch
- Department of Conservative Dentistry, St. Bartholomew's, London, UK
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Vaahtoniemi LH, Räisänen S, Stenfors LE. Effect of chlorhexidine and toothbrushing on the presence of bacteria on gingival and buccal epithelial cells. ORAL MICROBIOLOGY AND IMMUNOLOGY 1994; 9:315-7. [PMID: 7808776 DOI: 10.1111/j.1399-302x.1994.tb00078.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Swabs of buccal and gingival epithelial cells from healthy young adult donors were washed in physiological saline solution, smeared on glass slides and stained with acridine orange. The presence of bacteria attached onto epithelial cells was examined under a fluorescence microscope. Four hours after a chlorhexidine rinse, the number of cells with > 50 attached bacteria had almost completely vanished. The degree of bacterial colonization seemed to re-establish at a level exceeding the baseline. One week after chlorhexidine treatment the degree of colonization was still over the control level. Toothbrushing with a conventional toothpaste reduced immediately the number of cells with > 50 bacteria. The colonization had re-established to the pre-washing levels at the buccal sites at 1 h and at the gingival sites at 4 h after toothbrushing. A method for the evaluating of the antimicrobial power of oral hygiene products is presented.
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Affiliation(s)
- L H Vaahtoniemi
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Oulu, Finland
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Emilson CG. Potential efficacy of chlorhexidine against mutans streptococci and human dental caries. J Dent Res 1994; 73:682-91. [PMID: 8163738 DOI: 10.1177/00220345940730031401] [Citation(s) in RCA: 153] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Chemotherapeutic agents have been considered as having potential for the prevention of dental caries. Several substances have been evaluated as possible candidates, but no antimicrobial agent, with the exception of fluoride, has received as much experimental attention as the bisbiguanide chlorhexidine. This substance represents, so far, the most effective and best-documented agent. To be effective against caries, therapeutic dosages of the antimicrobial agent have to be given for a sufficient but finite time period to sites with established cariogenic plaque. In studies where this principle has been used, the aim has been to eliminate or strongly suppress the population of mutans streptococci. Of various antimicrobial agents and methods tested, the most persistent reduction of mutants streptococci has been achieved by chlorhexidine varnishes, followed by gels and mouthwashes. The best clinical effect resulting in a considerable caries reduction has been obtained when persons highly colonized with mutans streptococci have been treated with gels and when the results of the antimicrobial measures have been verified by microbiological examination.
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Affiliation(s)
- C G Emilson
- Department of Cariology, University of Göteborg, Faculty of Odontology, Sweden
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