A modification to the experimental gingivitis protocol to compare the antiplaque properties of two toothpastes

Experimental gingivitis in patients with and without altered passive eruption

BACKGROUND

Individuals with altered passive eruption (APE) are assumed to be more susceptible to periodontal diseases. To date, this hypothesis has not been sufficiently supported by scientific evidence. The aim of this study, using an experimental gingivitis model, was to examine the development and resolution of gingival inflammation in patients with APE when compared to patients with normal gingival anatomy.

METHODS

A localized experimental gingivitis was induced in 9 patients with APE (test group) and 9 patients without APE (control group) in the maxillary right quadrant. After 21 days, patients were instructed to resume proper home oral hygiene procedures. At baseline (day 0) and at days 7, 14, 21, 28, 35, and 42, plaque index (PlI), gingival index (GI), and gingival crevicular fluid volume (GCF) were evaluated for teeth 6 (canine), 7 (lateral incisor) and 8 (central incisor) of test and control groups.

RESULTS

During the experimental gingivitis phase (days 0 to 21), the rate of change in gingival inflammation (GI) was dramatically different between the APE test group and the control group. On day 21, at the time of maximum plaque accumulation, the GI of the APE test group was a 109% greater than the GI of the test group (P ≤ 0.001) despite similar plaque levels (P = 0.436). During the resolution of inflammation phase (days 22 to 42), the APE test group continued to exhibit statistically higher GI scores than the control group (P = 0.029).

CONCLUSION

In the presence of similar amounts of plaque deposits and plaque accumulation rates, APE patients exhibited differences in the development and resolution of plaque-induced gingival inflammation when compared to controls.

Effects of stabilized stannous fluoride dentifrice on dental calculus, dental plaque, gingivitis, halitosis and stain: A systematic review

Objectives

The aim of the present systematic review was to examine the scientific evidence for the efficacy of stabilized stannous fluoride (SnF₂) dentifrice in relation to dental calculus, dental plaque, gingivitis, halitosis and staining.

Data and sources

Medline OVID, Embase.com, and the Cochrane Library were searched from database inception until June 2017. Six researchers independently selected studies, extracted data, and assessed methodological quality. A meta-analysis of the 6-month gingivitis studies was done. Risk of bias was estimated using a checklist from the Swedish Agency for Health Technology Assessment (SBU, 2018).

Study selection

Two studies on dental calculus, 21 on dental plaque and gingivitis, 4 on halitosis, and 5 on stain met the inclusion criteria. Risk of bias was high for the studies on dental calculus, halitosis, and stain, and varied for the dental plaque and gingivitis studies. Significant reductions in dental calculus and in halitosis were reported for the SnF₂ dentifrice; no differences in stain reduction were noted. A meta-analysis on gingivitis found better results for the SnF₂ dentifrice compared to other dentifrices, though the results of the individual trials in the meta-analyses showed a substantial heterogeneity.

Conclusions

The present review found that stabilized SnF₂ toothpaste had a positive effect on the reduction of dental calculus build-up, dental plaque, gingivitis, stain and halitosis. A tendency towards a more pronounced effect than using toothpastes not containing SnF2 was found. However, a new generation of well conducted randomized trials are needed to further support these findings.

Clinical relevance

Adding a SnF₂ toothpaste to the daily oral care routine is an easy strategy that may have multiple oral health benefits.

A review of the effects of stannous fluoride on gingivitis

AIM

To review the literature on the effects of stannous fluoride on gingivitis.

MATERIAL AND METHODS

The Medline and cochrane central register of controlled trials were searched up to August 2005 to identify appropriate studies. The primary outcome measure was gingivitis.

RESULTS

Independent screening of titles and abstracts of 542 papers resulted in 36 publications (inter-reviewer ê score of 0.76), out of which 15 papers finally fulfilled the criteria of eligibility. For SnF(2)dentifrices, a statistically significant reduction in gingivitis was noted in comparison with control (weighted mean difference (WMD) of 0.15 (gingival index) and 0.21 (gingivitis severity index) (test for heterogeneity p<0.00001, I(2)=91.1% and p=0.03, I(2)=80.1%, respectively)). With regard to plaque reduction inconsistent results existed. On using the plaque index no differences were found, whereas meta-analysis of the Turesky index provided a WMD of 0.31 (p=0.01, test for heterogeneity p<0.0001, I(2)=91.7%). Because of insufficient data, a meta-analysis for SnF(2)mouth rinse and dentifrice/mouthrinse formulations was not performed.

CONCLUSIONS

The use of SnF(2) dentifrices results in gingivitis and plaque reduction when compared with a conventional dentifrice. The precise magnitude of this effect was difficult to assess because of a high level of heterogeneity in study outcomes.