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Biomedical subjects

M Addy

Publications and source records attributed to M Addy.

At least 37 records · Page 2Linked to original sources

Efficacy of mouthrinses in inhibiting the development of supragingival plaque over a 4-day period of no oral hygiene.

This study was a first stage evaluation of the plaque inhibitory properties of an experimental cetylpyridinium chloride (CPC)/essential oil mouthrinse. The study was a formulation, not ingredient, evaluation and comparisons were made with established mouthrinse products. The 5 rinses tested were: the experimental formulation; a triclosan/copolymer prebrushing mouthrinse; two negative control rinses, which differed only in color; and as a positive control, a 0.2% chlorhexidine mouthrinse. The study used a 5 cell, 4-day plaque regrowth, double-blind crossover design in which 15 subjects participated. Allocation of mouthrinse sequences was accomplished using 3 replicates of a 5 x 5 Latin square, incorporating balance for carryover. On Day 1, subjects received a scaling and polishing to reduce plaque, ceased toothcleaning, and commenced rinsing twice daily, under supervision, with the randomly assigned rinse. Rinsing time for the experimental and one negative control rinse was 30 seconds and for the other rinses was 60 seconds. On Day 5, plaque was scored by both index and area. Differences in plaque regrowth between the rinse groups were highly significant. The order of efficacy from the most effective was: chlorhexidine rinse (positive control); experimental CPC/essential oil rinse; triclosan/copolymer rinse; and the negative control rinses. From the calculated confidence intervals each rinse differed significantly from each other rinse, except for the two negative control rinses which were comparable to each other. Proportionately, the CPC/essential oil rinse was positioned 30 to 50% between the triclosan/copolymer rinse and the chlorhexidine (positive control). These findings suggest that the CPC/phenolic rinse would seem worthy of further evaluation for adjunctive benefits to oral hygiene.

Adult

A study of a pre-brushing mouthrinse as an adjunct to oral hygiene.

A previous clinical screening study demonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a pre-brushing rinse over a 6-week period. The study employed a 4 group parallel design with a minimum of 50 subjects per group. Subjects with a minimum baseline plaque index of 1.95 were recruited. The formulations employed were two variations of a CPC/essential oil rinse, a triclosan/copolymer product, and a hydroalcohol negative control. Subjects were rendered plaque free at baseline and then rinsed twice daily before toothbrushing with their allocated product. Plaque was scored at 6 days and 6 weeks. Plaque scores were reduced at 6 days compared to baseline but there were no significant differences between any of the groups. At 6 weeks, plaque scores were significantly lower in both CPC/essential oil groups compared to control. Although both CPC/essential oil groups showed plaque scores which were lower than the triclosan group, in only one of the groups was the difference significant. The triclosan product was not significantly different from control. The results support the previous findings that a CPC/essential oil rinse could be a useful adjunct to oral hygiene when used prior to normal toothbrushing.

Adolescent

Etiology, mechanisms, and management of dentine hypersensitivity.

Dentine hypersensitivity is a common painful condition of the teeth for which little is known of the etiology and predisposing factors. This tends to compromise management, and recurrence of the condition is frequent. Abrasive and erosive factors, by their effects on enamel and gingiva, are important in localizing sites of exposed dentine. Erosive agents are probably responsible for initiating sensitivity by opening dentinal tubules. Management should not only be treatment based. First, a differential diagnosis should be considered. Then, etiologic and predisposing factors should be identified and where possible removed, reduced, or modified. Treatments are largely aimed at blocking the hydrodynamic mechanism for stimulus transmission across dentine by occluding dentinal tubules. There is a need for further research into understanding the condition itself, its etiology, and the mode of action of the large number of varied but apparently effective therapeutic agents.

Dentin

Dentine hypersensitivity--the effect of toothbrushing and dietary compounds on dentine in vitro: an SEM study.

Dentine hypersensitivity occurs when dentinal tubules are open on the dentine surface and patent to a vital pulp. There has been limited interest in the aetiology of dentine hypersensitivity. In particular, little is known about agents that remove the dentine smear layer to expose tubules. Toothbrushing certainly may expose dentine, but whether a toothbrush per se has the effect of opening tubules has not been established. The aim of this study in vitro was to determine whether a toothbrush could remove or create a smear layer. In addition, the combined effects of toothbrushing with dietary fluids on dentine was assessed. Toothbrushing was observed, by scanning electron microscopy, both to remove and to recreate a smear layer on dentine specimens. However, the processes took a considerable time, and under conditions of normal toothbrushing it is unlikely that the latter plays a direct aetiological role in opening tubules. Indeed, together with toothpaste it is more likely that brushing has a therapeutic action by mechanically forming a smear layer. Conversely, and importantly, toothbrushing in the presence of dietary acids enhanced smear layer removal. This finding raises the question of whether the dental profession should be advising that teeth be brushed before meals rather than after, as is often the case.

Acid Etching, Dental

An in vitro study of the influence of X-ray beam angulation on the radiographic images of the amelocemental junction and simulated alveolar crest.

The aim of this in vitro study was to determine the effect of X-ray beam angulation on the radiographic images and relative positions of the amelocemental junction and alveolar crest. Using an artificial model to represent the tooth/bone relationship, radiographs were taken of a total of 15 extracted premolar teeth which had been divided into three distinct groups on the basis of the contour (configuration) of their approximal amelocemental junction. Radiographs of the tooth/bone units were taken at baseline and with a range of horizontal and vertical X-ray beam angulations from 5 degrees to 20 degrees. Analysis of the radiographs revealed that when using the ideal horizontal angulation the radiographic image of the amelocemental junction was dependent upon its contour and was not always represented by its mid-point bucco-lingually. Changing the horizontal angulation of the X-ray beam altered substantially that part of the junction visible on the film regardless of contour. Variation in the vertical angulation of the X-ray beam had little influence on the distance between the radiographic images of the amelocemental junction and a point representative of the approximal crest of the alveolar bone. It is concluded that the contour of the approximal amelocemental junction has an influence on its radiographic appearance and that films taken with an inappropriate horizontal angulation never provide an image of its mid-point bucco-lingually.

Alveolar Process

The effects of antimicrobial acrylic strips on the subgingival microflora in chronic periodontitis.

This study investigated the effects of root planing and/or the placement of acrylic strips containing chlorhexidine, metronidazole or tetracycline on the composition and antimicrobial susceptibility of the subgingival flora in chronic periodontitis. 101 periodontal pockets from 73 patients were entered into 6 treatment groups which were, chlorhexidine, metronidazole or tetracycline strips, root planing, root planing followed by metronidazole strips and a control, no treatment group. Total anaerobic counts and anaerobe/aerobe ratios were estimated from samples taken before treatment and 1, 2, 4, 8 and 12 weeks after treatment. In addition, a more detailed analysis of the effects of the treatments on the subgingival flora was carried out on 12 pockets in 12 patients. Tetracycline strips, metronidazole strips and root planing and metronidazole strips were more effective than chlorhexidine strips in causing reductions in total anaerobic count and anaerobe/aerobe ratio. However, the changes in microbial parameters rebounded to approach baseline levels 4 weeks after treatment. Chlorhexidine caused no detectable changes in the composition of the subgingival microflora, while metronidazole had a variable effect. Tetracycline appeared to effect major shifts in the composition of the microflora of treated pockets but caused a marked selection of tetracycline-resistant organisms.

Acrylic Resins

Radiographic evaluation of early periodontal bone loss in adolescents. An overview.

A number of studies have used radiographs to establish the prevalence of periodontal bone loss in adolescents, though widely differing findings have been reported. It is likely that such disparity of results can largely be attributed to the variety of criteria used to determine the presence of disease, some of which are highly subjective. In addition, a number of factors may affect the radiographic appearance of commonly chosen reference points. If epidemiological studies are to be interpreted correctly, it is important to examine these areas and, in particular, to determine the most objective means of recording disease in this age group. From a review of the literature, it would seem that assessments based on the radiographic distance between the amelo-cemental junction and the alveolar crest are the least subjective, yet whether this should be greater than 2 mm or 3 mm before bone loss is recorded, is still debated.

Adolescent

A comparison of natural product, triclosan and chlorhexidine mouthrinses on 4-day plaque regrowth.

There is a continuing search for ingredients to enhance the chemical plaque inhibitory action of oral hygiene products. Sanguinarine, other natural extracts and triclosan have already been used in products. The aim of this study was to evaluate a number of triclosan and natural product rinses for effects on plaque regrowth. In particular, the influence of other rinse components were assessed, notably sodium lauryl sulphate (SLS) and zinc. The study was a randomised, blind, 9-cell cross-over design to measure the effects of each rinse on 4-day plaque regrowth from a zero baseline. 15 volunteers rinsed 2x daily with each product and plaque was recorded by area and score. The 0.2% chlorhexidine rinse (positive control) was significantly more effective, and the saline rinse (negative control) significantly less effective, than other rinses. Sanguinarine alone was little different from saline and the addition of zinc made a modest improvement in activity. The 3 triclosan/SLS rinses were more effective than the sanguinarine rinses but similar to their minus triclosan control rinse. A natural product/SLS experimental rinse was second to chlorhexidine and, in many analyses, significantly better than all other rinses, but caused some oral erosions. The results indicate that the plaque inhibitory properties of basic ingredients such as SLS may be difficult to enhance or surpass. However, the possible range of recipes, particularly using natural ingredients, provides scope for research and development in the field of oral hygiene products.

Adult

A comparison of delmopinol and chlorhexidine on plaque regrowth over a 4-day period and salivary bacterial counts.

Delmopinol has been considered as a potential agent for the chemical control of plaque. The aims of these studies were to measure the effects of a 0.2% delmopinol hydrochloride mouthrinse on (1) plaque reformation and (2) salivary bacterial counts. Comparisons were made with a 0.2% chlorhexidine rinse and a placebo rinse. A group of 12 male volunteers took part in the plaque study which was of a double blind, randomised, 3 cell, cross-over design. From a zero plaque baseline subjects rinsed, 2x a day, under supervision, for 1 min with 10-ml volumes of the allocated rinse. After 4 days, during which no other form of oral hygiene was performed, plaque was scored by area and index. Plaque results were significantly lower with chlorhexidine and delmopinol compared with control, and with chlorhexidine compared to delmopinol. Side-effects with delmopinol were transient tingling and numbness of the tongue in some subjects. A 2nd group of 12 male volunteers received single, 1-min rinses of the 3 formulations. Salivary bacterial counts were determined immediately before and up to 420 min after rinsing. Compared to the control rinse, chlorhexidine significantly reduced bacterial counts of 420 min. Delmopinol produced a small reduction in bacterial counts which was only significantly different from control at one time point. Delmopinol deserves further evaluation as a chemical plaque inhibitor, particularly when used as an adjunct to normal toothcleaning.

Adult

Oral carriage of yeasts, coliforms and staphylococci in patients with advanced malignant disease.

Many patients with advanced cancer have oral problems, some of which may have a microbiologic basis. The oral flora in such patients has not, however, been characterized. This study has assessed the prevalence of yeasts, coliforms and coagulase positive staphylococci in the oral flora of 197 patients with advanced cancer. Both imprint cultures (n = 197) and oral rinses (n = 161) were collected. Yeasts were isolated from the mouths of 83% of the patients, coliforms from 49.1% and coagulase-positive staphylococci from 28%. All these percentages are considerably in excess of reported levels for healthy individuals. The results indicate a loss of colonization resistance of the oral mucosa in terminal cancer, with potential implications for the development of mouth care regimes for such patients.

Adult

The effect of a number of commercial mouthrinses compared with toothpaste on plaque regrowth.

Mouthwashes are frequently used as adjuncts to oral hygiene. However, for some products there is little supportive evidence that rinses provide greater benefits than plain water or additional benefits to the plaque inhibitory action provided by toothpaste. This study was a single blind, randomized, cross-over design in which 6 rinses were compared for inhibitory action against plaque regrowth. The formulations were a cetylpyridinium chloride rinse, a prebrushing detergent rinse, a peroxyborate rinse a toothpaste slurry rinse, a chlorhexidine rinse, and a saline rinse. From a zero baseline, plaque regrowth at day 5 was significantly reduced by chlorhexidine compared to peroxyborate; and, in turn, significantly reduced by peroxyborate compared to the other rinses. There were no significant differences between saline or a toothpaste slurry and the cetylpyridinium chloride or prebrushing rinse products. The findings would appear pertinent to the value of the respective rinses as adjuncts to oral hygiene.

Adult

Antibacterial activity of some triclosan-containing toothpastes and their ingredients.

The antibacterial activity of 4 triclosan-containing toothpastes was compared to a conventional fluoride dentifrice and triclosan and sodium lauryl sulphate (SLS), both singly and in combination. A panel of 17 bacteria was tested by an agar dilution method. At concentrations typical of those found in toothpastes, triclosan and SLS displayed approximately equal antibacterial activity. A paste containing triclosan and zinc citrate appeared more active than the other triclosan pastes which, in general, showed marginal superiority over the conventional paste. SLS, although included in dentifrice formulations for its detergent properties, may significantly contribute to the antibacterial profile of a product. The need for appropriate controls when evaluating experimental toothpastes is emphasized.

Aggregatibacter actinomycetemcomitans

Dentine hypersensitivity: its prevalence, aetiology and clinical management.

Dentine hypersensitivity can be a frustrating condition to treat. The most common form of treatment is use of a desensitizing dentifrice, but for many patients this may provide only partial pain relief and recurrence is common. Recent research has provided several important findings which may serve as a basis for refining the approach to dentine hypersensitivity management, and for improving the success of treatment. This paper reviews the research and outlines a management system which transfers readily to clinical practice.

Dentifrices

Loss of the first permanent molar and caries experience of adjacent teeth.

The caries experience of the occlusal and distal surfaces of the second premolars and the occlusal and mesial surfaces of the second permanent molars was examined in four groups of subjects aged 19-20 years. Group 1 comprised subjects with first permanent molars present, Group 2 subjects with early loss of the first permanent molar (before the age of 11-12 years), Group 3 subjects with late loss of the first permanent molar (after 11-12 years but before 15-16 years) and Group 4 included a combination of Group 2 and Group 3. Loss of the first permanent molar was associated with increased caries or restorations in the occlusal surfaces of adjacent teeth, but reduced caries or restorations in the proximal surfaces of adjacent teeth. Early loss of the first molar was associated with significantly greater caries or restoration experience in proximal surfaces than late loss, but no difference was detected for occlusal surfaces.

Adolescent

Clinical aspects of dentine hypersensitivity.

Dentine hypersensitivity is a common painful condition about which relatively little is known. A review of the literature reveals that most research has been concerned with the clinical assessment of therapeutic agents. However, even here there is little information concerning the actual mode of action of such agents. Many clinical aspects of the condition also appear anecdotal at best and there is always a need to consider a differential diagnosis to exclude other causes of dentinal pain. Detailed prevalence figures are not available for dentine hypersensitivity as it affects different groups, although age and possibly gender differences are apparent. Additionally, the condition shows predilections for certain oral sites which may be of aetiological relevance. Consistent with the hydrodynamic theory hypersensitivity lesions reveal large numbers of widened dentinal tubules at the surface and patent to the pulp. The use of dentine replica techniques could prove useful in objectively studying the condition and monitoring treatments. It is apparent that in clinical management little attention has been paid to factors which expose dentine and open tubules. Without consideration of aetiological factors the management of Dentine Hypersensitivity may be compromised.

Dentin Sensitivity

Ten years of kala-azar in west Bengal, Part I. Did post-kala-azar dermal leishmaniasis initiate the outbreak in 24-Parganas?

Following resurgence in Bihar of epidemic kala-azar, outbreaks of the disease were identified simultaneously in two separate foci about 500 km apart in West Bengal in 1980. While the outbreak in one of these foci, in northern West Bengal, was the result of a direct extension of the Bihar epidemic, the source of parasite in the other (in the village of Bandipur in the south of West Bengal) remained unknown until a case of nodulo-ulcerative post-kala-azar dermal leishmaniasis (PKDL) was located in the village. The continued presence of this case in the village from a time long before the outbreak aroused strong suspicion about its causal role. Laboratory-bred female Phlebotomus argentipes sandflies were allowed to feed on four cases of PKDL, including the case from Bandipur, to determine the transmission potential of these cases. Of a total of 400 flies in the experiment, 104 (26%) fed on the cases, and of these flies 44 died (31 within 48 hours of feeding). Of the surviving 60 flies, 32 developed promastigotes in the mid-gut. In view of the presence of the case of PKDL in the village prior to the outbreak and the availability of a susceptible human population and vectors, it is possible that the patient with PKDL was a source of Leishmania donovani parasites for the local focus. Furthermore, PKDL may act as a reservoir of parasites during inter-epidemic periods.

Animals