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Anticaries effects of polyphenolic compounds from Japanese green tea.
Otake S; Makimura M; Kuroki T; Nishihara Y; Hirasawa M
Department of Clinical Pathology, Nihon University School of Dentistry, Matsudo, Japan.
Caries Res (Switzerland) 1991, 25 (6) p438-43

The dental caries inhibiting effect of the extract from Japanese green tea, one of the most popular drinks in Japan, was studied both in vitro and in vivo. The crude tea polyphenolic compounds (designated Sunphenon) from the leaf of Camellia sinensis were found to effectively inhibit the attachment of Streptococcus mutans strain JC-2 (serotype c) to saliva-coated hydroxyapatide discs. Sunphenon was also inhibitory to water-insoluble glucan formation from sucrose by crude glucosyltransferase of S. mutans JC-2 (c). Among the tea catechins tested, (-)-epigallocatechin gallate and (-)-epicatechin gallate showed the most potent inhibition of the glucosyltransferase activity. Finally, significantly lower caries scores were observed in specific pathogen free rats infected with S. mutans JC-2 (c) and fed a cariogenic diet and/or drinking water containing 0.05% Sunphenon as compared with control rats not receiving polyphenolic compounds.

A pilot study of Japanese green tea as a medicament: antibacterial and bactericidal effects.
Horiba N; Maekawa Y; Ito M; Matsumoto T; Nakamura H
Department of Endodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
J Endod (United States) Mar 1991, 17 (3) p122-4

Antibacterial and bactericidal actions of extracts of four kinds of Japanese green tea were tested against 24 bacterial strains isolated from infected root canals. The extracts of all four teas had antibacterial and bactericidal actions against many of the bacteria.

Effect of tea polyphenols on glucan synthesis by glucosyltransferase from Streptococcus mutans.
Hattori M; Kusumoto IT; Namba T; Ishigami T; Hara Y
Research Institute for Wakan-Yaku, Toyama Medical and Pharmaceutical University, Japan.
Chem Pharm Bull (Tokyo) (Japan) Mar 1990, 38 (3) p717-20

In the course of our studies on the development of anti-plaque agents for prevention of dental caries, we investigated effects of some of tea preparations and their individual components on the glucan synthesis catalyzed by glucosyltransferase (GTF) from Streptococcus mutans. Extracts of green tea and black tea, and polyphenol mixtures showed appreciable inhibition in the synthesis of insoluble glucan. Among the components isolated from tea infusions, theaflavin and its mono- and digallates had potent inhibitory activities at concentrations of 1-10 mM against GTF. (+)-Catechin, (-)-epicatechin and their enantiomers had moderate inhibitory activities at these concentrations, while galloyl esters of (-)-epicatechin, (-)-epigallocatechin and (-)-gallocatechin had increased inhibitory activities.

Triterpene alcohols from the flowers of compositae and their anti-inflammatory effects.
Akihisa T; Yasukawa K; Oinuma H; Kasahara Y; Yamanouchi S; Takido M; Kumaki K; Tamura T
College of Science and Technology, Nihon University, Tokyo, Japan.
Phytochemistry (United States) Dec 1996, 43 (6) p1255-60

Eleven tabular and nine ligulate flowers from 15 species of Compositae plants were investigated for their triterpene alcohol constituents. This led to the isolation and identification of 11 triterpene alcohols as follows: heliaol, taraxasterol, psi-taraxasterol, alpha-amyrin, beta-amyrin, lupeol, taraxerol, cycloartenol, 24-methyl-enecycloartanol, tirucalla-7,24-dienol and dammaradienol. The tabular flowers of Calendula officinalis, Carthamus tinctorius, Cosmos bipinnatus, Chrysanthemum morifolium, Helianthus annuus and Matricaria matricarioides showed a characteristic feature by containing helianol as the most predominant component (29-86%) in the triterpene alcohol fractions. The triterpene alcohols from Compositae flowers were evaluated with respect to their anti-inflammatory activity against 12-O-tetradecanoylphorbol-13-acetate-ind uced inflammation (1 microgram per ear) in mice. All of these showed marked inhibitory activity, and their 50% inhibitory dose was 0.1-0.8 mg per ear.

[Anti-inflammatory action of a group of plant extracts]
Shipochliev T; Dimitrov A; Aleksandrova E
Vet Med Nauki (Bulgaria) 1981, 18 (6) p87-94

Use was made of Wistar albino rats in which an inflammation was induced via the simultaneous injection of caraginan and prostaglandin E1 in order to evaluate the antiinflammatory activity of 6 freeze dried plant extracts. It was found that with such model of inflammation the inflammatory effect of caraginan was strongly enhanced, which was accompanied by the rapid and prolific white blood cell extravasates. The freeze-dried extracts of St. John's-wort (Hypericum perforatum L.), potmarigold calendula (Calendula officinalis L.), camomile (Matricaria chamomilla L.) and plantain (Plantago lanceolata L. et Pl. major L.) were found to suppress both the inflammatory effect and the leukocyte infiltration. The extracts of symphytum (Symphytum officinale L.) and those of flax seed (Linum usitatissimum L.) did not inhibit the inflammation, however, they suppressed the leukocyte infiltration at the 3rd and 4th hour of the induced inflammation .

Anti-calculus activity of a toothpaste with microgranules.
Chesters RK; O'Mullane DM; Finnerty A; Huntington E; Jones PR
Unilever Dental Research,Port Sunlight Laboratory, Wirral, Merseyside, UK.
Oral Dis (England) Sep 1998, 4 (3) p213-6

OBJECTIVE: The objective of the trial was to determine the efficacy of the proven anticalculus active system (zinc citrate trihydrate [ZCT] and triclosan), when the ZCT is delivered from microgranules incorporated in a silica-based toothpaste containing 1450 ppm F as sodium fluoride.

DESIGN: A monadic, single-blind, two phase design clinical trial was used to compare the effect of the test and a negative control fluoridated toothpaste on the formation of supragingival calculus.

SUBJECTS AND METHODS: Male and female calculus-forming volunteers, aged 18 or over, were recruited for the study following a 2-week screening phase. All subjects were given a scale and polish of their eight lower anterior teeth at the start of both the pre-test and test phases. Subjects were supplied with a silica-based 1450 Fppm fluoridated toothpaste with no anti-calculus active for use during an 8-week pre-test phase. Calculus was assessed at the end of the pre-test and test phases using the Volpe-Manhold index (VMI). Subjects were stratified according to their pre-test VMI score (8-10, 10.5-12, > 12) and gender and then allocated at random to test or negative control toothpaste groups. Subjects with < 8 mm of calculus were excluded from further participation.

MAIN OUTCOME MEASURE: The outcome variable was the mean VMI score for the test and negative control groups.

RESULTS: The test toothpaste caused a statistically significant 30% reduction in calculus compared with the control paste after a 13-week use. No adverse events were reported during the study.

CONCLUSION: The incorporation of the ZCT in microgranules did not adversely affect the anticalculus activity of the new formulation.

Effect of citric acid concentration on dentin demineralization, dehydration, and rehydration: atomic force microscopy study.
Marshall GW Jr; Wu-Magidi IC; Watanabe LG; Inai N; Balooch M; Kinney JH; Marshall SJ
Department of Restorative Dentistry, University of California, San Francisco 94143-0758, USA.
graymar@itsa.ucsf.edu
J Biomed Mater Res (United States) Dec 15 1998, 42 (4) p500-7

Most current dentin bonding procedures use acid etchants to partially demineralize the dentin structure and provide pathways for resin infiltration. This study determined the recession rates of peritubular dentin and intertubular dentin as a function of pH during demineralization in citric acid solutions (0.0005-2.5M) and the effects of dehydration and rehydration on the partially demineralized dentin. Polished dentin disks were prepared with an internal reference layer and were studied at specific intervals for citric acid etching between pH 1 and 3.4 in an atomic force microscope. Peritubular dentin etched rapidly and linearly with time until it could no longer be measured. The intertubular surface began etching at nearly the same rate, but then recession slowed for all concentrations and stabilized after recession of less than 1 microm for all but the pH 1 solution. The decrease in recession was attributed to the limitation of contraction of the demineralized collagen scaffold as long as it remained hydrated. Dehydration following etching resulted in significant collapse of the surface, changes in roughness, and a slight decrease in tubule diameter for samples etched for 30 min. Measurements could not be made of the collapse for low pH samples, because shrinkage stresses disrupted the integrity of the reference layer. On rehydration, the dehydrated surfaces underwent an expansion up to the level seen after etching and tubule diameters returned to the etched values. These results indicate that the collapse of demineralized matrix is almost totally recoverable on rehydration.

The effectiveness of three irrigating solutions on root canal cleaning after hand and mechanical preparation.
Liolios E; Economides N; Parissis-Messimeris S; Boutsioukis A
Department of Dental Pathology and Therapeutics, School of Dentistry, Aristotle University of Thessaloniki, Greece.
Int Endod J (England) Jan 1997, 30 (1) p51-7

The purpose of this in vitro study was to evaluate and compare the efficacy of three irrigating solutions after hand and mechanical instrumentation. Sixty intact, single, straight-rooted, human teeth were used in this study. They were instrumented using K-files sizes 15 to 50 with hand or mechanical instrumentation. Mechanical instrumentation was with one of two handpieces, the Endocursor or Endolift. Instrumentation time for each file was 1 min. Each change of file was followed by irrigation with 1 mL 1% NaOCl. A flush of 2 mL of one of three irrigating solutions Largal Ultra, Tubulicid Plus or 50% citric acid, was administered at the end of the instrumentation and a final flush of 5 mL distilled water completed the treatment. The specimens were prepared and viewed under the scanning electron microscope. There were no significant differences in the smear layers produced by the three methods of instrumentation. The use of Largal Ultra and Tubulicid Plus removed considerable amounts of the smear layer regardless of the method of instrumentation. The use of 50% citric acid, on the other hand, removed the smear layer only partially whilst producing rather diverse findings.

Effect of citric acid clearance on the saturation with respect to hydroxyapatite in saliva.
Bashir E; Lagerlof F
Department of Cariology, School of Dentistry, Karolinska Institutet, Huddinge, Sweden.
Caries Res (Switzerland) 1996, 30 (3) p213-7

Citric acid contained in beverages and foods is one of the main causes of enamel erosion. It was hypothesized that the clearance of citric acid from saliva would influence the degree of salivary saturation with respect to hydroxyapatite (OHAp). Ten subjects rinsed with 2% citric acid, pH 2.1, for 5s. Before and at 1,2, 5, 10 and 15 min after the rinse, a small saliva sample was collected. The sample pH, ionic strength and the concentrations of ionized calcium, inorganic phosphate and citric acid were determined. The pH of the saliva decreased from 7.21 + or - 0.40 (mean + or - SD) at time zero to a minimum of 6.46 + or - 0.88 at 1 min after the rinse. It was back to baseline value after 15 min. The saliva was supersaturated with respect to OHAp at time zero. After the rinse with the citric acid the saturation level shifted to undersaturation in all individuals except one. At 1 and 2 min after the rinse the saliva was, on average, undersaturated. After 5 min the average saturation level was back to supersaturation. The individual differences were large. The correlations between the rate of clearance of citric acid during the 1 minute and the minimum degree of saturation with respect to OHAp at 1,2 and 5 min after the rinse were significant (r 0.84, r 0.76 and r 0.79, respectively). In conclusion, rinsing with citric acid will cause a decrease in the saturation level with respect to OHAp in a highly individual pattern.

Site specificity of citric acid retention after an oral rinse.
Bashir E; Gustavsson A; Lagerlof F
Department of Cariology, School of Dentistry, Karolinska Institutet, Huddinge, Sweden.
Caries Res (Switzerland) 1995, 29 (6) p467-9

Erosion of the buccal incisor enamel, most frequent in the upper jaw, has been associated with excessive oral exposure to citric acid -containing foodstuffs. The aim of the study was to determine the retention of citric acid at different sites in the mouth after a standardized exposure. Thirty-four normal subjects rinsed with 95.2 mmol/l (2%) citric acid, pH 2.1, for 5 s. At 1 min 55 s after the rinse a preweighed cotton pellet was used to collect saliva samples from upper labial incisor surfaces (UB), lower labial incisor surfaces (LB) and sublingually (SL). The citric acid concentration was determined enzymatically. The concentrations were (mean +/- SD): 32.12 +/- 19.50, 11.90 +/- 8.60 and 1.52 +/- 1.90 mmol/l in the saliva collected from the UB, LB and SL sites, respectively. Analysis of variance revealed that the citric acid concentration in the upper incisor site differed significantly from that of the lower incisor site (p < 0.001) and the sublingual site (p < 0.001), and that the lower incisor site differed significantly from the sublingual site (p < 0.001). The individuals differed significantly with respect to citric acid retention (p < 0.05). A significant correlation was found between UB and LB sites (r = 0.61, p < 0.05).

The effect of ultrasonic irrigation before and after citric acid treatment on collagen fibril exposure: an in vitro SEM study.
Higashi T; Okamoto H
Department of Endodontology and Periodontology, Hiroshima University School of Dentistry, Japan.
J Periodontol (United States) Oct 1995, 66 (10) p887-91

The surface characteristics of periodontally diseased human teeth after two treatments were compared both before and after partial demineralization with citric acid . Thirteen teeth were obtained from patients with advanced periodontal disease. Three teeth were selected for control groups and 10 were used for experimental groups. All diseased root surfaces were identified and outlined. The roots were cut longitudinally into two sections. They were then scaled and root planed and the paired sections were separately classified into two control or two experimental groups. Three sections in control group 1 were rinsed by syringe with saline solution. The three sections in control group 2 were treated with ultrasonic irrigation. The 10 sections in experimental group 1 were rinsed by syringe with saline solution before and after citric acid application; the 10 sections in experimental group 2 were irrigated ultrasonically before and after citric acid application. The concentration of the citric acid was 25% (pH 1.62) and the immersion time was 3 minutes. The root samples were examined by scanning electron microscope. A significant amount of grinding debris covered on all the root surfaces in control group 1, whereas smear was removed in control group 2. The features of root surfaces of the two experimental groups differed considerably. All specimens in experimental group 2 exhibited collagen fibrils exposed as a consequence of citric acid etching. On the other hand, the smear layer was not thoroughly removed from the root surface in experimental group 1, which meant that few collagen fibrils were exposed after partial demineralization. From these results, ultrasonic irrigation before and after citric acid application improves exposure of collagen fibrils, which may be desirable for clinical success in periodontal regenerative therapy.

Salivary clearance of citric acid after an oral rinse.
Bashir E; Ekberg O; Lagerlof F
Division of Cariology, Center for Clinical Oral Science, Huddinge, Sweden.
J Dent (England) Aug 1995, 23 (4) p209-12

OBJECTIVES: Citric acid clearance from the oral cavity may be an important factor in the erosion of dental enamel. The aim of the present study was to investigate the clearance pattern of citric acid in normal subjects.

METHODS: After determination of the unstimulated salivary flow rate and the residual volume of saliva after normal swallowing, 12 subjects rinsed with 95.2 mmol l-1 citric acid for 5 s. At 1, 2, 5, 10 and 15 min after the rinse a small saliva sample was collected and the concentration of citric acid was determined enzymatically. For each subject three separate experiments on different occasions were performed with a citric acid solution of pH 2.1 and one experiment with a solution of pH 4.5.

RESULTS: The salivary citric acid concentration declined biphasically: rapidly during the first 2 min, then more slowly. The elimination rate over the first minute was on average 87.7 mmol l-1 min-1 at pH 2.1 compared with 85.0 mmol l-1 min-1 at pH 4.5. The difference between individuals estimated from the areas under the clearance curve was strongly significant (P < 0.001). No significant relation was found neither between salivary flow rate and clearance, nor between residual volume after swallowing and clearance.

CONCLUSION: The clearance pattern of citric acid is an individual property.

Comparison between 3 triclosan dentifrices on plaque, gingivitis and salivary microflora.
Renvert S; Birkhed D
School of Dental Hygiene, University of Kristianstad, Sweden.
J Clin Periodontol (Denmark) Jan 1995, 22 (1) p63-70

3 triclosan-containing dentifrices were compared in a 6-month, unsupervised tooth brushing study. The effects on plaque, gingival bleeding and certain salivary micro-organisms (mutans streptococci, lactobacilli, total counts of streptococci and total counts of micro-organisms) were evaluated. 123 subjects were divided into 4 groups according to severity of gingival bleeding index. 112 subjects completed the study. Following a 4-week pre-experimental period, using a sodium monofluorophosphate dentifrice (placebo), the subjects were assigned to use one of 3 triclosan-containing dentifrices, available on the Swedish market: Colgate Paradent (a triclosan/copolymer dentifrice) (n = 26); Pepsodent Gum Health (a triclosan/zinc citrate dentifrice) (n = 31); Dentosal Friskt Tandkott (a triclosan/pyrophosphate dentifrice) (n = 28); or to continue with the placebo (n = 27). The results revealed that Colgate Paradent reduced baseline plaque values by 39% (Quigley and Hein) over the 6-month experimental period. The corresponding values for the other modalities were: a reduction of 6% for Pepsodent Gum Health, an increase of 5% for Dentosal Friskt Tandkott, and an increase of 2% for placebo. A significant difference in the plaque levels (p < 0.05) was found between Colgate Paradent and Pepsodent Gum Health and between Colgate Paradent and placebo. The gingival bleeding index was improved in all 4 groups. A significant difference (p < 0.05) was found with respect to bleeding between Colgate Paradent and placebo (p < 0.05) at the 3-month registration. A statistically significant increase over time in total number of streptococci and total colony forming units were found for the Dentosal, Pepsodent and placebo groups, but not for Colgate.(ABSTRACT TRUNCATED AT 250 WORDS)

Antimicrobial activity of Pelargonium essential oils added to a quiche filling as a model food system.
Lis-Balchin M; Buchbauer G; Hirtenlehner T; Resch M
School of Applied Science, South Bank University, London, UK. Lisbairnt@sbu.ac.uk
Lett Appl Microbiol (England) Oct 1998, 27 (4) p207-10

Eight essential oils obtained by steam distillation from the scented leaves of Pelargonium species and cultivars were added at 250, 500 and 1000 ppm to a quiche filling, inoculated with either Saccharomyces ludwigii or Zygosaccharomyces bailii (at 10(8) cfu g-1), Salmonella enteriditis or Listeria innocua (at 10(9) cfu g-1). The quiche fillings were then kept at 25 degrees C for 24 h and the residual number of micro-organisms determined using the pour plate technique. There was an effective antimicrobial activity by the Pelargonium essential oils at 250 ppm, comparable with that of commercial thyme oil, an excellent antimicrobial agent, against Saccharomyces ludwigii and Zygosaccharomyces bailii, and a lesser inhibition compared with commercial thyme against Salm, enteriditis. There was a greater diversity of activity against L. innocua, which was in some cases more effective than commercial thyme oil . At 500 ppm, there was a greatly increased inhibition of microbial growth using the Pelargonium essential oils, which was comparable with that of commercial thyme, clove, geranium and coriander oils. As there is no evidence for the toxicity of any of these novel Pelargonium oils, and their odour does not make the delicately flavoured quiche filling unpalatable, there is a strong potential for their use in food processing.

Factors that interact with the antibacterial action of thyme essential oil and its active constituents.
Juven BJ; Kanner J; Schved F; Weisslowicz H
Institute of Technology and Storage of Agricultural Products, Volcani Centre, Bet Dagan, Israel.
J Appl Bacteriol (England) Jun 1994, 76 (6) p626-31

The viable counts of Salmonella typhimurium on nutrient agar (NA) decreased upon the addition of either the essential oil of thyme or its constituent thymol, especially under anaerobic conditions. Antagonistic effects of thymol against Staphylococcus aureus were also greater under anaerobic conditions. In contrast to the phenolic constituents of the oil, thymol and carvacrol, the chemically related terpenes p-cymene and gamma-terpinene had no antagonistic effects against Salm. typhimurium. The addition of Desferal to NA counteracted the antibacterial effects of both thyme oil and thymol. No support was obtained, however, for a possible role of iron in the oxygen-related antibacterial action of the thyme oil and thymol or for the observed effect of Desferal. In the presence of thymol, the viable counts of Salm. typhimurium obtained on a minimal medium (MM) were lower than those obtained on NA. Addition of bovine serum albumin (BSA) neutralized the antibacterial action of thymol. It is suggested that the effects of BSA or Desferal are due to their ability to bind phenolic compounds through their amino and hydroxylamine groups, respectively, thus preventing complexation reactions between the oil phenolic constituents and bacterial membrane proteins. This hypothesis is supported by the marked decrease in the viable counts of Salm. typhimurium caused by either thyme oil or thymol when the pH of the medium was changed from 6.5 to 5.5 or the concentration of Tween 80 in the medium was reduced.

The comparative clinical efficacy of pyrophosphate/triclosan, copolymer/triclosan and zinc citrate/triclosan dentifrices for the reduction of supragingival calculus formation
Fairbrother KJ, Kowolik MJ, Curzon ME, Muller I, McKeown S, Hill CM, Hannigan C, Bartizek RD, White DJ
Procter and Gamble Company, USA.
J Clin Dent 1997;8(2 Spec No):62-6

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 (R) 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 (R) 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 (R) 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.

Vitamin-C, oral scurvy and periodontal disease.
Touyz LZ
S Afr Med J 1984 May 26;65(21):838-42

Scurvy and periodontitis both manifest gingival bleeding but constitute separate entities. Defective collagen in scurvy reflects many symptoms emanating from deficient Vitamin-C physiology. The various periodontal diseases are caused by oral plaque micro-organisms, the body's reaction to which is strongly influenced by inadequate functioning of leucocytes and monocytes. Although certain infections and systemic diseases cause gingival bleeding, avitaminosis C does not cause commonly encountered periodontal disease, but will aggravate established periodontitis. Vitamin-C should not be used for prophylaxis or cure of periodontitis in healthy well-nourished individuals. A patient with bleeding gingivae warrants referral to oral medicine and periodontics specialists for examination and treatment. (64 Refs.)

[Anticalculus dentifrices. A new era in preventive dentistry?]
Collys K; Slop D; Coomans D
Ned Tijdschr Tandheelkd. 1989 Dec;96(12):554-8.

Anticalculus toothpastes are available on the market. Toothpastes with Zinc compounds interfere mainly with the plaque formation. Dentifrices containing pyrophosphate give the highest reductions in calculus formation. The inclusion of pyrophosphate in a fluoride containing dentifrice did not interfere with the cariostatic action of fluoride on tooth enamel. The influence of anticalculus dentifrices on root caries and root hypersensitivity are, so far, not documented. Fundamentally, a lot of doubt still exists about the precise role of supragingival calculus formation in the onset of periodontal disease.

Effect of tea polyphenols on glucan synthesis by glucosyltransferase from Streptococcus mutans.
Hattori M, Kusumoto IT, Namba T, Ishigami T, Hara Y
Research Institute for Wakan-Yaku, Toyama Medical and Pharmaceutical University, Japan.
Chem Pharm Bull (Tokyo) 1990 Mar;38(3):717-20

In the course of our studies on the development of anti-plaque agents for prevention of dental caries, we investigated effects of some of tea preparations and their individual components on the glucan synthesis catalyzed by glucosyltransferase (GTF) from Streptococcus mutans. Extracts of green tea and black tea, and polyphenol mixtures showed appreciable inhibition in the synthesis of insoluble glucan. Among the components isolated from tea infusions, theaflavin and its mono- and digallates had potent inhibitory activities at concentrations of 1-10 mM against GTF. (+)-Catechin, (-)-epicatechin and their enantiomers had moderate inhibitory activities at these concentrations, while galloyl esters of (-)-epicatechin, (-)-epigallocatechin and (-)-gallocatechin had increased inhibitory activities. Study on feasibility of Chinese green tea polyphenols (CTP) for preventing dental caries]

[Study on feasibility of Chinese green tea polyphenols (CTP) for preventing dental caries].
You SQ
Department of Stomatology, Ning bo First Hospital.
Chung Hua Kou Chiang Hsueh Tsa Chih 1993 Jul;28(4):197-9, 254

This study demonstrated that streptococcus mutans could be inhibited completely after contacted with 0.1% CTP for 5 minutes. There were no drug resistance after repeat cultures in 0.025% CTP. Plaque Index and Gingival Index decreased significantly (P < 0.001) after 0.2% CTP were used to rinse and brush the teeth. Results proved that CTP is an effective agent to prevent dental caries.

[Management of gingival inflammation with active ingredients in toothpaste]
Lange DE; Lubbert H; Omid A
Dtsch Zahnarztl Z (Germany, West) Jun 1975, 30 (6) p382-4

In order to study the effect of active additives in toothpastes, three different toothpastes were tested in 60 persons for a period of four weeks.

Evidence for enhanced treatment of periodontal disease by therapy with coenzyme Q.
Matsumura T; Saji S; Nakamura R; Folkers K
Int J Vitam Nutr Res (Switzerland) Apr 1973, 43 (4) p537-48

No abstract.

Zinc in etiology of periodontal disease.
Polenik P
Med Hypotheses (England) Mar Stomatological Clinic, Medical 1993, 40 (3) p182-5

Microbial plaque is the main etiological factor of periodontal disease. The bacterial polysaccharides stimulate gingival neutrophils and macrophages to interleukin-1 (IL-1) production. IL-1 causes a complex of redistribution processes with liver as the central organ. Accumulation of zinc in liver and their copper and ceruloplasmin production also elicits increase of copper and decrease of zinc in gingiva. The elevated level of copper in connection with zinc deficiency in gingiva causes the increase of permeability of gingival epithelium for bacteria. The stimulated inflammatory infiltrate produces more IL-1 and the vicious circle is complete.

Diabetes and periodontal diseases. Possible role of Vitamin-C deficiency: an hypothesis.
Aleo JJ
J Periodontol (United States) May 1981, 52 (5) p251-4

An hypothesis is proposed relating the possible role of vitamin deficiency as an etiologic factor contributing to periodontal disease in diabetes. The hypothesis is based upon the following:

(1) transport of ascorbate across cell membranes may be impaired by glucose, but facilitated by insulin;

(2) glucose utilization is significantly accelerated by sublethal concentrations of endotoxin;

(3) endotoxin-induced histamine sensitivity of tissue is enhanced by a scorbic deficiency; and

(4) ascorbic acid deficiency alters mucosal barrier function. The interrelationship of these factors is discussed.

Relationship of mineral status and intake to periodontal disease.
Freeland JH; Cousins RJ; Schwartz R
Am J Clin Nutr 1976 Jul;29(7):745-9

A periodontal index (PI), based on visual and radiographic data, was used to evaluate the severity of periodontal disease in a group of 80 dental patients. The average PI was 3.1 +/- 1.8 SD (0=no detectable lesions, 8=most severe lesions). The PI was directly related to patient age (r=0.73; P is less than 0.01). The serum concentration of calcium copper, iron, magnesium, manganese, and zinc was measured. Regression of PI on the serum constituents demonstrated that serum copper was linearly related (r-0.64; P is less than 0.001) to the PI. The other serum parameters were not correlated to the PI. Dietary protein, calcium, and vitamin A were slightly related to the PI, based on a 24-hr dietary recall. Dietary trace elements were not related to the PI. These results indicate that the serum copper concentration, in some way is related to the severity of periodontal disease. Possibly the observation is linked to the role of copper in the inflammatory response since inflammation is a characteristic of periodontal disease.

Comparative in vitro activity of sanguinarine against oral microbial isolates.
Dzink JL, Socransky SS
Department of Periodontology, Forsyth Dental Center, Boston, Massachusetts 02115
Antimicrob Agents Chemother 1985 Apr;27(4):663-5

MICs of sanguinarine were determined for 52 oral reference strains and 129 fresh isolates from human dental plaque. Sanguinarine was found to completely inhibit the growth of 98% of the isolates at a concentration of 16,ug/ml.

REFERENCES

1. Dzink JL Socransk SS Carine against oral microbal isolates. Antiplaque Agents Chemother 1985;27:663-665

2. Babu JP, Waring MB Lyne SM, et al : Anti plaque activity of a sanguinaria-cotaning oral rise-an in vitro study. Compendium of Continuing Education in Dentistry 1984: Suppl 5 :s94-s97

3. Klewsky P, Vernier D: Sanguinarine and the control of plague in dental practice. Compendium of Continuing Education in Dentistry 1984: Suppl 5: s94-s97

4. Hannan JJ, Johnson J, Kuftinec MM : Long term clinical evaluation of sanguinaria tooth paste and oral rinse controlling plaque, gingivitas, and sulcular bleeding during orthodontist treatment . J Dent Res 1988;67:572

Clinical efficacy of a dentifrice and oral rinse containing sanguinaria extract and zinc chloride during 6 months of use.
Harper DS, Mueller LJ, Fine JB, Gordon J, Laster LL
Fairleigh-Dickinson University, Oral Health Research Center, Hackensack, NJ.
J Periodontol 1990 Jun;61(6):352-8

The efficacy of combined use of toothpaste and oral rinse containing sanguinaria extract and zinc chloride was compared to placebo products in a 6-month clinical trial. Sixty subjects with moderate levels of plaque and gingivitis were randomly assigned to active and placebo groups. Noninvasive measures of plaque and gingivitis were assessed at baseline and at 2, 6, 8, 14, 20, and 28 weeks. Bleeding on probing was measured at baseline and 6, 14, and 28 weeks. Active group scores were significantly lower (P less than .0001) than placebo scores at each post-baseline time point for all indices, with the exception of plaque at 2 weeks. The 28 week active group scores were 21% lower than the placebo group for plaque, 25% lower for gingivitis, and 43% lower for bleeding on probing. No dental staining or taste alteration was reported in the active group. Three of 30 active group subjects exhibited minor soft tissue irritations that resolved spontaneously without discontinuation of product use. Results indicate that the test products showed good levels of safety and efficacy when administered in a combined use regimen for 6 months.

Clinical effect of a sanguinaria dentifrice on plaque and gingivitis in adults.
Mallatt ME, Beiswanger BB, Drook CA, Stookey GK, Jackson RD, Bricker SL
Indiana University School of Dentistry, Oral Health Research Institute, Indianapolis.
J Periodontol 1989 Feb;60(2):91-5

A clinical trial was conducted to evaluate the effects of a sanguinaria-zinc chloride dentifrice on the prevention of plaque formation and gingivitis. A total of 59 young adults, 18 to 30 years of age, either performed supervised brushing with a 0.075% sanguinaria-0.05% zinc chloride dentifrice, a 0.24% sodium fluoride dentifrice, or rinsed daily with a 0.05% NaF solution. Clinical evaluations for plaque and gingivitis were performed after 7, 14, and 21 days of the test regimen. After 21 days, all subjects resumed twice daily supervised brushing and flossing and post-test evaluations were conducted after two weeks. The results showed that after 7, 14, and 21 days both groups using dentifrices had significantly less plaque and gingivitis than the group using the rinse, and there were no significant differences between the two groups using either the sanguinaria-ZnCl2 or the NaF dentifrices.

Supplementation or local application may reduce gingival exudate from inflammed and infected gums - which suggests improved tissue health. (Folate mouthwash appears to be more effective than oral folate.)
J Clin Periodontol 14(6):315-9, 1987

Experimental Double-blind Study: 60 pts with visible gingivitis rinsed for I min. twice daily with either 5 ml of 0.1% folate solution (1 mg/ml) or a placebo. After 4 wks., the folate 8p. was significantly improved compared to the placebo group. Dietary folate did not correlate with treatment results, suggesting a local effect (Pack ARC. Folate mouthwash: Effects on established gingivitis in periodontal patients. J Clin Periodontol 11:619-28, 1984).

Experimental Double-blind Study: 30 women in their 32nd wk. of pregnancy randomly received either placebo mouthwash and placebo tablets (Gp. A), placebo mouthwash 1 min. twice daily and folate 5 mg/d (Gp. B), or a 1% folate mouthwash and placebo tablets (Gp. C). After 28 days, folate levels increased signif~cantly in Gps. B and C. Gp. C showed a highly significant improvement in a gingival index despite no significant changes in a plaque index (p<0.01) while there were no significant changes in Gps. A or B (Thomson ME, Pack ARC. Effects of extended systemic and topical folate supplementation on gingivitis of pregnancy. J Clin periodontal 9(3):27580, 1982).

Experimental Double-blind Study: 30 women in their 4th or 8th mot of pregnancy randomly received either placebo mouthwash 1 min. twice daily and placebo tablets (Gp. A), placebo mouthwash and folate 5 mg/d (Gp. B), or 1% folate mouthwash and placebo tablets (Gp. C). The gingival index tended to increase throughout pregnancy in all gas. except Gp C, for whom there was a highly significant improvement in the 8th mot despite no change in plaque index. Compared to Gps. A and B, dietary intake of folate was significantly higher in Gp. C in the 8th mot (p<O.Ol) (Pack ARC, Thomson ME. Effects of topical and systemic folic acid supplementation on gingivitis in pregnancy. J Clin Periodontol 7(5):402-14, 1980).

Experimental Double-blind Study: 30 pts. with normal fasting blood folate levels rinsed their mouths daily with 5 cc of a 1 mg/cc folate solution or placebo. After 60 days, experimental subjects showed significant improvement in gingival health compare to controls (Vogel Rl et al. The effect of topical application of folic acid on gingival health. J Oral Med 33(1):20-22,1978).

Experimental Study: Contraceptive users with normal plasma folate levels demonstrated improved gingival health after receiving supplementation with folic acid 4 mg/d for 60 days (Vogel Rl et al. J Prev Dent 6:221, 1980).

Experimental Double-blind Study: 30 ptS. ingested either folic acid 2 mg twice daily or placebo. After 30 days, based on plaque and gingival indices, folic acid supplementation appeared to increase the resistance of the gingiva to local irritants leading to a reduction in inflammation. Plasma folate levels, which were normal, were unaffected by supplementation (Vogel Rl e' al. The effect of folic acid on gingival health. J periodontol 47(11):667-8, 1976)


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