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Objectives.Periodontal disease is prevalent and has an inflammation associated with not only oral but also systemic pathologies. The diagnosis by biomarkers is required for clinical practice on periodontal disease. The lactoferrin andα1-antitrypsin were both inflammation-related molecules. The present study investigated the relationship between the periodontal status and the two biomarkers in gingival retention fluid (GRF).Patients and Methods. In 63 subjects with periodontitis, the GRF was sampled from maxillary anterior gingiva using a microbrush for 30 seconds. The lactoferrin andα1-antitrypsin levels in GRF were measured by an enzyme-link solvent immunoassay. Periodontal status was evaluated by probing pocket depth (PD) and bleeding on probing (BOP).Results. There was a higher level of these biomarkers in saliva (median (ng/mL), lactoferrin: 3611.9,α1-antitrypsin: 4573.3) than in GRF (lactoferrin: 61.0,α1-antitrypsin: 54.7). There was a mild-to-moderate but significantly positive correlation in lactoferrin orα1-antitrypsin between GRF and saliva. There was a positively mild-to-moderate accuracy (area under the curve: 0.60–0.81) of lactoferrin orα1-antitrypsin in GRF or in saliva to distinguish the severity of periodontal status. The cutoff level (ng/mL) of lactoferrin in GRF for detecting ≥30% of PD ≥ 4 mm (moderate periodontitis) was 68.6 and for detecting ≥20% of BOP (clinically active periodontitis) was 61.2. The cutoff level (ng/mL) ofα1-antitrypsin in GRF for detecting ≥30% of PD ≥ 4 mm was 54.5 and for detecting ≥20% of BOP was 35.3.Conclusions.The data can promote an application of the measurements of lactoferrin andα1-antitrypsin in GRF to clinical practice on periodontal disease.

The aim of this study was to test the effects of B-group vitamin supplements on wound healing in diabetic mice. The mice in the experimental group were treated daily with 1 g/L B6, 1.25 mg/L B12, and 62.5 mg/L folic acid in their drinking water. Full-thickness excision wounds were created with 6-mm skin biopsy punches. Each wound closure was digitally photographed. Beginning on day 3 after wounding, the wound area in the diabetic mice was statistically larger than that of normal mice (p

This case report describes the clinical efficacy of treatment with basic fibroblast growth factor (FGF-2) for periodontal regeneration. A patient with aggressive periodontitis participated in a clinical trial involving administration of 0.3% FGF-2 in comparison with a placebo control. To evaluate the efficacy of FGF-2, standardized radiographs were taken before surgery and at 12, 24, and 36 weeks after FGF-2 treatment. The rate of increase in alveolar bone height was 86.9% at 36 weeks. The 6-year postoperative radiograph showed significant development of alveolar bone in comparison with the first visit. FGF-2 treatment may be effective for periodontal regeneration in cases of aggressive periodontitis. (J Oral Sci 58, 137-140, 2016).

Discrepancy in the labial gingival margin of the maxillary incisors poses a major aesthetic problem. Orthodontic extrusion can improve the aesthetic problem caused by gingival margin levels before restoration. In these case reports, orthodontic extrusion was performed with palatal circumferential supracrestal fiberotomy for improving the discrepancy of the labial gingival margin. Two years postoperatively, the position of the tooth and gingival margin remained stable. Orthodontic extrusion with palatal circumferential supracrestal fiberotomy was effective in improving the discrepancy of the labial gingival margin of maxillary incisors. (J Oral Sci 51, 651-654, 2009)

Background and Objective: Short-chain fatty acids, such as butyric acid, are detected in periodontal pockets and are thought to be involved in the initiation and progression of periodontal disease. In the present study, we examined the effects of butyric acid on adhesion molecule expression by human gingival epithelial cells. Material and methods: The human gingival carcinoma cell line, Ca9-22, was cultured in media that contained different concentrations of butyric acid. Results: Cell numbers were significantly decreased in a dose-dependent manner by butyric acid at concentrations of ≥ 0.2 mm. The expression of intercellular adhesion molecule-1 mRNA was significantly increased 6 h after stimulation. By contrast, the expression levels of integrins α6 and β4 were decreased. Similar results were obtained by flow cytometry. Conclusion: The results of the present study indicate that butyric acid alters the expression of adhesion molecules by Ca9-22 cells. The elucidation of the mechanism of action of butyric acid on the periodontium may help to clarify several aspects of the onset and progression of periodontal disease.

Bisphenol A (BPA) is a common ingredient in dental materials. However, its potential adverse effects on the oral cavity are unknown. The purpose of this study is to identify the genes responding to BPA in a human oral epithelial cell line using DNA microarray. Of the 10,368 genes examined, changes in mRNA levels were detected in seven genes: five were up-regulated and two were down-regulated. The expression levels of the calcium channel, voltage-dependent, L-type, alpha 1C subunit (CACNA1C), cell death activator CIDE-3 (CIDE-3), haptoglobin-related protein (HPR), importin 4 (IPO4), and POU domain, class 2 and transcription factor 3 (POU2F3) were significantly up-regulated in the cells exposed to 100 mM BPA. The spermatogenesis-associated, serine-rich 2 (SPATS2) and HSPC049 protein (HSPC049) were significantly down-regulated. The detailed knowledge of the changes in gene expression obtained using microarray technology will provide a basis for further elucidating the molecular mechanisms of the toxic effects of BPA in the oral cavity.

Invasive cervical root resorption is a relatively uncommon form of external root resorp- tion. Creeping attachment is defined as postoperative coronal migration of the gingival margin. We describe a case of invasive cervical root resorption following coronal shift of interdental papillae 15 years after modified Widman flap surgery. (J Oral Sci 55, 183-185, 2013)

Aims: The purpose of the present investigation was to assess the salivary levels of Streptococcus anginosus in periodontitis patients. Methods and Results: The salivary levels of Strep. anginosus were assessed using real-time polymerase chain reaction (PCR). Streptococcus anginosus was detected in 28 of 37 (75·6%) of periodontitis patients and in three of the 20 (15%) healthy subjects. The mean values for bleeding on probing and probing depth in positive patients were statistically higher than those in negative patients. A significant decrease in Strep. anginosus levels was observed after periodontal treatment. Conclusions: Although the levels of Strep. anginosus are extremely low, they may reflect the status of periodontal health. Significance and Impact of the Study: Real-time PCR is a useful method for obtaining the relative quantities of Strep. anginosus from saliva samples and for monitoring the effect of therapy.

歯周組織の付着の喪失後, 歯根面の露出に伴う根面齲蝕の発生を予防するために歯根面への塗布操作が, 容易な8%フッ化第一スズ含有ジェルを調製し, ヒト象牙質片 (試片) に本ジェルと対照のフッ化物を作用させたのち, 酢酸を用いた溶解性試験を行い, 試片表面の性状を走査電子顕微鏡 (SEM) で観察するとともに溶液中に溶出したカルシウム (Ca) 濃度を測定し, 本ジェルの象牙質片に対する脱灰抑制効果を検討した。ヒト健全第3大臼歯より縦横5mm×5mmに調整した試片に, 8%フッ化第一スズ含有ジェル (Gel群), 8%フッ化第一スズ水溶液 (SnF2群), リン酸酸性2%フッ化ナトリウムジェル (APF群), プロピレングリコールアルギネートの3%水溶液 (PGA群), 脱イオン水 (コントロール群) の5種類の試験液を用い, 試片表面に対し4分間作用させた。おのおのの試験液を作用させた試片を0.2M酢酸水溶液に30分間浸漬し, 溶液中に溶出したCa濃度を測定し, SEMにて各試片の表面観察を行った。その結果, 溶出したCa濃度はコントロール群, PGA群に比較してGel群, SnF2群, APF群は有意に低い値を示した。SEM所見ではコントロール群, PGA群の試片表面に全体的に象牙細管の開口が多く見られ, Gel群, SnF2群, APF群は象牙細管の開口はあまり見られなかった。これらのことより, 根面齲蝕の予防にフッ化第一スズ含有ジェルが応用可能であることが示唆された。

歯周疾患のスクリーニングテストに, 免疫学的ヘモグロビン検出試験紙 (抗体法) の応用を試み, 従来法であるペルオキシダーゼ法 (酵素法) と比較を行った。被検者は全身疾患を有していない成人男性106名および女性26名, 合計132名で, その年齢は35歳から55歳, 平均45.3歳であった。被検者から安静時無刺激全唾液を採取し, 両唾液潜血試験紙を使用して判定結果の比較を行った。さらに, 唾液採取後に口腔内診査を行い, probing depth (PD) およびbleeding on probing (BOP) を記録し, その値と両試験紙法の結果とを比較検討した抗体法の陽性率は54.5%, 酵素法の陽性率は55.3%と両試験紙法問に差は見られなかったが, 抗体法が歯周疾患のリスクファクターのひとつである年齢と強く相関した。抗体法陽性者のBOP値は平均で24.3%, 陰性者の平均は7.0%であった。また, 酵素法陽性者のBOP値は平均で23.1%, 陰性者は平均8.2%と両試験紙法間に差は見られなかった。しかしながら, 抗体法においてBOP値が10%未満の陽性者は8名存在したが, うち7名は最深PDが4mm以上 (BOP+) であったのに対し, 酵素法ではBOP値が10%未満の陽性者が13名存在し, うち2名が最深PD4mm以上 (BOP+) であった。 また, 抗体法陰性者60名のうち, 1カ所でも4mm以上のPD (BOP+) を有していた者が16名, 酵素法陰性者59名のうち1カ所でも4mm以上のPD BOP+) を有していた者が26名存在した。全体的に見て両試験紙法の一致率は80.3%であった。以上の (ことから抗体法は酵素法に較べ, 歯周疾患のスクリーニングテストの精度を向上させることが示唆された。

本研究は, チタン表面に形成されたプラークを安全でかつ効果的に除去することのできる清掃法を確立することを目的とし, ラバーカップ, ポリッシングブラシに, 各種ポリッシングペースト, 浮石沫, 水をそれぞれ組み合わせた清掃法が, チタン表面に対してどのような影響を及ぼすのかについて比較検討した基礎的実験である。実験材料として, チタン99.5%以上のチタン板を実験に供試した。チタン表面に油性マジックを塗り, 各種清掃法でこれを除去した後の表面粗さを計測した。次に, チタン板を保持装置に固定し, 口腔内に装着しプラークを付着させた。このプラークを各種清掃法で除去し, 走査型電子顕微鏡を用いてチタン表面性状およびプラークの除去状態を観察し, プラーク付着スコアで評価した。チタンの表面粗さは, 全ての清掃法とコントロールの間に統計学的に有意差は認められなかった。また, チタン表面性状およびプラークの除去状態は, 48時間口腔内に装着しプラークを蓄積したコントロールと比較し, 全ての組み合わせにおいて統計学的に有意差が認められた。この研究結果から各種清掃法は, 全ての組み合わせにおいてチタン表面性状を変えることなく短時間でプラーク除去が可能であり, またラバーカップよりもポリッシングブラシを使用した清掃法がプラーク除去効果の高いことが示された。

歯周疾患に対して, スケーリング, ルートプレーニングに代表される機械的プラークコントロールが行われている。近年, 化学的プラークコントロールの効果が着目され, 臨床で多く行われている。化学的プラークコントロールのひとつとして, 抗生物質の局所投与剤である塩酸ミノサイクリンペーストが臨床で応用されている。細菌学的効果および臨床パラメーターの改善について多くの報告がなされているが薬剤が接するであろう歯根表面への影響を検討した報告は見あたらない。そこで, 歯根面に対する塩酸ミノサイクリンペーストの影響をin vitroで検討することを目的とした。ヒト抜去歯から象牙質試片を切り出し, 濃度の異なる塩酸ミノサイクリンペースト溶液に順次浸漬され, その表面性状の変化と細胞親和性を知る目的で試片上でヒト歯根膜細胞を培養し, 走査型電子顕微鏡で観察した。なお, コントロールは, リン酸緩衝液で処理を行った。コントロール群に比較して塩酸ミノサイクリン処理群の試片は, スメヤー層が除去され, 歯根膜細胞の付着が多く認められた。また, 細胞が付着した状態で塩酸ミノサイクリンペーストを用いたことを想定して付着細胞に対して培養液中50μg/ml濃度になるように塩酸ミノサイクリンペースト溶液を添加し24時間培養した。しかし, 細胞増殖に対する著明な効果は認められなかった。以上の結果から化学的プラークコントロールを併用することにより, 象牙質表面のスメヤー層が除去され, 細胞が付着しやすい環境を作ることが示唆された。

Background Nicotine use is one of the most important risk factors for the development of cardiovascular and periodontal diseases. Numerous reports have suggested the possible contribution of disturbed lipid metabolism for the development of both disease groups. Despite these observations, little is known about the relationship between tobacco smoking and the development of these diseases. Our previous microarray data revealed that nicotine induced low-density lipoprotein receptor (LDLR) expression in oral epithelial cells (OECs). The aim of the present study was to confirm nicotine-mediated LDLR induction and to elucidate the signaling mechanisms leading to the augmented expression of LDLR in OECs. Methods and results LDLR and nicotinic acetylcholine receptor (nAChR) subunit expression was detected by real-time PCR. The production of LDLR was demonstrated by immunofluorescence staining. nAChR-mediated LDLR induction was examined by pre-incubation of the cells with its specific inhibitor, α-bungarotoxin (α-BTX). The functional importance of transcription factor specific protein 1 (Sp1) was examined by luciferase assay, mithramycin pre-incubation or by small interfering RNA (siRNA) transfection. The specific binding of Sp1 to R3 region of LDLR 5'-untranslated region was demonstrated with electrophoretic mobility shift assay (EMSA) and streptavidin-agarose precipitation assay followed by western blotting. The results confirmed that nicotine induced LDLR expression at the transcriptional level. Nicotine was sensed by nAChR and the signal was transduced by Sp1 which bound to the R3 region of LDLR gene. Augmented production of LDLR in the gingival epithelial cells was further demonstrated by immunofluorescence staining using the gingival tissues obtained from the smoking patients. Conclusions Taken together, the results suggested that nicotine might contribute to the development of both cardiovascular and periodontal diseases by inducing the LDLR in OECs thereby disturbing lipid metabolism.

Many studies have shown that alloplastic bone grafts are clinically stable and safe. Nevertheless, postoperative problems such as ankylosis and root resorption are associated with alloplastic bone grafts. This report examined two cases of ankylosis of nonresorbable hydroxyapatite (NHA) alloplastic grafts associated with recurrent periodontitis. There was no clear border between the NHA particles and dentin. The particles were irregularly shaped and had plaque on the surfaces. It is postulated that ankylosis of NHA particles and dentin is a contributing factor in recurrent periodontitis.

毛の先端を高度テーパード毛にした新形態の歯ブラシを作製したものを使用し, プラーク除去効果を検討した。年齢23～52歳の男女75名を被験者に1日2回, 3分間以上, スクラップ法およびゴットリーブの垂直法を併用したブラッシング法を行わせた。すなわち, テスト期間を2週間とし被験者をスタート時のプラーク付着率および歯間空隙の大きさによって2群に分け, 被験者のプラークを除去した後, 高度テーパード毛歯ブラシおよびラウンド毛歯ブラシを用いて1週間ずつクロスして使用させた。それぞれ1週間後のブラッシング後のプラーク付着歯面数からプラーク付着率を算出しグループ間での比較検討を行った。その結果, 高度テーパード毛歯ブラシはラウンド毛歯ブラシよりプラーク除去効果は統計的に有意 (p

Iwano Y, Sugano N, Matsumoto K, Nishihara R, Iizuka T, Yoshinuma N, Ito K. Salivary microbial levels in relation to periodontal status and caries development. J Periodont Res 2010; 45: 165–169. © 2010 John Wiley & Sons A/S Background and Objective: Although an inverse relationship between caries and periodontal disease has been suggested, some studies have reported a positive correlation between periodontal disease and the decayed, missing and filled teeth (DMF) index. The aim of the present study was to examine the relationship between caries and periodontal disease. Material and Methods: We assessed the clinical parameters and salivary levels of Porphyromonas gingivalis and Streptococcus mutans using real-time polymerase chain reaction in 40 subjects with varying degrees of caries and periodontal disease. Results: The salivary levels of S. mutans were significantly higher in the periodontally healthy group than in the periodontitis group. The salivary levels of P. gingivalis were significantly higher in the caries-free group than in the periodontally healthy group with caries. The salivary levels of S. mutans were significantly increased after the initial periodontal treatment. Conclusions: This study showed that an inverse relationship exists between periodontitis and caries in terms of the clinical and bacteriological findings.

Long-term studies have indicated that alloplastic bone grafts composed of nonresorbable hydroxyapatite (NHA) are clinically stable and safe. However, our previous report suggested that NHA grafts may be an etiological factor for recurrent periodontitis in the absence of supportive periodontal treatment (SPT). We removed infected NHA from the root surface by flap surgery in two cases of recurrent periodontitis. After removal of the infected NHA, the inflammation subsided in these cases and they were clinically stable for several years. (J Oral Sci 51, 659-663, 2009)

The purpose of this study was to evaluate the inhibitory effect of funoran containing chewing gum (FG) and eucalyptus extract- containing chewing gum (EG) on plaque formation. Fifteen dentists or dental students were assigned a random order of use of either FG, EG or a control gum. All subjects received professional tooth cleanings before the experiment. During the four-day test periods, no oral hygiene measures were allowed other than chewing three pieces of gum for approximately 10 min daily. Chewing gum was used following each morning, noon and evening meal. Plaque formation was evaluated by the Quigley and Hein index. The FG (1.83 +/- 1.1) and EG (1.97 +/- 1.1) significantly reduced plaque compared to the control gum (2.57 +/- 1.2). Our results suggest that FG and EG may be useful in inhibiting dental plaque formation.

In vitro studies suggest that enamel matrix derivative (EMD) affects the early stages of osteogenic maturation by stimulating bone cell proliferation. In the present study, we evaluated the effects of EMD and β-tricalcium phosphate (β-TCP) on bone augmentation within a titanium cap in rabbit calvaria, using 14 adult male Japanese white rabbits. The calvarium was exposed, a circular groove prepared, the marrow penetrated, and a standard hemispherical titanium cap placed in the groove. The cap was filled with a mixture of β-TCP and EMD at the experimental site, and was filled with β-TCP alone at the control site. At 1 and 3 months after cap implantation, animals were euthanized, and histological sections prepared. The sections were stained with basic fuchsin and methylene blue, and were examined using light microscopy. At 1 month, EMD tended to increase the amount of bone, but there was no significant difference in the amount of new tissue and mineralized bone between the experimental and control sites. The present findings indicate that the present mixture of EMD and β-TCP does not accelerate bone formation, compared with β- TCP alone. (J. Oral Sci. 47, 209-217, 2005)

The limitations of conventional 2-dimensional (2-D) radiographs have been emphasized in many studies. Because the image is a 2-D map of the 3-dimensional (3-D) tooth and periodontal tissue, these structures may be superimposed on each other. Recently, 3-D image analysis by computed tomography (CT) was introduced to dentistry, but it has been used only rarely in the periodontal field.The purpose of this case report was to introduce the clinical application of a newly developed, compact computed tomography system for evaluating the outcome of regenerative therapy in an adult patient with periodontitis (male, aged 55 years). To evaluate the bone defects including furcation involvement, we took an intraoral radiograph and performed CT scanning on tooth #19. We recorded a number of clinical parameters at the time of surgery. We compared the images of the bone defect obtained by CT images and the conventional radiograph with the true bone defect morphology at the surgical site.One year after the periodontal surgery, we again took CT scans and a conventional radiograph, and the new images of the bone defect were compared and evaluated. The new CT images were reconstructed for 3-D evaluation and compared with those taken before surgery. The CT provides 3-D images of excellent quality for evaluating the morphology of the periodontal bone defect and furcation involvement.We consider that CT is a useful aid in periodontal examination and diagnosis, and in the prediction and evaluation of periodontal treatment outcomes.

A study was conducted to examine the effect of endotoxin present in periodontal pockets on the proliferation and attachment of human cell lines on the culture plates (Ca9-22 and gingival fibroblasts). The endotoxin was collected from periodontal pockets of anterior teeth in patients with periodontal disease by subgingival irrigation with sterilized distilled water. The solutions obtained were then subjected to hot phenol-water extraction. The collected endotoxin from periodontal pocket and four other kinds of endotoxin obtained commercially as positive controls were added to cell cultures and the numbers of viable cells on the culture plates were counted. Among the commercially available endotoxins used in this study, only 500 micrograms/ml of endotoxin derived from Escherichia coli 0111:B4 significantly decreased the number of attachment cells of Ca9-22 and gingival fibroblasts on the culture plates. Endotoxin from periodontal pockets at 5 micrograms/ml also significantly decreased the numbers of attachment cells of both cell lines.

イオン導入電気歯刷子を用いて, 歯肉炎および歯周疾患の患者を対称に3施設で共同研究を行った。対象患者は男性36名, 女性49名の計85名であった。イオン歯刷子の通電効果をみるために4因子に割りつけを行い, 多元配置累積法により行った。診査項目は, プラーク, 歯石, 発赤, 腫脹, ポケットの深さ, 出血, 排膿および動揺の8項目である。プラークにおいては, 通電の有無と初期症状では通電有に効果が認められた (p

本実験の目的は, 0.2%Chlorhexidine水溶液と0.01%Sanguinarine含有Viadent ® 洗口液および, その歯磨剤のプラーク抑制効果を検討することである。実験開始時にProfessionaltoothcleaningを行いプラーク量を0にし, 各自の口腔清掃法にViadent ® 洗口液10ml, 30秒間の洗口を朝夕2回加え, 2週目にPlaqueIndexを記録し, 洗口を中止した。2週後に再びプラーク量を0とし, 0.2% Chlorhexidine水溶液による洗口をViadent ® と同様に2週間行わせ, PlaqueIndexを記録した。再び洗口を中止し, 2週後にプラーク量を0とし, Viadent ® 洗口液10m1, 30秒間の洗口を1日5回, ブラッシング時にViadent ® 歯磨剤を併用させ2週後にPlaqueIndexを記録した。その結果, 各実験期間でプラーク抑制効果は有意に認められた。Chlorhexidineの効果は最も高かったが, 副作用が多く認められた。一方, Viadent ® 製剤の使用では副作用はほとんど認められなかった。

非付着性プラーク中の内毒素と臨床所見の関連性を検討するために, 49名の被験者の歯周疾患罹患歯64歯に対し, 歯肉縁下洗浄を行い, そのポケット洗浄液中の内毒素量を測定し, 臨床所見と比較した。また, スケーリング, ルートプレーニング後の歯肉縁下洗浄を行い, 臨床所見と内毒素量の変化を観察した。Westphahlらの温フェノールー水抽出法にて内毒素を抽出し, パイロディック®を用い, 定量を行った。さらに15名の被験者の2歯をルートプレーニングし, 一方は週に1度, 1ヵ月間歯肉縁下洗浄を行い, 他方は行わなかった。その結果, ポケット洗浄液中の内毒素量とPD, GIおよびGBIは統計的に有意な正の相関を認めた。また, ルートプレーニング後に歯肉縁下洗浄を行った場合, 行わなかった場合に比較し, GI, GBIおよびポケット洗浄液中の内毒素量は低下し液中の内毒素量とPD, GIおよびGBIは統計的に有意な正の相関を認めた。また, ルートプレーニング後に歯肉縁下洗浄を行った場合, 行わなかった場合に比較し, GI, GBIおよびポケット洗浄液中の内毒素量は低下した。

歯間離開および歯の動揺と垂直性骨吸収の関連性についてX線写真を用いて研究を行った。本学歯周科来院患者の full-mouth X線写真から, 正しく撮影されたと判定した2,416枚を選択し, 診査表を参考に修復物や補綴物の装着された部位と歯の位置異常のある部位を除外し天然歯で隣接する部位, 計3,139隣接面を検索した。X線写真をトレースし, 歯間離開の距離, 垂直性骨吸収の程度を測定した。歯間離開の程度は class I (1mm>), class II (1mm≦

The purpose of this study was to evaluate the clinical effect of mace extract and egg-white lysozyme in two brands of chewing gum on gingival condition. Ever since mace extract containing dihydroguaiaretic acid was reported to inhibit the growth of Streptococcus mutans, plans were devised to include it in commercially available chewing gum. Before starting this study, two different types of experimental chewing gum containing mace extract or egg-white lysozyme were made up. A control was also prepared containing neither agent. The periodontal condition of 68 patients with gingivitis was determined based on PMA index (PMA), gingival index (GI), gingival bleeding index (GBI) and plaque scoring system (PSS) and randomly classified into three groups. Each group was instructed to use one or the other of the above type chewing gums after every meal. The results were as follows: 1. No clinical changes were observed in the control group during this study. 2. Gingival inflammation (PMA, GI, GBI) significantly improved as a result of using the experimental gums. 3. Plaque reduction was found only in the mece-extract gum group. 4. No clinical side effects were detected during this study.