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A multicenter clinical trial conducted by the authors compared the desensitizing efficacy of a new 5 percent potassium nitrate: 0.243 percent sodium fluoride dentifrice along with two clinically proven, commercially available desensitizing dentifrices to a placebo dentifrice. Sensitivity to cold air and tactile stimulation, along with patients' subjective assessments, were evaluated to assess the dentinal desensitizing efficacy of the test dentifrices. Results demonstrated that after four weeks, participants who used the new dentifrice formulation experienced significant decreases in dentinal sensitivity compared to the placebo group for all measured indexes.

Tartar control dentifrices have been proven effective in reducing the build-up of supragingival calculus deposits between professional tooth cleanings. In addition to providing consumers with a cleaner dentition, these formulations can, in principle, contribute to easier professional tooth cleaning. Until recently, clinical methods for evaluating the effects of tartar control dentifrices were limited to the assessment of area coverage of calculus on the tooth surface. The development of the Quanticalc dental scaler permits the quantitative clinical measurement of force and stroke number associated with supragingival calculus debridement. In this clinical study, two commercial tartar control dentifrices, one containing 5.0% pyrophosphate as the tartar control agent and the other containing a combination of 1.3% pyrophosphate and 1.5% Gantrez copolymer, were compared for efficacy in reducing the development of supragingival calculus between prophylaxes, and in facilitating easier calculus removal in subsequent scaling. Results showed that the two commercial dentifrices were equally effective in reducing calculus extent between prophylaxes. In contrast, the 5.0% pyrophosphate dentifrice was observed to be almost twice as effective on a percentage basis as the lower dosage pyrophosphate dentifrice in facilitating easier calculus removal. The enhanced activity of the 5.0% pyrophosphate dentifrice may be postulated to be due to elevated dosage of tartar control crystallization inhibitor or to potential side effects of copolymer in the other commercial dentifrice. Importantly, these results substantiate that the clinical benefits of tartar control dentifrices are not completely described by actions in reducing calculus build-up as assessed by VMI, and that important clinical benefits and differences in efficacy may be provided by these formulations in facilitating easier dental cleaning of supragingival calculus.

The Quanticalc (QC) dental scaler permits a quantitative assessment of the work used by professionals in calculus removal through the measurement of force dynamics and scaling strokes applied in calculus debridement. The purpose of this study was to use the QC to compare the clinical effects of two 5% pyrophosphate dentifrices on dental calculus in subjects following six-months' product use. Three-hundred forty-six subjects participated in a six-month, double-blind tartar control clinical trial involving traditional Volpe-Manhold Index (VMI) evaluations. Following the six-month VMI examinations, the subjects had a QC prophylaxis (scaling force measurements). The three dentifrice treatment groups included a control dentifrice (NaF only, Crest); NaF dentifrice containing 5.0% pyrophosphate (Crest Tartar Control); and NaF dentifrice containing 5.0% pyrophosphate plus 0.28% triclosan (antimicrobial). Subjects were balanced by baseline (pretest) VMI scores at the start of the trial. QC examinations revealed statistically significant reductions in total force and stroke number used by the therapist to scale the six anterior VMI teeth for subjects using the pyrophosphate tartar control dentifrices as compared to control dentifrice. The reduction in scaling effort amounted to almost 3 kg per scaling for subjects. QC results paralleled VMI reductions of calculus on the teeth and demonstrated that the use of 5% pyrophosphate dentifrices, with or without triclosan antimicrobial, results in significant reductions in the total (developed) force and strokes required by therapists in regular calculus debridement at a six-month interval. The clinical benefits of tartar control toothpastes may not only include reductions in cosmetically objectionable supragingival calculus, but in reducing professional effort in calculus debridement during regular prophylaxis.

The effects of a stabilized 0.454% stannous fluoride dentifrice, currently marketed as Crest Gum Care, on supragingival plaque, gingivitis, gingival bleeding and oral soft tissue condition were studied in 328 adult male and female subjects who completed a six-month, double blind clinical study. Following initial examinations, subjects presenting with a minimum of five gingival bleeding sites received a thorough dental prophylaxis and were instructed to brush at least twice a day for three months with a commercially available fluoride dentifrice, packaged in such a way as to blind its identity to the study subjects. This constituted the three-month pre-test period. At the end of this period, subjects were again examined, given a second oral prophylaxis, and randomly assigned to brush with one of the following dentifrices: 1) stabilized 0.454% stannous fluoride, 2) 0.243% sodium fluoride control, or 3) one of three experimental dentifrices. Subjects were instructed to brush their teeth as they normally would, at least twice a day for one minute per brushing. Follow-up examinations after three and six months of dentifrice use evaluated supragingival plaque, gingivitis, gingival bleeding, extrinsic tooth stain and oral soft tissue status. After six months, the stabilized stannous fluoride dentifrice significantly reduced gingivitis and gingival bleeding by 20.5% and 33.4% compared to the sodium fluoride control group. However, the stabilized stannous fluoride dentifrice group was not significantly different from the control dentifrice group with respect to supragingival plaque scores. As expected, accumulation of extrinsic tooth stain was greater in the stabilized stannous fluoride group than the control group. No unexpected nor clinically significant oral soft tissue health effects were associated with the use of the test dentifrices. The results from this clinical study demonstrate that over a six-month period, twice-daily use of a dentifrice containing 0.454% stabilized stannous fluoride significantly reduced gingivitis and gingival bleeding, relative to a 0.243% sodium fluoride control dentifrice.

Recently, a new stabilized stannous fluoride (SnF2) dentifrice (SSF) has been developed. The aim of the present work was to examine the antimicrobial activity of SnF2, and to assess the long-term microbial safety of this dentifrice in a series of in vitro and clinical evaluations. Results of in vitro time-kill experiments with representative oral bacteria demonstrated that SnF2 exerts broad antimicrobial activity against both Gram-positives and Gram-negatives and, in particular, has potent activity against Streptococcus mutans. Sixty-eight subjects participated in a nine-day plaque regrowth clinical study to assess the short-term antiplaque effect of SSF. The results revealed no significant differences from the negative control, suggesting that SnF2 does not detectably or directly alter plaque microbial viability or composition. Separately, evaluation of microbial safety in a subgroup of 120 subjects participating in a six-month clinical efficacy and safety trial found no significant ecological shifts between SSF and the negative (NaF dentifrice) control among 11 supragingival microbial populations examined. The potential for development of bacterial resistance to SnF2 was assessed under both in vitro and clinical conditions. In a rigorous assessment of the ability of bacterial populations to develop either phenotypic or genotypic resistance to SnF2, representative bacteria were exposed to continuous sub-lethal concentrations of SnF2 in a laboratory chemostat for at least 9 days. Results of time-kill experiments on exposed populations revealed no significant changes in susceptibility despite exposure of over 10(12) bacteria. Based on typical spontaneous mutation rates of 10(-6) to 10(-8), these results suggested that the potential for bacteria to develop resistance to SnF2 is low. Evaluation of susceptibility to SnF2 to over 800 bacterial isolates obtained over the course of the six-month clinical trial corroborate the in vitro findings, revealing no changes in susceptibility suggestive of development of resistance to SnF2 is a microbiologically safe agent for oral use and support separate clinical observations demonstrating the safety and efficacy of this stabilized SnF2 dentifrice.

There are few studies that provide information on the natural history of calculus formation. The purpose of this study is to evaluate the relationship between pre-scaling baseline calculus scores, the time since the last prophylaxis before baseline, and scores 8 weeks after scaling in a group of presumed heavy calculus formers. Scaling and polishing were completed on 203 subjects with Volpe-Manhold Index (VMI) calculus scores of 7 or higher, and the date of the last prophylaxis was noted. All were re-examined after 3 weeks. The group included 45.8% males and 54.2% females; the mean age was 41.74 (range = 24 to 72). Racial mix was 57.6% African-American, 39.9% white, and 2.5% other. The mean baseline VMI score was 24.07 (SD = 15.38, range = 7-97). The VMI scores were directly related (P = < .001) to the date of the last scaling and were highest in subjects whose last scaling was more than 2 years earlier (33.67) and least in subjects whose last scaling was less than 6 months previous (15.12). At 8 weeks the mean VMI score was 9.96 (SD = 7.30; range = 0-41). The VMI scores at this time were inversely related (P = < .05) to the date of the last scaling before baseline and were lowest in subjects whose last scaling was more than 2 years earlier (9.07) and highest in subjects with the last scaling less than 6 months previous to baseline (13.07).(ABSTRACT TRUNCATED AT 250 WORDS)