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In vivo evaluations of the neutralizing effect of a hydroxyl ion-releasing resin composite and a prophylactic gel on plaque acidogenicity: measured by the microtouch method
Umeå University, Faculty of Medicine, Odontology.
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The prevalence of dental caries has decreased dramatically in most developed countries since the sixties and the number of remaining teeth in adults has increased during the last decades. Elderly as a group will during aging become an increasing risk group for caries. Especially older individuals with hyposalivation are at increased risk for coronal and root caries and need increased oral care. A large part of the time spent by the dental team is occupied by prevention and treatment of secondary caries, which is the main reason of replacement or repair of restorations. Traditionally, prevention of caries is directed against the different risk factors of the individual such as oral hygiene, intake of fermentable carbohydrates, cariogenic microflora and oral dryness. In some restorative materials the release of fluoride can be used to decrease the risk of secondary caries alone or in combination with other preventive methods. New alternative preventive methods are necessary to complete traditional methods in order to decrease the caries risk in elderly and/or to prevent secondary caries. Addition of methods with buffering properties have been suggested and developed to supplement the biological buffering capacity of saliva.

The neutralizing effects of a hydroxyl ion-releasing resin composite and a prophylactic gel containing buffering properties on dental plaque acidogenicity was evaluated by the microtouch method.

In this method, a skin reference electrode was validated in comparison with a glass capillary reference electrode and used in the subsequent studies. Change of plaque acidogenicity on proximal surfaces of aged restorations of the hydroxyl ion-releasing resin composite was compared intra-individually a conventional hybrid resin composite and a non-filled enamel proximal surface. Relative frequencies of cariogenic microorganisms in plaque on these surfaces were studied. The effect of a single application of the prophylactic gel with buffering substances was evaluated on plaque acidogenicity in healthy individuals with low and normal salivary secretion rate. It was compared intra-individually with the same gel without buffering substances. The effect of multiple applications of the prophylactic gel on plaque acidogenicity was studied in institutionalized elderly individuals with subjectively reported oral dryness and compared intra-individually with the same gel without buffering substances.

Major results and conclusions from the studies are:

• The use of the skin reference electrode, in combination with the microtouch electrode, showed high validity in comparison with the conventional glass capillary reference electrode

• The hydroxyl ion-releasing composite resin countered plaque acidogenicity fall at two time points of the aged restorations and maintained it at levels where lesser demineralization occurs. No influence of the ion-release on the amount of cariogenic plaque microorganisms on the resin composite surface was observed

• A single application of the prophylactic gel with buffering substances showed a neutralizing effect of plaque pH in healthy individuals with normal salivary secretion rate. No effect was observed in low secretion rate individuals.

• Multiple applications of the prophylactic gel did not neutralize dental plaque acidogenicity in elderly individuals with subjective oral dryness

Place, publisher, year, edition, pages
Umeå: Odontologi , 2006. , 49 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 93
Keyword [en]
caries, clinical, buffering, elderly, plaque pH, resin composite, restorations, microorganisms
National Category
Dentistry
Identifiers
URN: urn:nbn:se:umu:diva-945ISBN: 91-7264-152-5 (print)OAI: oai:DiVA.org:umu-945DiVA: diva2:145155
Public defence
2006-12-15, Sal B, Tandlökarhögskolan, 90187, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2006-11-24 Created: 2006-11-24 Last updated: 2009-08-20Bibliographically approved
List of papers
1. Evaluation of a skin reference electrode used for intraoral pH measurements in combination with a microtouch electrode
Open this publication in new window or tab >>Evaluation of a skin reference electrode used for intraoral pH measurements in combination with a microtouch electrode
2004 (English)In: Clinical Oral Investigations, ISSN 1432-6981, Vol. 8, no 3, 172-175 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this in vivo study was to evaluate a skin reference electrode used with the microtouch method for measurements of intraoral pH. Registrations of plaque pH were made in ten healthy subjects before and up to 30 min after a mouth rinse with 10% sucrose. A microtouch electrode (Beetrode) was used in combination with two different half-cell reference electrodes: a skin silver-silver chloride plate or a glass capillary reference electrode. The skin electrode was placed on the subject's forearm in combination with a conductive gel. The glass capillary electrode, together with one of the test subject's fingers, was placed in a beaker with a 3 M KCl solution. High agreement between the two reference systems resulted in almost identical plaque-pH curves (r=0.97). The mean differences between the two systems at the different time points varied between -0.15 and +0.01 pH units, with an overall mean pH difference of 0.03 pH units. It can be concluded that the use of the skin reference electrode may very well replace the traditional reference electrode used in combination with a microtouch electrode for intraoral use.

Keyword
Dental plaque, electrode, plaque pH
Identifiers
urn:nbn:se:umu:diva-14724 (URN)doi:10.1007/s00784-004-0257-4 (DOI)14963726 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2009-08-18Bibliographically approved
2. Effect of a hydroxyl ion-releasing composite resin on plaque acidogenicity
Open this publication in new window or tab >>Effect of a hydroxyl ion-releasing composite resin on plaque acidogenicity
2005 (English)In: Caries Research, ISSN 0008-6568, Vol. 39, no 3, 201-206 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this in vivo study was to evaluate the neutralizing capacity, registered as change of plaque acidogenicity, on aged proximal restorations of an ion-releasing composite resin (IRCR), which releases hydroxyl, calcium, and fluoride ions at low pH. Twenty patients, with a mean age of 63 years (range 43-85), participated. All had one aged proximal IRCR restoration (mean age 15 months) and one nonrestored enamel surface to make an intraindividual comparison possible. The neutralizing effect of the IRCR was evaluated by measuring plaque pH, using the microtouch method, after a mouthrinse with 10% sucrose. The plaque pH measurements were repeated 1.5 years later on the IRCR (mean age 34 months), the enamel surfaces and a universal hybrid composite resin (CR). At both 15 and 34 months, the plaque on the IRCR surfaces showed the least acidogenic potential for the whole 60-min time interval. The largest differences between the IRCR, CR and enamel were found during the first 15 min. At 15 months, the total areas under the plaque pH curve (AUC(5.7) and AUC(6.2)) differed significantly between the IRCR and enamel surfaces for the time periods 0-5 min and 5-15 min. At 34 months, significant differences were found between IRCR and CR at the 0- to 5-min time period. It can be concluded that IRCR restorations countered the plaque pH fall and maintained it at levels where less enamel and dentin demineralization can occur. Copyright (c) 2005 S. Karger AG, Basel.

Identifiers
urn:nbn:se:umu:diva-17147 (URN)10.1159/000084799 (DOI)15914982 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2009-08-20Bibliographically approved
3. Levels of mutans streptococci and lactobacilli in plaque on aged restorations of an ion-releasing and a universal hybrid composite resin
Open this publication in new window or tab >>Levels of mutans streptococci and lactobacilli in plaque on aged restorations of an ion-releasing and a universal hybrid composite resin
2005 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, Vol. 63, no 1, 21-25 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this in vivo study was to evaluate the cariogenic microflora of plaque on aged restorations of a hydroxyl, fluoride, and calcium ion-releasing composite resin (IRCR) (Ariston pHc), and to compare it intra-individually with a universal hybrid composite resin and enamel. Each of 19 subjects received one proximal restoration of the IRCR, one proximal universal hybrid composite resin restoration (CR) and each subject had one non-filled proximal enamel control surface to make intra-individual comparisons possible. To avoid peak ion releases from the materials, aged restorations were studied. Plaque was collected from 57 surfaces using sterile applicator tips. Samples were cultured to determine the numbers of mutans streptococci, lactobacilli, and total microorganisms. The relative numbers for mutans streptococci (% of total bacteria) were: IRCR 0.59%, CR 0.40%, enamel 0.22%. Two outliers were found in the IRCR group. Excluding these outliers resulted in a relative number of 0.33%. Lactobacilli were detected in the plaque from only 9 surfaces and at very low relative proportions for all three surfaces: 0.01%. The enamel surfaces showed the lowest relative numbers of mutans streptococci and lactobacilli, but the differences were not significant. It can be concluded that the ion release of the IRCR did not influence the growth of cariogenic microorganisms in dental plaque.

Keyword
Antibacterial activity, caries, clinical, dental materials, microorganisms
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-17175 (URN)10.1080/00016350510019649 (DOI)16095058 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2012-03-01Bibliographically approved
4. Buffering effect of a prophylactic gel on dental plaque.
Open this publication in new window or tab >>Buffering effect of a prophylactic gel on dental plaque.
2006 (English)In: Clinical Oral Investigations, ISSN 1432-6981, Vol. 10, no 4, 289-295 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate the effect of a new prophylactic gel on plaque pH and plaque fluoride concentration. Twelve participants with normal (n=6, >/=0.7 ml/min) and low (n=6, <0.7 ml/min) stimulated whole salivary secretion rate were included. After 3 days of plaque accumulation, at random the participants were (1) treated with Profylin fluoride gel with buffering components (active gel), (2) treated with Profylin fluoride gel without buffering components (placebo gel), (3) asked to rinse with water, and (4) given no treatment. All test series were followed by rinsing with a nutrition solution; after which registration of plaque pH was performed during 60 min. There were two drop outs with low salivary secretion rate in the water session. The overall least pronounced pH fall was found after the use of the prophylactic gel. Significant differences between the prophylactic gel and the placebo gel were found for the participants with normal secretion rate. Fluoride plaque concentrations evaluated in 12 individuals after (1) application of the active gel, (2) rinsing with 0.2% NaF, and (3) rinsing with water showed significantly higher values after rinsing with the NaF solution. It can be concluded that application of the active gel, particularly in subjects with normal salivary secretion rate, in general, buffered plaque pH to higher levels. Factors like concentration of buffering agent and solubility of the gel need to be further evaluated to improve the effect.

National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-12896 (URN)10.1007/s00784-006-0060-5 (DOI)16937109 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2009-10-28Bibliographically approved
5. Buffering effect of a prophylactic gel on dental plaque in institutionalised elderly
Open this publication in new window or tab >>Buffering effect of a prophylactic gel on dental plaque in institutionalised elderly
Show others...
2007 (English)In: Gerodontology, ISSN 0734-0664, Vol. 24, no 2, 98-104 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The effect of multiple daily applications of a prophylactic gel, with buffering substances, on plaque acidogenicity in elderly institutionalised individuals was evaluated. Background: Many elderly suffer from reduced salivary flow, poor oral hygiene and increased levels of cariogenic bacteria and are considered to be at an increased risk for coronal and root caries. Reinforcing the buffering capacity of dental plaque by the addition of substances such as bicarbonate and phosphates may decrease their caries activity. Materials and methods: Fourteen elderly, with subjective dry mouth, were treated for 16-day-periods at random with: (i) Profylin fluoride gel with buffering components; (ii) Profylin fluoride gel without buffering components and (iii) rinsing with water. Applications were made four times a day and each period was followed by a 2-week wash-out period. The plaque pH was registered after a carbohydrate challenge and the following were recorded before and after each test period: stimulated salivary secretion rate, buffer capacity, number Colony Farming Units (CFU) mutans streptococci, lactobacilli and a sample of Candida albicans on oral mucosa. Results: Eleven participants (mean age 76.6 years) fulfilled the study. Changes in plaque pH measurements, when calculated as area under the curve (AUC(6.2) and AUC(5.7)) values (pH x min), before and after each of the three treatments, showed no significant differences. A tendency to a higher plaque acidogenicity and amount of cariogenic microorganisms was found after the gel treatments. C. albicans was found in low levels. Conclusion: Frequent applications of the gel did not result in an improved neutralising effect in the elderly. This may be caused by a combination of several factors, such as the level of oral dryness of the individuals and low solubility, release and retention of the gel substances in plaque. Instead, an increased plaque acidogenicity was noted.

Keyword
Plaque, odontology
National Category
Dentistry
Identifiers
urn:nbn:se:umu:diva-14765 (URN)10.1111/j.1741-2358.2007.00151.x (DOI)17518957 (PubMedID)
Available from: 2007-11-06 Created: 2007-11-06 Last updated: 2009-08-18Bibliographically approved

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