The aim of the study was to compare the efficacy of a 40% chlorhexidine (CHX) varnish (EC40, Certichem, Nijmegen, The Netherlands) with a 1% CHX-0.2% NaF gel in decreasing the level of salivary mutans streptococci (MS). The subjects were screened for a high level of MS using a Dentocult-SM® strip method (Orion Diagnostica, Finland). In varnish groups with fluoride (V_CHXF, n = 20) and without fluoride (V_CHX, n = 19), the CHX varnish was applied on dry teeth using an ampoule and an anesthetic syringe with blunt needle, and removed after 15 min. In group V_CHXF an additional 2.26% fluoride varnish (Duraphat®, Woelm Pharma GmbH, Eschwege, Germany) was applied. The CHX-NaF gel treatment included the application of the gel with rubber cups and dental tape for 5 min on three occasions during a week in group G_CHXF (n = 21). The level of MS (MSB agar) was significantly lower after 4 weeks than at baseline in V_CHX (p < 0.001) and V_CHXF (p < 0.05), but not after 12 weeks. In G_CHXF a significant decrease (p = 0.001) was observed after 4 weeks only with the strip method. In V_CHX and V_CHXF the strip values for MS were still reduced after 12 weeks. In V_CHX and G_CHXF a small, although statistically significant, increase was observed in the total number of microorganisms after 4 and 12 weeks. Opinions on taste sensations associated with the treatments were generally negative, but least negative in the V_CHXF group; fewer side effects were also reported in the V_CHXF group. The results indicate that one treatment with CHX varnish gives an equal or a longer suppression of salivary MS than three treatments with the gel form. Although the concentration of CHX is high, the varnish was associated with fewer side effects and complaints of bad taste than the 1% CHX-NaF gel, especially when coated by a fluoride varnish. This is probably due to an accurate application on teeth with a minimal contact with the oral mucosa.

The purpose of this practice-based study was to compare the clinical performance of a new universal composite resin material (Z250) used for Class III and V cavities in anterior teeth. Restorative materials (Z250 and Z100; 3 M ESPE) placed by six operators were used for a total of 150 restorations during the 6-month enrollment period. After 1 year, 141 restorations (76 Z250 and 66 Z100) were available and evaluated for overall quality, color match, marginal adaptation, surface appearance and the presence of secondary caries, using modified USPHS criteria. The overall quality was excellent for both materials and no significant changes were noted during the follow-up. None of the scores between the two materials were statistically significant. Major changes were seen in color match and surface appearance. At baseline, the color match of 71% of Z250 and 62% of Z100 was rated as Alfa, after 1 year the figures were 60 and 65%. Regarding surface appearance, 97% of the Z250 were rated Alfa at baseline, whereas at 1 year the figure was 76%. For Z100, the scores were 94 and 79%, respectively. After 1 year, the clinical performance of Z250 restorative composite resin was clinically acceptable and similar to that of Z100.

– The in vitro susceptibility of Streptococcus mutans, S. sobrinus and Lactobacillus casei to dental gels containing various combinations of amine fluoride (AmF 297), stannous fluoride (SnF2), and chlorhexidine (CHX) was studied. The combination of AmF‐SnF2 with a total fluoride content of 1.2% was the most effective against mutans streptococci but not against L. casei. At notably lower total fluoride concentration (0.4%), AmF as such or combined with SnF2, was significantly less effective against mutans streptococci than CHX or CHX‐AmF‐SnF2 combinations. CHX‐AmF combination was a slightly more potent inhibitor of streptococcal growth than CHX‐NaF. With L. casei the differences between various gels were small but CHX alone seemed to be the most effective. Of the studied agents, CHX seemed to be the most potent individual chemotherapeutic compound whose activity against S. mutans could be enhanced by combining it with AmF. However, clinical experiments are required to test the in vivo antibacterial efficacy of CHX‐AmF and AmF‐SnF2 combinations which were most effective in our in vitro experiments.

Abstract— Forty‐five young adults were divided into three groups of equal size and given a professional toothcleaning (3 times during 1 wk) with dental gels containing either chlorhexidine (CHX, 1%), or a SnF2‐amine fluoride (AmF) combination (F− content 1.20%). The control group received toothcleaning with a placebo gel. The study was done double blind. The number of salivary mutans streptococci was monitored for 11 wk after the gel treatment using both mitis‐salivarius‐bacitracin agar plates and the chairside method based on the adhesion of mutans streptococci on plastic strips (DentocuIt‐SM Strip mutans). Professional toothcleaning with a CHX gel was clearly most effective (P< 0.001) but the baseline levels of streptococci returned in 11 wk. SnF2‐AmF gel also reduced significantly (P< 0.001) mutans streptococci but recolonization occurred already in 7 wk. Placebo gel, i.e. professional toothcleaning as such, did not show any statistically significant effect on the numbers of salivary mutans streptococci. None of the treatments affected the levels of lactobacilli or the total aerobic flora in saliva samples. Professional toothcleaning with a CHX gel, or with a SnF2,‐AmF gel, can be regarded as an alternative to the commonly used, but more patience demanding, application of gel in mouth trays at home for individuals with high caries activity.

A new buffering lozenge (sucking tablet) was developed for patients susceptible to dental caries and erosion, in particular for those with reduced salivary secretion. As active ingredients this lozenge comprises of a combination of xylitol, fluoride, calcium, phosphate, zinc and buffering compounds. To test the lozenge's activity /« vivo, the release of ingredients was monitored in 19 healthy subjects for 22 min after sucking the lozenge was completed. In subjects with a normal salivary secretion rate the lozenge caused only a slight stimulation of saliva flow, but a significant elevation both in salivary pH and buffer effect was observed.Furthermore, fluoride, calcium and phosphate were effectively released into whole saliva with peak values 2-4 min after use. The same salivary parameters were also quantitated after 1 month's regular use (3 lozenges/day) but no consistent longterm changes were found. Salivary mutans streptococci and total anaerobic microflora did not change significantly during the long-term use. The results show that the buffering fluoride-and xylitolcontaining lozenge, which also releases calcium and phosphate, is active in vivo but its serviceability as a remineralizing agent, in particular for elderly patients with reduced salivary flow rate, has to be analysed separately.