The aim of this study was to compare the levels of fluoride and mutans streptococci in plaque grown on glass ionomer (Ketac-Fil) and composite (Silar) restorations in vivo. From tunnels left under the brackets bonded either with glass ionomer or composite, 14-day-old plaque samples were collected 14, 28, and 42 days after bonding. For glass ionomer the mean counts of mutans streptococci in plaque were 0.5 × 103, 6.7 × 103, and 8.8 × 103 CFU at the first, second, and third collection, respectively, whereas for composite restorations the corresponding values were 32.1 × 103, 14.6 × 103, and 120.6 × 103 CFU. For glass ionomer the mean concentrations of fluoride were 19,985, 5,788, and 5,019 ppm at first, second, and third collections of 14-day-old plaque samples, respectively, whereas for composite restorations the mean concentrations of fluoride were about 200 ppm throughout the study. The results show that the fluoride level in plaque growing on glass ionomer is much higher than that on composite restorations which seems to affect the level of mutans streptococci in dental plaque.
– In order to find out if it is possible to prevent caries and gingivitis by periodical use of chlorhexidine‐fluoride mouthrinses with or without strontium, and to find out what effects they have on salivary mutans streptococci and lactobacilli counts, a total of 243 schoolchildren aged 11 yr with high DMFS scores were randomly divided into four groups. One group (C) served as a basic control. Subjects in the second group (GXF) rinsed their mouths twice a day every third week with a rinsing solution containing 0.05% chlorhexidine gluconate and 0.04% NaF. In the third group (CXFS) the rinsing solution contained 500 ppm Sr during the first and second year and 15 ppm during the last 6 months, in addition to chlorhexidine and fluoride. In the fourth group (CX) the solution contained only 0.05% chlorhexidine gluconate. All the rinsing solutions had pH 5.8 buffered with succinic acid‐NaOH buffer. After 2 yr and 9 months, the mean DMFS (SD) increments in the C, GXF, GXFS, and GX groups were 3.8 (5.7), 2.5 (3.2), 3.5 (4.8), and 3.4 (5.5), respectively. The percentage of subjects with bleeding gingival units had decreased from initial to final values as follows: C, 81–38; GXF, 88–42; GXFS, 89–56; GX, 89–37. The number of lactobacilli and mutans streptococci in saliva remained virtually unchanged throughout the study. For caries increment and gingival bleeding, the differences between groups were not statistically significant. The chlorhexidine‐fluoride combination tended to prevent caries, but the effect on gingival bleeding and salivary counts of mutans streptococci and lactobacilli was negligible.
Thirty schoolchildren, 9–12 yr old with high DMF score, rinsed their mouths twice a day for 3 days with a chlorhexidine‐fluoride (CXF) solution or a chlorhexidine‐fiuoride‐strontium (CXFSr) solution. Streptococcus mutans counts (CFU) were made from saliva incubated on MSB agar and the gingival bleeding was recorded both before and after the rinsing period. S. mutans count decreased significantly immediately after the rinsing with each of the solutions (from 650 × 103 to 170 × 103 CFU/ml by CXF and from 500 to 170 × 103 CFU/ml by CXFSr). Within about 18 days after the rinsing with each solution the salivary S. mutans counts returned to the original level. Gingival Bleeding Index (GBI) was significantly reduced by half through the CXF rinsing while the slight reduction by CXFSr was nonsignificant. Both of these changes were temporary. The results suggest that short rinsing periods with the CXF solution may be more advisable than daily rinses as a contribution to the maintenance of oral health in subjects or groups in need of such a prophylaxis. The weaker effect found with the CXFSr solution suggests that the cariostatic effect recently found in rats with the same solution may be due to other mechanisms than reduction of the oral S. mutans count.
For study of the enamel‐protective effect of chlorhexidine‐fluoride applications, the labial surfaces of pieces of bovine incisors were treated with 0.2% chlorhexidine gluconate solution, with Duraphat fluoride varnish, or with both of the above agents, while one group was treated with distilled water and one was left as an untreated control. Furthermore, a placebo varnish was used in the chlorhexidine‐ and distilled‐water‐treated groups; all the varnishes were removed after 24 h. The enamel slabs were mounted pairwise in an artificial mouth to form approximal contacts. The teeth were continuously rinsed with a common pool of artificial saliva to which was added 3% sucrose, and which was infected on the first day with Streptococcus mutans, “Ingbritt”. The saliva was renewed daily and the incubation at 37°C lasted for 10 days. The appreciable softening found in the distilled‐water‐ and placebo‐varnish‐treated group tended to be prevented by the chlorhexidine and even more by the fluoride treatment, while the chlorhexidine‐fluoride treatment prevented enamel softening completely. The saliva, infected only on the first day, and renewed daily, tended to become more acidified toward the end of the experimental period, obviously because the fermenting organisms had infected the surfaces of the model and formed plaque‐like coatings on the enamel.
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