Caries Control in Overdenture Patients: 18-Month Evaluation on Fluoride and Chlorhexidine Therapies

Keltjens, H.M.A.M.; Schaeken, M.J.M.; Hoeven, J.S. van der; Hendriks, Jan C.M.

doi:10.1159/000261298

Cited by 29 publications

(14 citation statements)

References 24 publications

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“…A single application with a low-con centration chlorhexidine gel causes a strong initial sup pression , but only of short duration [Schaeken et al, 1989[Schaeken et al, , 1991. After repeated treatment with a 1% chlorhexidine gel, long-term suppression of mutans streptococci is achieved [Maltzet al, 1981;Emilson, 1981;Emilsonet al, 1987;Zickert et al, 1987;Emilson and Lindquist, 1988;Keltjens et al, 1990]. Long-term suppression of mutans streptococci can also be obtained after a single treatment with 40% chlorhexidine varnish, with lower concentra tions of chlorhexidine having less effect [Schaeken et al, 1989, 1991].…”

Section: Discussionmentioning

confidence: 99%

Effect of Single and Repeated Application of Chlorhexidine Varnish on Mutans Streptococci in Plaque from Fissures of Premolar and Molar Teeth

Ie¹,

Schaeken

1993

Caries Res

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The aim of this study was to determine the effects of one and two applications of 40% chlorhexidine varnish on the numbers of mutans streptococci in human dental fissure plaques from molar and premolar teeth. Twenty-nine subjects (aged 20-30 years) participated in the study and were randomly assigned to one of three groups. In each subject two fissures with high levels of mutans streprococci were selected. The fissures in group 1 (control group) were treated with placebo varnish containing no chlorhexidine. Fissures in group 2 received a single application of 40% chlorhexidine varnish, whereas fissures in group 3 received an additional chlorhexidine varnish application 1 week after the first application. Fissure plaque samples were taken prior to the first application of chlorhexidine varnish and subsequently 1, 2, and 4 months thereafter. Compared with the fissures in the control group, the suppression of mutans streptococci was significant in plaques from group 2 for up to 2 months and in plaques from group 3 for up to 4 months after application. Mutans streptococci were suppressed more strongly in premolar than in molar teeth and more strongly and for a longer period of time in fissures of premolar teeth treated twice than in fissures of premolars treated once.

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Section: Discussionmentioning

confidence: 99%

Effect of Single and Repeated Application of Chlorhexidine Varnish on Mutans Streptococci in Plaque from Fissures of Premolar and Molar Teeth

Ie¹,

Schaeken

1993

Caries Res

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“…Several studies (Toolson and Smith, 1978;Ettinger and Jacobsen, 1990;Keltjens et al, 1990) have provided evidence that the abutment teeth under an overdenture are exposed to a cariogenic environment. Thus, antimicrobial measure have been proposed as an adjunct to administration of fluoride.…”

Section: Discussionmentioning

confidence: 99%

“…Daily application of a small amount of gel containing 1% chlorhexidine improved the periodontal health of abutment teeth (Keltjens et al, 1991), and virtually eliminated mutans streptococci from the dental plaque (Keltjens et al, 1987), leading to almost complete prevention of caries (Keltjens et al, 1990).…”

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confidence: 99%

Effects of Chlorhexidine-containing Gel and Varnish on Abutment Teeth in Patients with Overdentures

et al. 1992

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Previous experiments have shown that daily use of 1% chlorhexidine gel strongly reduced caries development in the abutment teeth under overdentures. The present experiment was designed to determine whether intermittent application of chlorhexidine, either in a varnish or in a gel, might be used as an alternative preventive method, less demanding for the patient. To this end, 31 patients were distributed among four treatment groups, with the number of mutans streptococci in plaque and saliva used as a balancing criterion. The treatments consisted of a single application of 40% chlorhexidine varnish, daily application of 1% chlorhexidine gel for one week, or the corresponding placebo treatments with varnish or gel without chlorhexidine. Patients were re-called for bacteriological and clinical examination at various intervals during an eight-week period following treatment. Chlorhexidine varnish and chlorhexidine gel applications significantly suppressed mutans streptococci on the abutment teeth for four and eight weeks, respectively. In agreement with earlier findings, the numbers of Actinomyces viscosus/naeslundii in plaque were significantly increased after chlorhexidine varnish treatment. The chlorhexidine gel reduced plaque accumulation and gingival bleeding for one week but had no long-lasting effect. The results seem to justify a long-term clinical test of intermittent chlorhexidine applications as an alternative for daily use in patients with overdentures.

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“…The HRT also underwent regular CHX gel applications (4% methylcellulose, 85% glycerol base, 1% chlorhexidine digluconate, a few drops of peppermint oil) [Keltjens et al, 1990] at school, after breakfast and before lunch, for 3 consecutive days at 3-month intervals. The dental hygienists spread the gel on the children's teeth and cleaned them for 3-5 min using an electric toothbrush.…”

Section: Basic and Intensive Preventive Measuresmentioning

confidence: 99%

Caries-Preventive Effect of Chlorhexidine Gel Applications among High-Risk Children

Petti¹,

Hausen

2006

Caries Res

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Evidence on the caries-preventive effect of chlorhexidine (CHX) among high-risk children is inconclusive, possibly because obscured by fluoride exposure. We investigated the effect of CHX among initially 3-year-old subjects whose baseline d₃ft was = 0 and whose only regular fluoride exposure came from toothpaste. The subjects were assigned to three groups: high-risk test (HRT, n = 70), high-risk control (HRC, n = 71), and low-risk control (LRC, n = 70). Risk classification was based on salivary mutans streptococcal levels (MS, 5 cfu/ml). Basic measures (oral hygiene, dietary counselling every 4 months) were given to all groups. HRT also underwent CHX gel applications for 3 consecutive days at 3-month intervals for 15 months. Eighteen months after baseline d₃ft increments and proportions of children with d₃ft increment ≧1 (%d₃ft increment ≧1) among all groups were assessed. Anti-MS effect on high-risk children and caries-preventive effect on all children were statistically analysed by residual change analysis (MS), non-parametric tests and logistic regression analysis (caries). No differences were found between the groups in basic programme compliance. CHX significantly reduced MS levels. %d₃ft increment ≧1 and mean d₃ft increments were 34.3%, 0.56 (HRT), 32.4%, 0.54 (HRC) and 11.4%, 0.11 (LRC), with HRT/HRC values statistically significantly higher than LRC values and no significant difference between HRT and HRC. HRT children were not less likely to show new lesions than HRC children (OR = 1.09; 95% confidence interval 0.54–2.19), while high-risk children were 4 times more likely to show new lesions than low-risk children (OR = 3.71; 95% confidence interval 1.53–9.03). CHX gel applications showed moderate anti-MS effect but negligible caries-preventive effect.

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Caries Control in Overdenture Patients: 18-Month Evaluation on Fluoride and Chlorhexidine Therapies

Cited by 29 publications

References 24 publications

Effect of Single and Repeated Application of Chlorhexidine Varnish on Mutans Streptococci in Plaque from Fissures of Premolar and Molar Teeth

Effect of Single and Repeated Application of Chlorhexidine Varnish on Mutans Streptococci in Plaque from Fissures of Premolar and Molar Teeth

Effects of Chlorhexidine-containing Gel and Varnish on Abutment Teeth in Patients with Overdentures

Caries-Preventive Effect of Chlorhexidine Gel Applications among High-Risk Children

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