Effect of self‐administered daily irrigation with 0.02% SnF₂ on periodontal disease activity

Abstract

To determine the effect on periodontal health of a daily self-administered irrigation with 0.02% stannous fluoride (SnF2) solution, 28 subjects who had moderate to advanced periodontitis were randomly divided into 3 groups: a control group (n = 9) which used no irrigation, a group (n = 8) which used a self-administered water irrigation device (Water Pik) daily with water (H2O group) and a group (n = 11) which used the Water Pik in a similar manner but with SnF2 solution (SnF2 group). All subjects were instructed in routine tooth brushing and flossing but received no other periodontal treatment. 4 study sites were selected from each patient which had pocket depths greater than 4 mm and bleeding upon probing. Plaque index, gingival index, bleeding tendency, pocket depth, loss of attachment, and microbiologic samples of subgingival plaque for morphologic determinations were collected from all study sites at baseline, 2, 6, and 10 weeks. A cross-over was then initiated for 2 additional monthly checks in which the H2O group changed to SnF2 and the SnF2 group was divided into 2 subgroups which either continued to use SnF2 or changed to H2O. The control group completed the study at the beginning of the crossover. The clinical data showed significantly more improvement in periodontal health during the first 10 weeks for the SnF2 group (p less than 0.01). After cross-over, the clinical data indicated the group that changed from H2O to SnF2 significantly improved their periodontal health, while the group that changed from SnF2 to H2O became worse. The microbiologic data showed trends which agreed with the clinical data during the first 10 weeks but were less significant. After cross-over, the %s of motile rods and spirochetes were too small (0-7%) to establish statistically significant changes considering the accuracy of the technique used.

Effects on Gingivitis of Two Different 0.4% SnF2 Gels

“…The other treatment group, which used a 0.4% SnF2 gel with less than 2% available Sn2+ ions, showed no significant differences from the control group, whether the gel was used once or twice daily during the nine-month study period. This study is in agreement with previous clinical trials that have found SnF2 to have beneficial effects on periodontal status (Boyd et al, 1985;Saxton et al, 1986).…”

“…These effects appear to be related to the availability of the Sn2+ ion rather than the F-ion (Camosci and Tinanoff, 1984). Other clinical reports have demonstrated that topically applied SnF2 is associated with reduction of supragingival plaque, motile subgingival plaque micro-organisms, gingivitis, and pocket depth (for review, see Boyd et al, 1985). SnF2 has been topically applied in various vehicles, such as mouthrinses, glycerine-base gels, and irrigating solutions.…”

Clinical and microbiological effects of daily brushing with either NaF or SnF2 gels in subjects with fixed or removable dental prostheses

“…Derkson & 0.4% SnF: to their abutment teeth. Boyd et al (1985) found an approxi-MacEntee (1982) reported a 20% re-mate 65% reduction in subjects classiduction in gingival index in those sub-fied as having moderate to severe perio-dontitis, who irrigated their pockets daily with 0,02% SnF:. Frankel et al (1985) showed a 30% reduction in GI scores in subjects who rinsed with 0.1% SnF2 after periodontal surgery, Boyd et al, (1988) also found a 60% reduction in GI scores in orthodontic subjects brushing twice daily with Q.A'Vo SnF2.…”

“…Significant reductions in gingivitis, due to topical applications of SnF?. have been found in several studies (Mazza et al 1981, Derkson & MacEntee 1982. Boyd et al 1985, Frankel et al 1985, Boyd et al 1988), yet others have reported marginal or no effect (Leverett et al 1984, Wolff et al 1988).…”

The action of sodium fluoride on suspected periodontopathogens

“…In recent years administrations of 0.01-1.64% SnF2 have resulted in a significant reduction of human periodontal disease (3,17). The precise contribution of the Sn++ and F" ions in the antibacterial action of SnFa has not been delineated.…”