Sample tooth selection.

<p>Selection process: According to the randomization list, sample teeth are selected in a clockwise (CW) or counter clockwise (CC) direction. Example: For clockwise selection, start at the upper right quadrant from the most distal tooth going towards the mesial (CW, mandatory turn 1) </p><p></p><p></p><p>Select the most distal tooth in this quadrant that meets the criteria (at least 1 site with at least 1 site with PPDs of ≥ 4 mm); if 1 tooth is selected or none meets the criteria then</p><p></p><p></p><p>continue clockwise in the upper left quadrant and now select the most mesial tooth that meets the inclusion criteria, if 1 tooth is selected or none meets the criteria,</p><p></p><p></p><p>continue clockwise in the lower left quadrant and select the most distal tooth that meets the inclusion criteria, if 1 tooth is selected or none meets the criteria,</p><p></p><p></p><p>continue clockwise in the lower right quadrant and select the most mesial tooth that meets the inclusion criteria, stop if 1 tooth in each quadrant has been selected, if less than 4 teeth have been selected,</p><p></p><p></p><p>continue clockwise (optional turn 2), and start in the upper left quadrant going from mesial towards distal,</p><p></p><p></p><p>continue clockwise with optional turns 3 and 4 until a total number of 4 sample teeth have been included.</p><p></p><p></p><p></p> <p>Select the most distal tooth in this quadrant that meets the criteria (at least 1 site with at least 1 site with PPDs of ≥ 4 mm); if 1 tooth is selected or none meets the criteria then</p> <p>continue clockwise in the upper left quadrant and now select the most mesial tooth that meets the inclusion criteria, if 1 tooth is selected or none meets the criteria,</p> <p>continue clockwise in the lower left quadrant and select the most distal tooth that meets the inclusion criteria, if 1 tooth is selected or none meets the criteria,</p> <p>continue clockwise in the lower right quadrant and select the most mesial tooth that meets the inclusion criteria, stop if 1 tooth in each quadrant has been selected, if less than 4 teeth have been selected,</p> <p>continue clockwise (optional turn 2), and start in the upper left quadrant going from mesial towards distal,</p> <p>continue clockwise with optional turns 3 and 4 until a total number of 4 sample teeth have been included.</p> <p>For counter clockwise proceed as indicated in the figure above.</p

Impact of the Daily Use of a Microcrystal Hydroxyapatite Dentifrice on <i>De Novo</i> Plaque Formation and Clinical/Microbiological Parameters of Periodontal Health. A Randomized Trial

<div><p>Aim</p><p>This 12-week prospective, randomized, double-blind, two-center trial evaluated the impact of a microcrystalline zinc hydroxyapatite (mHA) dentifrice on plaque formation rate (PFR) in chronic periodontitis patients. We hypothesized that mHA precipitates cause delayed plaque development when compared to a fluoridated control (AmF/SnF₂), and therefore would improve periodontal health.</p><p>Material & Methods</p><p>At baseline and after 4 and 12 weeks, PFR and other clinical and microbiological parameters were recorded. Seventy periodontitis patients received a mHA or AmF/SnF₂ dentifrice as daily oral care without hygiene instructions. Four weeks after baseline, participants received full mouth debridement and continued using the dentifrices for another 8 weeks.</p><p>Results</p><p>Primary outcome PFR did not change statistically significantly from baseline to weeks 4 and 12, neither in mHA (n = 33; 51.7±17.2% vs. 48.5±16.65% vs. 48.4±19.9%) nor in AmF/SnF₂-group (n = 34; 52.3±17.5% vs. 52.5±21.3% vs. 46.1±21.8%). Secondary clinical parameters such as plaque control record, gingival index, bleeding on probing, and pocket probing depth improved, but between-group differences were not statistically significant. Microbiological analyses showed similar slight decreases in colony-forming units in both groups.</p><p>Conclusion</p><p>In patients with mild-to-moderate periodontitis, periodontal therapy and use of a mHA-or AmF/SnF₂ dentifrice without instructions induced comparable improvements in periodontal health but did not significantly reduce the PFR.</p><p>Trial Registration</p><p>ClincalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02697539?term=NCT02697539&rank=1" target="_blank">NCT02697539</a></p></div

Microbiological results from baseline through follow ups (means±SD). Log-transformed reduction factors.

<p>Microbiological results from baseline through follow ups (means±SD). Log-transformed reduction factors.</p

Microbiological results at baseline and follow ups (means±SD). Log–transformed bacteria counts.

<p>Microbiological results at baseline and follow ups (means±SD). Log–transformed bacteria counts.</p

Patient flow chart (mHA: microcrystalline zinc hydroxyapatite dentifrice, AmF/SnF₂: aminefluoride/stannous fluoride).

<p>Patient flow chart (mHA: microcrystalline zinc hydroxyapatite dentifrice, AmF/SnF₂: aminefluoride/stannous fluoride).</p

Clinical parameters at baseline and follow ups (means±SD.

<p>Clinical parameters at baseline and follow ups (means±SD.</p

Image_1_Caries-preventing effect of a hydroxyapatite-toothpaste in adults: a 18-month double-blinded randomized clinical trial.JPEG

BackgroundDental caries is a worldwide challenge for public health. The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect of a fluoride-free, hydroxyapatite toothpaste (test) and a toothpaste with sodium fluoride (1450 ppm fluoride; positive control) in adults.MethodsThe primary endpoint was the percentage of subjects showing no increase in overall Decayed Missing Filled Surfaces (DMFS) index. The study was designed as non-inferiority trial. Non-inferiority was claimed if the upper limit of the exact one-sided 95% confidence interval for the difference of the primary endpoint DMFS between test and control toothpaste was less than the predefined margin of non-inferiority (Δ ≤ 20%).ResultsIn total, 189 adults were included in the intention-to-treat (ITT) analysis; 171 subjects finished the study per protocol (PP). According to the PP analysis, no increase in DMFS index was observed in 89.3% of subjects of the hydroxyapatite group and 87.4% of the subjects of the fluoride group. The hydroxyapatite toothpaste was not statistically inferior to a fluoride toothpaste with regard to the primary endpoint.ConclusionHydroxyapatite was proven to be a safe and efficient anticaries agent in oral care.Clinical trial registrationNCT04756557.</p