The aim o f this study was to evaluate the effects of »Meridol« solution for mouth rinsing (containing SnF2 and aminfluoride 297) on plaque and gingiva. The study was carried out in four groups of children. Group A rinsed their mouth once a week during six months, group B once a day for a month, while groups KA and KB served as control. The criterion for relevant plaque recording was OH index as modified by green and Vermillion. Periodontal status was obtained by applying the CPTIN index. The plaque reduction was significant in groups A and B. When the solution was applied, it was noted the reduction in bleeding sextants. Results showed »Meridol« solution to be recommendable together with proper oral hygiene in the prophylactic treatment o f decay and gingivitis.U radu je ispitivan učinak Meridol tekućine za ispiranje usta (koja sadrži SnF2 i amin fluorid 297) na plak i gingivu. Ispitivanje je provedeno u četiri skupine djece. Skupina A ispirala je usta jedanput tjedno tijekom 6 mjeseci, skupina B jedanput dnevno tijekom mjesec dana, a skupine KA i KB bile su kontrolne. Kriterij za objektivnu registraciju plaka bio je OHI - indeks prema Greenu i Vermillionu. Podaci o stanju parodonta dobiveni su primjenom CPITN indeksa. Smanjenje plaka u A i B skupini bilo je značajno. Primjenom samo Meridola nisu uočene promjene na parodontnom tkivu gdje je već došlo do bolesnih promjena, uočeno je jedino smanjenje sekstanta s krvarenjem iz gingivnoga sulkusa. Rezultati ispitivanja pokazuju kako se Meridol tekućina može preporučiti u profilaksi karijesa i gingivitisa, uz odgovarajuće pravilno provođenje oralne higijene

Alenka Rajić

Neda Zdilar-Černy

Zdravko Rajić

English

HRČAK - Portal of Croatian Scientific and Professional Journals

Comparative Study on Meridol Solution Effect in Reducing Inflammatory Changes in the GumsKomparativna studija o djelovanju meridol tekućine na smanjenje upalnih promjena gingiveZdravko Rajić Neda Zdilar -  Černy * Alenka Rajić**Zagreb University Schoolof DentistryUnit of Children’s andPreventive DentistryDubrava Health Center,ZagrebUniversity Dental Clinic, ZagrebSummaryThe aim o f this study was to evaluate the effects o f »Meridol« solution for mouth rinsing (containing SnF2 and aminfluoride 297) on plaque and gingiva. The study was carried out in four groups of children. Group A rinsed their mouth once a week during six months, group B once a day for a month, while groups KA and KB served as control. The criterion for relevant plaque recording was OH index as modified by green and Vermillion. Periodontal status was obtained by applying the CPTIN index. The plaque re­duction was significant in groups A  and B. When the solution was applied, it was noted the reduction in bleeding sextants. Results showed »Meridol« solution to be recommendable together with proper oral hygiene in the prophylactic treatment o f decay and gin­givitis.Key words: mouth rinses, gingivitis, plaqueActa Stomatol. Croat. 1993; 27: 181-186ORIGINALPAPERReceived: 16 May 1993 Primljeno: 16. svibnja 1993.IntroductionThe severity of tooth decay has been gradual­ly decreased. However, inflammatory changes of the gingiva in children and periodontal chan­ges in older children resulting from poor hygi­ene are ever more frequently encountered (1,2). The plaque is a factor contributing to the onset and progression of decay and periodontal di­seases. Therefore, prevention and removal of the existent plaque is of a paramount importan­ce in the prophylactic treatment (3, 4, 5). In order to resolve this problem, many chemo­therapeutic agents have been tested. Most suit­able are those added to mouth rinse solutions. Stannous ions provide antibacterial effects byActa Stomatol. Croat., Vol. 27, br. 3, 1993.acting on the protein surface of bacteria, thus blocking the passage of carbohydrates into the cells (6, 7).Based the knowledge obtained so far about the effects of aminfluoride on bacterial adhe­rence and the effect of stannous fluoride (SnF2), these active substances are added to mouth rinse solutions. The »Meridol« solution used in this study contains active substances, such as aminfluoride 297 and stannous fluoride (SnF2), dissolved in destilled water with dye and flavor added. These substances in »Meri­dol« inhibit the formation of plaque, neutralize the bacterial action in the already existent plaque and favor the resistance of oral mucosa.181A S CZ Rajić et al. Mouthrinse Solution EffectThe aim of this study was to clinically evalu­ate the effect of »Meridol« solution on plaque index and gingival tissue.Methods and examineesThe criterion for unbiased plaque recording is determined by oral hygiene index (OHI) mo- difed by Green and Vermillion. Data on perio­dontal findings are collected by applying the CPITN index with probes (WHO Recording Periodontal Probe) to assess gingival bleeding, detect calculus and determine the depth of pe­riodontal pockets according to the latest WHO standards and methods.The OHI data are statistically processed at the Zagreb University Computer Center, based on the Stuart’s test of dependent samples. The study included four group of children of both sexes, aged 8-18 years. During the study pe­riod, no instructions were given as to oral hy­giene procedures, in order to avoid any possible educational influence on the results.Group A consisted of 67 children who rinsed their mouth with 100 ml of »Meridol« solution once a week for six months. In group A, OHI and CPITN indices were determined at the be­ginning of the study and six months later. Group B (31 child) rinsed their mouth once a day during one month. Plaque index and perio­dontal status were evaluated before and after the »Meridol« treatment. Groups KA (58 chil­dren) and KB (29 children) were control groups. In group KA, the above listed parame­ters were determined at the beginning of the study and six months later, and in group KB at the beginning of the study and one month later.ResultsIn group A, grade III of oral hygiene was found in 47.7% children (OHI ranging between 3.1 and 6.0) before the »Meridol« treatment; grade II of oral hygiene was present in 40.4% (OHI ranging between 1.6 and 3.0), whereas grade I was found in 11.9% children (OHI ran­ging between 0 and 1.5).After the six-month treatment with »Meridol« solution, the best results were achieved in the children who had the poorest oral hygiene sta­tus (grade III). Their percentage was reduced182Table 1. OHI index -  group A Tablica 1. OHI indeks -  grupa AGradeCheck-up I (0-1.5) 11(1.6-3.0) 111(3.1-6.0)I 11.9% 40.4% 47.7%II 14.9% 56.7% 28.3%Difference 3.0% 16.3% 19.4%Table 2. OHI index -  group KA Tablica 2. OHI indeks -  grupa KÄGradeCheck-up I (0-1.5) 11(1.6-3.0) 111(3.1-6.0)I 0% 46.5% 53.4%II 6.8% 37.9% 55.1%Difference 6.8% 8.6% 1.7%from 47.7% to 28.3%, i.e. by 19.4%. In the group with grade II oral hygiene, this percenta­ge increased from 40.4% to 56.7% (16.7%). Very similar results were obtained in the group with grade I oral hygiene, where an increase from 11.95 to 14.9% (3%) was observed.At the beginning of the study, control group KA, who received no treatment, had grade III oral hygiene index in 53.4% of the children and grade II in 46.6% of the children. No subject was free of plaque. The oral hygiene status was reexamined six months later, revealing grade III oral hygiene to have risen from 53.4% to 55.1% (1.7%). Grade II was found in 37.9% children, I.e. a 8.6% improvement in compari­son with the previous examination. 6.8% chil­dren had grade I, i.e. 6.8% of them more than in the first checkup.Table 3. OHI index -  group B Tablica 3. OHI indeks -  grupa BGradeCheck-up I (0-1.5) 11(1.6-3.0) 111(3.1-6.0)I 0% 6.4% 93.5%II 9.6% 38.7% 51.6%Difference 9.6% 32.3% 41.9%Acta Stomatol. Croat., Vol. 27, br. 3, 1993.A S CZ. Rajić et al. Mouthrinse Solution EffectGroup B had 93.5% children with grade III before the treatment, while only 6.4% of the children had grade II. None was found to have grade I. After a month of daily rinsing with »Meridol« solution 51.6% of the subjects show­ed grade III (a 41.9% increase in comparison with previous findings). Grade II increased from 6.4% to 38.7% (32.3%). Grade I was pre­sent in 9.6% children.Table 4. OHI index -  group KB Tablica 4. OHI indeks -  grupa KBGradeCheck-up I (0-1.5) 11(1.6-3.0) 111(3.1-6.0)I 0% 51.7% 48.2%II 3.4% 44.8% 51.7%Difference 3.4% 6.9% 3.5%Control group KB had the following pre­treatment results: grade III was present in 48.2% and grade II in 51.7% of the children; no child had grade I. After one month grade III in­creased by 3.5%, i.e. from 48.2% to 51.7%; grade II decreased by 6.9%, i.e. from 51.7% to 44.8% and 3.4% of the children had grade I of oral hygiene.Statistical data processing showed that im­proved results on the oral hygiene index after »Meridol« treatment were statistically signifi­cant in both study groups. It should be mentio­ned that the control groups did not show anyTable 5. Results of statistical data -  group A and group B Tablica 5. Rezultati statističkih podataka -  grupe A i grupe BGroup AGrupa ACheck-up after six months0-1.5 1.6-3.0 3.1-6.00-1.5% 3 4 01.6-3.0 4 19 13.1-6.0 4 20 12x2 = 21.17 df = 2 N = 67Group B Grupa BCheck-up after one month0-1.5 1.6-3.0 3.1-6.00-1.5% 3 0 01.6-3.0 2 1 03.1-6.0 2 14 12x2 = 17.07 N = 31df = 2 P<0.01Table 6. CPITN index -  group A  Tablica 6. CPITN indeks -  grupa ASextantCheck-up 0 1 2 3I 52.5% 12.9% 17.2% 17.4%II 57.7% 6.8% 17.9% 17.4%Difference 5.2% 6.1% 0.7% 0 %0 -healthy1 -bleeding2 -  calculus3 -  pockets0 -  zdravi1 -  krvarenje2 -  kamenac3 - džepovisignificant difference in the oral hygiene index between the pre and post-treatment examina­tions.The periodontal tissue condition was evalua­ted on the basis of CPITN index. Group A had the following results at the beginning of the stu­dy: out of 402 sextants examined, 52.5% were healthy, in 12.9% bleeding was present, 17.2%Table 7. CPITN index -  group KA Tablica 7. CPITN indeks -  grupa KÄSextantCheck-up 0 1 2 3I 50.9% 21.6% 16.4% 11.2%II 52.6% 19.8% 15.8% 11.8%Difference 1.7% 1.8% 0.6% 0.6%PcO.Ol0 -  healthy1 -bleeding2 - calculus 3 -  pockets0 -  zdravi1 - kivarenje2 -  kamenac3 -  džepoviActa Stomatol. Croat., Vol. 27, br. 3, 1993. A S C 7 83Z Rajić et al. Mouthrinse Solution Effecthad calculus and 17.4% had pockets. After 6 months of rinsing with »Meridol«, the number of healthy sextants increased from 52.5% to 57.7% (5.2%); 6.8% sextants were bleeding,i.e. 6.1% of them less than on previous exami­nation. Calculus were present in 17.9% of the sextants (a 0.7% reduction), while the percen­tage of sextants with pockets remained un­changed, i.e. 17.9%.In group KA, 348 sextants were examined. At the beginning of the study, 50.9% of them were healthy, 21.6% were bleeding, 16.4% had calculus, and 11,4% had periodontal pockets. Six months later, in the same number of exami­ned sextants, there were 52.6% healthy sex­tants, 19.8% of them bleed from gingival sul­cus, and 11.8% had pockets. Thus, 5.2% sex­tants were healthier, 6.8% had reduced blee­ding tendencies, calculus were present in 0.7% of sextants less than previously, and the percen­tage of sextants with pockets remained un­changed.Table 8. CPITN index -  group B Tablica 8. CPITN indeks -  grupa BSextantCheck-up 0 1 2 3I 8.1% 39.5% 41.1% 11.9%II 18.8% 30.3% 39.5% 11.9%Difference 10.7% 9.2% 1.6% 0 %0 - healthy 0 - zdravi1 -bleeding 1 - krvarenje2 -  calculus 2 -  kamenac3-pockets 3-džepoviIn group B, rinsing their oral cavity with »Meridol« once a day during one month, 186 sextants were tested in total at the beginning of the study and one month later. Only 8.1% of healthy sextants were found at the beginning; 39.5 were bleeding from gingival sulcus, 41.1% had calculus and 9.2% had pockets.In control group KB, 174 sextants were exa­mined. At the beginning of the study, 47.1% were healthy, 22.4% had bleeding tendencies, 20.7% had calculus, and 2.9% had pockets. A month later, 48.3% of the sextants were healthy (1.2% more than previously), while the percen-184tage with calculus and pockets remained almost unchanged.Table 9. CPITN index -  group KB Tablica 9. CPITN indeks -  grupa KBSextantCheck-up 0 1 2 3I 47.1% 22.4% 20.7% 9.2%II 48.3% 21.8% 20.7% 9.8%Difference 1.2% 0.6% 0 % 0.6%0 -healthy 0 - zdravi1 -  bleeding 1 -  krvarenje2 -  calculus 2 -  kamenac3-pockets 3 -džepoviDiscussion and conclusionThis study showed that the use of »Meridol« mouth rinsing solution containing active sub­stances, such as aminfluoride 297 and stannous fluoride (SnF2), reduces the amount of plaque, the reduction being statistically significant for groups A and B (8, 9). A slight improvement in plaque reduction was even noted in control groups. This might be explained by and ascri­bed to the presence of dentists at the school where mouth rinsing was carried out.The change in the periodontal status accor­ding to clinical findings in control groups was not statistically significant, which could be attri­buted to the presence of the dentist during each »Meridol« mouth rinsing. This change was due to too long rinsing intervals in group A (alto­gether once a week). In the control group KA oral hygiene instructions were needed in 21.6% of the sextants, calculus removal and oral hygie­ne instructions in 16.9% of the sextants, whe­reas in 11.2% complete treatment was necessa­ry. Group B performed rinsing once per day, but for a short period of one month. The pre­sence of bleeding from the gingival sulcus and layers of calculus following certain probe pres­sure, are the first signs of periodontal diseasej requiring prophylactic treatment, i.e. removal of bacterial plaque and calculus.The results, based on the CPITN index after the completition of the study, showed that 57.7% of the sextants in group A needed regu-Acta Stomatol. Croat., Vol. 27, br. 3, 1993.A S CZ. Rajić et al. Mouthrinse Solution Effectlar oral hygiene only; 6.8% of the sextants re­quired education in oral hygiene; 17.9% of the sextants required calculus removal and additio­nal education in oral hygiene, completed with full treatment; 16.4% needed oral hygiene ins­tructions and calculus removal; 11.2% needed complete treatment. In group B, after a month of mouth rinsing with »Meridol« solution 30.3% of the sextants needed oral hygiene in­structions, 39.5% needed calculus removal and oral hygiene instructions, and 11.9% needed complete treatment. In control group KB, 22.4% needed oral hygiene instructions, 20.7% needed calculus removal and instructions, while 9.2% needed complete treatment.After the »Meridol« solution treatment, a slight reduction was observed in the number of sextants with bleeding. Some authors found areduction in bleeding tendencies with the appli­cation of SnF2 (10).When »Meridol« solution was used once a week for six months no side effects were recor­ded, e.g., no yellow coloration of the teeth, which was observed by other authors when some other mouth rinse solutions containing stannous fluoride were applied. No side effects were present even when »Meridol« solution was applied daily for a month.In conclusion, we may say that »Meridol« mouth rinse solution is recommendable in the prophylactic treatment of decay and gingivitis along with regular and proper oral hygiene. This solution should also be recommended in cases with an increased risk of decay and gingi­vitis, as well as when oral hygiene has been ne­glected.KOMPARATIVNA STUDIJA O DJELOVANJU MERIDOL TEKUĆINE NA SMANJENJE UPALNIH PROMJENA GINGTVEAddress for correspondence: Adresa za korespondenciju:SažetakU radu je ispitivan učinak Meridol tekućine za ispiranje usta (koja sadrži SnF2 i amin fluorid 297) na plak i gingivu.Ispitivanje je provedeno u četiri skupine djece. Skupina A ispi­rala je usta jedanput tjedno tijekom 6 mjeseci, skupina B jedanput dnevno tijekom mjesec dana, a skupine KA i KB bile su kontrolne.Kriterij za objektivnu registraciju plaka bio je OHI -  indeks prema Greenu i Vermillionu. Podaci o stanju parodonta dobiveni su primjenom CPITN indeksa. Smanjenje plaka u A i B skupini bilo je značajno. Primjenom samo Meridola nisu uočene promjene na parodontnom tkivu gdje je već došlo do bolesnih promjena, uo­čeno je jedino smanjenje sekstanta s krvarenjem iz gingivnoga sul- kusa.Rezultati ispitivanja pokazuju kako se Meridol tekućina može preporučiti u profilaksi karijesa i gingivitisa, uz odgovarajuće pra­vilno provođenje oralne higijene.Ključne riječi: ispiranje usta, gingivitis, plakDr. Zdravko Rajić School of Dentistry Gunduličeva 5 41000 Zagreb, CroatiaActa Stomatol. Croat., Vol. 27, br. 3, 1993. A S C 185Z Rajić et al. Mouthrinse Solution EffectReferences1. HRASTE J. Socijalna stomatologija i oralna epide- miologija. Zagreb: Školska knjiga, 1982.2. RAJIĆ Z. i sur. Dječja i preventivna stomatologija. Zagreb: Jumena, 1985.3. Prevention of oral diseases. Erfurt: WHO, 1983.4. STAMM J W. Epidemiology of gingivitis.J Clin Periodontol 1986; 13:360-66.5. AURER-KOŽELJ J, VOUK M, BAČIĆ M, SRĐAK-JORGIĆ K, VUTUC-PAVLIĆ B, PLAN- ČAK D. Prevalencija bolesti parodonta na području općine Labin, Zbornik radova, Dani primarne zdrav­stvene zaštite Labin 1985., Labin 1985.6. TINANOFF N, HOCK J, CAMOSCI D, HELDEN L. Effect of stannous fluoride mouthrinse on dental plaque formation. J Clin Periodontol 1988; 7:232-2417. LARSON L C, ALLEN J M, HYMAN J J, PELLEN B G. Effect of a 0,2% SnF2 mouthrinse on gingival tissues and associated microflora. Clin Prevent Dent. 1985; 6:5-98. MUEHLEMANN H R. Aminfluoride und ihre An­wendung. Dtsch Zahnärztl Z 1983; 38:3-59. Oral Health Surveys Basic Methods, 3 d. Geneva: Who 1987.10. ZIMMERMANN A, FLORES DE JACOBY L, PAN P. Die Parodontalgesundheit unter Langzeitan­wendung von Meridol. Dtsch Zahnärztl Z 47:337-340 (1992) 5.186 A S C Acta Stomatol. Croat., Vol. 27, br. 3, 1993.

Komparativna studija o djelovanju meridol tekućine na smanjenje upalnih promjena gingive

Abstract

Similar works

Full text

Available Versions

HRČAK - Portal of Croatian Scientific and Professional Journals