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Shikonin is extracted from the roots of Lithospermum erythrorhizon, and shikonin extracts have been shown to have inhibitory effects on several bacteria. However, shikonin extracts are difficult to formulate because of their poor water solubility. In the present study, we prepared a shikonin dispersion, which was solubilized by the inclusion of β-1,3-1,6 glucan, and analysed the inhibitory effects of this dispersion on Streptococcus mutans and non-mutans streptococci. The shikonin dispersion showed pronounced anti-S. mutans activity, and inhibited growth of and biofilm formation by this bacterium. The shikonin dispersion also showed antimicrobial and antiproliferative effects against non-mutans streptococci. In addition, a clinical trial was conducted in which 20 subjects were asked to brush their teeth for 1 week using either shikonin dispersion-containing or non-containing toothpaste, respectively. The shikonin-containing toothpaste decreased the number of S. mutans in the oral cavity, while no such effect was observed after the use of the shikonin-free toothpaste. These results suggest that shikonin dispersion has an inhibitory effect on S. mutans and non-mutans streptococci, and toothpaste containing shikonin dispersion may be effective in preventing dental caries.

High-fluoride dentifrice is used to manage root caries, but there is no evidence whether its association with nanohydroxyapatite could provide an additional protection for root caries. Therefore, this study aimed to develop and evaluate the effect of an experimental dentifrice with high fluoride (F ) concentration and nanohydroxyapatite (nano-HA) on root dentin demineralization. After formulation of dentifrices, root dentin specimens were randomly assigned to six groups (n = 10) using different dentifrice treatments: placebo; nano-HA without F ; 1,100 µg F /g; 1,100 µg F /g + nano-HA; 5,000 µg F /g; and 5,000 µg F /g + nano-HA. A pH cycling model was performed for 10 days, in which treatments were performed twice a day. After that period, the longitudinal hardness was evaluated and the area of demineralization (ΔS) was calculated. The formulated dentifrices were evaluated for primary stability, cytotoxicity, and other technical parameters. Two-way ANOVA and Tukey's test with p set at 5% were used for data analysis. The experimental dentifrices were stable and had no cytotoxicity. Regarding dentin demineralization, the placebo group significantly increased ΔS compared to all other treatment groups (p<0.001). The dentifrices containing 5,000 µg F /g, regardless of the presence of nano-HA, led to a smaller lesion area in relation to the other treatments (p<0.001). The findings of this study suggest that nano-HA reduced dentin demineralization, and dentifrice with 5,000 µg F /g dentifrices, regardless of the presence of nano-HA, showed a greater reduction in root dentin demineralization.

Objectives The aim of this study was to compare the efficacy of a dentifrice without sodium lauryl sulfate (SLS) to a dentifrice with SLS in young adults aged 18–34 years on gingivitis. Material and methods One hundred twenty participants (non-dental students) with a moderate gingival inflammation (bleeding on probing at 40–70 % of test sites) were included in this randomized controlled double blind clinical trial. According to randomization, participants had to brush their teeth either with dentifrice without SLS or with SLS for 8 weeks. The primary outcome was bleeding on marginal probing (BOMP). The secondary outcomes were plaque scores and gingival abrasion scores (GA) as well as a visual analogue scale (VAS) score at exit survey. Baseline and end differences were analysed by univariate analysis of covariance (ANCOVA) test, between group differences by independent t test and within groups by paired sample t test. Results BOMP improved within groups from on average 0.80 at baseline to 0.60 in the group without SLS and to 0.56 in the group with SLS. No statistical difference for BOMP, plaque and gingival abrasion was found between both groups. VAS scores for taste, freshness and foaming effect were significantly in favour of the SLS-containing dentifrice. Conclusion The test dentifrice without SLS was as effective as a regular SLS dentifrice on gingival bleeding scores and plaque scores. There was no significant difference in the incidence of gingival abrasion. Clinical relevance In patients diagnosed with gingivitis, a dentifrice without SLS seems to be equally effective compared to a dentifrice with SLS and did not demonstrate any significant difference in gingival abrasion. In patient with recurrent aphthous ulcers, the absence of SLS may even be beneficial. However, participants indicate that they appreciate the foaming effect of a dentifrice with SLS more.

Context. The comparison of fluoride levels in saliva and plaque following the use of conventional, 2800 and 5000 ppm dentifrices for different time intervals up to 24 hours has not been explored. Aim. The aim of the present study was to assess salivary and plaque fluoride levels at different time intervals following the use of high fluoride dentifrices. Study Design. This randomised control trial was conducted on sixty adolescents between the age group of 16 and 18 years divided into three groups A, B, and C. Intervention. Subjects were asked to brush the occlusal surfaces of posterior teeth with one of the dentifrices for 2 min. Unstimulated whole saliva and plaque samples were collected at different time intervals. Fluoride levels were determined using SPADNS method. Data was collected and statistically analyzed using SPSS 20 Inc. by mixed repeated measure ANOVA. Results. A significant difference in fluoride levels was observed at different time intervals in both saliva (p=0.048) and plaque (p=0.03). The variance was low with time and concentration of the dentifrice used in saliva, whereas the magnitude of treatment was large for time (>0.25) but small for (<0.09) concentration in plaque. Conclusion. A significant difference in fluoride levels was observed at different time intervals in both saliva and plaque among the three groups. There was a positive correlation between fluoride levels in saliva and plaque. Both high fluoride dentifrices were effective in maintaining higher intraoral fluoride levels up to 12 hours and 5000 ppm up to 24 hours compared to conventional dentifrice.

Background Dental erosion and abrasion lead to progressive enamel loss, and preventive strategies often rely on fluoride dentifrices. Bioactive silica has emerged as a promising component due to its remineralizing potential, acting alone or synergistically with fluoride. This in vitro study evaluated the efficacy of bioactive silica dentifrices, with or without different fluoride concentrations, in promoting enamel remineralization and protecting against erosion‒abrasion cycles. Methods Sixty bovine enamel samples were assigned to five groups: RGS1 (bioactive silica dentifrice with 1450 ppm F), RGS2 (bioactive silica dentifrice with 1100 ppm F), RGS3 (bioactive silica dentifrice without fluoride), positive control (PC, 1100 ppm F dentifrice), and negative control (NC, fluoride- and silica-free dentifrice). The samples were subjected to a 5-day erosion-abrasion cycle with daily treatment with the assigned dentifrices. Enamel changes were assessed through surface microhardness recovery (%SMHR), fluorescence recovery (%ΔFR), surface loss (ΔSL), and surface roughness variation (ΔRa). The data were analyzed via one-way and repeated-measures ANOVA, followed by Tukey’s post hoc test (α = 0.05). Results All tested dentifrices significantly affected enamel properties. Compared with the controls, bioactive silica dentifrices improved the microhardness and promoted greater mineral gain ( p  < 0.05). RGS2 demonstrated the highest %SMHR and ΔFR values, along with lowest surface roughness and enamel loss, indicating superior protective potential. RGS1, RGS3 and PC followed, with intermediate outcomes. The NC group exhibited the poorest performance across all the parameters evaluated ( p  < 0.05). Conclusion Bioactive silica dentifrices significantly enhance enamel remineralization and protection against erosion-abrasion. The results highlight both the synergistic and independent roles of bioactive silica, supporting its application in daily oral care strategies for managing enamel wear. Clinical trial number Not applicable.

Originality/value: Analysis of multiple Asian countries' perspectives as observed by respondents from different countries on usage of visual elements is a key contribution on gender stereotyping.

Objectives To compare the effectiveness of using a 0.454% stannous fluoride-containing dentifrice twice daily in relieving dentinal hypersensitivity (DH) in a Chinese population. Materials and methods This was a single-centre, randomized, controlled, examiner-blind, three-treatment-arm, parallel-group study in participants with clinically diagnosed DH. Subjects who met inclusion criteria (n = 197) were randomly allocated into 3 groups: test group (n = 66)—using a 0.454% stannous fluoride-containing dentifrice twice daily; positive control group (n = 64)—using a 5.0% calcium sodium phosphosilicate-containing dentifrice twice daily; negative control group (n = 67)—using a 1150 ppm of NaF dentifrice twice daily. Status of DH was assessed at week 4 and week 8 by the same independent examiner. Changes from baseline in Schiff sensitivity score, tactile threshold and Dentine Hypersensitivity Experience Questionnaire (DHEQ) score were analysed using analysis of covariance models. The DHEQ evaluated subject-perceived oral health-related quality of life (OHRQoL). Results Statistically significant improvements in mean Schiff scores (p < 0.0001 for all products at Weeks 4 and 8), tactile threshold (p < 0.0001 for test and negative control at Weeks 4 and 8: Week 4 p = 0.0040 and Week 8 p < 0.0001 for positive control) and all DHEQ scores (p < 0.01 for all groups) were observed. No statistically significant differences were observed in the adjusted mean between all dentifrices at both timepoints, potentially driven by a placebo effect. Forty-two treatment-emergent adverse events (TEAEs) were reported (n = 32 subjects), with 2 serious AEs (n = 1) in the test group. TEAEs were not considered treatment-related. Conclusions All groups demonstrated statistically significant improvements in Schiff score, tactile threshold and OHRQoL. However, due to a possible placebo effect in the negative control, there were no statistically significant differences between the dentifrices. Clinical relevance This study adds to the growing research exploring why the placebo effect is a common phenomenon in DH studies. Trial registration: ClinicalTrials.gov Identifier: NCT04950465.

Objectives The present study evaluated fluoride (F) and calcium (Ca) concentrations in the biofilm fluid formed in situ under cariogenic challenge after using F dentifrices supplemented or not with sodium trimetaphosphate (TMP) or calcium glycerophosphate (CaGP). Methods Volunteers ( n  = 12) were randomly divided into 5 groups according to the toothpastes used: placebo (without F, CaGP or TMP), 1100 ppm F (1100F) and low-fluoride dentifrice (LFD, 550 ppm F) with no supplementation (550F) or supplemented with 1 % TMP (550F-TMP) or 0.25 % CaGP (550F-CaGP). In each phase, volunteers wore palatal appliances containing 4 bovine enamel blocks. Cariogenic challenge was performed with 30 % sucrose solution, 6 times/day. On the morning of the eigth day, biofilm samples were collected 12 h and 1 h after brushing and cariogenic challenge. F and Ca analyses in the biofilm fluid were performed with the inverted electrode after buffering with TISAB III and using the Arsenazo III method, respectively. Data were submitted to two-way ANOVA (repeated measures) and Student-Newman-Keuls test ( p  < 0.05). Results A dose-response relationship was verified between F concentrations in the dentifrices and in the biofilm fluid. Significant differences were observed among placebo, 550F, and 1100F only 1 h after brushing, without statistical differences among 550F, 550F-TMP, and 550F-CaGP. No defined trend was observed among the groups regarding Ca concentrations, with the highest values seen for placebo and 550F-CaGP. Conclusion The anticaries effect of LFDs supplemented with CaGP or TMP cannot be related to an increased availability of F and Ca in the biofilm fluid. Clinical significance The better performance of LFDs containing CaGP or TMP shown in previous studies should be attributed to their ability to interact with tooth enamel and with the biofilm, rather to their effect on the biofilm fluid.

There is a lack of clinical studies comparing dentifrices with high fluoride (F) concentration. The aim was to evaluate a dentifrice containing 5,000 ppm F compared to a dentifrice containing 1,450 ppm F in caries-active adolescents. The design was a 2-year, single-blind randomized controlled trial and 211 adolescents of 279 (76%) completed the trial. The subjects were divided into two groups and were given one of the assigned F dentifrices for daily unsupervised toothbrushing: (1) Duraphat 5,000 ppm F and (2) Pepsodent Superfluor 1,450 ppm F, both as NaF. The outcome variables were caries incidence and progression of proximal and occlusal caries. The subjects were asked to fill in a questionnaire to evaluate their compliance and they were divided into two subgroups: subgroup A, excellent compliance, and subgroup B, poor compliance. The latter group (28%) comprised the subjects who did not brush twice a day or did not use the dentifrice regularly. Adolescents using 5,000 ppm F toothpaste had significantly lower progression of caries compared to those using 1,450 ppm F toothpaste (A: p < 0.01, B: p < 0.001), with a prevented fraction of 40%. Subjects using 5,000 ppm F toothpaste had significantly lower caries incidence for compliance B compared to those using 1,450 ppm F toothpaste (p < 0.05); the prevented fraction was 42%. This may indicate that 5,000 ppm F toothpaste has a greater impact on individuals who do not use toothpaste regularly or do not brush twice a day. Thus, 5,000 ppm F toothpaste appears to be an important vehicle for caries prevention and treatment of adolescents with a high caries risk.

ObjectiveTo evaluate retention of intraoral fluoride in biofilm and saliva, an experimental dentifrice containing hydrocolloid (tara gum) was used as a controlled-release system for fluoride (F).Materials and methodsIn a triple-blind randomized crossover trial with washout, 18 individuals used the following different dentifrices for a week: 100-TGF (sodium fluoride NaF associated with tara gum, 1100 mg/L), 50-TGF (50% NaF associated with tara gum + 50% free NaF, 1100 mg/L), PC (free NaF, 1100 mg/L), TG (with tara gum and without F), and placebo (without F or tara gum). On the seventh day of dentifrice use, biofilm was collected at 1 and 12 h, and saliva was collected up to 60 min and 12 h after the last toothbrushing. F concentrations were determined by physico-chemical analysis of fluoride using the hexamethyldisiloxane-facilitated diffusion technique. Data were subjected to two-way analysis of variance (repeated measures) and Spearman’s correlation coefficient (p < 0.05) testing.ResultsNo significant difference was observed with the same dentifrice regarding F retention in biofilm at 1 and 12 h after toothbrushing for the 100-TGF, placebo, and TG groups (p > 0.05). The highest area under the curve values in saliva were found for the 50-TGF, 100-TGF, and PC groups.ConclusionThe dentifrice containing hydrocolloid as a controlled-release system for F promoted F retention in the oral cavity, even at 12 h after brushing.Clinical relevanceHydrocolloid added to dentifrices as a controlled-release system for F might contribute to a higher anti-caries effect.Trial registrationNCT02809014