Modern biofilm management and gum protection with hydroxyapatite: clinically tested
introduction
The oral biofilm consists of numerous different microorganisms. Up to 700 different bacteria can be found in the entire oral cavity. Each of these bacteria is able to settle in a biofilm, i.e. a polymicrobial community on the surface of the tooth enamel. The biofilm, often also called plaque, first develops on the gum line. Interactions with the host and its immune system can lead to inflammation of the gums (gingivitis) and even periodontitis. Therefore, it is important to control the plaque and remove it regularly. The best way to do this is to brush your teeth every day, i.e. mechanical plaque removal. Certain active ingredients in dental care products support plaque removal and thus biofilm control.
Question
Is a hydroxylapatite toothpaste just as effective in preventing periodontal disease as the previous gold standard with amine fluoride and tin fluoride?
material and methods
The study was carried out as a double-blind, randomized, parallel study at two different study centers (University Hospital Münster and University Hospital Würzburg). The duration of the study was three months and the formation of new plaque (plaque forming rate / PFR) was selected as the primary study outcome. Additional secondary parameters were also considered. The patients all had mild to moderate chronic periodontitis (tooth pocket depth of ≥ 4 mm on at least 4 teeth). All patients were trained in how to maintain oral hygiene at the start of the study. The patients were then randomly divided into two groups: One group used a toothpaste containing amine / tin fluoride (control) and a second group used a toothpaste containing hydroxylapatite for oral and dental care. Initially, the dental care products were used as before in home dental care. After professional teeth cleaning and periodontal therapy, the patients carried out their dental and oral care at home as instructed. The PFR was measured at regular control visits (after 4 weeks and 12 weeks). Finally, the results were checked for statistically significant differences between the groups with regard to the PFR.
Results
Figure: PFR hydroxyapatite (HAP) and amine fluoride / tin fluoride in comparison.
A total of 67 patients were included in the study. The patients were evenly divided between the two groups (amine / tin fluoride and hydroxyapatite). The mean age in both groups was 53 years (± approx. 13 years). The PFR was similar in both groups. Overall, the PFR could be improved. The secondary parameters also showed an even improvement in oral health in both groups. There were no significant differences in the PFR between the group with an amine / tin fluoride containing toothpaste and the group with a hydroxyapatite containing toothpaste.
Figure: PFR hydroxyapatite (HAP) and amine fluoride / tin fluoride in comparison.
conclusion
From a clinical point of view, a toothpaste containing hydroxylapatite is recommended for periodontitis prophylaxis, as is the established gold standard with amine and tin fluorides.