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Contexte: La fente labio-palatine complete unilateral (UCLP) est une malformation hereditaire ou multifactorielle qui peut etre corrigee avec succes par un traitement combine d'orthodontie, de chirurgie etde dentisterie restauratrice. Une telle approche multidisciplinaire dure de longues annees et reclame beaucoup de precautions vis a vis des dents et du parodonte du patient. Objectifs: Cette etude en bouche divisee avait pour but de comparer la sante parodontale et les parametres microbiologiques entre les regions des fentes et les autres. Materiel et methodes: 75 patients (52 hommes, 23 femmes) âges de 8 a 20 ans, et presentant une fente labio-palatine unilaterale complete (avant (n = 30), pendant (n = 34) et apres (n=11) le traitement orthodontique actif) se sont portes volontaires pour cette etude. Quatre regions ont ete determinees pour la comparaison en bouche divisee: les dents au voisinage de la fente (site 1), la dent dans la fente (site 2), et les dents contra-laterales correspondantes, respectivement, dans les quadrants non atteints (sites 3 et 4). Sur chaque site, les parametres parodontaux suivants ont ete releves: indices de plaque et de gingivite, profondeur de poche et perte d'attache, saignement au sondage, mobilite dentaire, (determinee a la vue et au Periotest), la perte osseuse radiographique et l'epaisseur de la gencive. En outre, trois echantillons de plaque sous gingivale groupes furent preleves (autour de la dent de la fente, sur les dents regardant la fente et sur les dents contra-laterales de cette derniere). Resultats: Les differences entre les dents voisines de la fente et les dents contra-laterales correspondantes etaient a la limite de la signification statistique (P≤0.05) pour l'indice de plaque, les profondeurs au sondage proximales et la perte d'attache (Les dents en regard de la fente ayant toujours des valeurs des parametres legerement plus forte). Lorsque la dent dans la fente etait comparee a la dent contra-laterale, les differences ne se rencontraient plus que pour les profondeurs de poches au sondage proximales, la perte d'attache et la perte osseuse, qui etaient significativement plus importantes pour la dent de la fente. L'analyse microbiologique ne revele aucune difference entre les differents sites, ni pour la proportion de bacteries aerobies et anaerobies (differences

Background: Breath odour is a complaint encountered worldwide, often linked to microbial overload in the oral cavity. This double blind, crossover, randomised study assessed the efficacy of several antiseptic mouthrinses or slurry vs. a control solution in the prevention of morning bad breath during an experimental period of 7 days without mechanical plaque control. Methods: Sixteen dental students with a healthy periodontium abolished, after a thorough professional cleaning, all means of mechanical plaque control during five experimental periods of 7 days, interleaved by washout periods of at least 3 weeks. During each experimental period, as the only oral hygiene measure, the students rinsed twice a day with one of the following formulations (in a randomised order): a 0.2% chlorhexidine-alcohol mouthrinse (CHX-Alc), a 0.05% CHX + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse (CHX-CPC-Zn), an amine fluoride/stannous fluoride (125 ppm F–/125 ppm F–) containing mouthrinse (AmF/SnF2Mr), a slurry of a tooth paste (AmF/SnF2Sl) containing amine fluoride (350 ppm F–) and stannous fluoride (1050 ppm F–) and a placebo solution (placebo). At days 0, 3 and 7, morning breath was scored via VSC level measurements of the mouth air, and organoleptic ratings of the mouth air and tongue coating. At the same visits both the degree of gingival inflammation and the de novo plaque formation were rated. At the end of each period a questionnaire for subjective ratings was completed and microbiological samples were taken from the tongue dorsum, the saliva and the supragingival plaque for anaerobic and aerobic culturing. Results: Although oral hygiene during the experimental periods was limited to rinsing, bad breath parameters systematically improved (P

Morning breath odor is an often-encountered complaint. This double-blind, crossover, randomized study aimed to examine the bad breath-inhibiting effect of 3 commercially available mouthrinses on morning halitosis during an experimental period of 12 days without mechanical plaque control.Twelve medical students with a healthy periodontium refrained from all means of mechanical plaque control during 3 experimental periods of 12 days (with intervening washout periods of at least 3 weeks). A professional oral cleaning preceded each period. During each experimental period, as the only oral hygiene measure allowed, the students rinsed twice a day with one of the following formulations in a randomized order: CHX-Alc (a 0.2% chlorhexidine [CHX] solution); CHX-NaF (CHX 0.12% plus sodium fluoride 0.05%); or CHX-CPC-Zn (CHX 0.05% plus cetylpyridinium chloride 0.05% plus zinc lactate 0.14%). After 12 days, morning breath was scored via volatile sulfur compound (VSC) level measurements of the mouth air and organoleptic ratings of the mouth air, the expired air, and a scraping of the tongue coating. At the 12-day visit, a questionnaire (subjective ratings) was completed and samples taken from both the tongue coating and the saliva for anaerobic and aerobic culturing and vitality staining. The de novo supragingival plaque formation was also recorded. All parameters were correlated with the baseline registrations.Although oral hygiene during the 3 experimental periods was limited to oral rinses, bad breath parameters systematically improved, with the exception of a slight increase in VSC levels while using CHX-Alc, a finding which was associated with the direct influence of the CHX on the sulfide monitor. The oral microbial load after the use of CHX-NaF remained unchanged, while for the CHX-Alc and CHX-CPC-Zn, significant reductions in both aerobic and anaerobic colony forming units (CFU)/ml were noticed in comparison with baseline data for both tongue coating and saliva samples. The composition of microflora, on the other hand, did not reveal significant changes. The supragingival plaque formation was inhibited, in descending order, by CHX-Alc, CHX-CPC-Zn, and CHX-NaF. The subjective scores for the rinses indicated a higher appreciation for CHX-CPC-Alc and CHX-NaF because of a better taste and fewer side effects.The results of this study demonstrate that morning halitosis can be successfully reduced via daily use of mouthrinses. CHX-Alc and CHX-CPC-Zn mouthrinses result in a significant reduction of the microbial load of tongue and saliva.

Mondvloeistof is een complexe vloeistof, grotendeels samengesteld uit een groot aantal klierspeeksels, met een geringe bijdrage van de creviculaire vloeistof en serum. Bij ontstekingen in mondweefsels neemt het aandeel van de creviculaire vloeistof en dat van serum toe. De secretie van speeksel bij de volwassene bedraagt ongeveer 500 ml/24 uur maar kan oplopen tot 1.000.

Objectives: Tongue cleaning has been advocated to improve oral malodor and to reduce reinfection of periodontal niches by eliminating tongue coating and/or reducing putrefaction by bacteria. Material and Methods: This cross-over, single-blind study on periodontitis-free, non-smoking, subjects with habitual oral hygiene (n=16), evaluated the effect of tongue cleaning (with either plastic scraper or nylon multi-tufted toothbrush), on the microbial load of the tongue dorsum (anterior and posterior of the sulcus terminalis), the extent of tongue coating, and taste sensation for bitter, sweet, salt, and sour. Both devices had been used twice daily for 2 weeks (toothbrush three forward–backward movements along the linea mediana and for each longitudinal third of the tongue; two strokes with the scraper along the linea mediana and along the borders of the tongue). Results: Two weeks of tongue brushing or scraping resulted in only negligible reductions in aerobic and anaerobic bacteria on the tongue (reductions

937 Background: Breath odor is scored by different techniques, each with its own shortcomings. Organoleptic ratings are uncomfortable for the patient, subjective, influenced by external parameters including food and cosmetics, and especially lack international calibration. Portable sulphide monitors are relatively expensive and neglect several major malodorous molecules (e.g., butyric and propionic acids, putrescine, and cadaverine). Gas chromatography necessitates expensive devices and experienced technicians. This pilot study explored the applicability of a new technique (saliva incubation) by comparing its discrimination power, in a morning bad breath inhibition study of antiseptics, to those of hydrogen sulphide (H2S) measurement devices and organoleptic ratings. Methods: After a professional cleaning, 8 periodontally healthy students abstained from all means of mechanical plaque control for 5 experimental periods of 7 days, with intervening washout periods of at least 2 weeks. During each experimental period, the students rinsed only twice daily with different antiseptics. At day 7, morning breath was scored clinically (volatile sulphide compound [VSC] level and organoleptic ratings), and 1.5 ml of saliva was collected and divided between 3 glass tubes that were sealed and incubated (37°C, anaerobic chamber). Immediately after collection and after 3 and 6 hours of incubation, the headspace air in one of the tubes was examined for VSC production and organoleptic measurements. Results: The investigations of the incubated saliva correlated well with the 7-day intraoral VSC recordings and organoleptic ratings (P ≤0.005). Moreover, evaluations showed a similar interproduct ranking for their efficacy in malodor control. The power analyses indicated a higher discrimination power for the saliva incubation test than for the intraoral registrations. Conclusions: The strong correlation between odor production of incubated saliva and clinical assessments suggests that the saliva incubation test may be used as an indirect method to measure oral malodor and can be employed to investigate the antimalodor effectiveness of oral hygiene products. J Periodontol 2003;74:937-944.

Breath odour is a complaint encountered worldwide, often linked to microbial overload in the oral cavity. This double blind, crossover, randomised study assessed the efficacy of several antiseptic mouthrinses or slurry vs. a control solution in the prevention of morning bad breath during an experimental period of 7 days without mechanical plaque control.Sixteen dental students with a healthy periodontium abolished, after a thorough professional cleaning, all means of mechanical plaque control during five experimental periods of 7 days, interleaved by washout periods of at least 3 weeks. During each experimental period, as the only oral hygiene measure, the students rinsed twice a day with one of the following formulations (in a randomised order): a 0.2% chlorhexidine-alcohol mouthrinse (CHX-Alc), a 0.05% CHX + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse (CHX-CPC-Zn), an amine fluoride/stannous fluoride (125 ppm F-/125 ppm F-) containing mouthrinse (AmF/SnF2Mr), a slurry of a tooth paste (AmF/SnF2Sl) containing amine fluoride (350 ppm F-) and stannous fluoride (1050 ppm F-) and a placebo solution (placebo). At days 0, 3 and 7, morning breath was scored via VSC level measurements of the mouth air, and organoleptic ratings of the mouth air and tongue coating. At the same visits both the degree of gingival inflammation and the de novo plaque formation were rated. At the end of each period a questionnaire for subjective ratings was completed and microbiological samples were taken from the tongue dorsum, the saliva and the supragingival plaque for anaerobic and aerobic culturing.Although oral hygiene during the experimental periods was limited to rinsing, bad breath parameters systematically improved (P0.001) with the three mouthrinses (CHX-Alc, CHX-CPC-Zn, AmF/SnF2Mr), with a superiority of the CHX-CPC-Zn solution when only VSC values were considered (P0.003). The AmF/SnF2 slurry and the placebo solution showed only minor changes with time. The three mouthrinses reduced significantly (P0.001) the bacterial load (aerobicanaerobic) in the saliva (or= 0.5 log reduction with a superiority (P0.005) for the CHX-Alc when compared to the two others). Changes in the bacterial load on the tongue dorsum could only be detected for the CHX-Alc solution (0.5 log). The antibacterial effect of the placebo solution and the slurry were negligible. The composition of microflora on the other hand did not reveal significant changes. The de novo supragingival plaque formation was significantly (P0.05) inhibited by the three mouthrinses with a slight superiority for the CHX-Alc solution. The degree of gingival inflammation at day 7 remained low (0.16) for all products. The CHX-Alc solution scored significantly worse for the subjective evaluation (questionnaires) concerning taste and sensitivity of tongue).The results of this study demonstrate that morning breath odour can be successfully reduced by the sole twice daily use of CHX-Alc, CHX-CPC-Zn or AmF/SnF2Mr mouthrinses, which all significantly reduced the bacterial load in the saliva and retarded the de novo plaque formation.

BACKGROUND Chlorhexidine (CHX) 0.2% solution, still the golden standard as mouthrinse for the prevention of plaque formation and development of gingivitis, has some limited side-effects such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain, and the content of alcohol. These side effects led to the search of new formulations. METHODS In this double-blind, randomised, cross-over study, 16 young dental students with a healthy periodontium, abolished all means of mechanical plaque control during 4 experimental periods of 11 days (separated from each other by a washout period of 3 weeks). During each experimental period, they rinsed 2x daily with one of the following mouthrinses in a randomised order: CHX 0.2% + alcohol (Corsodyl), CHX 0.12% + alcohol (Perio.Aid), CHX 0.12% + sodium fluoride 0.05% (Cariax Gingival) and CHX 0.12% + CPC 0.05% (Perio.Aid, new formulation). After 7 and 11 days of undisturbed plaque formation, clinical parameters were recorded, questionnaires completed and plaque samples (supragingivally and saliva) collected. RESULTS The CHX 0.12% + alcohol and the CHX 0.12% + CPC 0.05% formulations were as efficient as the CHX 0.2% mouthrinse in retarding de novo plaque formation (proven by clinical observations as well as by anaerobic and aerobic culture data), and always superior (p