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Clinical Trials Principles for Evaluation of Antimicrobial Drugs in Periodontal Disease Treatment

  • Alexandrina L. Dumitrescu
Chapter
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Abstract

According to the classic version of the non-specific theory in microbial aetiology of inflammatory periodontal disease, the indigenous oral bacteria in the absence of oral hygiene colonize the gingival crevice to form plaque. Inflammatory periodontal disease develops in the case of bacterial proliferation above the threshold of host resistance, caused by the combined biologic effects of the total plaque flora. All plaque bacteria are thought to have some of the various virulence factors causing gingival inflammation and periodontal destruction, and it is implied that plaque will cause disease regardless of its composition. Therefore, total plaque control is considered necessary in treatment and prevention, and this approach has certainly proved effective, where it can be carried out.

References

  1. ADA Council on Scientific Affairs. Acceptance Program Guidelines for Clinical Trial Protocols. Chicago: American Dental Association; 2007. Retrieved on http://www.ada.org/sections/scienceAndResearch/pdfs/guide_clinical_trial.pdf.
  2. Addy M, Moran JM. Evaluation of oral hygiene products: science is true; don’t be misled by the facts. Periodontol 2000. 1997;15:40–51.PubMedCrossRefGoogle Scholar
  3. Addy M, Moran J. Chemical supragingival plaque control in periodontal practice. In: Lindhe J, editor. Clinical periodontology and implantology. Oxford: Blackwell; 2007. p. 734–65.Google Scholar
  4. Addy M, Willis L, Moran J. Effect of toothpaste rinses compared with chlorhexidine on plaque formation during a 4-day period. J Clin Periodontol. 1983;10:89–99.PubMedCrossRefGoogle Scholar
  5. Addy M, Jenkins S, Newcombe R. Toothpastes containing 0.3% and 0.5% triclosan. II. Effects of single brushings on salivary bacterial counts. Am J Dent. 1989;2:215–9.PubMedGoogle Scholar
  6. Addy M, Jenkins S, Newcombe R. The effect of some chlorhexidine-containing mouthrinses on salivary bacterial counts. J Clin Periodontol. 1991;18:90–3.PubMedCrossRefGoogle Scholar
  7. Addy M, Greenman J, Renton-Harper P, Newcombe R, Doherty F. Studies on stannous fluoride toothpaste and gel (2). Effects on salivary bacterial counts and plaque regrowth in vivo. J Clin Periodontol. 1997;24:86–91.PubMedCrossRefGoogle Scholar
  8. Arweiler NB, Donos N, Netuschil L, Reich E, Sculean A. Clinical and antibacterial effect of tea tree oil-a pilot study. Clin Oral Investig. 2000;4:70–3.PubMedCrossRefGoogle Scholar
  9. Arweiler NB, Netuschil L, Reich E. Alcohol-free mouthrinse solutions to reduce supragingival plaque regrowth and vitality. A controlled clinical study. J Clin Periodontol. 2001a;28:168–74.PubMedCrossRefGoogle Scholar
  10. Arweiler NB, Reich E, Brecx M, Dörner M, Netuschil L. Influence of ethanol on the antibacterial and anti-plaque efficacy of an amine fluoride/stannous fluoride mouthrinse solution. J Parodontol Implantol Orale. 2001b;20:331–40.Google Scholar
  11. Arweiler NB, Auschill TM, Reich E, Netuschil L. Substantivity of toothpaste slurries and their effect on reestablishment of the dental biofilm. J Clin Periodontol. 2002;29:615–21.PubMedCrossRefGoogle Scholar
  12. Arweiler NB, Henning G, Reich E, Netuschil L. Effect of an amine-fluoride-triclosan mouthrinse on plaque regrowth and biofilm vitality. J Clin Periodontol. 2002b;29:358–63.PubMedCrossRefGoogle Scholar
  13. Arweiler NB, Auschill TM, Baguley N, Netuschil L, Sculean A. Efficacy of an amine fluoride-triclosan mouthrinse as compared to the individual active ingredients. J Clin Periodontol. 2003;30:192–6.PubMedCrossRefGoogle Scholar
  14. Arweiler NB, Boehnke N, Sculean A, Hellwig E, Auschill TM. Differences in efficacy of two commercial 0.2% chlorhexidine mouthrinse solutions: a 4-day plaque re-growth study. J Clin Periodontol. 2006;33:334–9.PubMedCrossRefGoogle Scholar
  15. Arweiler NB, Lenz R, Sculean A, Al-Ahmad A, Hellwig E, Auschill TM. Effect of food preservatives on in situ biofilm formation. Clin Oral Investig. 2008;12:203–8.PubMedCrossRefGoogle Scholar
  16. Auschill TM, Arweiler NB, Netuschil L, Brecx M, Reich E, Sculean A. Spatial distribution of vital and dead microorganisms in dental biofilms. Arch Oral Biol. 2001;46:471–6.PubMedCrossRefGoogle Scholar
  17. Auschill TM, Hein N, Hellwig E, Follo M, Sculean A, Arweiler NB. Effect of two antimicrobial agents on early in situ biofilm formation. J Clin Periodontol. 2005;32:147–52.PubMedCrossRefGoogle Scholar
  18. Barnett ML. The role of therapeutic antimicrobial mouthrinses in clinical practice: control of supragingival plaque and gingivitis. J Am Dent Assoc. 2003;134:699–704.PubMedGoogle Scholar
  19. Bonesvoll P. Influence of ionic strength, calcium, sodium dodecyl sulphate and urea on the retention of chlorhexidine in the human mouth after mouth rinses. Arch Oral Biol. 1977;22:273–9.PubMedCrossRefGoogle Scholar
  20. Bonesvoll P, Olsen I. Influence of teeth, plaque and dentures on the retention of chlorhexidine in the human oral cavity. J Clin Periodontol. 1974;1:214–21.PubMedCrossRefGoogle Scholar
  21. Bonesvoll P, Lokken P, Rolla G, Paus PN. Retention of chlorhexidine in the human oral cavity after mouth rinses. Arch Oral Biol. 1974;19:209–12.PubMedCrossRefGoogle Scholar
  22. Bosman CW, Powell RN. The reversal of localized experimental gingivitis. A comparison between mechanical toothbrushing procedures and a 0.2% chlorhexidine mouthrinse. J Clin Periodontol. 1977;4:161–72.PubMedCrossRefGoogle Scholar
  23. Botelho MA, dos Santos RA, Martins JG, Carvalho CO, Paz MC, Azenha C, Ruela RS, Queiroz DB, Ruela WS, Marinho G, Ruela FI. Comparative effect of an essential oil mouthrinse on plaque, gingivitis and salivary Streptococcus mutans levels: a double blind randomized study. Phytother Res. 2009;23:1214–9.PubMedCrossRefGoogle Scholar
  24. Brecx M, Netuschil L, Reichert B, Schreil G. Efficacy of Listerine, Meridol and chlorhexidine mouthrinses on plaque, gingivitis and plaque bacteria vitality. J Clin Periodontol. 1990;17:292–7.PubMedCrossRefGoogle Scholar
  25. Brecx M, MacDonald LL, Legary K, Cheang M, Forgay MGE. Longterm effects of Meridol and chlorhexidine mouthrinses on plaque, gingivitis, staining, and bacterial vitality. J Dent Res. 1993;72:1194–7.PubMedCrossRefGoogle Scholar
  26. Chilton NW. Conference on equivalence and superiority claims for products for gingivitis and periodontitis. J Periodontal Res. 1992;27:305–456.CrossRefGoogle Scholar
  27. Claydon N, Addy M. The use of plaque area and plaque index to measure the effect of fluoride and chlorhexidine toothpastes on 24-h plaque regrowth. J Clin Periodontol. 1995;22:540–2.PubMedCrossRefGoogle Scholar
  28. Claydon N, Addy M. A 24-h regrowth study to evaluate the plaque inhibitory properties of a proprietary liquid dentifrice. J Clin Periodontol. 1999;26:286–8.PubMedCrossRefGoogle Scholar
  29. Claydon N, Hunter L, Moran J, Wade W, Kelty E, Movert R, Addy M. A 6-month home-usage trial of 0.1% and 0.2% delmopinol mouthwashes (I). Effects on plaque, gingivitis, supragingival calculus and tooth staining. J Clin Periodontol. 1996;23(3 Pt 1):220–8.PubMedCrossRefGoogle Scholar
  30. Claydon N, Smith S, Stiller S, Newcombe RG, Addy M. A comparison of the plaque-inhibitory properties of stannous fluoride and low concentration chlorhexidine mouthrinses. J Clin Periodontol. 2002;29:1072–7.PubMedCrossRefGoogle Scholar
  31. Claydon NC, Addy M, Newcombe R, Moran J. The prevention of plaque re-growth by toothpastes and solutions containing block copolymers with and without polypeptide. J Clin Periodontol. 2005;32:545–8.PubMedCrossRefGoogle Scholar
  32. Cosyn J, Wyn I, De Rouck T, Collys K, Bottenberg P, Matthijs S, Sabzevar MM. Short-term anti-plaque effect of two chlorhexidine varnishes. J Clin Periodontol. 2005;32:899–904.PubMedCrossRefGoogle Scholar
  33. Council on Dental Therapeutics. Guidelines for acceptance of chemotherapeutic products for the control of supragingival dental plaque and gingivitis. J Am Dent Assoc. 1986;112:529–32.Google Scholar
  34. Cousido MC, Tomás M, Tomás I, Limeres J, García-Caballero L, Diz P. Effect of a neutralising agent on the evaluation of the antimicrobial activity of chlorhexidine on the bacterial salivary flora. Arch Oral Biol. 2008;53:981–4.PubMedCrossRefGoogle Scholar
  35. Cousido MC, Tomás Carmona I, García-Caballero L, Limeres J, Alvarez M, Diz P. In vivo substantivity of 0.12% and 0.2% chlorhexidine mouthrinses on salivary bacteria. Clin Oral Investig. 2010;14:397–402.PubMedCrossRefGoogle Scholar
  36. Daly CG, Highfield JE. Effect of localized experimental gingivitis on early supragingival plaque accumulation. J Clin Periodontol. 1996;23:160–4.PubMedCrossRefGoogle Scholar
  37. de Albuquerque RF, Head Jr TW, Mian H, Rodrigo A, Müller K, Sanches K, Ito IY. Reduction of salivary S. aureus and mutans group streptococci by a preprocedural chlorhexidine rinse and maximal inhibitory dilutions of chlorhexidine and cetylpyridinium. Quintessence Int. 2004;35:635–40.PubMedGoogle Scholar
  38. Deinzer R, Förster P, Fuck L, Herforth A, Stiller-Winkler R, Idel H. Increase of crevicular interleukin 1beta under academic stress at experimental gingivitis sites and at sites of perfect oral hygiene. J Clin Periodontol. 1999;26:1–8.PubMedCrossRefGoogle Scholar
  39. Deinzer R, Weik U, Kolb-Bachofen V, Herforth A. Comparison of experimental gingivitis with persistent gingivitis: differences in clinical parameters and cytokine concentrations. J Periodontal Res. 2007;42:318–24.PubMedCrossRefGoogle Scholar
  40. Elworthy A, Greenman J, Doherty FM, Newcombe RG, Addy M. The substantivity of a number of oral hygiene products determined by the duration of effects on salivary bacteria. J Periodontol. 1996;67:572–6.PubMedCrossRefGoogle Scholar
  41. Fine DH, Furgang D, Barnett ML, Drew C, Steinberg L, Charles CH, Vincent JW. Effect of an essential oil-containing antiseptic mouthrinse on plaque and salivary Streptococcus mutans levels. J Clin Periodontol. 2000;27:157–61.PubMedCrossRefGoogle Scholar
  42. Fine DH, Furgang D, Sinatra K, Charles C, McGuire A, Kumar LD. In vivo antimicrobial effectiveness of an essential oil-containing mouth rinse 12 h after a single use and 14 days’ use. J Clin Periodontol. 2005;32:335–40.PubMedCrossRefGoogle Scholar
  43. Fischman SL. Design of studies to evaluate plaque control agents. J Dent Res. 1979;58:2389–95.PubMedCrossRefGoogle Scholar
  44. ICH Harmonised Tripartite Guideline. Guidelinefor good clinical practice E6(R1) Step 4 version dated 10 June 1996. Retrived at http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/Efficacy/E6_R1/Step4/E6_R1_Guideline.pdf. Accessed on November 2011.
  45. Gehlen I, Netuschil L, Georg T, Reich E, Berg R, Katsaros C. The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. J Orofac Orthop. 2000;61:138–48.PubMedCrossRefGoogle Scholar
  46. Gjermo P, Bonesvoll P, Rolla G. Relationship between plaque-inhibiting effect and retention of chlorhexidine in the human oral cavity. Arch Oral Biol. 1974;19:1031–4.PubMedCrossRefGoogle Scholar
  47. Grant MM, Creese AJ, Barr G, Ling MR, Scott AE, Matthews JB, Griffiths HR, Cooper HJ, Chapple IL. Proteomic analysis of a noninvasive human model of acute inflammation and its resolution: the twenty-one day gingivitis model. J Proteome Res. 2010;9:4732–44.PubMedCrossRefGoogle Scholar
  48. Harper PR, Milsom S, Wade W, Addy M, Moran J, Newcombe RG. An approach to efficacy screening of mouthrinses: studies on a group of French products (II). Inhibition of salivary bacteria and plaque in vivo. J Clin Periodontol. 1995;22:723–7.PubMedCrossRefGoogle Scholar
  49. Harrap GJ. Assessment of the effect of dentifrices on the growth of dental plaque. J Clin Periodontol. 1974;1:166–74.PubMedCrossRefGoogle Scholar
  50. Herrera D, Roldán S, Santacruz I, Santos S, Masdevall M, Sanz M. Differences in antimicrobial activity of four commercial 0.12% chlorhexidine mouthrinse formulations: an in vitro contact test and salivary bacterial counts study. J Clin Periodontol. 2003;30:307–14.PubMedCrossRefGoogle Scholar
  51. Herrera D, Santos S, Ferrús J, Barbieri G, Trombelli L, Sanz M. Efficacy of a 0.15% benzydamine hydrochloride and 0.05% cetylpyridinium chloride mouth rinse on 4-day de novo plaque formation. J Clin Periodontol. 2005;32:595–603.PubMedCrossRefGoogle Scholar
  52. Human D, Fluss SS. The World Medical Association’s Declaration of Helsinki: historical and contemporary perspectives. 2001. Available at:http://www.wma.net/en/20activities/10ethics/10helsinki/draft_historical_contemporary_perspectives.pdf. Accessed on 9 Dec 2011.
  53. Imrey PB, Chilton NW, Pihlstrom BL, et al. Proposed guidelines for American Dental Association acceptance of products for professional, non-surgical treatment of adult periodontitis. Task Force on Design and Analysis in Dental and Oral Research. J Periodontal Res. 1994a;29:348–60.PubMedCrossRefGoogle Scholar
  54. Imrey PB, Chilton NW, Pihlstrom BL, et al. Recommended revisions to American Dental Association guidelines for acceptance of chemotherapeutic products for gingivitis control. Report of the Task Force on Design and Analysis in Dental and Oral Research to the Council on Therapeutics of the American Dental Association. J Periodontal Res. 1994b;29:299–304.PubMedCrossRefGoogle Scholar
  55. Jeffcoat M. What is clinical significance? J Clin Periodontol. 2002;29:30–2.PubMedGoogle Scholar
  56. Jenkins S, Addy M, Newcombe R. The effect of triclosan, stannous fluoride and chlorhexidine products on: (II) salivary bacterial counts. J Clin Periodontol. 1990;17:698–701.PubMedCrossRefGoogle Scholar
  57. Jenkins S, Addy M, Newcombe R. Triclosan and sodium lauryl sulphate mouthwashes (I). Effects on salivary bacterial counts. J Clin Periodontol. 1991;18:140–4.PubMedCrossRefGoogle Scholar
  58. Jenkins S, Addy M, Wade W, Newcombe RG. The magnitude and duration of the effects of some mouthrinse products on salivary bacterial counts. J Clin Periodontol. 1994;21:397–401.PubMedCrossRefGoogle Scholar
  59. König J, Storcks V, Kocher T, Bössmann K, Plagmann H-C. Antiplaque effect of tempered 0.2% chlorhexidine rinse: an in vivo study. J Clin Periodontol. 2002;29:207–10.PubMedCrossRefGoogle Scholar
  60. Lie MA, Timmerman MF, van der Velden U, van der Weijden GA. Evaluation of 2 methods to assess gingival bleeding in smokers and non-smokers in natural and experimental gingivitis. J Clin Periodontol. 1998a;25:695–700.PubMedCrossRefGoogle Scholar
  61. Lie MA, van der Weijden GA, Timmerman MF, Loos BG, van Steenbergen TJ, van der Velden U. Oral microbiota in smokers and non-smokers in natural and experimentally-induced gingivitis. J Clin Periodontol. 1998b;25:677–86.PubMedCrossRefGoogle Scholar
  62. Löe H, Theilade E, jensen SB. Experimental gingivitis in man. J Periodontol. 1965;36:177–87.PubMedCrossRefGoogle Scholar
  63. Lorenz K, Bruhn G, Heumann C, Hoffmann T, Netuschil L. How to select study designs and parameters to investigate the effect of mouthrinses? Part II: comparisons between the parameters used. J Physiol Pharmacol. 2009a;60:85–90.PubMedGoogle Scholar
  64. Lorenz K, Bruhn G, Netuschil L, Heumann C, Hoffmann T. How to select study designs and parameters to investigate the effect of mouthrinses? Part I: rationale and background. J Physiol Pharmacol. 2009b;60:77–83.PubMedGoogle Scholar
  65. Lorenz K, Mayer D, Bruhn G, Noack B, Brecx M, Heumann C, Toutenburg H, Netuschil L, Nagl M, Gottardi W, Hoffmann T. Effect of N-chlorotaurine mouth rinses on plaque regrowth and plaque vitality. Clin Oral Investig. 2009c;13:9–14.PubMedCrossRefGoogle Scholar
  66. Matheny JL, Abrams H, Johnson DT, Roth GI. Microcirculatory dynamics in experimental human gingivitis. J Clin Periodontol. 1993;20:578–83.PubMedCrossRefGoogle Scholar
  67. McBain AJ, Bartolo RG, Catrenich CE, Charbonneau D, Ledder RG, Gilbert P. Effects of a chlorhexidine ­gluconate-containing mouthwash on the vitality and antimicrobial susceptibility of in vitro oral bacterial ecosystems. Appl Environ Microbiol. 2003;69:4770–6.PubMedCrossRefGoogle Scholar
  68. McClanahan SF, Bartizek RD. Effects of triclosan/copolymer dentifrice on dental plaque and gingivitis in a 3-month randomized controlled clinical trial: influence of baseline gingivitis on observed efficacy. J Clin Dent. 2002;13:167–78.PubMedGoogle Scholar
  69. Moran J, Addy M, Newcombe R. The antibacterial effect of toothpastes on the salivary flora. J Clin Periodontol. 1988;15:193–9.PubMedCrossRefGoogle Scholar
  70. Moran J, Addy M, Kohut B, Hovliaras CA, Newcombe RG. Efficacy of mouthrinses in inhibiting the development of supragingival plaque over a 4-day period of no oral hygiene. J Periodontol. 1994;65:904–7.PubMedCrossRefGoogle Scholar
  71. Moran J, Addy M, Wade W, Milson S, McAndrew R, Newcombe RG. The effect of oxidising mouthrinses compared with chlorhexidine on salivary bacterial counts and plaque regrowth. J Clin Periodontol. 1995;22:750–5.PubMedCrossRefGoogle Scholar
  72. Netuschil L, Reich E, Brecx M. Direct measurement of the bactericidal effect of chlorhexidine on human dental plaque. J Clin Periodontol. 1989;16:484–8.PubMedCrossRefGoogle Scholar
  73. Netuschil L, Weiger R, Preisler R, Brecx M. Plaque bacteria counts and vitality during chlorhexidine, meridol and listerine mouthrinses. Eur J Oral Sci. 1995;103:355–61.PubMedCrossRefGoogle Scholar
  74. Netuschil L, von Ohle C, Brecx M. Die vitalfluoreszen­ztechnik in der plaqueforschung. Parodontologie. 1996;7:293–305.Google Scholar
  75. Netuschil L, Reich E, Unteregger G, Sculean A, Brecx M. A pilot study of confocal laser scanning microscopy for the assessment of undisturbed dental plaque vitality and topography. Arch Oral Biol. 1998;43:277–85.PubMedCrossRefGoogle Scholar
  76. Netuschil L, Hoffmann T, Brecx M. How to select the right mouthrinses in periodontal prevention and therapy. Part I. Test systems and clinical investigations. Int J Dent Hyg. 2003;1:143–50.PubMedCrossRefGoogle Scholar
  77. Newman MG. Design and implementation of clinical ­trials of antimicrobial drugs and devices used in periodontal disease treatment. Ann Periodontol. 1997;2:180–98.PubMedCrossRefGoogle Scholar
  78. Nogueira-Filho GR, Toledo S, Cury JA. Effect of 3 dentifrices containing triclosan and various additives. An experimental gingivitis study. J Clin Periodontol. 2000;27:494–8.PubMedCrossRefGoogle Scholar
  79. Pan P, Barnett ML, Coelho J, Brogdon C, Finnegan MB. Determination of the in situ bactericidal activity of an essential oil mouthrinse using a vital stain method. J Clin Periodontol. 2000;27:256–61.PubMedCrossRefGoogle Scholar
  80. Pretty IA, Edgar WM, Higham SM. A study to assess the efficacy of a new detergent free, whitening dentifrice in vivo using QLF planimetric analysis. Br Dent J. 2004;197:561–6; discussion 551.PubMedCrossRefGoogle Scholar
  81. Putt MS, Van der Weijden GA, Kleber CJ, Saxton CA. Validation of a 21-day, partial-mouth gingivitis model for evaluating chemotherapeutic dentifrices. J Periodontal Res. 1993;28:301–7.PubMedCrossRefGoogle Scholar
  82. Roberts WR, Addy M. Comparison of the in vivo and in vitro antibacterial properties of antiseptic mouthrinses containing chlorhexidine, alexidine, cetyl pyridinium chloride and hexetidine. Relevance to mode of action. J Clin Periodontol. 1981;8:295–310.PubMedCrossRefGoogle Scholar
  83. Rodrigues SV, Acharya AB, Bhadbhade S, Thakur SL. Hyaluronan-containing mouthwash as an adjunctive plaque-control agent. Oral Health Prev Dent. 2010;8:389–94.PubMedGoogle Scholar
  84. Rundegren J, Hvid EB, Johannson M, Ǻström M. Effect of 4 days of mouth rinsing with delmopinol or chlorhexidine on the vitality of plaque bacteria. J Clin Periodontol. 1992;19:322–5.PubMedCrossRefGoogle Scholar
  85. Saxton CA, Van der Ouderaa FJG. The effect of a dentifrice containing zinc citrate and triclosan on developing gingivitis. J Periodontol. 1989;24:75–80.CrossRefGoogle Scholar
  86. Schiott CR, Löe H, Jensen SB, Kilian M, Davies RM, Glavind K. The effect of chlorhexidine mouthrinses on the human oral flora. J Periodontal Res. 1970;5:84–9.PubMedCrossRefGoogle Scholar
  87. Shearer B, Hall P, Clarke P, Marshall G, Kinane DF. Reducing variability and choosing ideal subjects for experimental gingivitis studies. J Clin Periodontol. 2005;32:784–8.PubMedCrossRefGoogle Scholar
  88. Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000. 2002;28:12–55.PubMedCrossRefGoogle Scholar
  89. Tatakis DN, Trombelli L. Modulation of clinical expression of plaque-induced gingivitis. I. Background review and rationale. J Clin Periodontol. 2004;31:229–38.PubMedCrossRefGoogle Scholar
  90. The ADA Council on Scientific Affairs. Guidelines for chemotherapeutic products for control of gingivitis; 2008. Retrieved on http://www.ada.org/sections/scienceAndResearch/pdfs/guide_chemo_ging.pdf.
  91. Theilade E. The non-specific theory in microbial etiology of inflammatory periodontal diseases. J Clin Periodontol. 1986;13:905–11.PubMedCrossRefGoogle Scholar
  92. Theilade E, Wright WH, Jensen SB, Löe H. Experimental gingivitis in man. II. A longitudinal clinical and bacteriological investigation. J Periodontal Res. 1966;1:1–13.PubMedCrossRefGoogle Scholar
  93. Trombelli L, Farina R, Manfrini R, Tatakis DN. Modulation of clinical expression of plaque-induced gingivitis: effect of incisor crown form. J Dent Res. 2004a;83:728–31.PubMedCrossRefGoogle Scholar
  94. Trombelli L, Scapoli C, Orlandini E, Tosi M, Bottega S, Tatakis DN. Modulation of clinical expression of plaque-induced gingivitis. III. Response of “high responders” and “low responders” to therapy. J Clin Periodontol. 2004b;31:253–9.PubMedCrossRefGoogle Scholar
  95. Trombelli L, Tatakis DN, Scapoli C, Bottega S, Orlandini E, Tosi M. Modulation of clinical expression of plaque-induced gingivitis. II. Identification of “high-responder” and “low-responder” subjects. J Clin Periodontol. 2004c;31:239–52.PubMedCrossRefGoogle Scholar
  96. Trombelli L, Scapoli C, Calura G, Tatakis DN. Time as a factor in the identification of subjects with different susceptibility to plaque-induced gingivitis. J Clin Periodontol. 2006;33:324–8.PubMedCrossRefGoogle Scholar
  97. Trombelli L, Farina R, Minenna L, Carrieri A, Scapoli C, Tatakis DN. Experimental gingivitis: reproducibility of plaque accumulation and gingival inflammation parameters in selected populations during a repeat trial. J Clin Periodontol. 2008;35:955–60.PubMedCrossRefGoogle Scholar
  98. Tu YK, Blance A, Clerehugh V, Gilthorpe MS. Statistical power for analyses of changes in randomized controlled trials. J Dent Res. 2005;84:283–7.PubMedCrossRefGoogle Scholar
  99. Tu Y-K, Maddick I, Kellett M, Clerehugh V, Gilthorpe MS. Evaluating the quality of active-control trials in periodontal research. J Clin Periodontol. 2006;33:151–6.PubMedCrossRefGoogle Scholar
  100. van der Mei HC, White DJ, Atema-Smit J, van de Belt-Gritter E, Busscher HJ. A method to study sustained antimicrobial activity of rinse and dentifrice components on biofilm viability in vivo. J Clin Periodontol. 2006;33:14–20.PubMedCrossRefGoogle Scholar
  101. van der Weijden GA, Timmerman MF, Danser MM, Nijboer A, Saxton CA, Van der Velden U. Effect of pre-experimental maintenance care duration on the development of gingivitis in a partial mouth experimental gingivitis model. J Periodontal Res. 1994;29:168–73.PubMedCrossRefGoogle Scholar
  102. von Ohler C, Weiger R, Decker E, Schlagenhauf U, Brecx M. The efficacy of a single pocket irrigation on subgingival microbial vitality. Clin Oral Investig. 1998;2:84–90.CrossRefGoogle Scholar
  103. Weiger R, Netuschil L, Von Ohle C, Brecx M. Microbial vitality of supragingival dental plaque during initial stages of experimental gingivitis in humans. J Periodontal Res. 1995;30:204–9.PubMedCrossRefGoogle Scholar
  104. Weiger R, Netuschil L, Wester-Ebbinghaus T, Brecx M. An approach to differentiate between antibacterial and antiadhesive effects of mouthrinses in vivo. Arch Oral Biol. 1998;43:559–65.PubMedCrossRefGoogle Scholar
  105. Welk A, Splieth CH, Schmidt-Martens G, Schwahn Ch, Kocher T, Kramer A, Rosin M. The effect of a polyhexamethylene biguanide mouthrinse compared with a triclosan rinse and a chlorhexidine rinse on bacterial counts and 4-day plaque re-growth. J Clin Periodontol. 2005;32:499–505.PubMedCrossRefGoogle Scholar
  106. Yates R, Moran J, Addy M, Mullan PJ, Wade WG, Newcombe R. The comparative effect of acidified sodium chlorite and chlorhexidine mouthrinses on plaque regrowth and salivary bacterial counts. J Clin Periodontol. 1997;24:603–9.PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Alexandrina L. Dumitrescu
    • 1
    • 2
  1. 1.Department of PeriodontologyUniversity of Tromsø Institute of Clinical DentistryTromsøNorway
  2. 2.Private practiceBucharestRomania

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