Dental preservation in patients irradiated for head and neck tumours: A 10-year experience with topical fluoride and a randomized trial between two fluoridation methods

Horiot, J.C.; Schraub, S; Bone, M.C.; Bain, Y.; Ramadier, J O; Chaplain, Gilles; Nabid, N.; Thevenot, B.; Bransfield, Diana D.

doi:10.1016/s0167-8140(83)80009-7

Cited by 95 publications

(38 citation statements)

References 3 publications

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“…In patients with hyposalivation arising from irradiation in the head and neck area, long-term compliance with a 2-step regime is quite poor [Horiot et al, 1983;Epstein et al, 1996]. Therefore, the use of a remineralising saliva substitute alone could be a promising approach for dentate patients with hyposalivation to manage both outcomes (dental caries and hyposalivation).…”

Section: Discussionmentioning

confidence: 99%

Saliva Substitutes in Combination with Highly Concentrated Fluorides and Brushing: In vitro Effects on Enamel Subsurface Lesions

Tschoppe

Siegel²,

Meyer-Lueckel³

2010

Caries Res

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Hyposalivation is often associated with high caries activity, in particular in patients undergoing irradiation in the head/neck area. Besides the use of saliva substitutes to relieve the oral symptoms, daily application of fluoride gels or toothpaste (5,000 µg F^–/g) is recommended for caries prevention. The aim of this study was to evaluate potentially remineralising effects of these fluoride agents in combination with saliva substitutes on enamel subsurface lesions. Demineralised bovine specimens were either stored in mineral water [control; saturation with respect to octacalcium phosphate (S_OCP): 0.8], a demineralising saliva substitute (Glandosane; S_OCP: 0.3) or in a modified (with respect to S_OCP) saliva substitute [Saliva natura (SN); S_OCP: 1.9] for 5 weeks (37°C). The following treatments were applied twice daily (11–13/group): no treatment (0), ProSchmelz fluoride gel (PS; 10 min application), Duraphat toothpaste (DP; 10 s; brushing with toothpaste/storage solution slurry), combination of DP+PS. Mineral parameters before/after storage were evaluated from microradiographs. Storage in Glandosane led to significant demineralisation (p < 0.05; paired t test), whereas additional use of fluoride agents neutralised the demineralising effect (p > 0.05). Storage in water alone resulted in no changes in mineral parameters (p > 0.05), whereas in combination with fluorides remineralisation could be shown (p < 0.05). For SN alone, remineralisation was observed (p < 0.05), but no additional beneficial effects of fluorides were detected. Under the conditions chosen, the fluoride agents reduce the demineralising effects of Glandosane and promote the remineralisation of specimens stored in water. Remineralising effects of SN could not be enhanced by the fluorides.

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Section: Discussionmentioning

confidence: 99%

Saliva Substitutes in Combination with Highly Concentrated Fluorides and Brushing: In vitro Effects on Enamel Subsurface Lesions

Tschoppe

Siegel²,

Meyer-Lueckel³

2010

Caries Res

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“…Xerostomia-related dental caries progresses so rap idly that a perfect dentition can be totally ruined within I year [Dreizen et al, 1977], In clinical trials it has been shown, however, that good oral hygiene in combination with daily fluoride applications can re duce caries progression [Wescott et al, 1975;Dreizen et al, 1977;Katz, 1982;Markitziu et al, 1982: Horiot et al, 1983, The prophylactic regimens applied in these subjects are mainly based on clinical experience. Because these regimens are often inconvenient and time consuming for the patient, increased caries activ ity invariably results from a failure to comply com pletely with the prescribed use of fluoride-containing gels or mouthrinses [Wescott et al, 1975].…”

mentioning

confidence: 99%

A Model to Investigate Xerostomia-Related Dental Caries

Jansma¹,

Vissink

Sgravenmade

et al. 1988

Caries Res

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The aim of this study was to develop an in vivo model in which onset, progression, and prevention of xerostomia-related dental caries can be studied. The progress of the caries process was investigated on ground and polished human enamel blocks placed in the lower denture of 7 edentulous subjects suffering from xerostomia. During a period of 6 weeks the samples were analyzed at weekly intervals by means of scanning optical monitoring, scanning longitudinal microradiography, scanning electron microscopy, and hardness measurements. Although the indentation length increased significantly within 2 weeks, no demineralization could be yet observed with scanning optical monitoring, longitudinal microradiography, and electron microscopy in most samples. Starting from the 3rd week a progressive demineralization could be observed by all methods. The mineral loss (hydroxyapatite) in the 3rd week was 0.0126 kg·m^-2 (median) which increased to 0.0761·kg m^-2 after 6 weeks. Scanning electron microscopy showed a destruction which resembled that of natural xerostomia-related dental caries. From this study it may be concluded that the in vivo model developed is suitable for studying onset, progression, and prevention of xerostomia-related dental caries.

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“…Fluoride stärken die Säureresistenz der Zahnhartsubstanzen, fördern die Remineralisation und wirken inhibierend auf kariogene Mikroorganismen [36]. Empfohlen wird ein neutrales, 1%-iges Natriumfluoridgel, das täglich für 5-10 min mit Hilfe eines individuell angefertigten Trägers (Zahnschienen) appliziert werden sollte [23,48]. Säurehaltige Gele sollten vermieden werden, um unnö-tiger Demineralisation der Zahnhartsubstanzen, bei verminderter Remineralisierung durch den mangelnden Speichelfluss, und Irritationen der empfindlichen Mukosa vorzubeugen.…”

Section: Zahnärztliche Maßnahmenunclassified