Dextranase 함유 구강 세정액의 치태 제고 및 치은염 예방 효과에 관한 임상적 연구 (A) clinical trial of dextranase-containing mouthwash on the inhibition of plaque formation and gingivitis원문보기
치주질환의 주 원인은 세균성 치태와 그 세균산물이며 질환의 예방과 관리를 위해서는 적절한 치태 제거가 필요하다. 칫솔질만으로 치태를 완전히 제거하기가 쉽지않아 효율적인 치태 관리를 위해 안전하고 효능 높은 구강세정제의 개발이 요구되고 있다. 본 연구는 dextranase 효소함유 구강 세정액을 칫솔질에 보조적으로 병용시 치태 및 치은염을 억제하는데 효과적인지 평가하기 위하여 시행되었다. 전신적으로 건강한 성인 39인에서 ...
치주질환의 주 원인은 세균성 치태와 그 세균산물이며 질환의 예방과 관리를 위해서는 적절한 치태 제거가 필요하다. 칫솔질만으로 치태를 완전히 제거하기가 쉽지않아 효율적인 치태 관리를 위해 안전하고 효능 높은 구강세정제의 개발이 요구되고 있다. 본 연구는 dextranase 효소함유 구강 세정액을 칫솔질에 보조적으로 병용시 치태 및 치은염을 억제하는데 효과적인지 평가하기 위하여 시행되었다. 전신적으로 건강한 성인 39인에서 치석제거 및 치면세마후 1일 2회 정상적인 칫솔질을 하게 한 2주 후 칫솔질과 함께 세정액 (Dextranase 함유 세정제 : 실험군, 0.12% Chlorhexidine 액 : 양성대조군, Placebo액 : 음성대조군) 20cc를 1일 2회 30초간 함수하게 하였다. 실험 1, 3, 6개월 후 치태 축적도(Turesky-Quigley-Hein plaqueindex) 및 치은 염증도(Lo¨e-Silness gingival index), 치면 착색도(Area and sevetrity index)의 변화를 평가하고 구강내 부작용의 발생 빈도를 비교하였다. 치태 축적도와 치은 염증도 모두 실험군에서 양성대조군 및 음성대조군에 비해 유의하게 낮아 dextranase 양치에 의한 치태 축적 및 치은 염증 억제 효과가 가장 크게 나타났다. 치면 착색도는 실험 3개월과 6개월 후 양성대조군에서 음성대조군에 비해 유의하게 증가하였고, 실험군에서는 6개월 이후 음성대조군에 비해 유의하게 증가하였으나 양성대조군에 비해서는 유의하게 낮았다. 구강내 부작용의 빈도도 실험군은 혀의 침착, 미각 이상 및 상피 탈락 등이 빈번한 양성대조군에 비해 낮게 나타났다. 이상의 결과로 볼 때 칫솔질과 함께 장기간 구강내 세정시 dextranase 함유 세정제는 0.12% chlorhexidine 액보다 나은 치태 및 치은 염증도의 억제 효과를 가지고 있었으며, 치면 착색 및 구강 점막에 대한 부작용이 적어 치주 질환의 예방 및 치료에 이 효소함유 세정제가 매우 효과적임을 시사하였다.
치주질환의 주 원인은 세균성 치태와 그 세균산물이며 질환의 예방과 관리를 위해서는 적절한 치태 제거가 필요하다. 칫솔질만으로 치태를 완전히 제거하기가 쉽지않아 효율적인 치태 관리를 위해 안전하고 효능 높은 구강세정제의 개발이 요구되고 있다. 본 연구는 dextranase 효소함유 구강 세정액을 칫솔질에 보조적으로 병용시 치태 및 치은염을 억제하는데 효과적인지 평가하기 위하여 시행되었다. 전신적으로 건강한 성인 39인에서 치석제거 및 치면세마후 1일 2회 정상적인 칫솔질을 하게 한 2주 후 칫솔질과 함께 세정액 (Dextranase 함유 세정제 : 실험군, 0.12% Chlorhexidine 액 : 양성대조군, Placebo액 : 음성대조군) 20cc를 1일 2회 30초간 함수하게 하였다. 실험 1, 3, 6개월 후 치태 축적도(Turesky-Quigley-Hein plaque index) 및 치은 염증도(Lo¨e-Silness gingival index), 치면 착색도(Area and sevetrity index)의 변화를 평가하고 구강내 부작용의 발생 빈도를 비교하였다. 치태 축적도와 치은 염증도 모두 실험군에서 양성대조군 및 음성대조군에 비해 유의하게 낮아 dextranase 양치에 의한 치태 축적 및 치은 염증 억제 효과가 가장 크게 나타났다. 치면 착색도는 실험 3개월과 6개월 후 양성대조군에서 음성대조군에 비해 유의하게 증가하였고, 실험군에서는 6개월 이후 음성대조군에 비해 유의하게 증가하였으나 양성대조군에 비해서는 유의하게 낮았다. 구강내 부작용의 빈도도 실험군은 혀의 침착, 미각 이상 및 상피 탈락 등이 빈번한 양성대조군에 비해 낮게 나타났다. 이상의 결과로 볼 때 칫솔질과 함께 장기간 구강내 세정시 dextranase 함유 세정제는 0.12% chlorhexidine 액보다 나은 치태 및 치은 염증도의 억제 효과를 가지고 있었으며, 치면 착색 및 구강 점막에 대한 부작용이 적어 치주 질환의 예방 및 치료에 이 효소함유 세정제가 매우 효과적임을 시사하였다.
A novel glucanhydrolase (DXAMase) from a mutant of Lipomyces starkeyi (KSM 22) has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and DXAMase has been strongly bound to hydroxyapatitie...
A novel glucanhydrolase (DXAMase) from a mutant of Lipomyces starkeyi (KSM 22) has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and DXAMase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi DXAMase are desirable for its application as a dental plaque control agent. This study was performed to determine the adjunctive oral hygiene benefits and safety of dextranase (Lipomyces starkeyi KSM 22 DXAMase)-containing mouthwash when used alongside normal toothbrushing. This 6-month clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 3 and 6 months, subjects were scored for plaque accumulation (Turesky modification of Quingley-Hein's plaque index), gingivitis status (Lo¨e and Silness gingival index), and tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects providedt with allocated mousewash and instructed to use 20-ml volumes for 30s twice daily after toothbrushing. All the groups showed significant increase in plaque accumulation since 1 month of experiment. During 6 months' period, the Dextranase mouthwash group showed the least increase in plaque accumulation, compared to the Chlorhexidine mouthwash and placebo groups. As for gingival inflammation, all the groups showed significant increase during 6 months of experiment. The Experimental group (Dextranase mouthwash)also showed the least increase in gingival index score, compared to the Positive control (Chlorhexidine mouthwash) as well as the Negative control (placebo) groups. Whereas the tooth stain was increased significantly in the Positive control group, compared to the baseline score and the Negative control group since 3 months of mouthrinsing. it was significantly increased after 6 months in the Experimental group, still less severe than the Positive control group. As for the oral side effect, the Experimental group showed less tongue accumulation, bad taste, compared to the Positive control group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase provided adjunctive benefits to toothbrushing, comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, with long-term use of the mouthwash. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.
A novel glucanhydrolase (DXAMase) from a mutant of Lipomyces starkeyi (KSM 22) has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and DXAMase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi DXAMase are desirable for its application as a dental plaque control agent. This study was performed to determine the adjunctive oral hygiene benefits and safety of dextranase (Lipomyces starkeyi KSM 22 DXAMase)-containing mouthwash when used alongside normal toothbrushing. This 6-month clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 3 and 6 months, subjects were scored for plaque accumulation (Turesky modification of Quingley-Hein's plaque index), gingivitis status (Lo¨e and Silness gingival index), and tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects providedt with allocated mousewash and instructed to use 20-ml volumes for 30s twice daily after toothbrushing. All the groups showed significant increase in plaque accumulation since 1 month of experiment. During 6 months' period, the Dextranase mouthwash group showed the least increase in plaque accumulation, compared to the Chlorhexidine mouthwash and placebo groups. As for gingival inflammation, all the groups showed significant increase during 6 months of experiment. The Experimental group (Dextranase mouthwash)also showed the least increase in gingival index score, compared to the Positive control (Chlorhexidine mouthwash) as well as the Negative control (placebo) groups. Whereas the tooth stain was increased significantly in the Positive control group, compared to the baseline score and the Negative control group since 3 months of mouthrinsing. it was significantly increased after 6 months in the Experimental group, still less severe than the Positive control group. As for the oral side effect, the Experimental group showed less tongue accumulation, bad taste, compared to the Positive control group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase provided adjunctive benefits to toothbrushing, comparable to 0.12% chlorhexidine mouthwash in inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, with long-term use of the mouthwash. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.
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