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ANTIMICROBIALS: RINSES

Mazza, J. et al: Clinical and Antimicrobial Effect of Stannous Fluoride on Periodontitis. J. Clin Perio 8(3):203, 1981.

Purpose:

To measure the potential antimicrobial effects of topical stannous fluoride by utilizing morphological classification of subgingival and supragingival plaque changes in advanced periodontitis.

Materials and methods:

Ten male patients with advanced periodontal disease were included in this study.
Probing depths (PD) were >6 mm, with 25% bone loss. Three of these teeth diseased sites with PD < 4 mm with no bone loss. Clinical indices included, Plaque index, periodontal disease index, bleeding index. Samples were collected sub-and supragingivally for dark field photomicroscopy. Sites received direct subgingival irrigation with 1.64% stannous fluoride, 0.4% stannous fluoride, sterile saline. Healthy sites were irrigated with saline only. The patients returned 2,4, and 7 days for plaque samples, bacterial counts and clinical indices.
The process was repeated weekly for next 5 weeks.

Results:

Bacteriology-subgingival 1.64% SnF2 shift motile bacteroides (MB) and spirochetes (Sp) to cocci and rods. At 4 days 48.6% MB and Sp were totally eliminated. At 2 weeks, MB & Sp reappear at 2.0%. At 6 weeks, MB & Sp reached 28.8% At 8-10 weeks MB reached 40.0% 0.4% SnF2 similar but lesser shift diseased sites with saline, decrease of MB and Sp from 45.2 to 24.6% at 96 hours. However these levels returned to baseline by 1 week. Healthy sites were free of MB & Sp.
Bacteriology: Supragingival
Diseased sites demonstrated consistency of all 3 morphological groupings during 10-week. There was no change in PI.
Bleeding Index
Diseased sites showed a significant reduction at day 4 up to week 6 for the 1.64% group. There was a positive correlation between reduction of MB and Sp and a reduction in the bleeding index. 0.4% group showed a similar response but in lesser magnitude. Saline group showed minimal reduction. Healthy sites showed no change.

Conclusion:

1.64% SnF2 rinse showed a decrease of subgingival motile bacteria and spirochetes. By sixth week, these bacteria returned to 50% of original. Bleeding indices decreased. This correlated with decrease of MB. Sp 0.4 % SnF2 showed a similar pattern. Health sites were unchanged. Supragingival plaque index did not correlate with bleeding index, MB and Sp. 
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