Dextranase 함유 구강 세정액의 치태 제거 및 치은염 예방 효과에 관한 임상적 연구 = A clinical trial of Dextranase-containing mouthwash on the inhibition of plaque formation and gingivitis

다국어 초록 (Multilingual Abstract)

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/㎖ 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 Quigley-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 were provided 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 month's 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.