Effects of a stabilized stannous fluoride dentifrice on clinical, immunomodulatory, and microbial outcomes in a human experimental gingivitis model

J Periodontol. 2024 May;95(5):421-431. doi: 10.1002/JPER.22-0710. Epub 2023 Oct 27.

Abstract

Background: Stannous fluoride dentifrice is well established for its beneficial clinical effects. In this study, we evaluated the effects of stannous fluoride on inflammation and oral microbiome.

Methods: In this randomized, parallel-arm, double-blind, controlled clinical trial, we compared clinical resolution of experimental gingivitis by evaluating bleeding on probing, gingival index, and plaque index between stannous fluoride stabilized with zinc phosphate (test) and sodium fluoride (control) dentifrices. Further, these groups were compared for oral neutrophil counts, systemic priming of neutrophils, gingival crevicular fluid (GCF) expression of inflammatory markers, and the oral microbiome.

Results: We found significant reduction in bleeding on probing in the test group compared to the control group in experimental gingivitis when participants used the test dentifrice prior to induction of experimental gingivitis. The test group also showed significant reductions in GCF levels of inflammatory markers (matrix metalloproteinase 8 [MMP8], receptor activator of nuclear factor kappa-Β ligand [RANKL]), oral polymorphonuclear neutrophil (PMN) counts, and systemic neutrophil priming (CD11b expression) during experimental gingivitis. Further, significant reductions in the gram-negative genera Porphyromonas, Tannerella, and Treponema were noted in the test group.

Conclusion: The stannous fluoride stabilized with zinc phosphate dentifrice formulation demonstrated clinical reduction in gingival inflammation and a beneficial effect on microbiome and immune markers. This intervention should be explored as a preventive aid in the progression of plaque-induced gingivitis to periodontitis.

Keywords: gingivitis; microbiome; mouth; neutrophils; stannous fluoride; toothpastes.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Dental Plaque Index
  • Dentifrices* / therapeutic use
  • Double-Blind Method
  • Female
  • Gingival Crevicular Fluid*
  • Gingivitis* / microbiology
  • Gingivitis* / prevention & control
  • Humans
  • Leukocyte Count
  • Male
  • Matrix Metalloproteinase 8 / analysis
  • Microbiota / drug effects
  • Neutrophils* / drug effects
  • Periodontal Index*
  • Phosphates / therapeutic use
  • RANK Ligand
  • Sodium Fluoride* / therapeutic use
  • Tin Fluorides* / therapeutic use
  • Treatment Outcome
  • Young Adult
  • Zinc Compounds / therapeutic use

Substances

  • TNFSF11 protein, human