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2 The Taiwan J Oral Med Sci 007; 3:7-68 Printed in Taiwan, All rights reserved Tonzetich 1 volatile sulfide compounds,vcsc VSCs 90% amines skatole indole VSCs Yaegaki -ketobutyrate -ketobutyrate methionine methyl mercaptan acid amino Miyazaki portable sulfide monitor loss CPITN attachment organoleptic assessment 5 Tonzetich 6 3 Yaegaki 31 gas chromatography mm mm CH 3 SH/H S ratio gold standard Schmidt 7 10 mm 9.0% mm 51.8% Rosenberg

3 Quirynen 9 pilot study chlorhexidine CHX / 1 Bosy % CHX mm 6 1/ %-1% 3. OralChroma TM VSCs 11 ppb

4 The Taiwan J Oral Med Sci 007; 3:7-68 Printed in Taiwan, All rights reserved OralChroma TM Osaka, Japan ABILIT Corporation, pilot study sulcus terminalis linea mediana tongue /3 /3 3 / X 7 30 r 0.98 p c.c. 1 c.c. 1/ 1/ c.c. 1 c.c. 1 c.c. 1/ 1/ c.c. OralChroma TM OralChroma TM cm 8 0 no odor 1 really noticeable odor light but clearly noticeable odor 3 30 NSPT moderate odor strong odor 5 extremely foul odor

5 Wilcoxon Sign-Rank 0.1% CHX 0.05% CPC cetyl pyridium chloride Skuber Gagle TM 15-0 c.c. 30 1, Pearson, JMP5.0 mean % PD mean C A L GI mean 5 mm PPD PLI mean BI % Pearson Boferroni strategy Pearson p, p 0.05/ / Pearson 1, 3 51

7 53

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15 , 5 mm 5 mm 5 mm Tanaka 1 Oho 15 Schmidt 7 8 Tanaka 1 Oho 15 Schmidt 7 Rosenberg 61

16 The Taiwan J Oral Med Sci 007; 3:7-68 Printed in Taiwan, All rights reserved Yaegaki and Sanada 3, Tonzetich 1 90% Tonzetich 97.9% mm 51.8% mm 9.0% Miyazaki Liu 16 Coli Tonzetich 17 Bosy 10 Rosenberg Tonzetich Ng 6 5 mm 6

17 51.9% 0.1% CHX 0.05% CPC Herrera % CHX 0.05% CPC 0.1% CHX 0 Quirynen Zhao CPC 0.05% CHX 0.05% Quirynen % CPC 0.1% CHX 0.% CHX 67.37% Quirynen Quirynen Quirynen Avontroodt 18 63

18 The Taiwan J Oral Med Sci 007; 3:7-68 Printed in Taiwan, All rights reserved 5. Rosenberg M. Clinical assessment of bad breath: current concepts. J Am Dent Assoc 1996; 17: Tonzetich J, Ng SK. Reduction of malodor by oral cleansing procedures. Oral Surg Oral Med Oral Pathol 1976; : Schmidt NF, Missan SR, Tarbet WJ. The correlation between organoleptic mouth-odor ratings and levels of volatile sulfur compounds. Oral Surg Oral Med Oral Pathol 1978; 5: Rosenberg M, Kulkarni GV, Bosy A, McCulloch CA. Reproducibility and sensitivity of oral 0.1% CHX 0.05% CPC 1. Tonzetich J. Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol 1977; 8: Miyazaki H, Sakao S, Katoh Y, Takehara T. Correlation between volatile sulphur compounds and certain oral health measurements in the general population. J Periodontol 1995; 66: Yaegaki K K. Sanada K. Biochemical and clinical factors influencing oral malodor in periodontal patients. J Periodontol 199a; 63: Yaegaki K, Sanada K. Volatile sulfur compounds in mouth air from clinical healthy subjects and patients with periodontal disease. J Periodont Res 199b; 7: malodor measurements with a portable sulphide monitor. J Dent Res 1991; 70: Quirynen M, Mongardini C, van Steenberghe D. The effect of a 1-stage full-mouth disinfection on oral malodor and microbial colonization of the tongue in periodontitis. A pilot study. J Periodontol 1998; 69: Bosy A, Kulkarni GV, Rosenberg M, McCulloch CA.. Relationship of oral malodor to periodontitis: evidence of independence in discrete subpopulations. J Periodontol 199; 65: OralChroma TM : Oral malodor. In Newman MG, Taikei HH, Klokkevold PR, Carranza FA editors. Carranza's Clinical Periodontology. 10 th ed. Saunders; 006, P L oe H. The gingival Index, the plaque index and the retention index systems. J Periodontol 1967; 38: Silness J, L oe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 196; 6

19 : Tanaka M, Anguri H, Tarbet WJ. Reliability of clinical parameters for predicting the outcome of oral malodor treatment. J Dent Res 003; 8: Oho T, Yoshida Y. Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 001; 91: Liu XN, Shinada K, Chen XC, Zhang BX, Yaegaki K, Kawaguchi Y. Oral malodor-related parameters in the Chinese general population. J Clin Periodontol 006; 33: Coli JM, Tonzetich J. Characterization of volatile sulphur compounds production at individual gingival crevicular sites in humans. J Clin Dent 199; 3: Quirynen M, Avontroodt P.Effect of different chlorhexidine formulations in mouthrinses on de novo plaque formation. J Clin Periodontol 001; 8: Herrera D, Roldan S. Differences in antimicrobial activity of four commercial 0.1% chlorhexidine mouthrinse formulations: an in vitro contact test and salivary bacterial counts study. J Clin Periodontol 003; 30: Quirynen M, Zhao H. The impact of periodontal therapy and the adjunctive effect of antiseptics on breath odor-related outcome variables: a double-blind randomized study. J Periodontol 005; 76:

20 The Taiwan J Oral Med Sci 007; 3:7-68 Printed in Taiwan, All rights reserved The Levels of Volatile Sulfide Compounds in Mouth Air from Patients with Chronic Periodontitis Hao-Hui Chou, Chi-Cheng Tsai, Tai-Lien Wu, Yi-Hsin Yang, Kun-Yen Ho, Ya-Ping Ho, Yi-Min Wu Kaohsiung Medical University Graduate Institute of Dental Sciences College of Dental Medicine and Chung-Ho Memorial Hospital Department of Periodontics "Halitosis" refers to the condition of offensive mouth odor and may cause social embarrassment, emotional and psychological distress leading to a lack of self-confidence. Many studies indicate that the volatile sulfide compounds VSCs may be the main source of oral malodor. We attempt to clarify the relationship between the periodontal parameters and the VSCs measured by the method of gas chromatography GC, and to evaluate the improvement of several halitosis-related outcomes after a series of non-surgical periodontal treatment NSPT and gargling solution usage. Seventy-two chronic periodontitis patients with heavy tongue coating were assessed for oral malodor and periodontal status. Oral malodor was measured by VSCs with a GC monitor and organoleptic test. Thirty participants were selected randomly for the subsequent experiments. Only 5 participants have completed all experimental procedures. Sulfide measurements and periodontal parameters were measured in times among all the experimental stages. HS and CH3SH were accounted for approximately 97.9% of the total VSCs from mouth air. Significant correlations were observed: between OLTS organoleptic score and HS, OLTS, CH3SH, tongue coating score TCS and VSCs level. Significant correlations were also observed between the VSCs and BI% % of bleeding on probing, and TCS. Reduction of VSCs was significant 55.89% after only tongue scraping. Comparison to, VSCs was significantly reduced after NSPT and CHX gargling. There was no different for VSCs after CHX gargling in weeks and weeks. Based on the findings of the present study and many other investigators, oral malodor is closely associated with tongue coating and periodontitis, therefore, it is advised that the removal of tongue coating and periodontal treatment are prerequisite for the control of oral malodor. Key words: halitosis, oral malodor, volatile sulfide compounds 66

21 Correspondence: Chi-Cheng Tsai Address: 100, Shih-Chuan 1st Road, San Ming District, 807 Kaohsiung City, Taiwan Kaohsiung Medical University TEL: ext 11 FAX: Submitted: January, 1, 006 Accepted: February, 11,

The levels of volatile sulfur compounds in mouth air from patients with chronic periodontitis

J Periodont Res 2008; 43: 186 193 All rights reserved The levels of volatile sulfur compounds in mouth air from patients with chronic periodontitis Ó 2007 The Authors. Journal compilation Ó 2007 Blackwell