Biofilm management with hydroxyapatite – effective plaque reduction: a clinical study


The most important factor in at-home oral care is continuously reducing the build-up of plaque. For this, there are many commercially available toothbrushes and toothpastes with various compositions. Amine and tin oral care products are often considered the gold standard in biofilm reduction. Studies have shown that hydroxyapatite is also able to reduce plaque and therefore improve dental and oral health.


Is hydroxyapatite toothpaste just as effective in improving periodontal health as an amine/stannous fluoride toothpaste?

Material and methods

A double-blind, randomised, parallel study was conducted at two difference study centres (the university hospitals in Münster and Würzburg) over a period of three months. The plaque formation rate (PFR) was selected as the primary study parameter. Other secondary parameters were also considered. All of the patients had mild to moderate chronic periodontitis (tooth pocket depth of ≥ 4 mm on at least 4 teeth). All patients were trained in how oral hygiene was to be performed at the start of the study. Then the patients were randomly divided into two groups: One group used an amine/stannous fluoride toothpaste (control) and a second group used a hydroxyapatite toothpaste for oral and dental care. The toothpastes were initially used in at-home oral care as before. After the first follow-up, a professional cleaning and periodontal treatment, the patients performed their oral and dental care at home as instructed. The PFR was measured during regular check-ups (after 4 weeks and 12 weeks). Then the PFR results were compared for statistically significant differences in PFR between the groups.


A total of 67 patients were included in the study. The patient were distributed equally among the two groups (amine/stannous fluoride and hydroxyapatite). The average age in both groups was 53 years old (± ~13 years). The PFR was similar in both groups. An overall improvement in the PFR could be detected. The secondary parameters also showed an equal improvement in oral health in both groups. No significant differences in PFR could be determined between the group with an amine/stannous fluoride toothpaste and the groups with a hydroxyapatite toothpaste.


A hydroxyapatite toothpaste reduces plaque to the same extent and has the same positive effect on periodontal health as the established gold standard in tooth and oral health.

The publication of the study can be found  here.

Source: Harks, I., Y. Jockel-Schneider, U. Schlagenhauf, T. W. May, M. Gravemeier, K. Prior, G. Petersilka and B. Ehmke (2016). “Impact of the daily use of a microcrystal hydroxyapatite dentifrice on de novo plaque formation and clinical/microbiological parameters of periodontal health. A randomized trial.“ PLoS One 11: e0160142.