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Clinical Studies on Ardox-X® Technology 1997 1998 1998 1998 1999 Phase I Phase I Phase I Phase II Phase II Location Notox (NL) Loma Linda University (USA) Loma Linda University (USA) Queen’s Univ. Belfast (North Ireland) Royal London School of Medicine and Dentistry (UK) Purpose Evaluation of the mutagenic activity of Ardox-X® toothpaste Free radical generation study Cytotoxicity and mutagenicity study on Ardox-X® whiteninggel Chemical mechanism analysis Efficacy, Chemical model studies of neutralising oral malodour by Ardox-X® whitening gel Doctor Leading Trial/ Department Mr Verspeek Rip, Microlaboratory Prof. Y. Li, Department of Chemistry, Prof. Y. Li, Department of Chemistry Prof. E. Lynch/Dr M. Grootveld, Medicine and Dentistry Department Prof. E. Lynch/Dr M. Grootveld/ Medicine & Dentistry Department Compound Tested [Ardox-X ®] = 0,5 eq; toothpaste Ardox-X® Whitening gel Ardox-X® Whitening gel Several Ardox-X® technologies Several Ardox-X® technologies Results Ardox-X® toothpaste is not mutagenic in the salmonella typhirium reverse mutation assay and in the Escherichia coli reverse mutation assay The whitening gel does not contain or produce hydrogen peroxide and it generates only a neglible amount of harmful free radicals The whitening gel is not mutagenic and does not impose risks associated with the cytotoxity The study revealed the mechanistic action of the Ardox-X® technology in revealing the complex structure and reaction adducts Chemical structure of Ardox-X® whitening gel indicates potential efficacy against oral malodour cysteine and methionine species Study Number Study nr. 97006 Study nr. 98004 Study nr. 98006 Study nr. 98003 Study nr. 02005, 02-006 Date of Trial Type of Clinical Trial/Study Clinical Studies on Ardox-X® Technology Date of Trial 2001-2004 2002 2002 2002 2003 Type of Clinical Trial/Study Phase II, III Phase I Phase II Phase II Phase I Location Red Cross Hospital, Beverwijk (NL) University of Leiden (NL) Amsterdam Medical Centre (NL) University of Nijmegen (NL) Mubio products BV (NL) Purpose Treatment of Ardox-X® on patients with chronic ulcers The effect of Ardox-X® toothgel and skin gel on viral DNA Efficacy on Ardox-X® onychomycosis gel on 19 therapy resistant patients on Lamisil In vitro activity of Ardox-X® against clinical fungi Effect of oxygen donors on DNA damage Doctor Leading Trial/ Department Prof. Dr. R. Kreis, Department of Woundcare Dr Salimans/ M. Silvius Laboratories Dr Meinardi, Dermatology P. Verwij, M. Lotgerink, Department of medical microbiology Prof. F. Ramaekers, the University of Maastricht Compound Tested [Ardox-X®] = 4 eq; woundgel [Ardox-X®] = 0,5 eq [Ardox-X®] = 13 eq Several Ardox-X® formulations Ardox-X® Whitening gel Results 80% of treated open wounds showed faster healing Ardox-X® does not damage the DNA of the herpes simplex virus After application of Ardox-X® nail changes among nineteen onychomicosis therapy resistant patients on Lamisil reverted Ardox-X® showed invitro activity against all yeast and molds; Ardox-X® has potential to be used as topical treatments for superficial mycoses The whitening gel shows very limited DNA damage in cells when treated with high concentrated Ardox-X® gel Study Number Study nr. 03003 Study nr. 02001 Study nr. 02-027 Study nr. 02008 Study nr. 03008 Clinical Studies on Ardox-X® Technology 2003 2004 2005 2005 Phase II Phase II Phase II Phase III Location Schulke & Mayr (D) Schulke & Mayr (D) University of Aberdeen (UK) TNO, Leiden (NL) Purpose Challenge test Challenge test In vitro antifungal test Study of Angiogenese: invivo application in mice Doctor Leading Trial/ Department Matthew Daulby, Microbiology laboratory Matthew Daulby, Microbiology laboratory Prof. F.C. Odds/Inst. For Med. Sciences Pieter Koolwijk, Ph. D. Compound Tested Several Ardox-X ® concentrations Several Ardox-X® concentrations [Ardox-X®] = 20 eq; onychomycosis gel Several Ardox-X® concentrations Results Ardox-X® products showed broad antibacterial properties Parts of the technology showed antibacterial properties, but only the complete technology exhibits a full anti-bacterial spectrum Ardox-X® gel has a good clinical potential to be used as a topical anti-fungal agent. The complex showed efficacy against a range of fungi associated with skin and nail infections Ardox-X® technology stimulates angiogenesis and thus woundhealing Study Number Study nr. 03-010 Study nr. 04-001 Study nr. 05-001 and 05-002 Study nr. 05-006 Date of Trial Type of Clinical Trial/Study Clinical Studies on Ardox-X® for Periodontitis Date of Trial 1997 1997 2002 Type of Clinical Trial/Study Phase II, III Phase II Phase II Location Nijmegen University, Nijmegen (NL) Nijmegen University, Nijmegen (NL) Dentres Benelux, Nijmegen (NL) Purpose To evaluate the effectiveness of Ardox-X® toothpaste on periodontal bacteria To evaluate effectiveness of Ardox-X® toothpaste on Streptococcus mutans To compare four toothpastes for their anti-plaque/ antigingivitis potential and reducing periodontal bacteria Application Process Brushing teeth with Ardox-X® based toothpaste Brushing teeth with Ardox-X® based toothpaste Brushing teeth with Ardox-X® based toothpaste Doctor Leading Trial Dr. Van den Bosch Dr. Van den Bosch Prof. Dr. K.G. Konig Number of Patients 55 31 206 Results a) Bacteria causing periodontitis almost completely eliminated; b) Bleeding of the gums stopped; c) gingiva looks healthy. Streptococcus Mutans is measurably reduced (69,2%) after 1 week of brushing with tooth-gel a) Ardox-X® technology has antigingivitis potential; b) Adverse effect: Ardox-X® toothpaste (2%), Colgate total (27%), Signal (30%), Mentadent (67%); c) Highest bleeding index for Ardox-X®; d) Lowest increase of salivary levels of mutans streptococci Trial Design Double blind Double blind Double blind Study Protocol According to university protocol According to university protocols According to clinical trial protocol Clinical Studies on Ardox-X® for Periodontitis Date of Trial 2007-2008 2009-2010 - PENDING TRIAL Type of Clinical Trial/Study Phase II, III Phase II, III Location Dental clinic, Venlo (NL) Nijmegen University, Nijmegen (NL) Acta Amsterdam (NL) Purpose To evaluate the effectiveness of the Ardox-X® adjunctive topical application in reducing periodontitis a) To evaluate the in-vitro efficacy of Ardox-X® gel on periodontal and root caries associated pathogens b) Double blind placebo controlled clinical test on periodontal bacteria in human Application Process Administration of Ardox-X® gel into the pocket In vitro testing on agar plates Doctor Leading Trial Dr Berendsen, Dr. G.J. Meijer, DMD, PhD Prof W. Beertsen Dr W A. Van der Rijden M. Fernandez Number of Patients 33 To be determined after completion of the in-vitro test results Results a) After 3 months, a 66% reduction of pocket depth in male and 49% in female; b) Age (40-44 yr) showed greatest improvement; c) No difference in smokers vs. non smokers; d) Gold standard CHX value showed 4,2% reduction To be determined Case study, regular use In vitro testing; lab scale In-vivo double blind patient testing According to dental clinic protocol Will be conducted according to university protocol Trial Design Study Protocol Administration of Ardox-X® gel into the periodontal pocket Clinical Studies on Ardox-X® for Peri-Implantitis Date of Trial 2005-2007 Type of Clinical Trial/Study Phase II, III, IV Location Rijnstate Hospital Arnhem (NL) Purpose To evaluate the effectiveness of the Ardox-X® adjunctive topical application in peri-implantatis Application Process Oral administration of Ardox-X® gel Doctor Leading Trial Dr. P. Blijdorp, Dr. G.J. Meijer, DMD, PhD Number of Patients 34 Results a) Significant tissue recovery after 3 and 6 weeks; b) After 3 months 75% of the peri-implantitis cases were cured with definite reosseointegration in 15% of the implants; c) After 6 months reosseointegration of 3mm in 15% of the cases and of 2 mm in 60% of the cases Trial Design Study Protocol Case study, regular hospital use According to hospital clinic protocol Before treatment with Ardox-X®: severe redness of the gingiva, infection, poor woundhealing. After treatment with Ardox-X®: healthier gingiva, reduced redness, new tissue growth around implant. Clinical Studies on Ardox-X® for Oral Mucositis Date of Trial 2002-2005 2000-2007 Type of Clinical Trial/Study Phase II, III Phase II, III Location Rijnstate Hospital, Arnhem (NL) Rijnstate Hospital, Arnhem (NL) Various dental clinics (NL) Purpose To evaluate the effectiveness of Ardox-X® towards oral mucositis. To evaluate the effectiveness of Ardox-X® towards oral mucositis. Application Process oral rinse oral rinse Doctor Leading Trial Dr. P. Blijdorp Dr. P. Blijdorp Number of Patients 155 220 Results a) Erosive forms of oral mucositis: relief of symptoms after 1 week in 90% of cases b) Hyperkeratotic forms: relief of symptoms after 6 weeks in 75% of cases. In Hodgkin/nonHodgkin oncology treatment relief of symptoms in 80% of both cases during cytostatic and radiation courses. Oral mucositis symptoms are significantly reduced Regular hospital use Regular hospital use In feasibility studies with Ardox-X ® more than 80% of patients experienced a relief of symptoms. According to hospital clinic protocol According to hospital clinic protocol Trial Design Study Protocol Patient with oral mucositis: persistent harmful bacteria with painful lesions. Various dental surgeons