WO1992007548A1 - Improved anti-plaque compositions comprising a combination of morpholinoamino alcohol and chelating agent - Google Patents

Improved anti-plaque compositions comprising a combination of morpholinoamino alcohol and chelating agent Download PDF

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Publication number
WO1992007548A1
WO1992007548A1 PCT/US1991/006836 US9106836W WO9207548A1 WO 1992007548 A1 WO1992007548 A1 WO 1992007548A1 US 9106836 W US9106836 W US 9106836W WO 9207548 A1 WO9207548 A1 WO 9207548A1
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acid
composition
sodium
alcohol
weight
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PCT/US1991/006836
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French (fr)
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Pauline H. Pan
Linda D. Sturdivant
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Warner-Lambert Company
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q11/00Preparations for care of the teeth, of the oral cavity or of dentures; Dentifrices, e.g. toothpastes; Mouth rinses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/49Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds containing heterocyclic compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K2800/00Properties of cosmetic compositions or active ingredients thereof or formulation aids used therein and process related aspects
    • A61K2800/40Chemical, physico-chemical or functional or structural properties of particular ingredients
    • A61K2800/51Chelating agents

Definitions

  • plaque Bacterial aggregation on the teeth known as plaque has been identified as a cause of dental caries, gingivitis, periodontitis and other gum.diseases. Mechanical methods have been used for some time for the prevention of dental plague but have not generally
  • Octapinol has been tested for its ability to reduce plague formation and the development of gingivitis by Willard, Edwardsson, Attstom and Matsson, "The effect of Octapinol on dento-gingival plague and development of
  • octapinol may prevent the development of plague.
  • Some adverse side effects of octapinol are its toxicity lasting bitter taste and its brownish staining of the teeth.
  • U.S. Patent No. 4,636,382 describes morpholino compounds which are useful for the inhibition or removal of dental plague.
  • the '382 patent also discloses that a wide variety of chemical and biological agents have been suggested for the inhibition of plague, such as
  • U.S. Patent No. 4,610,871 describes the use of monoalkyl or dialkyl ethers of dianhydrdhexitols to inhibit the formation of plague and calculus on teeth.
  • U.S. Patent No. 4,178,363 describes the use of n-undecylenic acid or a calcium or zinc salt thereof for reducing dental plague and infections of the teeth and -gums.
  • U.S. Patent No. 4,119,711 describes spiro 1-(hydroxyalkyl)-piperidino derivatives which have efficacy in reducing the formation of plague.
  • 3,976,765 describes bis-biguanido hexanes in combination with nonionic surfactants and certain foam stabilizers for use in a variety of oral preparations. Additionally, U.S. Patent No. 3,887,712 discloses that alexidine dihydrofluoride is useful in the treatment of dental plague, calculus, gingivitis and related periodontal diseases. U.S. Patent No. 4,160,821 discloses that a glycerine solution of zinc chloride or other acceptable zinc salts provides effective therapy for gingivitis when applied to the gingivae and teeth.
  • Efforts continue toward finding improved means for reducing and/or eliminating plague without many of the side effects associated with the prior art, such as discoloratiqn of teeth or tongue, desguamation and soreness of oral mucosa, objectionable taste, toxicity and imbalance of the oral flora. It is an object of the present invention to provide novel compositions which are useful in the treatment of plague and gingivitis without many of the adverse side effects associated with prior art compositions. It is another object of this invention to provide anti-plague compositions which would cause little or no ecological imbalance of the oral flora.
  • compositions comprising a combination of a morpholinoamino alcohol and a chelating agent wherein these compositions possess synergistically improved anti-plague and anti-gingivitis activity.
  • the present invention relates to novel compositions - comprising a synergistic combination of one or more morpholinoamino alcohols or pharmaceutically-acceptable salt thereof and one or more chelating agents.
  • the morpholinoamino alcohol has the chemical formula
  • R is a straight or branched alkyl group containing 8 to 16 carbon atoms at the 2- or 3- position of the morpholino ring, and is a straight or branched alkyl group containing 2 to 10 carbon atoms terminating with a hydroxy group.
  • the chelatings agents include, for example, ethylenediaminetetraacetic acid, edetate sodium, edefate disodium, edetate calcium disodium, edetate trisodium, deferoxamine, ditio carb sodium, penicillamine, pentetic acid, succimer, trientine and the like.
  • the preferred morpholinoamino alcohol is 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine and the preferred chelating agents are ethylenediaminetetraacetic acid and its calcium and sodium salts.
  • the compositions preferably comprise about 0.005-5% by weight of the morpholinoamino alcohol and about 0.33% by weight of the chelating agent.
  • the compositions of this invention are useful in a wide variety of formulations, such as, for example, toothpaste, mouthwash, chewing gums and other dentifrices to reduce plaque or gingivitis. These compositions have synergistically improved anti-plague and anti-gingivitis activity with less side effects. DESCRIPTION OF THE DRAWINGS
  • Figure 1 is a transmission electron micrograph (136,000 x - magnification) of Fusobacterium nucleatum (ATCC # 10953) treated with 0. IM phosphate-buffered saline solution at pH 7.0. Outer membrane (OM), periplasmic space (PS), peptidoglycon layer (R) and cytoplasmic membrane (CM) are clearly shown.
  • OM outer membrane
  • PS periplasmic space
  • CM cytoplasmic membrane
  • 0 Figure 2 is a transmission electron micrograph (136,000 x magnification) of Fusobacterium nucleatum treated with 0.2% 3-(4-prpylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride for 30 minutes at 37°C.
  • Figure 2 shows bacteria cells with some surface blebs (B) .
  • the blebs (B) 5 possess outer membrane surfaces similar to those on the bacteria cells. Electron dense intracellular matrix is seen in these treated bacteria.
  • Figure 3 is a transmission electron micrograph (136,000 x magnification) of Fusobacterium nucleatum treated with 0 0.2% 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride and 0.1% ethylenediaminetetraacetic acid for 30 minutes at 37°C.
  • a greatly increased number of surface blebs (B) are evident as extensions of the outer membrance.
  • the inner cytoplasmic membrane (CM) is * discontinuously ruptured and the periplusmic space (PS) is expanded.
  • An absence of the peptidoglycon layer was noted.
  • novel compositions which have s improved anti-plague or anti-gingivitis activity.
  • novel compositions of the present invention comprise a synergistic combination of a pharmaceutically effective amount of a) one or more morpholinoamino alcohol(s) or pharmaceutically-acceptable salt thereof and b) one or more chelating agent(s).
  • the morpholinoamino alcohols useful according to this invention have the chemical formula
  • R_ is a straight or branched alkyl group containing 8 to 16 carbon atoms at the 2- or 3-position of the morpholino ring, and is a straight or branched alkyl group containing 2 to 10 carbon atoms terminating with hydroxy group.
  • R n and R 9 ranges from 10 to 20, more preferably from 12 to 16.
  • the morpholinoamino alcohols can be prepared by several processes as described in U.S. patent no.
  • 4,636,382 such as: (a) by alkylating a morpholino derivative having the formula
  • R. is as defined above; with an alkylating agent of the formula R 2 X
  • R_ is as defined above and X is halogen or an organic sulfonic ester, or wherein X together with a hydroxyl group present in R. is a reactive oxide;
  • R.. is as defined above, X is halogen or an organic sulfonic ester and A represents CHvisor groups, one CH_ group being substituted with the group R 1 ; with an amino alkanol " of the general formula
  • R ⁇ is as defined above:
  • R- is as defined above, n is O or 1, and R.. is as defined above and is at the 2-position when n is 1 and at the 2- or 3-position when n is O, or
  • R.. is as defined above and is a straight or branched alkyl group containing a group transformable to OH or CH 2 0H.
  • the most preferred morpholinoamino alcohol for use in this invention is 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine represented by the chemical formula
  • hydrochloride salt of 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine is also most preferred.
  • This compound is a white, odorless, crystalline powder which is very soluble in water, alcohols and chloroform and has a melting point of about 70°C.
  • the morpholinoamino alcohols of this invention can be used in their free base form or as pharmaceutically - acceptable salts thereof.
  • pharmaceutically - acceptable salts are the salts of acids such as acetic acid, phosphoric acid, boric acid, hydrochloric acid, maleic acid, benzoic acid, citric acid, malic acid, oxalic acid, tartaric acid, succinic acid, glutaric acid, gentisic acid, valeric acid, gallic acid, beta- resorcylic acid, acetyl salicylic acid, salicylic acid, perchloric acid, barbituric acid, sulfanilic acid, phytic acid, p-nitro benzoic acid, stearic acid, palmitic acid, oleic acid, myristic acid, lauric acid and the like.
  • the most preferred salts are those of hydrochloric acid.
  • morpholinoamino alcohols of this invention by themselves have only weak anti-microbial activity, it is critical to the practice of this invention that said morpholinoamino alcohols be present in combination with one or more chelating agent(s). It is the synergistic combination of said morpholinoamino alcohol and a chelating agent which provides the compositions of this invention with their improved anti-plaque and anti-gingivitis properties. Without being bound by any theory or mechanism of action, it is believed that these morpholinoamino alcohols inhibit key bacterial membrane functions such as carbohydrate uptake, cellular permeability, cell metabolism and cell division.
  • compositions of this invention comprising a combination of said morpholinoamino alcohols and chelating agents are extremely effective in inhibiting plague formation and reducing preformed plague and for treating gingivitis. These compositions have also demonstrated effectiveness in inhibiting acid production by bacteria such as Streptococcus mutans, and therefore these compositions would have anti-caries activity in example 2.
  • Chelating agents useful according to this invention are well known in the art as ligand-containing compounds which form coordination compounds in which a central metal ion is attached by two or more coordinate links.
  • Chelating agent as used herein includes both the uncomplexed and metal-complexed forms of the ligand-containing compounds.
  • Preferred chelating agents are ethylenediaminetetraacetic acid (EDTA) and its calcium and sodium salts (such as edetate sodium, edetate disodium, editate calcium disodium and edetate trisodium), deferoxamine, ditiocarb sodium, penicillamine, pentetic acid, succimer, trientine aluminum salts, citric acid-sodium salt, gluconic acid-sodium salt, tartaric acid, sodium hexametaphosphate, sodium acid pyrophosphate, sodium tripolyphosphate, anthranilic acid, phosphonate, polyacrylic acid, alkyl-diamine polyacetic acids and salts thereof and the like.
  • the most preferred chelating agents for use in this invention are EDTA and its calcium and sodium salts.
  • the morpholinoamino alcohols are present preferably in an amount ranging from about 0.005% to about 5.0% by total weight of said composition; more preferably from about 0.01% to about 1.0%; and most preferably from about 0.05% -to about 0.2%.
  • the amount of said chelating agents in the compositions preferably ranges from about 0.03% to about 0.50% by total weight of said compositions; more preferably from about 0.17% to about 0.40%; and most preferably from about 0.30% to about 0.35%.
  • the essence of the present invention is the synergistic effect of inhibiting and reducing the growth of plague bacteria, which is achieved when the morpholinoamino alcohols and the chelating agents are utilized in combination in effective concentrations in the 5 oral cavity.
  • the combined effects of the morpholinoamino alcohol, 3-(4-propylheptyl)-4- (2-hydroxyethyl) morpholine, with a chelating agent (disodium EDTA) are demonstrated in Figures 1-3 and Example II.Smaller guantities of each of these components are reguired to 0 obtain effective inhibition of plague and other bacteria than if each component was utilized alone. Since lower guantities of each component can be used in the compositions of this invention, the side effects associated with each of the components would be 5 correspondingly reduced or eliminated.
  • the composition may be a liquid such as a mouthwash or rinse.
  • the vehicle is typically a water-alcohol mixture.
  • the ratio of water to alcohol is in the range of from about 1:1 to about 20:1, preferably about 3:1 " to about 20:1 and most preferably about 3:1 to about 10:1 by weight.
  • the most preferred mouthwash or mouthrinse compositions comprise from 0 to about 30% by weight of alcohol such as ethanol.
  • the total amount of water-alcohol mixture in a mouthwash composition is typically in the range from about 70% to about 99.9% by weight of the composition.
  • the pH value of such mouthwash compositions is generally from about 4.0 to about 7.0 and preferably from about 5 to about 6.5. A pH below 4 would be irritating to the oral cavity. A pH greater than 7 would result in an unpleasant mouth feel.
  • Oral liquid compositions may also contain surface active agents in amounts up to about 5% and fluorine-providing compounds in amounts up to about 2% by weight of the composition.
  • the organic surface active material may be anionic, non-ionic, amphoteric, or cationic.
  • Suitable anionic surfactants are water-soluble salts of higher fatty acid monoglyceride monosul ates, such as the sodium salt of the monosulfated monoglyceride of hydrogenated coconut oil fatty acids; higher alkyl sulfates, such as sodium lauryl sulfate; alkyl aryl sulfonates, such as sodium dodecyl benzene sulfonate; higher alkyl sulfonacetates; higher fatty acid esters of 1,2-dihydroxy propane sulfonates; and substantially saturated higher aliphatic acyl amides of lower aliphatic amino carboxylic acids such as those having 12 to 16 carbons at the fatty acid, alkyl or acyl radicals.
  • Non-ionic surface active agents include condensates of sorbitan mono-oleate with from 20 to 60 moles of ethylene oxide (e.g., "Tweens” a trademark of ICI United States, Inc.), condensates of ethylene oxide with propylene oxide and condensates of propylene glycol (“Pluronics” a trademark of BASF-Wyandotte Corp.).
  • Amphoteric surfactants useful in the present invention are zwitterions having the capacity to act as either an acid or a base. They are generally non-irritating and non-staining.
  • Non-limitative examples of suitable amphoteric surfactants include cocoamidopropyldimethyl sultaine and cocodimethylbetaine (commercially available from Lonza Chemical Co. under the tradenames Lonzaine CS and Lonzaine 12C, respectively) .
  • Cationic surface active agents are molecules that carry a positive charge, such as the quaternary ammonium compounds.
  • Other suitable non-ionic surfactants are the condensation products of an alpha-olefin oxide containing 10 to 20 carbon atoms, a polyhydric alcohol containing 2 - to 10 carbons and 2 to 6 hydroxyl groups and either ethylene oxide or a heteric mixture of ethylene oxide and propylene oxide.
  • the resultant surfactants are heteric polymers having a molecular weight in the range of about 400 to about 1600 and containing 40% to 80% by weight of ethylene oxide, with a alpha-olefin oxide to polyhydric alcohol mole ratio in the range of about 1:1 to 1:3.
  • a fluorine providing compound may be present in the oral compositions of this invention. These compounds may be slightly water soluble or may be fully water soluble and are characterized by their ability to release fluroide ions or fluoride containing ions in water.
  • Typical fluorine providing compounds are inorganic fluoride salts such as soluble alkali metal, alkaline earth metal, and heavy metal salts, for example, sodium fluoride, potassium fluoride, ammonium fluoride, cuprous fluoride, zinc fluoride, stannic fluoride, stannous fluoride, barium fluoride, sodium fluorosilicate, ammonium fluorosilicate, sodium fluorozirconate, sodium monofluorophosphate, aluminium mono-and difluorophosphate and fluorinated sodium calcium pyrophosphate.
  • inorganic fluoride salts such as soluble alkali metal, alkaline earth metal, and heavy metal salts, for example, sodium fluoride, potassium fluoride, ammonium fluor
  • the fluorine providing compound is generally present in an amount sufficient to release up to about 0.15%, preferably about 0.001% to about 0.05%, fluoride by weight of the composition.
  • compositions of this invention may be substantially solid or pasty in character such as dental cream, toothpaste toothpowder or chewing gum.
  • Solid or pasty oral compostions contain polishing materials.
  • Typical polishing materials are abrasive particulate materials having particle sizes of up to about 20 microns.
  • Nonlimiting illustrative examples include: water-insoluble sodium metaphosphate, potassium metaphosphate, tricalcium phosphate, dihydrated calcium phosphate, anhydrous dicalcium phosphate, dicalcium phosphate, calcium pyrophosphate, magnesium orthophosphate, trimagnesium phosphate, calcium carbonate, alumina, aluminum silicate, zirconium silicates, silica, bentonite, and mixtures sthereof.
  • Polishing materials are generally present in an amount from about 20% to about 99% by weight of the composition. Preferably, it is present. in amounts from about 20% to about 75% in toothpaste, and from about 70% to about 99% in toothpowder.
  • a polishing agent of colloidal silica and alkali metal aluminosilicate complexes are preferred since they have refractive indices close to the refractive indices of gelling agent liguid systems commonly used in dentifrices.
  • the compositions of the present invention may additionally contain sweeteners, flavorants and colorants.
  • auxiliary sweeteners are utilized, the present invention contemplates the inclusion of those sweeteners well known in the art, including both natural and artificial sweeteners.
  • additional sweeteners may be chosen from the following non-limiting list:
  • Water-soluble sweetening agents such as monosaccharides, disaccharides and polysaccharides such as xylose, ribose, glucose, mannose, galactose, fructose, dextrose, sucrose, maltose, partially hydrolyzed starch, or corn syrup solids and sugar alcohols such as sorbitol, xylitol, mannitol and mixtures thereof.
  • Water-soluble artificial sweeteners such as the soluble saccharin salts, i.e., sodium, or calcium sacchari salts, cyclamate salts, acesulfame-K and the like, and the free acid form of saccharin.
  • Dipeptide based sweeteners such as L-phenylalanine methyl ester and materials described in U.S. Patent No. 3,492,131 and the like.
  • the amount of sweetener will vary with the desired amount of sweetness selected for a particular composition. This amount will normally be 0.01% to about 40% by weight.
  • the water-soluble sweeteners described in category A above are preferably used in amounts of about 5% to about 40% by weight, and most preferably from about 10% to about 20% by weight of the final composition.
  • the artificial sweeteners described in - categories B and C are used in amount of about 0.005% to about 5.0% and most preferably about 0.05% to about 2.5% by weight of the final composition. These amounts are ordinarily necessary to achieve a desired level of sweetness independent from the flavor level achieved from ⁇ 0 flavorants.
  • Suitable flavorings include both natural and artificial flavors, and mints such as peppermint, citrus flavors such as orange and lemon, artificial vanilla, cinnamon, various fruit flavors and the like. Both 15 individual and mixed flavors are contemplated.
  • the flavorings are generally utilized in amounts that will vary depending upon the individual flavor, and may, for example range in amounts of about 0.1% to about 6% by weight of the final composition.
  • the colorants useful in the present invention include the pigments which may be incorporated in amounts of up to about 2% by weight of the composition. Also, the colorants may include other dyes suitable for food, drug and cosmetic applications, and known as F.D. & C. dyes and 25 the like.
  • the materials acceptable for the foregoing spectrum of use are preferably water-soluble.
  • Illustrative examples include the indigo dye, known as F.D. & C Blue No. 2, which is the disodium salt of 5,5-indigotindisulfonic acid.
  • the dye known as ⁇ " F.D. & C. Green No. 1 comprises a triphenylmethane dye and is the monosodium salt of 4-[4-N-ethyl-p- sulfobenzylamino) diphenylmethylene]- [l-(N-ethyl -N-p-sulfoniumbenzyl)-2,5-cyclohexadienimine] .
  • the present invention also involves a method for treating teeth and gums to reduce plague or gingivitis comprising applying to the surface of the teeth and/or - gums the compositions of this invention as described earlier.
  • the compositions can be applied to the teeth and gums by any conventional means such as brushing, spraying, painting or rinsing of the oral cavity and the like.
  • the compositions not only retain plague accumulation, but has 0 been demonstrated to remove pre-existing plague as well. Additionally, the compositions show a prolonged effect on plague accumulation following cessation of treatment through about one week after use.
  • the compositions are also useful as a topical antiseptic and disinfectant which is applied externally to the skin.
  • EXAMPLE II A composition within the scope of this invention was prepared by mixing the ingredients presented in Table II -below. This composition was useful as an oral spray.
  • Example II was tested against the bacteria Fusobacterium nucleatum (ATCC # 10953) by treating the bacteria with the composition for 30 miniutes -at 37°C.
  • Transmission electron micrographs of the treated bacteria (Fig 3) were taken and compared to the micrographs of 1) control bacteria cells in 0.1 M phosphate-buffered saline soluton at pH 7.0 (Fig 1) and 2) bacteria cells (Fig 2) treated with an agueous composition containing only 0.2% of the morpholinoamino alcohol hydrochloride of Example II.
  • the bacteria cells treated with the composition of Example II according to this invention showed greater cell membrane destruction.
  • compositions within the scope of this invention were prepared by mixing the ingredients presented in Table III -below. These compositions were useful as a dentifrice.

Abstract

Compositions having improved anti-plaque activity comprise a synergistic combination of a) a morpholinoamino alcohol, such as 3-(4-propylheptyl)-4- (2-hydroxyethyl) morpholine, and b) a chelating agent such as ethylenediaminetetraacetic acid.

Description

IMPROVED ANTI-PLAQUE COMPOSITIONS COMPRISING A COMBINATION OF MORPHOLINOAMINO ALCOHOL AND CHELATING AGENT
BACKGROUND OF THE INVENTION AND INFORMATION DISCLOSURE
- Bacterial aggregation on the teeth known as plaque has been identified as a cause of dental caries, gingivitis, periodontitis and other gum.diseases. Mechanical methods have been used for some time for the prevention of dental plague but have not generally
^g achieved sufficient results. Studies have shown that mechanical methods such as the use of dental floss and interspace brushes do not eliminate interproximal plague. During the past decade or more chemical plague control as a substitute or supplement to mechanical methods has been
15 tried.
Octapinol has been tested for its ability to reduce plague formation and the development of gingivitis by Willard, Edwardsson, Attstom and Matsson, "The effect of Octapinol on dento-gingival plague and development of
20 gingivitis", Journal of Periodontal Research, Volume 18, pages 429-437, (1983). Here it is reported that octapinol may prevent the development of plague. Some adverse side effects of octapinol are its toxicity lasting bitter taste and its brownish staining of the teeth.
25 U.S. Patent No. 4,636,382 describes morpholino compounds which are useful for the inhibition or removal of dental plague. The '382 patent also discloses that a wide variety of chemical and biological agents have been suggested for the inhibition of plague, such as
^penicillin, chlorohexidine, 8-hydroxyguinoline and ethylenediamine tetraacetate. However, many of these chemical and biological agents are described as exhibiting insignificant effects and often causing serious side effects. The morpholino compounds of the '382 patent are described as having a low antibacterial effect and lacking, undesirable side effects such as discoloration of the teeth.
U.S. Patent No. 4,610,871 describes the use of monoalkyl or dialkyl ethers of dianhydrdhexitols to inhibit the formation of plague and calculus on teeth. U.S. Patent No. 4,178,363 describes the use of n-undecylenic acid or a calcium or zinc salt thereof for reducing dental plague and infections of the teeth and -gums. U.S. Patent No. 4,119,711 describes spiro 1-(hydroxyalkyl)-piperidino derivatives which have efficacy in reducing the formation of plague. U.S. Patent No. 3,976,765 describes bis-biguanido hexanes in combination with nonionic surfactants and certain foam stabilizers for use in a variety of oral preparations. Additionally, U.S. Patent No. 3,887,712 discloses that alexidine dihydrofluoride is useful in the treatment of dental plague, calculus, gingivitis and related periodontal diseases. U.S. Patent No. 4,160,821 discloses that a glycerine solution of zinc chloride or other acceptable zinc salts provides effective therapy for gingivitis when applied to the gingivae and teeth.
Efforts continue toward finding improved means for reducing and/or eliminating plague without many of the side effects associated with the prior art, such as discoloratiqn of teeth or tongue, desguamation and soreness of oral mucosa, objectionable taste, toxicity and imbalance of the oral flora. It is an object of the present invention to provide novel compositions which are useful in the treatment of plague and gingivitis without many of the adverse side effects associated with prior art compositions. It is another object of this invention to provide anti-plague compositions which would cause little or no ecological imbalance of the oral flora. ' It is a further object of this invention to provide compositions comprising a combination of a morpholinoamino alcohol and a chelating agent wherein these compositions possess synergistically improved anti-plague and anti-gingivitis activity. 5 SUMMARY OF THE INVENTION
The present invention relates to novel compositions - comprising a synergistic combination of one or more morpholinoamino alcohols or pharmaceutically-acceptable salt thereof and one or more chelating agents. The morpholinoamino alcohol has the chemical formula
Figure imgf000005_0001
wherein R, is a straight or branched alkyl group containing 8 to 16 carbon atoms at the 2- or 3- position of the morpholino ring, and is a straight or branched alkyl group containing 2 to 10 carbon atoms terminating with a hydroxy group. The chelatings agents include, for example, ethylenediaminetetraacetic acid, edetate sodium, edefate disodium, edetate calcium disodium, edetate trisodium, deferoxamine, ditio carb sodium, penicillamine, pentetic acid, succimer, trientine and the like. The preferred morpholinoamino alcohol is 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine and the preferred chelating agents are ethylenediaminetetraacetic acid and its calcium and sodium salts. The compositions preferably comprise about 0.005-5% by weight of the morpholinoamino alcohol and about 0.33% by weight of the chelating agent. The compositions of this invention are useful in a wide variety of formulations, such as, for example, toothpaste, mouthwash, chewing gums and other dentifrices to reduce plaque or gingivitis. These compositions have synergistically improved anti-plague and anti-gingivitis activity with less side effects. DESCRIPTION OF THE DRAWINGS
Figure 1 is a transmission electron micrograph (136,000 x - magnification) of Fusobacterium nucleatum (ATCC # 10953) treated with 0. IM phosphate-buffered saline solution at pH 7.0. Outer membrane (OM), periplasmic space (PS), peptidoglycon layer (R) and cytoplasmic membrane (CM) are clearly shown. 0 Figure 2 is a transmission electron micrograph (136,000 x magnification) of Fusobacterium nucleatum treated with 0.2% 3-(4-prpylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride for 30 minutes at 37°C. Figure 2 shows bacteria cells with some surface blebs (B) . The blebs (B) 5 possess outer membrane surfaces similar to those on the bacteria cells. Electron dense intracellular matrix is seen in these treated bacteria.
Figure 3 is a transmission electron micrograph (136,000 x magnification) of Fusobacterium nucleatum treated with 0 0.2% 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride and 0.1% ethylenediaminetetraacetic acid for 30 minutes at 37°C. A greatly increased number of surface blebs (B) are evident as extensions of the outer membrance. The inner cytoplasmic membrane (CM) is * discontinuously ruptured and the periplusmic space (PS) is expanded. An absence of the peptidoglycon layer was noted.
0
5 DETAILED DISCUSSION
This invention involves novel compositions which have s improved anti-plague or anti-gingivitis activity. The novel compositions of the present invention comprise a synergistic combination of a pharmaceutically effective amount of a) one or more morpholinoamino alcohol(s) or pharmaceutically-acceptable salt thereof and b) one or more chelating agent(s).
The morpholinoamino alcohols useful according to this invention have the chemical formula
Figure imgf000007_0001
wherein R_ is a straight or branched alkyl group containing 8 to 16 carbon atoms at the 2- or 3-position of the morpholino ring, and is a straight or branched alkyl group containing 2 to 10 carbon atoms terminating with hydroxy group. Preferably, the sum of the carbon atoms in said groups Rn and R9 ranges from 10 to 20, more preferably from 12 to 16. The morpholinoamino alcohols of this invention are described in U.S. patent no. 4,636,382; the disclosure of which is herein incorporated by reference.
The morpholinoamino alcohols can be prepared by several processes as described in U.S. patent no.
4,636,382, such as: (a) by alkylating a morpholino derivative having the formula
Figure imgf000007_0002
Figure imgf000007_0003
wherein R. is as defined above; with an alkylating agent of the formula R2X
wherein R_ is as defined above and X is halogen or an organic sulfonic ester, or wherein X together with a hydroxyl group present in R. is a reactive oxide;
(b) by ring closure of a compound having the general formula
Figure imgf000008_0001
wherein R.. is as defined above, X is halogen or an organic sulfonic ester and A represents CH„ groups, one CH_ group being substituted with the group R1 ; with an amino alkanol" of the general formula
NH2R2
wherein R^ is as defined above:
(c) by reducing a mono- or di-oxo substituted morpholine having the general formula
Figure imgf000008_0002
wherein R- is as defined above, n is O or 1, and R.. is as defined above and is at the 2-position when n is 1 and at the 2- or 3-position when n is O, or
(d) by starting from a morpholino compound having the general formula
Figure imgf000008_0003
wherein R.. is as defined above and is a straight or branched alkyl group containing a group transformable to OH or CH20H. - The most preferred morpholinoamino alcohol for use in this invention is 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine represented by the chemical formula
Figure imgf000009_0001
Also most preferred is the hydrochloride salt of 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine. This compound is a white, odorless, crystalline powder which is very soluble in water, alcohols and chloroform and has a melting point of about 70°C.
The morpholinoamino alcohols of this invention can be used in their free base form or as pharmaceutically - acceptable salts thereof. Some examples of pharmaceutically - acceptable salts are the salts of acids such as acetic acid, phosphoric acid, boric acid, hydrochloric acid, maleic acid, benzoic acid, citric acid, malic acid, oxalic acid, tartaric acid, succinic acid, glutaric acid, gentisic acid, valeric acid, gallic acid, beta- resorcylic acid, acetyl salicylic acid, salicylic acid, perchloric acid, barbituric acid, sulfanilic acid, phytic acid, p-nitro benzoic acid, stearic acid, palmitic acid, oleic acid, myristic acid, lauric acid and the like. The most preferred salts are those of hydrochloric acid.
As the morpholinoamino alcohols of this invention by themselves have only weak anti-microbial activity, it is critical to the practice of this invention that said morpholinoamino alcohols be present in combination with one or more chelating agent(s). It is the synergistic combination of said morpholinoamino alcohol and a chelating agent which provides the compositions of this invention with their improved anti-plaque and anti-gingivitis properties. Without being bound by any theory or mechanism of action, it is believed that these morpholinoamino alcohols inhibit key bacterial membrane functions such as carbohydrate uptake, cellular permeability, cell metabolism and cell division. - Bacterial cells which are weakened by these morpholinoamino alcohols are more effectively eradicated by chelating agents. Thus, compositions of this invention comprising a combination of said morpholinoamino alcohols and chelating agents are extremely effective in inhibiting plague formation and reducing preformed plague and for treating gingivitis. These compositions have also demonstrated effectiveness in inhibiting acid production by bacteria such as Streptococcus mutans, and therefore these compositions would have anti-caries activity in example 2.
Moreover, studies show a very low order of acute and subacute toxicity, no mutagenic activity, no adverse effect on reproduction and no staining of teeth by the morpholinoamino alcohols of the present invention. Chelating agents useful according to this invention are well known in the art as ligand-containing compounds which form coordination compounds in which a central metal ion is attached by two or more coordinate links. Chelating agent as used herein includes both the uncomplexed and metal-complexed forms of the ligand-containing compounds. Preferred chelating agents are ethylenediaminetetraacetic acid (EDTA) and its calcium and sodium salts (such as edetate sodium, edetate disodium, editate calcium disodium and edetate trisodium), deferoxamine, ditiocarb sodium, penicillamine, pentetic acid, succimer, trientine aluminum salts, citric acid-sodium salt, gluconic acid-sodium salt, tartaric acid, sodium hexametaphosphate, sodium acid pyrophosphate, sodium tripolyphosphate, anthranilic acid, phosphonate, polyacrylic acid, alkyl-diamine polyacetic acids and salts thereof and the like. The most preferred chelating agents for use in this invention are EDTA and its calcium and sodium salts.
In the compositions of the present invention, the morpholinoamino alcohols are present preferably in an amount ranging from about 0.005% to about 5.0% by total weight of said composition; more preferably from about 0.01% to about 1.0%; and most preferably from about 0.05% -to about 0.2%. The amount of said chelating agents in the compositions preferably ranges from about 0.03% to about 0.50% by total weight of said compositions; more preferably from about 0.17% to about 0.40%; and most preferably from about 0.30% to about 0.35%. ^0 The essence of the present invention is the synergistic effect of inhibiting and reducing the growth of plague bacteria, which is achieved when the morpholinoamino alcohols and the chelating agents are utilized in combination in effective concentrations in the 5 oral cavity. The combined effects of the morpholinoamino alcohol, 3-(4-propylheptyl)-4- (2-hydroxyethyl) morpholine, with a chelating agent (disodium EDTA) are demonstrated in Figures 1-3 and Example II.Smaller guantities of each of these components are reguired to 0 obtain effective inhibition of plague and other bacteria than if each component was utilized alone. Since lower guantities of each component can be used in the compositions of this invention, the side effects associated with each of the components would be 5 correspondingly reduced or eliminated.
In one form of this invention, the composition may be a liquid such as a mouthwash or rinse. In such a composition the vehicle is typically a water-alcohol mixture. Generally the ratio of water to alcohol is in the range of from about 1:1 to about 20:1, preferably about 3:1" to about 20:1 and most preferably about 3:1 to about 10:1 by weight. The most preferred mouthwash or mouthrinse compositions comprise from 0 to about 30% by weight of alcohol such as ethanol. The total amount of water-alcohol mixture in a mouthwash composition is typically in the range from about 70% to about 99.9% by weight of the composition. The pH value of such mouthwash compositions is generally from about 4.0 to about 7.0 and preferably from about 5 to about 6.5. A pH below 4 would be irritating to the oral cavity. A pH greater than 7 would result in an unpleasant mouth feel.
Oral liquid compositions may also contain surface active agents in amounts up to about 5% and fluorine-providing compounds in amounts up to about 2% by weight of the composition.
Surface active agents are organic materials which afford complete dispersion of the composition throughout the oral cavity. The organic surface active material may be anionic, non-ionic, amphoteric, or cationic. Suitable anionic surfactants are water-soluble salts of higher fatty acid monoglyceride monosul ates, such as the sodium salt of the monosulfated monoglyceride of hydrogenated coconut oil fatty acids; higher alkyl sulfates, such as sodium lauryl sulfate; alkyl aryl sulfonates, such as sodium dodecyl benzene sulfonate; higher alkyl sulfonacetates; higher fatty acid esters of 1,2-dihydroxy propane sulfonates; and substantially saturated higher aliphatic acyl amides of lower aliphatic amino carboxylic acids such as those having 12 to 16 carbons at the fatty acid, alkyl or acyl radicals.
Non-ionic surface active agents include condensates of sorbitan mono-oleate with from 20 to 60 moles of ethylene oxide (e.g., "Tweens" a trademark of ICI United States, Inc.), condensates of ethylene oxide with propylene oxide and condensates of propylene glycol ("Pluronics" a trademark of BASF-Wyandotte Corp.). Amphoteric surfactants useful in the present invention are zwitterions having the capacity to act as either an acid or a base. They are generally non-irritating and non-staining. Non-limitative examples of suitable amphoteric surfactants include cocoamidopropyldimethyl sultaine and cocodimethylbetaine (commercially available from Lonza Chemical Co. under the tradenames Lonzaine CS and Lonzaine 12C, respectively) . Cationic surface active agents are molecules that carry a positive charge, such as the quaternary ammonium compounds. Other suitable non-ionic surfactants are the condensation products of an alpha-olefin oxide containing 10 to 20 carbon atoms, a polyhydric alcohol containing 2 - to 10 carbons and 2 to 6 hydroxyl groups and either ethylene oxide or a heteric mixture of ethylene oxide and propylene oxide. The resultant surfactants are heteric polymers having a molecular weight in the range of about 400 to about 1600 and containing 40% to 80% by weight of ethylene oxide, with a alpha-olefin oxide to polyhydric alcohol mole ratio in the range of about 1:1 to 1:3.
A fluorine providing compound may be present in the oral compositions of this invention. These compounds may be slightly water soluble or may be fully water soluble and are characterized by their ability to release fluroide ions or fluoride containing ions in water. Typical fluorine providing compounds are inorganic fluoride salts such as soluble alkali metal, alkaline earth metal, and heavy metal salts, for example, sodium fluoride, potassium fluoride, ammonium fluoride, cuprous fluoride, zinc fluoride, stannic fluoride, stannous fluoride, barium fluoride, sodium fluorosilicate, ammonium fluorosilicate, sodium fluorozirconate, sodium monofluorophosphate, aluminium mono-and difluorophosphate and fluorinated sodium calcium pyrophosphate.
In a oral liquid composition such as a mouthwash, the fluorine providing compound is generally present in an amount sufficient to release up to about 0.15%, preferably about 0.001% to about 0.05%, fluoride by weight of the composition.
The compositions of this invention may be substantially solid or pasty in character such as dental cream, toothpaste toothpowder or chewing gum. Solid or pasty oral compostions contain polishing materials. Typical polishing materials are abrasive particulate materials having particle sizes of up to about 20 microns. Nonlimiting illustrative examples include: water-insoluble sodium metaphosphate, potassium metaphosphate, tricalcium phosphate, dihydrated calcium phosphate, anhydrous dicalcium phosphate, dicalcium phosphate, calcium pyrophosphate, magnesium orthophosphate, trimagnesium phosphate, calcium carbonate, alumina, aluminum silicate, zirconium silicates, silica, bentonite, and mixtures sthereof. Polishing materials are generally present in an amount from about 20% to about 99% by weight of the composition. Preferably, it is present. in amounts from about 20% to about 75% in toothpaste, and from about 70% to about 99% in toothpowder. In clear gels, a polishing agent of colloidal silica and alkali metal aluminosilicate complexes are preferred since they have refractive indices close to the refractive indices of gelling agent liguid systems commonly used in dentifrices. The compositions of the present invention may additionally contain sweeteners, flavorants and colorants.
In the instance where auxiliary sweeteners are utilized, the present invention contemplates the inclusion of those sweeteners well known in the art, including both natural and artificial sweeteners. Thus, additional sweeteners may be chosen from the following non-limiting list:
A. Water-soluble sweetening agents such as monosaccharides, disaccharides and polysaccharides such as xylose, ribose, glucose, mannose, galactose, fructose, dextrose, sucrose, maltose, partially hydrolyzed starch, or corn syrup solids and sugar alcohols such as sorbitol, xylitol, mannitol and mixtures thereof.
B. Water-soluble artificial sweeteners such as the soluble saccharin salts, i.e., sodium, or calcium sacchari salts, cyclamate salts, acesulfame-K and the like, and the free acid form of saccharin.
C. Dipeptide based sweeteners such as L-phenylalanine methyl ester and materials described in U.S. Patent No. 3,492,131 and the like.
In general, the amount of sweetener will vary with the desired amount of sweetness selected for a particular composition. This amount will normally be 0.01% to about 40% by weight. The water-soluble sweeteners described in category A above, are preferably used in amounts of about 5% to about 40% by weight, and most preferably from about 10% to about 20% by weight of the final composition. In contrast, the artificial sweeteners described in - categories B and C are used in amount of about 0.005% to about 5.0% and most preferably about 0.05% to about 2.5% by weight of the final composition. These amounts are ordinarily necessary to achieve a desired level of sweetness independent from the flavor level achieved from ^0 flavorants.
Suitable flavorings include both natural and artificial flavors, and mints such as peppermint, citrus flavors such as orange and lemon, artificial vanilla, cinnamon, various fruit flavors and the like. Both 15 individual and mixed flavors are contemplated. The flavorings are generally utilized in amounts that will vary depending upon the individual flavor, and may, for example range in amounts of about 0.1% to about 6% by weight of the final composition. 20 The colorants useful in the present invention, include the pigments which may be incorporated in amounts of up to about 2% by weight of the composition. Also, the colorants may include other dyes suitable for food, drug and cosmetic applications, and known as F.D. & C. dyes and 25 the like. The materials acceptable for the foregoing spectrum of use are preferably water-soluble. Illustrative examples include the indigo dye, known as F.D. & C Blue No. 2, which is the disodium salt of 5,5-indigotindisulfonic acid. Similarly, the dye known as ^" F.D. & C. Green No. 1, comprises a triphenylmethane dye and is the monosodium salt of 4-[4-N-ethyl-p- sulfobenzylamino) diphenylmethylene]- [l-(N-ethyl -N-p-sulfoniumbenzyl)-2,5-cyclohexadienimine] . A full recitation of all F.D. & C. and D. & C. colorants useful in the present invention and their corresponding chemical structures may be found in the Kirk-Othmer Encyclopedia of Chemical Technology, 3rd Edition, in Volume 6, at pages 561-595, which text is accordingly incorporated herein by reference. The present invention also involves a method for treating teeth and gums to reduce plague or gingivitis comprising applying to the surface of the teeth and/or - gums the compositions of this invention as described earlier. The compositions can be applied to the teeth and gums by any conventional means such as brushing, spraying, painting or rinsing of the oral cavity and the like. The compositions not only retain plague accumulation, but has 0 been demonstrated to remove pre-existing plague as well. Additionally, the compositions show a prolonged effect on plague accumulation following cessation of treatment through about one week after use. The compositions are also useful as a topical antiseptic and disinfectant which is applied externally to the skin.
The following examples are presented to further illustrate this invention. The examples are intended in an illustrative sense and not in a limitative sense. All parts and percentages are on a weight basis unless otherwise indicated.
5 EXAMPLE I A composition within the scope of this invention was prepared by mixing the ingredients presented in Table I = below. This composition was useful as a mouthwash.
Table I
Ingredient Amount (% w/v) 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride 0.05
Ethylenediaminetetraacetic acid 0.20
Non-ionic Surfactant 0.70
Sorbitol Solution (70% solids) 50.0
Ethanol (95% in water) 10.0
Coloring Agent 0.0004
Flavoring Agent 0.15
Deionized water (quantity sufficient to 100%)
EXAMPLE II A composition within the scope of this invention was prepared by mixing the ingredients presented in Table II -below. This composition was useful as an oral spray.
Table II
Ingredient Amount (% w/v) 03-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride 0.20
Ethylenediaminetetraacetic acid 0.10
Non-ionic Surfactant 1.20
Citric acid, hydrous 0.07
Ethanol (95% in water) 12.0
Glycerol 20.0
Sweeting Agent 0.01
Flavoring Agent 0.10
Deionized water (guantity sufficient to 100%)
0
5 The composition of Example II was tested against the bacteria Fusobacterium nucleatum (ATCC # 10953) by treating the bacteria with the composition for 30 miniutes -at 37°C. Transmission electron micrographs of the treated bacteria (Fig 3) were taken and compared to the micrographs of 1) control bacteria cells in 0.1 M phosphate-buffered saline soluton at pH 7.0 (Fig 1) and 2) bacteria cells (Fig 2) treated with an agueous composition containing only 0.2% of the morpholinoamino alcohol hydrochloride of Example II. The bacteria cells treated with the composition of Example II according to this invention showed greater cell membrane destruction.
EXAMPLE III Compositions within the scope of this invention were prepared by mixing the ingredients presented in Table III -below. These compositions were useful as a dentifrice.
Table III
Ingredient Amount (% w/v) g 3-(4-propyIhepty1)-4-(2-hydroxyethy1) morpholine hydrochloride 0.20
Ethylenediaminetetraacetic acid 0.20
5 Sodium Fluoride 0.24
Hydrated silica '■ 10-50
Xylitol 10-40 0
Xanthan Gum 0.1-1.5
Cocobetaine 0.1-1.5
5 Flavoring Agent 0.9
Deionized Water (guantity sufficient to 100%)
0
5 EXAMPLE IV A gel composition within the scope of this invention was prepared by mixing the ingredients presented in Table - IV below.
Table IV
Ingredient Amount ( w/v) 3-(4-propylheptyl)-4-(2-hydroxyethyl) morpholine hydrochloride 0.30
Ethylenediaminetetraacetic acid 0.20
Methyl Cellulose 2.0
Sorbitol Solution (70% solids) 50.0
Flavoring Agent 0.20
Deionized water (quantity sufficient to 100%)

Claims

1. A composition having anti-plaque or anti-gingivitis activity comprising in combination a pharmaceutically effective amount of a) a morpholinoamino alcohol or pharmaceutically - acceptable salt. thereof, wherein said morpholinoamino alcohol has the chemical formula
Figure imgf000022_0001
wherein R- is a straight or branched alkyl group containing 8 to 16 carbon atoms at the 2- or 3-position of the morpholino ring, and R. is a straight or branched alkyl group containing 2 to 10 carbon atoms terminating with a hydroxy group and b) a chelating agent.
2. The composition of claim 1 wherein said chelating agent is selected from the group consisting of ethylenediaminetatraacetic acid, edetate sodium, edetate disodium, edetate trisodium, edetate calcium disodium, deferoxamine, ditiocarb sodium, aluminum salts, citric acid-sodium salt, gluconic acid-sodium salt, tartaric acid, sodium hexametaphosphate, sodium acid pyrophosphate, sodium tripolyphosphate, anthranilic acid, phosphonate, polyacrylic acid, alkyl-diamine polyacetic acids and salts, penicillamine, pentetic acid, succimer and trientine.
3. The composition of claim 1 wherein the sum of the carbon atoms in said groups R-. and R? is 10 to 20.
4. The composition of claim 1 wherein said morpholinoamino alcohol is 3-(4-propylheptyl)-4- (2-hydroxyethyl) morpholine.
5. The composition of claim 1 wherein the amount of said morpholinoamino alcohol ranges from about 0.005% to about 5.0% by weight of said composition.
6. The composition of claim 1 wherein the amount of said morpholinoamino alcohol ranges from about 0.01% to about 1.0% by weight of said composition. -
7. The composition of claim 1 wherein the amount of said chelating agent ranges from about 0.03% to about 0.5% by weight of said composition.
8. The composition of claim 1 wherein the amount of said chelating agent ranges from about 0.17% to about
10 0.40% by weight of said composition.
9. The composition of claim 1 wherein said pharmaceutically-acceptable salts are the salts of acids selected from the group consisting of acetic acid, phosphoric acid, boric acid, hydrochloric acid,
15 malic acid, oxalic acid, tartaric acid, succinic acid, gallic acid, beta- resorcylic acid, acetyl salicylic acid, salicylic acid, perchloric acid, barbituric acid, sulfanilic acid, phytic acid p-nitro benzoic acid, stearic acid, palmitic acid, oleic
20 acid, myristic acid and lauric acid.
10. The composition of claim 1 wherein said composition is a tooth paste.
11. The composition of claim 1 wherein said composition is a liquid mouthwash.
2512. The composition of claim 1 wherein said composition is a chewing gum.
13. The composition of claim 11 wherein said mouthwash composition comprises from 0 to about 30% by weight alcohol.
30
14. The composition of claim 13 wherein said alcohol is ethanol.
35
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