Interaction between chlorhexidine and fluoride in a mouthrinse solution—a 4-day and 6-week randomized clinical pilot study

Dynamic killing effectiveness of mouthrinses and a D-enantiomeric peptide on oral multispecies biofilms grown on dental restorative material surfaces

OBJECTIVE

To evaluate the dynamics of killing of oral multispecies biofilms grown on dental restorative materials by commercially available mouthrinses and a D-enantiomeric peptide.

METHODS

Four composite resins (3M Supreme, 3M Supreme flow, Kerr Sonicfill, and Shofu Beautifil II) and one glass ionomer (GC Fuji II) were used as restorative materials. Plaque biofilms were grown on the surfaces of restorative material discs for 1 week. The surface roughness and biofilm attachment were assessed by atomic force microscopy and scanning electron microscopy. One-week-old biofilms grown anaerobically at 37°C were exposed to each of five solutions for one minute (twice daily for seven days): Listerine Total care and Paroex Gum mouthrinses, 0.12% chlorhexidine, 0.001% D-enantiomeric peptide DJK-5, and sterile water. The dynamic variation of the biovolume of the biofilms and the percentage of dead bacteria were monitored and analyzed using confocal laser scanning microscopy.

RESULTS

All restorative materials had similar surface roughness with intact biofilm attachment. The percentage of dead bacteria and biovolume of biofilms treated by each oral rinse solution remained constant between days 1 and 7, with no statistically significant difference. DJK-5 showed the highest percentage of dead bacteria (up to 75.7%; cf. ∼20-40% for other mouthrinses) of all solutions tested within 7 days.

CONCLUSIONS

DJK-5 outperformed conventional mouthrinses in killing bacteria in oral multispecies biofilms grown on dental restorative materials.

CLINICAL SIGNIFICANCE

The antimicrobial peptide DJK-5 is effective against oral biofilms and serves as a promising candidate for the development of future mouthrinses to improve long-term oral hygiene.

Effect of Pudilan Keyanning antibacterial mouthwash on dental plaque and gingival inflammation in patients during periodontal maintenance phase: study protocol for double-blind, randomised clinical trial

INTRODUCTION

Plaque control plays a critical role in the prevention and treatment of periodontitis. Antibacterial mouthwash is one of the most important tools for plaque control. Pudilan, including extracts of Scutellaria baicalensis root, Taraxacum mongolicum, Bunge corydalis herb and Isatis indigotica, was reported playing the role of anti-inflammatory and anti-bacterial. However, its effect on dental plaque and periodontal inflammation remains unknown. We aimed to assess the efficacy of Pudilan Keyanning antibacterial mouthwash which contains the active essence of Pudilan and 0.03%-0.06% cetylpyridinium chloride, as well as Pudilan active essence for plaque control and gingival anti-inflammation in patients during periodontal maintenance phase.

METHODS AND ANALYSIS

In this double-blind, randomised, placebo-controlled clinical trial, a total of 120 participants during periodontal maintenance phase will be enrolled. After supragingival scaling, they will be randomly assigned into three groups in a 1:1:1 ratio: the Pudilan Keyanning antibacterial mouthwash group, a chlorhexidine acetate mouthwash (0.12%) group or a placebo group with mouthwash containing the same components as the Pudilan Keyanning mouthwash except for Pudilan active ingredients. They will rinse with mouthwash, respectively, two times per day for 6 weeks. Clinical parameters (such as plaque index, bleeding index) and the level of volatile sulfide in the breath will be measured and analysed. The subgingival plaque will be collected and analysed microbiologically. Questionnaire feedback will be analysed.

ETHICS AND DISSEMINATION

The study protocol (V.4) was reviewed and approved by the Medical Ethical Committee of Peking University School and Hospital of Stomatology (Ethics Approval No. PKUSSIRB-201950153b). All participants signed a written consent form.

TRIAL REGISTRATION NUMBER

ChiCTR2000041253.

Toothpastes with Enzymes Support Gum Health and Reduce Plaque Formation

Enzymes in toothpastes can support host immune responses, and thus maintain oral health. This study aimed to investigate gingival health and the plaque-reducing effects of enzyme-containing toothpastes. A laboratory study tested the antimicrobial potential of different enzyme-containing toothpaste formulations. Two promising formulations (enzyme-containing toothpastes with glucose oxidase and D-glucose with (C+) and without Citrox (C-) Citrox) were investigated in a clinical crossover trial (two slurries: sodium lauryl sulfate-containing (SLS), a toothpaste without SLS (reference), and water). Subjects (n = 20) abstained from toothbrushing for four days and rinsed with a toothpaste slurry. Bleeding on probing (BOP) and plaque indices (PI) were measured. A mixed linear model was used to statistically compare the slurries with respect to BOP and PI change. The in vitro bacterial growth-inhibiting evaluation showed the best results for SLS, followed by C+ and C-. The change in BOP and PI exhibited statistically significant differences to water rinsing (BOP; PI changes in % points (difference of the baseline and post-rinse values: water = 8.8%; 90.0%; C+ = -1.4%; 80.4%; SLS = 1.5%; 72.1%; reference = 0.8%; 77.5%; C- = -1.8%; 75.1%). All slurries exhibited anti-gingivitis and anti-plaque effects, resulting in a prophylactic benefit for limited-access regions during brushing.

Cytotoxic and antibacterial effect of a red propolis mouthwash, with or without fluoride, on the growth of a cariogenic biofilm

OBJECTIVE

To evaluatein vitro the antibacterial activity, the antibiofilm effect and the cytotoxic potential of mouthwashes containing Brazilian red propolis with or without fluoride.

METHODS

The minimum inhibitory and bactericidal concentrations (MIC and MBC) against S. mutans, S. sanguinis, S. salivarius and L. casei were determined for RPE mouthwashes. A cariogenic biofilm with the aforementioned bacteria was formed over cellulose membrane disks (N = 30, 13 mm), which were submitted for 1 min to the following mouthwashes: plain mouthwash base; 0.05% NaF; 0.8% RPE; 0.8% RPE + 0.05% NaF and 0.12% chlorhexidine (CHX). The bacterial viability and the production of extracellular polysaccharide (EPS) were measured. Cytotoxic potential of the mouthwashes was also evaluated. For bacterial viability and EPS production, Mann-Withney and one-way ANOVA tests were performed followed by Tukey, with results considered significant when p ≤ 0.05.

RESULTS

MIC and MBC values of RPE mouthwashes ranged from 7.44 to 29.76 mg/mL and from 7.44 to ≥59.52 mg/mL, respectively, presenting better action against S. salivarius. RPE mouthwashes showed 44% of viable cells after 1 min of contact with fibroblasts. RPE (7.74) had the greatest reduction of viable total microorganisms and did not differ from the RPE + NaF (7.95) (p = 0.292). CHX (7.54) was the most effective in reducing Streptococcus spp, but did not differ from RPE (p = 0.521) and RPE + NaF (p = 0.238). There was no difference between the treatments regarding EPS production.

CONCLUSION

RPE and RPE + NaF mouthwash showed similar antibacterial activity, toxicity level and antibiofilm effect compared to CHX.