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Lallier TE, Goldfarb BS, Maney P. In vitro comparison of zinc-based, chlorhexidine, and essential oil mouth rinses. J Periodontol 2024. [PMID: 39012314 DOI: 10.1002/jper.23-0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Chlorhexidine (CHX)-based mouth rinses are frequently prescribed following periodontal surgeries. A more recently available brand of zinc-based mouth rinses advertises one of its mouth rinses as a substitute for chlorhexidine. The purpose of this study was to evaluate, in vitro, the effects of this brand of zinc-based mouth rinses on cell survival, cell motility, and gene expression of human gingival fibroblasts (HGFs). METHODS HGFs were exposed to essential oil (EO), CHX, and three types of one brand of zinc-based mouth rinses designed to treat breath malodor (ZnA), dry mouth (ZnB), and gingivitis (ZnC). Each mouth rinse was tested over a range of concentrations for its effects on HGF survival and motility. Gene expression of cytokines, interleukins, and growth factors were evaluated via reverse transcriptase-polymerase chain reaction (RT-PCR), as a means to assess potential influences on inflammation and wound healing. RESULTS Cell survival was significantly decreased for CHX and ZnC at 10% dilutions (p < 0.05). For all time points, cells exposed to ZnC displayed the greatest reduction in cell motility (p < 0.05). The various mouth rinses examined differentially altered the expression of growth factor transcripts. ZnC particularly enhanced the expression of BMP-2 and FGF-2. CONCLUSION ZnC was more cytotoxic and inhibited cell motility to a greater extent than any of the other mouth rinses. Therefore, using ZnC as an alternative to CHX could potentially have negative effects on wound healing after periodontal surgery. However, further investigation is required to confirm the clinical relevance of these in vitro findings. PLAIN LANGUAGE SUMMARY One type of zinc-based mouth rinse designed to replace chlorhexidine (often prescribed after oral surgeries) demonstrated the greatest oral cell death and reduction in cell movement when compared to other zinc-based mouth rinses. These zinc-based mouth rinses also reduced the amounts of proteins involved in regulating inflammation, potentially reducing the destruction of bone holding the teeth in place. They also changed the amounts of several molecules involved in tissue healing. It is unknown if this will speed or slow the healing of the soft tissues of the mouth.
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Affiliation(s)
- Thomas E Lallier
- Department of Cell Biology and Anatomy, Louisiana State University Health New Orleans School of Medicine, New Orleans, Louisiana, USA
| | - Brian S Goldfarb
- Department of Periodontics, Louisiana State University Health New Orleans School of Dentistry, New Orleans, Louisiana, USA
| | - Pooja Maney
- Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
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Min K, Bosma ML, John G, McGuire JA, DelSasso A, Milleman J, Milleman KR. Quantitative analysis of the effects of brushing, flossing, and mouthrinsing on supragingival and subgingival plaque microbiota: 12-week clinical trial. BMC Oral Health 2024; 24:575. [PMID: 38760758 PMCID: PMC11102210 DOI: 10.1186/s12903-024-04362-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Translational microbiome research using next-generation DNA sequencing is challenging due to the semi-qualitative nature of relative abundance data. A novel method for quantitative analysis was applied in this 12-week clinical trial to understand the mechanical vs. chemotherapeutic actions of brushing, flossing, and mouthrinsing against the supragingival dental plaque microbiome. Enumeration of viable bacteria using vPCR was also applied on supragingival plaque for validation and on subgingival plaque to evaluate interventional effects below the gingival margin. METHODS Subjects with gingivitis were enrolled in a single center, examiner-blind, virtually supervised, parallel group controlled clinical trial. Subjects with gingivitis were randomized into brushing only (B); brushing and flossing (BF); brushing and rinsing with Listerine® Cool Mint® Antiseptic (BA); brushing and rinsing with Listerine® Cool Mint® Zero (BZ); or brushing, flossing, and rinsing with Listerine® Cool Mint® Zero (BFZ). All subjects brushed twice daily for 1 min with a sodium monofluorophosphate toothpaste and a soft-bristled toothbrush. Subjects who flossed used unflavored waxed dental floss once daily. Subjects assigned to mouthrinses rinsed twice daily. Plaque specimens were collected at the baseline visit and after 4 and 12 weeks of intervention. Bacterial cell number quantification was achieved by adding reference amounts of DNA controls to plaque samples prior to DNA extraction, followed by shallow shotgun metagenome sequencing. RESULTS 286 subjects completed the trial. The metagenomic data for supragingival plaque showed significant reductions in Shannon-Weaver diversity, species richness, and total and categorical bacterial abundances (commensal, gingivitis, and malodor) after 4 and 12 weeks for the BA, BZ, and BFZ groups compared to the B group, while no significant differences were observed between the B and BF groups. Supragingival plaque vPCR further validated these results, and subgingival plaque vPCR demonstrated significant efficacy for the BFZ intervention only. CONCLUSIONS This publication reports on a successful application of a quantitative method of microbiome analysis in a clinical trial demonstrating the sustained and superior efficacy of essential oil mouthrinses at controlling dental plaque compared to mechanical methods. The quantitative microbiological data in this trial also reinforce the safety and mechanism of action of EO mouthrinses against plaque microbial ecology and highlights the importance of elevating EO mouthrinsing as an integral part of an oral hygiene regimen. TRIAL REGISTRATION The trial was registered on ClinicalTrials.gov on 31/10/2022. The registration number is NCT05600231.
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Affiliation(s)
- Kyungrok Min
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA.
| | - Mary Lynn Bosma
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - Gabriella John
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - James A McGuire
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - Alicia DelSasso
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - Jeffery Milleman
- Salus Research, Inc, 1220 Medical Park Drive, Building 4, Fort Wayne, IN, USA
| | - Kimberly R Milleman
- Salus Research, Inc, 1220 Medical Park Drive, Building 4, Fort Wayne, IN, USA
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Conte G, Pacino SA, Urso S, Greiling D, Caponnetto P, Pedullà E, Generali L, Consolo U, Checchi V, Gospodaru S, Bordeniuc G, Fala V, Kowalski J, Nowak M, Górska R, Amaliya A, Chapple I, Milward M, Maclure R, Nardi GM, Polosa R. Changes in Oral Health and Dental Esthetic in Smokers Switching to Combustion-Free Nicotine Alternatives: Protocol for a Multicenter and Prospective Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53222. [PMID: 38393754 PMCID: PMC10924261 DOI: 10.2196/53222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Although the detrimental effects of conventional combustible cigarettes on oral health and dental esthetics are well known, there is limited information about the long-term impact of combustion-free nicotine alternatives (C-F NA) such as e-cigarettes or heated tobacco products. OBJECTIVE This multicenter, prospective, 3-parallel-arm randomized controlled trial will investigate whether switching from combustible cigarettes to C-F NA will lead to measurable improvements in oral health parameters and dental esthetics over 18 months in adult smokers with limited gum disease. METHODS Regular smokers not intending to quit and without clinical signs of periodontitis will be randomly assigned (1:4 ratio) to either standard of care with brief cessation advice (control group; arm A) or C-F NA use (intervention group; arm B). The study will also include a reference group of never smokers (reference group; arm C). The primary end point is the change in the Modified Gingival Index (MGI) score from baseline between the control arm (arm A) and the intervention arm (arm B) at the 18-month follow-up. In addition, the study will analyze the within- and between-group (arms A, B, and C) changes in MGI assessment, plaque imaging, dental shade quantitation, tooth stain scores, and oral health-related quality of life questionnaires measured at each study time point. All participants will attend a total of 7 clinic visits: screening, enrollment, and randomization (visit 0); baseline visit-day 14 (visit 1); day 90 (visit 2); day 180 (visit 3); day 360 (visit 4); and day 540 (visit 5). This multicenter study will be conducted in 4 dental clinics in 4 countries. The statistical analysis will involve descriptive statistics for continuous and categorical data. Primary end points will undergo tests for normality and, based on distribution, either a 2-sided t test or Mann-Whitney U test. Linear mixed model with random factors center and study arms by center will also be applied. Secondary end points, including MGI assessment and quality of life, will be subjected to similar tests and comparisons. Only if one value of the parameter MGI is missing after day 1, the last available observation will be carried forward. The analysis will be performed on the substituted data. Secondary parameters will not have missing value replacement. RESULTS Participant recruitment began in October 2021, and enrollment was completed in June 2023. Results will be reported in 2025. CONCLUSIONS This will be the first study to provide key insights into oral health benefits or risks associated with using C-F NA in smokers who are seeking alternatives to cigarette smoking. TRIAL REGISTRATION ClinicalTrials.gov NCT04649645; https://clinicaltrials.gov/ct2/show/NCT04649645. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53222.
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Affiliation(s)
| | - Sebastiano Antonio Pacino
- Addendo srl, Dental Clinic, Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Salvatore Urso
- ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
- Department of Biological, Geological and Environmental Sciences, University of Catania, Catania, Italy
| | | | - Pasquale Caponnetto
- Center of Excellence for the Acceleration of HArm Reduction, University of Catania, Catania, Italy
- Department of Educational Sciences, Section of Psychology, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Center of Excellence for the Acceleration of HArm Reduction, University of Catania, Catania, Italy
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Luigi Generali
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Vittorio Checchi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | | | - Jan Kowalski
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Nowak
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Iain Chapple
- Periodontal Research Group, The University of Birmingham & Birmingham Community Healthcare Trust, Birmingham, United Kingdom
| | - Michael Milward
- Periodontal Research Group, The University of Birmingham & Birmingham Community Healthcare Trust, Birmingham, United Kingdom
| | - Robert Maclure
- R Maclure Clinical Research Ltd, Irby, Wirral, United Kingdom
| | - Gianna Maria Nardi
- Department of Dental and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Bosma ML, McGuire JA, DelSasso A, Milleman J, Milleman K. Efficacy of flossing and mouth rinsing regimens on plaque and gingivitis: a randomized clinical trial. BMC Oral Health 2024; 24:178. [PMID: 38310236 PMCID: PMC10837857 DOI: 10.1186/s12903-024-03924-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND To investigate the effects of combinations of mechanical (brushing and flossing) and chemotherapeutic regimens which included essential oils (EO) non-alcohol and alcohol-containing mouthrinses compared to brushing only in the prevention and reduction of plaque, gingivitis, and gingival bleeding. METHODS This was a randomized, virtually supervised, examiner blind, controlled clinical trial. Following informed consent and screening, subjects (N = 270) with gingivitis were randomly assigned to one of the following regimens: (1) Brush Only (B, n = 54); (2) Brush/Rinse (EO alcohol-containing mouthrinse) (BA, n = 54); (3) Brush/Rinse (EO non-alcohol containing mouthrinse) (BZ, n = 54); (4) Brush/Floss (BF, n = 54); (5) Brush/Floss/Rinse (EO non-alcohol containing mouthrinse) (BFZ, n = 54). Unflavored waxed dental floss (REACH unflavored waxed dental floss), and fluoridated toothpaste (Colgate Cavity Protection) were used. Examinations included oral hard and soft tissue, plaque, gingivitis, gingival bleeding, probing depth and bleeding on probing. RESULTS After 12 weeks, both BA and BZ and the BFZ group were superior in reducing interproximal plaque (30.8%, 18.2%, 16.0%, respectively), gingivitis (39.0%, 36.9%, 36.1%, respectively), and bleeding (67.8%, 73.6%, 79.8%, respectively) compared to B. The BF group did not provide significant reductions in interproximal plaque but did reduce interproximal gingivitis (5.1%, p = 0.041) at Week 4 and bleeding at Weeks 4 and 12 (34.6%, 31.4%, p < 0.001 respectively) compared to B. The BFZ group did not significantly reduce interproximal plaque, gingivitis or bleeding compared to BZ. CONCLUSIONS This study demonstrated that the addition of EO non-alcohol containing mouthrinse to the manual toothbrushing and flossing regimen further reduces plaque, gingivitis and bleeding showing that addition of EO mouthrinses (alcohol or non-alcohol containing) to the oral hygiene regimen provides sustained reductions in plaque to help maintain gingival health after a dental prophylaxis. Dental professional recommendation of the addition of an EO non-alcohol containing mouthrinse to daily oral hygiene routines of brushing or brushing and flossing should be considered to aid supragingival plaque control and improve gingivitis prevention. STUDY REGISTRY NUMBER NCT05600231.
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Affiliation(s)
- Mary Lynn Bosma
- Johnson & Johnson Consumer, 199 Grandview Road, Skillman, NJ, 08558, USA
| | - James A McGuire
- Johnson & Johnson Consumer, 199 Grandview Road, Skillman, NJ, 08558, USA.
| | - Alicia DelSasso
- Johnson & Johnson Consumer, 199 Grandview Road, Skillman, NJ, 08558, USA
| | - Jeffery Milleman
- Salus Research, 1220 Medical Park Drive, Building 4, IN, Fort Wayne, 46825, USA
| | - Kimberly Milleman
- Salus Research, 1220 Medical Park Drive, Building 4, IN, Fort Wayne, 46825, USA
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Montesani L, Montesani L, Mateo L, Daep C, Huber N, Isapour G, Zhang YP. Antibacterial and clinical effectiveness of a mouthwash with a novel active system of amine + zinc lactate + fluoride: a randomized controlled trial. Clin Oral Investig 2024; 28:90. [PMID: 38217757 PMCID: PMC10902027 DOI: 10.1007/s00784-023-05487-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/30/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES To support the daily oral hygiene of patients experiencing gum inflammation, a new mouthwash was developed containing an amine + zinc lactate + fluoride system. In vitro and clinical efficacy was assessed using traditional methods as well as using novel site-specific and subject-specific analyses of the clinical data. MATERIALS AND METHODS This mouthwash was evaluated in a 12-h biofilm regrowth assay against a negative control mouthwash and in a 6-month plaque and gingivitis clinical study as compared to a negative control mouthwash. Analyses of healthy versus inflamed sites, visible plaque versus non-visible plaque sites, as well as subject-level evaluations bring new perspectives to the overall performance of this mouthwash and its significance from a patient outcome perspective. RESULTS Studies demonstrated that this new mouthwash provided long-term (12-h) antibacterial activity after single application in vitro and reduced clinically all plaque and gingivitis parameters after 3 months and 6 months of use when compared to the negative control mouthwash. Examination of site-level and subject-level data determined that this mouthwash significantly increased the number of healthy sites in the oral cavity and significantly improved the gum health of subjects in the study, as compared to the negative control mouthwash. CONCLUSIONS In vitro and clinical research has demonstrated the antibacterial and clinical benefits of this mouthwash containing an amine compound + zinc lactate + fluoride system. CLINICAL RELEVANCE Our subject-specific and site-specific analyses provide the dental practitioner with tools that can be used to guide patients who suffer from gingivitis toward optimal product selection and use. CLINICAL TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov (reference no. NCT05821712).
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Affiliation(s)
| | | | - Luis Mateo
- LRM Statistical Consulting, West Orange, NJ, USA
| | - Carlo Daep
- Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | | | | | - Yun-Po Zhang
- Colgate-Palmolive Technology Center, Piscataway, NJ, USA.
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Brookes Z, McGrath C, McCullough M. Antimicrobial Mouthwashes: An Overview of Mechanisms-What Do We Still Need to Know? Int Dent J 2023; 73 Suppl 2:S64-S68. [PMID: 37867063 PMCID: PMC10690552 DOI: 10.1016/j.identj.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
This narrative literature review is the first in a 6-section supplement on the role of mouthwashes in oral care. This introduction briefly summarises current knowledge on antimicrobial mechanisms, relating to some of the most common over-the-counter mouthwash products available worldwide: chlorhexidine, hydrogen peroxide, cetylpyridinium chloride, povidone iodine, and essential oils. The aim of this first article is to describe how mouthwashes "kill" pathogenic microbes when used adjunctively and thus provide a basis for their widespread use to manage key oral diseases, namely caries, gingivitis, and periodontal disease. This article therefore sets the scene for subsequent, more detailed exploration of mouthwashes regarding their clinical effectiveness, impact on the oral microbiome, and possible effects on systemic health as well as natural alternatives and future directions. Other than the clinical effectiveness (for certain agents) of mouthwashes, on many topics there remains insufficient evidence for systematic review or formulation of robust national guidelines. The supplement, therefore, compiled by an international task team, is aimed at general dental practitioners across the globe, as an easy-to-read guide for helping to advise patients on mouthwash use based on the current best available evidence.
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Affiliation(s)
- Zoë Brookes
- Peninsula Dental School, Plymouth University, Plymouth, UK.
| | - Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, Melbourne, Australia
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Figuero E, Serrano J, Arweiler NB, Auschill TM, Gürkan A, Emingil G. Supra and subgingival application of antiseptics or antibiotics during periodontal therapy. Periodontol 2000 2023. [PMID: 37766668 DOI: 10.1111/prd.12511] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023]
Abstract
Periodontal diseases (gingivitis and periodontitis) are characterized by inflammatory processes which arise as a result of disruption of the balance in the oral ecosystem. According to the current S3 level clinical practice guidelines, therapy of patients with periodontitis involves a stepwise approach that includes the control of the patient's risk factors and the debridement of supra and subgingival biofilm. This debridement can be performed with or without the use of some adjuvant therapies, including physical or chemical agents, host modulating agents, subgingivally locally delivered antimicrobials, or systemic antimicrobials. Therefore, the main aim of this article is to review in a narrative manner the existing literature regarding the adjuvant application of local agents, either subgingivally delivered antibiotics and antiseptics or supragingivally applied rinses and dentifrices, during the different steps in periodontal therapy performed in Europe.
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Affiliation(s)
- Elena Figuero
- Department of Dental Clinical Specialties, Etiology and Therapy of Periodontal and Peri-implant Research Group, Faculty of Dentistry, University Complutense of Madrid, Madrid, Spain
- Etiology and Therapy of Periodontal and Peri-implant Research Group, University Complutense of Madrid, Madrid, Spain
| | - Jorge Serrano
- Etiology and Therapy of Periodontal and Peri-implant Research Group, University Complutense of Madrid, Madrid, Spain
| | - Nicole Birgit Arweiler
- Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Marburg, Germany
| | - Thorsten Mathias Auschill
- Department of Periodontology and Peri-implant Diseases, Philipps University of Marburg, Marburg, Germany
| | - Ali Gürkan
- Department of Peridontology, Ege University School of Dentistry, Bornova, Turkey
| | - Gülnur Emingil
- Department of Peridontology, Ege University School of Dentistry, Bornova, Turkey
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Garrido L, Lyra P, Rodrigues J, Viana J, Mendes JJ, Barroso H. Revisiting Oral Antiseptics, Microorganism Targets and Effectiveness. J Pers Med 2023; 13:1332. [PMID: 37763100 PMCID: PMC10532628 DOI: 10.3390/jpm13091332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
A good oral health status is mostly dependent on good oral hygiene habits, which knowingly impacts systemic health. Although controversial, chemical oral antiseptics can be useful in adjunct use to mechanical dental plaque control techniques in the prevention and management of local and overall health and well-being. This review aims to revisit, gather and update evidence-based clinical indications for the use of the most popular oral antiseptics, considering different types, microorganism targets and effectiveness in order to establish updated clinical recommendations.
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Affiliation(s)
| | | | | | | | | | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal (P.L.); (J.V.); (J.J.M.)
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Liu T, Chen YC, Jeng SL, Chang JJ, Wang JY, Lin CH, Tsai PF, Ko NY, Ko WC, Wang JL. Short-term effects of Chlorhexidine mouthwash and Listerine on oral microbiome in hospitalized patients. Front Cell Infect Microbiol 2023; 13:1056534. [PMID: 36816590 PMCID: PMC9932516 DOI: 10.3389/fcimb.2023.1056534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Chlorhexidine (CHX) and essential oil containing mouthwashes like Listerine® can improve oral hygiene via suppressing oral microbes. In hospitalized patients, CHX mouthwash reduces the incidence of ventilator-associated pneumonia. However, CHX use was also associated with increased mortality, which might be related to nitrate-reducing bacteria. Currently, no study determines oral bacteria targeted by essential oils mouthwash in hospitalized patients using a metagenomic approach. Methods We recruited 87 hospitalized patients from a previous randomized control study, and assigned them to three mouthwash groups: CHX, Listerine, and normal saline (control). Before and after gargling the mouthwash twice a day for 5-7 days, oral bacteria were examined using a 16S rDNA approach. Results Alpha diversities at the genus level decreased significantly only for the CHX and Listerine groups. Only for the two groups, oral microbiota before and after gargling were significantly different, but not clearly distinct. Paired analysis eliminated the substantial individual differences and revealed eight bacterial genera (including Prevotella, Fusobacterium, and Selenomonas) with a decreased relative abundance, while Rothia increased after gargling the CHX mouthwash. After gargling Listerine, seven genera (including Parvimonas, Eubacterium, and Selenomonas) showed a decreased relative abundance, and the magnitudes were smaller compared to the CHX group. Fewer bacteria targeted by Listerine were reported to be nitrate-reducing compared to the CHX mouthwash. Discussion In conclusion, short-term gargling of the CHX mouthwash and Listerine altered oral microbiota in our hospitalized patients. The bacterial genera targeted by the CHX mouthwash and Listerine were largely different and the magnitudes of changes were smaller using Listerine. Functional alterations of gargling CHX and Listerine were also different. These findings can be considered for managing oral hygiene of hospitalized patients.
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Affiliation(s)
- Tsunglin Liu
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Yen-Chin Chen
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Nursing, National Cheng Kung University, Tainan, Taiwan
| | - Shuen-Lin Jeng
- Department of Statistics, Institute of Data Science, Center for Innovative FinTech Business Models, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Jen Chang
- Graduate Institute of Integrated Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Jiu-Yao Wang
- Center of Allergy, Immunology and Microbiome (AIM), Department of Allergy and Immunology, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Cheng-Han Lin
- Center of Allergy, Immunology and Microbiome (AIM), Department of Allergy and Immunology, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Pei-Fang Tsai
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Nai-Ying Ko
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Nursing, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jiun-Ling Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan,Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan,*Correspondence: Jiun-Ling Wang,
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Kumbargere Nagraj S, Eachempati P, Paisi M, Nasser M, Sivaramakrishnan G, Francis T, Verbeek JH. Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental healthcare providers. Cochrane Database Syst Rev 2022; 8:CD013826. [PMID: 35994295 PMCID: PMC9394685 DOI: 10.1002/14651858.cd013826.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Aerosols and spatter are generated in a dental clinic during aerosol-generating procedures (AGPs) that use high-speed hand pieces. Dental healthcare providers can be at increased risk of transmission of diseases such as tuberculosis, measles and severe acute respiratory syndrome (SARS) through droplets on mucosae, inhalation of aerosols or through fomites on mucosae, which harbour micro-organisms. There are ways to mitigate and contain spatter and aerosols that may, in turn, reduce any risk of disease transmission. In addition to personal protective equipment (PPE) and aerosol-reducing devices such as high-volume suction, it has been hypothesised that the use of mouth rinse by patients before dental procedures could reduce the microbial load of aerosols that are generated during dental AGPs. OBJECTIVES To assess the effects of preprocedural mouth rinses used in dental clinics to minimise incidence of infection in dental healthcare providers and reduce or neutralise contamination in aerosols. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was 4 February 2022. SELECTION CRITERIA We included randomised controlled trials and excluded laboratory-based studies. Study participants were dental patients undergoing AGPs. Studies compared any preprocedural mouth rinse used to reduce contaminated aerosols versus placebo, no mouth rinse or another mouth rinse. Our primary outcome was incidence of infection of dental healthcare providers and secondary outcomes were reduction in the level of contamination of the dental operatory environment, cost, change in mouth microbiota, adverse events, and acceptability and feasibility of the intervention. DATA COLLECTION AND ANALYSIS Two review authors screened search results, extracted data from included studies, assessed the risk of bias in the studies and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data MAIN RESULTS: We included 17 studies with 830 participants aged 18 to 70 years. We judged three trials at high risk of bias, two at low risk and 12 at unclear risk of bias. None of the studies measured our primary outcome of the incidence of infection in dental healthcare providers. The primary outcome in the studies was reduction in the level of bacterial contamination measured in colony-forming units (CFUs) at distances of less than 2 m (intended to capture larger droplets) and 2 m or more (to capture droplet nuclei from aerosols arising from the participant's oral cavity). It is unclear what size of CFU reduction represents a clinically significant amount. There is low- to very low-certainty evidence that chlorhexidine (CHX) may reduce bacterial contamination, as measured by CFUs, compared with no rinsing or rinsing with water. There were similar results when comparing cetylpyridinium chloride (CPC) with no rinsing and when comparing CPC, essential oils/herbal mouthwashes or boric acid with water. There is very low-certainty evidence that tempered mouth rinses may provide a greater reduction in CFUs than cold mouth rinses. There is low-certainty evidence that CHX may reduce CFUs more than essential oils/herbal mouthwashes. The evidence for other head-to-head comparisons was limited and inconsistent. The studies did not provide any information on costs, change in micro-organisms in the patient's mouth or adverse events such as temporary discolouration, altered taste, allergic reaction or hypersensitivity. The studies did not assess acceptability of the intervention to patients or feasibility of implementation for dentists. AUTHORS' CONCLUSIONS: None of the included studies measured the incidence of infection among dental healthcare providers. The studies measured only reduction in level of bacterial contamination in aerosols. None of the studies evaluated viral or fungal contamination. We have only low to very low certainty for all findings. We are unable to draw conclusions regarding whether there is a role for preprocedural mouth rinses in reducing infection risk or the possible superiority of one preprocedural rinse over another. Studies are needed that measure the effect of rinses on infectious disease risk among dental healthcare providers and on contaminated aerosols at larger distances with standardised outcome measurement.
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Affiliation(s)
- Sumanth Kumbargere Nagraj
- Professor and Head, Department of Oral Medicine and Oral Radiology, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
- Honorary Research Fellow, Division of Surgery and Interventional Science, Department of Surgical Biotechnology, University College London, London, UK
| | - Prashanti Eachempati
- Professor and Head, Department of Prosthodontics, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
| | - Martha Paisi
- Peninsula Dental Social Enterprise, Peninsula Dental School, University of Plymouth, Plymouth, UK
| | - Mona Nasser
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | | | - Tony Francis
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Manipal University College Malaysia, Melaka, Malaysia
| | - Jos H Verbeek
- Cochrane Work, Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Bio-Mechanism of Catechin as Pheromone Signal Inhibitor: Prediction of Antibacterial Agent Action Mode by In Vitro and In Silico Study. Molecules 2021; 26:molecules26216381. [PMID: 34770790 PMCID: PMC8587927 DOI: 10.3390/molecules26216381] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
The utilization of medicinal plants has long been explored for the discovery of antibacterial agents and the most effective mechanisms or new targets that can prevent and control the spread of antibiotic resistance. One kind of bacterial cell wall inhibition is the inactivation of the MurA enzyme that contributes to the formation of peptidoglycan. Another approach is to interfere with the cell–cell communication of bacteria called the Quorum sensing (QS) system. The blocking of auto-inducer such as gelatinase biosynthesis-activating pheromone (GBAP) can also suppress the virulence factors of gelatinase and serine protease. This research, in particular, aims to analyze lead compounds as antibacterial and anti-QS agents from Gambir (Uncaria gambir Roxburgh) through protein inhibition by in silico study. Antibacterial agents were isolated by bioactivity-guided isolation using a combination of chromatographic methods, and their chemical structures were determined by spectroscopic analysis methods. The in vitro antibacterial activity was evaluated by disc diffusion methods to determine inhibitory values. Meanwhile, in the in silico analysis, the compound of Uncaria gambir was used as ligand and compared with fosfomycin, ambuic acid, quercetin, and taxifolin as the standard ligand. These ligands were attached to MurA, GBAP, gelatinase, and serine proteases using Autodock Vina in PyRx 0.8 followed by PYMOL for combining the ligand conformation and proteins. plus programs to explore the complex, and visualized by Discovery Studio 2020 Client program. The antibacterial agent was identified as catechin that showed inhibitory activity against Enterococcus faecalis ATCC 29212 with inhibition zones of 11.70 mm at 10%, together with MIC and MBC values of 0.63 and 1.25 μg/mL, respectively. In the in silico study, the molecular interaction of catechin with MurA, GBAP, and gelatinase proteins showed good binding energy compared with two positive controls, namely fosfomycin and ambuic acid. It is better to use catechin–MurA (−8.5 Kcal/mol) and catechin–gelatinase (−7.8 Kcal/mol), as they have binding energies which are not marginally different from quercetin and taxifolin. On the other hand, the binding energy of serine protease is lower than quercetin, taxifolin, and ambuic acid. Based on the data, catechin has potency as an antibacterial through the inhibition of GBAP proteins, gelatinase, and serine protease that play a role in the QS system. This is the first discovery of the potential of catechin as an alternative antibacterial agent with an effective mechanism to prevent and control oral disease affected by antibiotic resistance.
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Cota LOM, Villar CC, Vettore MV, Campos JR, Amaral GCLSD, Cortelli JR, Cortelli SC. Periodontal diseases: is it possible to prevent them? A populational and individual approach. Braz Oral Res 2021; 35:e098. [PMID: 34586212 DOI: 10.1590/1807-3107bor-2021.vol35.0098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
Periodontal diseases are infectious inflammatory chronic diseases of a multifactorial nature. They are primarily caused by dysbiotic ecological changes in dental biofilm, which may be influenced by risk factors. The prevention of periodontal diseases may involve different strategies focused on reducing distal, intermediate, and proximal risk factors at both the population and individual levels. Effective prevention depends on interdisciplinary and common risk factor approaches. Also, patient-centered preventive models are more effective than professional-centered models in the management of periodontal diseases. Regular and periodic control of dental biofilm is an essential measure for the different levels of prevention of periodontal diseases. The effectiveness of periodontal disease prevention largely depends on positive modifications of behavior, knowledge, health literacy, patient empowerment, motivation, and compliance.
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Affiliation(s)
- Luís Otávio Miranda Cota
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
| | - Cristina Cunha Villar
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Mario Vianna Vettore
- University of Agder - UiA, Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, Kristiansand, Norway
| | - Julya Ribeiro Campos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Dental Clinics, Oral Surgery and Oral Pathology, Belo Horizonte, MG, Brazil
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Shamseddine L, Chidiac JJ. Composition's effect of Origanum Syriacum essential oils in the antimicrobial activities for the treatment of denture stomatitis. Odontology 2021; 109:327-335. [PMID: 32808051 PMCID: PMC7430938 DOI: 10.1007/s10266-020-00547-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
This research has several purposes: First to assess the bacterial and fungal minimum inhibitory concentration of Origanum Syriacum essential oil. Second to quantify its bactericidal and fungicidal minimal concentration against S. aureus, S. mutans, and C. albicans found in denture stomatitis. The third purpose is to look at the influence of three different soils (Annaya, Bhanin and Michrif) on the essential oils composition. Three essential oils were extracted by hydro-distillation from three different Origanum Syriacum plant origins. Bioassays were conducted using a broth microdilution methods. Gas Chromatography analysis was used to calculate the abundance of most components in each essential oil. Post hoc tests assessed antimicrobial effects between ecotypes while Pearson's test correlated the different components and their antimicrobial efficiency (α < 0.05). All tested essential oils were efficient against all microorganisms. Origanum Syriacum essential oils derived from Annaya and Bhanin soils showed a superior antimicrobial activity compared to the Michrif one. The most abundant component and most efficient among all essential oils constituents was carvacrol. It can be concluded that Origanum Syriacum essential oils have an antimicrobial activity, which depends on the ecotype, its origin and its composition. They might be used to start a clinical trial for the treatment of denture stomatitis.
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Affiliation(s)
- Loubna Shamseddine
- Faculty of Dental Medicine, Department of Prosthodontics, Lebanese University, Beirut, Hadat Lebanon
| | - Jose Johann Chidiac
- Faculty of Dental Medicine, Department of Prosthodontics, Lebanese University, Beirut, Hadat Lebanon
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de Oliveira MA, da C Vegian MR, Brighenti FL, Salvador MJ, Koga-Ito CY. Antibiofilm effects of Thymus vulgaris and Hyptis spicigera essential oils on cariogenic bacteria. Future Microbiol 2021; 16:241-255. [PMID: 33625248 DOI: 10.2217/fmb-2020-0181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: The inhibitory and antibiofilm effects of Thymus vulgaris (EOTv) and Hyptis spicigera essential oils (EOHs) on cariogenic microorganisms were evaluated. Materials & methods: The chemical characterization of EOTv was performed by gas chromatography/mass spectrometry. Streptococcus mutans, Streptococcus gordonii, Streptococcus sanguinis, Streptococcus mitis, Streptococcus sobrinus, Lactobacillus acidophilus and Actinomyces naeslundii were used for agar diffusion assays and determination of minimal inhibitory and minimal bactericide concentrations. In addition, 20 streptococci and lactobacilli clinical isolates were also tested. The effects of essential oil on microbial initial biofilm formation and on preformed microcosm biofilm formed from human saliva were studied. Results & conclusion: Both essential oils had inhibitory effects on the cariogenic species and reduced the bacterial adherence to dental enamel. Essential oils were able to disrupt preformed microcosm biofilms. Thymus vulgaris and Hyptis spicigera essential oils have potential to be used in the development of formulations to the control of cariogenic biofilms.
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Affiliation(s)
- Maria Ac de Oliveira
- Department of Environmental Engineering & Oral Biopathology Graduate Program, Institute of Science & Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Mariana R da C Vegian
- Department of Environmental Engineering & Oral Biopathology Graduate Program, Institute of Science & Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
| | - Fernanda L Brighenti
- Department of Morphology & Pediatric Dentistry, Araraquara Dental School, São Paulo State University - UNESP, Araraquara, Brazil
| | - Marcos J Salvador
- Department of Plant Biology, Institute of Biology, University of Campinas - UNICAMP, Campinas, Brazil
| | - Cristiane Y Koga-Ito
- Department of Environmental Engineering & Oral Biopathology Graduate Program, Institute of Science & Technology, São Paulo State University - UNESP, São José dos Campos, Brazil
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Jung YA, Kim HS. [Effects of Oral Gargling with Aroma Solution in Psychiatric Inpatients: A Non-Randomized Controlled Trial]. J Korean Acad Nurs 2021; 50:200-209. [PMID: 32376809 DOI: 10.4040/jkan.2020.50.2.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the effects of oral gargling with an aromatic solution on xerostomia, objective oral status, and oral health-related quality of life in psychiatric inpatients. METHODS A nonequivalent control group with a non-synchronized design was used in this study. The experimental group (n=34) received oral gargling with an aroma solution, while the control group (n=33) gargled with 0.9% normal saline. Dependent variables were measured at pre-, post-, and follow-up test. Data were analyzed using an χ²-test, Fisher's exact probability test, t-tests, and repeated measures ANOVA using SPSS/WIN v.21.0. RESULTS After the intervention, significant differences were revealed in xerostomia (F=15.30, p <.001), objective oral status (F=38.44, p <.001), and oral health-related quality of life (F=62.70, p <.001) with an interaction effect between group and time. CONCLUSION These findings indicate that gargling with an aroma solution is more effective than 0.9% normal saline for the oral health of psychiatric inpatients. Therefore gargling with an aroma can be safely recommended as a brief, economical, and positive intervention in clinical settings.
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Affiliation(s)
- Yun Ah Jung
- College of Nursing, Kyungpook National University, Daegu, Korea
| | - Hee Sook Kim
- College of Nursing · The Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea.
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Spuldaro TR, Rogério Dos Santos Júnior M, Vicentis de Oliveira Fernandes G, Rösing CK. Efficacy of Essential Oil Mouthwashes With and Without Alcohol on the Plaque Formation: A Randomized, Crossover, Double-Blinded, Clinical Trial. J Evid Based Dent Pract 2021; 21:101527. [PMID: 34051963 DOI: 10.1016/j.jebdp.2021.101527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/02/2020] [Accepted: 12/22/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Essential oil (EO) mouthwash has been considered as one of the effective chemical agents as an adjunct to mechanical plaque control, without adverse effects compared with chlorhexidine (pigmentation, changes of taste, and formation of supragingival calculus), which limits its continuous use. New EO alcohol-based has emerged with questions regarding contraindications for its daily use. OBJECTIVE To compare the efficacy of EO mouthwashes with and without alcohol on the early supragingival and subgingival plaque formation using a plaque-free zone score system. METHODS This study was a crossover, randomized, double-blind clinical trial. Eleven participants, totaling 396 sites of evaluation, remained 4 days with no mechanical oral hygiene control and only used EO mouthwash with (control) and without alcohol (test) during this period. The presence of the plaque-free zone was recorded every 24 hours. Friedman and Wilcoxon tests were used with a 5% significance level. RESULTS The control group showed a more significant number of buccal surfaces free of plaque at 48, 72, and 96 hours compared with the test group. Both groups presented satisfactory efficacy up to 72 hours with a significant difference in favor of the control group. The presence of subgingival plaque on both the proximal and free surfaces was significantly higher in the test group. CONCLUSION EO with alcohol presented better results in retarding the early supragingival and subgingival plaque formation compared with EO without alcohol.
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Affiliation(s)
- Tobias Rauber Spuldaro
- Faculty of Dentistry, University Center of Serra Gaúcha - FSG, Caxias do Sul, RS, Brazil; Faculty of Dentistry, Catholic University of Portugal, Viseu, Portugal; Interdisciplinary Institute of Health Sciences (CIIS), Portugal; Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | | | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Effect of Citrus aurantium L. Essential Oil on Streptococcus mutans Growth, Biofilm Formation and Virulent Genes Expression. Antibiotics (Basel) 2021; 10:antibiotics10010054. [PMID: 33429924 PMCID: PMC7827172 DOI: 10.3390/antibiotics10010054] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
In an oral cavity, dental caries, periodontal disease, and endodontic lesions are caused by well-known bacterial and fungal pathogens. Essential oils (EOs) have demonstrated antimicrobial activity suggesting their use for oral hygiene. The goal of this study was to evaluate the interaction of bitter orange flower (Citrus aurantium L.) essential oil with cariogenic bacteria Streptococcus mutans and human gingival epithelial cells. After extraction, the chemical composition of the essential oil was analyzed by gas chromatography, and its antimicrobial activity was evaluated against the growth and the expression of virulent genes in S. mutans. Finally, the effects of this essential oil on human gingival epithelial cell adhesion and growth were assessed using cell adhesion and proliferation assays. We showed that the major constituents of the tested essential oil were limonene, linalool, and β-ocimene. The essential oil reduced the growth of S. mutans, and decreased expression of comC, comD, comE, gtfB, gtfC, and gbpB genes. It should, however, be noted that essential oil at high concentration was toxic to gingival epithelial cells. Overall, this study suggests that C. aurantium L. essential oil could be used to prevent/control oral infections.
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Levine M, Collins LM, Lohinai Z. Zinc chloride inhibits lysine decarboxylase production from Eikenella corrodens in vitro and its therapeutic implications. J Dent 2020; 104:103533. [PMID: 33189800 DOI: 10.1016/j.jdent.2020.103533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/26/2020] [Accepted: 09/14/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Dentifrices containing zinc reduce gingival inflammation and bleeding better than control dentifrices (no zinc). How zinc might work is not understood. We have shown that lysine decarboxylase (LdcE), an enzyme from Eikenella corrodens, converts lysine to cadaverine in dental biofilms. The lack of lysine impairs the dentally attached cell barrier to biofilm, causing biofilm products to leak into junctional epithelium and stimulate inflammation. In year-old beagle dogs, immunization with LdcE, induces antibodies that inhibit LdcE activity and retard gingivitis development. We therefore examined whether a zinc-mediated loss of LdcE activity could explain the beneficial effect of zinc dentifrices. METHODS We grew E. corrodens in modified tryptic soy broth with or without zinc chloride, and extracted LdcE from the cell surface using a Potter Elvehjem homogenizer. RESULTS Up to 0.96 mM zinc chloride in the bacterial growth medium did not change cell yield, but reduced the extracted protein content by 41% (R2 = 0.27, p < 0.05) and LdcE activity/mg extracted protein by 85% (R2 = 0.90, p < 0.001). In extracts from cells grown without zinc, 78 times this zinc chloride concentration (73 mM) was required to reduce LdcE activity by 75%. CONCLUSIONS Zinc ions inhibit the production of protein with LdcE activity at E. corrodens cell surfaces. The zinc ions may attach to cysteine residues that are unique to the N-terminal region of LdcE by interfering with the non-covalent polypeptide assembly that produces enzyme activity. CLINICAL SIGNIFICANCE Zinc ion-mediated inhibition of LdcE assembly may provide a rationale for the improved control of gingival inflammation by zinc dentifrices.
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Affiliation(s)
- Martin Levine
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States.
| | - Lindsay M Collins
- Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
| | - Zsolt Lohinai
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
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SOOFI M, KARAMI-MATIN B, PASDAR Y, HAMZEH B, MORADI-NAZAR M, AMERI H, NAJAFI F. What explains socioeconomic inequalities in dental flossing? Cross-sectional results from the RaNCD cohort study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E215-E220. [PMID: 32803008 PMCID: PMC7419114 DOI: 10.15167/2421-4248/jpmh2020.61.2.1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/24/2020] [Indexed: 12/04/2022]
Abstract
Introduction The magnitude and underlying determinants of socioeconomic inequality in dental flossing are poorly understood in Iran. This study aimed to measure and decompose socioeconomic inequalities in dental flossing in Ravansar, Iran. Methods Data of 10,002 individuals aged 35-65 years who participated in the Ravansar Non- communicable Diseases (RaNCD) cohort study in Kermanshah province, western Iran, were analyzed. Based on an asset-based method, socioeconomic status (SES) was measured using principal component analysis (PCA). The concentration index and curve were employed to measure socioeconomic inequality in dental flossing. Decomposition analysis was used to estimate the contribution of each determinant to the overall inequality. Results Of 10,002 participants, 11.74% were found to practice dental floss. The normalized CI for dental flossing was 0.327 in the entire population, 0.323 in females and 0.329 in males, indicating that the use of dental floss is more concentrated among high-SES individuals. The decomposition analysis indicated that SES (50.58%) and level of education (44.90%) respectively contributed the most to this inequality. Place of residence (10.55%) and age group (2.7%) were the next main contributors, respectively. Conclusions We found a low prevalence of dental flossing among participants in RaNCD study. We also observed a relatively high degree of pro-rich inequality in dental flossing. The observed inequality was mainly explained by socioeconomic status, level of education and place of residence. Policy interventions should consider these factors to reduce inequalities in dental flossing.
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Affiliation(s)
- M. SOOFI
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - B. KARAMI-MATIN
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Y. PASDAR
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - B. HAMZEH
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - M. MORADI-NAZAR
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - H. AMERI
- Health Policy and Management Research Center, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - F. NAJAFI
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Correspondence: Farid Najafi, Research Center for Environmental Determinants of Health, Health Institute,Kermanshah University of Medical Sciences, Kermanshah, Iran - Tel.: 00 988338281991 - Fax: 00 988338263048 - E-mail:
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Mehringer H, Fraga-González G, Pleisch G, Röthlisberger M, Aepli F, Keller V, Karipidis II, Brem S. (Swiss) GraphoLearn: an app-based tool to support beginning readers. RESEARCH AND PRACTICE IN TECHNOLOGY ENHANCED LEARNING 2020; 15:5. [PMID: 32175013 PMCID: PMC7048874 DOI: 10.1186/s41039-020-0125-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/29/2020] [Indexed: 06/10/2023]
Abstract
We assessed the Swiss-German version of GraphoLearn, a computer game designed to support reading by training grapheme-phoneme correspondences. A group of 34 children at risk for dyslexia trained three times a week during 14 weeks, on top of their standard school instruction. The sample was divided into two groups of 18 and 16 children, who started training at either the middle or the end of first grade. We found beneficial training effects in pseudoword reading in both training groups and for rapid automatized naming skills in the group that trained earlier. Our results suggest that both the efficiency in phonological decoding and rapid access to verbal representations are susceptible to facilitation by GraphoLearn. These findings confirm the utility of the training software as a tool to support school instruction and reading-related abilities in beginning readers. We discuss ideas to improve the content and outcomes of future versions of the training software.
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Affiliation(s)
- Hannah Mehringer
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
| | - Gorka Fraga-González
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
| | - Georgette Pleisch
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- MR-Center of the University Hospital of Psychiatry and the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Martina Röthlisberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
| | - Franziska Aepli
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
| | - Vera Keller
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
| | - Iliana I. Karipidis
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- MR-Center of the University Hospital of Psychiatry and the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, University of Zurich, Neumünsterallee 9, 8032 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- MR-Center of the University Hospital of Psychiatry and the Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zurich, Zurich, Switzerland
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Miksusanti, Fithri AN, Herlina, Wijaya DP, Taher T. Optimization of chitosan–tapioca starch composite as polymer in the formulation of gingival mucoadhesive patch film for delivery of gambier (Uncaria gambir Roxb) leaf extract. Int J Biol Macromol 2020; 144:289-295. [DOI: 10.1016/j.ijbiomac.2019.12.086] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/30/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
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Walsh LJ, Healey DL. Prevention and caries risk management in teenage and orthodontic patients. Aust Dent J 2020; 64 Suppl 1:S37-S45. [PMID: 31144319 DOI: 10.1111/adj.12671] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
As patients progress from childhood through to teenage years, they progress through periods of high caries risk as they undergo changes in lifestyle and oral microflora. Removable or fixed orthodontic treatment also alters the oral microflora and can dramatically increase caries risk. This paper outlines ways to identify the transition to higher caries risk, and practical ways to lower the risk of hard tissue loss from dental caries during orthodontic treatment across the teenage years, including tooth surface protection, optimised use of mechanical and chemical plaque control, and appropriate delivery of remineralising agents over time.
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Affiliation(s)
- L J Walsh
- The University of Queensland School of Dentistry, Herston, Brisbane, Australia
| | - D L Healey
- The University of Queensland School of Dentistry, Herston, Brisbane, Australia
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Essential oils as topical anti-infective agents: A systematic review and meta-analysis. Complement Ther Med 2019; 47:102224. [PMID: 31780027 DOI: 10.1016/j.ctim.2019.102224] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/27/2019] [Accepted: 10/17/2019] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE This study summarized evidence on the efficacy and safety of essential oils (EOs) in the treatment of topical infections. DESIGN AND SETTING Systematic review of clinical trials conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline. Electronic databases of the Cochrane, PubMed, EMBASE, Web of Science, and Scopus were searched from inception to November 2018. INTERVENTION Essential oil of any type, standard treatment and placebo. MAIN OUTCOME MEASURES Outcomes of the study include total acne count, acne severity index, reduction in total acne surface area, number of non-inflammatory acne lesions and inflammatory acne lesions, microbial cure rate, microbial decolonization rate, and new microbial emergence. RESULTS Non-significant but higher proportion of MRSA was cleared in EOs group (69% [95%CI: 34%, 96%]) compared to routine care (45% [95%CI: 36%, 53%]). Essential oils significantly lowered level of new MRSA emergence (9% [95% CI: 5%, 14%], I2 = 86.59%) compared to routine care (53% [95%CI: 30%, 75%], I2 = 86.59%). Four of the five studies on acne treatment showed equal or superior efficacy of EOs and the remaining one showed inferior efficacy to a control. In treatment of topical fungal infections, efficacy of essential oils were non-inferior compared to a standard treatment but superior to a placebo. CONCLUSION Essential oils could be considered as alternative treatment for acne, decolonization of MRSA, and topical fungal infections, yet the low quality and heterogeneity among the studies calls for further studies.
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Saliasi I, Llodra JC, Bravo M, Tramini P, Dussart C, Viennot S, Carrouel F. Effect of a Toothpaste/Mouthwash Containing Carica papaya Leaf Extract on Interdental Gingival Bleeding: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122660. [PMID: 30486374 PMCID: PMC6313435 DOI: 10.3390/ijerph15122660] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/13/2018] [Accepted: 11/23/2018] [Indexed: 12/31/2022]
Abstract
Clinical research on herbal-based dentifrice +/− mouth rinse products is very limited compared with the plethora of research on conventional oral care products under normal oral hygiene conditions. The aim of this study was to determine the anti-inflammatory effects of a novel plant Carica papaya leaf extract (CPLE) on interdental bleeding in healthy subjects. In this randomized, single-blind parallel-design study, the eligible subjects were generally healthy non-smokers, aged 18–26, who exhibited healthy periodontal conditions upon study entry. The participants were equally randomized into the following four groups: CPLE dentifrice, CPLE dentifrice and mouthwash, sodium lauryl sulfate (SLS)-free enzyme-containing dentifrice and SLS-free enzyme-containing dentifrice with essential oil (EO) mouthwash. Subjects were instructed to brush their teeth twice a day without changing their other brushing habits. Interdental bleeding (BOIP) was measured from inclusion (T0) until the fourth week (T4) of the study. Clinical efficacy was assessed after one, two, three and four weeks of home use. The analyses compared BOIP between groups and were then restricted to participants with ≥70% and then ≥80% bleeding sites at T0. Pairwise comparisons between groups were performed at T0 and T4, and a logistic regression identified correlates of gingival bleeding (T4). Among 100 subjects (2273 interdental sites), the median percentage of bleeding sites per participant at T0 was 65%. The bleeding sites dramatically decreased in all groups between T0 and T4 (relative variations from −54% to −75%, p < 0.01 for all). Gingival bleeding did not significantly differ between the CPLE dentifrice and the SLS-free dentifrice +/− EO mouthwash groups (from p = 0.05 to p = 0.86), regardless of the baseline risk level. Among the CPLE dentifrice users, fewer bleeding sites were observed when toothpaste and mouthwash were combined compared to bleeding sites in those who used toothpaste alone (21% vs. 32%, p = 0.04). CPLE dentifrice/mouthwash provides an efficacious and natural alternative to SLS-free dentifrice +/−EO-containing mouthwash when used as an adjunct to mechanical oral care to reduce interdental gingival inflammation.
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Affiliation(s)
- Ina Saliasi
- Laboratory "Systemic Health Care", EA4129, University of Lyon, 69008 Lyon, France.
| | - Juan Carlos Llodra
- Department of Preventive and Community Dentistry, Faculty of Odontology, University of Granada, 18010 Granada, Spain.
| | - Manuel Bravo
- Department of Preventive and Community Dentistry, Faculty of Odontology, University of Granada, 18010 Granada, Spain.
| | - Paul Tramini
- Department of Public Health, Faculty of Dental Medicine, University of Montpellier, 34090 Montpellier, France.
| | - Claude Dussart
- Laboratory "Systemic Health Care", EA4129, University of Lyon, 69008 Lyon, France.
| | - Stéphane Viennot
- Laboratory "Systemic Health Care", EA4129, University of Lyon, 69008 Lyon, France.
| | - Florence Carrouel
- Laboratory "Systemic Health Care", EA4129, University of Lyon, 69008 Lyon, France.
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Geisinger ML, Ogdon D, Kaur M, Valiquette G, Geurs NC, Reddy MS. Toss the Floss? Evidence-Based Oral Hygiene Recommendations for the Periodontal Patient in the Age of "Flossgate". Clin Adv Periodontics 2018; 9:83-90. [PMID: 31498572 DOI: 10.1002/cap.10048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/04/2018] [Indexed: 12/12/2022]
Abstract
FOCUSED CLINICAL QUESTION What are the key considerations for effective delivery of oral hygiene home care to best manage or prevent periodontal diseases? BACKGROUND Plaque control is critical for the management of periodontal diseases, but not all patients demonstrate the same risk for disease progression and challenges differ based upon clinical findings. This report seeks to present evidence-based oral hygiene recommendations for a variety of common periodontal diseases. SUMMARY Accurate diagnosis, risk assessment, and individualized delivery of oral hygiene instruction is necessary to ensure that patients can provide adequate home care to promote health and maintain the benefits of periodontal therapy. CONCLUSIONS Oral hygiene techniques and recommendations should vary based upon patients' clinical presentation and risk assessment. Utilization of evidence-based strategies to deliver personalized care will allow for optimal wellness for patients.
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Affiliation(s)
- Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Dorothy Ogdon
- Lister Hill Library, University of Alabama at Birmingham, Birmingham, AL
| | - Maninder Kaur
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | | | - Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, AL
| | - Michael S Reddy
- University of California, School of Dentistry, San Francisco, CA
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Kumar S. Evidence-Based Update on Diagnosis and Management of Gingivitis and Periodontitis. Dent Clin North Am 2018; 63:69-81. [PMID: 30447793 DOI: 10.1016/j.cden.2018.08.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article is an overview to update the practicing general dental practitioner about clinically relevant evidence-based topics published in the recent past in the diagnosis, etiopathogenesis, and management of gingivitis and periodontitis.
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Affiliation(s)
- Satish Kumar
- A.T. Still University, Arizona School of Dentistry and Oral Health, 5855 E Still Circle, Mesa, AZ 85296, USA.
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Valør LO, Norton IKR, Koldsland OC, Aass AM, Grjibovski AM, Preus HR. The plaque and gingivitis inhibiting capacity of a commercially available mouthwash containing essential oils and ethyl lauroyl arginate. A randomized clinical trial. Acta Odontol Scand 2018; 76:241-246. [PMID: 29216779 DOI: 10.1080/00016357.2017.1412499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE A commercially available mouth rinse with ethyl lauroyl arginate and essential oils claims to have better antimicrobial properties than the traditional essential oil products. The aim of this study was to compare the plaque and gingivitis inhibiting effect of the commercial product containing essential oils with ethyl lauroyl arginate with one placebo and one negative control in a modified experimental gingivitis model. MATERIALS AND METHODS In three groups of healthy volunteers, experimental gingivitis was induced and monitored over 21 d, simultaneously treated with the commercial test solution, 21.6% hydro-alcohol solution and sterile water, respectively. The maxillary right quadrant of each individual received mouthwash only, whereas the maxillary left quadrant was subject to both rinsing and mechanical oral hygiene. Compliance and side effects were monitored at d 7, 14, and 21. Plaque and gingivitis scores were obtained at baseline and d 21. RESULTS AND CONCLUSION Although the commercial product containing essential oils with ethyl lauroyl arginate performed statistically significantly better regarding average plaque scores on all surfaces combined than the placebo (p = .018) and negative control (p = .003) when no mechanical tooth cleaning was performed, the product still left the patient with enough plaque to cause gingivitis and thus seemed of questionable clinical benefit to the patient. ClinicalTrials.gov Identifier is NCT02884817.
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Affiliation(s)
- Liv O. Valør
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Inghild K. R. Norton
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Odd C. Koldsland
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anne Merete Aass
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Hans R. Preus
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Fan X, Peters BA, Min D, Ahn J, Hayes RB. Comparison of the oral microbiome in mouthwash and whole saliva samples. PLoS One 2018; 13:e0194729. [PMID: 29641531 PMCID: PMC5894969 DOI: 10.1371/journal.pone.0194729] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/08/2018] [Indexed: 12/14/2022] Open
Abstract
Population-based epidemiologic studies can provide important insight regarding the role of the microbiome in human health and disease. Buccal cells samples using commercial mouthwash have been obtained in large prospective cohorts for the purpose of studying human genomic DNA. We aimed to better understand if these mouthwash samples are also a valid resource for the study of the oral microbiome. We collected one saliva sample and one Scope mouthwash sample from 10 healthy subjects. Bacterial 16S rRNA genes from both types of samples were amplified, sequenced, and assigned to bacterial taxa. We comprehensively compared these paired samples for bacterial community composition and individual taxonomic abundance. We found that mouthwash samples yielded similar amount of bacterial DNA as saliva samples (p from Student's t-test for paired samples = 0.92). Additionally, the paired samples had similar within sample diversity (p from = 0.33 for richness, and p = 0.51 for Shannon index), and clustered as pairs for diversity when analyzed by unsupervised hierarchical cluster analysis. No significant difference was found in the paired samples with respect to the taxonomic abundance of major bacterial phyla, Bacteroidetes, Firmicutes, Proteobacteria, Fusobacteria, and Actinobacteria (FDR adjusted q values from Wilcoxin signed-rank test = 0.15, 0.15, 0.87, 1.00 and 0.15, respectively), and all identified genera, including genus Streptococcus (q = 0.21), Prevotella (q = 0.25), Neisseria (q = 0.37), Veillonella (q = 0.73), Fusobacterium (q = 0.19), and Porphyromonas (q = 0.60). These results show that mouthwash samples perform similarly to saliva samples for analysis of the oral microbiome. Mouthwash samples collected originally for analysis of human DNA are also a resource suitable for human microbiome research.
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Affiliation(s)
- Xiaozhou Fan
- Department of Population Health, NYU School of Medicine, New York, New York, United States of America
| | - Brandilyn A. Peters
- Department of Population Health, NYU School of Medicine, New York, New York, United States of America
| | - Deborah Min
- Department of Population Health, NYU School of Medicine, New York, New York, United States of America
| | - Jiyoung Ahn
- Department of Population Health, NYU School of Medicine, New York, New York, United States of America
- NYU Laura and Isaac Perlmutter Cancer Institute, New York, New York, United States of America
| | - Richard B. Hayes
- Department of Population Health, NYU School of Medicine, New York, New York, United States of America
- NYU Laura and Isaac Perlmutter Cancer Institute, New York, New York, United States of America
- * E-mail:
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Pelino JEP, Passero A, Martin AA, Charles CA. In vitro effects of alcohol-containing mouthwashes on human enamel and restorative materials. Braz Oral Res 2018; 32:e25. [PMID: 29561951 DOI: 10.1590/1807-3107bor-2018.vol32.0025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 02/21/2018] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the in vitro effects, including surface morphological characteristics and chemical elemental properties, of different mouthwash formulations on enamel and dental restorative materials, simulating up to 6 months of daily use. Human enamel samples, hydroxyapatite, composite resin, and ceramic surfaces were exposed to 3 different mouthwashes according to label directions - Listerine® Cool Mint®, Listerine® Total Care, and Listerine® Whitening - versus control (hydroalcohol solution) to simulate daily use for up to 6 months. The samples were analyzed using scanning electron microscopy (SEM), infrared spectrophotometry (µ-Fourier transform infrared microscopy), energy-dispersive X-ray (EDX) spectroscopy, and color analysis before and after exposure. No relevant changes were observed in the morphological characteristics of the surfaces using SEM techniques. The physical and chemical aspects of the enamel surfaces were evaluated using mid-infrared spectroscopy, and EDX fluorescence was used to evaluate the elemental aspects of each surface. There was no variation in the relative concentrations of calcium and phosphorus in enamel, silicon and barium in composite resin, and silicon and aluminum in the ceramic material before and after treatment. No relevant changes were detected in the biochemical and color properties of any specimen, except with Listerine® Whitening mouthwash, which demonstrated a whitening effect on enamel surfaces. Long-term exposure to low pH, alcohol-containing, and peroxide-containing mouthwash formulations caused no ultra-structural or chemical elemental changes in human enamel or dental restorative materials in vitro.
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Affiliation(s)
| | - Alan Passero
- Johnson & Johnson Consumer, Inc., São José dos Campos, SP, Brazil
| | - Airton Abrahao Martin
- Universidade do Vale do Paraíba - Univap, Physics Institute, São José dos Campos, SP, Brazil
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Lynch MC, Cortelli SC, McGuire JA, Zhang J, Ricci-Nittel D, Mordas CJ, Aquino DR, Cortelli JR. The effects of essential oil mouthrinses with or without alcohol on plaque and gingivitis: a randomized controlled clinical study. BMC Oral Health 2018; 18:6. [PMID: 29321067 PMCID: PMC5763666 DOI: 10.1186/s12903-017-0454-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 12/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The efficacy of several variants of essential oil mouthrinses has been studied extensively. This is the first study to compare the anti-plaque and anti-gingivitis efficacy of two marketed essential oil mouthrinses: one is an alcohol containing mouthrinse and the other one is an alcohol-free mouthrinse. METHODS This examiner-blind, parallel-group study randomized subjects to three groups: 1) Mechanical Oral Hygiene (MOH) only; 2) MOH plus Alcohol-Containing essential oil Mouthrinse (ACM); 3) MOH plus Alcohol-Free essential oil Mouthrinse (AFM). Primary endpoint was whole-mouth mean Modified Gingival Index (MGI) at six months. Secondary endpoints included whole-mouth mean MGI at one and three months, and whole-mouth mean Plaque Index (PI) and whole-mouth mean Bleeding Index (BI) at one, three and six months. Safety assessments were conducted at all time points. RESULTS A total of 370 subjects were enrolled; 348 subjects completed the study. After six months, subjects using essential oil mouthrinses with or without alcohol showed significant reduction (p < 0.001) in gingivitis (28.2% and 26.7%, respectively) and significant reduction (p < 0.001) in plaque (37.8% and 37.0%, respectively), compared to those performing MOH only. Significant reductions in MGI, PI, and BI (p < 0.001) were observed at one and three months and also at six months for mean BI. No statistically significant differences were observed for all measured indices between ACM and AFM groups at any time point. Both mouthrinses were well tolerated. CONCLUSIONS No significant differences were observed in the efficacy of ACM and AFM to reduce plaque and gingivitis, when used in addition to MOH, over six months. TRIAL REGISTRATION The trial was registered on clinicaltrials.gov on November 30, 2016. The registration number is NCT02980497 .
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Affiliation(s)
- Michael C Lynch
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Sheila Cavalca Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, Taubaté, São Paolo, Brazil
| | - James A McGuire
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Jane Zhang
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA.
| | - Danette Ricci-Nittel
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Carolyn J Mordas
- Johnson & Johnson Consumer Inc.,, 199 Grandview Road, Skillman, New Jersey, 08558, USA
| | - Davi Romeiro Aquino
- Nucleus of Periodontal Research, Dental School, University of Taubate, Taubaté, São Paolo, Brazil
| | - Jose Roberto Cortelli
- Nucleus of Periodontal Research, Dental School, University of Taubate, Taubaté, São Paolo, Brazil
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Tilliss T, Carey CM. As an Adjunct to Mechanical Oral Hygiene, Essential Oil-containing Mouthwash, Compared to Floss, Cetylpryidinium Chloride, or Placebo may be more Effective in Reduction of Plaque and Gingitivitis. J Evid Based Dent Pract 2017; 17:256-258. [PMID: 28865821 DOI: 10.1016/j.jebdp.2017.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Essential oils-containing mouthwashes for gingivitis and plaque: Meta-analysis and meta-regression. Haas AN, Wagner TP, Muniz FWMG, Fiorini T, Cavagni J, Celeste, RK. J Dent 2016;55:7-15. SOURCE OF FUNDING No specific funding for this systematic review TYPE OF STUDY/DESIGN: Meta-analysis and meta-regression.
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Serbiak B, Fourre T, Geonnotti AR, Gambogi RJ. In vitro efficacy of essential oil mouthrinse versus dentifrices. J Dent 2017; 69:49-54. [PMID: 28863962 DOI: 10.1016/j.jdent.2017.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/19/2017] [Accepted: 08/29/2017] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To compare the antimicrobial efficacy and kill penetration of essential oils (EO) mouthrinse versus stannous fluoride, and triclosan dentifrice slurries on saliva-derived biofilms using confocal laser scanning microscopy (CLSM). METHODS Saliva-derived biofilms were grown for 48h on hydroxyapatite discs using pooled, homogenized saliva from 8 healthy volunteers as the inoculum. The mean thickness of these biofilms was 84μm (range, 23-241μm). CLSM with viability mapping was used to visualize the antimicrobial kill penetration of each treatment regime within a biofilm. RESULTS At 30s treatment durations, CLSM imaging revealed greater antimicrobial activity and kill penetration of EO mouthrinse compared to sodium fluoride-, stannous fluoride-, and triclosan-containing dentifrice slurries. Quantification of biovolume revealed that EO mouthrinse treatment at 30s resulted in a greater non-viable biovolume proportion (84.6%±15.0%) than other treatment groups. Increasing the treatment duration of the triclosan dentifrice (to 60 and 120s) resulted in better penetration and an increased reduction of viable cells, comparable to EO mouthrinse treatment at 30s duration. Further, CLSM imaging showed that the combined treatment of a non-antimicrobial dentifrice (45s) with EO mouthrinse (30s) showed superior antimicrobial activity (96.2%±3.7%) compared to the antimicrobial triclosan-containing dentifrice used without a mouthrinse step (26.0%±32.0%). CONCLUSIONS Within typical exposure times, the EO-containing mouthrinse can penetrate deep into the accumulating plaque biofilm compared to the chemotherapeutic dentifrice slurries, and may provide an efficacious alternative to triclosan, when used as an adjunct with a mechanical oral care regimen. CLINICAL SIGNIFICANCE Using viability mapping and CLSM, this study demonstrated that EO-containing mouthrinse penetrates and kills microorganisms deeper and more effectively in plaque biofilm in typical exposure times when compared to dentifrice chemotherapeutic agents, providing an efficacious alternative to triclosan or stannous fluoride when used as an adjunct to mechanical oral care.
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Affiliation(s)
- Benjamin Serbiak
- Johnson & Johnson Consumer Inc., 199 Grandview Road, Skillman, NJ, 08558, USA.
| | - Tara Fourre
- Johnson & Johnson Consumer Inc., 199 Grandview Road, Skillman, NJ, 08558, USA.
| | - Anthony R Geonnotti
- Johnson & Johnson Consumer Inc., 199 Grandview Road, Skillman, NJ, 08558, USA.
| | - Robert J Gambogi
- Johnson & Johnson Consumer Inc., 199 Grandview Road, Skillman, NJ, 08558, USA.
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Essential oils-containing mouthwashes for gingivitis and plaque: Meta-analyses and meta-regression. J Dent 2016; 55:7-15. [PMID: 27628316 DOI: 10.1016/j.jdent.2016.09.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/06/2016] [Accepted: 09/08/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the efficacy of EO as adjuncts to mechanical plaque control (MPC) on the reduction of plaque and gingivitis when compared to placebo or cetylpyridium chloride (CPC). DATA Randomized controlled trials of at least 6 months of follow-up including systemically healthy individuals with gingivitis were included. SOURCES MEDLINE, EMBASE, Lilacs and SCOPUS were searched up to April 2016. From 3045 citations, 16 studies were included. 14 studies assessed the Quigley-Hein Plaque Index (QHI) and 11 studies assessed the Modified Gingival Index (MGI) and were included in meta-analyses and meta-regression. STUDY SELECTION The analysis of risk of bias suggested that the quality of the studies ranged from moderate to low. Mean QHI (WMD=-0.86, 95%CI -1.05 to -0.66) and MGI (WMD=-0.52, 95%CI -0.67 to -0.37) were lower for EO+MPC than placebo+MPC. Reductions in plaque and gingivitis were, respectively, 32% and 24% larger for EO+MPC than placebo+MPC. The decreases in QHI (WMD=-0.95, 95%CI -1.26 to -0.63) and in MGI (WMD=-0.34, 95%CI -0.53 to -0.15) observed in the EO+MPC group, compared to placebo+MPC in interproximal areas, were significantly different and in favor to EO+MPC. EO+MPC compared to CPC+MPC resulted in clinically lower levels of plaque and gingivitis. High heterogeneity (I2>95%) was found and explained (MGI-R2=63.6%; QHI-R2=80.1%) by differences between studies in the percentage of males, supervision of the mouthwashes and provision of oral hygiene. CONCLUSIONS EO seems to be superior to placebo+MPC and CPC+MPC for reduction of plaque and gingival inflammation in patients with gingivitis. Expected benefits may be clinically relevant and may also reach the interproximal area. CLINICAL SIGNIFICANCE Mouthwashes containing essential oils should be considered the first choice for daily use as adjuvants to self-performed mechanical plaque control.
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Profile: Evangelical Anne. Br Dent J 2016; 220:380. [DOI: 10.1038/sj.bdj.2016.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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