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Dumitrel SI, Matichescu A, Dinu S, Buzatu R, Popovici R, Dinu DC, Bratu DC. New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry. Molecules 2024; 29:3802. [PMID: 39202881 PMCID: PMC11357206 DOI: 10.3390/molecules29163802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.
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Affiliation(s)
- Stefania-Irina Dumitrel
- Department of Toxicology, Drug Industry, Management and Legislation, Faculty of Pharmacy, Victor Babes University of Medicine and Pharmacy, 2nd Eftimie Murgu Sq., 300041 Timisoara, Romania;
| | - Anamaria Matichescu
- Department of Preventive, Community Dentistry and Oral Health, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
- Translational and Experimental Clinical Research Centre in Oral Health, Victor Babes University of Medicine and Pharmacy, 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
| | - Stefania Dinu
- Department of Pedodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
- Pediatric Dentistry Research Center, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania
| | - Roxana Buzatu
- Department of Dental Aesthetics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
| | - Ramona Popovici
- Department of Management, Legislation and Communication in Dentistry, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
| | - Dorin Cristian Dinu
- Family Dental Clinic, Private Practice, 24 Budapesta Street, 307160 Dumbravita, Romania;
| | - Dana Cristina Bratu
- Department of Orthodontics II, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy Timisoara, 9 No., Revolutiei 1989 Bv., 300041 Timisoara, Romania;
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Tan KL, Bisconti I, Leck C, Billahalli T, Barnett S, Rajakulasingam K, Watts TJ. Bullous fixed drug eruption induced by fluconazole: Importance of multi-site lesional patch testing. Contact Dermatitis 2020; 84:350-352. [PMID: 33210283 DOI: 10.1111/cod.13745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/13/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Ky Lyn Tan
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Ilaria Bisconti
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Claire Leck
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Thippeswamy Billahalli
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK
| | - Sheena Barnett
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK.,Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Karalasingam Rajakulasingam
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK.,Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Timothy J Watts
- Department of Respiratory Medicine & Allergy, Homerton University Hospital NHS Foundation Trust, London, UK.,National Heart & Lung Institute, Imperial College London, London, UK
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Kotsailidi EA, Kalogirou EM, Michelogiannakis D, Vlachodimitropoulos D, Tosios KI. Hypersensitivity reaction of the gingiva to chlorhexidine: case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:156-160.e1. [PMID: 32527627 DOI: 10.1016/j.oooo.2020.04.814] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/15/2020] [Accepted: 04/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this case report was to document a case of delayed-type hypersensitivity reaction of the gingiva to chlorhexidine and review the literature on oral mucosal hypersensitivity reactions associated to chlorhexidine-containing oral hygiene products. STUDY DESIGN A 58-year-old man presented with a well-demarcated erythematous area on the right upper anterior gingiva. Incisional biopsy was performed. Postoperatively, chlorhexidine digluconate gel was prescribed twice a day, but the patient did not use it because he experienced intense burning immediately after the first application. The microscopic diagnosis was nonspecific mucositis. Hypersensitivity reaction was suspected. The patient reported use of 0.004% chlorhexidine digluconate-based toothpaste twice a day in the past few years. A delayed-type hypersensitivity reaction to the toothpaste was hypothesized, and its use was discontinued. Chlorhexidine, the common ingredient of both the toothpaste and the gel, was considered the allergen. The literature was reviewed on chlorhexidine-induced oral hypersensitivity reactions. RESULTS Two weeks after cessation of toothpaste use, complete remission of the lesion was observed without additional intervention. Four years later, no recurrence has been reported. The literature review yielded 7 studies reporting 20 patients with intraoral manifestations of hypersensitivity reactions associated with chlorhexidine-containing oral hygiene products. CONCLUSIONS Clinicians should be aware that oral hygiene products containing even low concentrations of chlorhexidine might induce hypersensitivity reactions.
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Affiliation(s)
- Elli Anna Kotsailidi
- Department of Periodontics, Eastman Institute for Oral Health, University of Rochester, New York, USA
| | - Eleni-Marina Kalogirou
- Department of Oral Medicine and Pathology, Faculty of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, New York, USA
| | | | - Konstantinos I Tosios
- Department of Oral Medicine and Pathology, Faculty of Dentistry, National and Kapodistrian University of Athens, Greece.
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Chiewchalermsri C, Sompornrattanaphan M, Wongsa C, Thongngarm T. Chlorhexidine Allergy: Current Challenges and Future Prospects. J Asthma Allergy 2020; 13:127-133. [PMID: 32210588 PMCID: PMC7069565 DOI: 10.2147/jaa.s207980] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 02/11/2020] [Indexed: 12/14/2022] Open
Abstract
Chlorhexidine is a synthetic bisbiguanide antiseptic and was introduced in healthcare use in 1954. Allergy to chlorhexidine has been increasingly reported particularly in the perioperative and medical procedural settings. The hypersensitivity reactions range from mild cutaneous reactions to anaphylaxis or death. There are many products and medical devices containing chlorhexidine that sometimes lack standardized labeling. With the various routes of chlorhexidine exposure, accidental or recurrent reactions in chlorhexidine-allergic patients have been reported. Therefore, we aim to review the most recent evidence in clinical manifestations, diagnostic methods, management, and preventive measures with a focus on the unique features of chlorhexidine allergy.
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Affiliation(s)
- Chirawat Chiewchalermsri
- Division of Allergy and Clinical Immunology, Department of Medicine, Phramongkutklao Hospital, Bangkok, Thailand.,Department of Medicine, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Mongkhon Sompornrattanaphan
- Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chamard Wongsa
- Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Torpong Thongngarm
- Division of Allergy and Clinical Immunology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Hamann D, Hamann C. Regarding "Risks and benefits of using chlorhexidine gluconate in handwashing: a systematic literature review". Am J Infect Control 2019; 47:1524. [PMID: 31587818 DOI: 10.1016/j.ajic.2019.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 10/25/2022]
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Yung CC, Watts TJ, Haque R. Successful desensitization to metronidazole in a patient with generalized fixed drug eruption. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019; 8:769-771.e1. [PMID: 31369825 DOI: 10.1016/j.jaip.2019.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Ching Ching Yung
- Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
| | - Timothy J Watts
- Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Rubaiyat Haque
- Department of Adult Allergy, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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