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Macherla S, Varghese J, Nayak UY, Velagacherla V, Lobo R, U V, Kamath V. Formulation and assessment of biological properties of garcinia indica fruit extract mouthrinse as an adjunct to oral hygiene regimen: an in vitro analysis. J Appl Oral Sci 2024; 32:e20230291. [PMID: 38865512 PMCID: PMC11189596 DOI: 10.1590/1678-7757-2023-0291] [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: 08/21/2023] [Revised: 03/29/2024] [Accepted: 04/18/2024] [Indexed: 06/14/2024] Open
Abstract
The prevalence of gingivitis is substantial within the general population, necessitating rigorous oral hygiene maintenance. OBJECTIVE This study assessed a Garcinia indica (GI) fruit extract-based mouthrinse, comparing it to a 0.1% turmeric mouthrinse and a 0.2% Chlorhexidine (CHX) mouthrinse. The evaluation encompassed substantivity, staining potential, antimicrobial efficacy and cytocompatibility. METHODOLOGY The study employed 182 tooth sections. For antimicrobial analysis, 64 extracted human teeth coated with a polymicrobial biofilm were divided into four groups, each receiving an experimental mouthrinse or serving as a control group with distilled water. Microbial reduction was assessed through colony forming units (CFU). Substantivity was evaluated on 54 human tooth sections using a UV spectrophotometer, while staining potential was examined on 64 tooth sections. Cytocompatibility was tested using colorimetric assay to determine non-toxic levels of 0.2% GI fruit extract, 0.1% Turmeric, and 0.2% CHX. RESULTS Data were analysed with one-way ANOVA (α=0.05). Cell viability was highly significant (p<0.001) in the 0.2% GI group (64.1±0.29) compared to 0.1% Turmeric (40.2±0.34) and 0.2% CHX (10.95±1.40). For antimicrobial activity, both 0.2% GI (20.18±4.81) and 0.2% CHX (28.22±5.41) exhibited no significant difference (P>0.05) at end of 12 hours. However, 0.1% Turmeric showed minimal CFU reduction (P<0.001). Substantivity results at 360 minutes indicated statistically significant higher mean release rate in 0.1%Turmeric (12.47±5.84 ) when compared to 0.2% GI (5.02±3.04) and 0.2% CHX (4.13±2.25) (p<0.001). The overall discoloration changes (∆E) were more prominent in the 0.2% CHX group (18.65±8.3) compared to 0.2% GI (7.61±2.4) and 0.1% Turmeric (7.32±4.9) (P<0.001). CONCLUSION This study supports 0.2% GI and 0.1% Turmeric mouth rinses as potential natural alternatives to chemical mouth rinses. These findings highlight viability of these natural supplements in oral healthcare.
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Affiliation(s)
- Shravya Macherla
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Periodontology, Manipal, Karnataka, India
| | - Jothi Varghese
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Periodontology, Manipal, Karnataka, India
| | - Usha Y Nayak
- Manipal Academy of Higher Education, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutics, Manipal, Karnataka, India
| | - Varalakshmi Velagacherla
- Manipal Academy of Higher Education, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutics, Manipal, Karnataka, India
| | - Richard Lobo
- Manipal Academy of Higher Education, Manipal College of Pharmaceutical Sciences, Department of Pharmacognosy, Manipal, Karnataka, India
| | - Viswanatha U
- Sri Dharmasthala Manjunatheshwara Centre for Research in Ayurveda & Allied sciences, Department of Biotechnology and Microbiology, Kuthpady, Udupi, Karnataka, India
| | - Vinayak Kamath
- Goa Dental College and Hospital, Department of Public Health Dentistry, Bambolim, Goa, India
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Szalai EÁ, Teutsch B, Babay V, Galvács A, Hegyi P, Hársfalvi P, Pál R, Varga G, Lohinai ZM, Kerémi B. Hyperpure chlorine dioxide versus chlorhexidine in intra-oral halitosis (ODOR trial) - protocol of a double-blinded, double-arm, parallel non-inferiority pilot randomized controlled trial. BDJ Open 2024; 10:35. [PMID: 38769314 PMCID: PMC11106080 DOI: 10.1038/s41405-024-00221-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Intra-oral halitosis (IOH) is the most common type of bad breath; its consequences impair quality of life. However, evidence-based treatment protocols and guidelines are lacking. Our aim is to investigate the effectiveness of chlorine dioxide as an applicable complementary treatment modality in IOH after tongue cleaning. METHODS AND ANALYSIS The ODOR trial will be a single-center, double-blinded, parallel-group, double-armed pilot randomized controlled trial with a non-inferiority design. The efficacy of hyperpure chlorine dioxide will be compared to chlorhexidine mouthwash. We plan to investigate the short-term effects of the intervention over a 3-h period. The primary endpoint will be changes in organoleptic test scores. At the end of the pilot investigation of the first 30 patients each, sample size calculation will be performed. If feasible, the investigators will continue the study by enrolling more patients. TRIAL REGISTRATION The trial has been registered at ClinicalTrials.gov (NCT06219226).
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Affiliation(s)
- Eszter Ágnes Szalai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Viktória Babay
- Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Adél Galvács
- Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Hársfalvi
- University of Veterinary Medicine Budapest, Department of Biostatistics, Budapest, Hungary
- BiTrial Clinical Research, Budapest, Hungary
| | | | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Zsolt M Lohinai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary.
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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Yazicioglu O, Ucuncu MK, Guven K. Ingredients in Commercially Available Mouthwashes. Int Dent J 2024; 74:223-241. [PMID: 37709645 PMCID: PMC10988267 DOI: 10.1016/j.identj.2023.08.004] [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: 06/28/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Mouthwashes, a cornerstone of oral and dental hygiene, play a pivotal role in combating the formation of dental plaque, a leading cause of periodontal disease and dental caries. This study aimed to review the composition of mouthwashes found on retail shelves in Turkey and evaluate their prevalence and side effects, if any. METHODS The mouthwashes examined were sourced from the 5 largest chain stores in each district of Istanbul. A comprehensive list of the constituents was meticulously recorded. The research was supported by an extensive compilation of references from scholarly databases such as Google Scholar, PubMed, and ScienceDirect. Through rigorous analysis, the relative proportions of mouthwash ingredients and components were determined. RESULTS A total of 45 distinctive variations of mouthwashes, representing 17 prominent brands, were identified. Amongst the 116 ingredients discovered, 70 were evaluated for potential adverse effects and undesirable side effects. The aroma of the mouthwash (n = 45; 100%), as welll as their sodium fluoride (n = 28; 62.22%), sodium saccharin (n = 29; 64.44%), sorbitol (n = 21; 46.6%), and propylene glycol (n = 28; 62.22%) content were the main undesireable features. CONCLUSIONS The limited array of mouthwashes found on store shelves poses a concern for both oral and public health. Furthermore, the intricate composition of these products, consisting of numerous ingredients with the potential for adverse effects, warrants serious attention. Both clinicians and patients should acknowledge the importance and unwarranted side effects of the compnents of the mouthwashes.
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Affiliation(s)
- Oktay Yazicioglu
- Istanbul University, Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey
| | - Musa Kazim Ucuncu
- Altinbas University, Faculty of Dentistry, Department of Restorative Dentistry, Istanbul, Turkey.
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Waqar SM, Razi A, Qureshi SS, Saher F, Zaidi SJA, Kumar C. Comparative evaluation of propolis mouthwash with 0.2% chlorhexidine mouthwash as an adjunct to mechanical therapy in improving the periodontitis among perimenopausal women: a randomized controlled trial. BMC Oral Health 2024; 24:26. [PMID: 38183081 PMCID: PMC10770993 DOI: 10.1186/s12903-023-03768-4] [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: 07/24/2023] [Accepted: 12/12/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE To evaluate the efficacy of Propolis mouthwash compared to chlorhexidine mouthwash as an adjunct to mechanical therapy in improving clinical parameters in perimenopausal women with chronic periodontitis. METHODOLOGY A double-blind, randomized, controlled clinical trial was conducted by recruiting 144 subjects with mild to moderate chronic periodontitis. After scaling and root planning, subjects were allocated to two treatment groups: 0.2% chlorhexidine mouthwash and 20% propolis mouthwash twice daily for six weeks. Clinical parameters such as pocket probing depth (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP) were analysed at baseline, six weeks, and 12 weeks. RESULT The mean value of PPD in the propolis group was 4.67 at baseline, reduced to 4.01 at six weeks and 3.59 at 12 weeks. While in the chlorhexidine group, the baseline value of 4.65 reduced to 4.44 and 4.25 at six weeks and 12 weeks, respectively. The baseline value of the mean CAL in the propolis group was 4.45. This value was reduced to 4.15 at six weeks and 3.77 at 12 weeks. For the chlorhexidine group, the baseline value of CAL was 4.80, which was reduced to 4.50 and 4.19 at six weeks and 12 weeks. The mean value of bleeding on probing in the propolis group was 77.20, which decreased to 46.30 at six weeks and 14.60 at the final visit. In the chlorhexidine group, the mean value of 77.30 was reduced to 49.60 and 22.80 at subsequent visits. CONCLUSION This study concludes that both propolis and chlorhexidine mouthwash positively improve clinical parameters; however, propolis is significantly more effective in improving BOP. TRIAL REGISTRATION ID: NCT05870059, Date of Registration: 02/02/2022. ( https://beta. CLINICALTRIALS gov/study/NCT05870059 ).
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Affiliation(s)
- Syeda Maliha Waqar
- Department of Oral Biology, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Afifa Razi
- Department of Oral Medicine and Diagnosis, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Saima Sameer Qureshi
- Department of Periodontology, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Fizza Saher
- Department of Oral Biology, Ziauddin College of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Syed Jaffar Abbas Zaidi
- Department of Oral Biology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Chander Kumar
- Department of Periodontology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
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Afrasiabi S, Entezari S, Etemadi A, Chiniforush N. The influence of different mode of power density during antimicrobial photodynamic therapy for photokilling of Streptococcus mutans. Photodiagnosis Photodyn Ther 2023; 44:103770. [PMID: 37640204 DOI: 10.1016/j.pdpdt.2023.103770] [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: 07/05/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the inactivation potency of riboflavin and curcumin plus blue diode laser against Streptococcus mutans with different power densities. MATERIALS AND METHODS In this in vitro study, standard-strain S. mutans was exposed to curcumin and riboflavin plus blue diode laser with different power densities (0.4-1.0 W/cm2) as well as chlorhexidine (CHX). The colony forming units (CFUs)/mL was calculated. Data were analyzed by one-way ANOVA. RESULTS Antibacterial analysis indicated that the blue diode laser irradiation with curcumin and riboflavin provided a satisfactory reduction of the S. mutans level. In addition, S. mutans was more affected by curcumin + blue diode laser when the power density was set to 1.0 W/cm2 (P < 0.0001). Meanwhile, bacterial suspensions treated with CHX showed maximum colony number reduction, compared with the control (P < 0.0001). CONCLUSION This study showed the blue diode laser along with curcumin had strong bactericidal effect on S. mutans, and this effect improved by increasing the power density.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvin Entezari
- Dentist, Faculty of Dentistry, Tehran Medical Sciences. Islamic Azad University, Tehran, Iran
| | - Ardavan Etemadi
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Laser Research Center of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Kaypetch R, Rudrakanjana P, Tua-Ngam P, Tosrisawatkasem O, Thairat S, Tonput P, Tantivitayakul P. Effects of two novel denture cleansers on multispecies microbial biofilms, stain removal and the denture surface: an in vitro study. BMC Oral Health 2023; 23:852. [PMID: 37951865 PMCID: PMC10640750 DOI: 10.1186/s12903-023-03535-5] [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: 07/10/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND The continuously increasing demand for removable denture appliances and the importance of adequate denture cleaning have led to the development of various denture cleansing products. The aim of this study was to evaluate the efficacy of two novel denture cleansing agents (GE and TM) and three commonly available cleansers (0.5% sodium hypochlorite; NaClO, 0.12% chlorhexidine gluconate; CHX, and Polident®; POL) on multispecies microbial biofilm formation, stain removal and physical properties of dentures. METHODS The antimicrobial activities of denture cleansing agents were determined against major oral opportunistic pathogens including Streptococcus mutans, Staphylococcus aureus, Escherichia coli and Candida albicans, using time-kill assays. Multispecies microbial biofilms grown on acrylic resins for 72 h were generated to determine the antibiofilm effects of cleansing agents by confocal laser scanning microscopy (CLSM). Evaluations of the tea and coffee stain removal properties and the alterations in the physical properties of dentures were also performed. The toxicity of cleanser residues released from denture acrylics to fibroblast cells was investigated using MTT assay. RESULTS All denture cleansing agents tested could effectively kill oral bacteria and Candida albicans. Furthermore, after immersion for more than 3 h, the cleansers Polident®, GE and TM could efficiently penetrate and inhibit multispecies denture biofilms with effects similar to 10 min of immersion in 0.5% NaClO. However, immersion in 0.12% CHX for 20 min showed less antibiofilm activity. The NaClO solution had the highest efficacy for removing stains from the artificial teeth. Conversely, the CHX solution enhanced tea and coffee staining, and the teeth immersed in this solution showed clinically unacceptable colour changes (ΔE > 5.5). However, the colour differences of teeth stained and immersed in POL, GE and TM cleansers were in the clinically acceptable range. There was no significant difference among the POL, GE and TM cleansers in terms of stain removal efficacy. The cleansers GE and TM did not alter the surface roughness and colour of the materials, moreover the residues of both cleansers did not exhibit cytotoxicity. CONCLUSION Two novel denture cleansing agents containing natural products, GE and TM exhibited effective antimicrobial activity, antibiofilm and stain removal capabilities without toxicity or disturbance of the physical properties of acrylics.
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Affiliation(s)
- Rattiporn Kaypetch
- Research office, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Peerapong Tua-Ngam
- Research office, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Orada Tosrisawatkasem
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Rajthevi, Bangkok, 10400, Thailand
| | - Sarut Thairat
- Research office, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pairin Tonput
- Research office, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pornpen Tantivitayakul
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, 6 Yothi Street, Rajthevi, Bangkok, 10400, Thailand.
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Oliveira JA, da Silveira MI, de Oliveira Alves R, Bezerra FJB, de Oliveira GJPL, Pigossi SC. Effect of a gel containing green tea extract and hyaluronic acid on palate pain scores and wound healing after free gingival graft: a quasi-randomized controlled clinical trial. Clin Oral Investig 2023; 27:6735-6746. [PMID: 37775584 DOI: 10.1007/s00784-023-05282-x] [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: 07/03/2023] [Accepted: 09/24/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of a gel containing green tea extract and hyaluronic acid (HA) on pain scores and wound healing in donor sites after free gingival graft (FGG). MATERIALS AND METHODS Forty-two patients requiring FGG were included in three groups: (1) control group (n = 14), no material was placed in the donor area; only the clot was kept in position by sutures; (2) placebo group (n = 14), vehicle gel applied 3 times a day for 7 days; and (3) test group (n = 14), gel containing green tea extract and HA applied 3 times a day for 7 days. The wound size by clinical measurement (WS-CM) and photographic image (WS-PI), complete wound epithelialization (CWE), and palatal mucosa color were evaluated after 3 days and 1, 2, and 4 weeks postoperatively. The visual analog scale (VAS) for pain and analgesic consumption were used to assess participant's perception in the same postoperative periods. RESULTS A similar progressive reduction in the wound size, associated with an improvement in the color pattern, was observed in all groups (p > 0.05). No significant differences were found for CWE and pain assessment between the examined groups (p > 0.05). CONCLUSION The gel containing green tea extract and HA application in palatal wounds after FGG removal does not provide clinical healing benefits using this investigated protocol. CLINICAL RELEVANCE This is the first clinical study evaluating the effect of gel containing green tea extract and HA on the palate postoperative pain control and wound healing after FGG. TRIAL REGISTRATION http://clinicaltrials.gov : NCT05270161.
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Affiliation(s)
- Jovânia Alves Oliveira
- School of Dentistry, Alfenas Federal University (Unifal-MG), Alfenas, Minas Gerais, Brazil
| | | | - Roberta de Oliveira Alves
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia-UFU, School of Dentistry, Umuarama Campus, Bloco UMU4L, Pará Avenue, 1720, Uberlandia, MG, 38405-320, Brazil
| | | | - Guilherme José Pimentel Lopes de Oliveira
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia-UFU, School of Dentistry, Umuarama Campus, Bloco UMU4L, Pará Avenue, 1720, Uberlandia, MG, 38405-320, Brazil
| | - Suzane Cristina Pigossi
- Department of Periodontology and Implantodontology, School of Dentistry, Federal University of Uberlandia-UFU, School of Dentistry, Umuarama Campus, Bloco UMU4L, Pará Avenue, 1720, Uberlandia, MG, 38405-320, Brazil.
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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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Herczegh A, Csák B, Dinya E, Moldován A, Ghidán Á, Palcsó B, Lohinai ZM. Short- and long term antibacterial effects of a single rinse with different mouthwashes: A randomized clinical trial. Heliyon 2023; 9:e15350. [PMID: 37095907 PMCID: PMC10121446 DOI: 10.1016/j.heliyon.2023.e15350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/14/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Objectives Reducing the microbial level in the aerosol created during dental procedures is essential to avoiding infections. The aim of this study was to examine the change in Streptococcus mutans (S. mutans) and the total bacterial load in human saliva in vivo after a single rinse with different mouthwashes. Material and methods One mL of unstimulated saliva was collected from volunteers with poor oral hygiene at baseline and 5 min after a 1-min rinsing with diluted Solumium Oral® (hyper-pure 0.0015% chlorine dioxide; ClO2), Listerine Total Care®, Corsodyl® (0.2% chlorhexidine-digluconate; CHX), or BioGate Si*CLEAN for bacterial investigation. In a second study, volunteers rinsed with 0.003% ClO2 or CHX for 1 min, and saliva was collected at baseline, after 5 min, and after 90 min. After plating, the total plate and S. mutans colony numbers were determined. Results In the first study, ClO2 and CHX similarly reduced both total germ and S. mutans numbers, while Listerine Total Care® decreased only the S. mutans counts. BioGate Si*Clean had no effect on either the total germ or S. mutans numbers. In the second study, an increasing tendency toward bacterial regrowth was observed with CHX after 90 min compared to the 5-min value, while no change was measured after ClO2 rinsing. Conclusion Hyper-pure ClO2 rinsing may be a new promising preventive and therapeutic adjuvant in dental practice, as it is similar in effectiveness to the gold standard CHX-containing mouthwashes, especially in patients concerned with taste or tooth discoloration during oral health therapy.
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Mulla M. Self-reported Knowledge and Practice of Saudi Dental Hygiene Students Towards the use of Chlorhexidine Mouthwash. Open Dent J 2023. [DOI: 10.2174/18742106-v17-230317-2022-160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Aim:
To assess the knowledge and practice of Saudi dental hygiene students regarding the use of mouthwashes in clinical practice.
Background:
Mouthwashes are chemical plaque control agents which are widely used for the prevention of tooth decay, gaining fresh breath, reducing plaque and calculus formation, and reducing gingival inflammation. Chlorhexidine is considered a gold standard mouthwash because of its substantivity action. Thus, it is very important for dental practitioners to understand the knowledge and practices regarding the use of Chlorhexidine mouthwash
Objective:
The primary objective of this study was to find dental hygiene students’ knowledge about chlorhexidine mouthwash and its side effects and also identify their practice toward the use of mouthwashes as plaque inhibiting agents.
Methods:
An online version of a pre-tested and validated questionnaire was used to test the knowledge and practices towards the use of Chlorhexidine mouthwash. Thus, A Cross-sectional questionnaire survey was carried out in Saudi Arabia on dental hygiene students.
Results:
A total of 144 filled questionnaires were obtained out of which 88% were male and 12% were female. After converting the scores into percentages, any score <60% was categorized as a poor score, 60-80% as an average score, and >80% as a good score. Dental hygiene students showed an average knowledge about Chlorhexidine mouthwash with a score of 62.27% and also poor practice with a score of 57.98%.
Conclusion:
The findings of this cross-sectional study demonstrate that most of the Dental hygiene students in Saudi Arabia have got average knowledge and poor practice about the usage of Chlorhexidine mouthwash.
Clinical Significance:
Being the oral health care providers, it is mandatory for dental hygiene students to have adequate knowledge regarding the usage of mouthwashes. With optimum knowledge, they will be able to deliver the right information to the patients thereby ensuring the proper practice of the same.
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Di Spirito F, Amato A, Di Palo MP, Cannatà D, Giordano F, D’Ambrosio F, Martina S. Periodontal Management in Periodontally Healthy Orthodontic Patients with Fixed Appliances: An Umbrella Review of Self-Care Instructions and Evidence-Based Recommendations. Dent J (Basel) 2023; 11:dj11020035. [PMID: 36826180 PMCID: PMC9954872 DOI: 10.3390/dj11020035] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
The present umbrella review aimed to characterize periodontal self-care instructions, prescriptions, and motivational methods; evaluate the associated periodontal outcomes; and provide integrated, evidence-based recommendations for periodontal self-care in periodontally healthy orthodontic patients with fixed appliances. The presently applied study protocol was developed in advance, compliant with the PRISMA statement, and registered on PROSPERO (CRD42022367204). Systematic reviews published in English without date restrictions were electronically searched until 21 November 2022 across the PROSPERO Register and Cochrane Library, Web of Science (Core Collection), Scopus, and MED-LINE/PubMed databases. The study quality assessment was conducted through the AMSTAR 2 tool. Seventeen systematic reviews were included. Powered and manual toothbrushes showed no significant differences in biofilm accumulation, although some evidence revealed significant improvements in inflammatory, bleeding, and periodontal pocket depth values in the short term with powered toothbrushes. Chlorhexidine mouthwashes, but no gels, varnishes, or pastes, controlled better biofilm accumulation and gingival inflammation as adjuncts to toothbrushing, although only for a limited period. Organic products, such as aloe vera and chamomile, proved their antimicrobial properties, and herbal-based mouthwashes seemed comparable to CHX without its side effects. Motivational methods also showed beneficial effects on periodontal biofilm control and inflammation, while no evidence supported probiotics administration.
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Affiliation(s)
- Federica Di Spirito
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
- Correspondence:
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Maria Pia Di Palo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Davide Cannatà
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Stefano Martina
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
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12
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Chen E, Wang T, Tu Y, Sun Z, Ding Y, Gu Z, Xiao S. ROS-scavenging biomaterials for periodontitis. J Mater Chem B 2023; 11:482-499. [PMID: 36468674 DOI: 10.1039/d2tb02319a] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Periodontitis is defined as a chronic inflammatory disease in which the continuous activation of oxidative stress surpasses the reactive oxygen species (ROS) scavenging capacity of the endogenous antioxidative defense system. Studies have demonstrated that ROS-scavenging biomaterials should be promising candidates for periodontitis therapy. To benefit the understanding and design of scavenging biomaterials for periodontitis, this review details the relationship between ROS and periodontitis, including direct and indirect damage, the application of ROS-scavenging biomaterials in periodontitis, including organic and inorganic ROS-scavenging biomaterials, and the various dosage forms of fabricated materials currently used for periodontal therapy. Finally, the current situation and further prospects of ROS-scavenging biomaterials in periodontal applications are summarized. Expecting that improved ROS-scavenging biomaterials could be better designed and developed for periodontal and even clinical application.
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Affiliation(s)
- Enni Chen
- Department of Periodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Tianyou Wang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Yuan Tu
- Department of Periodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - ZhiYuan Sun
- Department of Periodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Yi Ding
- Department of Periodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Zhipeng Gu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, China
| | - Shimeng Xiao
- Department of Periodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
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Comparison of 0.12% Chlorhexidine and a New Bone Bioactive Liquid, BBL, in Mouthwash for Oral Wound Healing: A Randomized, Double Blind Clinical Human Trial. J Pers Med 2022; 12:jpm12101725. [PMID: 36294864 PMCID: PMC9605239 DOI: 10.3390/jpm12101725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Following surgery, healing within the oral cavity occurs in a hostile environment, and proper oral care and hygiene are required to accelerate recovery. The aim of the current study is to investigate and compare the bioreactivity characteristics of mouthwashes based on either chlorhexidine (CHX) or a novel bone bioactive liquid (BBL) in terms of oral healing within seven days application post-surgery. A randomized, double blind clinical trial was conducted in 81 patients, wherein the mouthwashes were applied twice a day for a period of 7 days. The visual analog scale (VAS) protocol was applied to determine pain index scores. Early wound healing index (EHI) score was determined for evaluating oral cavity healing progress. No adverse effects were observed using the mouthwashes, but CHX application resulted in stained teeth. Applications of both CHX and BBL were sufficient to reduce pain over a period of 7 days. However, the BBL group demonstrated a statistically significant reduction in VAS scores starting on day 4. The EHI scores were significantly higher in the BBL group compared with the CHX group, independent of tooth location. No differences in either VAS or EHI scores due to gender were observed. Compared with the commercially available CHX mouthwash, application of the BBL mouthwash reduced pain and accelerated oral cavity healing to a greater extent, suggesting it effectively improves the oral cavity microenvironment at the wound site in mediating soft tissue regeneration.
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Poppolo Deus F, Ouanounou A. Chlorhexidine in Dentistry: Pharmacology, Uses, and Adverse Effects. Int Dent J 2022; 72:269-277. [PMID: 35287956 PMCID: PMC9275362 DOI: 10.1016/j.identj.2022.01.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 12/14/2021] [Accepted: 01/29/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives The aim of this work was to review the current uses of chlorhexidine (CHX) in dentistry based on its mechanism of action, whilst highlighting the most effective protocols that render the highest clinical efficacy whilst limiting adverse drug reactions. Methods A literature search was conducted using the key words chlorhexidine, mechanism of action, adverse effects, and dentistry using databases in the University of Toronto library system. The titles and abstracts were read, and relevant articles were selected. Results A total of 1100 publications were identified, 100 were investigated, and 67 of them were used. Out of the 67 selected articles, 12 were reviews on CHX; 5 articles focussed on CHX gels; 13 focussed on CHX mouthwashes; 8 focussed on CHX products; 13 discussed adverse effects associated with CHX; 13 focussed on periodontal pathology and treatment; 6 focussed on implant periodontal and dental surgeries; 7 evaluated effects on caries; 6 looked at the mechanisms of action; and 12 focussed on the antibacterial and antimicrobial impact on the oral biome. There were multiple areas of overlap amongst the articles, and results showed that CHX provides different uses, but mainly as an adjunct to various treatments. Mouthwash was the most superior medium when used in short time spans when mechanical prophylaxis was not possible for the prevention of gingivitis and maintenance of oral hygiene. CHX products are often used in periodontics, post–oral surgical procedures, and as a prophylaxis for multiple invasive procedures with minimal adverse effects. Tooth staining was the most negative adverse effect reported by patients. Conclusions CHX's antimicrobial properties make it an ideal prophylactic when mechanical debridement is not possible. CHX mouthwash appears to be more effective compared to gels. Concentrations of 0.12% to 0.2% are recommended; any mouthwash with concentrations above 0.2% will unnecessarily increase the unwanted side effects. CHX is useful amongst various areas of dentistry including oral surgery, periodontics, and even general dentistry. For long-term treatments, especially in periodontitis patients (stage I-III) undergoing nonsurgical treatments, CHX chips are recommended. CHX chips are also recommended as an adjunct to implant debridement in patients with peri-implant mucositis and peri-implantitis over CHX mouthwash and gels.
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15
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Sarembe S, Kiesow A, Pratten J, Webster C. The Impact on Dental Staining Caused by Beverages in Combination with Chlorhexidine Digluconate. Eur J Dent 2022; 16:911-918. [PMID: 35196724 DOI: 10.1055/s-0041-1742123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES There are several hypotheses regarding how chlorhexidine (CHX) digluconate causes staining with the role of beverages, specifically the precipitation of anionic dietary chromogens onto adsorbed cations, the most probable cause. The aim of this study was to investigate and compare the staining potential of common beverages using an in vitro staining and brushing model to better understand the interactions between chromogens from different beverage categories and the teeth. MATERIALS AND METHODS Human enamel samples were exposed to a cyclic treatment of artificial saliva and 0.2% CHX mouthwash combined with a range of beverages, with and without brushing, simulating a period equivalent to 2 weeks. Eleven beverages were tested: diet coke, diet lemonade, white wine, red wine, lager beer, black tea, coffee, black tea with milk, coffee with milk, ginger and lemon infusion, and water. Toothbrushing was performed in a brushing simulator with toothpaste and also with water. Colorimetric differences were determined by ΔE using a VITA Easyshade dental spectrophotometer. Statistical analyses were performed by one-way analysis of variance with post hoc Tukey's honestly significant difference test and Levene's test. RESULTS Black tea and red wine produced highest staining, which agrees with the literature. Significant staining was also observed for a ginger and lemon infusion, coffee, coffee with milk, tea with milk, and lager beer compared with water (p < 0.05). The staining potential of diet coke in combination with brushing appeared to be connected to its low pH. Both white wine and diet lemonade produced stain comparable to the water control. After treatment with high staining beverages, scanning electron microscope evaluation confirmed the formation of a surface layer. The mechanical resistance of the stain differed depending on the beverage, black tea stain was the most resistant. The addition of milk to tea and coffee considerably modified the stain layer and the adhesion to the tooth surface. CONCLUSION The data may help demonstrate that appropriate user guidance can avoid stain and in turn help improve user compliance during short-term use of this gold standard antimicrobial treatment.
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Affiliation(s)
- Sandra Sarembe
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle, Germany
| | - Andreas Kiesow
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle, Germany
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16
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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17
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Naguib GH, Abd El-Aziz GS, Mously HA, Alhazmi WA, Alnowaiser AM, Hassan AH, Hamed MT. In vitro Investigation of the Antimicrobial Activity of Mouth Washes Incorporating Zein-Coated Magnesium Oxide Nanoparticles. Clin Cosmet Investig Dent 2021; 13:395-403. [PMID: 34588818 PMCID: PMC8473931 DOI: 10.2147/ccide.s327912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/01/2021] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This in vitro study was undertaken to investigate the antimicrobial effect of distinctive oral mouth washes after the addition of zein-coated (Magnesium oxide) MgO nanoparticles on exemplary of some oral microorganisms. MATERIALS AND METHODS Three hundred and twelve samples were used in this study. A set of five concentrations of MgO nanoparticles with zein and without zein-coating were incorporated into three oral mouth washes: Listerine zero, Listerine total control and Oral B in the mass percentages of 0.3%, 0.5%, 1%, 2%, 5% and 10%, in addition to controls with no MgO nanoparticles. The antimicrobial effect of three mouth washes with variable concentrations of MgO was tested against the following organisms: Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis and Candida albicans using the disc diffusion test (DDT) and direct contact test (DCT). Data were analyzed using one-way ANOVA statistical test. RESULTS The tested mouthwashes with zein-coated MgO nanoparticles showed significant differences of antimicrobial activity on S. mutans, S. aureus, E. faecalis, and C. albicans in the disc diffusion test. While in the DCT, all tested mouthwashes with MgO nanoparticles with and without zein coating showed antimicrobial activity on all tested microorganisms. CONCLUSION Zein-coated MgO nanoparticles may be considered as a potential antimicrobial agent when added to oral mouthwashes. Future analysis, including in vivo studies, is required in order to incorporate zein/MgO nanoparticles into oral mouthwashes that may improve its antibacterial property.
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Affiliation(s)
- Ghada H Naguib
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral Biology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Gamal S Abd El-Aziz
- Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hisham A Mously
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wafaa A Alhazmi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer M Alnowaiser
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali H Hassan
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed T Hamed
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Fixed Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Papadakis I, Spanou A, Kalyvas D. Success Rate and Safety of Dental Implantology in Patients Treated With Antiresorptive Medication: A Systematic Review. J ORAL IMPLANTOL 2021; 47:169-180. [PMID: 32663267 DOI: 10.1563/aaid-joi-d-19-00088] [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: 11/22/2022]
Abstract
There is no agreement of data on the subject of implant failure and the development of osteonecrosis in patients receiving antiresorptive agents. The purpose of this systematic review is to evaluate whether dental implants placed in patients on antiresorptive medication have an increased failure rate and whether the implant placement or the implant existence are risk factors for developing medication-related osteonecrosis of the jaw (MRONJ). An electronic search was conducted in PubMed/Medline, and all publications fulfilling the inclusion criteria were included. The search was completed by a hand research of the references cited in all electronic identified publications, resulting in 411 articles. Based on the inclusion criteria, 32 studies were included, with a total of 5221 patients, 12 751 implants, 618 cases of implants loss, and 136 cases of MRONJ analyzed. Because of the small number of studies, most of which were characterized by a low level of quality, it cannot be established that the use of antiresorptive medication affects dental implant survival rates. The risk of MRONJ as an early or late complication is also not well established. Therefore, successful dental implant procedures in patients receiving antiresorptive medication might be possible, but more studies need to be carried out in the future to verify this topic. Apart from intravenous antiresorptive drugs, which remain an absolute contraindication, the use of antiresorptive medication is not a contraindication to dental implantology, but it must be accompanied by careful treatment planning, informing patients about possible complications, and essential long follow-up periods.
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Affiliation(s)
- Ioannis Papadakis
- Department of Oral and Maxillofacial Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandra Spanou
- Department of Oral and Maxillofacial Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Demos Kalyvas
- Department of Oral and Maxillofacial Surgery, National and Kapodistrian University of Athens, Athens, Greece
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19
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Collins JR, Veras K, Hernández M, Hou W, Hong H, Romanos GE. Anti-inflammatory effect of salt water and chlorhexidine 0.12% mouthrinse after periodontal surgery: a randomized prospective clinical study. Clin Oral Investig 2021; 25:4349-4357. [PMID: 33389135 DOI: 10.1007/s00784-020-03748-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this study was to compare the anti-inflammatory efficacy of sodium chloride- and a 0.12% chlorhexidine mouth rinses in patients undergoing minimal invasive periodontal surgery. MATERIALS AND METHODS Forty-seven patients with a diagnosis of periodontitis and indication for access flap procedure were randomly selected. Group A: a sodium chloride (salt)water-based mouth rinse (test group) or group B: a 0.12% chlorhexidine mouth rinse (control group) administered after surgery. Gingival Index (GI) were evaluated in the whole mouth and in the surgical site at baseline (T1), a week later (T2), and 12 weeks (T3) after the treatment. Total MMP activity was measured in GCF using a commercial kit and plate reader. Medians of total MMP activity and GI were compared for time intervals T1 vs. T2, T1 vs. T3, and T2 vs T3 using Friedman tests and Wilcoxon signed rank tests, and were also compared between test and control using Mann-WhitneyU tests at each timepoint. RESULTS The average GI values showed significant differences between baseline and T2 (p = 0.0005) and baseline and T3 (p = 0.003) in the test group. CONCLUSION The sodium chloride-mouth rinse use after periodontal surgery seems to have similar anti-inflammatory properties as CHX mouth rinse and can be used regularly postoperatively after periodontal surgical procedures. CLINICAL RELEVANCE The use of salt water mouthwash showed an anti-inflammatory effect similar to CHX 0.12% after minimal invasive periodontal surgery. Salt water mouthwash is accessible to the world population and can contribute on the healing process after periodontal surgery.
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Affiliation(s)
- James Rudolph Collins
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic.
| | - Kenia Veras
- Department of Periodontology, School of Dentistry, Pontificia Universidad Católica Madre y Maestra (PUCMM), Santo Domingo, Dominican Republic
| | - Marcela Hernández
- Department of Pathology and Oral Medicine, School of Dentistry, Universidad de Chile, Santiago, Chile
| | - Wei Hou
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook, NY, USA
| | - Houlin Hong
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook, NY, USA
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
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Bunk D, Eisenburger M, Häckl S, Eberhard J, Stiesch M, Grischke J. The effect of adjuvant oral irrigation on self-administered oral care in the management of peri-implant mucositis: A randomized controlled clinical trial. Clin Oral Implants Res 2020; 31:946-958. [PMID: 32716603 DOI: 10.1111/clr.13638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 07/19/2020] [Accepted: 07/19/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This single-blinded randomized clinical trial evaluated the effect of adjuvant oral irrigation in addition to self-administered oral care on prevalence and severity of peri-implant mucositis. MATERIAL & METHODS After randomization, patients suffering from peri-implant mucositis were assigned to the following: Group 1 (control) received oral hygiene instruction following a standardized protocol, including a sub- and supramucosal mechanical debridement. Group 2 and 3 additionally were instructed to use an oral irrigator with either water or 0.06% CHX solution. One implant per patient was considered for examination. Clinical examinations included Probing Depth, Bleeding on Probing (BOP-positive sites), and Modified Plaque and Gingival Index. A surrogate variable (mucositis severity score) was applied measuring severity of disease. Statistical analysis included linear regression models and sensitivity analysis. RESULTS Sixty periodontally healthy patients were examined for presence and severity of peri-implant mucositis. 70% of all patients reached complete resolution of disease after 12 weeks. The prevalence of peri-implant mucositis after 12 weeks was 50% in group 1, 35% in group 2, and 5% in group 3. Average BOP-positive sites were reduced in all groups after 12 weeks (mean change from baseline: group 1: -1.5; group 2: -1.8; group 3: -2.3). CONCLUSION Within the limits of the study, adjuvant use of an oral irrigator with 0.06% CHX in addition to mechanical biofilm removal and oral hygiene instruction can reduce the presence and severity of peri-implant mucositis after 12 weeks.
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Affiliation(s)
- Daniel Bunk
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
| | - Michael Eisenburger
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
| | - Sebastian Häckl
- Institute for Biostatistics, Hannover Medical School, Hanover, Germany
| | - Jörg Eberhard
- School of Dentistry and the Charles Perkins Centre, Faculty of Health and Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Meike Stiesch
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany
| | - Jasmin Grischke
- Clinic of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Hanover, Germany.,Robokind Robotics for Mankind Foundation, Hannover, Germany
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21
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Van Swaaij BWM, van der Weijden GA(F, Bakker EWP, Graziani F, Slot DE. Does chlorhexidine mouthwash, with an anti-discoloration system, reduce tooth surface discoloration without losing its efficacy? A systematic review and meta-analysis. Int J Dent Hyg 2020; 18:27-43. [PMID: 31054209 PMCID: PMC7003798 DOI: 10.1111/idh.12402] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/02/2019] [Accepted: 04/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores. MATERIAL AND METHODS MEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed. RESULTS Screening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [-0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [-0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [-0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [-0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [-3.98; -1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [-3.32; 3.55]). CONCLUSION There is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.
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Affiliation(s)
- Bregje W. M. Van Swaaij
- Department of Dental Hygiene, Hogeschool Arnhem NijmegenUniversity of Applied SciencesNijmegenThe Netherlands
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - G. A. (Fridus) van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Eric W. P. Bakker
- Division Clinical Methods and Public Health, Academic Medical Centre (AMC)University of AmsterdamAmsterdamThe Netherlands
| | - Filippo Graziani
- Department of Surgical, Medical Medical and Molecular Pathology and Critical Care MedicineUniversity of PisaPisaItaly
- Department of PeriodontologyUCL Eastman Dental InstituteLondonUK
| | - Dagmar E. Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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The Contribution of Photodynamic Inactivation vs. Corsodyl Mouthwash to the Control of Streptococcus mutans Biofilms. Curr Microbiol 2020; 77:988-996. [PMID: 31997000 DOI: 10.1007/s00284-020-01901-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/21/2020] [Indexed: 02/05/2023]
Abstract
This work compared the inhibition effect of the commercially available mouthwash Corsodyl, containing 0.1% chlorhexidine digluconate, and photodynamic inactivation (PDI) employing methylene blue (MB) with irradiation from a red laser on 24-h biofilms formed by Streptococcus mutans strains on hydroxyapatite surfaces. The cytotoxicity of Corsodyl and MB was evaluated by Galleria mellonella surviving assay. The viability of biofilm cells after exposure to mouthwash and PDI was determined by counting colony-forming units. The inhibitory effect of antimicrobial agents was confirmed by confocal scanning laser microscopy. MB did not exhibit a cytotoxic effect on larval survival. Non-diluted Corsodyl slightly decreased the survival of larvae. Using our PDI parameters achieved better inhibition than with non-PDI, proving a significant effect on the eradication of S. mutans biofilms and therefore could be an appropriate supplement for the eradication of dental caries.
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23
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Marconcini S, Goulding M, Oldoini G, Attanasio C, Giammarinaro E, Genovesi A. Clinical and patient-centered outcomes post non-surgical periodontal therapy with the use of a non-injectable anesthetic product: A randomized clinical study. ACTA ACUST UNITED AC 2019; 10:e12446. [PMID: 31353819 PMCID: PMC6899940 DOI: 10.1111/jicd.12446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 01/01/2023]
Abstract
Aim The aim of this study was to determine the impact of different full‐mouth decontamination (FMD) protocols on the effectiveness of an intrapocket anesthetic gel in periodontal maintenance patients. Methods Patients undergoing the periodontal maintenance program and with the need for FMD participated in this study. Patients were randomly allocated to non‐surgical periodontal therapy (NSPT) with either a preparatory 15‐day decontamination phase, including chlorhexidine mouth rinse and domiciliary hygiene instructions (modified FMD: test group), or without it (FMD: control group). In both groups, NSPT was performed with the aid of a non‐injectable anesthetic gel. Clinical and patient‐related outcomes were recorded during a 6‐month follow‐up period. Results Sixty patients completed the 6‐month study. Both groups experienced relevant clinical improvements after NSPT, but the test group showed a significant change in periodontal parameters already after the initial 15‐day preparatory period, and overall significantly better results in periodontal outcomes when compared with the control group at the last 6‐month follow up: the gingival index was 2.07 ± 1.25 in the control group and 1.13 ± 0.51 in the test group. Less pain and dental‐related anxiety were perceived by patients in the test group showing a 6‐month mean visual analog scale of 2.13 ± 1.25 in the control group and 1.13 ± 0.83 in the test group. Conclusion The present study suggested that the modification of the standard FMD could improve the clinical efficacy of non‐injectable anesthetic, along with patients’ short‐ and mid‐term appreciation and compliance.
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