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Checchi V, Forabosco E, Dall'Olio F, Kaleci S, Giannetti L, Generali L. Assessment of colour modifications in two different composite resins induced by the influence of chlorhexidine mouthwashes and gels, with and without anti-staining properties: An in vitro study. Int J Dent Hyg 2024; 22:655-660. [PMID: 37691471 DOI: 10.1111/idh.12747] [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: 03/29/2023] [Revised: 08/12/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Chlorhexidine (CHX)-based products are the most effective chemical agents used in plaque control and oral disinfection. One of their side effects is tooth and restoration staining. For this reason, CHX products with anti-discolouration systems (ADS) have been developed. The aim of this in vitro study was to compare different CHX-based products (gel and mouthwash) with or without ADS in composite colour modification. METHODS Two hundred specimens were created, 100 of which were made of packable composite and 100 of flowable composite. After 24 h, colour coordinates (L*, a*, b*, C*, h°) were recorded using a spectrophotometer (T0). Then, all samples were subjected to a CHX/tea staining model and immersed in human saliva for 2 min. Composite specimens were divided in 10 groups (N = 20). Control groups (PC, FC) were soaked in distilled water and test groups (PG, PGads, FG, FGads, PM, PMads, FM and FMads) were immersed in CHX-based solutions or brushed with CHX gel. Then the cycle was repeated 6 times, and colour differences (ΔEab and ΔE00) were finally calculated. RESULTS Through flowable composites, FC and FG showed the highest colour differences, respectively ΔEab = 3.48 ± 1.0, ΔE00 = 2.24 ± 0.6 and ΔEab = 2.95 ± 1.3, ΔE00 = 1.53 ± 0.6. In the composite groups instead, PM and PMads showed the highest colour differences, respectively ΔEab = 2.78 ± 1.3, ΔE00 = 1.94 ± 0.8 and ΔEab = 2.71 ± 1.4, ΔE00 = 1.84 ± 0.9. CONCLUSIONS CHX-containing products are able to cause stains on restorative composite materials. Discolouration is more likely to occur in flowable composites than packable composites, and ADS-containing products cause fewer pigmentations than CHX products without ADS. Packable composites showed more staining after mouthwash treatment, whereas flowable composites underwent higher discolouration after treatment with gels.
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Affiliation(s)
- V 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
| | - E Forabosco
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - F Dall'Olio
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - S Kaleci
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - L Giannetti
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - L 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
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Sarembe S, Michler N, Ufer C, Kiesow A. In Vitro Model to Evaluate the Development of Discolorations on Human Enamel Caused by Treatment with Mouth Rinses and Black Tea Considering Brushing. Eur J Dent 2024; 18:925-932. [PMID: 38262467 PMCID: PMC11290939 DOI: 10.1055/s-0043-1777047] [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: 01/25/2024] Open
Abstract
OBJECTIVES The study aimed to develop and test an in vitro model to investigate the staining potential of mouth rinses on human enamel, considering alternating intake of black tea and tooth brushing, thus mimicking the situation in the oral cavity more realistically. MATERIALS AND METHODS Eight mouth rinses with six different active ingredients (benzydamine hydrochloride [BNZ], polyhexamethylene biguanide hydrochloride [PHMB], chlorhexidine digluconate [CHX], hexetidine gluconate [HEX], octenidine dihydrochloride [OCT] and octenidine dihydrochloride + 2-phenoxyethanol [OCTP]) and concentrations were tested. Sets of six halved human molar crowns were initially pretreated by soaking in artificial saliva (30 min). Afterward, the cyclic treatment was started by soaking in artificial saliva (2 min), staining with black tea (1 min), brushing with toothpaste (5 s), and soaking in the mouth rinse (30 s). Samples were rinsed with distilled water after each treatment step. The cyclic treatment was repeated 30 times, mimicking the consumer behavior after 15 days. Photographic images were taken after 0, 10, 20, and 30 cycles. Color measurements were conducted after each staining and brushing step using a VITA-Easyshade spectrophotometer to determine the difference in lightness ∆L and the total color difference ∆E. STATISTICAL ANALYSIS Analysis of variance and post-hoc Tukey test (α = 0.05) were applied. RESULTS The new testing model with included brushing sequences allowed to assess the staining behavior on human teeth and provided a clear differentiation between the different investigated products. In detail, up to cycle 10, ΔE values increased for all mouth rinses with each additional cycle number. However, while ΔE values continued to increase for 0.15% BNZ, 0.1% PHMB, and 0.2% CHX between treatment cycle 10 and 30, ΔE values only slightly increased after treatment with 0.08% OCTP, 0.1% OCTP, 0.1% OCT, and 0.1% HEX. After 20 and 30 cycles, significantly less staining was found for 0.08% OCTP, 0.1% OCT, 0.1% HEX as compared to 0.2% CHX, 0.15% BNZ, and 0.1% PHMB (p < 0.05). ΔE-values were significantly lower after treatment with 0.1% OCTP as compared to 0.2% CHX1 and 0.2% CHX2 (p < 0.05). CONCLUSION The proposed new methodology was found to be appropriate for assessing the staining progression of mouth rinses over a simulated application period of 15 days. The model allows differentiation of products with different active ingredients and concentrations.
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Affiliation(s)
- Sandra Sarembe
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - Nicole Michler
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - Carolin Ufer
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - Andreas Kiesow
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
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Andrucioli MCD, Ferreira Amato PA, Kuchler ÉC, Matsumoto MAN, Bergamo AZN, Silva RABD, Silva LABD, Nelson-Filho P. Effect of chlorhexidine mouthwashes on periodontal parameters and extrinsic tooth staining in orthodontic patients. Am J Orthod Dentofacial Orthop 2023; 164:855-861. [PMID: 37642605 DOI: 10.1016/j.ajodo.2023.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Periodontal health and biofilm control are primordial to success in orthodontic treatment. This study aimed to evaluate the effect of chlorhexidine (CHX) mouthwashes on periodontal status and extrinsic tooth staining in orthodontic patients. METHODS Thirty-three patients of both sexes, aged 11-33 years, under orthodontic treatment with fixed appliances at <16 months, were randomly distributed into 2 groups. In the control group, patients received mechanical hygiene instruction, and in the experimental group, patients also used CHX wash twice a week for 60 days. The effectivity of the protocols was evaluated using the plaque, gingival, gingival bleeding, and discoloration indexes before the hygiene protocol was applied, 15, 30, and 60 days after protocol implementation. RESULTS In the experimental group, there was a decrease in the plaque, gingival, and gingival bleeding indexes at the different evaluation periods (P <0.05). In addition, there was a significant difference in the discoloration index at 60 days compared with initial time points after implementing hygiene protocols in the experimental group (P <0.05). In contrast, there were no significant differences in plaque, gingival, gingival bleeding, and discoloration indexes in the control group at any time (P >0.05). CONCLUSIONS CHX mouthwash administered 30 days, twice a week, significantly improved the periodontal status with mild brown staining. After this period, expressive extrinsic tooth staining was observed.
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Affiliation(s)
| | | | - Érika Calvano Kuchler
- Department of Orthodontics, University Medical Centre of Regensburg, Regensburg, Germany
| | - Mírian Aiko Nakane Matsumoto
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Ana Zilda Nazar Bergamo
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | | | - Léa Assed Bezerra da Silva
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Paulo Nelson-Filho
- Department of Pediatric Clinic, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Yang L, Yergeshov AA, Al-Thaher Y, Avdokushina S, Statsenko E, Abdullin TI, Prokopovich P. Nanocomposite orthopaedic bone cement combining long-acting dual antimicrobial drugs. BIOMATERIALS ADVANCES 2023; 153:213538. [PMID: 37390562 PMCID: PMC10824671 DOI: 10.1016/j.bioadv.2023.213538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/22/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023]
Abstract
Antibiotic loaded bone cements are widely used in total joint replacement (TJR); despite many limitations such as a burst release which leads to antibiotic concentration below inhibitory levels and possibly contributing to the selection of antibiotic resistant strains. In order to address such limitations and to simultaneously address antibiotic resistance and short-term antimicrobial activity, we developed a nanocomposite bone cement capable of providing a controlled release of antimicrobial agents from bone cement to act as prophylaxis or treatment against prosthetic joint infections (PJIs). Gentamicin and chlorhexidine were loaded in combination on silica nanoparticles surface using layer-by-layer coating technique (LbL) combining hydrolysable and non-hydrolysable polymers. The drug release from the nanocomposite continued for >50 days at concentrations higher than the commercial formulation containing the same amount of antimicrobial drugs, where burst release for few days were observed. Moreover, the nanocomposite bone cement showed superior antimicrobial inhibition without adversely affecting the mechanical properties or the ability of osteoblasts to grow. In vivo experiments with an infected bone lesion model along with mass-spectrometric analysis also provided further evidence of efficacy and safety of the implanted nanocomposite material as well as its prolonged drug eluting profile. The developed nanocomposite bone cement has the potential to reduce PJIs and enable treatment of resistant established infections; moreover, the newly developed LbL based nano-delivery system may also have wider applications in reducing the threat posed by antimicrobial resistance.
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Affiliation(s)
- Lirong Yang
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Abdulla A Yergeshov
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 18 Kremlyovskaya St., 420008 Kazan, Russia
| | - Yazan Al-Thaher
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - Svetlana Avdokushina
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 18 Kremlyovskaya St., 420008 Kazan, Russia
| | - Evgeny Statsenko
- Institute of Geology and Petroleum Technologies, 4/5 Kremlyovskaya St., 420111 Kazan, Russia
| | - Timur I Abdullin
- Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, 18 Kremlyovskaya St., 420008 Kazan, Russia
| | - Polina Prokopovich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK.
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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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Ting M, Dahlkemper A, Schwartz JJ, Woodfork M, Suzuki JB. Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review. Biomedicines 2023; 11:1694. [PMID: 37371789 DOI: 10.3390/biomedicines11061694] [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: 05/15/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
(1) There are limited clinical trials to support the effectiveness of mouth rinses when used as a preprocedural rinse against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This systematic review aims to evaluate the efficacy of antiseptic mouth rinses as a preprocedural rinse in reducing SARS-CoV-2 oral viral load in-vivo. (2) Methods: A literature search was conducted through November 2022 for the following databases: PubMed, Web of Science, Cochrane Library, and Google Scholar. The evaluated outcomes were quantitative changes in viral load and the statistical significance of that change after using antiseptic mouth rinses. (3) Results: 14 randomized controlled trials (RCT) were selected for risk of bias assessment and data extraction. (4) Conclusion: Within the limits of this systematic review, preprocedural mouth rinses may significantly reduce SARS-CoV-2 in the mouth, thus, reducing the viral particles available for airborne dispersion. Preprocedural mouth rinses may be an effective strategy for reducing airborne SARS-CoV-2 dispersion in the environment. Their use may be a preventive strategy to reduce the spread of COVID-19 in selected medical and healthcare facilities, including dental clinics. Potential preprocedural mouth rinses are identified for use as an integral part of safe practice for healthcare protocols. This systematic review was registered with the National Institute for Health Research, international prospective register of systematic reviews (PROSPERO): CRD42022315177.
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Affiliation(s)
- Miriam Ting
- Department of Periodontics, University of Pennsylvania, Philadelphia, PA 19104, USA
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
- Think Dental Learning Institute, Paoli, PA 19301, USA
| | - Alex Dahlkemper
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Jeremy J Schwartz
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Manzel Woodfork
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Jon B Suzuki
- Department of Graduate Periodontics, University of Maryland, Baltimore, MD 21201, USA
- Department of Graduate Prosthodontics, University of Washington, Seattle, WA 98015, USA
- Department of Graduate Periodontics, Nova Southeastern University, Ft. Lauderdale, FL 33314, USA
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7
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Hu J, Yu J, Liu H, Wang Z, Haapasalo M, Haney EF, Hancock REW, Deng S, Shen Y. Dynamic killing effectiveness of mouthrinses and a D-enantiomeric peptide on oral multispecies biofilms grown on dental restorative material surfaces. J Dent 2023; 134:104552. [PMID: 37201774 DOI: 10.1016/j.jdent.2023.104552] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE To evaluate the dynamics of killing of oral multispecies biofilms grown on dental restorative materials by commercially available mouthrinses and a D-enantiomeric peptide. METHODS Four composite resins (3M Supreme, 3M Supreme flow, Kerr Sonicfill, and Shofu Beautifil II) and one glass ionomer (GC Fuji II) were used as restorative materials. Plaque biofilms were grown on the surfaces of restorative material discs for 1 week. The surface roughness and biofilm attachment were assessed by atomic force microscopy and scanning electron microscopy. One-week-old biofilms grown anaerobically at 37°C were exposed to each of five solutions for one minute (twice daily for seven days): Listerine Total care and Paroex Gum mouthrinses, 0.12% chlorhexidine, 0.001% D-enantiomeric peptide DJK-5, and sterile water. The dynamic variation of the biovolume of the biofilms and the percentage of dead bacteria were monitored and analyzed using confocal laser scanning microscopy. RESULTS All restorative materials had similar surface roughness with intact biofilm attachment. The percentage of dead bacteria and biovolume of biofilms treated by each oral rinse solution remained constant between days 1 and 7, with no statistically significant difference. DJK-5 showed the highest percentage of dead bacteria (up to 75.7%; cf. ∼20-40% for other mouthrinses) of all solutions tested within 7 days. CONCLUSIONS DJK-5 outperformed conventional mouthrinses in killing bacteria in oral multispecies biofilms grown on dental restorative materials. CLINICAL SIGNIFICANCE The antimicrobial peptide DJK-5 is effective against oral biofilms and serves as a promising candidate for the development of future mouthrinses to improve long-term oral hygiene.
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Affiliation(s)
- Jinghao Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000, China; Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, V6T 1Z3, Canada
| | - Jian Yu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, V6T 1Z3, Canada; The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory for Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, V6T 1Z3, Canada
| | - Zhejun Wang
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, V6T 1Z3, Canada
| | - Markus Haapasalo
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, V6T 1Z3, Canada
| | - Evan F Haney
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, V6T 1Z4, Canada
| | - Robert E W Hancock
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, V6T 1Z4, Canada
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310000, China.
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, V6T 1Z3, Canada.
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8
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Zhou F, Mu X, Li Z, Guo M, Wang J, Long P, Wan Y, Yuan T, Lv Y. Characteristics of Chinese herbal medicine mouthwash clinical studies: A bibliometric and content analysis. JOURNAL OF ETHNOPHARMACOLOGY 2023; 307:116210. [PMID: 36736713 DOI: 10.1016/j.jep.2023.116210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 12/18/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Fen Zhou
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Xiaoying Mu
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Zhaoyu Li
- School of Nursing, Capital Medical University, Beijing, 100069, China.
| | - Manjie Guo
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Jianan Wang
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Pengyi Long
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Yujia Wan
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Ting Yuan
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
| | - Yunpeng Lv
- School of Nursing, Beijing University of Chinese Medicine, Beijing, 10029, China.
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Song J, Hong L, Zou X, Alshawwa H, Zhao Y, Zhao H, Liu X, Si C, Zhang Z. A Self-Supplying H 2O 2 Modified Nanozyme-Loaded Hydrogel for Root Canal Biofilm Eradication. Int J Mol Sci 2022; 23:ijms231710107. [PMID: 36077503 PMCID: PMC9456354 DOI: 10.3390/ijms231710107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
The success of root canal therapy depends mainly on the complete elimination of the root canal bacterial biofilm. The validity and biocompatibility of root canal disinfectant materials are imperative for the success of root canal treatment. However, the insufficiency of the currently available root canal disinfectant materials highlights that more advanced materials are still needed. In this study, a nanozyme-loaded hydrogel (Fe3O4-CaO2-Hydrogel) was modified and analyzed as a root canal disinfectant material. Fe3O4-CaO2-Hydrogel was fabricated and examined for its release profile, biocompatibility, and antibacterial activity against E. faecalis and S. sanguis biofilms in vitro. Furthermore, its efficiency in eliminating the root canal bacterial biofilm removal in SD rat teeth was also evaluated. The results in vitro showed that Fe3O4-CaO2-Hydrogel could release reactive oxygen species (ROS). Moreover, it showed good biocompatibility, disrupting bacterial cell membranes, and inhibiting exopolysaccharide production (p < 0.0001). In addition, in vivo results showed that Fe3O4-CaO2-Hydrogel strongly scavenged on root canal biofilm infection and prevented further inflammation expansion (p < 0.05). Altogether, suggesting that Fe3O4-CaO2-Hydrogel can be used as a new effective biocompatible root canal disinfectant material. Our research provides a broad prospect for clinical root canal disinfection, even extended to other refractory infections in deep sites.
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Affiliation(s)
- Jiazhuo Song
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Lihua Hong
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
| | - Xinying Zou
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Hamed Alshawwa
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Yuanhang Zhao
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Hong Zhao
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Xin Liu
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Chao Si
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Zhimin Zhang
- Department of Endodontics, School of Dentistry, Jilin University, Changchun 130021, China
- Correspondence:
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Adjunctive Use of Active Compounds such as Chlorhexidine in the Nonsurgical Treatment of Peri-Implant Mucositis for Oral Health: A Systematic Review and Meta-Analysis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:2312784. [PMID: 36065438 PMCID: PMC9440847 DOI: 10.1155/2022/2312784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/09/2022] [Indexed: 11/18/2022]
Abstract
Background. Peri-implant mucositis (PiM) is characterized as a reversible inflammatory change of the peri-implant soft tissues without alveolar bone loss or continuing marginal bone loss. Without proper control of PiM, the reversible inflammation may advance to peri-implantitis (PI). Mechanical debridement (MD) by the implant surface is the most common and conventional nonsurgical approach to treat PiM but with limitations in complete resolution of diseases. For more than a decade, chlorhexidine (CHX) and active compounds has been investigated in the treatment of PiM. Therefore, the aim of this systematic review and meta-analysis was to evaluate the efficacy of CHX treatment in combination with MD versus MD alone or MD+placebo in patients with PiM on their oral health problems. Methods. A search using electronic databases (Ovid MEDLINE, EMBASE, Science Direct databases, and Cochrane Central Register of Controlled Trials) and a manual search up to May 2022 were performed independently by 2 reviewers and included eligible randomized controlled trials (RCTs) comparing MD+CHX versus MD alone or MD+placebo. The assessment of quality for all the selected RCTs was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. Disease resolution of PiM (absence of BOP), IPPD reduction, IBOP% reduction, and PI% reduction after treatment as primary outcomes were selected as the primary outcomes. Weighted mean differences (WMD) and 95% confidence interval (CI) were for continuous outcomes, and odds ratio (OR) and 95% CI was for dichotomous outcomes using random effect models. This review is registered on the PROSPERO database (CRD42020221989). Results. After independent screening, nine eligible studies were included in this systematic review and meta-analysis. Meta-analysis showed OR of disease resolution between test and control groups amounted to 1.41 (95% CI (0.43, 4.65),
,
) not favoring adjunctive CHX treatment over MD alone. Through subgroup analysis, the results indicated that oral irrigation of CHX may have more benefits on the resolution of PiM. Similarly, CHX did not significantly improve IPPD reduction at both short-, medium-, and long-term follow-up. Only a short-term effect has been observed at IBOP% reduction (
, 95% CI (10.94, 16.81),
,
), IPI reduction (
, 95% CI (0.09, 0.14),
,
), and FMPPD reduction (
mm, 95% CI (0.03, 0.35),
,
) with adjunctive CHX application. Conclusion. Adjunctive CHX application may have some benefits to improve the efficacy of MD in PiM treatment by reducing IBOP%, IPI, and FMPPD in short-term. But these benefits disappeared at medium- and long-term follow-up. In order to achieve better disease resolution of PiM, adjunctive CHX irrigation with MD may be suggested and has positive potential. Well-designed large clinical trials are needed in future.
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11
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Clinical Efficacy of 1% CHX Gluconate Gel and 0.12% CHX Solution: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159358. [PMID: 35954713 PMCID: PMC9368169 DOI: 10.3390/ijerph19159358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
Chlorhexidine (CHX) is an effective antibacterial agent and is used in dental treatment in several formulations. The aim of this study was to compare the effectiveness of CHX solution and CHX gel on dental plaque inhibition and gingivitis relief by a randomized clinical trial. Thirty-eight participants were randomly divided into two groups: control group (0.12% CHX solution) and test group (1% CHX gel). Participants were provided with CHX products and were instructed to use each product in the morning and evening for 1 week. Clinical results were evaluated by analyzing the collected data of Turesky et al. the modified Quigley-Hein Plaque Index (TQHPI), gingival index (GI) and the BANA test. Measurements were conducted 4 weeks and 8 weeks after using chlorhexidine products. The results were analyzed using repeated measured ANOVA and paired t-test. TQHPI and GI were significantly different after treatments in both groups (p < 0.001). The GI decreased more in the test group compared to the control group 4 weeks and 8 weeks later. In both groups, the BANA score also significantly decreased (p < 0.001) after 8 weeks, though the BANA score decreased relatively more in the CHX gel group than the CHX solution group. These results suggest that 1% CHX gel is more effective in reducing gingivitis and bacteria of periodontal disease than the 0.12% CHX solution. Therefore, the 1% CHX gel is expected to be actively used for non-surgical treatment of periodontal disease patients.
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12
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Natto ZS, Bakhrebah MA, Afeef M, Al-Harbi S, Nassar MS, Alhetheel AF, Ashi H. The short-term effect of different chlorhexidine forms versus povidone iodine mouth rinse in minimizing the oral SARS-CoV-2 viral load: An open label randomized controlled clinical trial study. Medicine (Baltimore) 2022; 101:e28925. [PMID: 35905275 PMCID: PMC9333084 DOI: 10.1097/md.0000000000028925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Several investigations evaluated the possibility of different types of mouth wash rinse in minimizing the SARS-CoV-2 load. However, results still controversial. The study aim is to assess the short-term efficiency of several over-the-counter mouth rinses and lozenges in minimizing the salivary viral load for SARS-CoV-2 in patients with confirmed COVID-19 in comparison to saline. This is a randomized controlled clinical trial with 4 arms. The recruited cases were randomized using a simple randomization technique and were assigned to chlorhexidine digluconate mouth rinse (CHX mouth rinse), 2 mg of chlorhexidine digluconate lozenges (CHX lozenges), povidone iodine mouth rinse (PVP-I mouth rinse) or saline as a control group. Saliva were collected from all study subjects by passive drool technique at two time points. First, prior to intervention with mouth rinse or the lozenges, the baseline saliva sample was collected. Second saliva samples were collected immediately after the mouth rinse. Real time PCR was conducted and the value threshold cycle (Ct) for each sample was recorded. Majority of the participants had an education level of high school or less (60%), were married (68.3), males (58.3%), and non-smokers (58.5%). No statistically significant differences between groups at the two times test (P > .05). However, a significant decrease of salivary viral load in all four groups combined (P-value for E genes = .027, and for S genes = .006), and in PVP-I mouth rinse specifically (P = .003 and P = .045, respectively). Povidone iodine mouth rinse showed a potential influence on the reduction of the viral load on a short-term basis. However, longer-term studies of the effect of these products should be conducted.
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Affiliation(s)
- Zuhair S. Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- *Correspondence: Zuhair S. Natto, Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia (e-mail: )
| | - Muhammed A. Bakhrebah
- Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | - Marwah Afeef
- Study and Research Department, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Samiah Al-Harbi
- Intensive Care Unit, King Fahad General Hospital, Jeddah, Saudi Arabia
| | - Majed S. Nassar
- Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
| | - Abdulkarim F. Alhetheel
- King Khalid University Hospital, Riyadh, Saudi Arabia
- Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | - Heba Ashi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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13
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Singh N, Puzhankara L, Kedlaya MN, Ramanarayanan V. Effectiveness of tea tree oil versus chlorhexidine in the treatment of periodontal diseases: a systematic review. Evid Based Dent 2022:10.1038/s41432-022-0259-6. [PMID: 35821403 DOI: 10.1038/s41432-022-0259-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022]
Abstract
Background Plaque biofilm that adheres to tooth surfaces and gingiva is the main aetiology of periodontitis. Chlorhexidine (CHX) is considered as a gold standard anti-plaque and anti-gingivitis agent but it has side effects such as permanent staining of teeth and dysgeusia. Tea tree oil (TTO) is an essential oil extracted from the leaves of Melaleuca alternifolia. Many studies have reported that TTO exerts strong antibacterial, antifungal, antiviral and anti-inflammatory activities.Primary study objective The review aims to answer the question of whether TTO (intervention) is a viable alternative to CHX (comparator) for the management of gingival and periodontal disease (outcomes) in adolescents and adults (population).Methods/design The following search terms were used in PubMed, Scopus, Proquest, Web of Science, EBSCO (dentistry and open access), Cochrane database, Clinical.gov.org and ctri.nic.in to search for relevant articles: patients with periodontal disease; OR periodontitis; OR gingivitis; OR gingival inflammation; AND essential oil; OR tea tree oil; OR Melaleuca alternifolia; AND chlorhexidine; AND reduction in gingival index; OR reduction in plaque index; OR reduction in bleeding from gums. The initial check for the title and abstract screening followed by removal of duplicates in Mendeley Reference Manager (version 1.19.4) based on the inclusion and exclusion criteria were performed.Primary outcome measures Parameters such as plaque index (PI), plaque surface score, gingival index (GI), bleeding index or bleeding as measured by % of sites with bleeding on probing (BOP) or bleeding scores, papillary bleeding index (PBI), were the primary outcomes considered.Results TTO is found to be superior to CHX in reducing signs of gingival inflammation; however, CHX is superior to TTO in inhibiting plaque formation, probably due to its increased substantivity.Conclusion TTO may be used as an alternative to CHX for reduction of gingival inflammation in conjunction with efficient plaque control measures.
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Affiliation(s)
- Niharika Singh
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Lakshmi Puzhankara
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Madhurya N Kedlaya
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Venkitachalam Ramanarayanan
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwavidyapeetham, Kochi, Kerala, India
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14
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Divnic-Resnik T, Shen JJ, Nguyen JVT, Lu DW, Miletic V. Effects of bioflavonoid-containing mouth rinses on optical properties of tooth-coloured dental restorative materials. Sci Rep 2022; 12:9944. [PMID: 35705613 PMCID: PMC9200838 DOI: 10.1038/s41598-022-14254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/03/2022] [Indexed: 11/26/2022] Open
Abstract
This study investigated differences in colour (ΔE00) and translucency parameter (ΔTP00) of nanofilled/microhybrid composites and a glass-ionomer cement following immersion in bioflavonoid (Citrox)- or chlorhexidine-based mouth rinses. Sixty disc-shaped specimens (N = 5/group) of Filtek Supreme (3M), Gradia Anterior (GC) and Fuji IX (GC) were exposed to Citrox/0.2%CHX (Perio+0.2, Curaprox), Citrox/0.09%CHX (Perio+0.09, Curaprox), 0.2%CHX (Savacol, Colgate-Palmolive) or distilled water by 2-min agitation daily for 28 days in an orbital shaker at 200 rpm at 37 °C. Colour recordings were performed using a clinical spectrophometer to obtain CIELab coordinates. General linear model, ANOVA, Tukey test (α = 0.05) and Pearson correlation test were used to analyse data. ΔE00 ranged between 0.33 (Gradia_Savacol_T28) and 6.35 (Fuji_Savacol_T28) (p < 0.001). ΔTP00 ranged between 0.36 (Fuji_ Perio+0.2) and 1.73 (Fuji_Savacol) (p < 0.05). Savacol resulted in higher ΔE00 of Filtek and Fuji and ΔTP00 of Filtek than Perio+0.09 and Perio+0.2 (p = 0.005). Perio+0.09 and Perio+0.2 resulted in higher ΔE00 at T7 than T28 (p < 0.05). There was no correlation between ΔTP00 and ΔE00 (r = 0.445, p = 0.147). Generally, Perio+0.2 and Perio+0.09 mouth rinses produced similar or lower ΔE00 and ΔTP00 than Savacol. GIC Fuji showed higher ΔE00 and similar or higher ΔTP00 than composites Filtek and Gradia. ΔE00 in all materials decreased in Perio+0.2 and Perio+0.09 over time.
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Affiliation(s)
- Tihana Divnic-Resnik
- The University of Sydney, Faculty of Medicine and Health, Sydney Dental School, 2 Chalmers Street, Surry Hills, 2010, Australia
| | - Jay Junyang Shen
- The University of Sydney, Faculty of Medicine and Health, Sydney Dental School, 2 Chalmers Street, Surry Hills, 2010, Australia
| | - Jim Vinh The Nguyen
- The University of Sydney, Faculty of Medicine and Health, Sydney Dental School, 2 Chalmers Street, Surry Hills, 2010, Australia
| | - Derek Weidi Lu
- The University of Sydney, Faculty of Medicine and Health, Sydney Dental School, 2 Chalmers Street, Surry Hills, 2010, Australia
| | - Vesna Miletic
- The University of Sydney, Faculty of Medicine and Health, Sydney Dental School, 2 Chalmers Street, Surry Hills, 2010, Australia.
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15
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Lorusso F, Tartaglia G, Inchingolo F, Scarano A. Early Response and Clinical Efficacy of a Mouthwash Containing Chlorhexidine, Anti Discoloration System, Polyvinylpyrrolidone/Vinyl Acetate and Sodium DNA in Periodontitis Model: A Triple-Blind Randomized Controlled Clinical Trial. Dent J (Basel) 2022; 10:dj10060101. [PMID: 35735643 PMCID: PMC9221572 DOI: 10.3390/dj10060101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/26/2022] [Accepted: 06/01/2022] [Indexed: 12/18/2022] Open
Abstract
Polyvinylpyrrolidone/vinyl acetate (PVP/VA) is a molecule with increased adhesion capacity, and can be associated in the bacterial plaque control with sodium DNA, a natural anti-aging molecule able to improve gingival trophism. The aim of the study is to test at two weeks the antimicrobial and antiplaque properties, subjects affected by chronic periodontitis, showed by a mouthwash containing Chlorhexidine (CHX) 0.2% with Anti Discoloration System (ADS), PVP-VA, and Sodium DNA in comparison with a placebo mouthwash. A single center randomized controlled trial was conducted on a total of fifty-four (54) subjects. In the test Group (n = 27) patients were treated by a 0.2% Chlorhexidine (CHX) mouthwash with ADS, PVP-VA, and Sodium DNA, while a placebo mouthwash was used in the control Group (B). The full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and gingival index (GI) were assessed at baseline, and at 1 and 2 weeks after treatment. FMPS score recorded at baseline (V2) was 52.7 ± 9.2 in the Group Test and 58.2 ± 6.1 in the Group Control (p > 0.05). After 1 week (V3), FMPS was 13.3 ± 5.6 in the Group Test and 18.7 ± 4.3 in the Group Control (p < 0.05), while at V4 (2 weeks), FMPS was 14.2 ± 4.1 in the Group Test and 20.3 ± 5.2 in the Group Control (p < 0.05). FMBS score recorded at baseline (V2) was 46.7 ± 8.7 in the Group Test and 49.2 ± 6.2 in the Group Control (p > 0.05). After 1 week (V3), FMBS was 12.7 ± 4.2 in the test Group Test and 18.5 ± 5.9 in the control Group Control (p < 0.05), while after 2 weeks (V4), it was 13.1 ± 3.2 in the Group Test and 19.8 ± 4.9 Group Control (p < 0.05). This trial has clinically showed the efficacy of a new formulation of chlorhexidine mouthwash in reducing bacterial plaque and gingival inflammation. A significant reduction of inflammation and bleeding scores was found in periodontal patients treated by a mouthwash containing CHX 0.2% with ADS, PVP-VA, and Sodium DNA compared to those treated with a placebo mouthwash.
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Affiliation(s)
- Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Gianluca Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20122 Milan, Italy;
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
- Department of Oral Implantology, Dental Research Division, College Ingà, UNINGÁ, Cachoeiro de Itapemirim 29312, Brazil
- Correspondence: ; Tel.: +39-087-1355-4084 (ext. 4099)
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16
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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: 66] [Impact Index Per Article: 33.0] [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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17
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Amaliya A, Ramadhanti R, Hadikrishna I, Maulina T. The Effectiveness of 0.2% Chlorhexidine Gel on Early Wound Healing after Tooth Extraction: A Randomized Controlled Trial. Eur J Dent 2022; 16:688-694. [PMID: 35016228 PMCID: PMC9507567 DOI: 10.1055/s-0041-1739544] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective
This study aimed to evaluate the effect of 0.2% chlorhexidine (CHX) gel on wound healing after tooth extraction.
Materials and Methods
A single blind, randomized controlled trial was performed recruiting 32 participants who underwent dental extractions. Patients were randomly allocated for CHX group or placebo group. The primary outcomes were wound closure measured with calipers and healings were assessed by Landry et al index after 7 days of topical application of allocated gels on extraction sites.
Results
The wound closures were greater in CHX group compared with placebo group and healing scores were correlated with the use of CHX gel (
p
-value < 0.05).
Conclusion
In a population of healthy nonsmoker adults, application of 0.2% CHX gel twice a day for 7 days after tooth extraction has a beneficial effect on wound healing.
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Affiliation(s)
- Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Rika Ramadhanti
- Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Indra Hadikrishna
- Department of Oral Surgery, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Tantry Maulina
- Department of Oral Surgery, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
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18
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Al Thaher Y, Alotaibi HF, Yang L, Prokopovich P. PMMA bone cement containing long releasing silica-based chlorhexidine nanocarriers. PLoS One 2021; 16:e0257947. [PMID: 34587194 PMCID: PMC8480893 DOI: 10.1371/journal.pone.0257947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022] Open
Abstract
Prosthetic joint infections (PJI) are still an extremely concerning eventuality after joint replacement surgery; growing antibiotic resistance is also limiting the prophylactic and treatment options. Chlorhexidine (a widely used topical non-antibiotic antimicrobial compound) coatings on silica nanoparticles capable of prolonged drug release have been successfully developed and characterised. Such nanocarriers were incorporated into commercial formulation PMMA bone cement (Cemex), without adversely affecting the mechanical performance. Moreover, the bone cement containing the developed nanocarriers showed superior antimicrobial activity against different bacterial species encountered in PJI, including clinical isolates already resistant to gentamicin. Cytocompatibility tests also showed non inferior performance of the bone cements containing chlorhexidine releasing silica nanocarriers to the equivalent commercial formulation.
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Affiliation(s)
- Yazan Al Thaher
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
| | - Hadil Faris Alotaibi
- Department of Pharmaceutical Sciences, Pharmacy College, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Lirong Yang
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
| | - Polina Prokopovich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United Kingdom
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19
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Li W, Liang Y, Zhang X, Liu C, He L, Miao L, Sun W. A deep learning approach to automatic gingivitis screening based on classification and localization in RGB photos. Sci Rep 2021; 11:16831. [PMID: 34413332 PMCID: PMC8376991 DOI: 10.1038/s41598-021-96091-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/26/2021] [Indexed: 12/22/2022] Open
Abstract
Routine dental visit is the most common approach to detect the gingivitis. However, such diagnosis can sometimes be unavailable due to the limited medical resources in certain areas and costly for low-income populations. This study proposes to screen the existence of gingivitis and its irritants, i.e., dental calculus and soft deposits, from oral photos with a novel Multi-Task Learning convolutional neural network (CNN) model. The study can be meaningful for promoting the public dental health, since it sheds light on a cost-effective and ubiquitous solution for the early detection of dental issues. With 625 patients included in this study, the classification Area Under the Curve (AUC) for detecting gingivitis, dental calculus and soft deposits were 87.11%, 80.11%, and 78.57%, respectively; Meanwhile, according to our experiments, the model can also localize the three types of findings on oral photos with moderate accuracy, which enables the model to explain the screen results. By comparing to general-purpose CNNs, we showed our model significantly outperformed on both classification and localization tasks, which indicates the effectiveness of Multi-Task Learning on dental disease detection. In all, the study shows the potential of deep learning for enabling the screening of dental diseases among large populations.
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Affiliation(s)
- Wen Li
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China
| | - Yuan Liang
- University of California, Los Angeles, USA
| | - Xuan Zhang
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China
| | - Chao Liu
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China
| | - Lei He
- University of California, Los Angeles, USA
| | - Leiying Miao
- Department of Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China.
| | - Weibin Sun
- Department of Periodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, No.30 Zhongyang Road, Xuanwu District, Nanjing, Jiangsu, People's Republic of China.
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20
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Soheilifar S, Khodadadi H, Naghdi N, Farhadian M. Does a diluted chlorhexidine-based orthodontic mouthwash cause less discoloration compared to chlorhexidine mouthwash in fixed orthodontic patients? A randomized controlled trial. Int Orthod 2021; 19:406-414. [PMID: 34049835 DOI: 10.1016/j.ortho.2021.05.001] [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: 02/24/2021] [Revised: 05/01/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Chlorhexidine gluconate is currently the most effective oral antimicrobial agent against microorganisms, but discoloration of the teeth prevents its long-term use and can reduce patient cooperation. In this study, the effect of chlorhexidine and a diluted chlorhexidine-based, fluoride, cetylpyridinium and vitamin added mouth rinse (Orthokin) on stain index in fixed orthodontic patients was compared. MATERIALS AND METHODS This study was performed as a double blind randomized controlled trial on 50 patients undergoing fixed orthodontic treatment in the age group of 14-30 years. The patients were categorized as two groups of chlorhexidine and Orthokin mouth rinses and were asked to use mouthwash for eight weeks. Groups were matched according to colouring food consumption. Extrinsic staining index was assessed by modified Loben technique. Data was analysed by SPSS software. P value was set to be 0.05. RESULTS In the chlorhexidine group, the stain extent index and overall stain index were increased significantly at 8 weeks (P<0.001 and P=0.002, respectively). However, the increase in stain intensity index was insignificant (P=0.07). In Orthokin group, the changes in stain extent, stain intensity and overall stain were insignificant (P=0.66, P=1.000, P=0.47, respectively). CONCLUSION According to the results of the present study, chlorhexidine mouthwash causes more staining of teeth compared to Orthokin mouthwash. It seems that lower concentrations of chlorhexidine can be prescribed to orthodontic patients. Although these compounds are effective in sense of oral hygiene, they do not cause significant discoloration.
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Affiliation(s)
- Sepideh Soheilifar
- Department of Orthodontics, Dental Implant Research Centre, Hamedan university of medical sciences, Hamadan, Iran
| | | | - Navid Naghdi
- Oral and maxillofacial surgery department, Dental Implant Research Centre, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of biostatistics, School of public health and research centre for health sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Sánchez SV, Navarro N, Catalán-Figueroa J, Morales JO. Nanoparticles as Potential Novel Therapies for Urinary Tract Infections. Front Cell Infect Microbiol 2021; 11:656496. [PMID: 33954121 PMCID: PMC8089393 DOI: 10.3389/fcimb.2021.656496] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/23/2021] [Indexed: 12/21/2022] Open
Abstract
Urinary tract infection (UTI) is one of the most common reasons for antibiotic treatment. Nevertheless, uropathogens are steadily becoming resistant to currently available therapies. In this context, nanotechnology emerges as an innovative and promising approach among diverse strategies currently under development. In this review we deeply discuss different nanoparticles (NPs) used in UTI treatment, including organic NPs, nanodiamonds, chemical and green synthesized inorganic NPs, and NPs made of composite materials. In addition, we compare the effects of different NPs against uropathogens in vivo and in vitro and discuss their potential impact the in the near future.
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Affiliation(s)
- Sofía V Sánchez
- Department of Pharmaceutical Science and Technology, School of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile.,Center of New Drugs for Hypertension (CENDHY), Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile
| | - Nicolás Navarro
- Department of Pharmaceutical Science and Technology, School of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile.,Center of New Drugs for Hypertension (CENDHY), Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile
| | - Johanna Catalán-Figueroa
- Departamento Farmacología, Facultad de Ciencias Químicas, Instituto de Farmacología experimental de Córdoba (IFEC-CONICET), Universidad Nacional de Córdoba, Córdoba, Argentina.,Facultad de Medicina, Escuela de Química y Farmacia, Universidad Católica del Maule, Talca, Chile
| | - Javier O Morales
- Department of Pharmaceutical Science and Technology, School of Chemical and Pharmaceutical Sciences, University of Chile, Santiago, Chile.,Center of New Drugs for Hypertension (CENDHY), Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile
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22
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Reda B, Hollemeyer K, Trautmann S, Volmer DA, Hannig M. First insights into chlorhexidine retention in the oral cavity after application of different regimens. Clin Oral Investig 2021; 25:6109-6118. [PMID: 33825020 PMCID: PMC8531059 DOI: 10.1007/s00784-021-03910-y] [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: 09/25/2020] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
Objectives This in situ study aimed to determine and compare the chlorhexidine (CHX) retention in the oral cavity after the application of different CHX pharmaceutical regimens. Methods Five volunteers used different CHX treatment regimens including mouth rinses, dental spray and toothpaste gel. After the application of the different CHX regimens, 2-μl samples were taken from saliva and buccal mucosa pellicle as well as the dental pellicle samples formed on standardized enamel surfaces. Sample collection was conducted at six time points within 12 h. Retention of CHX was measured using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. Results CHX retention values in the oral mucosa pellicle were significantly higher than those in saliva. CHX remained in the mucosal pellicle at microgrammes per millilitre levels for 12 h after mouth rinsing, 10 h after spray application and 2 h after using the toothpaste. CHX was detected in the dental pellicle for at least 12 h after application of mouth rinsing and spray. Retention of CHX after mouth rinsing or spray application was significantly higher than the retention after using toothpaste. Conclusions Oral mucosa was the favourable site for CHX retention. Higher mouth rinse concentration and longer rinsing time produced a slight increase in CHX retention. CHX spray provided considerable retention values, whereas toothpaste gel delivered the lowest retention after application. MALDI-TOF was a sensitive method with excellent limits of quantification for CHX detection.
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Affiliation(s)
- Bashar Reda
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Saar, Germany
| | - Klaus Hollemeyer
- Physical Chemistry and Didactics of Chemistry, Saarland University, Campus B2 2, 66123, Saarbrücken, Germany
| | - Simone Trautmann
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Saar, Germany
| | - Dietrich A Volmer
- Department of Chemistry, Bioanalytical Chemistry, Humboldt University of Berlin, Brook-Taylor-Strasse 2, 12489, Berlin, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital, Saarland University, Building 73, 66421, Homburg, Saar, Germany.
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23
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Tatar G, Salmanli M, Dogru Y, Tuzuner T. Evaluation of the effects of chlorhexidine and several flavonoids as antiviral purposes on SARS-CoV-2 main protease: molecular docking, molecular dynamics simulation studies. J Biomol Struct Dyn 2021; 40:7656-7665. [PMID: 33749547 DOI: 10.1080/07391102.2021.1900919] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The recent outbreak of COVID-19 caused by a new human coronavirus called SARS-CoV-2, is continually causing worldwide human infections and deaths.The main protease (3CLpro), which plays a critical role in the life cycle of the virus, makes it an attractive target for the development of antiviral agents effective against coronaviruses (CoVs).Currently, there is no specific viral protein targeted therapeutics.Therefore, there is a need to investigate an alternative therapy which will prevent the spread of the infection, by focusing on the transmission of the virus.Chlorhexidine (CHX) and flavonoids agents have shown that they have a viral inactivation effect against enveloped viruses, and thus facilitate the struggle against oral transmission.Especially, some flavonoids have very strong antiviral activity in SARS-CoV and MERS-CoV main protease.This study was conducted to evaluate the CHX and flavonoids compounds potential antiviral effects on SARS-CoV-2 main protease through virtual screening for the COVID-19 treatment by molecular docking method.According to the results of this study, CHX, Kaempferol-3-rutinoside, Rutin, Quercetin 3-beta-D-glucoside and Isobavachalcone exhibited the best binding affinity against this enzyme, and also these compounds showed significant inhibitory effects compared to the SARS-CoV-2 main protease crystal structure inhibitor (N3).Especially, these compounds mainly interact with His41, Cys145, His163, Met165, Glu166 and Thr190 in SARS-CoV-2 main protease binding site. Further, MD simulation analysis also confirmed that stability of these interactions between the enzyme and these five compounds.The current study provides to guide clinical trials for broad-spectrum CHX and bioactive flavonoids to reduce the viral load of the infection and possibly disease progression.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Gizem Tatar
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Karadeniz Technical University, Trabzon, Turkey
| | - Merve Salmanli
- Dentistry Faculty of Dentistry, Department of Pediatric, Karadeniz Technical University, Trabzon, Turkey
| | - Yakup Dogru
- Dentistry Faculty of Dentistry, Department of Pediatric, Karadeniz Technical University, Trabzon, Turkey
| | - Tamer Tuzuner
- Dentistry Faculty of Dentistry, Department of Pediatric, Karadeniz Technical University, Trabzon, Turkey
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24
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Kerémi B, Márta K, Farkas K, Czumbel LM, Tóth B, Szakács Z, Csupor D, Czimmer J, Rumbus Z, Révész P, Németh A, Gerber G, Hegyi P, Varga G. Effects of Chlorine Dioxide on Oral Hygiene - A Systematic Review and Meta-analysis. Curr Pharm Des 2021; 26:3015-3025. [PMID: 32410557 PMCID: PMC8383470 DOI: 10.2174/1381612826666200515134450] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/29/2020] [Indexed: 12/26/2022]
Abstract
Background Effective and selective oral rinses are required in the daily medical and dental practice. Currently mouthwashes used have substantial side effects. Objectives Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The search terms used were “chlorine dioxide” AND “oral”, and only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2-tests. Results 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487-0.952 vs 0.489-1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457–0.967 vs 0.489–1.001, respectively) and also in bacterial counts. Conclusion Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this outcome is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.
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Affiliation(s)
- Beáta Kerémi
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Katalin Márta
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Kornélia Farkas
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary,Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - László M Czumbel
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Barbara Tóth
- Department of Pharmacognosy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Zsolt Szakács
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Dezső Csupor
- Department of Pharmacognosy, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - József Czimmer
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltán Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Péter Révész
- Department of Otorhinolaryngology (ENT), Medical School, University of Pecs, Pecs, Hungary
| | - Adrienn Németh
- Department of Otorhinolaryngology (ENT), Medical School, University of Pecs, Pecs, Hungary
| | - Gábor Gerber
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary,Szentágothai Research Centre, University of Pecs, Pecs, Hungary
| | - Gábor Varga
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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25
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Scannapieco FA, Gershovich E. The prevention of periodontal disease-An overview. Periodontol 2000 2020; 84:9-13. [PMID: 32844421 DOI: 10.1111/prd.12330] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
It is widely accepted that common diseases of the oral cavity, such as gingivitis and periodontitis, are preventable. Based on a large body of scientific evidence, a number of preventive strategies are known to prevent these diseases, but only if routinely implemented. Unfortunately, while most preventive strategies are theoretically simple to understand, they are often difficult to employ in practice at individual and public health levels. This volume of Periodontology 2000 provides the most current information on the state of the science and the evidence base supporting a preventive perspective for the management of periodontal disease, including evidence for proven interventions as well as cutting-edge ideas for potential future interventions. In addition to well-established and scientifically proven approaches (tooth and implant cleansing, topical chemotherapeutics, reduction in risk factors such as tobacco smoking), a number of new ideas are now under investigation, including antioxidant agents, probiotics, vaccines, and slow-release alternative chemotherapeutics. Furthermore, there are new ideas to alter patient behaviors with the aim to improve adherence to preventive strategies. Finally, examples from implementation science and public health are provided that suggest novel approaches to bring new ideas into clinical practice.
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Affiliation(s)
- Frank A Scannapieco
- Department of Oral Biology, University at Buffalo, The State University of New York, Buffalo, NY.,School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY
| | - Eva Gershovich
- School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY
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26
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Chow EPF, Maddaford K, Trumpour S, Fairley CK. Translating mouthwash use for gonorrhoea prevention into a public health campaign: identifying current knowledge and research gaps. Sex Health 2020; 16:433-441. [PMID: 31099331 DOI: 10.1071/sh18237] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/13/2019] [Indexed: 11/23/2022]
Abstract
The gonorrhoea rate among gay and bisexual men who have sex with men (MSM) has been increasing rapidly in many Western countries. Furthermore, gonorrhoea is becoming increasingly resistant to antibiotics and only limited options remain for treatment. Recent evidence suggests that the oropharynx may play an important role in gonorrhoea transmission. It is hypothesised that reducing the prevalence of oropharyngeal gonorrhoea will also reduce the population incidence of gonorrhoea. Mouthwash has been proposed as a novel non-antibiotic intervention to prevent oropharyngeal gonorrhoea; hence, reducing the probability of antibiotic resistance developing. However, its efficacy is yet to be confirmed by a randomised controlled trial - the findings of which will be available in 2019. If the trial shows mouthwash is effective in preventing gonorrhoea, this finding could potentially be translated into a public health campaign to increase the mouthwash use in the MSM population. This article summarises the current evidence of the effectiveness of mouthwash against gonorrhoea and discusses the potential literature gaps before implementing the mouthwash intervention at a population level.
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Affiliation(s)
- Eric P F Chow
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia; and Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia; and Corresponding author.
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia
| | - Sabrina Trumpour
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia; and Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia; and Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia
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27
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Mouthwash Effects on LGG-Integrated Experimental Oral Biofilms. Dent J (Basel) 2020; 8:dj8030096. [PMID: 32882798 PMCID: PMC7560143 DOI: 10.3390/dj8030096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
In order to investigate the effects of mouthwashes on oral biofilms with probiotics, we compared in biofilms the susceptibility to mouthwashes of probiotic Lactobacillus rhamnosus GG (LGG) and oral pathogens Streptococcus mutans, Streptococcus sanguinis, and Candida albicans. We also evaluated these pathogens’ susceptibility to the mouthwashes and their recovery after mouthwash-rinsing in biofilms with/without LGG. First, 1-day-/3-day-old LGG-integrated multi-species biofilms were exposed for 1 min to mouthwashes containing chlorhexidine, essential oils, or amine fluoride/stannous fluoride. Cells were plate-counted and relative survival rates (RSRs) of LGG and pathogens calculated. Second, 1-day-/3-day-old multispecies biofilms with and without LGG were exposed for 1 min to mouthwashes; cells were plate-counted and the pathogens’ RSRs were calculated. Third, 1-day-old biofilms were treated for 1 min with mouthwashes. Cells were plate-counted immediately and after 2-day cultivation. Recovery rates of pathogens were calculated and compared between biofilms with/without LGG. Live/Dead® staining served for structural analyses. Our results showed that RSRs of LGG were insignificantly smaller than those of pathogens in both 1-day and 3-day biofilms. No significant differences appeared in pathogens’ RSRs and recovery rates after treatment between biofilms with/without LGG. To conclude, biofilm LGG was susceptible to the mouthwashes; but biofilm LGG altered neither the mouthwash effects on oral pathogens nor affected their recovery.
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Abstract
The commercial marketplace has seen a rapid increase in the number of over-the-counter charcoal-containing mouthwashes. The purpose of this systemic review was to examine the clinical and laboratory evidence supporting therapeutic claims of efficacy and safety of use of charcoal-based mouthwashes. Secondly, the product labels and information of 36 commercially marketed charcoal mouthwashes were reviewed for active ingredients. Only 8% of charcoal mouthwashes contained an active ingredient, such as cetylpyridinium chloride or chlorhexidine. There is insufficient evidence to substantiate the therapeutic and cosmetic marketing claims of charcoal-based mouthwashes, including antimicrobial activity, anti-halitosis, tooth whitening, periodontal disease control, caries reduction and tooth remineralisation, among others. Moreover, there is no available information on charcoal particulate size or abrasivity of any of these products. Dental clinicians should advise their patients to exercise caution when using over-the-counter charcoal-containing mouthwashes because of the lack of evidence supporting therapeutic or cosmetic effectiveness as well as safety.
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29
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Assessment of the antibacterial, antivirulence, and action mechanism of Copaifera pubiflora oleoresin and isolated compounds against oral bacteria. Biomed Pharmacother 2020; 129:110467. [PMID: 32603890 DOI: 10.1016/j.biopha.2020.110467] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/19/2020] [Accepted: 06/24/2020] [Indexed: 01/12/2023] Open
Abstract
The microorganisms that constitute the oral microbiome can cause oral diseases, including dental caries and endodontic infections. The use of natural products could help to overcome bacterial resistance to the antimicrobials that are currently employed in clinical therapy. This study assessed the antimicrobial activity of the Copaifera pubiflora oleoresin and of the compounds isolated from this resin against oral bacteria. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays provided values ranging from 6.25 to > 400 μg/mL for the C. pubiflora oleoresin and its isolated compounds. The fractional inhibitory concentration index (FICI) assay showed that the oleoresin and chlorhexidine did not act synergistically. All the tested bacterial strains formed biofilms. MICB50 determination revealed inhibitory action: values varied from 3.12-25 μg/mL for the oleoresin, and from 0.78 to 25 μg/mL for the ent-hardwickiic acid. Concerning biofilm eradication, the C. pubiflora oleoresin and hardwickiic acid eradicated 99.9 % of some bacterial biofilms. Acid resistance determination showed that S. mutans was resistant to acid in the presence of the oleoresin and ent-hardwickiic acid at pH 4.0, 4.5, and 5.0 at all the tested concentrations. Analysis of DNA/RNA and protein release by the cell membrane demonstrated that the oleoresin and hardwiickic acid damaged the bacterial membrane irreversibly, which affected membrane integrity. Therefore, the C. pubiflora oleoresin and ent-hardwickiic acid have potential antibacterial effect and can be used as new therapeutic alternatives to treat oral diseases such as dental caries and endodontic infections.
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30
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Vilela MM, Salvador SL, Teixeira IGL, Del Arco MCG, De Rossi A. Efficacy of green tea and its extract, epigallocatechin-3-gallate, in the reduction of cariogenic microbiota in children: a randomized clinical trial. Arch Oral Biol 2020; 114:104727. [DOI: 10.1016/j.archoralbio.2020.104727] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/25/2022]
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32
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Li W, Jiang X, Sun W, Wang S, Liu C, Zhang X, Zhang Y, Zhou W, Miao L. Gingivitis identification via multichannel gray‐level co‐occurrence matrix and particle swarm optimization neural network. INTERNATIONAL JOURNAL OF IMAGING SYSTEMS AND TECHNOLOGY 2020; 30:401-411. [DOI: 10.1002/ima.22385] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/12/2019] [Indexed: 08/30/2023]
Affiliation(s)
- Wen Li
- Department of Endodontics, Nanjing Stomatological HospitalMedical School of Nanjing University Nanjing People's Republic of China
| | - Xianwei Jiang
- Nanjing Normal University of Special Education Nanjing People's Republic of China
- Department of InformaticsUniversity of Leicester Leicester United Kingdom
| | - Weibin Sun
- Department of Periodontics, Nanjing Stomatological HospitalMedical School of Nanjing University Nanjing People's Republic of China
| | - Shui‐Hua Wang
- School of Architecture Building and Civil engineeringLoughborough University Loughborough United Kingdom
| | - Chao Liu
- Department of Orthodontics, Nanjing Stomatological HospitalMedical School of Nanjing University Nanjing People's Republic of China
| | - Xuan Zhang
- Department of Periodontics, Nanjing Stomatological HospitalMedical School of Nanjing University Nanjing People's Republic of China
| | - Yu‐Dong Zhang
- Department of InformaticsUniversity of Leicester Leicester United Kingdom
| | - Wei Zhou
- Department of Periodontics, Nanjing Stomatological HospitalMedical School of Nanjing University Nanjing People's Republic of China
| | - Leiying Miao
- Department of Endodontics, Nanjing Stomatological HospitalMedical School of Nanjing University Nanjing People's Republic of China
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33
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AlJameel AH, Almalki SA. Effect of triphala mouthrinse on plaque and gingival inflammation: A systematic review and meta‐analysis of randomized controlled trials. Int J Dent Hyg 2020; 18:344-351. [DOI: 10.1111/idh.12444] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/17/2020] [Accepted: 05/03/2020] [Indexed: 11/27/2022]
Affiliation(s)
- AlBandary Hassan AlJameel
- Department of Periodontics and Community Dentistry College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Sultan A. Almalki
- Department of Preventive Dental Sciences College of Dentistry Prince Sattam Bin Abdulaziz University Alkharj Saudi Arabia
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34
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Makvandi P, Gu JT, Zare EN, Ashtari B, Moeini A, Tay FR, Niu LN. Polymeric and inorganic nanoscopical antimicrobial fillers in dentistry. Acta Biomater 2020; 101:69-101. [PMID: 31542502 DOI: 10.1016/j.actbio.2019.09.025] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/26/2019] [Accepted: 09/17/2019] [Indexed: 02/08/2023]
Abstract
Failure of dental treatments is mainly due to the biofilm accumulated on the dental materials. Many investigations have been conducted on the advancements of antimicrobial dental materials. Polymeric and inorganic nanoscopical agents are capable of inhibiting microorganism proliferation. Applying them as fillers in dental materials can achieve enhanced microbicidal ability. The present review provides a broad overview on the state-of-the-art research in the field of antimicrobial fillers which have been adopted for incorporation into dental materials over the last 5 years. The antibacterial agents and applications are described, with the aim of providing information for future investigations. STATEMENT OF SIGNIFICANCE: Microbial infection is the primary cause of dental treatment failure. The present review provides an overview on the state-of-art in the field of antimicrobial nanoscopical or polymeric fillers that have been applied in dental materials. Trends in the biotechnological development of these antimicrobial fillers over the last 5 years are reviewed to provide a backdrop for further advancement in this field of research.
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35
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Santi SS, Casarin M, Grellmann AP, Chambrone L, Zanatta FB. Effect of herbal mouthrinses on dental plaque formation and gingival inflammation: A systematic review. Oral Dis 2019; 27:127-141. [PMID: 31837279 DOI: 10.1111/odi.13254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 09/04/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
To evaluate the effect of herbal mouthrinses as an adjuvant to oral hygiene on dental plaque and gingival inflammation in subjects with gingivitis. Searches were conducted in the PubMed/MEDLINE, Cochrane-CENTRAL, EMBASE, Web of Science, LILACS/BIREME, Clinical Trials Registry and grey literature for Randomised Clinical Trials (RCTs) published up to April 2018 without language restrictions. From 4,013 paper found, 20 studies met the eligibility criteria and were included. The herbal mouthrinses achieved significant reductions in dental plaque and gingival inflammation compared to placebo rinses. Five herbal products (Camelia sinensis, Azadirachta indica, Anacardium occidentale Linn, Schinus terebinthifolius and Curcuma longa) showed better results than chlorhexidine in dental plaque and gingival inflammation reductions. However, the unclear risk of bias of most included RCTs precludes definitive conclusions. Therefore, it is necessary to improve the design of future RCT in other reduced potential bias that may affect the degree of precision of treatment outcomes in order to evaluate the effect size and clinical relevance of herbal mouthrinses.
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Affiliation(s)
- Samantha Simoni Santi
- Department of Stomatology, Periodontics, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil
| | - Maísa Casarin
- Department of Semiology and General Dentistry, Periodontics, School of Dentistry, Universidade Federal de Pelotas - UFPel, Pelotas, Brazil
| | - Alessandra Pascotini Grellmann
- Department of Stomatology, Periodontics, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil
| | - Leandro Chambrone
- MSc Dentistry Program, Ibirapuera University, Sao Paulo, Brazil.,Unit of Basic Oral Investigation (UIBO), School of Dentistry, El Bosque University, Bogota, Colombia.,Department of Periodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA
| | - Fabricio Batistin Zanatta
- Department of Stomatology, Periodontics, School of Dentistry, Universidade Federal de Santa Maria - UFSM, Santa Maria, Brazil
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36
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Valkenburg C, Else Slot D, Van der Weijden GF. What is the effect of active ingredients in dentifrice on inhibiting the regrowth of overnight plaque? A systematic review. Int J Dent Hyg 2019; 18:128-141. [PMID: 31675470 PMCID: PMC7217014 DOI: 10.1111/idh.12423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/29/2019] [Accepted: 10/30/2019] [Indexed: 01/08/2023]
Abstract
Objectives The aim of this systematic review was to establish the adjuvant clinical effect of brushing with a dentifrice containing purported active ingredients as compared to a regular sodium fluoride dentifrice with respect to the inhibition of overnight dental plaque regrowth from studies with human participants. Methods MEDLINE‐PubMed, EMBASE and Cochrane CENTRAL were searched, up to June 2019. The inclusion criteria were controlled clinical trials with participants aged ≥ 18 years in good general health. Studies were included that evaluated the effect of toothbrushing with a dentifrice on the inhibition of overnight dental plaque regrowth when an active ingredient was added to the dentifrice as compared to a common sodium fluoride product. Data were extracted from the eligible studies, the risk of bias was assessed, and a meta‐analysis was performed where feasible. Result Independent screening of 213 unique papers resulted in 10 eligible publications that provided 14 comparisons. Stannous fluoride and triclosan dentifrices were found as the active ingredients. The descriptive analysis indicated that all, but two comparisons demonstrated an additional effect on the active‐ingredient dentifrice. The meta‐analysis supported and strengthened these findings. It showed that when plaque was scored digitally, a DiffM was −3.15(95% CI [−4.61:‐1.69], P < .001, prediction interval [−5.07;‐1.24]). When plaque was scored clinically, the difference of means (DiffM) was −0.33(95% CI [−0.49:‐0.16], P < .001, prediction interval [−0.87; 0.21]). Conclusion The results of this review demonstrate moderate‐quality evidence that brushing with an active‐ingredient dentifrice with stannous fluoride or triclosan does provide an added clinically relevant effect concerning plaque inhibition capabilities that surpass the effect of a regular sodium fluoride dentifrice.
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Affiliation(s)
- Cees Valkenburg
- General Dentist and Clinical Epidemiologist, Hoevelaken, The Netherlands.,Department of Periodontology Academic Centre for Dentistry, Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology Academic Centre for Dentistry, Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ga Fridus Van der Weijden
- Department of Periodontology Academic Centre for Dentistry, Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Ancuceanu R, Anghel AI, Ionescu C, Hovaneț MV, Cojocaru-Toma M, Dinu M. Clinical Trials with Herbal Products for the Prevention of Dental Caries and Their Quality: A Scoping Study. Biomolecules 2019; 9:E884. [PMID: 31861065 PMCID: PMC6995540 DOI: 10.3390/biom9120884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 12/12/2022] Open
Abstract
It is currently recognized that an injudicious strategy about caries in the last decades has been not only focusing of research mostly in children, but also the narrow focusing on fluoride, because despite sufficient availability of fluoride in water and oral healthcare products, caries levels escalate steadily as people get older and caries remain a main public health issue to be settled. In the last two decades the scientific community intensified efforts of exploring other products for caries prevention, herbal products being one of these approaches. Preliminary evidence indicated that clinical trials for caries prevention with herbal products are heterogeneous in design, quality and products evaluated, we therefore performed a scoping review intended to explore the main characteristics of such clinical trials. From an initial collection of 1986 unique papers from different literature databases, 56 articles satisfied the inclusion and exclusion criteria. The species investigated, dosage forms, study designs, duration of intervention, controls, endpoints, quality of reporting, and risk of bias are discussed. Of the trials reviewed here, 85.71% reported positive results but given the methodological flaws and biases affecting them, it is difficult to conclude on the efficacy of those products based on the studies published thus far.
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Affiliation(s)
- Robert Ancuceanu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania (M.V.H.); (M.D.)
| | - Adriana Iuliana Anghel
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania (M.V.H.); (M.D.)
| | - Camelia Ionescu
- Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 010221 Bucharest, Romania;
| | - Marilena Viorica Hovaneț
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania (M.V.H.); (M.D.)
| | - Maria Cojocaru-Toma
- Faculty of Pharmacy, Nicolae Testemițanu University of Medicine and Pharmacy, 2025 Chisinau, Moldavia;
| | - Mihaela Dinu
- Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, 020956 Bucharest, Romania (M.V.H.); (M.D.)
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Sezgin Y, Memis Ozgul B, Alptekin NO. Efficacy of oil pulling therapy with coconut oil on four-day supragingival plaque growth: A randomized crossover clinical trial. Complement Ther Med 2019; 47:102193. [DOI: 10.1016/j.ctim.2019.102193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/22/2019] [Accepted: 09/03/2019] [Indexed: 11/17/2022] Open
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Clinical efficacy of an Aloe Vera gel versus a 0.12% chlorhexidine gel in preventing traumatic ulcers in patients with fixed orthodontic appliances: a double-blind randomized clinical trial. Odontology 2019; 108:470-478. [PMID: 31664632 DOI: 10.1007/s10266-019-00468-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
Abstract
Traumatic oral ulceration (TOU) is one of the most common side effects of orthodontic treatments. The objective of this trial is to compare the clinical efficacy of an 80% Aloe Vera gel, prepared using a master formula, versus a commercial 0.12% Chlorhexidine (CHX) gel for TOU prevention in participants wearing fixed orthodontic appliances. This report represents a single-centre, university-based, double-blinded, randomized controlled trial with 2 parallel arms. Patients aged 12 years or older, in the permanent dentition, and about to start fixed orthodontic treatment in this university setting were randomly allocated to use either Aloe Vera or CHX gel, following the cementation procedure. Pre-treatment and 1 month after the cementation clinical assessment and digital photographic images were taken of the teeth and assessed by 2 clinical assessors for the presence or absence of TOUs. A total of 140 were randomized and completed the trial. The overall prevalence of TOUs was 43.6%. Overall 5.7% of patients treated with Aloe Vera gel showed did not suffer from TOUs, whereas in the CHX arm, a total of 57 (81.4%) were affected by this outcome reaching a significant result (p < 0.001). In terms of relative risk (RRs) and confidence intervals (CIs), Aloe Vera provided better results than CHX with an RR of 0.07 (95%CI 0.03-0.16; p < 0.001), and with a patients' number needed to treat of 1.3 (95%CI 1.16-1.54). There were no adverse effects. These results suggest that Aloe Vera gel administration in patients with fixed orthodontic appliances could be important for effective prevention of TOU.
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40
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Periodontal status of children with primary immunodeficiencies: a systematic review. Clin Oral Investig 2019; 24:1939-1951. [PMID: 31628543 DOI: 10.1007/s00784-019-03055-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/05/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of this systematic review was to appraise the existing literature on periodontal disease in children affected by different types of neutrophil-associated primary immunodeficiencies (PIDs). METHODS A PRESS-validated search strategy was developed to search through databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, LILACS, Google Scholar and Open Grey. All included studies were assessed for methodological quality and risk of bias. RESULTS One hundred eighteen articles reporting on 160 PID patients were included for qualitative analysis. The majority (70%) were individual case reports. Clinical and radiographic manifestations of the periodontal disease included poor oral hygiene, generalised alveolar bone loss, severe gingival inflammation, increased pocket depths, tooth mobility and gingival recession. For most studies, the primary intervention was periodontal treatment in the form of scaling and root planing or dental extractions. Stabilisation of the periodontal condition varied between different PIDs. In severe congenital neutropenia (SCN), 61% of cases reported stabilisation of the periodontal condition, while for all other PIDs, 'stability' was reported in less than 43% of cases. CONCLUSION The published literature suggests that patients with PIDs can present with severe periodontitis and that conventional treatment approaches have limited benefits.
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Coelho AS, Laranjo M, Gonçalves AC, Paula A, Paulo S, Abrantes AM, Caramelo F, Ferreira MM, Silva MJ, Carrilho E, Botelho MF. Cytotoxic effects of a chlorhexidine mouthwash and of an enzymatic mouthwash on human gingival fibroblasts. Odontology 2019; 108:260-270. [PMID: 31624978 DOI: 10.1007/s10266-019-00465-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 09/26/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the cytotoxic effects of an enzymatic mouthwash and of a chlorhexidine mouthwash on human gingival fibroblasts. The metabolic activity of the fibroblasts exposed to each mouthwash was assessed by the MTT assay and the protein content was assessed by the SRB assay. The flow cytometry was used to evaluate the cell cycle and the types of cell death. The oxidative status was evaluated through the DCF and the DHE probes and the intracellular GSH concentration and the mitochondrial membrane potential through JC-1. The cytotoxicity of both mouthwashes was found to be dependent on the exposure time and on the concentration. However, the cytotoxicity of the enzymatic mouthwash was found to be lower than that of the chlorhexidine mouthwash. A trend towards increased oxidative stress was observed for both mouthwashes. After exposing the fibroblasts to the mouthwashes, a G2/M phase block was observed and cell death occurred predominantly by necrosis. The effects of chlorhexidine on fibroblasts were identified at lower concentrations than those used in clinical practice. Therefore, the use of chlorhexidine as an antiseptic in surgical and postoperative situations should be limited. In order to clarify the clinical significance of the enzymatic mouthwash cytotoxicity new clinical studies will be necessary.
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Affiliation(s)
- Ana Sofia Coelho
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal. .,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal. .,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal. .,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal. .,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.
| | - Mafalda Laranjo
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Biophysics Institute, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Ana Cristina Gonçalves
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Biophysics Institute, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Anabela Paula
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Siri Paulo
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Endodontics Institute, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Ana Margarida Abrantes
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Biophysics Institute, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Francisco Caramelo
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Laboratory of Biostatistics and Medical Informatics, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Manuel Marques Ferreira
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Endodontics Institute, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | | | - Eunice Carrilho
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
| | - Maria Filomena Botelho
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CIMAGO - Center of Investigation on Enviromnent, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.,Biophysics Institute, Faculty of Medicine, University of Coimbra, Área de Medicina Dentária, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
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Badar SB, Zafar K, Ghafoor R, Khan FR. Comparative evaluation of Chlorhexidine, Metronidazole and combination gels on gingivitis: A randomized clinical trial. Int J Surg Protoc 2019; 14:30-33. [PMID: 31851746 PMCID: PMC6913552 DOI: 10.1016/j.isjp.2019.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction Dental plaque has been established as an etiological factor in the development of gingivitis and periodontitis. Several antimicrobials including Chlorhexidine and Metronidazole have been used as an adjuvant to mechanical plaque removal. Objective To compare 0.8% Metronidazole gel, 0.2% Chlorhexidine gel and alternate application of the two gels in reducing gingival inflammation when used for 14 days as an adjuvant with home based oral hygiene instructions. Methods The bleeding sites, probing depth and the gingival index score will be calculated. (Group A standard 0.2% Chlorhexidine gel applied on the marginal gingiva; Group B subjects will be instructed to apply 0.8% Metronidazole gel; Group C subjects 0.2% Chlorhexidine gel on the marginal gingiva after morning tooth brushing and 0.8% Metronidazole gel after evening tooth brushing). After 2 weeks second clinical examination will be carried out for bleeding sites, probing depth and the gingival index score. Scaling & polishing of teeth in all three groups and oral hygiene instructions will be reinforced. Subjects will be recalled at 6 weeks for evaluation of gingival and oral hygiene indices. Descriptive statistics for variables such as age, baseline clinical parameters including probing depth, bleeding sites, gingival index, and oral hygiene index will be computed. Generalized estimation equation (GEE) will be run to account for the correlated data for the comparison of study arms. Friedman test will be used to assess the bleeding sites among three study groups at the baseline and endpoint. Similarly, gingival index and oral hygiene index in the three groups at baseline, after 2 weeks and 4 weeks will be compared. The level of significance will be kept at 0.05.
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Affiliation(s)
| | - Kamil Zafar
- Aga Khan University Hospital, Karachi, Pakistan
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Valkenburg C, Van der Weijden FA, Slot DE. Plaque control and reduction of gingivitis: The evidence for dentifrices. Periodontol 2000 2019; 79:221-232. [PMID: 30892760 PMCID: PMC7328759 DOI: 10.1111/prd.12257] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This paper focuses on plaque control and the management of gingivitis in adults and summarizes the evidence of commercially available dentifrices as gathered from existing systematic reviews. Three internet sources were used to search for appropriate papers (up to and including February 2017). The search strategy was designed to include any systematic review published on dentifrices that also included an evaluation of plaque and gingivitis scores. Characteristics of the individual reviews, such as methodological aspects, quantitative data and conclusions, were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Independent screening of 205 unique reviews resulted in 10 published and eligible systematic reviews. One publication evaluated the mechanical contribution of dentifrice to plaque removal. Eight papers were identified that evaluated the efficacy of a proposed single active ingredients, of which two reviewed more than one potentially active ingredient. One study compared two active ingredients. This meta-review appraised the current state of evidence and found that toothbrushing with a standard fluoride dentifrice does not provide an added effect for the mechanical removal of dental plaque. Evidence suggests that compared with a standard dentifrice, those containing triclosan or stannous fluoride have benefits with respect to gingival health and control of dental plaque.
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Affiliation(s)
- Cees Valkenburg
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Fridus A. Van der Weijden
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Dagmar E. Slot
- Department of PeriodontologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
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Lu MM, Ge Y, Qiu J, Shao D, Zhang Y, Bai J, Zheng X, Chang ZM, Wang Z, Dong WF, Tang CB. Redox/pH dual-controlled release of chlorhexidine and silver ions from biodegradable mesoporous silica nanoparticles against oral biofilms. Int J Nanomedicine 2018; 13:7697-7709. [PMID: 30538453 PMCID: PMC6251470 DOI: 10.2147/ijn.s181168] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Oral plaque biofilms pose a threat to periodontal health and are challenging to eradicate. There is a growing belief that a combination of silver nanoparticles and chlorhexidine (CHX) is a promising strategy against oral biofilms. PURPOSE To overcome the side effects of this strategy and to exert maximum efficiency, we fabricated biodegradable disulfide-bridged mesoporous silica nanoparticles (MSNs) to co-deliver silver nanoparticles and CHX for biofilm inhibition. MATERIALS AND METHODS CHX-loaded, silver-decorated mesoporous silica nanoparticles (Ag-MSNs@CHX) were fabricated after CHX loading, and the pH- and glutathione-responsive release profiles of CHX and silver ions along with their mechanism of degradation were systematically investigated. Then, the efficacy of Ag-MSNs@CHX against Streptococcus mutans and its biofilm was comprehensively assessed by determining the minimum inhibitory concentration, minimum bactericidal concentration, minimal biofilm inhibitory concentration, and the inhibitory effect on S. mutans biofilm formation. In addition, the biosafety of nanocarriers was evaluated by oral epithelial cells and a mouse model. RESULTS The obtained Ag-MSNs@CHX possessed redox/pH-responsive release properties of CHX and silver ions, which may be attributed to the redox-triggered matrix degradation mechanism of exposure to biofilm-mimetic microenvironments. Ag-MSNs@CHX displayed dose-dependent antibacterial activity against planktonic and clone formation of S. mutans. Importantly, Ag-MSNs@CHX had an increased and long-term ability to restrict the growth of S. mutans biofilms compared to free CHX. Moreover, Ag-MSNs@CHX showed less cytotoxicity to oral epithelial cells, whereas orally administered Ag-MSNs exhibited no obvious toxic effects in mice. CONCLUSION Our findings constitute a highly effective and safe strategy against biofilms that has a good potential as an oral biofilm therapy.
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Affiliation(s)
- Meng-Meng Lu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China,
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China,
| | - Yuran Ge
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China,
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China,
| | - Jing Qiu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China,
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China,
| | - Dan Shao
- CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China,
| | - Yue Zhang
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China
| | - Jing Bai
- School of Materials Science and Engineering, Southeast University, Nanjing, 211189, China
| | - Xiao Zheng
- Department of Pharmacology, Nanomedicine Engineering Laboratory of Jilin Province, College of Basic Medical Sciences, Jilin University, Changchun, 130021, China
| | - Zhi-Min Chang
- CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China,
| | - Zheng Wang
- CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China,
| | - Wen-Fei Dong
- CAS Key Laboratory of Bio-Medical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, 215163, China,
| | - Chun-Bo Tang
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, 210029, China,
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China,
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45
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Trombelli L, Simonelli A, Pramstraller M, Guarnelli ME, Fabbri C, Maietti E, Farina R. Clinical efficacy of a chlorhexidine-based mouthrinse containing hyaluronic acid and an antidiscoloration system in patients undergoing flap surgery: A triple-blind, parallel-arm, randomized controlled trial. Int J Dent Hyg 2018; 16:541-552. [PMID: 30101416 DOI: 10.1111/idh.12361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/16/2018] [Accepted: 07/20/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the postsurgery gingival healing as well as plaque, gingival inflammation and staining levels following the use of a 0.2% chlorhexidine (CHX) solution with or without antidiscoloration system (ADS) and 0.2% hyaluronic acid (HA). METHODS Patients undergoing flap surgery at sites with an intact or reduced but healthy periodontium participated in a parallel-arm RCT. After surgery, patients used the assigned mouthrinse (CHX + HA + ADS or CHX) for 21 days. At days 7 and 21, the healing process was evaluated at experimental teeth using a composite index, namely the Gingival Healing Index (GHI). GHI score was obtained as the sum of the scores related to the severity of wound dehiscence (score 1-3) and the profile of the buccal and oral aspects of the papilla (score 1-3). Therefore, GHI ranged from 2 (worst quality of healing) to 6 (optimal quality of healing). Plaque Index (PlI), Gingival Index (GI), angulated bleeding score (AngBS), and tooth and tongue staining were also assessed. RESULTS In both groups, GHI assumed values of 5 or 6 at both days 7 and 21 in ≥50% of patients, and low median values of PlI, GI, AngBS and staining were observed during the 21-day period. Except for a significantly lower GI in CHX group at day 7, no other significant intergroup differences were found. CONCLUSIONS Postsurgery plaque control based on either CHX or CHX + HA + ADS mouthrinses results in optimal plaque control and quality of early gingival healing along with limited tooth and tongue staining.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Anna Simonelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy
| | - Mattia Pramstraller
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Maria Elena Guarnelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Chiara Fabbri
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Elisa Maietti
- Center of Clinical Epidemiology, University of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
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46
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Muniz de Oliveira R, da Rosa Gioppo NM, Oliveira de Carvalho J, Carvalho Oliveira F, Webster TJ, Marciano FR, Oliveira Lobo A. Decontamination of mobile phones and electronic devices for health care professionals using a chlorhexidine/carbomer 940® gel. Front Chem Sci Eng 2018. [DOI: 10.1007/s11705-018-1728-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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47
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Robbins MR. Recent Recommendations for Management of Human Immunodeficiency Virus-Positive Patients. Dent Clin North Am 2018; 61:365-387. [PMID: 28317571 DOI: 10.1016/j.cden.2016.12.006] [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] [Indexed: 02/07/2023]
Abstract
Human immunodeficiency virus (HIV) infection has become a chronic condition. HIV is not a valid reason to deny, delay, or withhold dental treatment. There are no absolute contraindications and few complications associated with comprehensive oral health care treatment delivered in an outpatient setting for asymptomatic HIV-infected patients and clinically stable patients with AIDS. Consultation with the patient's medical provider and modifications in the delivery of dental treatment may be necessary when treating patients with advanced HIV disease or other comorbid conditions. Oral health care is an integral and important part of comprehensive health care for all patients with HIV/AIDS.
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Affiliation(s)
- Miriam R Robbins
- Department of Dental Medicine, Winthrop University Hospital, 200 Old Country Road, Suite 460, Mineola, NY 11501, USA; Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA.
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48
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Zhang J, Ab Malik N, McGrath C, Lam O. The effect of antiseptic oral sprays on dental plaque and gingival inflammation: A systematic review and meta-analysis. Int J Dent Hyg 2018; 17:16-26. [PMID: 29405627 DOI: 10.1111/idh.12331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To review the effectiveness of antiseptic oral sprays on oral health. METHODS AND MATERIALS Three electronic databases (PubMed, Cochrane Library and Web of Science) were systematically searched to identify relevant studies. Only randomized controlled trials (RCTs) comparing the effect of oral sprays to placebo/control spray or mouthrinse on dental plaque and gingival inflammation were included. RESULTS Among a total of 996 papers, 20 effective studies fulfilled the selection criteria, and 8 studies were suitable for inclusion in meta-analyses. A meta-analysis of three studies using a 0.2% chlorhexidine (CHX) spray intervention, without prophylaxis at baseline, showed reductions in Plaque Index (PI) (Silness and Löe) and Gingival Index (GI) (Silness and Löe) scores of 0.74 (95% CI: -1.03 to -0.45) and 0.22 (95% CI: -0.38 to -0.06), respectively. Five studies provided a prophylaxis for subjects before study initiation. Three of these five studies used 0.2% CHX spray. A meta-analysis demonstrated an increase of 0.18 (95% CI: -0.01 to 0.37) in PI (Silness and Löe) scores. Two RCTs compared 0.12% and 0.2% CHX spray, and a meta-analysis showed increases of 1.71 (95% CI: 1.27 to 2.14) and 1.58 (95% CI: 1.23 to 1.93), respectively, in PI (Quigley and Hein) scores. Of the RCTs not amenable to meta-analysis, eight studies reported significant improvements in PI and GI scores. CONCLUSIONS Available evidence suggests that oral sprays are an acceptable delivery method for antiseptic agents. Further high-quality studies are warranted to determine the effectiveness of alternative chemotherapeutic agents delivered via oral sprays on oral health.
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Affiliation(s)
- J Zhang
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - N Ab Malik
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - C McGrath
- Periodontology and Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Olt Lam
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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49
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Effects of sub-minimum inhibitory concentrations of lemon essential oil on the acid tolerance and biofilm formation of Streptococcus mutans. Arch Oral Biol 2017; 87:235-241. [PMID: 29331510 DOI: 10.1016/j.archoralbio.2017.12.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 12/19/2017] [Accepted: 12/28/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Lemon essential oil (LEO) is a kind of secondary metabolite from lemon peels and has been found to inhibit cariogenic bacteria for decades. However, its effects on main cariogenic virulence factors are rarely reported. The present study aimed to investigate the effects of sub-minimum inhibitory concentrations (sub-MICs) of LEO on the acid tolerance and biofilm formation of Streptococcus mutans (S. mutans) and preliminarily reveal the possible underlying mechanisms. DESIGNS Effects of LEO on the acid tolerance and biofilm formation of S. mutans were investigated by the broth dilution method and crystal violet staining method respectively. The expression of luxS, srtA and spaP gene was also determined to explore the underlying mechanism. In addition, Tea polyphenols (TP), a major natural inhibitor of cariogenic virulence factors, and limonene (LIM), the major component of LEO, were selected as comparisons to evaluate the effects of LEO. RESULTS Sub-MICs of LEO, LIM and TP exhibited a dose-dependent inhibition of growth of S. mutans at pH ranging from 4.0 to 7.0. The formation of S. mutans biofilm was remarkably inhibited and the inhibitory rates of LEO, LIM and TP were 97.87%, 94.88% and 96.01% respectively at 1/2 MIC. Similarly, a down-regulation was observed in the expression of luxS, srtA and spaP gene at sub-MIC levels. CONCLUSIONS Effects of LEO were similar or slightly stronger than LIM and TP, suggesting that LEO might represent a novel, natural anticarious agent that inhibited the specific genes associated with bacterial acid tolerance and biofilm formation without necessarily affecting the growth of oral bacteria.
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50
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Tokajuk G, Niemirowicz K, Deptuła P, Piktel E, Cieśluk M, Wilczewska AZ, Dąbrowski JR, Bucki R. Use of magnetic nanoparticles as a drug delivery system to improve chlorhexidine antimicrobial activity. Int J Nanomedicine 2017; 12:7833-7846. [PMID: 29123396 PMCID: PMC5661836 DOI: 10.2147/ijn.s140661] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Nanotechnology offers new tools for developing therapies to prevent and treat oral infections, particularly biofilm-dependent disorders, such as dental plaques and endodontic and periodontal diseases. Chlorhexidine (CHX) is a well-characterized antiseptic agent used in dentistry with broad spectrum activity. However, its application is limited due to inactivation in body fluid and cytotoxicity toward human cells, particularly at high concentrations. To overcome these limitations, we synthesized nanosystems composed of aminosilane-coated magnetic nanoparticles functionalized with chlorhexidine (MNP@CHX). In the presence of human saliva, MNPs@CHX displayed significantly greater bactericidal and fungicidal activity against planktonic and biofilm-forming microorganisms than free CHX. In addition, CHX attached to MNPs has an increased ability to restrict the growth of mixed-species biofilms compared to free CHX. The observed depolarization of mitochondria in fungal cells treated with MNP@CHX suggests that induction of oxidative stress and oxidation of fungal structures may be a part of the mechanism responsible for pathogen killing. Nanoparticles functionalized by CHX did not affect host cell proliferation or their ability to release the proinflammatory cytokine, IL-8. The use of MNPs as a carrier of CHX has great potential for the development of antiseptic nanosystems.
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Affiliation(s)
- Grażyna Tokajuk
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok.,Department of Intergrated Dentistry, Medical University of Białystok
| | - Katarzyna Niemirowicz
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok
| | - Piotr Deptuła
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok.,Department of Materials and Biomedical Engineering, Białystok University of Technology
| | - Ewelina Piktel
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok
| | - Mateusz Cieśluk
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok
| | | | - Jan R Dąbrowski
- Department of Materials and Biomedical Engineering, Białystok University of Technology
| | - Robert Bucki
- Department of Microbiological and Nanobiomedical Engineering, Medical University of Białystok
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