Effect of fluoride varnish and chlorhexidine-thymol varnish on mutans streptococci levels in human dental plaque: a double-blinded randomized controlled trial

Glycolysis and Automated Plaque Regrowth Method for Evaluation of Antimicrobial Performance

PURPOSE

This study explored the potential of a new in vitro method in evaluating antiplaque benefits from five sets of antimicrobial systems including cetylpyridinium chloride (CPC), stannous fluoride (SnF2), Listerine essential oil mouthwashes (+/- alcohol), zinc chloride (ZnCl2), and sodium fluoride. (NaF).

METHODS

Gingival dental plaque was collected and propagated using sterilized tryptic soy broth and sucrose, and then allocated into separate glycolysis and regrowth recipes for antiplaque evaluations. Glycolysis measurements (in duplicate) were recorded via pH microelectrode on plaque-treatment samples thermomixed (1200 rpm, 37 °C) for 4 h. For plaque regrowth, optical densities (in duplicate) were automatically collected on plaque-treatment samples using a microplate reader (linear shaking, 37 °C) from baseline to 4 h.

RESULTS

Calculations of percent change in pH and optical density were performed and analyzed for each set of antimicrobial treatment groups. Statistical analysis (one-way ANOVA, Student-Newman-Keuls stepwise comparison tests) revealed dose responses and significant differences (p < 0.05) among treatment groups, including between negative and clinically relevant positive controls.

CONCLUSIONS

This lab method produces results consistent with published clinical observations. This glycolysis and plaque growth method is sensitive to antimicrobial mechanisms of action, and may offer a convenient and clinically relevant screening tool in the evaluation of putative antimicrobial agents and formulations.

Comparative Evaluation of Plaque Inhibitory and Antimicrobial Efficacy of Probiotic and Chlorhexidine Oral Rinses in Orthodontic Patients: A Randomized Clinical Trial

Background

Antimicrobial agents serve as an effective adjunct in plaque control, and chlorhexidine has been the gold standard. However, the philosophy that natural agents are better for children's oral health is on the rise. Probiotic technology represents a breakthrough approach to maintain oral health by utilizing natural beneficial bacteria commonly found in healthy mouths.

Aim and Objective

To compare efficacy of probiotic and chlorhexidine oral rinses in orthodontic patients.

Materials and Methods

30 healthy patients undergoing fixed orthodontic treatment were randomly selected for the study by block randomization and allocation concealment and were divided into three groups: group a, 0.2% chlorhexidine mouthwash; group b, probiotic mouthwash; and group c, a control group.

Results

Probiotic and chlorhexidine groups had significantly decreased plaque indices as compared to the control group. However, greater improvement was seen in the gingival indices than plaque indices with better results in the probiotic group than the chlorhexidine group. No statistical significance was observed in the streptococcus count of probiotic and chlorhexidine groups at the end of the intervention period.

Conclusion

The comparison of probiotics to chlorhexidine has proven that probiotics are as effective as chlorhexidine as an adjunctive chemical plaque control agent.

Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

Comparison of the Effect of Fluoride Varnish, Chlorhexidine Varnish and Casein Phosphopeptide- Amorphous Calcium Phosphate (CPP-ACP) Varnish on Salivary Streptococcus mutans Level: A Six Month Clinical Study

INTRODUCTION

Dental caries is the most widespread disease which has a multi factorial origin. Streptococcus mutans is considered to be the chief pathogen in its development. Different varnishes are available which can be used for the prevention of the carious process.

AIM

To compare the effect of fluoride varnish, chlorhexidine varnish and fluoride varnish containing Casein Phosphopeptide - Amorphous Calcium Phosphate (CPP-ACP) on salivary Streptococcusmutans count in children with mixed dentition over a period of six months.

MATERIALS AND METHODS

Seventy two children of age 6-12 years with mixed dentition were selected fulfilling inclusion and exclusion criteria and divided into three groups: Group I- Fluoride varnish group; Group II- Chlorhexidine varnish group; Group III- MI varnish (fluoride varnish containing CPP-ACP) group. After thorough oral prophylaxis and restorative treatment the varnishes were applied to the teeth once a week for four consecutive weeks in the respective groups. Salivary Streptococcus mutans count (CFU/ml of saliva) was estimated at baseline, 1 month, 3 months and 6 months after varnish application. Bonferroni post-hoc test and paired t-test for inter group and intra group comparison was used in the study.

RESULTS

A statistically significant reduction in salivary S. mutans colony count was seen with all three groups at all the different time intervals. Maximum reduction was noted in chlorhexidine varnish group at all the intervals after varnish application.

CONCLUSION

Prevention of dental caries plays a vital role in paediatric dental practice. The use of dental varnish has proved to be effective in reducing the dental caries. Chlorhexidine varnish was found to show maximum reduction in salivary S. mutans count for six month period, when compared to MI varnish and fluoride varnish. Thus, chlorhexidine varnish can be used as potent caries inhibiting agent and promote good oral health.

Effect of a chlorhexidine/thymol and a fluoride varnish on caries development in erupting permanent molars: a comparative study

AIM

To compare the caries preventive effect of a chlorhexidine/thymol-containing antibacterial varnish with a fluoride varnish when topically applied during the eruption of permanent molars.

METHODS

The study group consisted of 189 patients, 5-14 years of age, with one 1st or 2nd permanent molar in the process of eruption. After stratification for type of molar and stage of eruption, the patients were randomised to either quarterly topical applications with an antibacterial varnish (Cervitec(®) Plus; CV group) or biannual applications with a fluoride varnish plus biannual treatments with placebo varnish (Fluor Protector; FV group). The duration of the study was 2 years. The primary endpoint was caries incidence (initial and cavitated) in the erupting molars and the secondary outcome was salivary mutans streptococci (MS) counts.

RESULTS

The groups were balanced with respect to socio-economy, oral hygiene, dietary habits and caries experience at baseline. The dropout rate was 11.6 %. The caries incidence was low (< 10 %) in both groups and there was no significant difference between the CV and FV groups with respect to occlusal caries development in the erupting molars (relative risk 1.08, 95 % CI 0.94-1.25). Significantly lower levels of salivary MS were disclosed in the CV group at the end of the study (p < 0.05).

CONCLUSIONS

No difference in occlusal caries development in young permanent molars was displayed after topical applications of either a chlorhexidine/thymol varnish or a fluoride varnish during tooth eruption.